Since I have become a chiropractor One of the things I love is treating complicated situations that are no the slandered chiropractic case. I also love treating the spine and it is the bread and butter of the chiropractic industry, but some times you just need a change and challenge to keep life interesting.
One of theses areas is the treatment of heel or foot pain, in many cases this may be diagnosed as Planter fasciitis. A study was performed by Daniels and Morrell on plantar fasciitis and they found it “improved after a course of a multimodal treatment approach using chiropractic manipulation and soft tissue therapy in addition to exercise and stretching therapies.”(Daniels CJ, Morrell AP. Chiropractic management of pediatric plantar fasciitis: a case report.J Chiropr Med, 2012 Mar;11(1):58-63)
Many of my patients come in complaining of foot pain and this may also have an affect on there back and neck pain. In my 10 years of practice I have treated many athletes for back, shoulder, wrist, elbow, hip and Knee pain but as well as these complaints 10-15 percent also have heel and foot pain complaints at one time or another.
II have found that in some cases the foot pain may resolver with a few adjustments but in many cases this requires a multi modality approach. This approach often includes chiropractic adjustments of the foot and ankle joints, facial release techniques such as trigger-point, cold laser, and stretching as well as strengthening exercises. As a last resort special shoe inserts night be needed but not until the foot is aligned more normally. At this point
Anatomy of the Heel
The prominence at the posterior end of the foot is the heel and is crested by a projection from the calcaneus or heel bone. Other articulating bones of the ankle are the mortise (tibia and talus). When weight is applied to the foot the forces are distributed along the five toes or metatarsals. The lateral support stretches over the cuboid bone in the front to the heel and the medial support moves over the three cuneiform bones and the navicular to the heel. These bones form the three functional arches of the foot which are the medial longitudinal, lateral longitudinal, transverse arches. It is these arches that distribute compressive forces across an uneven terrain across the foot. Often when patients have foot pain they go to the drug store and buy arch supports but many of these supports only account for the main arch in the foot and as we know see there are three arches that need to be supported as well as the navicular bone and this is why in my office when arch supports are needed we recommend custom made orthodic supports. They are more expensive but worth the cost they many last up to 5 years if treated properly. Orthodics often help with the biomechanics of the foot. The heel is the actual point of contact during the heel-strike portion of the gait cycle. It is also an important point on which weight must be equally balanced from the forefoot and heel. When walking there needs to be a 50/50 weight distribution at the forefoot and hindfoot. Without this 50/50 distribution the gait and the standing positions are unhealthy.
When the foot is healthy the arches are working well together during gait and the heel strikes the ground in a slightly supinated position and during the gait cycle it moves into a slightly pronated position. Stand up and walk a few paces do you notice how it feels. A healthy gait is present in only only in about 10 percent of patients that I see. More often I see patient who are over pronating. This excessive pronation results in flattening of the arches and collapsing of the foot, this causes the heel to strike the ground in an over supinated position altered the heel-strike pattern and creating stress in the heel, but also altered biomechanical patterns of the foot. In the end this can lead to pain in the foot and heel. Excessive supination occurs much less frequently, most statistics suggest less than 5 percent, so its effects on the heel are not as profound.
First there is the condition of Achilles tendinitis. This is due to excessive pronation of the feet and affects the tendon of the triceps surae. The collapse of the foot creates tension in the Achilles tendon, causing it to bow inward and this bowing is happening every time the foot over pronates creating microtrauma and stress to the Achilles tendon. If the Patient supinates, the bowing of the Achilles tendons is outward and creates similare strain and stress on the bones and soft tissue. Over time the body calcifies these tendons to support the joints that are unstable and spurs can develop on the posterior, superior portion of the calcaneus bone. Tight muscles and trigger-points may also form in the gastrocnemius and soleus muscles of the foot and lower leg. Achilles tendonitis is often debilitating due to the the pain and this continues to alter gait and mobility patterns to the point that it prohibits walking for any amount of time without pain. According to Papa “A combination of conservative rehabilitation strategies may be used by chiropractors to treat midportion Achilles tendinopathy and allow an individual to return to pain-free activities of daily living (ADLs) in a timely manner.” (Papa JA. Conservative management of Achilles tendinopathy: a case report.J Can Chiropr Assoc, 2012 Sep;56(3):216-24.)
Another common condition of the foot and heel is plantar fasciitis. A healthy plantar fascia ligament exhibits elastic properties but over time,the three arches of the foot tend to collapse. Over time this leads to excessive pronation and stresses the plantar fascia chronically. This causes the ligament to stay overstretched and it loose its elasticity and becomes longer due to the plastic deformation. Supination creates a thinner, tighter foot due to the tendency of the foot to roll outward creating a high instep with collapsed transverse and lateral arches in these patients. In either case, we can note biomechanical instability and irritation to the plantar fascia from its origin at the calcaneal tubercle across to the insertion on the metatarsal heads. In these patients symptoms begin as a dull ache in the underside of the heel that is more of an annoyance. Patients can still perform normal activities and sports, but over time the pain becomes more intense and sharp, these patients have to curtail or eventually stop their activities. In the later phases, pain can move off the heel and into the middle of the fascia, or at the insertion on the metatarsal heads.
