The Knee Cap and Knee Pain

13 Jul

The knee can be divided into four compartments—the front, inside, back, and outside—which intimately interact with each other. The compartment located in the front of the knee includes the knee cap (or patella), the groove in which it slides in, and the muscles that attach to the patella. The patella is the body’s largest “floating bone” (technically called a sesmoid bone). The function of the patella is to act as a kind of pulley that allows the knee to fully and easily extend. This area of the knee is often referred to as the “extensor mechanism”, as it is responsible for allowing the knee to extend or straighten.

When full extension cannot be accomplished, this is referred to as “extension lag” or “flexion contracture.” Extension lag is often caused by weakness of one of the four quadriceps muscles called the vastus medialis oblique (VMO), and depending on the cause of the weakness, exercises that specifically address this problem are very important in regaining the ability of the knee to fully lock out in extension.

Flexion contracture results in a similar inability to fully extend or straighten the knee, but the cause is not due to muscle weakness but rather the shortening or “contracture” of the muscles that flex the knee called the hamstrings, which are located behind the leg and knee. This can happen when patients are bed-bound, and it can become a permanent impairment if the hamstrings are not used or properly stretched on a regular basis.

Another problem associated with the patella is a softening of the cartilage behind the knee cap, which is called chondromalacia patella (CP). One symptom associated CP includes burning pain in the front of the knee, especially when the knee is bent for a prolonged period of time. Symptoms can be very intense but usually improve quickly once the knee is straightened out or the person can stand or walk.

The shape of the patella as well as the shape and depth of the groove in which the knee cap glides can be altered by trauma and/or genetic reasons. This can also predispose the patient to problems in this compartment of the knee. A common genetic example is an excessively knocked knee (technically called genu valgus). This results in the disproportionate rubbing of the patella on the outer ridge of the femoral groove, which can be painful.

Doctors of chiropractic are trained to assess, diagnose, and treat patients with knee pain utilizing manual therapies, modalities, exercise, and orthotics for foot/ankle conditions, as well as the application of braces and/or taping of the knee.

FOR A FREE NO-OBLIGATION CONSULTATION CALL 717-697-1888

Dr. Brent Binder
4909 Louise Drive, Suite 102
Mechanicsburg Pa, 17055

Member of Chiro-Trust.org

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 Most Important Principles for Staying Young: One Regulation You Should Keep…

10 Jul

Our basic premise is that your body is amazing.  You get a do over. It doesn’t take that long, and it isn’t that hard if you know what to do.  In these notes, we give you a short course on what to do so it becomes easy for you and for you to teach others. We want you to know how much control you have over both the quality and length of your life.

In recent months, I shared a summary and some secrets from of our new book AgeProof: Living Longer Without Running Out of Money or Breaking a Hip (released February 28th, 2017—thank you to all of you who bought a copy). This month, I want to bring up a concern that may help you (and the rest of America or whatever country you’re from) be AgeProof: Don’t let them ruin your food by doing away with the regulation on Trans Fats.

In 2013, New York banned trans fats in restaurants.  As the ban rolled out over a three-year period, counties that went with the new rule right away experienced a 6.2 percent decrease in hospital admissions for myocardial infarction (heart attack) and stroke compared with counties that hadn’t yet adopted the restriction.

A United States-wide ban on trans fats would save about a $150 billion dollars a year in just hospital costs, not to mention the productivity loses that would be averted by fewer people having cardiovascular events. The federal government itself would book over $60 billion in savings.

Thanks to the FDA listing trans fats as not generally regarded as safe (GRAS), as well as docs and healthy eating advocates getting the word out that partially hydrogenated vegetable oils (that’s what trans fats are) are unhealthy, Americans now consume 80 percent fewer trans fats than they did a decade ago! And in 2018, we’re set for a nationwide ban.

Trans fats got into the food supply as a way to extend the shelf life of packaged edibles by infusing hydrogen into vegetable oils, transforming them into a more solid state and extending the shelf life of prepared foods and baked goods (and shortening yours—maybe that’s why they call it shortening).

So get trans fats off your plate now. How? Read labels. Don’t eat or buy foods with “partially hydrogenated ” anything on the ingredients list. Understand that the labeling law allows products to claim “0 grams of trans fats” if they contain less than 0.5 grams of trans fat per serving. Eating several portions of foods containing some trans fat may boost your total intake to a level high enough to affect your health. Your best bet: Stay clear of prepared and packaged baked goods and foods. You’ll be living with more energy and a younger RealAge.

Thanks for reading. Feel free to send questions—to  AgeProoflife@gmail.com

Dr. Mike Roizen

 

NOTE: You should NOT take this as medical advice.

This article is of the opinion of its author.

Before you do anything, please consult with your doctor.

