Chiropractic for Headaches: What Studies Say

Headache and Migraine

Headaches are one of the most common reasons patients visit our clinic. In fact, it is estimated that 9/10 Americans suffer from headaches. About 5 percent of all headaches are warning signals caused by physical problems that require serious medical intervention. The remaining 95 percent of headaches are primary headaches, such as tension, migraine, or cluster headaches. Needless to say, it is important to get checked out by your Chiropractic physician to make sure your headaches are in that 95 percent and it is in fact a primary headache not caused by something more sinister.

The greatest majority of primary headaches are associated with muscle tension in the neck. Today, Americans engage in more sedentary activities than in the past, and more hours are spent in one fixed position or posture (such as sitting in front of a computer). This can increase joint irritation and muscle tension in the neck, upper back and scalp, causing your head to ache. It is particularly the muscles at the base of the neck that tend to develop knots called trigger points. These trigger points cause radiating ache and pressure-like pain to the base of the skull, eyes, forehead, and/or scalp area depending on which muscles are affected. Check out this link for a diagram of tension headache patterns.

A simple at home test you can do yourself is to rub the back and sides of your neck near the base of the skull. You may find knots back there. If you press into those knots and this causes pain to travel to your head, you can be pretty sure that this is a tension headache caused by tight muscles. Try rubbing out these knots and see if this helps to relieve your headache. If so, your headache should respond to Chiropractic care as numerous studies have shown.

In 2001, Duke University Center for Health Policy Research completed their evidence report on treatments for tension-type and cervicogenic headaches. They concluded that Chiropractic care had markedly superior long-term results compared to traditional medical treatment, and that Chiropractic manipulation sustained improvement longer in headache frequency and severity compared to other treatments. The Cochrane Collaboration, a systematic review of evidence, reached a similar conclusion to the Duke study in 2004. In 2011 a study published in the Journal of Manipulative and Physiological Therapeutics  found that chiropractic care, including spinal manipulation, can improve migraine and cervicogenic headaches.

If you are among the 9/10 Americans suffering from headaches. Get in touch with your Chiropractic Physician. If you don’t have one and live in the Tulsa area, give us a call at Reactivate Therapy. We would be happy to help.

Knee Pain Tips and Tricks

Knee Pain
Causes of Knee Pain

Knee pain is typically caused by mechanical dysfunction related to altered position and movement. The most common cause for knee dysfunction is a tracking or alignment disorder. We are concerned with how the knee moves and if the knee shifts inwards or outwards throughout its motion. Imagine the hinges on a door. They need to line up straight in order to function correctly. If not, every time you use the door, the hinges will grind. The same thing can happen with the knee. If the knee begins to travel inwards, then the outside of the knee is compressed while the inside of the knee is under tension. This also causes the kneecap to travel to the outside of its normal groove in the leg bone. The dysfunction puts stress on the meniscus, ligaments, cartilage, tendons, and other structures in the knee. Over time, the damage adds up. One could expect to develop osteoarthritis and other problems if the issue isn’t corrected.

So why would the knee begin to move and track differently? I often tell my patients, “You’re not just what you eat…You are what you do”. If you tend to sit with your right leg crossed over the left for hours a day at your desk, or if you have poor form squatting, then you are likely training an altered movement pattern or muscle imbalance. The muscles of the leg are designed to coordinate together acting to keep the joint in line throughout it’s range of motion. Weak or overactive muscles alter the coordination resulting in poor tracking.

Another issue may be down in the foot and ankle. Those who have fallen arches or “pronation of the foot” will tend to shift the knee inwards. Of course, there can always be an acute trauma like a sports injury or car wreck that damages tissues upon one dramatic event. Even so, the mechanics will be altered and lead to further degenerative changes if not corrected. Hence the reason you do rehab after surgical repair.

Does knee pain go away on its own?

Most Knee pain will go away on its own if the offending activity is stopped. However, knee pain usually comes back when people become active again. Most patients experience a pattern of remissions (it gets better), then exacerbations (it gets worse), with a general trend of more severe episodes over time. This is because the bad mechanics causing knee pain are not resolved without corrective treatment and the damage accumulates weakening structures in the knee.

When to see a Doctor

Knee pain that does not go away after two weeks of rest, or knee pain that returns after resuming normal activities is a big warning sign that something is not working right in the knee. Though the cause is usually mechanical in nature, there are some other more serious reasons for knee pain that could be disastrous to ignore. Better to be safe than sorry. If your knee pain doesn’t go away in two weeks, you need to see a doctor…preferably one that is familiar with musculoskeletal conditions. You may receive a referral from your family doctor to see a Chiropractor and/or physical therapy.