We have all known some one with a sprained ankle. Ankle sprains range from the very mild kind to the severe, grades 1 through 3. The milder types are suggested when a patient complains of “turning the ankle.” This is like when someone missteps off a curb or a step. The opposite extreme is when ligaments and tendons are torn due to a traumatic injury. Either way, biomechanics, particularly of the calcaneus and talus, are compromised. The most common type an inversion ankle sprain, the calcaneus bone moves medial while the talus tends to move lateral. There is also an eversion sprain, where the talus bone moves medial while the calcaneus tends to move lateral. Recall that the bony anatomy allows inversion ankle sprains to occur much more frequently. In either case, the movement of the bones inhibits normal mobility. Since most people do not see a chiropractor after a sprained ankle, the bones stay out of alignment, leading to a slow rate of healing, chronic degree of tenderness and decreased function, and a tendency to repeatedly sprain the ankle in the future. Thus, it is imperative that chiropractors intervene and break this cycle. A 2004 study suggested “high velocity, low amplitude chiropractic manipulative therapy to the spine, pelvis, and extremities, particularly at the ankle, should be considered when managing young recreational athletes with functional chronic, recurrent, ankle inversion sprains.” (Gillman SF. The impact of chiropractic manipulative therapy on chronic recurrent lateral ankle sprain syndrome in two young athletes. J Chiropr Med, 2004 Autumn;3(4):153-9.)
Heel Spurs are a painful and common problem of the heel. As previously discussed, a heel spur forms at the posterior, superior calcaneus bone courtesy of Achilles tendinitis. The most common place we see a spur is on the underside of the foot at the calcaneal tubercle where the plantar fascia originates. The worse the chronic pull on the bone, the worse the spur. Spurs form when the body tries to stabilize an unstable joint. According to Wolf’s Law the Body will remove calcium from places where it is not needed and deposit it in areas were force and instability requirer it. We can’t take the spur away, of course, but we can help it from getting worse and if the joint stabilizes the body may even re-absorb some of the calcium reducing the size of the spur. Depending on how quickly you seek treatment for one or more of the above ailments, the faster they heal. If a patient is acute enough and there is sharp pain and inflammation, modalities like cold laser, ultrasound, ice, etc., are indicated. You can also provide light, soft-tissue therapy at this stage, making sure you apply the appropriate amount of pressure.
Chiropractic treatment for foot and ankle injuries!
Adjusting the bones of the feet to restore healthy biomechanics is extremely important. Adjusting the calcaneus, talus, navicular and cuboid bones is particularly helpful. If you don’t get in there and move those bones, they will not heal very well and will be prone to future injuries.
Another helpful tool is stabilizing orthotics. These are flexible, have all three arches and are custom molded and help to support the patient’s feet as well as the rest of their body. A 2002 study suggests the effectiveness of applying orthotics and ankle braces during the acute and subacute phases of ankle rehabilitation. (Mattacola CG, Dwyer MK. Rehabilitation of the ankle after acute sprain or chronic instability. J Athl Train, 2002 Dec;37(4):413-429.) The use of orthotics, when necessary, has been a part of chiropractic practice as well as my practice. They help to maintain proper biomechanics and structural integrate as well as helping hold the adjustments longer.
Ankle stretches and stabilization exercises also can be provided, and they are helpful as well as easy. A passive exercise (Doctor performs) would be to have the patient cross the affected ankle over the opposite leg and passively dorsiflex, plantarflex, invert and evert the foot. Another exercise is to have the patient stand on the edge of a step or a door frame and stretch the calf muscles, each repetition should be held for 30 seconds. Stabilization exercises should be performed with elastic tubing. The patient performs the following active movements of the foot and ankle dorsiflexion, plantarflexion, eversion and inversion. Elastic tubing is easy and convenient, and you can change the resistance quickly.
It is common for patients to walk into our office complaining of ankle and foot pain. At our office we take a few moments to listen, look and feel so we can help them in a manner that isn’t complicated or time consuming. Since the ankle is such an important stability structure for the entire body, our patients benefit tremendously from our expertise and care of their ankle and their entire body.By: Dr. Paul R. Mahler mahler-chiropractic.com
Chiropractic is safe and effective for neck pain.
As a chiropractor I have always told my patients that in most case, when it comes to neck pain the best medicine is no medicine at all. Now according to a new study published in the Annals of Internal Medicine studies are now showing this it true (http://www.annals.org/content/156/1_Part_1/1.abstract?aimhp). The study, was funded by the National Institutes of Health, tracked 272 patients with recent neck pain. These patients were treated using three different methods medication, exercise, and chiropractic care.
After 12 weeks the patients who used a chiropractor or exercised were over twice as likely to be pain free when compared to those who used only medicine. The patients treated by a chiropractor experienced the highest rate of success with 32 percent saying they were pain free, compared to 30 percent of those who exercised. Only 13 percent of patients treated with medication said they no longer experienced pain.
As a chiropractor this does not supries me since neck pain is a mechanical problem. It makes sense that mechanical treatment such as chiropractic care and exercies work better than a medicin which is a chemical solution. The pain is not due to difficiny in anti-inflamatories. Acording to an ABC world News report Dr. John Messmer who specializes in family medicine at Penn State College of Medicine agrees. “I always prescribe exercises and/or physical therapy for neck pain,” he wrote. “I also tell patients that the exercises are the treatment and the drugs are for the symptoms.” The exercises prescribed to patients in the study were simple and designed to be performed at home with the help of instructional photos, see the exercies here (http://www.annals.org/content/suppl/2011/12/29/156.1_Part_1.1.DC1/156-1-1-supplement.pdf).
You must also keep in mind the other finding in the studie that chiropractic care was actualy mor effective than even exercise so if your Doctor only perscribes exercises and Physical theripy remind them that chiropractic is more effective and can work well with thes two treatment options. It is also important to remember that chiropractic care is not for just neck pain and back pain but a good chiropractor should be part of your health and wellness team. I will even assign exercises to go with the chiropractic care increasing the effectiveness of treatment.Paul R. Mahler Jr. DC Mahler Family Chiropractic Center 1144 wyoming Ave. Kingston, PA. 18704 http://mahler-chiropractic.com May be reproduced in whole only. We can treat car accidents including neck pain, back pain, rotator cuff, foot pain, carpal tunnel, and much more.
