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Contents

1 2012 5

1.1 August . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

About (2012-08-24 08:12) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

Plantar Fasciitis (2012-08-24 09:58) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

1.2 September . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

Neck Pain (2012-09-22 10:46) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

Stress Fracture of the Tibia (2012-09-27 12:12) . . . . . . . . . . . . . . . . . . . . . . . . . 12

1.3 October . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

Hip Joint Injuries (2012-10-31 06:45) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

1.4 November . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

Sinus Tarsi Syndrome (Complex Ankle Sprain) (2012-11-05 10:45) . . . . . . . . . . . . . . 18

Get Relief From Shoulder Joint Injuries? (2012-11-17 10:31) . . . . . . . . . . . . . . . . . . 20

How Does a Chiropractor Help Treat Spinal Nerve? (2012-11-24 11:45) . . . . . . . . . . . 25

1.5 December . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28

How to treat Hamstring Muscle Strains? (2012-12-21 09:53) . . . . . . . . . . . . . . . . . . 28

How to Get Comfort from Low Back Pain? (2012-12-29 11:51) . . . . . . . . . . . . . . . . 34

2 2013 41

2.1 January . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 41

How is a Cervical Spine damage Diagnosed? (2013-01-17 10:49) . . . . . . . . . . . . . . . . 41

How to treat Distal Leg Fracture? (2013-01-19 08:08) . . . . . . . . . . . . . . . . . . . . . 45

How to cure Lumber Back Pain? (2013-01-22 11:27) . . . . . . . . . . . . . . . . . . . . . . 47

2.2 February . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50

Are you suffering from Medial Calcaneal Nerve? (2013-02-08 06:33) . . . . . . . . . . . . . 50

How to get comfort from Wrist Bone Injury? (2013-02-23 06:15) . . . . . . . . . . . . . . . 52

How to get Comfort from Wrist Pain? (2013-02-26 10:03) . . . . . . . . . . . . . . . . . . . 54

2.3 March . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56

How to prevent Hand Discomfort? (2013-03-20 06:56) . . . . . . . . . . . . . . . . . . . . . 56

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How to get Relaxation from Knee Joint Injury? (2013-03-29 05:27) . . . . . . . . . . . . . . 58

2.4 April . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60

How to get Relief from Anterior Leg Pain? (2013-04-13 10:46) . . . . . . . . . . . . . . . . . 60

How to recover from Scoliosis (Spine Disease)? (2013-04-25 07:26) . . . . . . . . . . . . . . 61

2.5 May . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63

How to Prevent Scapula (Shoulder) Injury? (2013-05-10 11:13) . . . . . . . . . . . . . . . . 63

Chiropractic Treatment for Arm Injury (2013-05-16 06:22) . . . . . . . . . . . . . . . . . . . 65

2.6 June . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 68

How can I Prevent Wrist Pain? (2013-06-25 09:59) . . . . . . . . . . . . . . . . . . . . . . . 68

2.7 July . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70

How to Prevent and Care for Tension Headaches? (2013-07-29 05:24) . . . . . . . . . . . . . 70

2.8 August . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73

Physical Therapy Treatment for Neck Pain (2013-08-29 11:15) . . . . . . . . . . . . . . . . 73

2.9 September . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 76

How can I get comfort from Sciatica Pain? (2013-09-24 08:40) . . . . . . . . . . . . . . . . . 76

2.10 October . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78

Chiropractic Workers’ Compensation (2013-10-14 06:47) . . . . . . . . . . . . . . . . . . . . 78

2.11 November . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 80

Postural Analysis and Correction (2013-11-12 11:50) . . . . . . . . . . . . . . . . . . . . . . 80

2.12 December . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83

Identifying and Treating Tension Headaches (2013-12-16 09:18) . . . . . . . . . . . . . . . . 83

3 2014 87

3.1 January . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 87

Clavicle or Collarbone Fracture: Symptoms and Treatment (2014-01-11 11:25) . . . . . . . 87

3.2 February . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89

Snapping Hip Syndrome: Treating Your Popping Hip Syndrome (2014-02-26 10:36) . . . . . 89

3.3 March . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92

Popliteal Cyst (2014-03-27 10:24) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 92

3.4 April . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93

Radiculopathy and Chiropractic (2014-04-25 12:19) . . . . . . . . . . . . . . . . . . . . . . . 93

3.5 May . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95

Treating Ankylosing Spondylitis (2014-05-30 12:29) . . . . . . . . . . . . . . . . . . . . . . . 95

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Chapter 1

2012

1.1 August

About (2012-08-24 08:12)

Acute Spine Therapy & Rehab Chiropractic Clinic

Acute Spine Therapy & Rehab Chiropractic Clinics located at Gaithersburg Maryland and Tacoma ParkMaryland are the premier chiropractic clinics providing efficient and finest chiropractic care for work placeinjuries and back pain, neck pain, headaches, whiplash injuries and soft tissue injuries resulting from autoaccidents. Our professional and board certified doctors; Dr. Gibbson and Dr. Wings employ most advancedand effective Chiropractic techniques to assess your auto accident injuries and create equally effective treat-ment plans to get you on the fast track of rehabilitation. We specialize in treating any of the musculoskeletalinjuries resulting from traumatic car accidents.

Do not delay and make an appointment today, as even the slightest of the pains can be turned out intosomething serious. And do not worry if you do not have health insurance, at Acute Spine Rehaband Physical Therapy Chiropractic Clinics our patients’ health and well being are our topmost priorities. In other words, no insurance is needed to avail our treatment benefits. Ourprofessional Chiropractors use the most gentle, non-invasive and scientific Chiropractic techniques and designpatient specific care plans to help you to resume your normal life as soon as possible.

Call us today at (301)977-0640 to learn more about how we can help you.

#1 Pain Treatment & Physical Therapy in Gaithersburg MD

We specialize in treating Back Pain, Whiplash injuries, Neck Pain, Shoulder Pain, and Hip and Leg Pain. Dr.Gibson will design your treatment plan. Do not wait and contact us for your next appointment today, at(301)977-0640.

The Sure Signs that make us stand apart

• Personalized Care Plans

• No Insurance needed

• Board certified and highly acknowledged Doctors

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• Welcome Same day appointments/Walk-ins

• Accept your Attorney’s assignment

• Bi-lingual, professional and co-operative staff

Plantar Fasciitis (2012-08-24 09:58)

Why is plantar heel pain more in the morning?

This is defined as [1]pain on the [2]plantar surface of the heel and is the most common cause of poste-rior [3]heel pain.

Do you know the source of pain in plantar fasciitis?

• [4]Plantar Fascia

• Subcalcaneal Bursa

• Fat Pad

• Long Plantar ligament

• Medial calcaneal branch of tibial nerve

• [5]Nerve to abductor digiti minimi.

Clinical Features

The patient complains of [6]pain in the heel, which is more in the morning. It gradually subsides asthe patient takes a few steps. The pain increases on prolonged standing, walking, etc.

Clinical Tests

Tenderness can be elicited on the medial aspect of the posterior heel. Passive stretching of the [7]toesincreases pain in the [8]heel.

Types of Plantar Fasciitis

INSERTIONAL PLANTAR FASCIITIS

• Called the [9]heel pain syndrome.

• Pain is felt at the medial tubercle.

DIFFUSE PLANTAR FASCIITIS

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• Pain felt diffusely over the heel and the [10]sole of the foot.

Radiographs

Consisting of the routine AP, Lateral and oblique views is advised. However, the X-ray does not showany changes in [11]plantar fasciitis. It helps to detect calcaneal [12]spur and other heel pathologies.

Treatment

• Measures to reduce pain and inflammation taping, temporary or permanent shoe orthosis, [13]heelcushion, weight management, etc.

• Measures to improve the neurodynamics of the tibial nerve-active [14]calf muscle stretching and calfsoft tissue mobilisation.

• [15]Joint mobilization with talocalcaneal glides.

• Strengthening the [16]muscles that support the arch namely the posterior tibial, peroneal and intrinsicmuscles.

• No response to conservative [17]treatment for three months-LIHC (Local Infiltration of Hydrocortisone)is indicated.

• No response to conservative [18]treatment for 6 months-surgery (partial release) is advised.

Rehabilitation Methods

• Massage the heel by [19]hand.

• Rolling of the [20]foot over a tennis ball.

• Stretching [21]exercises of the tendon-[22]Achilles and [23]Hamstrings and intrinsic muscle exercises ofthe foot.

• Wearing heel cups helps to reduce shock and thus [24]pain.

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1.2 September

Neck Pain (2012-09-22 10:46)

Treatment of the Athlete with Neck Pain:

The management of the athlete with [1]neck pain depends on careful assessment of the [2]muscles, [3]jointsand neural structures. Technique selection will depend on the diagnosis and the irritability of the condition.

There are a number of different techniques available for the correction of these abnormalities. Theseinclude manual [4]therapy techniques applied to the joints (e.g. mobilizations, manipulation), muscles (e.g.hold-relax, [5]soft tissue therapy and dry needling) and neural structures (e.g. neural tissue mobilization), aswell as [6]therapeutic exercise. As there is often more than one structure involved (e.g. joint and muscle), acombination of treatment methods is commonly required (e.g. [7]joint mobilization and specific therapeuticexercise).

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The general principles of [8]treatment should be followed. These include trialing one technique at a time andassessing the effect of that technique by comparing pre-treatment and post-treatment clinical findings. If onetechnique should be attempted.

Muscles and Fascia

The common soft tissue abnormalities found in patients with neck pain are focal areas of increased [9]muscletone, trigger points, [10]muscle tightness and shortening, and deficits in motor activity and control (e.g.proprioception).

Treatment of Neck Pain

• [11]Treatment should be aimed at restoring normal muscle length, tone, timing, strength, enduranceand control, with the overall aim of restoring normal movement.

• Soft tissue techniques aimed at reducing [12]pain and improving muscle length and tone.

• Dry needling of trigger points in the suboccipital muscles, sternocleidomastoid, scalenes, and trapeziusand levator scapulae can restore normal muscle length and eliminate trigger points.

• Specific therapeutic exercise, such as training of the deep [13]neck flexion.

Joint Abnormalities

The joints of the [14]cervical spine frequently make a significant contribution to the patient’s pain. The mostcommon abnormality found on examination is hypomobility of one or more intervertebral segments. Manualtherapy techniques can be used to treat stiff or[15] painful intervertebral joints. The aim when treating jointdysfunction is to restore full, pain-free range of motion. The two major types of [16]manual therapy used inthe treatment of joint abnormalities are mobilization and manipulation. The choice of which manual therapytechniques to use depends on the diagnosis, the clinicians knowledge of [17]trauma, pathology and the repairprocess, and irritability of the condition.

Mobilization

A number of different mobilization techniques are used in the treatment of [18]neck pain. There are threecommonly used techniques for upper cervical spine (occiput-C2) problems and six techniques for the lowercervical spine. The basic techniques for the [19]upper cervical spine are:

• Longitudinal movement (e.g. manual traction)

• Posteroanterior (PA) central pressure

• PA unilateral pressure

The basic techniques used in the middle and [20]lower cervical spines are:

• The above three

• Lateral Flexion

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• Rotation

• Anteroposterior (AP) unilateral pressure

The choice of which manual therapy techniques to depends on: the severity, irritability and nature the [21]pain;the direction of movement dysfunction gained from movement tests and manual examination; and knowledgeof the underlying pathology. The application of the technique is influenced by pain need to alter the [22]jointposition), the relationship between pain and resistance, whether the pain influenced by weight-bearing, andthe clinicians ability to control the technique. When to progress a technique and the rate of progressiondepends on the results of continuous reassessment. Possible progression include the grade of [23]mobilizationthe position joint, the speed of the technique, the amount of compression and the use of combined movements.

A highly irritable condition should be treated with techniques that do not aggravate the condition. Itis often helpful to begin with accessory movements performed in a neutral position or a position of ease, shortof discomfort. Higher grades of mobilization or manipulation can be used in non-irritable conditions if loss ofmotion and increased tissue resistance are the primary problems.

Exercise Therapy

[24]Exercise therapy is an important component of the treatment of the patient with neck pain. Thedifferent types of exercise therapy used include [25]stretching, range of motion, strength, endurance and motorcontrol exercises.

Stretching

A number of different stretching exercises can be performed by the patient. [26]Muscles that can bene-fit from stretching include:

• Lateral flexors

• Levator scapulae

• Trapezing

• Pectoralis major

• Upper cervical extensors.

Range of Motion Exercises

Active flexion, rotation and side flexion exercises should be performed within the [27]pain-free range. Cautionis required with extension extension may irritate the condition. Circular combined movements should not beperformed.

Endurance and motor control

• Individuals with neck pain, both traumatic and non-traumatic, have a reduced ability to hold innerrange positions of upper cervical flexion.

• The deep neck flexor muscles (longus colli and longus capitis) are thought to be critical for controllingintervertebral motion and cervical lordosis.

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• Patients with neck pain displayed signs of motor dysfunction, including delayed onset of the deep[28]neck flexors and contralateral sternocleidomastoid and anterior scalene muscles during unilateral[29]shoulder flexion/extension and a trend for greater sternocleidomastoid and anterior scalene activitythan controls.

