Frozen Shoulder

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Frozen shoulder, also known as adhesive capsulitis, is a malady that affects 2-3% of the population. Often the main indicator is initial pain in the joint and decreased mobility. Frozen shoulder can affect people of any age from children to adulthood, but is most commonly diagnosed in people ranging from 40 - 70 years of age, predominantly women.

The shoulder joint itself is called a ball and socket joint. Ligaments, tendons and muscles work together to provide support, strength and the wide range of motion that enables us to move our arms and hands in a variety of positions in order to complete tasks. All the functions of the shoulder can be compromised by underlying inflammatory diseases and misuse. The specific causes of frozen shoulder perplex are varied and largely still unknown, but onset begins with initial pain, followed by restriction in mobility and finally recovery.

Frozen shoulder can often be referred to as insidious in nature. The symptoms and development of the disorder are slow and can take up to a year or two to set in. Often patients will experience pain that will increase over time. As chemical changes take place in the shoulder joint, thick strands of tissue called adhesions form and begin to restrict mobility. The lubricating synovial capsule in the shoulder joint thickens and provides less lubrication. By the time the sufferer begins to notice a significant issue in lack of mobility, the disorder has set in and requires treatment. 

The good news is that although the causes of frozen shoulder are varied, treatment is straight forward and the disorder can be resolved. Often clinicians, including our experienced and caring staff, can provide the correct manipulation and physiotherapy to help you regain mobility and resolve the disorder. Contact our office so we can address your condition immediately. 

Causes of Frozen Shoulder
Adhesive capsulitis (Frozen Shoulder) can be attributed to misuse and injury, myocardial infarction, upper torso surgery, such as arm and shoulder surgery or mastectomy, and even lack of use. When the shoulder joint goes unused and remains in the same position for long periods of time, such as when a patient is placed in a sling or unable to use their arm, the joint tightens and mobility is decreased. An autoimmune response in the area may cause the joint to stiffen and restrict the joint causing the initial pain. When the initial pain is not addressed, the inflammatory nature of the disorder will progress and adhesions form in the joint further restricting mobility and increasing the level of pain.

Frozen Shoulder Due to Systemic Disorders
A large population of patients who suffer from systemic diseases may be more likely to develop frozen shoulder. These systemic diseases include those who suffer from thyroid disorders such as hyperthyroid and hypothyroid, both overactive and underactive thyroid function. Other diseases include diabetes, cardiovascular disease, tuberculosis and Parkinson's Disease. Frozen shoulder treatment related to these diseases is paramount and the importance of early diagnosis followed by early manipulation and treatment are necessary, because more drastic treatments are often times not an option. Our chiropractic staff are experts in diagnosing and treating the issue to help resolve your pain and regain your range of motion, so you may return to a normal routine.

Frozen Shoulder in Surgical Patients
Patients who have recently gone through shoulder surgery such as rotator cuff repair or repair to the labrum, one of the many tendons in the shoulder, may experience frozen shoulder. Patients who have had recent mastectomy or cardiovascular surgery are at risk, as well. The reason they are more susceptible to the disorder is lack of use of the shoulder. When the shoulder remains in the same position for a prolonged period of time, the joint stiffens and the pain sets in.

Once the surgical site heals sufficiently, physiotherapy and chiropractic manipulation are highly recommended to help return range of motion to the joint and reduce pain. Our office can develop a program for you that will reduce the pain and increase the range of motion over a healthy period so you can return to a normal schedule in you life.

Chiropractic Treatment of Frozen Shoulder
Chiropractic therapy for frozen shoulder can produce the results you need and resolve your frozen shoulder. Our staff will evaluate your baseline range of motion and pain level to develop a plan tailored to you. In-office physiotherapy coupled with exercise you may do at home will address and increase your range of motion. It will also build the muscle to prevent muscular atrophy or the shrinkage of important muscles in the shoulder. Coupled with treatment for inflammation in the joint space, patients can see improvement over a period of time and resolution of the disorder.
Hard work is the key. Failure to work on stretching in the office as well as at home can delay the recovery process. Trust our staff to direct you along the path to recovery.

Sources:
http://www.diabetes.org/living-with-diabetes/complications/related-conditions/frozen-shoulder.html
http://www.mayoclinic.com/health/frozen-shoulder/DS00416/DSECTION=risk-factors http://www.aafp.org/afp/990401ap/1843.html http://www.healthgrouponline.com/frozenshoulder.html

What You Need to Know About Sciatica

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I am not sure if you're back has ever hurt, but if it has or it does currently, you need to read this. The term "sciatica" describes the symptoms of leg pain and possibly tingling, numbness or weakness that usually originates in your lower back and travels down through your buttocks and down the LARGE sciatic nerve in the back of your leg.