Deep tissue massage and chiropractic work well together it is not always one or the other.
We recently had a patient in the chiropractic clinic that trapped a nerve in their neck and needed a mix of treatments from the Chiropractor and deep tissue massage. Through the first stages of the injury the patient shoulder and neck muscles had gone into spasm and proved to be too tender to receive a chiropractic manipulation. Deep tissue massage alternatively could be familiar with loosen from the muscle spasm allowing the region to wind down. The tenderness across the shoulder and neck decreased after receiving several massage treatments. The individual ended up being in a position to receive chiropractic manipulation to complete the treatment programme therefore regaining full range of motion without pain that helps and to prevent reoccurrences from the injury.
When asked which treatment methods are better deep tissue massage or manipulation with a chiropractor then the answer then is neither as both treatments put in place the procedure and repair off musculoskeletal health.
Mahler Chiropractic Comments
A lot of people believe most chiropractors just offer manipulation. We presume it is important to treat each complaint while using best researched answer to that specific case, in lieu of practising only that which you are comfy with or exactly what a particular clinic offers. It really is that is why we help GP, physiotherapists, sports masseurs and also cranio sacral therapists. We do this to ensure that each person gets the most appropriate maintain their complaint. As practitioners we’re constantly developing our skills, learning new techniques and researching alternative therapies.
Deep tissue massage is designed treat the soft tissues of the body including muscles and connective tissue (ligaments and tendons). Using such techniques as trigger pointing. Pressure is applied to increase blood flow to the injury to reduce pain and inflammationPaul R. Mahler Jr. DC Mahler Family Chiropractic Center 1144 wyoming Ave. Kingston, PA. 18704 http://mahler-chiropractic.com Article is provided by seolink.com We can treat car accidents including neck pain, back pain, rotator cuff, foot pain, carpal tunnel, and much more using these techniques.
Treating chronic back pain and neck pain from a whiplash injury
After a car accident neck pain is one of the primary complaints. This is due to the fact the the head weighs around 10 lbs and during acceleration and deceleration that can create a lot of force on some of the smaller muscles and ligaments of the body, the result is whiplash and neck pain. After a whiplash injury, it is fairly common for people to suffer from chronic neck pain and back pain. During a chiropractic examination certain factors in a patient’s history an physical exam can be used to evaluate for this possibility. This process will help the chiropractor identify the patient who is at risk of developing chronic pain resulting from a whiplash injury, so that aggressive preventative measures can be taken.
At Mahler family Chiropractic Center, in Kingston Pa, the general approach to managing a patient’s chiropractic treatment is critical to the success of preventing chronic pain from a whiplash injury.
- It is important that the patients pain be reduced in the first several weeks of treatment.
- After This the focus shifts toward restoration of the function of the patients joints and muscles using both active and passive therapy procedures. This also means helping the patient return to work, home and recreational activities as soon as possible. The transition back to these activities is often gradual and takes time. It is important for the chiropractor to get the patient back to these activities even if the patient is not sure that he or she can engage in them fully.
- It is important that the patient gets back to normal activities and restoring the patients confidence after a whiplash injury is an important part of the chiropractor s job and also important for rehabilitation.
- Exercise, both for the purpose of correcting faulty movement patterns and instability, and for general fitness, is important in this effort to treat a whiplash injury.
Teaching the patient that hurt does not necessarily mean harm and the nature of chronic pain means placing focus on those activities the patient can do, rather than those they can not perform. This is a major part of treating chronic pain and in disability prevention after a whiplash injury. At Mahler Family Chiropractic Center we integrate the strategies explained above to develop the most effective approach for recovering from a whiplash injury and preventing future episodes of back pain.Paul R. Mahler Jr. DC Mahler Family Chiropractic Center 1144 wyoming Ave. Kingston, PA. 18704 http://mahler-chiropractic.com May be reproduced in whole only. We can treat car accidents including neck pain, back pain, rotator cuff, foot pain, carpal tunnel, and much more.
Chiropractic health care a drug free solution!
Chiropractic is a health care system that targets the central nervous system via the spinal column to help maintain good health. A chiropractor leverages the recuperative power of the body to cure itself naturally and efficiently. Chiropractic health care focuses on the connection between the vertebral column alignment and performance as coordinated by the nerve network and how that association affects the preservation and regaining of health.
Chiropractic care involves analyzing and treating the cause of disease which occurs when the spinal column is misaligned or subluxated. The bones of the spinal column when misaligned interrupt the messages of the nerves in the central nervous system. These messages balance and control cells, tissues, and organs of the body. Chiropractors address these subluxations and by delicately changing the alignment of the vertebrae, reduce or alleviate abnormal communication in the nervous system permitting the human body to appropriately operate and repair.
A Chiropractic Physicians Treatment is Distinct from Traditional Medical Care
If you’re considering visiting a Kingston Chiropractors or a Chiropractor near Wilkes Barre PA for the 1st time, you’re most likely wondering what kind of results you can anticipate. Having realistic expectations is important. A Chiropractic specialist’s will explain the chiropractic process and therapy and how it is being presented may have a vital role in the satisfaction with the adjustment you receive. Your experience will be improved by an explanation leading to understanding of the service itself, but don’t mistake chiropractic treatment for medical therapy. A chiropractors is not meant to replace medical physicians. A Medical Doctor addresses disease while a chiropractic specialist focuses on health. Not having a disease is very different than actually being healthy. The purpose of chiropractic therapy is to improve your health and well-being not simply to treat your illness.
