Dorsiflexion is a important movement that occurs in the ankle. Dorsiflexion the ability for the ankle to bend upward towards your head. We need a minimum of 10 degrees to have good functioning ankle. Its common to lose this motion. Pointing our toes down is called plantar flexion. Look at this patient feet. The left ankle lost its dorsiflexion.
I want to thank the patient for lettings me use these pictures.
Loss of range of motion can be treated with with adjustments and home exercises. Look at how much better the ankle bends after an adjustment to the foot and ankle. This patient responded very well. He is young and the problem was not going for too long so he responded super well.
Patient was also given one strengthening exercise as well as a stretching to do at home to help him heal faster.
We treat ankle pain all the time here at Sikorsky Chiropractic. If you’re experiencing any pain or an injury to your ankle give the office a call!
New research has re-affirmed that weakness of one cervical muscle group is closely tied to chronic neck pain. This unit is also implicated as a provocative factor for cervical radiculopathy, cervicogenic headache, and cervicogenic vertigo.
A 2020 JMPT study re-affirmed that weakness of the deep neck flexors is common in cervical radiculopathy patients:
“Current results confirmed the presence of cervical multifidus and longus colli muscle atrophy in subjects with chronic radicular neck pain.” (1)
The deep neck flexors include four muscles that lie behind the trachea on the front of the cervical spine. The group includes the longus colli, longus capitis, rectus capitis, and longus cervicis. Due to their proximity to the spine and their short length, the muscles are primary stabilizers of the cervical spine.
If you’re experiencing neck pain contact the office! We help ease neck pain every day.
Amiri-Arimi S, Bandpei MA, Rezasoltani A, Javanshir K, Biglarian A. Asymmetry of Cervical Multifidus and Longus Colli Muscles Size in Participants With and Without Cervical Radicular Pain. Journal of Manipulative and Physiological Therapeutics. 2020 Mar 1;43(3):206-11.
I love when a study confirms what I’ve been telling patients. I recommend fish oils to most of my patients.
This study confirms the importance of fish oils. A meta-analysis of 40 clinical trials found that supplementation with fish oil is associated with a 35% reduced risk of fatal heart attacks, a 13% reduced risk of heart attacks, and a 9% reduced risk of fatal coronary heart disease.
Specifically, the study found that EPA+DHA supplementation is associated with a statistically significant reduced risk of:
The study found that cardiovascular benefits appear to increase with dosage. The data showed that adding an extra 1000 mg of EPA and DHA per day decreased the risk of cardiovascular disease and heart attack even more. For example, the risk of cardiovascular disease events decreased by an additional 5.8% and the risk for heart attack decreased by an additional 9%.
Continue to take your fish oils supplement or even increase the dosage. It might help save your life!
If you have questions on where to begin, please call the office. Not only can Dr. Steve get you on the right track with supplements but we have them for sale.
Far too often in today’s healthcare system, patients are being let down by their healthcare providers. As the patient, you deserve to be guided back to health appropriately and efficiently. Too many injured and ailing people are not being thoroughly evaluated, therefore not receiving appropriate conservative care, nor are they given a game plan to prevent the pain or injury from returning in the future. There are many types of ailments and illnesses, but for the purpose of this article we will be discussing musculoskeletal pain and injuries.
There are 3 fundamental aspects of care you deserve as the patient
Comprehensive Evaluation and Assessment
Conservative Treatment Options
Prevention Training
Comprehensive Evaluation and Assessment
Too often a patient presents to their primary care physician or specialist and they are given a proper history and consultation, but a very low-level musculoskeletal exam. Many times, the doctor doesn’t even assess the muscle tissue, joint function and/or the movement of the patient. In many cases they perform a few orthopedic tests, may refer you for some diagnostic imaging, before concluding that you must rest for 6 weeks and finally prescribe you some medication to help “manage” your condition.
As a patient it is important to understand what you should expect from a comprehensive evaluation and assessment. Your evaluation and assessment should provide you with a working diagnosis and the potential indirect causes of the pain or injury. The diagnosis should be specific and clearly communicated.
In order to determine an appropriate working diagnosis a comprehensive evaluation should include, but is not limited to:
A thorough History & Consultation
Functional Assessment: Assessing weakness, tightness, faulty movement patterns.
Orthopedic Exams, Range Of Motion, Neurological testing as needed.
Muscle and Joint Palpation/Testing.
Gait Analysis (if deemed necessary)
When a thorough evaluation and assessment is performed it provides the healthcare provider with the information required to determine the appropriate course of care. This allows for an informed decision regarding which conservative treatment options would be best suited for your individual case.
Conservative Treatment Options
In my opinion, you deserve to have a comprehensive hands-on approach to your pain or injury. Most patient presentations respond best to a specific combination of therapies. This may include muscle therapy, joint restriction chiropractic adjustments, rehab exercises, and advice on how to train and prevent further exacerbations of the injury. You may not need both the muscle therapy and chiropractic adjustment for all pain or injuries, but many will optimally benefit from all four approaches above.