Product Recommendations

If your day involves a lot of kneeling, try a foam knee pad. Place the pad under your knees when kneeling on hard surfaces: like gardening or cleaning or repairs at home. If you are moving around a lot, you may want to consider knee pads that stay on your knees. Make sure and get strap-on knee pads with Velcro for easy attachment. If your profession requires a lot of work kneeling on hard surfaces, it would be wise to invest in nicer pads. Otherwise, you can find them for less than $10 online.

A simple knee strain or tendinitis may benefit from a compressive brace. These types of braces can improve support stabilizing the joint during activities. It can also help to create compression that will reduce swelling. These braces are more for mild injuries that require support when you are active. To use a compressive brace, simply slide the brace on with the hole over the knee cap. There’s usually no left or right sidedness to these items.

For patellar tendinitis, one may try patellar straps. These devices go below the knee cap to take stress off the tendon during activity. A similar idea is the ITB strap to support the iliotibial band for “runner’s knee”. The strap easily fastens above the knee far enough not to contact the knee cap and features a gel pad that is placed on the outside of the thigh.
In cases of instability such as a moderate to severe sprain, ligament tear, or meniscal injury, a hinged brace may be favorable. The action of the hinge limits any side-to-side motion and keeps the joint in check. In these cases, a patient would not want to be doing any strenuous activity and the brace simply functions to help someone to walk so they can go about their day-to-day business with less limitations. Use this type of brace by positioning the hinge at the level of the knee between the two bones of the upper and lower leg with the knee slightly bent. Secure the bands around the top then bottom. Ensure it is firm, but not so tight to cause decreased blood flow. This should be comfortable enough to wear for 1 or 2 hours. While still seated, bend and straighten the knee to ensure it feels right and the bend is occurring in the correct place. Get up and take a few steps. Do any readjustments as needed.

Further adjustments may need to be done throughout its use to reposition and to relieve pressure caused by the brace.

In more severe cases, when a patient has advanced osteoarthritis or is post-surgical, a ROM hinged brace may be the solution. This type of brace is fitted and calibrated to limit the range of motion of knee flexion and extension. The purpose is to prevent specific end ranges of motion that may damage the joint as well as provide control of side-to-side movement in the knee. Ideally, the movement range of the brace would be increased over time as you progress through a course of treatment and the joint improves. To use this brace properly, you should have it fitted by a professional. The instructions are essentially the same as above with the additional step of calibration specific to your condition. Only a doctor or therapist should do this part.

Braces are not meant to be a long-term solution. They are a preventative measure against reinjury to allow you to heal. They should not be worn all of the time: only when performing tasks that require knee support. There are many online companies out there providing quality durable medical and rehab equipment. Your local drug store likely carries a variety of simpler items. If the problem persists, you need to seek the help of a professional.

When to Use PRICE

The mnemonic PRICE stands for Protection, Rest, Ice, Compression, and Elevation. Traditionally these methods are used for the first 72 hours after an injury. Protection & Rest so you don’t irritate/reinjure. Ice to bring down the temperature. Compression to combat swelling. Elevation to decrease the blood pressure to the affected limb. All of this works to reduce the natural inflammatory response that your body mounts to an injury. 

This once traditional method is now being challenged and could even be said to be controversial. The idea here is that the body responds with inflammation for a reason: to promote healing and repair. There is an increase in blood flow and capillary dilation so that the body can bring in more nutritional/healing factors and likewise get rid of waste products. This of course results in swelling and warmth that speeds up metabolism: which can be a good thing. However, the argument can be made that our modern-day bodies tend toward too much inflammation to the point where it can be harmful. A little swelling might be OK, but if the swelling seems substantial, PRICE is probably best. I coach my patients to use PRICE briefly after re-exacerbations or reinjuries. 

The 20/20 rule is usually a good strategy for icing a knee. Put ice in a plastic bag and wrap in cloth. Place on area for 20 minutes, then spend 20 minutes with it off, then 20 minutes on again. You can cycle through this several times. Instead of ice in a bag, peas or frozen vegetables work great. There are also plenty of form fitting gel packs on the market. You freeze them and reuse them. Never place and keep a frozen item directly on the skin, you need to use a cloth buffer.

An alternative to the above is an ice massage. Simply take a piece of ice and put it directly on the skin continuously moving it for about 10 minutes. Make sure and slide the ice so that it is completely off an area then back on again. The movement is important to ensure the tissue doesn’t get damaged. An Ice massage is great for getting in the contours along the knee cap. It also works excellent for muscle spasms.

There are devices for more severe knee inflammation that cool and compress at the same time. Some of them have a feature that pumps and cycles chilled water into the compress like the Polar Active Ice and Aircast Cryo Cuff. These devices are a little on the expensive side, but can be worth it if your condition is severe enough.