• The craniocervical flexion test was devised as a staged test of deep neck flexor action.

• This test should be conducted on patients with neck pain to detect deficits in endurance (holding capacity)of the deep neck flexors and the degree of coactivation of the superficial neck flexors (sternocleidomastoid,anterior scalenes).

• Greater superficial neck [30]muscle fatigue (both sternocleidomastoid and anterior scalenes) found onthe side of the patient’s pain (in patient with chronic unilateral neck pain) suggests the need for exercisetraining to be specific.

• It is important to train [31]cervical muscle control in patients with neck pain.

• The clinician must pay particular attention to compensation strategies such as cervical retraction orexcessive superficial muscle activity.

Strengthening

Self-resisted isometric strengthening [32]exercises can be performed in lateral flexion, rotation, flexion andextension.










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Physcial Therapy Treatment for Neck Pain | Acute Spine Rehab & Physical Therapy (2013-08-29 11:15:35)[…] around the neck is the most obvious symptom but it can be referred to the shoulders, shoulder blade area or tothe face and head. Headaches too […]

Stress Fracture of the Tibia (2012-09-27 12:12)

Treatment For a Tibial Stress Fracture :

[1]Stress fractures are more commonly a cause of [2]shin pain in athletes in impact, running and jump-ing sports. Overall limb and [3]foot alignment as well as limb length discrepancy may also play a role. Theincidence of stress fractures is increased by playing on more rigid, unforgiving surfaces. Approximately 90% of [4]tibial stress fractures will affect the postero-medial aspect of the [5]tibia, with the middle third andjunction between the middle and distal thirds being most common. Proximal metaphyseal stress fracturesmay be related to more time loss from sports as they do not respond as well to functional bracing, whichallows earlier return to play.

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Stress fractures on the anterior edge of the tibia, the tension side of the [6]bone, are more resistant to[7]treatment and have a propensity to develop a non-union when compared to the risk of posteromedial stressfractures. A simple memory tool for the problematic anterior tibial stress fracture is anterior is awful.

A classic case presentation for a routine postero-medial stress fracture is as follows:

• Gradual onset of [8]leg pain aggravated by exercise.

• Pain may occur with walking, at rest or even at night.

• Examination-localized tenderness over the tibia.

• Biomechanical examination may show a rigid, cavus foot incapable of absorbing load, an excessivelypronating foot causing excessive [9]muscle fatigue or a leg length discrepancy.

• Tenderness to palpation along the medial border with obvious tenderness. (Note that, occasionally, astress fracture of the posterior cortex produces symptoms of [10]calf pain rather than leg pain).

• Bone scan and MRI appearances of a stress fracture of the tibia. MRI scan is of particular value as theextent of edema and cortical involvement has been directly correlated with the expected return to sport.

• A CT scan may also demonstrate a [11]stress fracture.

Treatment

Prior to initiating treatment or during the treatment plan it is important to identify which factors pre-cipitated the [12]stress fracture. The most common cause is an [13]acute change in training habits, such as asignificant increase in distance over a short period of time, beginning double practice days after laying offtraining for a season, or a change to a more rigid playing surface. Shoe wear, biomechanics and repetitiveimpact sports such as running and gymnastics have also been implicated. The athletes coach can play a keyrole in modifying training patterns to reduce the risk of these [14]injuries. In women, reduced bone densitydue to hypoestrogenemia secondary to athletic amenorrhea (the female athlete triad) may be a contributingfactor. All female athletes with a first-time stress fracture should be screened for the female athlete triad.

The classic treatment plan is as follows:

• Initial period of rest (sometimes requiring a period of non-weight-bearing on crutches for pain relief)until the [15]pain settles.

• The use of a pneumatic brace has been described. Studies have shown a markedly reduced return toactivity time with such use compared with average times in two of three studies and compared witha traditional [16]treatment group in the third. In this latter study the brace group returned to full,unrestricted activity in an average of 21 days compared with 77 days in the traditional group.

• The brace should extend to the [17]knee as the mid-leg version may actually increase the stresses acrossa mid shaft stress fracture.

• Once a stress fracture is clinically healed the athlete is advised to use the brace during practice andcompetition.

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• Clinical healing implies minimal to no palpable pain at the fracture site and minimal to no pain withactivities in the brace. Using this plan, there have been no reported cases of progression to completecatastrophic [18]fracture of the tibia.

• If pain persists, continue to rest from sporting activity until the [19]bony tenderness disappears (fourto eight weeks).

• Once the patient is pain-free when walking and has no bony tenderness, gradually progress the qualityand quantity of the [20]exercise over the following month.

• The athlete should be asked to continue to use a pneumatic brace to complete the current season untilan appropriate period (four to eight weeks) of rest can occur.

• Cross training with low-impact exercises, including swimming, cycling, maintaining conditioning andreduces risk of recurrence.

• Pain associated with [21]soft tissue thickening distal to the fracture site can be treated by soft tissuetechniques.












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1.3 October

Hip Joint Injuries (2012-10-31 06:45)

Causes, Symptoms and Treatment of Hip Joint Pain:

[1]Hip joint injuries can be difficult to diagnose as they often present in association with other painfulpathologies generating problems. The Patient may present with a confusing [2]pain pattern; pain may derivefrom the pelvis and back, as well as from the [3]soft tissues surrounding the hip. Mechanisms of hip injuriesinclude high-velocity [4]trauma (e.g. motor racing accident, equestrian) and overuse injuries in which alteredbiomechanics affect energy transference between the [5]lower limb and trunk.

Clinical features

[6]Pain from the hip joint may be felt in a number of areas. The pain is commonly a dull ache, although itmay be associated with a clicking or catching sensation. The pain may be referred to the anterior aspect ofthe knee. The hip may be inflamed as part of a generalized rheumatological disorder. Primary idiopathic[7]osteoarthritis of the hip may be seen in the older athlete. The pain of an osteoarthritic hip may be worsein the mornings or after activity. Septic [8]arthritis of the hip is rare. In children between 5 and 12 years,Perthes disease should be considered, while in older adolescents between the ages of 12 and 16 years, a slippedcapital femoral epiphysis may cause [9]hip pain. A young patient with a slipped capital femoral [10]epiphysismay present with very little pain and may simply present with a painless limp.

Examination

No one test is definitive for hip joint pathology. However, there are a number of tests used to assess irritationand restriction of the hip joint itself. These include: the circumduction test; hip quadrant flexion, adductionand internal rotation; internal rotation with added adduction; [11]flexion, abduction, and external rotation(FABER or Patrick’s test); and the impingement. It is unusual to find a case of an injured [12]hip that doesnot have coexisting iliopsoas dysfunction. The reason for this is not known, but possible causes include directirritation of the iliopsoas as it crosses the anterior aspect of the hip joint; the [13]iliopsoas being recruited asa secondary stabilizer; and the iliopsoas being overloaded as a hip flexor due to restriction in hip movement.

Findings on examination due to iliopsoas dysfunction include:

• Mmyofascial tightness in the [14]iliopsoas muscle on abdominal palpation

• [15]Tenderness and thickening of the mid-lumbar facets (L3-4) on [16]lumbar palpation

• Restricted extension on modified Thomas testing.

Investigations

Investigations include plain radiographs of the pelvis and lateral views of the hip. A full pelvis view isnecessary to be able to assess the hip joint for the presence of dysplasia and to compare the two sides.

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[17]Pathology seen on plain X-ray of the hip is often missed or referred to as a normal variant. Evidenceof dysplasia includes a short or angled roof, and signs of [18]acute/ chronic impingement, such as an osacetabulae (often mistakenly called a normal variant), femoral bossing, Ganz lesions and impingement cysts(often called synovial pits). [19]Injection of the hip joint with local anesthetic with post-injection assessmentof pain using a pain chart is probably about 70 % accurate. This accuracy can be improved by examiningthe hip pre- and post-injection. [20]Arthroscopy of the hip joint remains the most sensitive and specificinvestigation. In patients presenting with pain in the areas described and hip joint signs on examination, theclinician should maintain a high index of suspicion for labral [21]injury, irrespective of the results of imaging.Thus, if the clinician has a high index of suspicion of hip joint pathology, examination of the hip under localanesthetic or early arthroscopy is warranted.

Synovitis

[22]Synovitis is a complication of most hip injuries but can present as the primary problem, particularlywhen associated with rheumatological conditions. It usually responds well to X-ray guided injections of[23]corticosteroid.

Symptoms of Hip Injury:

With the increasing use of MRI and hip arthroscopy, labral tears of the [24]hip joint are being increasinglyrecognized as a cause of hip pain. The mechanism of injury can be due to extrinsic or intrinsic mechanisms.

Extrinsic mechanisms include:

• Motor vehicle accidents

• Lateral impact [25]syndrome (landing on the side the hip)

• Lifting/twisting incidents

• Squatting/loading

• Twisting on a weight-bearing hip (athletes)

• Passive [26]impingement (e.g. in cyclists, horse riders, truck drivers, builders up ladders)

• Active impingement (e.g. in dancers, martial arts, water polo).

Intrinsic mechanisms include:

Instability:

• Dysplasia (congenital and acquired)

• Low postural tone

• Torn ligamentum teres

• Incongruity of femoral head

Structural impingement:

• Pistol grip deformity (old slipped capital femoral epiphysis)

• Femoral bossing

• Ganz lesions.

16

Treatment of Hip Injury:

• The natural history of an untreated acetabular labral tear is slow but progressive degenerating todegenerative hip joint [27]disease.

• Treatment of these injuries involves arthroscopic [28]surgery have been good, especially in those withminimal or no associated chondral damage.

• [29]Chiropractic treatment might help you delay any need for surgical operation and the earliest youaccept treatment the more likely you are to benefit.

• However, should you need surgery; [30]rehabilitation after surgery is important to toughen your musclesand reconstruct or maintain the flexibility of your hip and other related[31] joints.

• Any physical precautions you take before the surgery can affect both the outcome and your improvementtime. It is also advantage remembering that doing [32]exercises to harden your upper body will helpyou survive better.










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32. http://acutechiro.com/Chiropractic-treatment-for-arthritis-carpal-tunnel-syndrome-auto-work-slip-falls-sports-injuries-in-md.

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1.4 November

Sinus Tarsi Syndrome (Complex Ankle Sprain) (2012-11-05 10:45)

Causes, Diagnosis and Treatment of Ankle Sprain:

The [1]sinus tarsi is a small osseous canal running from an opening anterior and inferior to the lateralmalleolus in a posteromedial direction to a point posterior to the medial malleolus. The interosseus [2]liga-ment occupies the sinus tarsi and divides it into an anterior portion, which is part of the talo calcaneonavicular[3]joint, and a posterior part, which represents the subtalar joint. It is lined by a synovial membrane and inaddition to ligament it contains small [4]blood vessels, fat, and connective [5]tissue.

Causes of Ankle Sprain:

Although [6]injury to the sinus tarsi may result from [7]chronic overuse secondary to poor biomechan-ics (especially excessive pronation), approximately 70 % of all patients with [8]sinus tarsi syndrome havehad a single or repeated inversion injury to the [9]ankle. It may also occur after repeated forced eversionto the ankle, such as high jump take off. The sinus tarsi contain abundant synovial tissue that is prone tosynovitis and inflammation when injured. An influx of inflammatory cells may result in the development of alow-grade inflammatory synovitis. Other causes of sinus tarsi syndrome may include [10]chronic inflammationin conditions such as gout, inflammatory arthropathies, and [11]osteoarthritis.

18


























Clinical features:

The symptoms of sinus tarsi syndrome include:

• [12]Pain which may be poorly localized but is most often centered just anterior to the lateral malleolus

• Pain that is often more severe in the morning and may diminish with exercise

• Pain that may be exacerbated by running on a curve in the direction of the affected ankle-the patientmay also complain of ankle and foot [13]stiffness, a feeling of instability of the hind foot and occasionallyof weakness

• Difficulty walking on uneven ground

• Full range of pain-free [14]ankle movement on examination but the subtalar joint may be stiff

• Pain on forced passive eversion of the subtalar joint; forced passive inversion may also be [15]painfuldue to damage to the subtalar ligaments

• [16]Tenderness of the lateral aspect of the ankle at the opening of the sinus tarsi and occasionally alsoover the anterior talofibular ligament; there may be minor localized [17]swelling.

Diagnosis of Ankle Sprain:

The most appropriate diagnostic test is [18]injection of 1 mL of a short -acting local anesthetic agent(e.g. 1 % lignocaine [lidocaine]) into the sinus tarsi. In sinus tarsi syndrome, this injection will relieve pain sothat functional tests, such as hopping on the affected [19]leg, can be performed comfortably (for diagnosis).An ankle X-ray may be performed to exclude degenerative changes of the subtalar joint. MRI may show anincreased signal and fluid in the [20]sinus tarsi.

Treatment of Ankle Sprain:

• Conservative [21]management includes relative rest, ice, NSAID, and electrotherapeutic modalities.Mobilization of the subtalar joint is essential.

• [22]Rehabilitation involves proprioception and strength training. Biomechanical correction may beindicated.

• Direct infiltration of the sinus tarsi with corticosteroid and local anesthetic agents may prove [23]thera-peutic but it is important that all underlying abnormalities are also corrected.









