Archive | Joint Pain RSS feed for this section

A Weak Core May Contribute to Hip Pain

10 Dec

When people think of hip pain, they generally turn to hip-specific exercises as a self–help strategy.  However, recent evidence shows there’s a correlation between poor core stability of the trunk and injury to the lower extremities, which includes the hips.  In March 2018, Belgian researchers reviewed data from nine previously published studies with a focus on the importance of core stability and its relationship to lower extremity musculoskeletal injuries in a healthy athletic population. The investigators reported that core strength, core proprioception (balance), and neuromuscular control (coordination) of the core are directly linked to the likelihood of lower extremity injuries.

Let’s take a closer look at three specific core strengthening exercises that can be done relatively fast and are highly effective (you can view several demonstration videos on YouTube if you search for “stuart mcgill’s big-3 core exercises”).

1) The Curl-Up (abdominal strength): STEP 1 — Lie on your back, straighten your left leg, and bend your right leg, placing the right foot next to the left knee.  STEP 2 — Tuck your hands under your low back to prop up the lumbar curve (so it does not flatten out).  STEP 3 — Curl up by lifting your head, neck, and shoulders only a few inches off the floor (keep your chin tucked).  STEP 4 — Hold for 7–8 seconds (or work up to this).  STEP 5 — Slowly lower your trunk back to the ground.  Repeat five times with the right leg bent and five times with the left leg bent, while keeping the opposite leg straight.  This exercise helps reduce low back disk compression, which is significant when performing a conventional sit-up exercise.

2) The Bird-Dog (core, back, and gluts):  STEP 1 — Kneel on all-fours (hands and knees).  STEP 2 — Keeping your back flat, lift and straighten out the LEFT arm and RIGHT leg parallel to the floor. STEP 3 — To further activate the core muscles, draw a square with the arm and leg while bracing the abdominal muscles (firm up your abs, as if to brace for being punched in the stomach). STEP 4 — Return to the starting position and repeat on the opposite side (repeat STEP 3 again).

3) The Side-Bridge (obliques): STEP 1 — Lie on your side, elbow directly under your shoulder and bend your knees 90°. To increase the difficulty, keep the legs/knees straight. STEP 2 — Lift your hips off the ground so you are holding your weight with your elbow and knees (or feet). STEP 3 — Hold the “Up” position for as long as possible. STEP 4 — Repeat steps 1-3 on the opposite side.

Doctors of chiropractic are trained to evaluate the entire person from the feet up to the head to identify issues elsewhere in the body that may contribute to or even cause the patient’s chief complaint. For many patients, managing hip-related conditions may involve treatment to address issues in the core (as described in this article), the lower back, and even the feet or knees!

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.
Advertisements

What Is Frozen Shoulder?

15 Nov

Adhesive capsulitis (also known as “frozen shoulder”) is the end result of inflammation, scarring, thickening, and shrinkage of the capsule that surrounds the humeral head or “ball” part of the ball and socket joint. Adhesive capsulitis dramatically reduces the range of motion of the affected joint, which can severely impact one’s ability to carry out their normal daily activities. A frozen shoulder may or may not be associated with shoulder pain and tenderness. Though all movements are affected, raising the arm to the side is often the most impaired movement of the shoulder.

Conditions such as tendinitis, bursitis, and rotator cuff injury can lead to adhesive capsulitis, especially if the person refuses to move the shoulder for an extended length of time. Diabetes, chronic inflammatory arthritis (such as rheumatoid) of the shoulder, and chest or breast surgery are known risk factors for adhesive capsulitis.

The condition is diagnosed following a review of the patient’s history for prior trauma caused by over reaching/lifting or from repetitive movements. The examination will look for severe loss of shoulder range of motion (ROM), both active and passive. X-ray, blood tests for underlying illnesses, and other imaging approaches may also be required to make a final determination for adhesive capsulitis.

Treatment for adhesive capsulitis has classically included an aggressive combination of anti-inflammatory medications, cortisone injections, manual therapies (such as joint manipulation, mobilization, and traction), exercise training, ice (if painful), heat (if no pain), and physiotherapy modalities such as ultrasound, electric stimulation, laser, etc.