Do These Knee Exercises Before a Workout

If you are having mild knee problems, then there are some things you can do to improve the joint mechanics before your workout or activity. Try these simple warmups even before stretching. All you need is a resistance band (flat is best). This 5 to 10-minute routine is designed to loosen up your joints and activate muscles that will help to stabilize the knee ensuring proper tracking during your next activities. If you experience pain during any of these maneuvers, do not continue. Modify by reducing the amount of movement or do the easier version. While a muscular burning sensation is OK, joint pain or sharp pain is not acceptable. If all fails to relieve pain, discontinue the maneuver.

Marching knee taps:
March in place for 30-60 seconds with high knees tapping opposite hand to knee. Make sure to keep chest over pelvis and do not bend forward to tap knee. If pain, avoid twisting your torso too much. You can also tap same side hand to knee or avoid raising your knee so high. 

Heel to Butt March: 
Stand on one leg bringing the opposite heel towards the butt. The standing leg should remain slightly bent at knee. Attempt to hold for about 2 seconds then switch. This should be gentle. If you experience pain or cramping, don’t raise your heels so high. Alternate feet for 30-60 seconds.

Lunge steps w/ side bend: 
Put your hands on your hips. Take a big 2 or 3-foot step forward making sure to keep both feet pointing straight and thighs in line with feet. The back heel should come up with toes pointing forward. The front foot should be flat with toes forward. Keep your chest over your pelvis. Reach the hand opposite your front leg up over your head and bend gently to the side until you feel a slight stretch. Slowly come out of the bend. Step the back foot forward even with the other foot so your are again standing. Alternate left and right stepping forward with bending for 30-60 seconds. If painful, ensure you are keeping your knee over your feet and try reducing the size of your steps.

Sidestep w/ Knee Band: 
Place an exercise band around your knees. Stand with feet slightly wider than shoulders while maintaining slight knee bend. Step to the left about one foot pushing the knee against the band and pause when both feet are firmly planted. Then bring feet back together returning to the start position. Alternate stepping (left, center, right, center) in this one-two-one-two motion for 30-60 seconds. You can also take multiple steps left, then multiple steps right once you get the hang of it. If pain, make sure knees are over feet throughout the motion or take smaller steps.

Knee Band Squat: 
Place band around knees. Place feet slightly wider than shoulder width apart with feet turned out about 15 degrees. Push knees outward against band keeping knees over feet. Put your hands out it front with shoulders back. Slowly start to drop your pelvis bending from the hips and knees. Keep your chest over your pelvis lowering your body only about a foot. Hold for 2 seconds and return. Repeat for 30-60 seconds. If pain, ensure knees over feet and toes not turned out too far. Don’t over-arch your back. Also try lifting hands up as you lower your body. Don’t look down, slightly lift chin instead and look forward.

Marching Bridge w/ Band: 
Lay on your back. Place band around knees. Place feet flat with knees bent to about 90 degrees. Push against the band and raise your pelvis off the ground: this is the starting position. Now, lift one foot about an inch off the ground and hold for 2 seconds. Place the foot on the ground returning to start position. Alternate sides for 30-60 seconds. If this is too much, try placing your heels closer to your buttocks. Ensure you aren’t pushing your knees outwards too far. You can also just raise and lower the pelvis without the march or put less pressure against the band to reduce stress.

If Pain Continues with Workouts or Activities

It is generally a good idea to discontinue your more aggressive activities after a knee injury. Two weeks of avoiding the use of the knee is standard. When you return to activities, go slow and careful. Build stepwise using caution and control, then move to more aggressive maneuvers. Check your form. You might benefit from having a trainer take a look at your routine to make sure your form is good and suggest alternative exercises should the pain persist during a particular movement. If you are still experiencing pain, it is time to see an expert like a Chiropractic Physician.

Plantar Fasciitis Solutions

Plantar Fascia

A sharp pain in the bottom your foot with the first step out of bed in the morning is an almost sure sign that you have plantar fasciitis. This is a problem with the connective tissue that runs from your toes to the back of your heel and ties into the calf muscles. This tissue can become damaged and inflamed causing that debilitating foot problem that you can no longer ignore. So what do you do about it?

Let’s talk about possible plantar fasciitis treatment. Maybe you tried rubbing it. Maybe you tried heat or cold packs. Maybe you tried rolling it out with a tennis ball or even a frozen bottle of water. Is the pain still there? You’re going about it all wrong.

Plantar fasciitis often doesn’t respond well to massage techniques alone simply because the problem isn’t that it needs stretched or massaged. It needs to destress so it can heal. It’s overstretched and taking the brunt of the force at impact from walking or running. The plantar fascia really is a last resort barrier much the same as a ligament and is not meant to be under constant repetitive tension. The muscles and shape of the foot are designed to absorb the impact during gait like a spring or shock absorber. The muscles in your foot are meant to hold the bones in such a way to form arches. These arches are nature’s design to withstand repetitive impact while walking or running. If the intrinsic foot muscles responsible for forming these arches weaken, this results in loss of arches and the plantar fascia is pulled to tension. Now with each step, the plantar fascia is put under more stress than what it can handle. The result is progressive damage to the fibers.

