Pain Relief Chiropractic

The term tennis elbow is widely known because it’s a common malady associated with tennis (and more recently, pickleball), primarily due to the use of a back-hand stroke. For those who play racquet sports, there’s another common orthopedic condition that includes the word tennis: tennis leg. 

The condition is characterized by a popping noise in the calf during a movement associated with the leg pushing off during a jump, sprint, or sudden change of direction followed by a sharp, burning sensation that makes it difficult to bear weight on the leg. Though it may not initially be observed, tennis leg can lead to superficial bruising, swelling, limitations in knee and ankle range of motion, and increased calf pain at the end-range of ankle dorsiflexion (bringing the toes toward the nose) and with manual palpation. It’s important to note that like tennis elbow, tennis leg is not just a sport-related injury but can also occur in non-athletes.

If you hadn’t heard the term before, you may be surprised to discover it was first clinically described way back in 1883! The condition was initially attributed to rupture of the plantaris muscle tendon in the calf region of the lower leg.  However, more recent studies using ultrasound and MRI have shown that in nearly all cases, tennis leg is the result of injury to the gastrocnemius and/or soleus muscles in the calf. In one study, researchers evaluated MRIs of 58 patients with tennis leg and observed that edema or disruption of the medial head of the gastrocnemius at the muscle-tendon junction in 55 cases (90.2%); fluid collection between the medial head of the gastrocnemius and soleus in 44 cases (72.1%); injury to the soleus muscle (which is deeper to the gastrocnemius) in 22 (36.1%) of the cases; and plantaris muscle disruption in 7 cases (11.5%). In rare cases, tennis leg may be due to deep venous thrombosis posing as a muscle injury, which may require prompt medical attention.

Treatment generally follows the PRICE (Protect, Rest, Ice, Compress, Elevate) protocol and may include the use of a boot, modalities to reduce inflammation and promote healing (like laser or pulsed magnetic field), passive range of ankle/knee motion within pain boundaries, and manual therapies to address any musculoskeletal disorders in adjacent parts of the body that may have preceded and contributed to the injury. 

Pain Relief Chiropractic

4909 Louise Dr

Mechanicsburg, PA 17055

(717) 697-1888

Member of Chiro-Trust.org 

Tags: Joint Pain

Hip pain is a condition that becomes more common with age. It’s reported that 1 in 7 seniors experience significant hip pain on most days, particularly with simple movements such as sitting and standing. In addition to being painful, these individuals are also likely to report a diminished ability to carry out their regular activities. As such, it’s not unusual for a hip pain sufferer to schedule a visit with a doctor of chiropractic to see if a conservative course of care can benefit them without the need for medications, injections, or surgical intervention.

When a patient first presents for chiropractic care for hip pain, they will be asked to complete paperwork to describe both their past medical history and their current hip pain. This may also include questionnaires using diagrams and scales to assess pain and disability. The information provided will be useful to rule out red flags (fracture, infection, malignancy, and/or acute nerve injury) that may necessitate referral to a specialist or emergency services. The data will also provide insights as to the potential cause/s of the patient’s hip pain. 

The possible causes for hip pain are myriad. In addition to trauma, arthritis, congenital defects, and other issues that can affect the soft tissues and bones that comprise the hip joint, the pain experienced as “hip pain” may actually be referred pain from the low back or buttocks. Or the patient might not even have hip pain but may be mistaking pain from nearby locations as hip pain. There may even be indication that the underlying cause is not musculoskeletal in nature and part of a larger issue that may need to be co-managed with the patient’s medical physician. 

Once a chiropractor has reviewed the information provided by the patient, they will conduct a physical examination of the hip joint that may include analysis of gait or walking, sitting, and standing; ability to stand on one leg; range of motion (ROM) from seated and recumbent positions; leg length variance; muscle length checks; and neurovascular assessments in the lower limbs. This may also involve evaluation of the feet, ankles, knees, and lower back, as musculoskeletal disorders in these areas can place added stress on the affected hip during movement and would need to be treated to provide a satisfactory outcome for the patient.

