Share This With Your PCP!

Unfortunately the following saga is way too typical in our office. Last month I saw a new patient who had severe low back pain (LBP) for over 2 years. The pain was so severe she was living on pain meds, going right home from work and going to bed. She was not participating in life and was extremely frustrated. She had seen her Primary Care Physician (PCP) from the onset of her pain. She was referred to multiple specialists for advanced testing, injections and more medications, none of which gave her any real relief or hope.

Finally after two (2) years, at the repeated encouragement of Lyn Rome, her hair stylist, she came into my office, explained in detail all she had been through and the frustration of living with pain. My exam ruled out all the “red flags” or pathological causes of her pain. My diagnosis was dysfunction of her left Sacro-iliac joint and sciatic nerve entrapment. Simply put, the largest joint in her body (in the butt area) was stuck and the longest and thickest nerve in the body which goes from the low back to the toes was not gliding properly. Of course she also had muscles spasms because her muscles were short and tight to protect the joint that was not moving, setting up a visors cycle of pain that kept perpetuating itself.

I felt confident I could help her, but since she was skeptical and nervous from her prior medical treatments I recommended a 2 week trial of chiropractic care to see how she would respond. I wish all of my patients responded so quickly, but after 2 treatments she had significant decrease in pain, stopped the pain meds and didn’t have to go right to bed after work. Obviously the trial of care was successful and she is on the road to recovery.

Two (2) years of her life was wasted because of ignorance (or bias) on the part of her PCP. Unfortunately this is a scenario I see all the time at our office, but it shouldn’t be that way. Any competent medical doctor who keeps up with the literature should know that chiropractic care has been well documented as an effective treatment for LBP. (It is not the only condition we treat, but the most researched). There really is no excuse for collaboration between your PCP and the chiropractic profession for the best interest of the patient, especially for the treatment of LBP.

Now there is even more proof! In the May 2018, on-line edition of the JAMA (Journal of the American Medical Association), a new studies found that “usual medical care plus chiropractic care reported a statistically significant improvement in low back pain intensity and disability at 6 weeks compared with those who received usual care alone.” In a study of 750 people, from the ages of 18-50, the addition of including chiropractic care documented statistically significant improvement included less reported pain, less disability, more patient satisfaction and less pain medications used. Across the board including chiropractic care reduced pain and suffering.The conclusion of this study states, “this trial provides additional support for the inclusion of chiropractic care as a component of multidisciplinary health care for low back pain, as currently recommended in existing guidelines”. Note the words…as currently recommended in existing guidelines.

The number one cause of disability worldwide is LBP! At least 20% of Americans will have LBP lasting at least 1 day over the next 3 months. LBP is the 2nd reason why patients visit their PCP. The direct cost of LBP in 2010 was $34 billion, and adding in lost work and productivity costs the US economy up to $200 Billion. At the present time only 8-14% of the US population receives chiropractic care annually. So why aren’t PCPs referring to chiropractors. Getting historical, there have been excellent studies validating chiropractic care and multiple government reports recommend a greater utilization of chiropractic care.

As far back as 1993 the Ontario Ministry of Health published what is called the Manga Report. The Manga Report’s conclusion was to make chiropractors the gatekeepers for treating LBP for many reasons concluding: “On the evidence, particularly the most scientifically valid clinical studies, spinal manipulation applied by chiropractors is shown to be more effective than alternative treatments for low back pain. Many medical therapies are of questionable validity or are clearly inadequate; there is no clinical or case-control study that demonstrates or even implies that chiropractic spinal manipulation is unsafe in the treatment of low back pain. Some medical treatments are equally safe, but others are unsafe and generate iatrogenic (doctor-induced) complications for low back pain patients. Our reading of the literature suggests that chiropractic manipulation is safer than medical management of low back pain; and there is an overwhelming body of evidence indicating that chiropractic management of low back pain is more cost-effective than medical management.”

Then in 1994, the US Agency on Health Care Policy and Research (AHCPR) released Clinical Guidelines for Management of Acute Low Back Pain. These Guidelines were created an expert panel to provide PCPs with recommendations on the assessment and treatment of LBP. Again the conclusions included:
• Conservative treatment such as spinal manipulation should be pursued in most before cases considering surgical intervention;
• Prescription drugs such as oral steroids, antidepressant medications and colchicine are not recommended for acute low back problems.