Before visiting a chiropractor it is important to under stand that chiropratic is not just for back pain, neck pain and othe phisical aliaments but for over all health. As well as over all health a chiropractor can help manage auto accidents, carpal tunnel syndrome, fibromyalgia, headaches, migraines, herniated disc, neck pain, sciatica, sports injuries, scoliosis, back pain, and much more. A chiropractor can treat infants, the elderly, children, audults, children with special needs, and pregnant women. Chiropractic physycians are for much more than just neck and back pain.
Can a Chiropractic Physician Help?
The short answer is often yes. Spinal subluxations are generally due to stress that overwhelms the body’s resilience and coping ability. This stress can be physical stress and can occur as the result of an automobile accident or slipping on a wet sidewalk, improper posture, occupational trauma, or birth trauma. It can be emotional stress as a result of heavy emotional shock or the inability to adjust to a stressful event, or even chemical shock as a result from the inappropriate usage of prescription or illicit drugs, inadequate food stuffs, or environmental poisons. These misalignments disrupt the standard function, reducing your body’s capability to operate, evolve, and heal from injuries by creating interference within the nervous system.
Chiropractic Physicians address these misalignments by delicately fixing the alignment of the backbones of the spinal column, reducing or alleviating abnormal messaging so permitting the body to properly self regulate, adapt and regenerate. The care and upkeep of the spinal column and nerve system is a necessary component of healthcare. Spinal hygiene is more important that dental hygiene but often neglected due to lack of understanding. Your Wilkes Barre and Kingston PA Chiropractors will assist you to start chiropractic care with this understanding so you will appreciate the whole process of recieving chiropractic therapy.
Ab Workouts If you have a killer ab workout share it with other in the comments section of this blog.
Individuals are continuously inquiring of me which the very best ab exercises are to get a flatter stomach. The typical belief that ab exercises should improve you to get rid of belly fat is among the main mistakes I encounter daily as a health and fitness professional. Almost every person has differing levels of too much body type fat in the ab region, and the best method to burn off that~ extra abdomen fat continues to elude a lot of people today.
The dilemma is that most people are looking for the incorrect workouts and exercise sorts to shed difficult belly fat. Most people are seeking for a miraculous combination of abdominals exercises combined into the best abdominal workout ever created that will burn off their stomach fat quicker than you can examine this article.
Regrettably, ab-specific workouts do not eat up fat off of the stomach. Abdominal exercise won’t help in reducing belly. They only tone and reinforce the underlying abdominal muscles. The thing you really want to focus on is a total body strategic workout that will bring about a much better metabolism rise and fat-burning hormonal feedback from the training program as a whole.
In addition, basically carrying out cardiovascular exercises won’t essentially produce the best metabolic feedback or hormonal response either. The thing you genuinely need is a much more rounded exercise program which concentrates on working out the entire body using resistance work out routine and multi-joint exercises in a larger intensity style.
This kind of elevated intensity total body training routine merged with a healthy well balanced diet regime packed with nutrient denseness on a normal basis, is the real magic formula to losing the added stomach fat which covers up the ab muscles. Doing so is a considerably greater plan of attack in contrast to merely trying to do abdominal routines and wishing that simply carrying out a bunch of ab workouts like abdominal crunches and leg raises are will make you get rid of your stomach fat.
The incredible point is that the vast majority of the population still believes that to elimate belly fat, you need to do ab routines every day employing tons of of reps. I see individuals offering this sort of wrong advice daily on most of the physical fitness forums. Please do not use up your time with this breed of advice!
Now just before you say “how can an abs professional not propose ab workouts”, realize that I do strongly believe that a certain overall amount of abdominal-specific workout routines blended into your routines are useful. Abdominal workouts should improve you strengthen and tone the ab muscles and are helpful for other purposes such as a healthy back and posture when carried out correctly. But the actuality stays that ab exercises are not essential for fat loss.
A much smarter total body resistance training routine regimen and a clear wholesome diet are the prime factors. Quite a few of the full body workouts additionally indirectly work the ab muscles and core owing to the stabilization mandated in a worthwhile amount of the tough variations.
This Article was provided by an author from Seolink but has been red and approved by Dr. Paul Mahler of Mahler Family Chiropractic Center, Kingston, PA for posting on our blog. Check the comments section for Additional advice by Dr. Mahler.
The golf swing places a large amount of stress on the low-back, and over time the lower back becomes fatigued. This will results in a decrease in performance and possible injury.
So how do you prevent such an injury from occurring? Golfers can takes steps to prevent low back injuries. One of these steps is the implementation of a fitness program targeted at improving your golf game. Included in this routine will be exercises targeted at improving lower back flexibility such as the one above and strengthening the lower back to avoid injury and pain. This part of the program contains a series of golf-specific flexibility exercises geared to maintaining the range of motion within the lower back. One exercise to increase flexibility in the lower back is descried here. It is a simple exercise for the low back to improve flexibility and rotation during the back-swing, and it also helps keep the musculature of the lower back flexible.
Here’s how to perform the exercise. First begin the exercise by lying on your side with the left hip in contact with the floor, then bend both knees approximately 90 degrees, resting the right knee on top of the left. The second step is to extend both arms straight out from the shoulders, resting the left arm on the floor, and hands clasped together and slowly raising your right arm off the left. Finlay continue to raise and rotate the right arm until it is resting on the floor opposite your left arm and hold this position for 20-30 seconds, and repeat the exercise sequence by switching sides. This should be performed 2-4 times on each side. Remember, to go slow with a new exercise and, check with your physician before starting any new physical training program.