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Get Relief From Shoulder Joint Injuries? (2012-11-17 10:31)

Symptoms , Diagnosis and Treatment of Acromioclavicular (AC Injury):

Introduction

The [1]AC joint is another common site of injury in athletes who fall onto the point of the [2]shoulder.Stability of the AC joint is provided by a number of structures. These are in order of increasing importance,the joint capsule, the AC ligaments and the coracoclavicular ligament comprising the conoid and trapezoid[3]ligaments.

The most commonly used classification system for [4]AC joint injuries is that modified by Rockwood,which recognizes six different types of injury.

20


































Types of Injury

• Type I Injury[5]

• Type II Injury

• Type III Injury

• Type IV Injury

• Type V Injury

• Type VI Injury

Type I injury corresponds to sprain of the capsule of the [6]joint and is characterized clinically by localizedtenderness and pain on movement, especially horizontal flexion. Type II injuries correspond to a completetear of the [7]AC ligaments with sprain of the coracoclavicular ligaments. On examination, as well as localizedtenderness, there is a palpable step deformity.[8] Type III and V injuries consist of complete tears of thecoracoclavicular ligaments, the conoid and trapezoid. In type III and V injuries, a marked step deformity ispresent.

Type V injuries can be distinguished from type III injuries radio graphically by the amount of displacement.A type V injury has between three and five times greater [9]coracoclavicular space than normal, claviculardistance than the uninjured side. Type V injury typically involves much greater soft tissue injury and includesdamage to the [10]muscle fascia and occasionally the skin. Type IV injuries are characterized by posteriordisplacement of the clavicle and type VI injuries have an inferiorly displaced clavicle into either a subacromialor subcoracoid position. Types IV, V and VI injuries also have complete rupture of all the ligament complexesand are much rarer [11]injuries than types I, II and III.

[12]Management is based on the general principles of management of ligamentous injuries. Initially, ice isapplied to minimize the degree of damage and the injured part is immobilized in a sling for pain relief. Thismay be for two to three days in the case of type I injuries or up to six weeks in severe type II or type IIIinjuries. [13]Isometric strengthening exercises should be commenced once pain permits. Return to sportis possible when there is no further localized tenderness and full range of [14]pain-free movement has beenregained. Protection on return to sport can be provided by tape applied to the AC joint.

Treatment of Shoulder Joint Injuries

21

• The [15]treatment of type III injuries is controversial.

• Historically, most of these injuries have been treated surgically.

• However, recently most clinicians consider that results with conservative management are at least asgood.

• [16]Surgery should then be reserved for type IV, V and VI injuries and those type III injuries that failto respond adequately to conservative management.

• The surgical treatment of [17]AC joint injuries has been hampered by the large forces distracting thearm inferiorly from the clavicle and the paucity of techniques available to anatomically restore thecoracoclavicular ligaments while holding the [18]arm in the reduced position.

Chronic Acromioclavicular Shoulder Joint Pain

[19]Chronic AC joint pain may occur as a result of repeated minor injuries to the AC joint or follow-ing a type II or type III injury. The fibro cartilaginous meniscus situated within the AC joint may be dam-aged. Osteolysis of the outer end of the clavicle is seen occasionally, especially in weightlifters performinglarge numbers of bench presses. X-ray ill this condition shows marked [20]osteoporosis of the distal end of theclavicle. Movements such as horizontal flexion are painful. Another symptom is[21] rotator cuff impingementdue to the abnormal scapular position that results from loss of the clavicle strut. Treatment consists oflocal [22]physiotherapy, including electrotherapeutic modalities and mobilization, combined with musclestrengthening. A corticosteroid injection into the AC joint may relieve pain. Persistent cases require resectionof the distal clavicle.

Osteoarthritis of the AC joint may occur as a result of recurrent injuries. This is characterized by atypical X-ray appearance with sclerosis and [23]osteophyte formation. AC joint pain is usually localized tothe AC a joint.

Symptoms and Diagnosis of Shoulder Joint Pain

• [24]Symptoms may be reproduced by AC joint compression using the Paxinos test or cross-arm adduction.

• The diagnosis can be confirmed and [25]treatment initiated with an injection of local anesthetic andcorticosteroid into the AC joint.

• Persistent AC joint pain may be managed by distal clavicle excision.

• This procedure can be carried out arthroscopically.

• While this procedure is technically reasonably easy to perform; the procedure aims to replace half[26]joint with scar tissue.

• From a biological perspective this makes little sense, which may be why there are very few publicationsreporting the outcomes of this procedure.

Examination of Shoulder Joint Pain

Examination of the [27]shoulder must include an examination of the cervical and upper thoracic spine.Often, cervical lateral flexion or rotation away from the side of the shoulder pain may be reduced or painful.Palpation of the spine, both centrally over the spinous processes and disk spaces and laterally over the

22

apophyseal joints, may reveal stiffness or tenderness. If the cervical or [28]upper thoracic spine is suspected ofbeing a possible cause of shoulder pain, it is useful to treat the hypomobile segment(s) and reassess shouldermovements following treatment to see if there is any reduction in pain. This may indicate that there is acontribution to [29]shoulder pain from the intervertebral joints.

Referred Pain of Shoulder Joint Pain

The shoulder and [30]upper arm are common sites of referred pain. The pain perceived by the athletemay result from local abnormalities, referred pain or both. The joints of the cervical and upper thoracic spinefrequently refer pain to the shoulder region. It is important to ascertain in the history whether the patientexperiences pain or stiffness of the neck. It must be remembered that the neck or upper thoracic spine mayrefer pain even when there is little or no local neck pain present. Similarly, a malfunctioning shoulder oftenhas associated periscapular and trapezial (i.e. neck) pain.

[31]Muscles and fascia in the neck, upper thoracic and scapular regions may also contribute to shoul-der pain. Active trigger points can be found in any of the muscles of the neck and shoulder but those thatcommonly contribute to shoulder pain are in the trapezius, infraspinatus, levator scapulae and rhomboids.[32]Soft tissue techniques and dry needling can be used to treat trigger points.

We specialize in treating Back Pain, Whiplash injuries, Neck Pain, Shoulder Pain, and Hip and Leg Pain. Dr.Gibson will design your [33]treatment plan. Contact us for your next appointment today, at [34](301)977-0640.

[35]http://acutechiro.com/







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How Does a Chiropractor Help Treat Spinal Nerve? (2012-11-24 11:45)

Symptoms And Chiropractic Treatments for Spondylolisthesis:[1] [2]

[3]Spondylolisthesis refers to the slipping of part or all of one vertebra forward on another. The termis derived from the Greek spondylos, meaning [4]vertebra, and olisthanein, meaning to slip or slide down aslippery path.

It is often associated with [5]bilateral pars defects that usually develop in early childhood and have adefinite family predisposition. Pars defects that develop due to athletic activity (stress fractures) rarely resultin spondylolisthesis.

Signs and Symptoms for Spondylolisthesis

• Spondylolisthesis is most commonly seen in children between the ages of 9 and 14.

• In the vast majority of cases it is the L5 vertebra that slips forward on the S1.

• The [6]spondylolisthesis is graded according to the degree of slip of the vertebra.

• A grade I slip denotes that a vertebra has slipped up to 25 % over the [7]body of the vertebra underlyingit; in a grade II slip the displacement is greater than 25 %; in a grade III slip, greater than 50 %; andin a grade IV slip, greater than 75 %.

• Lateral X-rays best demonstrate the extent of vertebral slippage.

Clinical Features for Spondylolisthesis

• Grade I spondylolisthesis is often asymptomatic and the patients may be unaware of the detect.

• Patients with grade II or higher slips may complain of [8]low back pain, with or without [9]leg pain.

• The back pain is aggravated by extension activities.

• On examination, there may be a palpable dip corresponding to the slip.

• Associated soft tissue abnormalities may be present.

• In considering the [10]treatment of this condition, it is important to remember that the patient’s lowback pain is not necessarily being caused by the spondylolisthesis.

25

Clinical Treatment for Spondylolisthesis

Treatment of athletes with grade I or grade II symptomatic spondylolisthesis involves:

• Rest from aggravating activities combined with abdominal and extensor stabilizing exercises and[11]hamstring stretching.

• Antilordotic bracing, which may also be helpful.

• Mobilization of [12]stiff joints above or below the slip on clinical assessment; gentle rotations may behelpful in reducing pain; manipulation should not be performed at the level of the slip.

• Athletes with grade I or grade II spondylolisthesis may return to [13]sport after treatment when theyare pain-free on extension and have good [14]spinal stabilization. If the symptoms recur, activity mustbe ceased.

• Athletes with grade III or grade IV spondylolisthesis should avoid high speed or contact sports.[15]Treatment is symptomatic. It is rare for a slip to progress; however, if there is evidence ofprogression, spinal fusion should be performed.

Chiropractic Treatments for Spondylolisthesis

1. Your course of action relies on your symptoms. Your chiropractic specialist may use one of the var-ious types of [16]backbone modification (also termed as a backbone adjustment) an effective, hands ontechnique that helps recover movement to the backbone to improve combined movement. Spinal modificationtechniques your [17]chiropractic specialist may use include:

• Specific [18]spinal manipulation

• Flexion-distraction technique

• Instrument-assisted manipulation

• Trigger point therapy

• Manual joint stretching and resistance techniques

• Instrument-assisted [19]soft tissue therapy

2. The priority objectives of chiropractic specialist proper maintain treating spondylolisthesis are to boostgood backbone techniques and to improve posture and positioning.

3. Therapeutic workouts are also a significant part of maple grove [20]chiropractic for spondylolisthe-sis.

4. Your [21]chiropractic specialist will recommend specific workouts to help promote stability.

5. Corrective backbone care and workouts can help reduce hyperlordosis and also help address inflam-mation and pain caused by spondylolisthesis.

If activities person are harmed. They are suffering from Spondylolisthesis discomfort then Dr. Gibson

26

is a Panel Qualified Chiropractic specialist with Actual Treatment rights in the state of Maryland Doctor.For more information Call At: [22]301-977-0640.

[23]http://acutechiro.com/

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1.5 December

How to treat Hamstring Muscle Strains? (2012-12-21 09:53)

Treatment of Hamstring Muscle Strains: [1]

[2]Acute, moderate, or severe [3]hamstring strains are common [4]injuries among sprinters, hurdlers, and longjumpers. They also occur in other sports involving sprinting, especially football and field hockey. There is atendency towards an increased incidence with increasing age. [5]Hamstring injuries occur frequently despitethe prevalence of stretching and strengthening programs.

Biomechanics of Hamstring Injury:

The majority of [6]hamstring muscle injuries occur in the biceps femoris [7]muscle, mainly at the muscle-tendon junction. They are usually a non-contact injury and mostly occur during sprinting. During maximalsprinting the hamstrings become highly active in the terminal swing phase as they work eccentrically todecelerate the swinging [8]tibia and control extension of the [9]knee. The hamstrings then remain active intothe initial stance phase, whereby they work concentrically as an extensor of the [10]hip joint. Recent studieshave demonstrated that during unperturbed sprinting the point of failure is most likely to occur during theterminal swing phase just prior to [11]foot strike. It is at this point that the [12]hamstrings are maximallyactivated and are approaching peak length.

Factors that predispose to Hamstring Strain:

Predisposing factors are generally divided into Intrinsic (person-related) and Extrinsic (environment-related)factors.

• [13]Intrinsic Predisposing Factors

• [14]Extrinsic Predisposing Factors

Intrinsic Predisposing Factors

• Age

• Previous [15]Injury

• Race

• Flexibility

28

• Strength

• Neuromyofascial

• Lumbopelvic Stability

• [16]Joint Dysfunction

Extrinsic Predisposing Factors

• Warm-up

• Fatigue

• Fitness Level

• Training Modalities

Additional specific predisposing factors in recurrent hamstring injuries:

• Inadequate [17]Rehabilitation: This may lead to deficits in strength and/or flexibility.

• Angle of peak torque: As mentioned above, footballers with a history of hamstring strain develop peaktorque at angles representing shorter muscle length, which therefore makes them vulnerable to load inthe muscle under lengthened situations.

• Neural tension: Injury may result in increases in neural tension.

Prevention of hamstring muscle injuries:

1. Stretching

A warm-up [18]stretching program was found to statistically reduce the number of hamstring injuriesin a military population.

2. Strengthening Program

Correcting strength deficits can lower injury to the [19]hamstrings. Pre-season hamstring muscle strengtheningusing an open chain weight machine reduced the number of minor hamstring injuries but not the number ofsignificant injuries. Specific eccentric training may be more important in view of the mechanism of injury.

3. Thermal Pants

The use of thermal pants has been suggested to have a role in reducing the recurrence of [20]hamstringinjuries.

4. Combined Programs

A number of multifactorial programs appear to have been effective in reducing the number of hamstringinjuries. The programs have included:

29

• Increasing the amount of anaerobic interval rather than aerobic training, stretching while [21]muscle isfatigued, sport-specific training drills, and closed chain rather than open chain leg weights.

• A program combining general interventions such as improved warm-up, regular cool down, and a seriesof exercises to improve stability of [22]ankle and knee joints, flexibility and strength of the trunk, hipand [23]leg muscles, as well as to improve coordination, reaction time and endurance-this was found tobe effective in reducing injuries in soccer players, including [24]thigh injuries.