The benefits of chiropractic care both in human suffering level and economic savings is well documented and recommended by multiple government agencies. I still don’t understand why the chiropractic profession is not getting more referrals from the medical profession. Going back to the patient in the first paragraph, in her words she lost 2 years of her life and had lost hope of ever being able to function and doing the most basic activities like walking with her husband or sitting in a restaurant. My bias is that she should have been referred for chiropractic care after the pain lasted for 2 weeks while following her PCPs advice. When the pain persisted and multiple therapies failed, at the very least her PCP could have said I don’t know much about chiropractic health care, but since you are not feeling better why don’t you give it a try.

I don’t fault the present generation of medical doctors. Chiropractic care is not part of their educational curriculum. I have seen this first hand. For eight (8) years family practice residents first at University of Vermont and then Tufts had a one (1) day rotation at my office. I asked each resident in all your years of medical school and residency how much did they learn about chiropractic health care. The answer across the board was “nothing”. Then I’d ask how much did they learn about the musculoskeletal system? The answer across the board this time was “not much”. Then I’d ask my final question which was how many vertebrae are in the spine? In 8 years only 1 Family Practice Resident was able to rattle off the correct answer which is 24.

Then the medical resident spent the day with me watching me interact and treat my patients. At the end of the day across the residents would say how impressed they were. They didn’t realize the scope of chiropractic practice and the benefits of manipulation. My advice was always the same. When you finish your residencies and hang up your shingle to practice, meet a few chiropractors in your community, find one or two that you feel comfortable with and refer your patients to them. Unfortunately this type of rotation at a chiropractic office was and still is a rare event in the training of medical residents.

Hopefully you have read down this far. The only way your PCP is going to know about this new study (and historical guidelines) is if you share this article with them. Please email your PCP and attach this article. Ask if he/she has read the new JAMA study on the significant benefits of including chiropractic care in collaboration with “usual medical care” for patients with low back pain? If not the link is here: Effect of Usual Medical Care Plus Chiropractic Care vs Usual Medical Care Alone on Pain and Disability Among US Service Members With Low Back Pain: A Comparative Effectiveness Clinical Trial

Sharing this article with your PCP this will help build bridges between the two professions and the winner is you, the consumer of health care.

For more information please contact me at drbradweiss@performancehealthcenter.com

The Concussion Muscle

Concussions are awful. There are close to 4 million sports related concussions in the U.S. every year. Your brain gets shaken up like an egg inside its shell. The skull doesn’t crack but the brain gets rattle around. You might lose consciousness, balance, ability to talk, have a headache and the world appears fuzzy. You go through concussion protocol testing and spend anywhere from a few days to weeks resting.
Slowly you start to feel better and eventually get on with life. 15% of concussion suffers have lingering effects which last beyond 3 months which is labeled “post-concussion syndrome. Persistent symptoms include inability to concentrate, memory issues, fatigue, dizziness, irritability, anxiousness, insomnia, blurry vision, noise and light sensitivity, and headache.

A recent study from the American Journal of Neuroradiology (AJNR) tried to determine if there was correlation between the suboccipital muscles and recovery time from post-concussion syndrome. The suboccipital muscles connect the upper neck vertebrae to the back part of the skull called the occiput. There are seven (7) muscles that make up the suboccipital muscles. An MRI of sixty-four consecutive patients with post-concussion syndrome was performed and symptoms were tested using standard concussion protocols.

Of the seven (7) suboccipital muscles only one (1) muscle’s cross-sectional diameter proved to have a direct association with post-concussion symptoms. That muscle is the Rectus Capitus Posterior Minor. (RCPMinor). There was a direct correlation with the RCPMinor and “greater symptom severity, longer recovery time, poor verbal memory performance and headache”. None of the other suboccipital muscles had a direct correlation.
What is so special about the RCPMinor muscles that it effects the recovery time ofpost-concussion syndrome? The RCPMinor is the only suboccipital muscle that has a ligament bridge that connects to the dura mater of your spinal cord right where your brain and spinal cord join. The dura mater is the outer protective membrane of the spinal cord. The theory is that the RCPMinor tugs on the spinal cord covering contributing to post-concussion symptoms.