Exercises performed by the patient are also highly important for achieving a satisfactory outcome. The patient can begin immediately with pendulum-type exercises, long-axis traction (while sitting, grip the chair seat and lean to the opposite direction while relaxing the shoulder muscles to open up the ball-and-socket joint), and eventually strengthening exercises (TheraTube, TheraBand, light weights, etc.).

A recent study involved 50 patients with frozen shoulder (20 males, 30 females, ages 40-70 years) who underwent chiropractic care for a median time frame of 28 days (range: 11-51 days). Researchers looked at patient-reported pain on a 1-10 scale and their ability to raise the arm sideways (abduction). Of the 50 cases, 16 resolved completely (100%), 25 showed 75-90% improvement, 8 showed 50-75% improvement, and 1 experienced less than 50% improvement.

 

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.

Knee Pain – Do I Need a Replacement?

22 Oct

About a quarter of adults experience frequent knee pain, which results in limited function, reduced mobility, and impaired quality of life.  Osteoarthritis (OA) is the most common cause of knee pain in those over 50 years of age, and it is the #1 reason for total knee replacement (TKR). The rate of TKR in the United States and the United Kingdom has increased substantially in recent decades, which many have written off as a consequence of our aging populations. But is that really the case?

One study reviewed long-term data from the National Health and Nutrition Examination Surveys (NHANES) and the Framingham Osteoarthritis (FOA) study. The research team concluded that advancing age is indeed a factor behind the increase in TKR since the 1970s, but it doesn’t tell the whole story. The researchers also found that obesity is a risk factor for symptomatic osteoarthritis of the knee, and as you know, obesity rates have skyrocketed in the last four decades.

So, what can be done to reduce your risk for a total knee replacement? There isn’t anything you can do about getting older, but there’s a lot you can do to maintain a healthy weight. Begin by switching to a more anti-inflammatory diet such as the Mediterranean diet or the Paleo diet. You don’t have to change everything you eat all at once. Start by eating an extra serving of vegetables and one less serving of processed food a day. As you notice yourself starting to feel better, it will give you the confidence to make further dietary modifications.

Because the primary way for the cartilage in your joints to get nutrients is through movement, you’ll need to become more active. Increase the number of steps you take per day and raise the intensity over time. You should also engage in balance and strength training exercises.

Of course, you’ll also need to ensure your knee isn’t subjected to abnormal movements both above and below that can compromise the tissues that make up the joint. For example, ankle pronation can overload the medial compartment of the knee. Similarly, a problem in the hip, pelvis, or lower back can also place stress on the knee, which can impair its function. That’s why doctors of chiropractic evaluate the whole patient to identify any and all contributing factors to a patient’s chief complaint. Otherwise, the patient may not experience a satisfactory outcome.

 

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.

Deep Gluteal Syndrome – What Is It?

17 Sep

The term deep gluteal syndrome (DGS) describes a condition that causes pain in the buttock that may travel down the back of the leg when the sciatic nerve is irritated. There are various structures that can result in sciatic nerve entrapment within the gluteal space which include the following: the piriformis muscle; fibrous bands containing blood vessels; the gluteal muscles; hamstring muscles, the Gemelli-obturator internus (muscle) complex, vascular (blood vessels) abnormalities; and space-occupying lesions.

Unique features within a patient’s history and physical examination can help to differentiate and define the specific site of sciatic nerve entrapment. It is common for patients with sciatic nerve entrapment to have a prior history of trauma, symptoms when sitting, and radiating pain from the low back and/or hip with tingling into the affected leg. If the nerve becomes damaged, diminished reflexes and/or muscle weakness can occur.

Because of the relationship between the lumbar spine (lower back) and the hip, it’s important to examine both regions in order to rule out a lumbar spine pathology as either the cause or a contributing factor to a patient’s symptoms. Failure to do this on a timely basis can lead to chronic pain and reduce quality-of-life based on an inaccurate diagnosis and treatment.