Clinical Features:

The main aim of the clinical history, examination, and investigations is to differentiate between the significant[25]hamstring tear and neuromyofascial referred [26]pain primarily from gluteal trigger points but also fromlumbar spine and SIJ structures.

Treatment of Hamstring Strain:

There is very little scientific evidence on which to base one’s [27]management of hamstring injuries. Onlyone study has compared the efficacy of two treatment regimens, so much of the regimen described below ison the basis of our clinical experience. Clearly, further research needs to be performed in this area.

• Acute management

Acute injuries should always be assessed before any [28]treatment, including ice, is administered. The[29]RICE program should be commenced. Pain-free, active [30]knee extension may be performed while sittingfollowing 10-15 minutes of ice. This active stretching of the [31]hamstring is conducted for 5 minutes andthe whole process may be repeated every hour in the initial phase. The athlete may actually wake everyfew hours to use this technique in order to ensure inflammation settles as quickly as possible. This processnormally takes place over two to three days or until inflammation has settled.

• Medication

The role of NSAIDs in the treatment of [32]acute muscle injuries such as the hamstring is controversial. Themost common recommendation in the literature is short-term use (three to seven days) starting immediatelyafter [33]injury. The intended aim of using NSAIDs is to keep the inflammatory process under control and toprovide analgesia. However, the normal healing process could be blunted as a result and the repair responsedelayed. There is a case to delay [34]treatment with NSAIDs until two to four days after injury because thedrugs interfere with chemotaxis of [35]cells, which is necessary for the repair and remodeling of regeneratingmuscles.

• Stretching

In the acute phase, pain-free range of motion should be achieved as soon as possible. If there is long-termloss of range of motion, then specific stretching should be undertaken to focus on the affected area.

• Soft Tissue Therapy

30

At an appropriate time depending on the severity of the injury, [36]soft tissue techniques can be used inthe treatment of hamstring strains. The distal musculotendinous region is palpated therapists [37]shoulder.Digital ischemic pressure and treated in knee [38]flexion with the foot resting on the and sustained myofascialtension are used. Abnormalities of the gluteal muscles may be associated with hamstring strains. Theseregions may be treated in a side-lying position using [39]elbow ischemic pressure with the [40]tissue on stretchand the muscle contracting.

• Manual Therapy

The presence of a degree of hypomobility in any segment of the [41]lumbar spine, found on examination,should be treated. If increased neural tension is found at examination, neural stretches should be included inthe treatment regimen.

• Strengthening

Strengthening is an essential component of prevention and [42]rehabilitation of hamstring injuries. Musclestrengthening should be specific for deficits in motor unit recruitment, muscle bulk, type of contraction andability to develop tension at speed. [43]Muscle strengthening is mode-specific, in other words concentric muscleexercises lead to increases in concentric strength, eccentric muscle exercises lead to increases in eccentricstrength, with little or no crossover.

• Progressive running program

Early commencement of a progressive running program is an important part of a rehabilitation following ahamstring [44]muscle injury. Scientific studies need to be performed to validate this program but [45]physio-therapists with over 20 years experience of this program are convinced of its effectiveness. The basic principlesare listed below with further detail:

• Running program starts 48 hours after injury.

• 20 minute running sessions twice a day.

• Preceded by 10 minutes of gentle hamstring stretching.

• Commences with jogging with short stride.

• Patient encouraged to increase stride length and pace gradually over the session as the [46]ache allows.

• Interval running over 100 m with acceleration, maintenance and deceleration phases.

• If there is even the slightest increase in pulling sensation through the hamstring, then the session mustimmediately cease. The [47]athlete should apply ice and the program can be attempted again as earlyas the next 12 hours.

• Finish with 10 minutes of gentle hamstring stretching and then apply ice to the injured area for 10minutes.

• Criteria for return to sport

31

There is no standard time for return to sport after hamstring injury as every [48]hamstring injury is different.No scientific studies have examined the outcomes of various return to play strategies. It does not appear thatthe MRI appearance is a good indicator of readiness to return to play. Rather than a specific time frame it ispreferable to have definite criteria for return to sport:

• Completion of progressive running program.

• Full range of movement (equal to uninjured leg).

• Full strength (equal or almost equal to uninjured leg).

• [49]Pain-free maximal contraction.

• Successful completion of a full week of maximal training.

It is important to continue the [50]strengthening program for a few weeks after return to sport.

Hamstring Strains are very common sport related injury that occur in athletes activities. If you are sufferingfrom Hamstring Muscle Strains then contact Dr. Gibson. Dr. Gibson utilizes new technologies and therapiesto facilitate prompt recovery. Call at: [51]301-977-0640

[52]http://www.acutechiro.com

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How to Get Comfort from Low Back Pain? (2012-12-29 11:51)

Investigation and Treatment of Low Back Pain:[1]

Any of the nociceptive (pain-producing) structures of the [2]lumbar spine may cause low [3]back pain.These structures include the [4]vertebral venous plexus, dura mater, [5]ligaments of the vertebral arches,[6]muscles and their fascia, vertebral bodies, laminae, [7]apophyseal joints and the anulus fibrosus of the[8]intervertebral disk.

Provocation techniques have demonstrated that damage to the intervertebral disks and the apophysealjoints are the most common causes of [9]low back pain. With low back pain of lengthy duration, a number offactors will contribute to the overall clinical picture. These may include abnormalities of the ligaments of theintervertebral joints, muscles and [10]fascia, as well as neural structures.

Causes of Low back pain

There are two specific entities that may cause [11]disk pain-torsional [12]injury of the anulus fibrosusand compression injury. The anulus fibrosus is most vulnerable to a combination of axial rotation and forward[13]flexion, which corresponds to the clinical situation of lifting in a bent and rotated position.

The other common site of damage is the apophyseal [14]joint. Possible causes of pain from the apophy-seal joint include subchondral [15]fractures, [16]capsular tears, capsular avulsions and hemorrhage intothe joint space. Abnormalities of Joints, muscles and neural structures may contribute significantly tothe pain. In [17]low back pain of relatively recent onset, the greatest contribution to the pain is usuallyfrom the [18]joints. Each of these components must be assessed clinically and abnormalities treated. [19]

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Functional (clinical) instability in low back pain

Stability of the [20]lumbar intervertebral segments is principally provided by osseous and ligamentousrestraints. However, without the influence of neuro-muscular control, the segments are inherently unstableupon movement. Therefore, a combination of muscle forces and passive structures are utilized to dynamicallystabilize the [21]ligamentous spine under various demands of daily living and athletic activity. It is importantthat the definition of stability includes the concept of control, rather than just [22]hypermobility or increaseddisplacement and range of movement, as it has been historically, although this will be the case in someconditions such as [23]spondylolisthesis.

History

The aim of the history in a patient with low [24]back pain is to determine the location of the [25]pain,its mechanism of onset, its degree of irritability, any radiation to the [26]buttocks or [27]legs, the aggravatingand relieving factors and any previous history of back problems and response to [28]treatment in the past.Factors that aggravate and relieve the pain, such as flexion/extension and how easily the pain is aggravated,are important in determining the type and intensity of treatment. Potentially serious symptoms that mustbe noted include:

• Cauda equina symptoms, for example, [29]bladder or bowel dysfunction

• [30]Spinal cord symptoms, for example, difficulty walking, tripping over objects

• Sensory symptoms, for example, pins and needles, paresthesia

• Motor symptoms, for example, [31]muscle weakness

• Systemic symptoms, for example, weight loss, [32]malaise

• Night pain.

Examination

Examination of the patient with low back pain includes assessment of pattern, timing and range of movement,detection of [33]stiffness and [34]tenderness in muscles and joints, and detection of neurological abnormalitiesor evidence of neural irritation.

1. Observation

35

• From behind

• From the side

2. Active movements

• Flexion

• Extension

• [35]Lateral flexion

• Combined movements-quadrant position

• Single leg extension

3. Passive movements

• Overpressure may be applied at the end of range of active movements

• Muscle length (e.g. psoas, hamstring, gluteals)

• [36]Hip quadrant

4. Palpation

• Spinous processes

• Transverse processes

• Apophyseal joints

• [37]Sacroiliac joint

• Iliolumbar ligament

• [38]Paraspinal muscles

• Quadratus lumborum

• Gluteal muscles

5. Special tests

• Straight leg raise/slump test

• Prone [39]knee bend/femoral slump

• Sacroiliac joint test

• Neurological examination

36

Investigations and Treatment of Low Back Pain:

• In the mangement of most cases of low back pain, investigations are not required. However, there arecertain clinical indications for further investigation.

• X-ray should be performed if [40]traumatic fracture, [41]stress fracture, spondylolisthesis or structurallumber instability are suspected. It is also advisable to X-ray those patient whose low back pain is notresponding to [42]treatment or where sinister abnormality may be suspected.

• CT scanning is commonly performed in cases of suspected [43]nerve root compression but usually addslittle to the clinical picture unless specific neurological signs are present.

• Disk protrusions and disk bulges are commonly seen in asymptomatic patients and the CT scan, unlikeMRI, is unable to provide any further information on the internal structure of the [44]intervertebraldisk.

• However, spinal canal stenosis and [45]facet joint arthropathy are well defined on CT scanning. Thepresence of a pars interarticularis defect may also be confirmed on CT scanning.

• [46]Degenerated disks that have lost fluid have a characteristic appearance on MRI. MRI may confirmthe presence of an anular tear in the disk and provide information about the [47]vertebral end plate.

• It is used most commonly when surgery is planned for the [48]treatment of an [49]acute or chronic diskherniation.

• Although diskography is the only imaging test for diskogenic pain, psychological factors can significantlyalter the result of these tests.

Low Back Pain is very common among all ages of persons. Acute Spine Chiropractor and Physical TherapyGaithersburg MD offers comprehensive chiropractic, physical therapy for your Low back Pain. Call Today at:[50]301-977-0640

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Chapter 2

2013

2.1 January

How is a Cervical Spine damage Diagnosed? (2013-01-17 10:49)

Causes and Symptoms of Cervical Spine Injury:

[1]Injuries of the [2]cervical spine are dangerous; and if associated with neurological damage, the results canbe devastating. Cervical backbone [3]bone injuries cause to significant deaths. Throat injury in [4]sportsmencan quickly end or change the future of an sportsman. Failing to effectively identify and provide early care incervical [5]backbone crack cases may cause to harmful problems.

Causes

• Fall from height: It is the most common cause in developing countries.

• Diving Injuries: Diving into water with insufficient depth or in an [6]inebriated condition.

• Road Traffic Accidents (RTAs): Common cause in developed countries, e.g. [7]whiplash injury.

• Gunshot Injuries: These injure the cervical spine and the [8]cord directly.

[9]

Mechanism of Injury

41

• Pure [10]Flexion Force: For example, compression [11]fracture of [12]vertebral body, e.g. fall fromheight.

• Flexion Rotation Force: For example, fall on one side of the [13]shoulder, disruption of facet capsule isseen.

• Axial Compression: For example, fall of an object on the head results in load compression, e.g. explosivecomminuted fracture of C5 body.

• Extension Force: For example, avulsion fractures of superior margin of vertebral body, e.g. whiplashinjury.

• Lateral Flexion: For example, [14]fracture pedicle, fracture transverse process and [15]facet joints, etc.

• Direct Injuries: For example, fracture spinous process and body. Due to assault, [16]gunshot injury, etc.

Definition

It is an unconventional and inconsequential [17]ligamentous injury of the [18]cervical spine allegedly due toan extension [19]injury following a rear-end collision in an RTA.

Incidence

• It is seen in about 25 percent of rear-end collision of RTAs.

• Seventy percent of those affected are women.

• It is common in the 3rd or 4th decades.

Clinical Features

1. Symptoms

• Upper [20]neck pain that becomes worse with movement.

• Occipital [21]headache.

• [22]Neck stiffness.

• Rarely vertigo, auditory or visual disturbances, etc.

2. Signs

• Decreased range of neck movements.

• Neck [23]muscle spasm is seen.

42

Note: [24]Symptoms appear within 48 hours of injury and 57 percent recover within three months. Finalstate is reached by one year.

Investigations

X-rays are usually normal. MRI helps to make a [25]diagnosis.

Treatment

It is mainly conservative and consists of the following:

• Drugs: NSAIDs, [26]muscle relaxants, etc. are given.

• Collars: These are recommended for the first three days.

• Short arc active movements are slowly begun.

• Active ROM exercises are slowly commenced.

• After the [27]pain subsides, isometric strengthening exercises are slowly commenced.

• Other modalities take ultrasound, traction, manipulation, massage, etc. also helps.

A cervical [28]backbone damage is a disastrous damage that occurs to the central source backbone betweenthe levels of the first cervical central source backbone (C1) and the seventh cervical central source backbone(C7). The [29]spinal cord is a bundle of nerves that extend from the base of the [30]brain down through thefirst or second [31]lumbar central source backbone. If you want to take best [32]treatment then call today atour Chiropractic Treatment Center in MD: [33]301-977-0640

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Dave (2013-01-17 11:20:00)I found Acute Spine people very professional and they know what to do. I went through the treatment for my spine byDr. Gibson and his treatment works perfectly alright for problem. I would recommand this place everyone in the areafor all your chiro practor and physical therapy needs.