Keep in mind not all lower back injuries can be prevented, but with the implementation of a lower back flexibility and strengthening program, the possibility of one occurring to you can be greatly reduced.
Most acute low back injuries that occur during a game of golf will get better over a couple of days. The most common injuries from golf include, muscle strains which typically occurs with rough or forceful golf swings or a sudden shift during the downswing, muscle and tendon sprains which generally occurs due to excessive use, accidents or swing abnormalities while playing golf, and disc injuries which can occur from swinging abnormalities. It is important to not that disc injuries may be present but symptoms may not occur without the incorrect golf swing (see preventing golf injuries).
For relief of the miner low back pain and to promote healing from golf-related injuries and low back pain, it is generally advisable to rest for a day or two, and apply ice. It is advisable not to further stress inflamed muscles by continuing to play golf through an episode of low back pain. If you take time off the injury will often heal quicker allowing you to get back to golf sooner. It is important to continuing stretching and exercise programs between golf sessions. A low-impact aerobic exercise program, such as walking for 30 to 40 minutes every other day can be helpful and after the low back pain has stopped, slowly return to playing golf and apply the prevention tips to help avoid injuries.
It is well known one of the most common injuries in golf is the lower back. Research indicates more than half of all golfers will incur a lower back injury at some time during their playing careers. Professional golfers spend great deal of time and energy preventing low back injuries. So prevention in this case is the best medicine. If you do injure your low back and the pain continues for more than a few day to a week, a specific problem may be the cause of the back pain and a chiropractic professional should be consulted. Chiropractic are uniquely train in neuromuscular injuries and can often help get you back on the links sooner, you might even shave a stroke or two off your game.Contact a chiropractor By: Paul R. Mahler DC mahler-chiropractic.com may be reproduced in whole only
Should I pick ice or heat? Ice is almost always safe, where heat can cause more damage to the area of injury. If you have an ice allergy or major vascular problem you should consult your physician first. Heat on the other hand is a great pain reliever but it increases inflammation. In conditions such as back injuries, sprains or strains and sports related injuries more inflammation equals more tissue damage and a longer period to heal.
So if you have low back pain or neck pain you should initially use ice until consulting with a physician. To use ice apply for 15 to 20 min. then leave off for at least an hour. If you use anything other than water ice put a towel or tee shirt between you and the gel pack. The gel pack is the temperature of the freezer and can give you ice burn otherwise.
It is important to remember that the acute phays can last several weeks due to re injury and does not necessarily fit the ice for three days while acute then use heat.
Six great exercises to rehabilitate, strengthen, and prevent injury of the shoulders.
1: Scapular Retraction: For this exercise, you will need elastic exercise material, such as Thera-band.
- Put the band around a solid object, at about waist level. Each hand should hold an end of the band.
- With your elbows at your sides and bent to 90 degrees, pull the band back to move your shoulder blades toward each other. It should feel like you are trying to hold a pencil between your shoulder blades.
- Return to the starting position.
- Repeat 8 to 12 times. and up to 3 sets
As you improve and If you have good range of motion in your shoulders, try this exercise with your arms lifted out to the sides, with your elbows at a 90-degree angle. Raise the elastic band up to about shoulder level. Pull the band back to move your shoulder blades toward each other. Return to the starting position
- Attach elastic to secure object at waist level.
- Place a rolled up towel between elbow and body.
- Grasp elastic in hand, elbow bent to 90 degrees.
- Rotate arm outward and return.
- Slowly return to start position and repeat.
- Do 8-12 reps and up to 3 sets. Do both shoulders see guidelines below.
- Secure elastic at waist level.
- Place a rolled up towel between elbow and body.
- Sit or stand with involved side to elastic,
- Grasp elastic and pull hand inward, across body, as shown.
- Slowly return to start position and repeat.
- Do 8-12 reps and up to 3 sets. Do both shoulders see guidelines below.
4: Shoulder Flexion
- Stand on elastic.
- Begin with arm at side, elbow straight, thumb up.
- Grasp elastic.
- Raise arm in front over head, keeping elbow straight.
- Slowly return to starting position.
- Do 8-12 reps and up to 3 sets. Do both shoulders see guidelines below.
5: Shoulder Extension
- Secure elastic at waist level as shown.
- Grasp elastic and pull arm backwards keeping elbow straight.
- Slowly return to start position.
- Do 8-12 reps and up to 3 sets. Do both shoulders see guidelines below.
- In the first week place the stability ball on a wall about the level of your chest with feet out from the wall.
- As you improve work you way to the floor this is harder than it sounds be careful.
- Lay with your chest on the stability ball
- Place your hands at the sides of your chest.
- Place your toes on the floor, legs straight.
- Push your body up until your arms are almost straight (do not lock your elbows).
- Hold and balance for two seconds.
- Slowly return to the starting position and repeat.
- Do 8-12 reps and up to 3 sets.
It is important to remember that for is the most important thing wen performing these exercises not the amount of weight or repetitions, so start slow and work into the shoulder exercise over several weeks. It is also important to work both shoulders evenly don’t neglect the good shoulder but keep it light with the good shoulder until the injured one caches up. It is important to maintain balance at all time you don’t want to injury the good shoulder so if you can only do 8 reps on the injured side do 8 with the good side.
Start with exercise 1,2, and 3 on week one, In week 2 to 4 add exercises 4 and 5. and after 1 to 2 months add exercise 6. The rate at which you add these exercises depends on how you feel don’t over do it but keep moving forward. This is a routine that should be performed 2-4 times a week for the rest of your life. It will help you avoid future injuries as well and can be used to prevent rotator cuff injuries. The bad shoulder will catch up don’t worry and good luck.