While the specifics of treatment will vary from patient to patient, as well as the chiropractor’s training and clinical experience, care may involve a multimodal approach that includes manual therapies, exercise training, nutrition recommendations, and physiotherapy modalities aimed at restoring normal movement to the hip and other joints that could play a role in the patient’s chief complaint. As with many conditions, the longer it persists, the more time it can take to achieve a complete recovery, if at all. If you’re currently experiencing hip pain, call your doctor of chiropractic sooner rather than later. 

Pain Relief Chiropractic

4909 Louise Dr

Mechanicsburg, PA 17055

(717) 697-1888

Member of Chiro-Trust.org 

Tags: Joint Pain

Hyaline cartilage is the slick, translucent tissue that lines joint surfaces and allows for the smooth movement of joints in the body, including the hip. If the structure or health of this cartilage is compromised, it can gradually wear away, leading to joint pain, stiffness, and disability. Eventually, the hip osteoarthritis patient may have no choice but to accept a dramatically reduced lifestyle or undergo total hip arthroplasty. Is it possible to prevent osteoarthritis of the hip or at least slow its progression?

Unfortunately, the answer isn’t a firm yes or no. There appears to be a genetic component to osteoarthritis risk, so you may be destined for the condition. However, it does appear that if you manage to avoid major trauma to the hip and stay physically active and otherwise live a healthy lifestyle, then it may be possible to significantly reduce the risk for developing the condition and requiring surgical intervention. 

Between 2014 and 2017, researchers in Germany conducted a study in which nearly 24,000 patients with either hip or knee osteoarthritis received usual care or participated in a structured program focused on guidelines-recommended therapies and patient empowerment, including lifestyle changes and exercise interventions. Patients in the experimental group were 33.6% less likely to be hospitalized or undergo joint replacements related to their knee/hip. 

 Chiropractic care offers a unique opportunity for patients as the initial history typically includes a comprehensive review of systems including all aspects of health, both past and present. This approach often extends care well past the primary presenting complaint (hip pain, in this case) to include patient education regarding diet/nutrition, stress management, sleep quality enhancement, and more. Additionally, a doctor of chiropractic will assess related areas of the body to identify problems that can affect normal movement patterns (the foot, ankle, knee, pelvis, low back) as addressing these issues may be critical to help the patient achieve a satisfactory outcome.

Pain Relief Chiropractic

4909 Louise Dr

Mechanicsburg, PA 17055

(717) 697-1888

Member of Chiro-Trust.org 

Tags: Joint Pain

Shoulder injuries are common in athletes, especially those requiring overhead repetitive movements at high velocity and extreme range of motion. For example, shoulder injuries account for 19% of injuries to baseball players and nearly 40% of injuries to swimmers. Because a shoulder injury can sideline an athlete and even prematurely end their season, a current trend in sports medicine is to find ways to prevent shoulder injuries in the first place.

A systematic review conducted in 2022 looked at 25 studies conducted between 1970 and 2018 to uncover common risk factors for shoulder injuries among athletes from a variety of sports including volleyball, handball, basketball, swimming, water polo, badminton, baseball, and tennis. In the final analysis of the review, the authors concluded that prevention programs should focus on strengthening the rotator cuff muscles and maximizing shoulder range of motion. 

In fact, another literature review found that a pre-season range of motion evaluation may help identify athletes at risk for a shoulder injury during the coming season. The review included 15 studies involving a total of 3,313 collegiate or Olympic athletes from sports with overhead shoulder movements such as baseball and swimming. The results indicated that the risk for shoulder injury was greatest for swimmers whose external shoulder rotation range of motion fell outside of the 94-degree to 99-degree range. For baseball players, especially pitchers, an external shoulder range of motion difference between the throwing and non-throwing arm below five degrees was associated with a two-fold greater risk for shoulder and/or elbow injury. 

As the saying goes, prevention is the best medicine. So if you participate in sports that include overhead movements, schedule an appointment with your doctor of chiropractic before the season starts so they can evaluate you to uncover any current conditions that may lead to issues during competition as well as instruct you on ways to augment your pre-season training regimen to maximize the function of your shoulder, including its external range of motion.

