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Chiropractic Care: A Non-Invasive Treatment for Disc Herniations

Each year many people will undergo back or neck surgery to repair a herniated disc. Majority of these surgeries will be a Microdissectomy due to a disc herniation. While some cases of herniated discs may require surgery, many cases will respond to less-invasive treatments such as chiropractic care.

What is a disc herniation? Between each vertebrae in your spine there is an Intervertebral Disc (with the exception of the first 2 cervical vertebrae.) These discs act as shock absorbers between the vertebrae, providing cushioning and flexibility during your daily activities. Think of your discs as shocks on your car, without them your spine would have no give or flexibility feeling every bump.

Statistically, many people have disc herniation’s but not all show symptoms. Typically, the pain will begin locally in the back or neck. If the herniation becomes bad enough to compress a nerve, the pain may progress to the leg or arm. Statistically, many cases will begin locally and progress slowly over-time. There are many different causes for a disc herniation. Contrary to popular belief, many people cannot pin point the exact mechanism of the injury. This is because much of the issue is often related to lifestyle, allowing symptoms to build slowly over-time. It is often poor posture, weight gain, or in-activity that allows the injury to progress. For example, when you have poor posture it places abnormal stress on the muscles which clamp down on the discs limiting motion in the joints. The intervertebral discs rely on motion for nutrition. It is important to note that since they are made mostly of cartilage there is no blood supply. This makes prevention key! Chiropractic helps by addressing the cause of the problem: Immobile joints and tight muscles compressing the disc. By releasing the pressure through gentle, non-invasive adjustments, therapeutic exercise, myofascial release we can serve to relieve the pressure in the disc and establish more normal range of motion reducing inflammation and nerve irritation.

If you are experiencing back or neck pain don’t wait, Click Here and make an appointment today and start healing!

 

Keep Moving.

Dr. James Ellis

(781) 460-0939

www.evolvedhealthchiropractic.com

Fix Your Posture- Part 2

In last week’s post I discussed the beginning stages of a “postural syndrome” that occurs due to many of our sedentary lifestyles. I addressed the upper trapezius, and levator scapulae muscles which become increasingly tight in many of us pulling our shoulders forward creating that “slumped” postural appearance and forward head carriage.

It is important to begin stretching these tight muscles immediately if you are experiencing back or neck pain. If these muscles stay in this abnormal strained position no matter how many times we mobilize the joints the muscles will be pulling everything right back.

 

Be patient! These postural distortions did not happen over-night and will not be fixed over night. Much like your muscles make the necessary connections to learn to ride a bicycle or a skateboard, your body will also adapt to abnormal postural stress’s creating a “postural syndrome” seen above.

Now that we have began stretching the tight, over-active, muscles, we must also address the muscles which have become under-active due to these compensations. The group of muscles that we will address today are known as the Deep Neck Flexors. Due to the forward head carriage (see above) these muscles become increasingly under-active due the over-activity of the upper trapezius and levator muscles, among others we will discuss.

The deep neck flexors are a group of muscles consisting of the Longus Colli, Longus Capitis,  Rectus Capitis Anterior, and Rectus Capitis Lateralis. This group of muscles is responsible for forward and side bending of the head and neck. They serve to support the weight of the head, and stabilize the head and neck; similar to the abdominal core making them essential for proper posture.

Click Here to read he full article!

Dr. James Ellis

www.evolvedhealthchiropractic.com

My Top 3 Exercises for Neck Pain

One of the more common issues I have seen lately is postural neck pain. This usually results from too much sitting or desk work coupled with already sub par posture. This can lead to tension headaches, tendonitis, impingement and muscle imbalances. Treating this condition requires a custom approach.  Initially spinal manipulation along with passive stretching the perfect intervention to break the pain cycle and decrease inflammation.

How long will it take to experience relief? Relief is usually experienced immediately post treatment however it is initially temporary. Like exercising, we are trying to lengthen and strengthen certain muscles; like going to the gym it takes a few sessions to maximize results. More often than not the cause of neck pain is a result of lifestyle (i.e. sitting at your desk, sitting in your car while commuting, etc.) This being said you will occasionally need a “tune-up” a few times a year. Prevention is key!

You can and should be exercising on your own in addition, and this will be an part of you correcting your posture and maintaining it!  The more that you can do to correct the problem early on, the better off you will be. Below are three of the most effective exercises that will aid in correcting posture, and relieving pain. Give them a try; feel better to perform better.

1.) Chin Tucks: Similar to the wall angels, we will begin by standing with your back and head against the wall. I recommend starting with a small towel roll behind you’re head against the wall. Begin by placing 2 fingers on your chin; now draw your chin back into the wall (creating a “double chin”). Hold for a few seconds and relax. This will target the deep neck flexors and help to correct a forward head posture which causes increased tension in your neck due to  perceived increase in head weight.