You can follow Dr Roizen on twitter @YoungDrMike (and get updates on the latest and most important medical stories of the week).  The YOU docs have two newly revised books: The patron saint “book” of this column YOU Staying Young—revised and YOU: The Owner’s Manual…revised —yes a revision of the book that started Dr Oz to being Dr Oz.  These makes great gifts—so do YOU: ON a Diet and YOU: The Owner’s Manual for teens.  

Michael F. Roizen, M.D., is chief wellness officer and chair of the Wellness Institute at the Cleveland Clinic. His radio show streams live on http://www.radioMD.com Saturdays from 5-7 p.m. He is the co-author of 4 #1 NY Times Best Sellers including: YOU Staying Young.

Important Carpal Tunnel Syndrome Facts

6 Jul

Carpal tunnel syndrome (CTS) occurs as the result of the median nerve being trapped or squeezed as it passes through the carpal tunnel, which is located in the wrist. Nine flexor tendons with their covering or sheathes, blood vessels, and connective tissue also pass through the carpal tunnel, creating a tight passageway between the forearm and hand. Therefore, swelling of tendons and/or their sheathes, leaking of synovial or joint fluid from the many carpal joints, or bone spurs, cysts, and/or systemic swelling can each impinge on the median nerve. Basically, ANYTHING that increases the pressure inside the tunnel can cause the symptoms associated with CTS.

Symptoms associated with CTS include pain, numbness, tingling, a “half-asleep” feeling, swelling, and a weak grip (such as difficulty unscrewing the lid from a jar). Sleep interruptions are common as we often sleep with a bent wrist, which further increases the pressure on the various soft tissues in the area.

Some people have a greater risk of developing CTS. For example, women are three times more likely than men to develop the condition due to a smaller tunnel and wrist as well as a slightly different tunnel shape. The following can increase the risk of developing or worsening CTS: diabetes, hypothyroidism, birth control pills and/or other hormonal replacement therapies, pregnancy, and some types of inflammatory arthritis.

Jobs that require fast, repetitive work without enough rest time and those that require forceful gripping also carry an increased risk for CTS. Ergonomic factors such as certain job tasks, tool handle shape, body position on a line or machine, prolonged sitting (especially when the head/neck is not in a neutral position), and work that requires telephone use (especially without headsets), must be addressed to gain proper control of the condition.

The diagnosis of CTS is made from a combination of a careful history and physical examination of the hands, arms, shoulders, and neck, as it is VERY IMPORTANT to make sure it is truly CTS and not a group of conditions or something totally different. Hence, your doctor may run a series of tests to differentiate between the many possible causes of CTS. Typically, a careful evaluation can lead to a successful diagnosis of CTS but occasionally, further tests are necessary.

The chiropractic treatment approach for CTS includes the typical rest, ice, night splints, exercises, and job modifications that most healthcare providers utilize. The unique feature that separates chiropractic from medical-based, non-surgical care is the use of manual therapies applied to not only the forearm, wrist, and hand, but also frequently the elbow, shoulder, and neck, as these areas frequently contribute to the patient’s symptoms and must also be managed for a successful outcome.

FOR A FREE NO-OBLIGATION CONSULTATION CALL 717-697-1888

Dr. Brent Binder
4909 Louise Drive, Suite 102
Mechanicsburg Pa, 17055

Member of Chiro-Trust.org

Pregnancy and Low Back Pain – Part 1

3 Jul

Did you know that between 50% of all pregnant women suffer from back pain and 50-75% experience back pain during labor?

There are MANY reasons why back pain becomes an issue for women during their pregnancy. The first and most obvious reason is the displaced weight gain of 25-35 pounds (on average) resulting in pain in both the upper quarter (often from the increase in breast volume and weight) and lower quarter (from the growing baby). As the baby develops, an expectant mother’s center of gravity moves forward causing her to sway back, which can overload the lower region of the spine. The women most at risk for pregnancy-related back pain include those who are overweight prior to their pregnancy, those who perform physically strenuous work, and those with a history of back pain.

Another factor that can increase a woman’s risk for back pain during pregnancy is water retention. Not only does retaining water increase the load the body must carry, placing added stress on the musculoskeletal system, but water retention has also been associated with stiffer joints throughout the body, which can increase the risk for musculoskeletal pain—including back pain.

The body requires more fluid during pregnancy to maintain the health of a growing baby, and drinking water is one of the best ways to hydrate. The American Pregnancy Association (APA) reports that the body produces 50% more body fluids during pregnancy.

Fluid retention is a common complaint during pregnancy. By the third month of pregnancy, approximately 50% of women notice swelling in their hands and feet and most have significant swelling by the third trimester. Sudden and new swelling in the face, hands, and eyes accompanied by blurred vision, severe headache, painful urination, and/or the inability to urinate with abdominal pain and hypertension (>140/90) may represent a medical emergency called pre-eclampsia. This occurs later in the pregnancy, usually after the twentieth week. If this is suspected, don’t delay in obtaining emergent medical care!