Exercise mistakes are common, correct them before you injure yourself!
Sixty percent of people who initiate an exercise program wind up injuring themselves in the first month, and if you are hurt you will never reach your fitness goals. Most people who start an exercise program either want to burn fat or build lean muscle mass. So how do we work smarter and safer to achieve our fitness goals.
First and foremost is proper form, if your form is not correct, you need to reduce the amount of weight you are using and/or slow down. Proper form is too important to ignore, weather it is a workout for the shoulder or exercises for the back . If you can not maintain proper form then you are trying to do too much and it will result in not achieving your goals. Correct form is key when doing any exercise. If you want to get the most out of your workouts, you have to use correct form. There is a right way to exercise and a wrong way to exercise, and this applies to each and every exercise you perform. Lack of proper form is the number-one cause of injuries. Most of the time, when a person tries mimic someone in the gym, the person they are looking too as a model saw someone else do the exercise and they are doing it wrong as well.
Next lets review sets and repetition. If you are trying to gain muscle or get stronger,you want to do low reps and higher sets. You put on a heavier weight and do 6-8 reps per set, with proper form, for 4-5 sets. On the other hand, if you are just trying to build endurance and lean out, then you should typically do 15-20 reps per set for 2-3 sets. If your goals are some were in-between then these two can be blended to archive your own personal goals.
Lat pulldown, pulling bar behind neck can cause serious injury to the shoulder. The correct way is pulling bar down in front of you while squeezing your back muscles.
Push-ups, you should never have a dip or arch in your back or lock your arms. The correct way is Arms should be underneath you and not locked, back parallel to the floor, and engage your core muscles the entire time.
Walking lunges, when performing a lunge, do not extend the front knee past the front foot this will cause injury at some point. The correct way is when you are in a split stance, go straight down and do not let your front knee go past your foot.
Leg press, your knees should not be by your ears; that is not a position your knees are used to being in, especially under heavy weight. The correct way is to keep 80 percent of the weight in your heels; press out and go a little past 90 degrees.
Abs crunches, pulling the head up as you’re doing a crunch. The correct way is relax your head and bring your shoulders off the ground, engaging your abs and rotating your hips to the ground.
Squats, knees coming forward over your toes is not correct. The correct way to perform this exercise is as if you were sitting back on a chair and putting 80 percent of your weight on your heels. Then lean slightly forward so you won’t fall back.
Chest press, lifting the weight using your back (high arch). The correct way is keep your back flat and relax your shoulders while lifting the weight.
Cardio is something that lots of people do wrong. You should not do an hour of straight cardio unless you compete in endurance events such as marathons. I recommend high-intensity training short sets repeated often. An example of this would be a 30-second sprint or quick walk followed by a 60-second jog, then another 30-second sprint, repeat that cycle about 10-12 times. This form of interval training will get improved results in less time.
Frequency can be another problem the body needs to rest and rebuild it is better to train 2 to 3 days with a day or two in between for the body to recover. This will help you avoid repetitive injuries and alow for balance in your life.
Movements to Avoid When Exercising:
1. Using jerking motions, especially when lifting. Speed is fine when done appropriately, but you should always have fluid motion and proper form when performing any and all exercises; otherwise you could strain or even tear something.
2. Using body parts not required for the exercise. Have you ever seen people doing biceps curls and rounding their shoulders or arching their backs? Those are just two of the big no-no’s that can lead to injury.
3. Locking out your knees or elbows. Never lock your joints when working out; keep them slightly bent so the weight will not be transferred to the joints.
4. Arching your back. Picture someone on the barbel bench press, lifting a weight that is actually too heavy for them. Chances are that eventually, they will start arching their back. Sooner than later, that back is going to give out and they won’t be able to exercise for days, weeks or even longer.
Lets start out those new Year exercise programs right and have a long healthy year.By: Paul R. Mahler Jr. DC Mahler Family Chiropractic Center 1144 wyoming Ave. Kingston, PA. 18704 http://mahler-chiropractic.com May be reproduced in whole only. We can treat sports injuries including shoulder pain, rotator cuff, ankle pain, foot pain, knee pain, and much more.
Scoliosis is not a disease it is a descriptive term that refers to an abnormal spinal curve. All spines have curves these are normal in the neck, upper back and lower back it is normal to find anterior to posterior curves. Humans need these spinal curves to help the upper body maintain proper balance and alignment over the pelvis. Scoliotic curves are a right to left translation not an anterior to posterior translation and this leads to weakness and instability in the spine.
Who is at risk?
Scoliosis affects 2% of women and 0.5% of men in the general population. Scoliosis may be caused through several mechanisms, including congenital spine deformities, genetic conditions, neuromuscular problems and limb length inequality. Additional causes of scoliosis include cerebral palsy, spina bifida, muscular dystrophy, spinal muscular atrophy and tumors. Over 80% of scoliosis cases are idiopathic, which meaning we do not know the cause. Most idiopathic scoliosis cases are found in otherwise healthy people.
Idiopathic scoliosis is found in three categories based on age. The first is infantile found in children ages 3 and under. The next type is juvenile scoliosis found in 3-9 years old. Finally we have adolescent scoliosis found in10-18 years old. Not often but in very rare case scoliosis can occur in adult hood due to trauma. The most common form of scoliosis, representing approximately 80% of idiopathic scoliosis cases, is Adolescent Idiopathic Scoliosis (AIS), which develops in young adults around the onset of puberty. Adolescent scoliosis is often due to a rapid growth cycle in which the bones grow faster than the soft connective tissue, tendons and ligaments, and leads to an imbalance from one side to another.