I am only aware of one soft tissue technique that can isolate, evaluate and treat the RCPMinor muscle. That technique is called Active Release Techniques® or (ART). ART is patented and consists of over 500 specific protocols which differentiate, isolate, evaluate and treat the individual muscles in the body. The goal of ART is to release adhesions or scar tissue in muscles, ligament and nerve pathways in the body, in essence the soft tissues of the body. ART is cutting edge and is becoming the gold standard in treating soft tissue injuries. ART is done by hand. In order to become certified in ART you need to go through a certification course. Certification needs to be renewed every year. There are only 40 +/- certified ART providers in Massachusetts.

In the suboccipital region it is possible to isolate and evaluate the RCPMinor muscle using ART. If the RCPMinor is found to be short & tight, a specific tension is applied to the muscle which can normalize the tone and function. I have been an ART provider for 20 years. I have helped many patients suffering from whiplash injuries, headaches and post-concussion symptoms. Even before this study was published I have found that clinically the RCPMinor is a key muscle to treat to resolving post-concussion symptoms.

It’s not important to remember the name of the Rectus Capitus Posterior Minor muscle, but it is important to know that ART is one technique that is very effective in finding, evaluating and treating this muscle. If you, a family member or friend has been frustrated due to post-concussion syndrome, chronic headaches or whiplash injury, please get evaluated by an ART certified provider.
To find a certified ART provider anywhere in the world clink this link: http://activerelease.com/find-a-provider.asp

If you would like more information please contact me at: drbradweiss@performancehealthcenter.com

It’s Summer and I’m Back on the Courts!

For several months in a row last spring I wrote about my experiences post-knee surgery and the grueling rehab process I was going through.  It’s hard to believe that is now 15 months post-surgery.  The good news is that I am back doing all the activities I was able to do prior to my ACL tear and surgical replacement!

I’ve never had a serious injury before and never had to be a committed and compliant patient.  I worked hard and followed the advice of the skilled professional that I put my trust in.  I was able to ski by mid- winter and since the spring have been playing tennis several times a week.  My knee is strong and pain-free.  I have no limitations.  At times I do get swelling, but regular icing keeps it to a minimum (and feels good on these hot summer days we are experiencing).  I know I am not 100% rehabbed, but am getting closer every day!

This has been a learning experience on many levels.  Most importantly, I have a much better appreciation for the trust and confidence my patients put in me.  It is not easy being compliant with appointments and the homework I prescribe to get out of pain and optimizing function.  Between family and work responsibilities we all have busy lives.  Squeezing in one more appointment is not always easy.  I always remind my patients that it is not easy and there is never the right time to do this, but if they do the work now, they will be glad they did short term, and more importantly long term.

George Burns when he turned 90 said, “If I knew I was going to live this long I would have taken better care of myself”.  I want all my patients to say when they turn 90, “I knew I was going to live this long so I took great care of myself”.   Of course there are bumps in the road, like my knee injury, and when that happens extra care is needed.  That’s how I live my life and I hope I inspire my patients to do the same.

Now that the hard part of my rehab is over, I will continue with my “extra” exercises to make sure my knee serves me well for the many years I plan to work as a chiropractor and play hard.  Many thanks go to my team of professionals who helped me get to this place.  Dr. Brian McKeon has been my go to orthopedist for 14+ years.  I’ve always told my patients when I made a referral, if it was me, Dr. McKeon is who I would go to.  When it was me that is exactly what I did.  Steve Crowell and his amazing team of physical therapists at Rebound Physical Therapy got me moving.  Rebound Physical Therapy is my “outsourced” physical therapy department and they always make me look good when I refer my patients there.  Drs. VanNederynen and Ball, were instrumental in keeping me functional and relieved the physical stress I was putting on my body from walking funny- 1st with crutches, then with my brace, and then from limp that lasted longer than I expected.  Bernadette, Performance Health Center’s amazing massage therapist accelerated my healing with incredible massages and cupping.  Lastly, Anita Luck, my Functional Movement Therapist, has taught me how to use my body in 3-D so my body can handle the demands I put on it, even when the unexpected happens.

I have and will continue to refer my patients to these exceptional providers I have now experienced firsthand, and have even more confidence in them than ever.

I hope you all have an enjoyable, safe and healthy summer!  Now get out there and have fun!

Brad Weiss, D.C.

drbradweiss@performancehealthcenter.com

It’s Summer and I’m Back on the Courts!

For several months in a row last spring I wrote about my experiences post-knee surgery and the grueling rehab process I was going through.  It’s hard to believe that is now over one year post-surgery.  The good news is that I am back doing all the activities I was able to do prior to my ACL tear and surgical replacement!