The point is, until you reshape the foot and strengthen those muscles, you will continue to do damage to the plantar fascia and your condition will worsen. So how do you reshape your foot? One cheap and easy solution may be to grab yourself a pair of orthotics (shoe inserts) from the store. This will help to mold your foot and support your arches. However, one size does not always fit all and you may need to consider custom orthotics which can be quite expensive. You are also going to need to retrain the muscles in your foot with specific exercises. One of my favorites is the short foot progression. This is a complicated exercise, so it may be easier to start with the Pen & Penny exercise. Additionally, any tightness along the kinetic chain in the leg will need to be addressed, especially the calf and hamstring as these muscles have fascial plane connections to the plantar fascia. it is also  important to make sure the joints of the foot themselves have good motion and alignment, so manipulation of the foot bones can help profoundly. Lastly, therapeutic modalities like soft tissue manipulation, and ultrasound can help with proper fascial healing. But again, soft tissue modalities alone will not solve the problem if the foot is not retrained to hold the proper arch and reduce the tension on the plantar fascia.

If you think you have plantar fasciitis, you’ll want to get checked out by an expert in biomechanics like a Chiropractic physician. Feel free to give our office a call if you have questions or want to set up an appointment.

Chiropractic and Athletic Performance

Over the past couple of decades, a mountain of research is showing how Chiropractic care improves athletic performance. Chiropractic makes athletes more efficient and heal from injury faster. From football teams to professional body builders, more and more athletes are turning to Chiropractors to be at the top of their game. Why?

In competitive sports performance, the difference between winning and losing is sometimes measured in microseconds. Athletes need every little bit of strength, speed and flexibility they can muster. A Chiropractic Physician’s focus is improved biomechanics. In other words, this type of doctor is concerned with how the body moves. You may not know it, but many Chiropractors work not only on the spine, but any musculoskeletal problem. Chiropractors can improve range of motion, strength, flexibility, coordination, reaction time, and the ability of the body to recover and resist injury. This not only means improved performance, but the ability to recover from injury faster and even prevent injuries.

According to Palmer College of Chiropractic, an estimated 90% of all world-class athletes routinely use Chiropractic care to prevent injuries and boost their performance. All NFL teams employ on-staff chiropractors, as well as 72% of PGA golfers and the majority of NBA, MLB and NHL teams.

Many famous athletes have used Chiropractic to stay on top of their game including: Tiger Woods, Arnold Schwarzenegger, Tom Brady, and Evander Holyfield. These athletes recognize that Chiropractic has significantly improved recovery times and helped to improve performance.

The ultimate goal of Reactivate Therapy is to get our patients back to the activities that they love. We recognize that the more active you are, the healthier you will be. Exercise doesn’t just improve cardiovascular health, it also helps to regulate hormones, improve your immune system, decrease stress, maintain a healthy weight, and generally keep you living a longer and happier life. We want our patients to be able to live an active lifestyle because it improves overall health, and we know just how much pain and injury can be a barrier to that goal. 

So, if you are an athlete, or you are an on-the-go weekend warrior, you can look to Chiropractic to improve your game and stay active. Feel free to give us a call if pain or injury is getting in the way of your active lifestyle.

Evidence Based Chiropractic in Modern Medicine

Scientifically proven to improve function and performance

Chiropractic has had a history of riding on the outskirts of mainstream healthcare, but all this is changing with evidence based chiropractic. More and more people are coming to Chiropractors now than ever before and are realizing the benefits of the physical treatments that Chiropractors can provide for relief of their aches and pains. With more and more chiropractic effectiveness studies appearing, Chiropractors have now moved into mainstream healthcare with an evidence-based approach. Consider the following:

  • Nearly every healthcare insurance in the U.S. offers Chiropractic benefits.
  • Chiropractic has been endorsed by The Agency for Health Care Policy and Research under the U.S. Department of Health and Human Services.
  • 90% of professional athletes utilize Chiropractic to stay at the top of their game with almost all professional teams having a Chiropractor on staff.
  • Chiropractic has been recommended by The American Pain Society and The American College of Physicians.
  • Chiropractors have earned physician status in most states.
  • Chiropractors attend 8 years of college education to earn their doctorates with total credit hours equivalent to that of MDs and DOs.
  • Medicare reform is occurring in an effort to include all services provided by Chiropractors.
  • Hospitals have been implementing Chiropractic care as part of their treatment options and some Chiropractors have hospital privileges.
  • The effectiveness of manipulation has been established with chiropractic and headaches research.
  • Other health care professionals are utilizing joint manipulation like Chiropractors in their treatment of musculoskeletal conditions including Physical Therapists and Medical Doctors. In truth, osteopaths have been manipulating joints and muscles since the profession’s conception and before the advent of Chiropractic.
  • Many Chiropractors have integrated practices that include medical staff such as MDs, DOs, PTs, and Nurse Practitioners.
  • In some states, Chiropractors have prescription rights.