Acute Spine Rehab & Physical Therapy (2013-01-17 11:31:33)Thanks alot.

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How to treat Distal Leg Fracture? (2013-01-19 08:08)

Classification and Treatment of Distal Tibial Fractures: [1]

These are severe [2]injuries and are predominantly due to high energy axial loading forces following the RTAor fall from height unlike the [3]malleolar fractures, which are mainly due to low energy rotational forces.These are also called as distal [4]tibial explosion [5]fractures.

Incidence

Here are some of the vital statistics concerning the [6]pilon fractures:

• It accounts for less than 10 percent of all [7]lower limb fractures.

• Males are more commonly affected than females.

• Mean age is 35-40 years.

Classifications

The important classifications have been described namely.

1. Ruedi and Allgower Classifications: This were the classification that was widely used. Three vari-eties are described.

• Type I: Undisplaced cleavage fracture of the [8]joint.

• Type II: Displaced but minimally comminuted fractures.

• Type III: Highly comminuted and displaced [9]fractures.

2. AO/OTA Classification: This is the most recent classification and it consists of the following varieties.

• Type A: [10]Extra-articular fractures.

45

• Type B: Partial intra-articular [11]fractures.

• Type C: Total [12]intra-articular fractures.

Depending upon the amount of comminution, each variety is divided into three groups. Any of these groupsare again divided into three subgroups depending on the fracture characteristics.

The associated [13]soft tissue [14]injuries are classified into four categories from 0-3 from negligible damageto extensive soft tissue damage. Tscherne and Goetzen proposed this classification.

Clinical Features

The patient complains of [15]pain, [16]swelling, deformity, and inability to bear weight. Open woundsare a disaster and the patient may complain of [17]cold, clammy feet and loss of sensation.

Investigations

Routine X-rays of the [18]ankle consists of the AP, lateral and ankle mortise views. CT scan is moreuseful and gives more information about the nature and extent of the [19]injury than mere X-rays.

Treatment

Minimally displaced fractures (Type A variety) can be treated conservatively with a plaster cast. Grosslydisplaced fractures require surgical treatment consisting of open reduction and internal fixation with plateand screws. External fixation is the other useful method of [20]treatment and the methods are:

• [21]Hybrid fixation

• Ilizarov’s fixation

• Monolateral fixator

These external fixators can be used across ankle or on the same side of the [22]joint.

Primary Arthrodesis: This is considered in extremely communited [23]pilon fractures where reconstruc-tion is next to impossible. External fixators can be used to bring about the [24]arthrodesis.

Distal leg bone accidents are complicated accidents with a high side-effect rate. Management of distalshin bone accidents, with or without articular participation, is a healing task. Call today for Best Chiroprac-tic doctors: [25]301-977-0640


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How to cure Lumber Back Pain? (2013-01-22 11:27)

Causes and Treatment of Cauda Equina:

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[1]

[2]Cauda Equina Syndrome is seen in [3]injuries below the level of first [4]lumbar vertebra. It is essen-tially injury to the [5]nerve roots below L1.

Causes

• Tumors of the [6]spine.

• Pott’s [7]disease.

• Protrusion of disk-large midline disk prolapse at 4-5.

• [8]Fracture dislocation of the [9]thoracolumbar spine.

Clinical Features

Symptoms

The patient complains of [10]back pain, [11]perineal pain, difficulty in micturition, impotence in male,etc.

• Sensory signs: The most salient feature of a [12]cauda equina lesion is an area of saddle-shapedhyperesthesia and later anesthesia (involving [13]buttocks, anus and perineum).

• Motor signs: Flaccid paralysis below the [14]knee.

• Reflexes: [15]Ankle jerk is lost and the knee jerk is increased due to the weakness of the opposing[16]hamstrings.

• Bladder symptoms: Common problems are retention of urine with overflow. Even after a severe caudaequina, lesion reflex micturition is established later, reflex being mediated through the [17]vesical plexus.

• Anal sphincter relaxation: leading to incontinence of the bowels.

Investigations

Plain X-ray, CT scan, MRI of the affected part is recommended.

Treatment

Prompt surgical intervention is the [18]treatment of choice. This consists of operative stabilization of

48

the [19]fractures, bowel, back and bladder care and other [20]rehabilitating measures have already beendescribed above.

Prognosis in Spinal Cord Injuries

Ten-year survival rate in [21]spinal cord injury is 86 percent.

The spinal cord ends in the lumbar area and continues through the vertebral canal as spinal nerves. CallToday for quick appointment: [22]301-977-0640


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2.2 February

Are you suffering from Medial Calcaneal Nerve? (2013-02-08 06:33)

Clinical Features and Treatment of Medial Calcaneal Nerve (Foot Pain):

[1] The [2]medial calcaneal nerve is a branch of the posterior [3]tibial nervearising at the level of the medial malleolus or below and passing superficially to innervate the skin of the[4]heel. Occasionally it may arise from the lateral [5]plantar nerve, a branch of the posterior tibial nerve. Ithas been theorized that a valgus [6]hind foot may predispose joggers to compression of this nerve branch.

Clinical Features

• Entrapment or irritation causes burning pain over the inferomedial aspect of the [7]calcaneus, whichoften radiates into the arch of the [8]foot, and is aggravated by running.

• Examination reveals [9]tenderness over the medial calcaneus and a positive Tinel’s sign. There is oftenassociated excessive pronation.

Investigations

• [10]Nerve conduction studies can help confirm the diagnosis.

• [11]Injection of local anesthetic at the point of maximal tenderness with a resultant disappearance ofpain will confirm the diagnosis.

Treatment

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• [12]Treatment involves minimizing the [13]trauma to the nerve with a change of footwear or the use ofa pad over the area to protect the nerve.

• Use of local electrotherapeutic modalities and transverse friction to the painful site may help to settlethe [14]pain.

• If this is not successful, injection of [15]corticosteroid and local anesthetic agents into the area of pointtenderness may be helpful.

• [16]Surgery may be required to decompress the nerve.

Other Causes

• Two conditions that generally cause [17]foot pain but may present as [18]medial ankle pain are [19]stressfractures of the calcaneus and the navicular.

• Referred pain from neural structures may occasionally present as medial ankle pain.

• Entrapment of the medial plantar nerve generally causes [20]midfoot pain but may present as medialankle pain.

The Medial Calcaneal sensors is a division of the tibial sensors, which is a significant sensors providing mostof the muscle tissue and epidermis of the returning of the leg. The medial calcaneal sensors occurs from theprimary sensors of the inner part of the ankle, screen on the inner part of the rearfoot, and resources theepidermis over the inside element of the returning heel. [21]Dr. Gibson is a Board Certified Chiropractorwith Physical Therapy privileges in the state of Maryland. Call Today at: [22]301-977-0640


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How to get comfort from Wrist Bone Injury? (2013-02-23 06:15)

Types and Treatment of Wrist Bone Injury:

These are rare [1]injuries and account for 1 to 2 percent of all [2]carpal fractures. It is often associated withcarpal-metacarpal dislocations.

Mechanism of Injury

Isolated [3]capitate fractures are rare and are known to occur due to an axial loading injury to the middlefinger to which the capitate is attached below. Direct blow is the other mechanism of [4]injury.

[5]

Types

Three types are described:

• Isolated capitate fracture is rare.

• Associated with carpal-[6]metacarpal dislocation.

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• Scaphocapitate syndrome: This is more common.

This consists of fracture of the waist of the scaphoid and a proximal capitate fracture.

Signs & Symptoms

Common Damaged Hand signs & symptoms:

• Hand [7]discomfort

• Inflammed wrist

• Pain is more intense when going the wrist back (extending)

Clinical Features

• [8]Pain

• [9]Swelling

• Restricted wrist movements are seen

Investigation

Plain X-ray of the [10]wrist can diagnose capitate fractures. In difficult cases, CT scan is advised.

Treatment

• Undisplaced fractures are treated by a below [11]elbow cast for 4 to 6 weeks.

• Displacement is an indicator for fixation, as is concomitant surgery [12]treatment on the [13]scaphoid.

• If the scaphoid is broken it will be set, and at that establishing the [14]capitate fracture may be set aswell.

The Wrist bone is the biggest carpal cuboid, though it is not the most regularly broken, and is hardly everbroken in solitude. Accidents to the capitate are often aspect of complicated injuries. [15]Acute Spine Rehab& Physical Therapy is best Chiropractic Clinic in MD. Do not wait and contact us for your next appointmenttoday, at [16](301)977-0640.









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How to get Comfort from Wrist Pain? (2013-02-26 10:03)

Types, Investigation and Treatment of Hamate Bone:

The [1]Hamate Bone is one of the many [2]carpal bone fragments in the hand, and it has an external placeformed like a little connect. The hamate cuboid is on the pinkie handy part of the [3]hand, and it is one ofmany typical brittle cuboid fragments that a football gamer can have. This accounts for 2 to 4 percent of allcarpal fractures.Mechanism of Injury

It could be due to a direct blow or indirect force while trying to grip an object.

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[4]

Types of Wrist Bone Fracure:

[5]Hamate Fractures could be either:

• [6]Body Fractures

• Hook Fractures

Clinical Features

• [7]Pain in the medial side of the palm and comes on with grip is quite typical of hamate fractures.

• Few patients may present with [8]ulnar nerve (distal) paraesthesia or palsy.

• Ruptures of the ring and little fingers are seen in some severe cases.

Investigations

• Plain X-ray of the [9]wrist (AP lateral and oblique views) usually helps in detecting the fracture.

• CT scan helps in doubtful cases.

Treatment

• [10]Acute fractures are treated by immobilization with short [11]arm cast for 6 to 10 weeks.

• Non-union of the hook are usually [12]treated by excision.

The hamate cuboid is a pitching wedge formed cuboid discovered below the little handy and near to thehand. It projects in a ’hook’ development. Accidents to this cuboid are relatively unusual but neverthelesshave improved in popularity as contribution increases in activities that use softball bats and racquets. [13]Dr.Gibson is a Board Certified Chiropractor with Physical Therapy privileges in the state of Maryland. CallToday : [14]301-977-0640

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2.3 March

How to prevent Hand Discomfort? (2013-03-20 06:56)

Clinical Features and Treatment of Hand Pain:

[1] The complaint of [2]discomfort in the area of the [3]radial styloidis not rarely experienced in exercise, and its most typical etiological foundation is stress. This may be seriousand take the way of a immediate strike or, however, may continue from only one intense abduction.

Mechanism

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It is usually because of the starting crank of an engine being suddenly reversed by a backfire and striking thewrist with a force. It is common in chauffeurs and is an avulsion [4]fracture of the [5]radiocarpal ligament.

Clinical Features

• [6]Pain

• [7]Swelling

• Tenderness over the radial styloid process

• Movement of the [8]wrist, especially radial deviation, is painful

Radiographs

Radiograph AP view of the wrist shows it as a transverse fracture.

Treatment

• Immobilization of the [9]thumbs with a safety [10]splint or throw may be necessary to offer relax forthe [11]muscle, which reduces the discomfort.

• However, people regularly eliminate the splint because of the limitation it enforces, and there is somequery about its advantages when used alone.

• [12]Physical therapy [13]treatment is used to decrease the pain and swelling.

[14]Acute Spine Rehab & Physical Therapy specialize in treating Hand Pain, Back Pain, Whiplash injuries,Neck Pain, Shoulder Pain, and Hip and Leg Pain. [15]Dr. Gibson will design your treatment plan. Do notwait and contact us for your next appointment today, at [16](301)977-0640.


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How to get Relaxation from Knee Joint Injury? (2013-03-29 05:27)

Clinical Features and Treatment of Runner’s Knee:

[1] [2]Chondromalacia Patella is defined as a blistering, cystic changeof the patellar cartilage and it usually affects the [3]medial facet of the patella. This condition is commonlyassociated with vastus medialis tendinitis. It is caused by the combination of several factors, which ultimatelypush the [4]patella out of its groove on the [5]femur. It is attributed to a decrease in sulphated mucopolysac-charide in the ground substance.

Clinical Features

• The patient complains of generalized deep [6]pain in the knee.

• The knee may be swollen with a chronic effusion of synovial fluid and there will be a positive[7]patellofemoral grinding test when the condition is severe.

• The [8]vastus medialis will be weak, radiographs will occasionally show spurring and the patient will beunable to do squats.

• In this condition the typical complaint is that of pain in the [9]knees after prolonged sitting as inwatching a movie or while traveling.

Investigations

Radiographs of the knee shows irregular retro-patellar surface. Arthroscopy is an extremely useful di-agnostic technique. MRI is another very useful investigative option.

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Differential Diagnosis

• Chronic [10]synovitis of the knee

• [11]Sprain of the retinacula

Treatment

[12]Treatment consists of ice and ultrasound massage of the painful area, realignment of the maltrack-ing of the patella by orthotic therapy and arthroscopic shaving of the [13]retropatellar surface gives excellentresults.

[14]Dr. Gibson is a Board Certified Chiropractor with [15]Physical Therapy privileges in the state ofMaryland. Dr. Gibson utilizes new technologies and therapies to facilitate prompt recovery. Do not wait andcontact us for your next appointment today, at [16](301)977-0640.