If you've ever had this type of pain, you know that it's something you want to get rid of as fast as possible.

Sciatica (pronounced sigh-at-ih-kah) is not a medical diagnosis in and of itself - it is a symptom of an underlying medical condition.

Sciatica is often characterized by one of more of the following symptoms:

• Constant pain in only one side of the buttock or leg (rarely can occur in both legs)
• Pain that is worse when sitting
• Burning or tingling down the leg (vs. a dull ache)
• Weakness, numbness or difficulty moving the leg or foot
• A constant pain on one side of the rear
• A sharp pain that may make it difficult to stand up of to walk

Sciatic pain can vary from infrequent and irritating to constant and incapacitating. These are symptoms of an underlying situation in your body and the longer you let them go or cover them with aspirin or some other drugs, the worse the problem will become.

Specific sciatica symptoms also vary widely in type, location, and severity, depending upon the condition causing your sciatica (such as a lumbar herniated disc). If you have had or do have symptoms currently make sure you call the office immediately. 

Cause and Effect

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Hi!

Think about this.

When we get sick or experience aches and pains, it's tempting to look for causes outside ourselves.

Convenient Culprits:

Bad luck. Like accidents or being in the wrong place at the wrong time.

Germs. Blaming illness on germs overlooks one critical ingredient--being a hospitable host!

Genetics. The new fall guy is "bad genes." Yet, research shows that gene expression is a reaction to our environment.

We live in a world of cause and effect.

Every Symptom Has a Cause

It's tempting to look to outside causes, but many health problems are the result of our own choices, beliefs, and habits. Sometimes the effects can take decades to appear.

FACT: Bad Health is the "result" of your body's inability to accommodate physical, chemical, or emotional stress.

Similarly, if you not only want to feel good, but have good health results, this happens when your body works the way it was designed to get. Get checked!

Chiropractic Care as a Secret Ingredient

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Your body, your physical self, is a deeply complex structure, and as a result is exquisitely sensitive to changes in initial conditions. For example, eating high-calorie fast food on a regular basis may lead, not only to weight gain and possible blood sugar problems, but also to problems such as autoimmune disorders including asthma and celiac disease.

To guard against such problems, we need to pay attention to the "triangle of life." Importantly, the smooth functioning of the triangle of life takes for granted that all your body's different systems can work together accurately and efficiently. Regular chiropractic care is the secret ingredient in this process. By restoring spinal alignment and removing nerve interference, regular chiropractic care helps you get the most out of your exercise, nutrition, and rest, so that you can achieve your highest levels of health and well-being.

The Power of Cross-Training

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Cross-training refers to a combination of different methods of exercise. Specifically, cross-training refers to the combination of strength training and cardiovascular training in your overall exercise program. Whether you're a 14-year-old just starting out on your first fitness program, or whether you're a 74-year-old who hasn't exercised in more than 40 years, cross-training will provide optimal results for the time and effort you spend on exercise.

In cross-training, it's not that you're doing aerobic and strength-training activities simultaneously. Rather, you're incorporating both methods in your weekly exercise regime. One week you might do three sessions of strength training and two sessions of cardiovascular activity. The next week you could do three sessions of aerobic exercise and two sessions of strength training. The result is that, overall, approximately half of your exercise time is devoted to each of these two methods.

The remarkable outcome of combining two distinctly different training modes is that both sets of results are enhanced.^1,2 Doing cardiovascular exercise on alternate days makes you stronger. In other words, your muscular strength and size are greater than they would be if strength training were your only form of exercise. Correspondingly, doing strength training on alternate days provides you with heightened cardiovascular gains. Specifically, your stroke volume (the amount of blood pumped on each contraction of your heart muscle) and vital capacity (the amount of air you can take in on each breath) are greater than the results you would have obtained by only doing aerobic exercise.

The benefits of cross-training are automatic. There's nothing you need to do intentionally to achieve these gains, other than engaging in your cross-training program five days a week. When you train your heart and lungs by doing cardiovascular (really, cardiorespiratory) exercise, your skeletal muscles automatically participate in your walking, running, biking, or swimming activity. When you do strength training, exercising your chest, back, shoulders, arms, and legs (on different split-training days, of course), your heart and lungs automatically participate, pumping the extra blood and breathing in the extra oxygen required for any vigorous physical activity.