So, what is it exactly that has changed? In a word…research. Funding for Chiropractic research has grown tremendously along with its increased demand, and this has allowed the profession to show its effectiveness in treating a multitude of conditions. And, as the profession grows, more Chiropractors are using the evidence-based approach to care. That is to say that more of the profession is adopting a style of practice that utilizes treatments that have been proven by scientific research to be effective. This change probably explains why more medical professionals are not only referring to Chiropractors but are also Chiropractic patients themselves. Chiropractors use the same physical examination procedures used by mainstream medical professionals using the same terminology to make communication easy. Many Chiropractors no longer ascribe to the philosophy that a subluxation or misalignment is to blame for organic disease. Rather, as the evidence shows, they believe improper alignment and movement is at the root of the majority of joint and muscle pain.

Essentially, the evidence-based view of musculoskeletal conditions is this: Due to acute trauma, repetitive trauma, or bad habits, our position and movement becomes altered. Big or small, further changes in our body’s mechanics occur over time. Joints misalign. Muscle tone imbalance occurs. The shape and character of our soft tissue and bones is altered. Eventually the changes lead to increased stress, wear and tear on our tissues. Our muscles become tight and contracted and dysfunctional. We develop arthritis, tendinitis, ligament damage, nerves become entrapped or irritated, and we are in pain. Therefore, treatment by an evidence-based Chiropractor focuses on normalizing those mechanical dysfunctions with goals like improving range of motion, tenderness, tightness, inflammation, nerve function, and of course pain.

Patients suffering from joint, muscle, and even nerve pain can consider Chiropractic as an alternative to medication or surgery. Typical treatment from Chiropractors includes: manipulation of joints and soft tissue; physiotherapies such as electro-muscle stimulation, therapeutic ultrasound, traction, and decompression; and rehab like targeted stretches and exercises. In Oklahoma, Chiropractors also have the option to advance their scope of practice to perform injectable therapies with vitamins, minerals, and neutraceutical medicines effective to decrease inflammation, help repair joints and soft tissue, and decrease pain. If you are suffering from any of the above symptoms, chances are, there is a Chiropractor close by that can help.

Alternative Pain Solutions

Consider something else

Humans have come a long way. We have people out there walking around with surgically implanted 3-D printed organs. We have antibiotics for infections that might otherwise kill us. I shattered my foot when I was a young man, and a skilled orthopedic surgeon put me back together almost as good as new. I got LASIK and now I see 20/20. I will be the first to say that I feel very blessed to be living in a time of such advancement in medical technology. We are also lucky to be living in a time where we are beginning to recognize the benefits of other alternative options for care.

There exist many reliably effective drug free pain solutions which are grouped together in a category we call “Alternative Medicine”. Though some really shouldn’t be considered alternative. Mainstream medicine is classically drugs and surgery. Unfortunately, many effective treatments that fall outside of that standard approach are generally regarded as less effective or even placebo. That term, Alternative Medicine, carries negative connotations: like it is somehow secondary or less valuable. Calling these treatments alternative would seem to imply these methods are only useful if standard medical treatment fails or is contraindicated…as if it were a Hail Mary Play. However, I would argue that, often times, the alternative medical approach is actually the best first plan of attack simply because it carries less risk.

I think we can all agree that mainstream medicine carries significant risks of unwanted results like short-term and long-term side effects from drugs and the inherent risks of surgical procedures. Even over the counter NSAIDs like ibuprofen and acetaminophen can cause serious damage over time including gastrointestinal bleeding, cardiovascular problems, and kidney failure. This is why we trust our doctors to help us weigh the risks vs the benefits of a treatment and why it takes so long to become a doctor.

My question is this: If there were other options out there, which have been proven to be effective in many cases, and with less risks and side-effects, then wouldn’t you want that on the table as an option? In fact, wouldn’t you want to try it first? Why then call it Alternative? Why go with an aggressive approach first? Go from the most conservative to the most aggressive instead. It will save millions in health care costs, and it will be better for the patient.

In the face of an opioid epidemic and an aging population, our country needs to reconsider the traditional avenues for addressing the management of pain in the United States. Here are some conservative approaches to pain management to consider as an alternative to the traditional medical treatments such as drugs and surgery.