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2.4 April

How to get Relief from Anterior Leg Pain? (2013-04-13 10:46)

Types and Treatment of Leg Pain:

[1] [2]Meralgia paresthetica is a condition recognized by losing pain in the ex-ternal part of your [3]upper leg. The cause of meralgia paresthetica is pressure of the sensors that resourcesfeeling to the outer lining area of the skin of your upper leg.

Types

• Idiopathic: Here, the exact cause is unknown.

• Spontaneous: This is due to mechanical compression anywhere throughout the course of the [4]nerve.The common site of [5]injury is at the exit of the nerve at the pelvis.

• Iatrogenic: This is commonly seen after surgeries like anterior iliac crest [6]bone grafting and anteriorpelvic procedures and prone positioning for surgeries.

Clinical Features

This is characterized by [7]pain, numbness and paresthesia along the anterolateral aspect of the [8]thigh.

Diagnostic Test

If there is relief of pain and paresthesia after injecting local anesthetic, the [9]diagnosis is clinched.

Treatment

• Idiopathic type: Improves by removal of the compressive agents, nonsteroidal anti-inflammatory drugsand local steroid injection.

• Iatrogenic type: Care should be [10]exercised during pelvic surgery.

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[11]Acute Spine Chiropractor and Physical Therapy Gaithersburg MD offers comprehensive chiropractic,physical therapy, and long lasting medical solutions for your back pain, [12]neck pain, shoulders, hips andlegs. Call now for Quick Appointment: [13]301-977-0640


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How to recover from Scoliosis (Spine Disease)? (2013-04-25 07:26)

Clinical Features and Treatment of Scoliosis:

[1]

[2]Scoliosis is the lateral curvature of the [3]spine in the upright position in the coronal plane. The lateralcurvature is usually accompanied by some rotational deformity. Only man boasts of an erect posture. Naturehas designed four physiological curves in the so-called erect spine, [4]cervical and lumbar lordosis, dorsal curvein the thoracic spine and the sacral region. Thus, when the spine develops a [5]lateral curve, it is abnormal.It throws the well-adjusted spinal mechanism out of gear and poses the following problems:

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• A cosmetically unacceptable deformity

• Deranges the load and force transmission mechanism through the spine

• Jeopardizes the functions of vital organs like lungs, heart by overcrowding the ribs

• Managing it is cumbersome and unrewarding experience most of the times

Clinical Features

• Though idiopathic [6]scoliosis can occur at any age, it usually appears clinically between 10 and 13years. It is more common in females (10 %).

• The disease is usually asymptomatic and is usually accidentally discovered.

• The diagnosis is usually made on routine physical examination.

Radiology

Radiographic evaluation of the [7]spine is the only available method to determine the severity of the curve. Itis repeated at intervals to determine the progression of the curve.

Treatment

The most important aspect in the [8]treatment of scoliosis is early detection of the curve. A curve that isobvious in standing position has already approached 30-40 degree. Detecting a curve before it reaches 20degree is of utmost importance because curves over 20 degree tend to progress. Frequent re-examinations areessential. The treatment depends on the age of the patient and the severity of the curve.

• Nonsurgical treatment: Observation is the primary [9]treatment of all curves and more so for curves lessthan 20 degrees. At present, radiography is the only delite documentation of curve size and progression.

• Orthotic treatment: This is effective in skeletally immature persons. For mild or moderate curves,Milwaukee brace, [10]Boston brace, Reisser’s turn buckle cast, localizer cast, etc. are used and the 20degree level is considered still for bracing.

• Other nonoperative measures: [11]Exercises, traction and electrical stimulation have been unsuccessfullytried in adolescent variety.

[12]Acute Spine Rehab & Physical Therapy is the best [13]Chiropractic Clinic in Gaithersburg, MD.[14]Dr. Gibson has expertise in more gentle techniques and uses computer assisted technology for bothdiagnosis and treatment of spine and [15]joint problems. Contact Us at: [16]301-977-0640 or Visit:[17]http://www.acutechiro.com

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Monique (2013-05-13 10:56:21)Great Information... Appreciate!

Acute Spine Rehab & Physical Therapy (2013-05-16 05:17:34)Thanks.

2.5 May

How to Prevent Scapula (Shoulder) Injury? (2013-05-10 11:13)

Clinical Features and Treatment of Shoulder Injury:

[1] [2]Scapula is a flat [3]bone thickly covered by [4]muscles.

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Incidence

• It is a rare [5]injury.

• 3 to 5 percent of all shoulder girdle injuries.

• 0.4 to 1 percent of all fractures.

• Mean age is 35 to 45 years.

Functions

• Stabilizes the upper extremity against the [6]thorax.

• Links the upper extremity to the glenoid.

Mechanism of Injury

• Direct blow-fall of a heavy object on the [7]shoulder blade.

• Axial loading on the outstretched [8]hands.

Classification

Type I: Coracoid, acromion and small fractures of the body.

Type II: The glenoid and [9]neck fractures.

Type III: Body fractures major.

Clinical Features

The patient complains of [10]pain and [11]swelling, arm is held adducted to the sides of the chest, allmovements of the shoulder, especially abductions, are painful, may be associated rarely with pneumothoraxand inability to elevate the arms may give a feeling of pseudo-rupture of the [12]rotator cuff.

Radiographs

A true scapular AP view and a true lateral view (axillary view) helps to make the diagnosis.

Treatment

• Nonoperative Methods: Undisplaced scapular fractures may be [13]treated conservatively with rest,sling, strap, etc.

• Operative Methods: Displaced fractures need open reduction and internal fixation with K-wires, screws,etc.

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[14]Dr. Gibson is a Board Certified Chiropractor with [15]Physical Therapy privileges in the state of [16]Mary-land. Dr. Gibson also has expertise in more gentle techniques and uses computer assisted technology forboth diagnosis and [17]treatment of spine and joint problems. Call now at: [18]301-977-0640

Visit our Website: [19]http://www.acutechiro.com/

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Chiropractic Treatment for Arm Injury (2013-05-16 06:22)

Classification and Treatment of Arm Splint:

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[1]

[2]Medial condyle bone injuries include a crack range that expands through and distinguishes the me-dial metaphysis and epicondyle from the rest of the humerus. By meaning, the [3]fracture range must includethe trochlear articular area. It is rare in children (1 %) and is seen in age group 8 to 14 years.

Classification

1. Anatomical Location

• Type I: Fracture line [4]lateral to trochlea.

• Type II: Fracture line through the apex of trochlea.

• Type III: Fracture line through the capitulo-trochlear groove.

2. Stages of Displacement

• Impacted

• Complete

• Displaced and rotated

Clinical Features

Usual signs and [5]symptoms of fracture, [6]tenderness and crepitus are positive over the [7]medial condyle.

Radiograph

Routine AP and lateral views help to make an accurate diagnosis.

Treatment

Stages I and II: Above [8]elbow cast or [9]splint.

Stage III: Open reduction and internal fixation and K-wire fixation.

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Complications

• Missed diagnosis

• Non-union with [10]cubitus varus

• Delayed union

• Cubitus valgus due to growth stimulation

• [11]Ulnar neuropathy

[12]Dr. Gibson is a Board Certified Chiropractor with [13]Physical Therapy privileges in the state of Maryland.Originally from Colorado, and after completing his undergraduate studies at the University of Colorado, Dr.Gibson attended graduate school in the Finger Lakes region of New York where he obtained his Doctorate in[14]Chiropractic at New York Chiropractic College. He has been in private practice since 2003. Call now forQuick Appointment: [15]301-977-0640


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2.6 June

How can I Prevent Wrist Pain? (2013-06-25 09:59)

Common Conditions and Treatment information:

[1]Wrist pain is an extremely common complaint, and there are many common causes of this problem. It isimportant to make an accurate diagnosis of the cause of your [2]symptoms so that appropriate [3]treatmentcan be directed at the cause. Injury to the sensitive structures of the [4]wrist and hand, or inflammatoryconditions such as bursitis or [5]tendonitis often respond well to conservative [6]physical therapy and chiro-practic care. Conversely if left untreated, may require more invasive medical treatments such as injections oreven surgery. The following is a partial list of conditions that we treat successfully at our center:

[7]1. Tendonitis

[8]Tendonitis is a common problem that can cause wrist pain and [9]swelling. Wrist tendonitis is due toinflammation of the tendon sheath. Treatment of wrist pain caused by tendonitis usually does not requiresurgery.2. Sprain

Wrist sprains are common [10]injuries to the ligaments around the wrist joint. [11]Sprains can cause problemsby limiting the use of our hands. If you are experiencing symptoms associated with Tendonitis or Sprain, callour office today to see how our techniques can benefit you.3. Carpal Tunnel Syndrome

[12]Carpal tunnel syndrome is the condition that results from dysfunction of one of the nerves in the wrist.In carpal tunnel syndrome the median nerve is compressed, or pinched off, as it passes through the [13]wristjoint.

4. Arthritis

[14]Arthritis is a problem that can cause wrist pain and difficulty performing normal activities. There areseveral causes of arthritis, and fortunately there are a number of [15]treatments for wrist arthritis.

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5. Fractures

A wrist fracture is a common orthopedic injury. Patients who sustain a broken wrist may be treated in acast, or they may need surgery for the [16]fracture.

Call your doctor about your wrist pain

If you are unsure of the cause of your wrist pain, or if you do not know the specific [17]treatment recom-mendations for your condition, you should seek medical attention. Treatment of these conditions must bedirected at the specific cause of your problem. Some signs that you should be seen by a [18]doctor include:

• Inability to carry objects or use the arm

• Injury that causes deformity of the joint

• Wrist pain that occurs at night or while resting

• [19]Wrist pain that persists beyond a few days

• Inability to straighten or flex the joint

• Swelling or significant bruising around the joint or forearm

• Signs of an infection, including fever, redness, warmth

• Any other unusual symptoms

[20]Dr. Gibson utilizes new technologies and [21]therapies to facilitate prompt recovery. While trained inthe traditional chiropractic approach, Dr. Gibson also has expertise in more gentle techniques and usescomputer assisted technology for both diagnosis and treatment of [22]spine and joint problems. Call Today :[23]301-977-0640










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2.7 July

How to Prevent and Care for Tension Headaches? (2013-07-29 05:24)

Symptoms and Prevention of Headaches:

[1] About 4 percent to 5 percent of U.S. adults suffer from [2]chronicheadaches, which may occur nearly every day. The cause of the most commonly reported [3]headache, tensionheadaches, is actually still unknown.

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An estimated 75 percent to 90 percent of people who complain of frequent headaches are suffering from[4]tension headaches. Some experts believe they stem from contracted muscles, while others believe they’rerelated to changes in your brain chemicals, such as serotonin, endorphins and others, which help your nervescommunicate. The most common triggers of tension headaches include:

• [5]Stress

• Not enough sleep

• Certain foods and food additives, such as chocolate, cheese, caffeine and monosodium glutamate (MSG).

• Grinding your teeth

• Depression and [6]anxiety

• Skipping meals

• Poor posture

• Lack of [7]exercise

• Holding your head or neck in an awkward position for a long time

• Hormonal changes related to menstruation (PMS), menopause, pregnancy or hormone use

• Sleeping in an awkward position

• [8]Eye strain

• Fatigue

• Smoking

• Alcohol

• Sinus infections, colds or flu

Symptoms of Tension Headaches

Typically, tension headaches cause an [9]aching or squeezing sensation on both sides of your head, fore-head or back of head. The [10]pain is often described as a tight band around your head, or a feeling thatyour head is ”in a vise.” The pain may be mild to moderately intense. Tension headaches may also include:

• [11]Neck and jaw discomfort

• Insomnia

• Tenderness on your scalp, neck and [12]shoulder muscles

• Fatigue

• Irritability and trouble concentrating

• Loss of appetite

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[13]Tension headaches can come on at any time, but may be more common when you’re anticipating a stressfulevent, such as a confrontation at work or at home. They can last anywhere from 30 minutes to a full week.

Prevention of Tension Headaches

Lifestyle changes will go far in keeping tension headaches at bay. The top tips for [14]headache reliefinclude:

• Eat a healthy, balanced diet.

• Get enough quality sleep each night. If you have difficulty sleeping, try listening to the highly recom-mended Sleep Easy CD to help you ”shift gears” and relax into sleep.

• Improve your [15]posture. This will help to keep strain on your muscles, tendons and bones to aminimum.

• Keep your stress well-managed. We all have stress; it’s the way you deal with it that makes all thedifference. Schedule regular times to de-stress during your day by meditating, soaking in a bubble bath,reading or taking a long walk.

• Get regular massages. [16]Massages can help to relieve headache pain, and they also loosen up tightmuscles in your neck and shoulders, which may also be contributing to your headache.

When Can Headaches be Serious?