The synergy created by the cross-training format potentiates the results obtained from each method.³ The improved performance of your heart and lungs, derived from aerobic training, enables greater strength training gains. A stronger musculoskeletal system, derived from training with weights, causes your heart and lungs to become more efficient to meet new demands. A positive feedback loop is established from which you obtain improved health and enhanced wellness and  well-being.

The best time to begin your new cross-training program is today. Start slowly, increase duration and intensity gradually, and evaluate your gains at 6- and 12-week intervals. Your chiropractor is experienced in exercise rehabilitation and will help you design a cross-training program that works for you.

1. Fournier SB, et al: Improved Arterial-Ventricular Coupling in Metabolic Syndrome after Exercise Training. Med Sci Sports Exerc  2014 May 27.

2. Kolka C: Treating Diabetes with Exercise - Focus on the Microvasculature. J Diabetes Metab 4:308, 2013

3. Dos Santos ES, et al: Acute and Chronic Cardiovascular Response to 16 Weeks of Combined Eccentric or Traditional Resistance and Aerobic Training in Elderly Hypertensive Women: A Randomized Controlled Trial. J Strength Cond Res 2014 May 19.

Surprising Ways a Chiropractor Can Help You

Via Karen Erickson, DC..American Chiropractic Association

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Well-designed studies have shown that chiropractic care (often just called "chiropractic") is at least effective-and sometimes more effective - than traditional medicine for treating certain types of physical complaints. Emerging research indicates that chiropractic affects more than just the spine and surrounding muscles. It has been used to successfully treat a variety of conditions, including digestive complaints and ear infections.

Ways chiropractic can help...

DIGESTIVE DISORDERS.

A survey of 1,494 patients found that 22% reported digestive relief following chiropractic treatments, even though the majority had never mentioned digestive issues to their chiropractors. Many of the spinal nerves that are affected by chiropractic manipulation control digestive functions. Patients who undergo routine manipulations may experience changes in their levels of digestive fluids, the speed at which foods moves through the intestinal tract or the strength and/or frequency of intestinal contractions. We're often told by patients that manipulations for, say neck or low-back pain not only helped their musculoskeletal complaints but also resulted in improvements in constipation, irritable bowel syndrome and other digestive issues.

Digestive problems need to be medically diagnosed first, but the most effective treatments involve an integrative approach, which can include chiropractic. I often get referrals from medical doctors of patients with constipation, colitis, or irritable bowel syndrome. Help for colic: A study published in the Journal of Manipulative and Physiological Therapeutics found that colicky babies treated with chiropractic cried about three hours less daily than they did before, compared to a one-hour reduction in those given the drug dimethicone, s standard treatment. The manipulations given to children are very gentle. Many have a reduction in colic after just one of two treatments. Look for a chiropractor who specializes in children's problems.

TENSION HEADACHE.

The headaches that we all get from time to time often are related to the cervical spine in the neck. Known as cervicogenic headaches, these occur when vertebral misalignments cause muscle tightness or spasms. The tension begins in the neck but can radiate through the occipital nerves that rise upward from the base of the skull. A study that compared patients receiving chiropractic care for tension headaches with those who were treated with the antidepressant amitriptyline showed reduction in both the frequency and pain intensity of these types of headaches. Most important, the chiropractic patients sustained these improvements after the treatment period, unlike patients who were treated with medication.

In a typical treatment, the chiropractor attempts to realign the cervical joints by manipulating the neck and head. The main goals of the treatment, apart from adjusting the vertebrae, are to increase the range of motion, relax the surrounding muscles and decrease pain and inflammation. People who have only recently started getting headaches often will improve after one or two sessions with a chiropractor. Those who have suffered from headaches for years probably will require multiple treatments before they start to notice a significant improvement.

Also important: The chiropractor will take a detailed history to learn why there is misalignment in the neck. This usually is due to life style issues. For example, many of us look down at our computer monitors, which puts excessive tension on the neck. Raising the monitor to eye level can correct this. Women may be advised to carry a handbag rather than a heavy shoulder bag. Cradling your phone between your neck and shoulders also can cause problems. If you often find yourself doing this, get a headset. It's not clear if chiropractic manipulations may affect nerves that control vascular expansion and contraction, a key component of migraines.

EAR INFECTIONS.