2.) Scapular Retractions: This can be done either in a seated rowing position or prone with no weights at home. I recommend starting prone in order to perfect the movement. Remember, these are not about weight. Begin Face down, lye with your palms facing up arms at side of your body. Begin by pinching your shoulder blades together (down and back) while rotating your palms to face the floor. Additionally extend your head and chest off of the floor noting a nice stretch. This will target the rhomboids as well as mid to lower traps to correct any rounding of the shoulders.

3.) Wall Angels (scapular wall slides): Begin by standing with back against wall; feet about 18 inches away from the wall. Lift your arms up to 90 degrees (elbows perpendicular to body) and press your elbows and hands into the wall behind you. To begin, pull your elbows back and down into the wall, noticing tension in your mid to lower lats, now relax slowly back to starting position. The goal is to maintain contact with the hands, elbows, and shoulders on the wall throughout the entire movement. This exercise will target shoulder mobility as well as aiding in correcting an exaggerated kyphosis. Tip: Try these with a band for more of a challenge!

 

Keep Moving!

 

Dr. James Ellis

www.evolvedhealthchiropractic.com

Chronic Ankle Sprains? Fix Your Feet With These Simple Drills

Most active people have suffered an ankle sprain at one time or another accompanied by swelling, pain, weakness, and a long road to complete recovery!  Many runners and athletes may find themselves more susceptible to future sprains and strains even after the initial problem has resolved. This is because soft-tissue healing can take anywhere from 12-18 months and there is usually always involvement of one or more ligament!

A bit about the anatomy of your ankles. The ankle is held together by several ligaments: on the inside of the ankle you have the deltoid ligaments (less likely to sprain) among others, and on the outside of the ankle you have the anterior and posterior talofibular ligaments a long with the calcaneofibular ligaments to name a few. Most sprains/strains of the ankle occur from excessive plantar flexion and inversion (about 80%) affecting the lateral ligaments (most commonly the anterior talofibular ligaments). These ligaments (even when over-stretched and not torn) take a very long time to heal and when no treatment is given to promote healing will cause the tissue to heal abnormally (think of a patch over a hole) causing less tissue extensibility and improper function. Remember, there is no blood supply to the tendon itself.  Over-time this exacerbates muscle imbalances and leads to a chronic biomechanical deficit. This being said, some intervention is necessary to ensure that the tissue heals properly to prevent future sprain/strains.

In the early stages of an ankle sprain your doctor or therapist should advise a couple of days of rest and elevation. In addition to resting and elevating at home your doctor should also recommend manual therapy techniques to facilitate healing. This may include manipulation of the joint, traction, heat, myofascial release, and eventual therapeutic exercise. It is very important to address joint stiffness early on to ensure proper movement and healing.

“Weak ankles” become an issue when the tissues discussed above heal improperly; usually because no treatment was received. This will exacerbate existing muscle imbalances leading to dysfunction making you more susceptible to injury. The solution to this issue is to reestablish appropriate movement and fix muscle imbalances. Most athletes I see that suffer from chronic ankle sprains exhibit deficits in their gait, hips, and lower leg muscles. These deficits have likely been an issue for a long time and have continued to build until an injury occurs.

Does this sound like you? First, have your gait evaluated by your doctor or therapist, then try these simple drills to help balance the muscles in your feet and lower leg. You will notice a stronger, more athletic ankle!

All drills to be performed shoes-off (except for walking on your heals) and for a length of about 25 meters; preferably on grass or any hard surface:

  1. Walk with feet inverted
  2. Walk with feet toe-in
  3. Walk backwards on your toes
  4. Walk with feet everted
  5. Walk with feet toe-out
  6. Walk on heels

Dr. James Ellis

www.evolvedhealthchiropractic.com

Improve Your Hip Mobility

Much like your shoulder mobility, your hips are also negatively effected by the effects of sitting at that dreaded desk job 40+ hours a week. When discussing your “hip mobility” I am referring to the ability of the pelvis to adapt in different daily movements, such as walking, running, bending down or squatting. It is vital for our spines that hips move the way they are supposed to avoid excessive flexion of your spine. As many of you may know or have heard, when bending down or squatting down we want to limit flexion of the spine. We have all heard “lift with your legs”, the concept behind this is that it will prevent you from flexing your spine forward. Flexion and rotation under a load is one of the main risk factors for a disc herniation.

What is “hip mobility?” With our sedentary lifestyles our muscles become imbalanced, or inhibited which can hinder the ability of the hips to move the way they need to. Why does this occur? If you are sitting now pay attention to your current posture. You will likely find that you are slumped forward a bit and your lower back is slightly rounded, abs at rest, hips and knees bent. You may even “feel” your lower back. The problem occurs from too much sitting, too often. Overtime, much like learning to ride a bike, your muscles like your hamstrings and hip flexors will begin to assume this shortened position. Your core muscles (deep in the abs) will become inhibited because they are not needed to stabilize your body in a sitting position, and your glute muscles are of no use either. This means that your lower back that you just noticed is slightly flexed is now essentially the sole stabilizer of your upright posture. This is fine because you are stable when sitting, but what about when you go to get up, run, or exercise? This is where many begin to experience problems. Many people with lower back pain find that the pain has come on slowly or perhaps all of the sudden; either way, this pain is likely a result of an underlying issue that has been going on for quite some time and your body is now beginning to recognize.