I’ve never had a serious injury before and never had to be a committed and compliant patient.  I worked hard and followed the advice of the skilled professional that I put my trust in.  I was able to ski by mid- winter and since the spring have been playing tennis several times a week.  My knee is strong and pain-free.  I have no limitations.  At times I do get swelling, but regular icing keeps it to a minimum (and feels good on these hot summer days we are experiencing).  I know I am not 100% rehabbed, but am getting closer every day!

This has been a learning experience on many levels.  Most importantly, I have a much better appreciation for the trust and confidence my patients put in me.  It is not easy being compliant with appointments and the homework I prescribe to get out of pain and optimizing function.  Between family and work responsibilities we all have busy lives.  Squeezing in one more appointment is not always easy.  I always remind my patients that it is not easy and there is never the right time to do this, but if they do the work now, they will be glad they did short term, and more importantly long term.

George Burns when he turned 90 said, “If I knew I was going to live this long I would have taken better care of myself”.  I want all my patients to say when they turn 90, “I knew I was going to live this long so I took great care of myself”.   Of course there are bumps in the road, like my knee injury, and when that happens extra care is needed.  That’s how I live my life and I hope I inspire my patients to do the same.

Now that the hard part of my rehab is over, I will continue with my “extra” exercises to make sure my knee serves me well for the many years I plan to work as a chiropractor and play hard.  Many thanks go to my team of professionals who helped me get to this place.  Dr. Brian McKeon has been my go to orthopedist for 14+ years.  I’ve always told my patients when I made a referral, if it was me, Dr. McKeon is who I would go to.  When it was me that is exactly what I did.  Steve Crowell and his amazing team of physical therapists at Rebound Physical Therapy got me moving.  Rebound Physical Therapy is my “outsourced” physical therapy department and they always make me look good when I refer my patients there.  Drs. VanNederynen and Ball, were instrumental in keeping me functional and relieved the physical stress I was putting on my body from walking funny- 1st with crutches, then with my brace, and then from limp that lasted longer than I expected.  Bernadette, Performance Health Center’s amazing massage therapist accelerated my healing with incredible massages and cupping.  Lastly, Anita Luck, my Functional Movement Therapist, has taught me how to use my body in 3-D so my body can handle the demands I put on it, even when the unexpected happens.

I have and will continue to refer my patients to these exceptional providers I have now experienced firsthand, and have even more confidence in them than ever.

I hope you all have an enjoyable, safe and healthy summer!  Now get out there and have fun!

Brad Weiss, D.C.

drbradweiss@performancehealthcenter.com

 

 

Do This and Live Longer!

When asked how long do you want to live, the answer should include not only a number but a statement on quality of life.  So how do we live longer with quality?  New data is being published monthly confirming that longevity is 25% genetic and 75% lifestyle.  Here’s a fact.  Sitting is killing us.  Computers were supposed to give us more leisure time, but instead we as a society are sitting more and spending more time at work and home in front of a computer.  Standing desks are becoming popular, but in my opinion only a little better than sitting.  We are meant to move.  Life is motion. Standing in 1 place for hours at a time is not much better than sitting for hours at a time.  I am more a fan of shaking it up. Sit for 20-30 minutes, get up and move/stretch, then stand for 20-30 minutes and then move/stretch again.

By now most everyone has heard the latest mantra, ”sitting is the new smoking”.  The good news is that there is now an antidote for sitting.  Its call exercise!  That’s right.  A new study, published in Lancet in September 2016 looked at the effects of mortality of people who sit 8 hours a day.  The bottom line, after looking at one million people, following them from 2-18 years, it take 1 hour of moderate exercise to negate 8 hours of sitting as it relates to mortality.  To quote the authors:  “High levels of moderate intensity physical activity (ie, about 60–75 min per day) seem to eliminate the increased risk of death associated with high sitting time.”

Do you run? Maybe you should.  A new study in Progress in Cardiovascular Disease from March 2017, concluded, “runners have a 25%-40% reduced risk of premature mortality and live approximately 3 years longer than non-runners”.  It doesn’t matter if you run slowly or sporadically and smoke, drink or are overweight. This study compared running to other exercises, including cycling and swimming, and no other exercise was comparable running for the impact on life span.

