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Chiropractic or Physical Therapy?

Chiropractic or Physical Therapy? This is a question that many people seem to have when they are experiencing either acute or chronic pain. I was actually amazed at how many people do not really understand what either do exactly. This makes it kind of difficult to make an educated decision, right?

Lets start with a brief breakdown of both professions: Physical Therapists (Physiotherapists or PT’s) focus on conservative treatment of musculoskeletal conditions mainly through exercises, stretching, and mobilizations. With a physical therapist the patient will be taking an active role. You can expect to exercise, stretch, and mobilize different muscles during your appointment’s. The end goal is to not only eliminate or reduce pain, but allow the patient to develop the strength necessary to return work, sport, etc.

Chiropractic is a profession that focuses on diagnosing and treating musculoskeletal condition’s related to joints and muscles of the spine and extremities. Chiropractic Physician’s often do more manual therapy in the form of soft-tissue manipulation, joint manipulation (adjustment), and passive modalities. Patients assume more of a passive role making chiropractic care ideal for patients in acute pain (sprain/strain, disc herniation, whiplash, muscle strain/tear, etc.) Chiropractic Physicians focus more on “foundation” or joint movement than physical therapists, which tend to focus more on the muscle movement.

So which is right for you? BOTH! Depending on your stage of healing, you should be seeing both a chiropractor and a physical therapist. Typically, I will see a patient first, then once the joints and muscles are moving well enough they will be referred to PT in order to strengthen the muscles. A good therapist will recommend both therapies, as addressing both the muscles and the joints is the only way to completely correct a musculoskeletal problem.

Our office routinely works with medical doctors and physical therapists for the better patient outcomes. Our mission is to provide the best in evidence based chiropractic care. This often means working with orthopedists, medical doctors, and physical therapists to accomplish better, more permanent results. Most importantly, keeping patients doing what they love to do, and out of surgery!

If you are experiencing muscle or joint pain we can help! Call or schedule online: (781) 460-0939

Keep Moving.

Fix Your Posture- Part 4

If you have not been following a long I have been discussing the beginning stages of what some may consider as an epidemic; “postural syndrome.” I have now  addressed three very important groups of muscles that are necessary for proper postural alignment.  If you missed these posts simply click on the links to catch up (click here for Part 1, Part 2, Part 3).

Continuing in our quest for great posture, today I will talk about an often over-looked sourced of rounded shoulders; the pectorals. The pectoral muscles are better known as the bench press muscles as they are responsible for adduction of the arms, and humerus. The pectoral group (composed of a major and a minor) also help to move the scapula anteriorly and inferiorly against the thoracic wall allowing for smooth motion. The pectoralis minor is of most concern as it directly attached to the scapula (shoulder) and ribs. This will serve as a perfect lever to pull those shoulder into a rounded position distorting the curves of your spine and placing abnormal stress on the muscles of the back, shoulder, and neck.

The pectoralis minor serves as a secondary breathing muscle that may be recruited in those that are deconditioned. The muscle lies in close proximity to the Thoracic Outlet, which is a small opening in your neck and shoulder where the nerves of your spine exit to innervate your limbs. When shortened this muscle may serve to close down that space creating an impingement on the nerves exiting the spine. This is commonly marked by tingling, numbness, discoloration, or coldness in the hands.  It is in your best interest in other words to be sure that this muscle is of adequate length and not causing any impingements!

Click Here to learn the #1 stretch for short, tight, pectorals!

 

Keep Moving.

Dr. James Ellis

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

Conservative Management of “Runner’s Knee”

A chronically painful knee can be not only painful for the athlete but can also be very difficult to diagnose. This is because often times the pain can be vague and seem to “come and go.” After ruling out any more serious complications, I find one common cause of knee pain is known as “runners knee” otherwise known as patellofemoral pain syndrome. This is characterized by vague pain behind and around the knee cap often made worse with activity, bending,  and going down stairs. Mild swelling may also be noted. The cause is typically multifactorial and usually related to over-use. Muscle imbalances in the legs resulting from pelvic, knee, and feet alignment issues are typically present.

How is it Diagnosed?

A physical exam will be performed with range of motion and orthopedic testing of the knee. You doctor may also order an X-Ray or MRI if he feels necessary. Pain is often noted in deep flexion especially when weight bearing(such as squatting) and is frequently felt behind the knee often made worse with activity.

How is it Treated?

Step number one is to consult your physician and have the knee examined. Most cases of runners knee require some professional intervention or they may become chronic. Initial treatment may include passive modalities such as ultra-sound, muscle stimulation, or heat. The alignment of the knee, hips and feet will need to be addressed by a chiropractic physician. Additionally, rehabilitation exercises should be prescribed in order to correct the underlying problems with muscle imbalances. This can be corrected through techniques such as myofascial release, manipulation, and therapeutic exercise.

The bottom Line

Consult a chiropractic physician or sports medicine doctor for an accurate diagnosis and to rule out more serious pathologies. The treatment plan should include a multifactorial approach including passive modalities, manipulation of any joint dysfunctions, and therapeutic exercise to correct muscle imbalance’s.

 

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