Some adults and virtually all children accumulate fluids in the Eustachian tube, the passage between the throat and the middle ear. The fluid is a perfect medium for viruses and bacteria, which can cause otitis media, an infection or inflammation of the middle ear. Many studies have shown that chiropractic can relieve and prevent ear infections without antibiotics. The treatments, which include chiropractic adjustment and massage of the lymph nodes along the neck and around the ear, help drain excess fluid. The adjustment helps regulate the nervous system, which in turn drains the Eustachian tube and promotes long-term drainage.

SINUSITIS.

People with chronic sinusitis (inflammation of the mucous membranes in the sinuses) rarely get long-term relief from antibiotics or other types of conventional medicine, such as antihistamines and decongestants. Chiropractic can sometimes relieve all or most of the typical symptoms, such as facial pain and nasal congestion. People with chronic sinusitis often have a misalignment in the cervical vertebrae. Chiropractic adjustments may help sinuses drain more efficiently. The treatment for sinusitis also includes applying pressure to the sinuses near the eyebrows and on either side of the nose.

REPETITIVE STRESS DISORDERS.

Most repetitive stress injuries, including tennis elbow, are caused by tendonitis, an inflammation of the fibrous tissue that connects muscles to bones. Carpal tunnel syndrome, another type of repetitive stress injury, is caused by nerve inflammation in the wrist. Doctors usually treat these conditions with anti-inflammatory drug, including steroid injections in severe cases. For carpal tunnel syndrome, surgery to "release" pressure on the nerve is sometimes recommended. Chiropractic, a more conservative approach, is effective for virtually all types of repetitive stress disorders. Manipulations to realign joints and improve range of motion can reduce pressure on tendons and nerves. The movements also improve lymphatic drainage, which reduces inflammation, improves circulation and accelerates healing.

Heavy Lifting

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All of us who've experienced a back injury of one sort or another have been told at some point to “avoid heavy lifting.” That type of advice appears to be a no-brainer or at least redundant, as no one whose back is hurting is going to try to pick up an air conditioner or even a 100-foot reel of garden hose. In this context, it’s important to remember the words of Shakespeare’s Cassius: “The fault, dear Brutus, is not in our stars, but in ourselves”. The problem isn't the heavy lifting, as such. The real problem is in us, that is, in our overall level of conditioning or physical fitness.

Most back injuries don’t occur as a result of heavy lifting, but rather are caused by a seemingly innocuous event such as bending over in the shower to retrieve a bar of soap that has fallen to the floor. Other likely pain-producing scenarios are bending over to place a bag of groceries in the trunk o f a car bending over to tie a loose shoelace. None of these circumstances involved lifting extraordinary weight.  Rather, the common elements are lack of flexibility and lack of appropriate muscle tone and strength to support the weight of your body in a forward flexed position.

The problem isn't lack of big muscles. Picking up a bar of soap or positioning a 15-pound grocery bag doesn't require bulging biceps or massive lats. The problem is lack of conditioning. Most of us no longer do actual physical work on a regular basis. We spend the large majority of our day sitting, either working, reading, or watching entertainment on television or other devices. The result of such lack of activity is twofold. Muscles lose strength and muscle fibers are replaced by fat. Additionally, tendons and ligaments contract and become tight, losing their necessary composition of elastic fibers. The functional loss associated with these physiological changes is profound. We experience these change every time we feel a twinge, or worse, in our backs.

The fix is easy and primarily focuses on building up core muscle strength.^1,2 Core training is directed toward your deep abdominal muscles. The main such muscle is the transverses abdominis, which surrounds your entire waist, protecting and supporting your lower back. You can think of this critically important structure as your internal weight belt. Activation of the core muscles is required for all effective physical activity.³ Without this essential foundation, any minor attempt at work, even bending over to pick up a pencil, can lead to disaster in the form of excruciating back pain.

Core training includes exercises such as the scorpion, lying windmill with bent legs, push-ups, squats, and the plank. Many good books and numerous online videos are available to provide instruction in the performance of core exercises. Your chiropractor is experienced in rehabilitative exercise and will help guide you to the training methods that are best for you.

¹Inani SB, Selkar SP: Effect of core stabilization exercises versus conventional exercises on pain and functional status in patients with non-specific low back pain: a randomized clinical trial. J Back Musculoskel Rehabil 26(1):37-43, 2014

²Brumitt J, et al: Core stabilization exercise prescription, part 2: a systematic review of motor control and general (global) exercise rehabilitation approaches for patients with low back pain. Sports Health 5(6):510-3, 2013

³Wang XQ, et al: A meta-analysis of core stability exercise versus general exercise for chronic low back pain. PLoS One 2012;7(12):e52082. doi: 10.1371/journal.pone.0052082. Epub 2012 Dec 17