What’s the best type of exercise? Another new study from Cell Metabolism, March 2017, compared exercise types in 2 different age groups; younger than 30 and older than 64. They were broken into 4 groups: 1) vigorous weight lifting only; 2) high intensity interval training; 3) moderate biking for 30 minute alternating days with light weight lifting; 4) and of course a control group.

Of course all of the 3 groups who exercised showed improvement in fitness and blood regulation.  What they didn’t expect was how on a cellular level, the mitochondria of the High Intensity Interval Training group improved their ability to generate energy. Mitochondria are the power plants of our cells. Not only did the Mitochondria generate more energy, they were more of them and they were healthier than in every other group.  This benefit was larger in the greater than 64 age group.  The authors conclude that older people’s cells respond best to robust exercise.

What is the take away?  If you sit, you need to exercise to live a long healthy life.  If you have a full time job that requires sitting, you need to exercise 1 hour a day to negate the potentially detrimental effects of sitting on your body.  Running prolongs life, up to 3 years that of none-runners!  Any exercise is better than no exercise.  High Intensity Interval Training helps you energy cells work better and should be part of your exercise regime.  So the answer to the headline is to EXERCISE.  Exercise is the key factor to living longer and healthier!

Spring has finally sprung!  Now’s a great time to start exercising!  Start slow and build up your endurance and strength.  If you need advice on how to get started or if your body is physically fit to exercise, give us a call at 508-655-9008, or email me at: drbradweiss@performancehealthcenter.comNaticN

Strengthen Your Brain With Exercise

Regular Exercise can strengthen your brain.  We all know regular exercise is great for our cardiovascular system, and that it will strengthen our muscles and even increase our bone density, but a lesser known benefit is that regular exercise can make you smarter and protect your brain from shrinkage as it ages.

Research has even revealed that exercise can increase neurogenesis, or the formation of new brain cells, in the brain’s hippocampus.

Research has time and time again shown that people who engage in healthy behaviors such as exercise and proper nutrition are less susceptible to the cognitive declines associated with the aging process.

One study published in 2013 looked at healthy behaviors in nearly 2,300 men over the course of thirty years. Researchers looked at the participants’ behaviors and cognitive abilities starting in middle age tracked their progress throughout old age.

The researchers found that men who practiced certain healthy behaviors were around 60 percent less likely to experience cognitive impairment and dementia as they aged. These healthy behaviors included not smoking, maintaining a healthy BMI, regularly exercising, consuming lots of vegetables and fruits and consuming a low to moderate amount of alcohol.

Here are 5 ways that exercise impacts your brain- (from the December 2016 Team HOTSHOT web site): http://www.teamhotshot.com/blog/5-ways-exercise-impacts-brain/

  • Exercise helps the brain learn and retain – In various human and animal studies, results show that exercise not only helps the brain retain information (i.e., support/improve memory), but also helps the brain acquire new information. While some variances in research findings exists, much of this discrepancy is attributed to the type and duration of exercise prescribed to the study participants.
  • Consistent exercise helps avoid dementia – There is still a great deal we do not know about dementia. However, scientists and doctors are confident in a few preventative measures. Chief among them is healthy living: eat right, don’t smoke, and exercise. Exercise has been shown to slow the effects and reduce the risk of Alzheimer’s, Huntington’s, and Parkinson’s diseases. Even once these terrible diseases strike, exercise has been shown to slow the debilitating functional decline they bring about.
  • Exercise can help ease and prevent depression – Exercise has been shown effective in treating depression and, interestingly, seems to work in a dose-dependent manner much like anti-depressants. The more exercise, the greater the impact. While more research is needed, early studies also point to exercise as a mechanism to avoid the onset or development of depression.
  • Exercise mixed through your day helps concentration – Breaking up tasks such as working on a project or preparing a presentation with some aerobic-style exercise helps improve executive functions like tuning out distractions. Don’t worry, you don’t have to run a marathon over the course of your work day. Just 15-20 minutes of moderate engagement every few hours seems to make a measurable difference.
  • Reduce stress, improve life – While many people self-report a stress reduction after exercise, some scans seem to show an actual, physical shrinking in the amygdala—a part of the brain strongly implicated in processing stress, anxiety, and fear. As nice as stress-free living can be in general, it turns out less stress leads to living longer! That’s right, increased stress is strongly linked to increased occurrence of heart disease, hypertension, diabetes, and memory loss.