  • Chiropractic Manipulation                     
  • Naturopathic/Homeopathic Medicine               
  • Massage Therapy    
  • Weight loss      
  • Anti-inflammatory Diet                         
  • Acupuncture        
  • Physical Therapy                        
  • Meditation
  • Yoga                                    
  • Pilates                                          
  • Tai Chi
  • Water Aerobics           

Arthritis

It has come to my attention that many of my patients have been told they have arthritis, but don’t know which kind or what really causes it. First off, there are many different kinds of arthritides (plural for arthritis). There are metabolic arthritides such as gout where too much uric acid builds up in the joints and forms crystals that damage the joints; there are autoimmune diseases like rheumatoid arthritis that tricks the body into attacking the connective tissue in joints; there is the possibility of an infection in the joint that leads to arthritis; but the most common type of arthritis is osteoarthritis, and this is usually what a doctor means when he/she tells you that you have arthritis.

So, what is osteoarthritis? This type of arthritis is known by many names: spondylosis, degenerative joint disease, degenerative arthritis, degenerative arthrosis, arthrosis, and several more uncommon terms. Osteoarthritis (OA) is nicknamed the wear-and-tear disease of the joints. This is because OA is the result of excessive stress in the form of tension, friction, and compression that repetitively occur over time causing degeneration of the elements of the joint that keep it moving smoothly. This degeneration leads to stiffness, pain, swelling, and those grinding/clicking/popping noises called “crepitus”. Osteoarthritis is often found along side other types of problems related to excess physical stress like degenerative disc disease, herniated discs, tendinitis, and bursitis. Each joint in the body is susceptible to OA, but as you can imagine it shows up more often in joints that bear more weight and stress like hips and knees. Typically a doctor will diagnose you with OA by X-ray. Changes we look for are: loss of joint space (which indicates erosion and damage to the cartilage), pieces of bone loose in the joint, bone spurs, enlargement or thickening of the bone around the joint, alteration of the alignment of the joint, deformity of the joint, and a handful of other findings. Doctors may use the term “bone-on-bone” when it gets bad enough that there is no more cartilage.
The most important thing to remember here is that osteoarthritis is the result of excessive wear and tear from bad joint mechanics. Many of my patients will say something like “Well Doc, I’m just getting old”. My reply is usually to ask if one of their knees is older than the other. Because, if OA is truly due to age, then why does one side typically start to have problems before the other? It is true that the older a body is, the more opportunities it has had to undergo wear and tear, and the more likely that damage will result in OA. But, time and old age by itself does not produce OA. The alteration of the mechanics of the joint results in OA. There has to be a problem with the joint, and this problem leads to damage over time that finally culminates in this type of arthritis.
Attributing arthritis to old age is associated with falsely accepting that there is nothing that can be done about the problem. Nothing could be further from the truth. It may be true that the more advanced the OA, the harder it can be to treat, but this does not mean that the problem should be ignored. In the medical world, this mind-set is called “taking on the sick role”. Don’t take on the sick role! If you decide to do nothing about the problem, it will continue to get worse. It is much better to nip OA in the bud rather than let it get so bad that the only realistic solution includes joint replacement surgery. Once you have that surgery, things will never be the same. The biomechanics in the area will permanently be altered, not to mention the risks of surgery or the recovery/rehab or the expense. The point is, don’t let it get to the point of surgery. That old trick knee or a past accident/injury can be the beginning of OA, but it doesn’t have to end in full blown OA. Even if the osteoarthritis is advanced, and even if a surgery needs to be performed, the underlying dysfunction that caused the arthritis is still there and needs to be corrected, or problems will continue/reoccur. So, you are going to have to address this no matter which way you go. Better to correct it sooner than later.
I want everybody to understand something. Every joint in the body is meant to be in a certain position and move a certain way. As the two joint surfaces move relative to one another, they are meant to remain congruent, or flush against each other. Imagine a ball and socket joint. If the ball is not centered in the middle of the joint as it goes through it’s motions, then the ball rides up on one side of the cup grinding and causing excessive friction. This damages the joint and leads to further changes. Alterations in the balance of the muscles and/or ligaments around the joint result in bad joint mechanics. This can be from an injury or a bad habit like improper posture. Muscles are important because they keep that joint centered in the correct position as the joint goes through it’s movement. If the muscles are not balanced, then the joint capsule becomes stretched and altered. These joint capsules are made up of ligaments that connect one bone to another. It is composed of fibrous material that ensures that the bones are held together tightly and keep the bone from sliding too far in any direction. If you have ever heard of an ACL tear, then you know that this important ligament keeps the knee from shifting forward, and if damaged, the knee becomes unstable because there is nothing to keep the motion in check. These ligaments/joint capsules can actually become stretched and warped with repetitive damage. The capsule will be tight and shortened on one side and stretched long on the other. If this happens, they no longer do their job and the joint rides out of place. If left uncorrected, these types of abnormal joint mechanics will lead to OA.
Now that you understand how these alterations can lead to damage ultimately resulting in OA, you probably want to ask…How do we fix this? Well, it’s not easy–you are going to need an expert (and I’m not talking about a personal trainer). It all comes down to re-balancing the joint: this includes the muscles and the ligaments. The first thing we need to do is get the tension of that joint capsule equal again. We need to stretch the shortened side. This is the side(s) where there is a restriction in the range of motion (ROM). This can be done with manipulation or adjustment. The next thing we need to do is stretch the tightened muscles. This can be done by a health care provider or by the patient themselves; preferably a combination of the two. This takes time, but once the ROM has been normalized, it is time to strengthen the correct set of muscles around the joint. If you try to strengthen the muscles first without normalizing the ROM, it is possible that you will be doing more damage by reinforcing the bad pattern. It would be like running after you sprain an ankle. Once those muscles are correctly stretched and strengthened in the right pattern, this will keep the joint centered and eventually the capsule will heal and normalize again because the capsule/ligament fibers shrink up over time if they are not always being stretched out. So if the muscle does its job keeping the ROM of the joint in check, then the ligament/capsule has an opportunity shorten back up to it’s normal length thereby re-establishing it’s ability to correctly stabilize the joint.
This process takes time. Treatment should be approached as a coordinated effort between the physician and the patient working as a team. Furthermore, both physician and patient should be patient, expecting progress to happen slowly over time: especially if the problem has existed for a long time. It is also important to understand that pain is not a good indicator of when the problem has been fixed, but rather by the ROM and balance in the joint. This is because it typically takes quite a bit of dysfunction and damage to start producing painful symptoms. So when treatment alleviates the pain, this is usually only about 20% progress. The joint is still dysfunctional and if the joint does not get properly balanced and stabilized, then the condition will return. At this point, the patient will have lost a lot of progress. Don’t throw away your time and money: finish the treatment just the way you would finish out your antibiotic even if you are feeling better.
If you have arthritis, or a painful or stiff joint that isn’t getting better, or if you have had a recent injury, then please seek out a Chiropractic Physician. This is our bread and butter. A Chiropractor treats OA like a dentist treats tooth decay: it is our main work. If you have any questions, please contact our clinic.