Conservative treatment should not be a “one size fits all” approach. With multiple therapies available, each which targets different tissues it is important that your care plan is individualized based on the findings from your comprehensive assessment.
Prevention Training
There are few things more frustrating from both the patient’s or doctor’s perspective than the return of the pain or injury. There are many potential factors that can contribute to re-aggravation of your injury or symptoms. These include over-use strain from work, life or sport, not following the prescribed exercises, or the lack of injury prevention training from your healthcare provider. As an informed patient, these are a sample of some prevention options you should expect instructions on.
Activities of Daily Living Training: Many activities we do in our daily life cause physical strain when performed improperly.
Return to Work/Sport Advice: Proper time frame for return and potential modifications.
Body Awareness and Preparation: Proper lifting, bending, posture, etc.
Corrective Exercises: Core stability exercises.
Desk Ergonomics Tips: Desk sitting is causing many of your conditions.
Proper Equipment recommendations: Proper running shoes for a runner.
Skills/Technique Training: Golf swing technique from a teaching professional.
To summarize, there are many potential shortcomings that you may experience when you see any healthcare provider for your musculoskeletal pain or injury. The first step is being an informed patient, and understanding what quality care entails. I have outlined some key points that you as an informed patient should come to expect from your provider when you seek treatment for any musculoskeletal condition.
A comprehensive assessment including but not limited to a thorough history, a functional movement assessment, palpation (assessing by hand) of the joints, muscles, tendons and ligaments
An exam that assesses the body as a whole in order to determine the root cause, and does not only focus on the point of pain. For example, many times a patient with low back pain has hip range-of-motion and mid-back mobility issues that have led to the low back being over-worked.
A specific working diagnosis based off of the comprehensive exam.
All your conservative treatment options should be explained and discussed, offering you a chance to ask any questions you might have and provide clarity regarding our plan.
You should expect to receive advice regarding preventative care for your injury, so once you are out of pain, you can avoid re-injury or aggravations.
Upper Cross Syndrome describes a type of common muscle imbalance.
This occurs when the neck flexors and the middle back become weak while the pectoral muscles and the muscles at the base of the skull become tight. This produces a familiar pain pattern at the base of the neck and the shoulders, as well as joint dysfunction at the base of the skull and shoulders.
Upper Cross Syndrome can lead to neck pain.
The main physical causes of this condition are:
Desk job
Too much sitting
Driving long hours
Poor posture
Working out incorrectly
How many hours a day do you sit in front? Photo by subham saha
However, with the proper education, you can protect yourself from many of these causes. The primary sufferers of this condition, especially chronic cases, often have poor posture while sitting at a desk for most of the day. A co-morbid factor is a sedentary lifestyle with little physical activity. This poor sitting posture leads to a re-enforcement of the Upper Crossed Syndrome, and it is crucial that you arrange your workstation to facilitate a proper posture as best as possible.
The best way to combat this problem is, of course, to prevent it before it starts.
If possible, minimize sitting for long periods of time and take frequent work breaks to take short walks around the office to reset your posture.
There are methods of rehabilitative exercise that can be taught to you to reverse any damage already done and prevent a progression of this condition, as well as instill healthy habits for you to employ for the rest of your life.
What You Can Do About It
If you are currently experiencing neck pain that you may believe is related to Upper Cross Syndrome, this condition can be conservatively managed relatively quickly. Make an appointment today and get on the road to recovery.
Does adding hip exercises to quadriceps exercises result in superior outcomes in pain, function and quality of life for people with knee osteoarthritis? The short answer is YES.
Anyone with Osteoarthritis in their knees knows how it can limit their life. For one example walking could become difficult and painful.
A study from the British journal of sports medicine has found strengthening the hips muscle can help with knee osteoarthritis.
Walking improved after the addition of hip strengthening to quadriceps strengthening in people with knee Osteoarthritis. The addition of resistance hip exercises to quadriceps resulted in greater improvements in patient-reported pain and function
simple but effective hip exercise
Key points
Land-based exercise reduces pain and improves function in people with knee osteoarthritis (KOA) over the short to medium term.
People with KOA have weakness in hip abduction is (7%–24% weaker than control patients).
Hip abduction strength is positively related to function in people with KOA.
Hip strengthening is beneficial compared with non-exercise interventions in people with KOA.
Hislop AC, Collins NJ, Tucker K, Deasy M, Semciw AI. Does adding hip exercises to quadriceps exercises result in superior outcomes in pain, function and quality of life for people with knee osteoarthritis? A systematic review and meta-analysis. British Journal of Sports Medicine. 2020 Mar 1;54(5):263-71. Link
“Obesity is associated with a higher risk of tendinopathy, tendon tear and rupture, and complications after tendon surgery than non-obesity.”