The majority of headaches do not signal an underlying illness, but in rare cases headaches can be re-lated to serious conditions. You should see a [17]health care provider right away if you:

• Experience a severe headache that comes on suddenly

• Have fever, a stiff neck, mental confusion, numbness, weakness or double vision along with your headache

• Are over the age of 50 and start to experience headache pain you’ve never felt before

• Get headaches from coughing, moving quickly or straining

• Have a headache after a head injury

[18]Dr. Gibson is a Board Certified Chiropractor with [19]Physical Therapy privileges in the state of Maryland.Call now for Quick Appointment: [20]301-434-1850 or Visit: [21]http://www.acutechiro.com

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2.8 August

Physical Therapy Treatment for Neck Pain (2013-08-29 11:15)

Common Causes and Symptoms of Neck Pain:

[1]Neck pain is common. The cause can be obvious like an [2]accident or more subtle when related toa repetitive task or prolonged position. There are many triggers for neck pain most of them are not serious.

[3]Physical therapists are skilled in the examination and [4]treatment of neck pain and associated [5]headaches,[6]arm pain, numbness or pins and needles.

[7]

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Common Causes of Neck Pain

Neck pain is rarely serious. If you are concerned about radiating left arm pain or any severe constantnew headache symptoms associated with vomiting, fever or dizziness.

Most [8]neck pain will have an identifiable cause but it can take time to work this out.

Some obvious examples are:

• [9]Whiplash

• Muscle and [10]ligament strains from lifting, twisting or falling awkwardly

• Sleeping awkwardly e.g. in a chair

• [11]Arthritis

Common Symptoms of Neck Pain

Pain around the neck is the most obvious [12]symptom but it can be referred to the shoulders, [13]shoulderblade area or to the face and head. Headaches too are a common result of longstanding neck irritation. Ifa cervical nerve is irritated as it leaves your neck you may feel pain and or numbness/ pins and needles inyour arm and hand. Dizziness and light headedness can also be provoked by neck strain. Frequently [14]jointstiffness and tense muscles limit the movement of your neck.

Symptoms

1. Regularly and gently move your [15]neck as pain allows

2. Avoid keeping your neck completely still and do not wear a collar

3. Try to ‘let go’ of the muscles around your [16]neck and let your shoulders gently drop as you breatheout. Be aware if you are clenching your teeth.

4. Try to reduce your anxiety and stress levels, take time to unwind

5. Use a heat pack around your neck, follow the instructions and do not have it hot enough to burn

6. Over the counter painkillers that work for you can be taken. Relieving the pain will help to relaxmuscles and allow you to move your neck

7. Take regular breaks from using computers and get advice from your [17]physical therapist on correctworking postures

8. Avoid looking at screens offset to either side and cut down on the time you spend with your headforward or down.

Physical Therapy Treatment

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• Physical therapists will take time to listen as you explain your [18]pain/symptoms

• On completing a thorough examination they will explain their findings and diagnosis

• They will answer any serious concerns you have

• Based on the examination they will discuss the most suitable evidence based [19]treatment from a vastlist of skills.

• They will look at the possible causes and work with you to prevent recurrence

• They will provide you with specific exercises and advice to follow at home.

[20]Acute Spine Rehab & Physical Therapy is specialize in treating [21]Back Pain, Whiplash injuries, NeckPain, Shoulder Pain, and Hip and Leg Pain. [22]Dr. Gibson will design your [23]treatment plan. Do not waitand [24]contact us for your [25]next appointment today, at [26](301)977-0640.





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2.9 September

How can I get comfort from Sciatica Pain? (2013-09-24 08:40)

Symptoms, Causes and Treatment of Sciatica Pain:

[1] [2]Sciatica describes persistent [3]pain felt along the [4]sciatic nerve, which runs from thelower back, down through the buttock, and into the [5]lower leg. The sciatic nerve is the longest and widestnerve in the body, running from the lower back through the buttocks and down the back of each [6]leg. Itcontrols the muscles of the lower leg and provides sensation to the thighs, [7]legs, and the soles of the feet.

Sciatica occurs most frequently in people between the ages of 30 and 50 years old. Most often, it tends todevelop as a result of general wear and tear on the structures of the lower spine, not as a result of [8]injury.

Symptoms of Sciatica Pain

The most common symptom associated with [9]sciatica is pain that radiates along the path of the sci-atic nerve, from the lower back and down one leg; however, [10]symptoms can vary widely depending onwhere the sciatic nerve is affected. Some may experience a mild tingling, a dull ache, or even a burningsensation, typically on one side of the body.

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Some patients also report:

• A pins-and-needles sensation, most often in the toes or [11]foot

• Numbness or [12]muscle weakness in the affected leg or foot

Pain from sciatica often begins slowly, gradually intensifying over time. In addition, the pain can worsenafter prolonged sitting, sneezing, coughing, bending, or other sudden movements.

Causes of Sciatica Pain

• The most common cause of sciatica is irritation of the sciatic nerve in the lower back (lumbar region)due to a herniated or ruptured disc.

• Spinal discs are shock-absorbing cushions between each vertebra that keep your spine flexible.

• Discs have a stronger outer ring and a soft jelly-like center, but as we age, spinal discs can deteriorate,becoming drier, flatter, and more brittle.

Diagnosis of Sciatica Pain

Your doctor of [13]chiropractic will begin by taking a complete patient history. You’ll be asked to de-scribe your pain and to explain when the [14]pain began, and what activities lessen or intensify the pain.Forming a diagnosis will also require a physical and neurological exam, in which the doctor will pay specialattention to your spine and legs. You may be asked to perform some basic activities that will test your sensoryand muscle strength, as well as your reflexes. For example, you may be asked to lie on an examination tableand lift your legs straight in the air, one at a time.

Treatment for Sciatica Pain

• For most people, [15]sciatica responds very well to conservative care, including chiropractic.

• Keeping in mind that sciatica is a symptom and not a stand-alone medical condition, treatment planswill often vary depending on the underlying cause of the problem.

• [16]Chiropractic offers a non-invasive (non-surgical), drug free treatment option.

• The goal of chiropractic care is to restore spinal movement, thereby improving function while decreasingpain and inflammation.

• Depending on the cause of the sciatica, a chiropractic treatment plan may cover several differenttreatment methods, including but not limited to [17]spinal adjustments, ice/heat therapy, ultrasound,TENS, and rehabilitative exercises.

[18]Dr. Gibson is a Board Certified Chiropractor with [19]Physical Therapy privileges in the state of [20]Mary-land. Dr. Gibson utilizes new technologies and therapies to facilitate prompt recovery. While trained inthe traditional chiropractic approach, Dr. Gibson also has [21]expertise in more gentle techniques and usescomputer assisted technology for both diagnosis and [22]treatment of spine and joint problems.

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2.10 October

Chiropractic Workers’ Compensation (2013-10-14 06:47)

When a worker suffers from a [1]work injury, He is eligible to claim medical and financial allowances under[2]workers’ compensation. The insurance provider is required to provide for all the medical expenses connected

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to your work injuries. [3]Chiropractic Care is cost -efficient as well as time efficient in treating and healingwork related [4]injuries and getting the injured worker back to his work as healthy as before.

[5] Acute Spine Rehab and Physical Ther-apy: Specialize in Auto / Work / Slip and Fall injuries

Work related injuries mostly result into fractured bones, muscle injuries, contusions, [6]back pain, neckpain etc. which can influence his job efficacy. [7]Chiropractors are very well proficient in dealing withcomplexities related to work injuries. They help the injured workers to recover quickly and get back to workwith as less complications as possible.

To claim for compensation, first of all the injured worker has to get his injury accepted as work related injuryby the [8]insurance provider. For this he has file the report of the injury with the state labor’s department.There after should get prescription from the consulting [9]physician for rendering the services of the [10]doctorsof chiropractic.

A well- organized [11]Chiropractic Workers’ Compensation Program focuses on assisting the compensa-tion claimants to regain their lost work efficiency and job capabilities, thereby reducing their pain and stress.It may consists of :

• Strengthening and conditioning of damaged muscles, bones and tissues for safe and timelyreturn to job.

• Chiropractic adjustments to relieve[12] back and neck pain.

• Spinal mechanics, Work place Ergonomics, FCE and WH modules to educate the injuredworkers for the elimination and prevention of injuries in the future.

• Dietary counseling and Nutritional Guidance

[13]Chiropractic provides quality care for work related injuries without much disturbing and evacuating themfinancially. Chiropractors accepting workers’ compensation cover their medical costs from the supportinginsurance carriers of the workers.

[14]Contact [15]Acute Spine and Physical Rehab Therapy, if you are a victim of work relatedinjury and need urgent chiropractic care. We accept payments from [16]workers’ compensa-tion plans and as well can design and execute a customized payment and treatment plan asper your requirements, while providing you with the best health benefits and making you asstaunch and sturdy as before.

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2.11 November

Postural Analysis and Correction (2013-11-12 11:50)

Does Posture Matter????

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[1] Pos-ture Analysis & Correction

Posture is the shape that body assumes while sitting, standing, bending or lying. Ideal or good pos-ture involves ideal [2]positioning of the joints which in turn also reduces pressure on them. Whereas badposture increases stress on joints as it disturbs coordination among different body parts- viz. head, trunkand limbs.

Postural Analysis and Correction is an exercise based program that deals with and relieves the poor bodyconditions or symptoms resulting from poor posture. It involves both the assessment and correction techniquesto improvise the overall well being of the individual.

[3]Postural Analysis and Correction Program is divided into three different stages :

• Assessment of your posture and detection of faults

• Recognizing the factors leading to poor posture

• Correcting the detected [4]postural faults

Assessment of Posture : The [5]body posture is analyzed and the areas that need correction are identified.For this purpose the whole of the body is divided into different segments and each segment is assessedindividually and inferences are drawn accordingly. Based upon these inferences, correction for each imbalanceis prescribed. Following tests and techniques are adopted to [6]analyze the postural faults :

• Two photographs showing the whole body from back and side are taken

• Spinal Alignment test is conducted

• Postural analysis, while a person moves or sits

• Measuring and estimating deviation from normal posture

• Joint mobility and flexibility tests

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• Testing muscles’ length and strength

Identifying causes of Faulty Postures: After assessing the postural deformities, causes leading to these[7]postural faults are also detected. Both the genetical and positional misalignment can give rise to posturalfaults. Faulty genes are responsible for genetically poor postural forms; as some people have flat feet sincetheir birth. Positional causes involve :

• Bad postural habits

• Psychological reasons

• Muscular spasms, imbalance or contracture

• Weak or stretched muscles

• Pain in muscles leading to avoidance posture

• Hypo or hyper mobility of joints

• Respiratory Conditions

• Excessive Weight

• Inability to perceive the body position

[8]Correcting Postural Faults : Both the genetical as well as positional postural deformities can bereformed, with the basic difference being that genetical [9]postural faults can take longer time. But to correctand resolve the deformities caused by both, requires [10]postural awareness and exercises. Along with thesupportive measures and strengthening exercises, heat and massage therapy to treat bones and ligaments aretried. Apart from these, following exercises are performed to correct postural faults :

• Weak muscles are strengthened using strengthening exercises

• Exercises enhancing core strength and flexibility are administered

• To eliminate tightness in the muscles, stretching exercises are administered which in turn also reducepain or muscular pain

• Exercises strengthening or increasing physical strength and capacity are administered

• Correct positioning of individual body parts and in unison as well is shown and taught

• ”Back Schools” educate and make the patients aware about back health care and body mechanics atwork place

[11]Contact [12]Acute Spine and Physical Rehab Therapy for eliminating symptoms like jointdegeneration, back pain, rounded shoulders, spinal and cardiovascular dysfunction resultingdue to poor posture. We develop and design customized Postural Analysis and Correctionprograms catering to your specific and immediate needs, which include methods and techniquesto improvise the overall quality of your life.

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2.12 December

Identifying and Treating Tension Headaches (2013-12-16 09:18)

What do you mean by Tension Headaches?

[1]Tension Headaches are the most commonly and frequently occurring headaches. These are not lim-ited to adults only but the children and teens are also falling prey to these headaches. Patients [2]sufferingfrom Tension Headaches feel mild to moderate pain at the both sides of head. They may also feel tightnessaround their skull.

What are the causes of Tension Headaches?

Though these are the most common type of [3]headaches but their exact causes are not known. Followingfactors may be enlisted as the potential causes of tension Headaches:

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[4] Treat-ing Tension Headaches

• Insufficient Sleep

• Skipping meals

• Stress

• Underlying illness

• Eye Strain

• Muscular tension

• Poor posture

• Anxiety or tension

• Over exertion

• Bright Sunlight

• Dehydration

• Noise

• Specific smell

• Indirect Tobacco Smoke

• Exposure to some allergens

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• Eating certain foods

• Pollution

• Weather changes

What are the symptoms of Tension Headaches?

• Pain affecting both sides of head

• Tightness of neck and shoulders’ muscles

• Dull or moderate headache

• Pressure across your forehead or eye brows

• Pain lasts from 30 mins. to several hours and at times, it lasts for several days

• Tenderness around forehead or scalp

• Sensitivity to light and noise

How can Tension Headaches be treated?

Tension Headaches can generally be relieved by painkillers and by making certain modifications in yourlifestyle. Following [5]treatment options can be employed for curing Tension Headaches:

• Analgesics or pain killers like ibuprofen, paracetamol or aspirin are prescribed.

• Acupuncture is employed to the patients with chronic Tension Headache

• Soft tissue therapy and spinal manipulations are administered.

• Stress management techniques can be very effective to treat Tension Headache.

• Massage theory can also be included as reliable treatment option.

