Our Toxic World: Arsenic

by Blog ArticlesPainful Conditions, Syndromes & Physiology

Our Toxic World | Arsenic

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arsenic exposure

Arsenic is a natural component of the earth’s crust and is widely distributed throughout the environment in the air, water and land. It is highly toxic in its inorganic form.

Long-term exposure, mainly through drinking-water and food, can lead to chronic arsenic poisoning. Skin lesions and skin cancer are the most characteristic effects.

Arsenic Toxicity

Mechanisms of Exposure

People are exposed to elevated levels through contaminated drinking water, by using contaminated water in food preparation and irrigation of food crops, through industrial processes, through exposure to treated woods, by eating contaminated food, and by smoking tobacco.

Water Contamination in the US:  In a national study of groundwater quality, the USGS found contamination of nearly half of the wells sampled in parts of aquifers used for drinking-water supply at a concentration of 1 µg/L or greater. Detection was more common and concentrations generally  higher in the west than in the east.

About 7 percent of the wells sampled were contaminated at a concentration that exceeded the MCL of 10 µg/L, indicating a potential health risk. The greatest concern was in the Southwest, where concentrations exceeded the MCL in about 16 percent of drinking-water wells sampled.

Food Contamination:  Arsenic occurs naturally in a variety of foods such as fruits, vegetables, grains and fish.  Most recently, low levels have been detected in rice and juice products.

Health Effects

Acute Effects:  The immediate symptoms of acute poisoning include vomiting, abdominal pain and diarrhoea. These are followed by numbness and tingling of the extremities, muscle cramping and death, in extreme cases.

Long-term Effects:  The first symptoms of long-term exposure (for example, through drinking-water and food) are usually observed in the skin, and include pigmentation changes, skin lesions and hard patches on the palms and soles of the feet (hyperkeratosis). These occur after a minimum exposure of approximately five years and may be a precursor to skin cancer.

In addition to skin cancer, long-term exposure may also cause cancers of the bladder and lungs. The International Agency for Research on Cancer (IARC) has classified arsenic and its compounds as carcinogenic to humans, and has also stated that contaminated drinking-water is carcinogenic to humans.

Other adverse health effects that may be associated with long-term ingestion include developmental effects, diabetes, pulmonary disease, and cardiovascular disease. Arsenic-induced myocardial infarction, in particular, can be a significant cause of excess mortality.

Treatment for Arsenic Exposure

The first step to treating arsenic exposure is to eliminate the source of the exposure.  Clean drinking water, uncontaminated food, and clean air are a must.

No treatment of proven benefit is currently available to treat chronic arsenic toxicity. Treatment options advocated are vitamin and mineral supplements and antioxidant therapy (especially increasing glutathione levels). The benefits of these treatment measures need to be evidence based to receive endorsement and wider application.

Read about other common environmental exposures.

Our Toxic World

by Blog ArticlesPainful Conditions, Syndromes & Physiology

Our Toxic World

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I really do try to stay upbeat in most situations.  Take a deep breath and carry on right?  But what if that deep breath is killing you?  What if instead of qi you get environmental toxins? 

American culture used to be baseball and apple pie.  So wholesome…  Nowadays, it’s instant gratification and disposable trinkets.  When was the last time you cart abandoned because prime wasn’t an option?

Come down the rabbit hole with me as we explore the Environmental working group‘s (EWG) list of top environmental toxins.  Learn a few tips and tricks to help reduce your exposure, protect your family, and support your body in the process.

Let’s start by simply naming what it is that’s killing us.

Environmental Toxins

Environmental Toxins

I’m not sure if you’ve ever tried to actually read something on the EWG website, but it’s an awful user experience.

They offer several really nice guides on specific topics, but click on any given link and you will get research overload.

Let’s start with something simple…a list.

1) Arsenic

A known human carcinogen, arsenic is a common contaminant in food and water. It was also used in virtually all pressure-treated wood products before EWG helped get it off the market.