If you want to build a better mind, start by working on your physical health first. Go for a walk, start incorporating more fresh fruits and vegetables into your diet and try to give up any bad habits like tobacco use or excessive alcohol consumption. Some of these might be more difficult than others, but your brain will thank you for years to come.

If you have any questions about this blog or about your health in general, please feel free to contact me at:  drtomball@performancehealthcenter.com

Happy Marathon-ing Boston Runners!

It is that time of year!  Spring is in the air… Easter, Passover, April Vacation, and of course, the Boston Marathon are all too quickly approaching.  Woo-Hoo!!!

I wouldn’t be doing my job as a Chiropractor if I didn’t write something this month in regards to the marathon, and offering advice to my patients and friends how they can better take care of themselves during this exciting time of year.

In previous years I have chatted about how runners can be more proactive and take care better care of themselves leading up to the marathon. I want to switch gears and talk a little more about recovery and what runners can do “post-marathon” to help speed up their recovery and get back on the road to training afterwards.  There are so many words of advice, tips, recommendations etc., I am going to just focus on a couple of things that I find to be VERY true and that have worked for me in the past.

Usually the biggest or most commonly asked question by a runner is, “How long should I wait to run again after the marathon?”   Well this was one of the questions I did ask after my first marathon in 2008, it certainly wasn’t the first question I asked.  I am not sure about all of you, but I wasn’t sure I would run again after getting through all of that for the first time, and having no clue what I was doing, lol.  But, for all of those who are inquiring, general rule of thumb seems to be 1-2 weeks depending on how one feels.

Many articles say 5-7 days of rest post marathon, which I am totally fine with. BUT, those articles that people fail to read the entirety of, also state that after 5-7 days off, the next few weeks after that initial week should be taken lightly with training as the body is trying to recover.  Usually within 3-4 weeks a runner can return to regular training, or harder workouts, providing there are no subsequent injuries those runners is dealing with from before the marathon, or an injury resulting from the marathon.

Another hot topic, or should I say “cool” topic, are ice baths for recovery post marathon.  Most runners inquire about the effectiveness of ice baths and when or how long to soak in the tub of ice for.  The general idea in regards to this type of cryotherapy treatment is that the exposure to cold helps the body fight the micro trauma (tiny little tears) in the muscle fibers causing soreness by the repetitive exercise that just took place.  Constricting the blood vessels for a short period of time can help to flush toxins released by the body during the event, and intern, help to decrease or reduce inflammation, swelling, and breakdown of tissue in the body.

Some post-race and post-competition festivities have ice baths at the finish waiting for the competitors after they have cooled down a bit.  If that isn’t all that enticing to you, upon returning home or back to your hotel that day, and before you hop into the shower would be a good time to do so.  I recommend getting into the tub and filling it with cold water around you first (up to your waste), and then dumping the bags of ice into the water after you are submerged.  Or just hop in the tub in your race shorts, and sports bra ladies, and let someone else have the pleasure of dumping the ice in all around you.  It is best to stay submerged in the ice bath for about 10 minutes.  More time is not necessary, and I am sure no one will be jumping at the idea of soaking in a bath of ice any longer then they have to.

I really hope these tips helps you all in your road to recovery post Boston Marathon this year.  If you have any questions about post marathon recovery, please feel free and contact me at drv@performancehealthcenter.com.  And as always, I am a big fan of a post marathon chiropractic adjustment and ART to help realign your body, and a post-race massage within a few days’ post-marathon.  Happy Marathon-ing everyone, think positive thoughts to carry you through that day, and I will be there with you all in spirit!

Don’t Let Your Kids Become a CDC Statistic!

The numbers are staggering.  According to the Center for Disease Control (CDC):

  • High school athletes account for an estimated 2 million injuries and 500,000 doctor visits and 30,000 hospitalizations each year.
  • More than 3.5 million kids under age 14 receive medical treatment for sports injuries each year.
  • Children ages 5 to 14 account for nearly 40 percent of all sports-related injuries treated in hospitals. On average the rate and severity of injury increases with a child’s age.
  • Overuse injuries are responsible for nearly half of all sports injuries to middle and high school students
  • According to the CDC, more than half of all sports injuries in children are preventable.