To combat fluid retention, avoid constrictive clothing around the wrists and ankles, rest with the feet elevated (especially when temperatures exceed 75-85º F / 25-30º C), use ice packs, wear comfortable shoes, and try support tights or stockings. Dietary options for reducing fluid retention include the use of certain herbs and vitamins, and foods such as celery, onions, eggplant, garlic, parsley, mint, bananas, coconut, dandelion, melons, salmon (omega-3 fatty acids), cucumber, and more.

FOR A FREE NO-OBLIGATION CONSULTATION CALL 717-697-1888

Dr. Brent Binder
4909 Louise Drive, Suite 102
Mechanicsburg Pa, 17055

Member of Chiro-Trust.org

The Importance of the Cervical Curve

26 Jun

When looking at the neck from the left side, the cervical curve should look “C-shaped”, or lordotic. This develops when infants learn to lift and hold their head up while laying on their stomach and continues to progress when a child starts moving around on all fours.

When we bend our head forward and backward, the most active cervical vertebrae are the C4, C5, and C6 vertebrae that make up the mid-lower cervical spine. Therefore, this region normally “wears out” first, resulting in degenerative joint disease (DJD) and degenerative disk disease (DDD). This is part of the normal, natural aging process, and can flatten and/or reverse one’s cervical curve. However, trauma can significantly accelerate degeneration.

Among some practitioners and researchers, there has been speculation that abnormal cervical curvature may result in altered blood flow from the heart to the back of the brain.

A 2015 study looked specifically at the hemodynamics (the dynamics of blood flow) through the vertebral arteries in individuals with a normal vs. a flat or reversed cervical curve. The research team found an association between the loss of the normal cervical curvature and an alteration of the normal blood flow through the vertebral arteries that travel through small holes in the cervical vertebrae. In their conclusion, they commented on the importance of correcting the cervical curve in order to restore the altered flow of blood.

Altered blood flow through the vertebral arteries has also been implicated AS A risk FACTOR IN vertebral-basilar insufficiency (VBI) stroke. In addition, a flat or reversed cervical curve can increase tension on the vertebral arteries which may lead to weakening of the arterial wall making them more susceptible to injury and inflammation, which can cause the arteries to narrow, limiting blood flow to the back part of the brain.

One of the goals of chiropractic is to improve posture, which can include restoring the cervical lordotic curve. To accomplish this, your doctor of chiropractic may utilize several in-office and home-based therapies; however, please be patient as cervical lordosis retraining can take time!

FOR A FREE NO-OBLIGATION CONSULTATION CALL 717-697-1888

Dr. Brent Binder
4909 Louise Drive, Suite 102
Mechanicsburg Pa, 17055

Member of Chiro-Trust.org

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 “Many Faces” of Whiplash

19 Jun

Whiplash typically involves an injury to the neck, but it can often include symptoms outside of the cervical region, which is why the term “whiplash associated disorder” (WAD) may be a more appropriate description for the condition. WAD is most commonly associated with car accidents, but other forms of trauma, such as a slip and fall, can also result in WAD. So what makes WAD so unique?

Researchers have divided WAD into three primary classes: WAD I is basically pain with negative examination findings; WAD II includes pain with examination findings such as loss of motion; and WAD III includes the WAD II findings plus neurological losses (altered sensation and/or strength in the arm). There is also a WAD IV that includes fractures and dislocations.

Whiplash associated disorder may include a constellation of symptoms that are often wide ranging —from nothing to minor, short-term discomfort to chronic, permanent, disabling problems that greatly affect the rest of the patient’s life. Studies have shown that recovery is more likely in patients with a WAD I injury than those with a WAD II injury. Likewise, the chance of recovery is higher among those with WAD II than those with WAD III.

But the controversy in any classification system include the “outliers”, or those that don’t get better when the physical factors involved and the WAD class suggests they should. This is what has perplexed researchers and healthcare professionals since this injury was first described in 1928 among those injured in train accidents (under the term “railroad neck”).

A 2017 review of past studies suggests that physical factors may play a smaller role in recovery prediction than psychosocial factors, or how the injured person deals with the injury emotionally or mentally. The review found the risk of pain becoming a chronic issue (lasting longer than three months) is elevated in patients with greater post-injury pain intensity and disability, whiplash grades (WAD III > WAD II > WAD 1), cold hyperalgesia (more sensitive to cold sensation), post-injury anxiety, catastrophizing (thinking things are worse than they are), and how long a patient waited to seek treatment.

Doctors of chiropractic are trained to assess and treat patients with WAD as well as provide them with exercises and other self-help management strategies to better enable them to recover from their injury.

FOR A FREE NO-OBLIGATION CONSULTATION CALL 717-697-1888

Dr. Brent Binder
4909 Louise Drive, Suite 102
Mechanicsburg Pa, 17055

Member of Chiro-Trust.org

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.

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