2) Asbestos

EWG research showed that 10,000 people die each year of asbestos-related diseases and unearthed documents showing that corporate executives concealed for decades the dangers of making or handling asbestos-containing materials.

3) BPA

BPA  leaches from can linings and plastic water bottles/containers into foods, beverages and infant formula – and ends up in the bodies of 93 percent of Americans.

4) Chromium-6

Nearly 200 million Americans across all 50 states have been exposed through their tap water to higher-than-recommended levels of chromium-6, a cancer-causing chemical. Chromium-6 was made famous in the 2000 biographical film “Erin Brockovich.” 

5) Dioxin

EWG found cancer-causing dioxin and related chemicals in the blood of every American it tested, including cord blood from 20 newborns that came into the world “pre-polluted.”

6) Flame Retardants

For decades, foam furniture, baby products and electronics have been loaded with needless flame retardants that migrate out of products and into our bodies. These chemicals have been linked to cancer and hormone disruption, as well as deficits in motor skills, attention and IQ in children.

7) Lead

Chronic exposure to lead is a well-known threat to health, especially for children, but it’s still a persistent problem.  Flint Michigan is not unique.

8) Mercury

Mercury exposure from eating fish carries serious health risks, especially for developing fetuses.  Every worry about those old amalgam fillings?

9) Nanomaterials & Microplastics

These vanishingly small particles are turning up in thousands of new products, including cosmetics and are bioaccumulating.

10)  Perchlorate

This component of rocket fuel, which can affect thyroid hormone levels currently has no national drinking water standard.

11)  Pesticides

Pesticides are designed to kill “pests”, but some pesticides can also cause health effects in people. The likelihood of developing health effects depends on the type of pesticide.  Some health effects from pesticide exposure may occur right away, as you are being exposed. Some symptoms may occur several hours after exposure. Other effects may not be noticed for years, for example cancer.

12) Phthalates

These endocrine-disrupting “plasticizer” chemicals are everywhere in modern society.  Several have been banned in children’s toys, but they are still widely used chemicals that  pollute almost everyone’s bodies.

13) PFA’s

In 1946, DuPont introduced Teflon to the world, changing millions of people’s lives – and polluting their bodies. Today, the family of compounds including Teflon, commonly called PFAS, is found not only in pots and pans but also in the blood of people around the world, including 99 percent of Americans. PFAS chemicals pollute water, do not break down, and remain in the environment and people for decades. Some scientists call them “forever chemicals.”

14) Triclosan

Consumer products containing this antibacterial pesticide don’t protect you from germs or disease, but they do expose you to a hormone-disrupting chemical. 

15) 2,4-D

2,4-D (2,4-dichlorophenoxy) is a systemic phenoxy herbicide developed in the 1940s and still in use today (think Agent Orange).  ,4-D is reported to have negative effects on the endocrine system (specifically the thyroid and gonads) and immune system.

16) Gyphosate

Glyphosate is a toxic pesticide widely used on crops. The active ingredient in Monsanto’s Roundup, it is sprayed on oats right before harvest to dry them out, so it ends up in many oat-based products, like cereals and breakfast bars.

On March 28, 2017, the California Environmental Protection Agency’s Office of Environmental Health Hazard Assessment confirmed that it would add glyphosate to California’s Proposition 65 list of chemicals known to cause cancer. 

Joint Hypermobility Syndrome

by Blog ArticlesPainful Conditions, Syndromes & Physiology

Joint Hypermobility Syndrome

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Hypermobility means that your joints are more flexible than other people’s (you may think of yourself as being double jointed). When this causes pain, it might be joint hypermobility syndrome.

People with high levels of flexibility often gravitate towards activities where flexibility is a goal or even rewarded.  Think of activities such as dance, yoga, performance art, and the circus arts.  This increased level of flexibility, however, comes at a price.  If you are one of those amazingly flexible few, you may have joint hypermobility syndrome and need to consider how to age well and protect yourself from injury.