Spring sports will be starting soon for your kids.  Don’t let them become a CDC statistic.  Prior to participating in sports your children should have a functional evaluation.  How is their range of motion? How is their posture? Are all the joints in their spine and extremities moving correctly?  How is their muscle tone and balance?  How quick is the muscle activation response time?  These are all good indicators on the state of an athlete’s functional health.  A good thing about being young is that if is a problem they usually respond quickly to chiropractic care.

If you missed the pre-season evaluation or you have a child who is still side-lined and suffering from a sports related injury, do not give up. It is never too late.

In December I meet a young teenage athlete who was not able to participate in sports because of lingering back pain for over a year and a half.  He injured himself in a baseball game where he was the short stop.  He fell over an opponent and twisted as he landed.  He had not been able to participate in sports since this injury.  During the consult, his mother said to me, “I just want a diagnosis so I know what is wrong.”  She had taken her son to multiple physicians without a concrete diagnosis.  He had a course of PT without lasting benefit.  I did my assessment and found dysfunction, or stuck joints, in his low back, muscle guarding and sciatic nerve entrapment.  His mom was relieved on knowing there was something wrong. She was even happier when I was able to provide a mechanical solution to her son’s mechanical problem.  The great news is that he able to swing a bat and throw a baseball again without pain!  He is looking forward to baseball tryouts in a few weeks.

Not only do we assess athlete’s pre-season function and get our patient’s out of pain and back to sports, the most important service we provide is called Performance Care. The goal of Performance Care is to optimize mechanical function and catch little issues before they become serious ones.  All the chiropractors at Performance Health Center get pleasure knowing that we pay a small role in our patient’s success!

Two of our teenage athletes have recently made major accomplishments in their sports:

  • Matt Gastaldo of Natick High School won his weight class at the Division 2 state wrestling meet last month.

I encourage all athletes to have regular chiropractic care during their sports season.  Race cars need more maintenance than street cars, and athletes are like race cars. If there is an injury, as long as there is no blood or guts, the faster they get checked and treated with functional chiropractic treatment, the faster the recovery, the faster they get back to sports and the least chance of lasting injury.

There is often a long term detriment from participating in youth sports. It amazes me how many adults I meet who trace their pain complaints back to high school sports.  If they had the benefit of a sports minded chiropractor when they were participating in youth sports they might not have ended up in chronic pain.

If you have any questions on what is involved in a pre-sports functional examination, want to optimize your performance, or are side-lined because of injury please call us at 508-655-9008, or email me at drbradweiss@performancehealthcenter.com

 

Dynamic Stretching, the “Pre-workout”

If you look up Wikipedia’s definition of dynamic stretching, this is what comes up, “Dynamic stretching is a form of stretching beneficial in sports utilizing momentum from form, and the momentum from static-active stretching strength, in an effort to propel the muscle into an extended range of motion not exceeding one’s static passive stretching ability”.

Performing dynamic stretches in a “pre-workout” or warmup are a series of active stretches that move the muscles through their range of motion, helps to improve range of motion surrounding the joints, helps to elevate core body temperature, and stimulate the nervous system.

Dynamic stretching primes the muscle to be ready to contract and relax, just as they would need to be ready to function during a sprint, run or jumping motion etc.  Being dynamic stretching is an active movement, it helps to prevent over-stretching, which can also fatigue the muscles.  Fatiguing the muscles prior to a workout can provoke injury or unfavorable symptoms to the area.  That is one of the main reasons coaching have gotten away from prescribing static stretching before a workout.  In fact, many coaches suggest athletes do a dynamic warm up every day to help keep muscles limber and ready to move at all times.

Dynamic stretching also helps to mentally prepare the athlete before the workout or competition.  Static stretching can be more relaxing, and while there is definitely a place for it, static stretching can almost trick one’s body into relaxation mode and make it more difficult to transition to “competitor” or “beast mode”.

Dynamic stretches target major muscle groups when warming up.  For example, when running, dynamic stretches target hamstrings, quads, glutes, hip flexors and calves to help prime these areas for movement.  Usually a couple of minutes of light jogging is recommended first to get the blood flowing before getting into a 5-10 minutes of dynamic stretching.  Walking butt kicks (heel to butt), knee hugs (walking knee the chest), walking toe touches, walking lunges with an overhead reach, glute bridges, heel and toe walks, are just a handful of great dynamic stretches to get one warmed up and the muscle groups prepared for the intensity of the workout that follows.   It really is something so easy to work into a warm up, and would most likely replace a more static routine one is doing, so it would not add much time on to one’s routine either.  Some of you reading this may find that you are already doing some type of dynamic stretching prior to a workout without even knowing it!