Carpal Tunnel

Hand and wrist pain or numbness

Everybody has a carpal tunnel, but a few of us also have carpal tunnel syndrome. This is a condition that causes pinching of the nerve at the wrist and can lead to weakness, numbness, and pain. If you have to shake your hand(s) to get relief, then this is another sign of carpal tunnel syndrome. Symptoms usually include pain and/or numbness on the palm side of the hand and typically only affects half of the palm on the thumb side. In other words, carpal tunnel has a particular distribution of symptoms that includes the thumb, the index finger, the middle finger, and sometimes part of the ring finger. If this doesn’t sound familiar, you probably have something different: ulnar tunnel syndrome, cubital tunnel syndrome, or even a pinched nerve in the neck.

The carpal tunnel is a canal formed by bones and soft tissue in the wrist that permits tendons from the forearm and the median nerve to enter into the hand. Sometimes the shape and size of this tunnel can change due to changes in the positions of the bones that make the carpal tunnel or inflammation or both. This change in shape and size can cause the contents of the carpal tunnel to become entrapped or compressed.

Some activities associated with carpal tunnel include driving for extended periods, typing in a form that is not ergonomic, or repetitive use of the hands in a flexed or extended position. These activities train the muscles in your wrist and hand in a bad position and slowly makes changes to the carpal tunnel over time. 

If you want to avoid surgery for carpal tunnel, then there are conservative treatments that will likely fix the problem. The first is manipulation of the bones in the hand. This is most expertly done by a Chiropractor. There are also specific stretches and exercises to do that will retrain the muscles to open up the carpal tunnel. These need to be done under the supervision of a physician, because they can also cause symptoms to worsen.

If you’d like to learn more about carpal tunnel you can check it out at the bottom of this page.

If you think you have carpal tunnel, give us a call for a free consultation: 918-600-2969.

Why Do I Hurt?

Reasons for pain

A painful back, achy muscles, a sore shoulder, a tense neck, arthritis, tendinitis, bursitis, and even most headaches are all a similar group of problems. They are biomechanical problems. In the majority of cases, these conditions are the result of wear, tear, and tension on structures in the body that are necessary for movement. So why do we develop these troubles? The answer for most people is bad habits and trauma. We acquire a pattern of movement and posture that is unfavorable. This causes undue stress and strain on ligaments, muscles, and joints. Sitting for long periods with our heads forward, previous injury that causes a limp or limited range of motion, using electronic devices, lifting objects incorrectly, bending & stooping forward during activities, and even our sleeping habits can cause us to have an unnatural posture and to move incorrectly.

It takes time for these altered positions to affect the body. As we move around throughout our day, the altered position and movement causes small but repetitive damage. This is like driving around on a misaligned tire. Biomechanical issues get worse and worse over time, and the longer we wait to address them, the more damage we do. This is why it is important to correct these abnormalities sooner rather than later. We want to quickly address joint and muscle problems that make us more susceptible to injury and eventually lead to worse things like arthritis, herniated discs and neuropathy.