People with a family history of spinal deformity are at greater risk for developing scoliosis and early detection is essential. If a scolioses curve is discovered before the growth plates close in a persons early twenties there is high likely hood of partial or complete correction.
About Scoliosis: Symptoms
The warning signs of scoliosis are shoulders are different heights, one shoulder-blade is more prominent than the other, head is not centered directly above the pelvis, appearance of a raised, prominent hip, rib cages are at different heights, uneven waist, changes in look or texture of skin overlying the spine, and leaning of entire body to one side. These can all be signs but don mean you have scoliosis you should see your chiropractor for a complete evaluation and remember that x-ray is the best way to diagnose scoliosis.
A standard exam that is often used by chiropractor is called the Adam’s Forward Bend Test. Most children should be tested in the fifth or sixth grade. For this test, the patient is asked to lean forward with his or her feet together and bend 90 degrees at the waist. The examiner can then easily view from this angle any asymmetry of the trunk or any abnormal spinal curvatures. It should be noted that this is a simple screening test scoliosis is usually confirmed with an x-ray of the spine. The curve is then measured by the Cobb Method and is discussed in terms of degrees. Generally speaking, a curve is considered significant if it is greater than 25 to 30 degrees. Curves exceeding 45 to 50 degrees are considered severe and often require more aggressive treatment or surgical intervention. The chiropractor may also conduct exams to test reflexes, motor and sensory functions, and breathing ability. After a diagnosis is made, your doctor will suggest a treatment plan.
Once scoliosis has been diagnosed there are several factors to take into account when discussing treatment. Spinal maturity, is the patient’s spine still growing and changing? Degree and extent of curvature, how severe is the curve and how does it affect the patient’s lifestyle? Location of curve, according to the Scoliosis Research Society, thoracic (upper spine) curves are more likely to progress than thoracolumbar (middle spine) or lumbar (lower spine) curves. Potential for progression, patients who have large curves prior to their adolescent growth spurts are more likely to experience curve progression.
After all the test and exams are assessed there are four treatment options for scoliosis: (1) observation, (2) orthopedic bracing, (3) surgery, (4) chiropractic care
Chiropractic Care:Spine Treatment
Chiropractic care is non-invasive Treatment for scoliosis. This means that when undergoing treatment you do not have to take any prescription drugs or go through a surgical procedure. The process is all natural and drug free. This is because the main principle of chiropractic is to focus on the body’s own natural healing abilities. Chiropractic treatment deals with the adjustment of the spine and according to the research conducted by the National Scoliosis Foundation, chiropractic adjustment has been found to be a good alternative treatment for those who suffering from scoliosis. Chiropractic treatment for scoliosis may involve several procedures depending on the severity of the condition. These treatments may include spinal manipulation, active exercise methods, and postural counseling.
So how can chiropractic treatment help you with your scoliosis? Chiropractic care does not only treat the current problems that are associated with scoliosis but it can also help in alleviating and controlling the symptoms that comes with it. Scoliosis patients who have been treated with chiropractic care have reported to have reduction in the size of the curves, measured using the Cobb Method. This does not happen overnight. Chiropractic care for scoliosis requires multiple visits in order for the patient to experience its full benefits. A chiropractor can also monitor your progress to ensure that you are doing the right thing and to see if the treatment yields favorable results. A chiropractor will recommend you to check with another medical specialist if he or she thinks that is the best course of action for you regarding your condition.By: Paul R. Mahler Jr. DC Mahler Family Chiropractic Center 1144 wyoming Ave. Kingston, PA. 18704 http://mahler-chiropractic.com May be reproduced in whole only. We can treat scoliosis and back pain including sciatica, disc, herniation, slipped disc, stenosis, and much more.
What is sciatica? Sciatica is a set of symptoms and not the disease itself. If you have some or all of the following symptoms you may have sciatica. These symptoms include leg pain associated with numbness, tingling, and weakness but the pain id coming from the nerve and it is a nerve pain. Sciatica is caused by pressure on nerves located in the lumbar spine or the sacrum, and is often present in conjunction with low back pain. Sciatic pain and numbness is felt along the path of the nerve and travels trough the buttock and down the back of the leg into the foot. Sciatica is named for the nerve that it follows the sciatic nerve. sciatica is a symptom of an underlying condition and is not a condition of its own. While often simple in nature there can be sever underlying factors associated with sciatica and medical intervention may be required A chiropractor can diagnose and treat sciatica and will let you know if there is any immediate danger. There can be many causes for sciatica and many of them are simple.
What is the sciatic nerve?
The sciatic nerve originates from the lumbo-sacral spine and travels down the leg all the way to the great toe. Sciatica follows the path of this nerve. There are two lumbar nerve roots and three sacral nerve roots that are involved in the sciatic nerve. These nerve roots are the 4th and 5th lumbar nerve roots and three sacral nerve roots which are the 1st, 2nd, and 3rd sacral nerve roots. These are the five nerve roots involved in creating the sciatic nerve. The sciatic nerve is what supplies the nerves to the leg from the buttocks to the foot.
The Six Common Sciatica Causes
It is important to understand the underlying causes of sciatic when treating it. There are six common causes of sciatica and several less common causes. The first 4 causes can be more difficult to treat but the final two are the lest degenerative cause and highly treatable, as well as the most common two reasons for sciatica.
- Herniated disk is one of the first causes to rule in or rule out.