Should anyone reading this have any questions in regarding dynamic stretching and incorporating this into their pre-workout routine, please feel free to contact me at: drv@performanacehealthcenter.com

 

 

 

You Got Some Nerve!

The truth is you have a lot of nerve!

  • There are more nerves in your body than stars in the Milky Way.
  • The human brain alone consists of about 100 billion neurons. If all these neurons were lined up it would for a 600 mile long line.
  • The nervous system transmits impulses at 100 meters per second, or 224 miles per hour
  • There are 43 different pairs of nerve which connect the nervous system to every part of your body. 12 pairs exit in your brain and 31 pairs are connected to your spinal cord..

The longest nerve in the body is the sciatic nerve.  It is made up of nerve roots from 5 levels of your low back and sacrum (L4-S3) and ends at the tip of your toes.  The sciatic nerve is about the size of your thumb as it passes through your buttocks.  The sciatic nerve travels in the spaces between the large muscles in your leg (often with the arteries and veins).  Sciatica is the term used when the sciatic nerve gets irritated and causes pain that radiates down the leg.  We treat sciatica successfully every day in our office.

The sciatic nerve can get entrapped anywhere from where the nerves exit the spine to the toes.  When a nerve loses its ability to glide, or move, within it pathway the function of the nerve can be corrupted.  There are areas where the sciatic nerve is more frequently entrapped.  One is the tarsal tunnel.  You’ve heard of carpal tunnel. The tarsal tunnel is in the foot, just below and behind the inside of your ankle bone (or medial malleolus).  Another common entrapment site is the piriformis muscle (one of the deep muscles of your buttocks).

There are functional diagnostic tests to determine if and where the sciatic nerve is entrapped.  Active Release Techniques® (or ART®) has specific protocols to release entrapped nerves.  There are about 35+ ART® certified providers in Massachusetts and only 10+ ART® Nerve Entrapment certified providers, of which 3 practice at Performance Health Center. It amazes me on how many of the patients we meet have been living in pain, sometimes for years with sciatic nerve entrapment.  Having an entrapped sciatic nerve can manifest in many ways, not only leg pain. Since nerve entrapments are a functional condition it requires a functional solution and ART® provides one.

Recently I saw a patient who had bilateral foot pain for 3 years, initially caused by wearing bad running shoes too long.  Over the 3 years before I meet her, she was labeled with having many different pain syndromes from multiple medical providers. She even had nerve release surgery on both her tarsal tunnels.  The day I met her, she gave me her detailed history and I performed an exam with included sciatic nerve entrapment screening.  I uncovered poor motion of the joints of her low back and sciatic nerve entrapment.  The function test of the sciatic nerve was so obvious she understood and felt the tension as I performed the test maneuver.  When I explained to her what I thought was the problem, that her sciatic nerve was entrapped at the tarsal tunnel, and told her I thought I could help her, she teared up. She told me that of all the doctors she had seen over the years, I gave her the most thorough exam, explained her problem in a way she could understand it and gave her hope.

The good news is that after 8 treatments she is doing much better.  The pain level is significantly reduced. She can walk without pain. She is not running yet, but will be within the next 2 months. She had a functional problem caused by faulty biomechanics of her spine and sciatic nerve pathway.  Our functional treatment approach includes manipulation of her low back (where the nerves that make up the sciatic nerve exits the spine), ART ® on the muscles of the LB and leg, plus sciatic nerve entrapment ART® protocols, and Kinesio® Taping to minimize the tension on the sciatic nerve at the tarsal tunnel between treatments.  It is not possible to correct 3+ years of faulty motor patterns in the body overnight, but just like braces on teeth, if we continue to put a demand on the body, it will change.

Getting our patients out of pain is usually the easy part of treatment.  The next and most important phase is the rehabilitation, or re-education to optimize the body’s function.  Of course our patients have responsibilities too.  They need to improve the ergonomics at work and play. They receive stretches and strengthening exercises when appropriate, and are an active participant in their treatment.

If you or anyone you know is sick and tired of being sick and tired, and think they have done everything to get better.  Remind them if they have not had the benefit of ART®, they have not done everything!  As always, after the initial examination, if we do not think we can help, we will make the appropriate referral.  If you have any questions, please feel free to email me at: drbradweiss@performancehealthcenter.com