How do we assess “hip mobility?” This could be as simple as a gait assessment, however, my favorite way to assess an active population is through an over-head squat. The squat is a foundational movement in humans, much like crawling. This will bring out even latent movement issues. When we begin to descend in a squat of utmost importance is to maintain a “neutral spine.” This is the position between flexion and extension where we are bracing our abdomen not allowing the back to round. In someone with the issues described above we may begin to notice the pelvis begin to “curl under” as we descend otherwise known as a “but wink”. At what point we will notice this will depend on a few factors: hamstring (and calf length), lower back tightness, core stability, balance, and of course your anatomy. Not everyone is meant to squat under a weight glutes to heels (all the way down). However, everyone should be able to perform a parallel squat.

Your body is fantastic at achieving your desired movement even if you have to recruit other muscles. If your hamstrings, hips, and lower back are tight the joints in your spine cannot and will not move the way they need to creating “hypomobilities” . With this “hypomobility” of some joints your body will begin to compensate, using other joints and muscles too much leading to extra wear and tear. Perhaps of most importance is the fact that your discs in your spine act as shock absorbers and spacers limiting friction and absorbing impact. Discs have no blood supply (except the outer layer), rather they rely on movement for nutrition. When the joints are hypomobile (stuck) your discs are getting inadequate nutrition which may over time lead to degeneration, or disc herniations. Combine the harmful effects of sitting 8 hours a day with someone who is otherwise active with sports, weight-lifting, or running and they will eventually be injured.

How do You improve it?
•Get up and move hourly from your desk! Even if it is only a brief walk to the water cooler.
•Stretch your hamstrings and calves
•Foam roll your back and hamstrings before and after exercise to “warm up” the muscles.
•Get adjusted! This will relieve the muscle tension establishing normal joint movement which is oh so important.

Keep Moving!

Dr. James Ellis

Evolved Health Chiropractic & Sports Medicine

(781) 460-0939

www.evolvedhealthchiropractic.com

Improve Your Shoulder Mobility

Anyone who is a regular gym-goer may have heard the term “thoracic mobility” before. It has become a particularly popular topic in Cross-Fit circles and sports where a maximal shoulder end range of motion is desired (the lock out). This is necessary for exercises such as pull-ups, hand stand push-ups, ring work, and over head press’ (power and Olympic lifters are not safe either!). But, what does this mean and how do we improve it?

To perform any above head movement requires first a stable shoulder. This means that all of the associated muscles are firing and working properly providing stability to an otherwise unstable joint (just ask anyone with a shoulder injury!) If you have not accomplished the ability to stabilize the shoulder in these moves; you shouldn’t be doing them since this will eventually lead to injury. Once the shoulder is stable we can discuss mobility of shoulder. Though it is more likely for an injury to occur due to instability, mobility of course plays a factor.

When discussing shoulder mobility in over-head moves I am referring to the ability of the humerus to pass under the subacromial space in the shoulder without impingment. This space is already quite small so it is important that we have appropriate movement of the shoulder (often termed scapulo-humeral rhythm.) When we raise our arms over-head (as we do when pressing) the scapula should begin to rotate after 60 degrees which allows the humerus to pass under the subacromial space. The ability for this to occur is very important for injury prevention of over-head athletes! Shoulder impingements will occur when the space between the coracoid and humerus narrows which leads to the rotator cuff muscles to “catch” as they pass under the structure. Over-time this will lead to fraying and injury of these muscles and potentially tears.

In order to maintain the necessary space for your rotator cuff when lifting your arms above head the scapula must retract and rotate upwards. Mobility of the thoracic spine is particularly important as it will impact retraction of the scapula. Additionally, assumption of a slumped posture (which many of us have from desk jobs) which causes shortened pecs, and upper traps that will pull the shoulders forward creating an anterior tilt in the scapula reducing the space needed. In summary, when the shoulder is not moving properly and the subacromial space is reduced from lack of thoracic spine mobility and tight muscles it will eventually lead to some sort of impingement.

So what can you do to prevent/fix this issue?
•Have your thoracic spine mobility assessed
•incorporate some “pre-hab” in your normal routine; this should include rhomboid, mid and lower trap work.
•Stretch your pecs, and upper traps.

I urge you all to incorporate a bit of pre-hab; your body and gains will thank you in the long run!

Keep Moving.

 

Dr. James Ellis DC, MSACN

www.evolvedhealthchiropractic.com