So how can we fix or prevent these problems? Well, we have to retrain the body to perform the normal movement and posture correctly once again. The first step is to try to eliminate or modify the activities that are causing the abnormality. Our bodies tend not to be able to posture and move correctly when we are in pain, so we must reduce the pain as much as possible. We use physiotherapies like E-stim and ultrasound to do this. Next, we need to correct the alignment and motion of an articulation with joint manipulation. Another powerful tool is rehabilitation. Basically, rehabilitation consists of specific stretches and exercises. Rehab really focuses in on the muscles that position the body. It takes time and repetition, but these tools together form a powerful mode of manual medicine.

Traditional medical solutions for biomechanical issues like low back pain usually start with medicine and then go to surgery. Medicines work on symptoms like swelling and pain, but won’t correct posture or movement abnormalities in a biomechanical problem. Of course, surgery should be a last resort. Behavior modification, physiotherapy, joint manipulation and rehabilitation are natural, effective, and safe methods to tackle these problems before they get so bad that surgery becomes necessary. If you are having issues that appear to be affecting your joints and muscles, contact a physician who is a biomechanical expert like a Chiropractor.

We Are Our Habits

Bad habits

We’ve all heard the old adage, “We are what we eat”. Well, I would go a step further and say “We are our habits”. Everybody has habits: some good, some bad. Those general routines, patterns, and vices that make up our daily and weekly lives end up building our lifestyles.

Take diet for example. Most of us have been on a diet, but what happens afterwards? We do or don’t accomplish our weight loss goals and then return to eating the way we did before dieting. In the short term, we may be creating change for the good. However, a birds eye view gives you a better picture. You’ve likely been on and off different diets over the years gaining and losing weight and maybe even driving yourself a little crazy along the way.

Another example… Many people struggle to quit smoking or drinking. They quit for a whole month and then have a few in a social situation. Then they beat themselves up for it and feel “what’s the point” and start smoking/drinking again regularly. Then they try again and maybe go several months, but again have a moment of weakness and revert back in a cycle that destroys their self-confidence and sense of self-discipline.

What about exercise? We know we need it. Some months we are really good about getting enough activity and other months we find ourselves busy, or just too tired and overwhelmed to make it into the gym or go for that run. Then, we get mad with ourselves for failing to follow through with our exercise goals adding more stress to our lives.

STOP! Such self inflicted stress may work in the short term, but not the long term. We often do more damage to ourselves worrying about what we have failed to change. This view is a narrow black and white picture of health: either we do or don’t succeed. This is both untrue and self-defeating. See the bigger picture. Our health and our lifestyle choices are a long term decision, not just a few weeks or months. 

Habits are hard to change. In fact, I would say they are too hard to change dramatically in a short period. Experts have found that on average it takes a little over 2 months for a new behavior to become automatic. We often put too much pressure on ourselves to make these changes and then beat ourselves up if we don’t stick with them. I propose a different view of ourselves and our habits.

First, don’t beat yourself up if you have a moment of weakness. It’s not healthy. Instead, give yourself a pat on the back and be proud of the change that you made for that period of time. Realize that you didn’t lose the good you did. You might find yourself more encouraged to try again. 

Second, don’t create drastic changes like revolutionizing the way you eat because you want to “try” a new diet. Instead, take one thing at a time to improve and transform it into a permanent habit. For instance, take two months and focus on what you drink. Instead of a soda or other sugar load at lunch, vote for water or an unsweetened tea. Get in the habit of drinking bottled water at home. At the grocery store, pass right by those sugary beverages and select something better. Blend a good juice once in a while when you want something different. Start brewing tea at home with little or no sugar. Build your habits and choices one step at a time and start making those choices routine.

Third, don’t listen to that commercial! You may not be aware that there is a science behind marketing, and the health field is absolutely riddled with deceptive marketing tactics. Advertisers will find ways to capture your attention and pull at emotional strings to convince you to try their newest and latest product. Manufacturers and distributors pay hundreds of billions every year to push their product, but most of them (even though they may be “FDA Approved”) have absolutely no clinical evidence of their efficacy. It’s hard to hear, but there is no miracle solution. There are several products that can help (like nicotine patches), but you will still have to do the leg work of choosing to form different habits.

Change can be made. Just take one thing at a time and get used to making good choices, give yourself enough time to make it automatic (at least 2 months), then stick with it. It will become part of your routine and won’t seem like a chore or like you have to sacrifice something. I bet you won’t even think about it after a while. And, if you do have a moment of weakness, don’t throw it all away and go back. Just make a better choice the next time and keep feeling good about yourself and your decisions. You have the power to do this time and again over the years improving your health and the quality of your life. If you want some guidance, please reach out to us at our clinic.