• Biofeedback, a relaxation technique to manage stress and pain is also employed.

How [6]chiropractor can help to treat Tension Headache?

• [7]Chiropractic adjustments are performed to enhance spinal function and to reduce stress.

• Nutritional advice regarding changes in diet and supplementing Vitamin B complex in diet is forwarded.

• Chiropractors also counsel patients regarding good posture, work ergonomics and relaxation techniques.

• Exercises and stretches to strengthen muscles and to eliminate pressure on the neck are administered.

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[8]Contact [9]Acute Spine Rehab and Physical Therapy for long term relief from musculoskele-tal ailments. Our professional and efficient [10]doctors of Chiropractic relieve you of all yoursymptoms without any invasive medical intervention.




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Chapter 3

2014

3.1 January

Clavicle or Collarbone Fracture: Symptoms and Treatment (2014-01-11 11:25)

What do we mean by Clavicle Fracture?

The Clavicle Fracture or Collarbone fracture is one of the most common [1]fractures in young adults.The collarbone known as clavicle bone, joins your breast bone to the shoulder. [2]Clavicle fractures occurmainly due to hard falls, [3]sports injuries and above all due to the traumatic vehicle collisions.

[4]Fractures to the collar bone occur either because of the direct blow to the shoulder or due to the di-rect trauma to the collar bone itself.

What are the symptoms of Clavicle fracture?

Clavicle Fracture is very much painful and makes the movement of your arm difficult. Its common symptomsinclude:

[5] Clavicle Fracture

• Swelled or tender collarbone

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• Acute pain while moving your shoulder

• Slumping or sagging shoulder; forward, downward or inward

• Difficulty in lifting up the arm

• Deformed shoulder or a bulge near the shoulder

• A crackling sound can be heard moving the shoulder

• Stiffness in the shoulder or inability to move your shoulder

• Bruising over the collarbone

• Numbness and tingling down the arm

What are the treatment options available to treat Clavicle fracture?

Following treatments are opted for [6]healing broken collarbones:

• [7]Doctors usually opt for a sling or ‘figure of eight wrap’ to immobilize the arm and as well to comfortpain. This further helps in keeping the bone in position while the healing process.

Once the bone begins to heal and the pain subsides; patients are prescribed for [8]physicaltherapy treatment.

• In the beginning, [9]physical therapists may perform gentle shoulder and elbow exercises.

• Range of motion exercises are performed to improve the stiffness of the shoulder.

• Normal strengthening exercises are performed to restore and overcome the weakness of[10] shoulderbones.

• Once a fracture is healed properly, a more strenuous [11]rehabilitation regime is followed to rebuildshoulder’s flexibility.

It is very important and necessary to follow up your doctor during the healing process, so that he or she canexamine from time to time whether the fracture has not moved out of place or fused incorrectly; as it canpresent further complications.

[12]Contact [13]Acute Spine Rehab and Physical Therapy [14]Chiropractic Clinics for the effi-cient treatment of any of your [15]work related or auto accident injuries. Our acknowledged[16]chiropractors design patient specific care plans and as well employ patient proven treatmenttechniques to treat and help you to get you back on the track of your normal routine.







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3.2 February

Snapping Hip Syndrome: Treating Your Popping Hip Syndrome (2014-02-26 10:36)

What do we mean by Snapping Hip Syndrome?

[1]Snapping Hip Syndrome also known as Coxa Saltans, Iliopsoas Tendinitis or Dancer’s Hip is a pathologicalhip condition in which you feel a snapping sensation or at times, hear an audible popping sound wheneveryour hip is flexed or extended; i.e. when you walk, run, get up from a chair or swing your leg round. Youngathletes, runners, ballet dancers, gymnasts, horse riders are more prone to this condition. This conditionusually arises when a muscle or tendon slides abnormally over a bone. In case of [2]hip joint, it can eitherhappen at the iliotibial band (outer of the hip) or at iliopsoas tendon (pelvic area).

Which conditions lead to Snapping Hip Syndrome?

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[3] Snapping HipSyndrome Treatment

Pain and discomfort associated with [4]Snapping Hip Syndrome interferes with your day to day activi-ties. Following are the potential causes of this discomfiture:

• If the iliotibial band snaps over the greater trochanter (bony protrusion outside the hip joint)

• If while flexing the [5]hip, the hip flexor muscle glides over the pelvic protrusion

• Tear of the cartilage within the [6]hip joint

• Repetitive and physically demanding movements

• Repeated, vigorous and sudden hip flexion movements

• Extreme thickening of tendons in the hip region

• Tightness in the [7]hip muscles and tendons around the hip joint

• Tightness in the hip muscle structure during the adolescent growth spurts

What are the signs and symptoms of Snapping Hip Syndrome?

• Clicking or Snapping in the groin or front of the hip

• Pain or feeling of discomfiture in front of the hip due to swelled iliopsoas bursae

• [8]Hip bursitis; i.e. painful swelling of fluid-filled sacs that cushion the hip joint

• Unsteadiness

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• Tenderness in the front of hip

• Symptoms worsens with bending

What are the treatment options available to treat Snapping Hip Syndrome?

An appropriate rehabilitation program tailored according to current condition, needs and requirementsof the patient can cure this deformity. Surgery is rarely advised and needed. Following [9]treatment optionsare adopted to [10]treat Snapping Hip Syndrome:

• Initially ice and rest are advised to subside pain and swelling

• Activities aggravating the symptoms are either modified or reduced

• [11]Stretching exercises are prescribed to strengthen the muscle structure surrounding hip joint

• Range of motion exercises are prescribed to strengthen the medial hip rotators

• Modalities like Ultrasound, Iointophoresis and electrical stimulation may be used

• Strengthening exercises are performed to improvise the muscular weakness and tightness in the thigh

• Quadriceps stretching, hip stretching, [12]hamstring stretching, piriformis stretch and iliotibial bandstretch exercises are performed

[13]Contact Acute Spine and Physical Rehab Therapy for the adequate and proficient treat-ment of any of yours work related or [14]auto-accident injuries. Our board certified andprofessional [15]doctors of Chiropractic tailor a customized [16]treatment program after com-pletely examining and diagnosing your conditions and will help you to get back to your workas soon as possible.




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3.3 March

Popliteal Cyst (2014-03-27 10:24)

Baker’s Cyst and Its Treatment

[1] Baker’s Cyst

[2]Baker’s Cyst also known as ‘[3]Poplited Cyst’ is a swelling on the back of a [4]knee joint. The cysthas nothing to do with the baking activity, but is named after the surgeon William Morrant Baker; who hadfirstly described the situation. More women than men are affected by this condition because females are atthe greater risk of developing [5]rheumatoid arthritis.

What do we mean by Baker’s Cyst?[6]Baker’s Cyst is a protrusion or swelling on the back or the popliteal area of the knee caused by the fluidfrom the [7]knee joint resulting in stiffness and [8]knee pain. Pain worsens with the flexion and extension ofyour knee. Arthritis, infection, torn knee cartilage and other [9]knee injuries can cause this problem.

What are the treatment options suggested to treat Baker’s Cyst?Before treating [10]Baker’s Cyst it is all the more important and necessary to treat the underlying kneeproblems like; [11]osteoarthritis or any knee injury, as this may help to ease or speed up the healing of Baker’sCyst. Other than this, following treatment options are suggested:

• Initially, [12]doctors may suggest to rest the affected knee and as well to eliminate the activities ag-gravating the condition.• Application of Ice-packs are suggested to relieve pain and swelling.• [13]Doctors may suggest crutches to ease the pain and to take weight off the affected leg.• Strengthening exercises are suggested to ease and strengthen the muscles of the [14]knee joint.• Gentle range of motion exercises are suggested to keep the knee joint moving.• Patients are prescribed to wear the elastic or compression bandages to support the[15] knee joint.• If you are over-weight, [16]doctors may suggest you to reduce weight.

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[17]Contact Acute Spine Rehab and Physical Therapy Chiropractic Clinics for the state-of the-art treatmentof any of your work related and auto accident related injuries. Our board certified practitioners develop indi-vidualized treatment plans and use minimally invasive and patients’ verified treatment techniques promisingyou a safer and successful return to work.

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3.4 April

Radiculopathy and Chiropractic (2014-04-25 12:19)

How Chiropractic can help to treat Cervical Radiculopathy?

Various factors are responsible to generate different types of [1]neck pains. While mechanical [2]neckpain results from the injury or inflammation in the soft tissues of the neck; radicular pain results from theirritation and compression on the [3]nerve roots. Radicular pain is usually much deeper and steadier thanthe mechanical pain and the certain activities and positions exaggerate the condition and reproduce pain

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times and again.

What do we mean by Cervical Radiculopathty?

Cervical Radiculopathy is a pathological condition with variety of side effects. It is a condition charac-terized by [4]pain and neurological symptoms resulting from the compression to the one or more [5]cervicalvertebrae which make up the upper of the neck. It can radiate up to the arms and largely depends upon thetype of nerve affected.

What are the Chiropractic treatment options present to treat Cervical Radiculopathy?

For those suffering from Cervical Radiculopathy, [6]chiropractic manipulation presents them with greaterpossible chances of recovery. The [7]chiropractic treatment focuses at:

• Alleviating Pain

• Enhancing Motion

• [8]Rehabilitating Function to head, neck and back regions

[9]Doctors of Chiropractic use following methods to help and relieve the patients with [10]Cervical Radicu-lopathy:

• Manual Manipulations are used to relieve pressure to the [11]nerve root

• [12]Cervical Spinal Manipulation technique is practiced where joint is moved through tolerable range ofmotion

• Different adjustment techniques are used where patient’s body is placed in specific and diversifiedpositions to achieve maximum adjustment of the [13]spine and to restore normal range of motion as well

• Gonstead Adjustment techniques are administered where specially designed tables and chairs are usedto position the patient

• Traction, soft tissue massage and ultrasound therapy is used to restore functioning to the affected joints

• [14]Stretching exercise are used to re-position the affected joints

• Ice and Electrical Muscle Stimulation is used to lessen the inflammation in the nerves and muscles

• Adjunctive Therapy including; therapeutic massage, heat application and gentle strengthening exercisesis administered to treat [15]cervical spine complaints.

[16]Contact Acute Spine Rehab and Physical Treatment for the prompt and state of art diagnosis, evaluationand treatment of your spinal and nerve disorders. Our prudent [17]chiropractors make use of various non-invasive techniques and therapies to help you to regain your health and motion and get back to your work assoon as possible.




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3.5 May

Treating Ankylosing Spondylitis (2014-05-30 12:29)

[1]Ankylosing Spondylitis is a condition associated with a group of [2]arthritis that can cause spine inflamma-tion. This condition is more common among males and affects them in their teens and 20’s. It is a commoncause of back pain among adolescents and young adults.

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What do we mean by Ankylosing Spondylitis?

[3]Ankylosing Spondylitis; also known as [4]Bechterew’s Disease is the chronic inflammation of the spine andthe sacroiliac joint. It is the spondyloarthritis of the spine and pelvis. Under this condition; the [5]spine’sbones may cement or fuse together thus resulting into a rigid spine. It lessens the function and mobility ofspine and gives it a bamboo like appearance and results in a stooped-over posture.

What are the treatment options available to treat Ankylosing Spondylitis?

Ankylosing Spondylitis can be cured with the help of exercises and medications. [6]Chiropractic treat-ment aims at reducing your pain and stiffness, obtaining a good posture, preventing deformity and enhancingyour functioning. [7]Chiropractors help you to keep yourself active because only moving and functioningproperly can save your spine from becoming stiff. Chiropractic treatment for Ankylosing Spondylitis mayinclude:

• Specific strengthening and flexibility exercises are used to stretch the shortened muscle chains and alsoto lessen the pain and joint stiffness.

• Push and relax techniques under ‘adjustment treatments’ are used to regain neck flexibility.

• [8]Chiropractors may also design a nutritional protocol to slower the spine inflammation.

• Manual mobilizations are suggested to reduce pain and joint stiffness and to improve posture and spinalmobility.

• Except the conventional exercises; flexibility exercises for cervical, thoracic and lumbar spine; andrespiratory exercises to improve lung capacity are advised.

• Aerobic exercises, such as; swimming and walking are recommended.

• [9]Chiropractors also educate you about Ankylosing Spondylitis progresses and what can be done tominimize the effect of the problem.

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• Heat and cold therapies are used simultaneously and as required. Heat therapy helps to relax and torelieve pain and cold therapy helps to minimize inflammation.

• Use of assistive devices like; canes or walkers may be recommended to make you physically active andto lessen the stress on joints as well.

• Back extension exercises are recommended to maintain erect posture and to avoid the forward curvatureof the spine as well.

• Patients may be advised to sleep on the hard mattress and without pillow.

• Hydrotherapy; which involves special exercises in warm water is recommended to maintain a goodposture.

• Electrotherapy may be suggested to contract your muscles; which ultimately helps to ease pain andpromote healing.

[10]Contact [11]Acute Spine Therapy & Rehab Chiropractic Clinic for the efficient and state of the arttreatment of any of your neuro musculoskeletal problem or injury. We not only relieve you of your immediatediscomfort and ailment but also help you to prevent its recurrence, thus improving your overall health andwell-being.

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