In one study, researchers found that a tight piriformis muscle plays a role in the majority of cases of DGS. The piriformis muscle can be stretched from a seated position. First, cross the leg, grasp the knee of the crossed leg, and pull toward the opposite shoulder (i.e., right knee toward left shoulder and vice versa). Next, arch the low back during this process and twist the trunk to the crossed knee side. Lastly, move the crossed knee in a circular manner to “work” the entire muscle. Do this for 30-60 seconds per side, multiple times a day.

The key to successful management is a prompt, accurate diagnosis followed by conservative care. While conservative treatment approaches to stretch the piriformis muscle and to reduce any pressure on the sciatic nerve are usually enough to reduce pain and improve function in patients with the condition, in some cases more invasive treatments such as injections or surgery may be necessary.

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.

What Causes Shoulder Pain?

13 Aug

Each year, Americans make 7.5 million doctor visits related to shoulder/upper arm pain. After neck and back pain, shoulder pain is one of the top reasons patients seek chiropractic care. So, why are shoulder injuries so prevalent?

Though there are many possible explanations that address this question, there’s a simple answer: anatomy. There are essentially three joints that make up the shoulder: 1) scapulothoracic joint, 2) the glenohumeral joint, and 3) the acromioclavicular joint. These joints work simultaneously and in harmony to carry out the many tasks we throw at our upper extremities from swimming to swinging a tennis racket or even reaching up to hang a curtain or change a light bulb. The overall structure of the shoulder favors mobility over stability and as a result, there is a greater chance for injury. So, what can we do to prevent shoulder injuries?

Perhaps the most important strategy is to think before you act; that is, don’t take unnecessary chances such as over-lifting in especially awkward positions. Try asking someone else for help instead. Also, use proper form and stay conditioned. Research shows that a strong core (back and belly) can help prevent shoulder injuries.

Common shoulder conditions include (but are not limited to): inflammation (bursitis and tendinitis), instability (“sloppy” joints), arthritis (bone/cartilage injury/wear), fracture, and nerve injuries. Injuries can be acute (from an obvious cause) or more commonly, they can be chronic from wear and tear and can occur gradually over time (from no obvious, single cause).

It’s important to understand that a shoulder complaint may be the end result of dysfunction throughout the body, just as a knee problem can place added stress on the hip (or vice versa). So in addition to direct treatment of the shoulder, your doctor of chiropractic may identify and treat problems elsewhere in the body (forward head carriage, poor core strength, leg length deficiency, etc.) that likely contribute to your shoulder pain complaint. In order to promote a speedy recovery, your chiropractor may also recommend certain food or vitamins/supplements with the aim of reducing inflammation.

 

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.

Can Chiropractic Help Prevent a Hamstring Injury?

12 Jul

Sports that require rapid acceleration and deceleration, cutting left and right, agility, jumping, and bending pose a unique risk for injury to the lower limbs. Hamstring injuries are the most prevalent injury in Australian rules football, afflicting 16% of players, causing an average of 3.4 missed matches per injury, accounting for the most time lost due to injury, and having the highest recurrence rate once players return to the active roster. Moreover, a player’s performance can be highly diminished by hamstring injuries.

In a 2010 study, researchers randomly assigned 57 male Australian football players to either a control group that received the current best practice medical and sports science management or an intervention group that received the same care with the addition of a sports chiropractic manual therapy injury prevention program that included manipulation/mobilization and/or soft tissue therapies to the spine and lower extremities. Both groups received a minimum of one treatment per week for six weeks, one treatment every two weeks for three months, and one treatment per month for the remainder of the season (three months).

At the close of the season, the researchers found that the group receiving the chiropractic injury intervention program reported significantly fewer primary lower-limb muscle strains and weeks missed due to no-contact knee injury than the other group. Though lower-limb injury prevention was the primary focus of this study, the players in the chiropractic group also experienced fewer episodes of back pain.

Because dysfunction in one area of the body can place added stress elsewhere, it’s important to examine the whole patient in order to identify other issues that may either be the cause or contribute to the patient’s chief complaint. Likewise, preventative care focused on maintaining proper motion in the joints throughout the body can lead to a reduced risk for injury, as was demonstrated by this study.

 

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.