- The second cause of sciatic that must be check out is lumbar spinal stenosis. Due to a narrowing of the spinal canal pressure is put on the nerve roots that make up the sciatic nerve. Stenosis is relatively common in adults over age 60.
- Degenerative disc disease is the next culprit to check out. Disc degeneration as people place stress on there low back over a life time disc’s can be damaged. When someone has one or more degenerated disc’s they can put presure on the sciatic nerve causing sciatica. Degenerative disc is an earlier stage of disc degeneration.
- The fourth cause of sciatica is isthmic spondylolisthesis. This condition occurs when a small stress fracture allows one vertebral body to slip anterior on another vertebral body.
- The next cause is piriformis syndrome. The sciatic nerve runs under the piriformis muscle and the muscle can irritates or pinches the sciatic nerve . This is not a true radiculopathy, but the leg pain can feel the same as sciatica caused by a nerve irritation.
- Finally we have sacroiliac joint dysfunction, which is commonly seen and treated by chiropractors. Inflammation or scare tissue in the sacroiliac joint can also irritate the fifth lumbar nerve, which lies on top of the sacroiliac joint, causing sciatica-type pain.
Sciatica may also be cause by changes in the body that occur during pregnancy, including weight gain, a shift on one’s center of gravity, and hormonal changes. Sciatica can also be caused by scar tissue, muscle strain, and in rare cases spinal tumor or infection. It is important to know the underlying cause of sciatica so it can be properly treated. The cause of sciatica may change or modify the treatment used.
Symptoms of Sciatica
The symptoms of sciatica are different from muscle aches and pains. Some of the clues you many have sciatica are constant pain in one, or some times both, sides of the buttock or leg, pain that is worse when sitting, Burning or tingling down the leg, weakness, numbness or difficulty moving the leg or foot, a constant pain on one side of the rear, and a sharp pain that may make it difficult to stand up or to walk. These are all related to the pressure on the nerve and not due to actual dysfunction of the leg. Sciatic pain comes in many forms and flavors. It varies from infrequent and irritating to constant and incapacitating pain that affects every day life. The symptoms are as varied as the pain and may change in location and severity, depending upon the condition causing the sciatica. Sciatica can be very painful but it is important to note that it is rare that permanent nerve damage will result. It should be noted at this time that the one symptom that should never be ignored when sciatica is present is loss of bowl or balder control if this happens seek immediate medical attention and call 911, this can be a life threatening condition.
Sciatic neuritis or sciatica is an irritation and inflammation of the great sciatic nerve which is also the largest nerve in the body. The pain quality ranges from dull, sharp, burning or electrical and it may be accompanied by numbness, tingling, muscle weakness in the affected leg and the feeling of pins and needles. The symptoms may vary in intensity and in the frequency. Classic sciatic pain radiates from your lower back into to your buttock and down the back of your legs. Sitting, coughing, or sneezing will increase the symptoms of sciatica by increasing inter abdominal pressure.
Sciatica symptoms vary based on where the compressed nerve root is located. The forth lumbar nerve root symptoms usually affect the thigh. Patients may feel weakness in straightening the leg, and may have a diminished knee-jerk reflex. While fifth lumbar nerve root sciatica symptoms may extend to the big toe and ankle. Patients may feel pain or numbness on top of the foot, and between the big toe and second toe. Finally in first sacral nerve root includes the outer part of the foot is involved and it may radiate to the little toe. Patients may experience weakness when raising the heel off the ground or trying to stand on tiptoes. If multiple nerve roots are compromised the patient may experience several of these symptoms at once.
In rare cases sciatica symptoms that worsen quickly may require immediate surgery. The following symptoms indicate a need for immediate medical care may be necessary. Sciatica symptoms that continue to get worse rather than improve, which may indicate possible nerve damage, especially if the progressive symptoms are neurological. Symptoms that occur in both legs and cause either bladder or bowel incontinence or dysfunction, which may indicate cauda equina syndrome. Cauda equina syndrome extremely rare but found in 2% of herniated lumbar disc cases.
Patients should seek immediate medical attention if they experience any of the above symptoms.
Chiropractic Approach (Treatment for back pain and sciatica)
Most chiropractor use several treatment to treat sciatic and it is often based on the location and cause of the sciatic. Chiropractic adjustments to the spine & lower extremities are some of the most common types of treatments used by chiropractors. Spinal adjustments and manual manipulation performed by appropriately trained chiropractor are focused on providing better spinal alignment, which helps to address a number of underlying causes sciatic nerve pain. Manual manipulation done to address the right indications by appropriately trained chiropractor can create a better healing environment and should not be painful. In addition to chiropractic adjustment your chiropractor will probably use a combination of physiotherapies, active care rehabilitation, nutritional support, and laser therapy (to reduce inflammation & provide specific nourishment to the peripheral nerves). This approach is safe, non-invasive and non-toxic. If you have been suffering with sciatica call our office to schedule a free, no-obligation consultation. We can sit down together and discuss your case. I look forward to speaking with you soon!
Medical Approach to Sciatica
The medical approach to treating sciatica is with drugs including anti-inflammatories, analgesics and steroids. Drugs will not cure sciatica. They will only temporarily mask symptoms.
The surgical approach to treating sciatica often involves removing part of the disc (discectomy), or cutting away part of the vertebrae (laminectomy). 50% of all spinal surgeries fail (meaning that the patient’s symptoms are unresolved after a 3 year follow-up). There are always risks involved with surgery including complications, infection and even death. Surgery should ALWAYS your last resort, not your first approach.By: Paul R. Mahler Jr. DC Mahler Family Chiropractic Center 1144 wyoming Ave. Kingston, PA. 18704 http://mahler-chiropractic.com