Medial epicondylitis: odds ratio (OR) 1.9
Achilles tendinopathy: OR 3.81
Patellar tendinopathy: OR 1.10
Plantar fasciitis: OR 2.97
Rotator cuff tendinopathy: OR 1.25
Rotator cuff tear: OR 2.35
Rotator cuff rupture leading to tendon surgery OR 3.13 – 3.51
Photo by Joenomias–2512814
Macchi M, Spezia M, Elli S, Schiaffini G, Chisari E. Obesity Increases the Risk of Tendinopathy, Tendon Tear and Rupture, and Postoperative Complications: A Systematic Review of Clinical Studies. A Publication of The Association of Bone and Joint Surgeons®| CORR®. 2020 Apr 14. Link
Having good running form is another way to prevent running injuries. There are many nuances to running form. We’ll discuss the big three. They are Cadence, Posture and Foot placement.
Cadence (Stride Length)
The amateur runner may not put much thought into their running beyond putting one foot in front of the other, however, if you are finding yourself with consistent pain in your shins or recurring lower leg injuries the way you run may be playing a role. New research has demonstrated that when you take a longer stride as you run, the ground reaction force on your legs will be increased. This increased force can lead to more injuries and micro traumas that can lead to chronic injuries and discomfort.
With Cadence think quick feet. A faster stride will reduce the amount of time you spend on the ground and decreased ground-reaction force. This reduces the impact on your body gets hitting the ground.
If you think that this may be affecting your ability to run pain-free, try taking some shorter runs and actively think about taking shorter steps while running. Your legs will have to move faster to maintain the same pace as before. It will take some time to retrain your brain to alter your running pattern, but with some regular training, you should be able to make the transition.
Photo by sasint–3639875 See how long her stride is? If the foot is landing far in front of you, your cadence is most likely low.
Posture
Good posture will help you run with less pain and prevent injuries. Basically good posture will create good running posture. Your head should be over your ribcage and your rib cage should be over you pelvis and pelvis over your feet. This posture will let you run using less energy. If your posture is good it will be easier to fill your lungs with air. Next is to engage your core and build midline stabilization.
Foot Placement
Stand with your feet shoulder width apart. This is a very stable position. Now stand with one foot in front (heel to toe). That’s harder right? Standing this way or running this way takes a lot of balance and energy. We’ll call this cross over gait. When we run we should land with our foot under our knee and our knee under our hip. This will support your center of mass better. Think leaning tower of Pisa, the top is not over the bottom making it unstable.
Photo by John-Silver–3202135 The base would be the foot and the hip would be the top.
Take a look at this runner. His foot is on the midline of the body. The leg is not stacked The hip is not stacked over knee or foot. Can you see the pelvis dropping on the left side as well?
Photo by Andrea Piacquadio Can you see the cross over gait? The foot is midline, the hip once again is not stacked over the knee and foot. Look at her stomach muscles. Can you see the twisting? Here’s an example of the core not being engage and lack of midline stabilization.
If you are new to running or experienced and need help we are here! Please call the office to set up an appointment.
People that come into our chiropractic clinic for treatment after lumbar disc herniation or disc bulging frequently have a history of pain which is worse in the morning and then improves after they’ve been up moving around for a bit.
Often they have some questions about what exercises and stretches they can do in the morning to make them feel better. We learned more about morning back pain in a disc – injured patient after the research of Michael Adams in the 1980s.(1,2) Adams referred to the “diurnal behavior of the disc” which mostly refers to the tendency for the discs to absorb moisture from the tissues around them overnight.
The discs soak up the fluids from the tissues around them while a person is recumbent in bed overnight. So in the morning when they wake up the outer layers of the disc are under a bit more tension, which we refer to as hydrostatic pressure.
In turn, the disc becomes a bit more plump, adding pressure to nerves and surroundingstructors.
So what should you do? Once you get out of bed you should not bend over right away. Try to keep your back straight or try stretching backward .
Next, use your hips to bend over the sink to brush your teeth.
A straight back using my hips to bend over.Bending at the lumbar spine causing lots of pressure on the lumbar discs
The above picture is a great way to cause sharp shooting pain in the morning.
Try to sit up straight or use a back support in the small of your back like in the picture above.
Sitting with a more normal curve in the lumbar spine helps take the pressure off of the lumbar discs and helps decrease pain.
A wrong way to sit
Sitting like this cause more disc pressure causing disc irritation. It can cause the disc to bulge more.
Discs are fatter in the morning because the absorb fluid overnight. So think of a jelly doughnut if the doughnut has more jelly its more likely to shoot out if you put pressure on it.
So remember back straight, stomach tight will help prevent lower back pain and help you heal if you have pain.
Dr. Steve Sikorsky | Chiropractic Care Elgin, Illinois