Pain Relief Chiropractic

4909 Louise Dr

Mechanicsburg, PA 17055

 (717) 697-1888

Member of Chiro-Trust.org 

Tags: Joint Pain

Most people have rolled an ankle in their lifetime.  Usually, an ankle sprain heals without any consequence, but that isn’t always the case. According to the current research, a third or more of lateral ankle sprain patients may experience long-term problems like ankle instability that necessitates splinting or taping the ankle before engaging in sports or other weight-bearing physical activities. Can chiropractic care help reduce the risk of ankle instability and other chronic issues that can arise from a lateral ankle sprain?

In 2022, researchers conducted a systematic review and meta-analysis of data from three studies that included 180 patients to assess the effectiveness of manual therapy and/or exercise in the management of lateral ankle sprains. The type of manual therapies used in the three studies included non-thrust mobilization, thrust manipulation, and myofascial release methods—all techniques utilized by chiropractors on a daily basis. The exercises focused on proprioception (balance oriented), stretching, and strengthening. 

The research team observed that the combination of manual therapy and exercise is more effective than exercise alone in improving ankle ranges of motion, lower limb function, and pain, leading them to conclude that the addition of manual therapy to lateral ankle sprain treatment will improve clinical outcomes. In addition to reducing the risk for ankle instability, lateral ankle sprain patients who receive manual therapy may also have a lower risk for reduced thickness of the plantar fascia, reduced cross section size (atrophy) of the peroneus brevis muscle, and altered activation patterns of select lower limb muscles, which may significantly reduce their risk for reinjury. This can be very important for rugby, tennis, football, volleyball, and basketball athletes as ankle-related issues affect roughly half of participants in these sports.

Chiropractic colleges educate students on the application of manual therapies to the upper and lower extremities. Additionally, many post-graduate programs offer continuing education courses on the same topic. The next time you, a family member, or friend suffers an ankle sprain, be sure to consider chiropractic care. 

Pain Relief Chiropractic

4909 Louise Dr

Mechanicsburg, PA 17055

 (717) 697-1888

Member of Chiro-Trust.org 

Tags: Joint Pain

Each year, surgeons perform hundreds of thousands of total hip arthroplasties (hip replacements), and the most common reason is osteoarthritis of the hip. This condition isn’t caused by an underlying disease, rather it’s due to wear and tear of the hip joint from everyday activities over time. Not only can osteoarthritis of the hip be painful, but it can reduce the range of motion of the joint, making it difficult to move around. Most patients seek to avoid or delay surgery as much as possible, which drives many to seek chiropractic care. The question is: what can a doctor of chiropractic do to manage osteoarthritis of the hip?

Doctors of chiropractic receive training in the application of several manual therapies of varying force, depending on the condition, patient preferences, and the practitioner’s clinical expertise. In one study that included 60 hip osteoarthritis patients, researchers used a technique called long-axis distraction mobilization (LADM) at varying levels of force and found that high-force LADM yielded superior results with respect to range of motion of the hip joint, although low- and medium-force treatment led to similar improvements in pain. 

A follow-up study by the same researchers with another group of 60 hip osteoarthritis patients found that low-force LADM performed better with respect to reducing pain sensitivity in the hip as well as the low back and knees. On the other hand, high-force LADM brought greater improvements in overall function. A systematic review from 2022 that included ten studies found that the combination of LADM with thrust manipulation and mobilization with movement (two-to-three treatments a week for two-to-six weeks) can provide even larger improvements with respect to pain and range of motion.

When managing a patient with musculoskeletal pain, chiropractors will often use a combination of several approaches—a multimodal approach—to achieve the best possible outcomes with respect to pain and function. This includes manual therapies, specific exercises, physiotherapy modalities, nutritional recommendations, and more. In addition to treatments directed at the hip itself like those listed above, doctors of chiropractic will also assess the motion of the joints in the lower back, knees, and ankle as abnormal mechanics in these areas can put added stress on the hip and affect recovery. 

Pain Relief Chiropractic

4909 Louise Dr

Mechanicsburg, PA 17055

 (717) 697-1888

Member of Chiro-Trust.org 

Tags: Joint Pain