Intrigued?  Read on!

The Nuts and Bolts of Hypermobility

Joint Hypermobility

Hypermobility usually comes up when I’m initially working on a patient.  It may be really hard to get their joints to tension, or when I do an ankle adjustment their knee and hip come along for the ride.  They may not have that classic “double jointed” presentation, but it is distinctly noticeable.  Your connective tissues don’t lie.

Collagen and Elastin

Bare with me for a minute while we go down a rabbit hole.  It’s worth the trip.

Your ligaments are comprised primarily of two types of protein, the aforementioned collagen and elastin.  Collagen provides structural integrity while the Elastin is responsible for a ligament’s ability to stretch and deform.  Without Collagen you would be a rubbery mess, and without Elastin you would be as stiff and the tin man.  

Your specific mix of Collagen and Elastin is dictated by a dozen or so genes.  Thanks mom!  

Collagen and Elastin make up most of what we think of as being our soft and connective tissues: skin, fascia, ligaments, tendons, etc.  Muscles are different because they also contain contractile elements.

Ligaments, specifically, provide a supportive role.  They hold your joints together, your organs in place, your teeth in their sockets…you get the idea.  You can think of the texture of a ligament as being somewhat akin to that of saltwater taffy?  It’s pretty darn tough, but if you keep at it you can get it to stretch. 

This quality is known as a ligament’s “creep.”  The fibers are slow to lengthen, but under sustained stress they do.  They don’t really snap back…a good analogy is when you overstretch the elastic in your sock.  It does the job, but that sucker is going to sag.

Ligaments & Hypermobility

From the direction of the conversation, you may have already guessed what is coming next.  If you are already more flexible than the average bear, and you continue to stretch your ligaments…at some point you may find yourself with an unstable joint.  This means that your ligaments are not able to hold their respective bones in a proper alignment.

Now, you may be looking down at yourself and noticing that your joints are not flopping around like raggedy ann or andy despite the fact that you are very flexible.  Well, our bodies are good at their jobs.  We have redundant systems in place.

If you are overly flexible, you make up for that lack of ligamentous stability with muscular strength.  Your muscles also attach to the bones, kind of necessary for movement to occur.  Since muscles have contractile fibers, they are able to shorten and don’t stay stretched out.  “So what’s the problem?” you may ask.

In a nutshell, your muscles are doing two jobs instead of one.  They aren’t just moving you through space, they are also holding you together.  This makes repetitive activities especially trying on the muscles around the joints.  You may have noticed that you are more likely to get tendinitis, plantar fasciitis, shin splints…any one of those pesky inflammatory connective tissue injuries.  This common inflammatory theme also means that you are more likely to build up scar tissue in your fascia (ouch!).

On a more serious note, when you are in an accident your joints usually have two lines of defense: muscles and ligaments.  You are pretty much flying with one engine.  You may be more likely to dislocate a joint when a stiffer soul would only sprain a ligament.  Also, you are more prone to recurring injuries such as ankle sprains and shoulder dislocations.

The makeup of your connective tissue also affects the valves in your veins and heart.  Those with excessive flexibility may be more prone to varicose veins and swelling of the legs.  In more extreme inherited genetic connective tissue syndromes, such as Ehler Danlos, the heart may be more profoundly affected.

So What is a Flexible Soul to do About Hypermobility?

Play to your strengths, literally!

Stress & Your Body

by Blog ArticlesPainful Conditions, Syndromes & Physiology

STRESS & YOUR BODY

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Stress has both benefits and downfalls. It is an adaptation needed for survival. We have evolved through the fight or flight response, which provides the physical energy and mental focus to remove us from dangerous situations (Segerstrom, 2006).

Examples of good include physical tension on muscles or the vasculature system to further strengthen, alertness as a needed to take an exam, or pay attention driving during bad weather. (Cleveland Clinic, 2017)

When it becomes chronic and mismanaged it is a detriment to our health and well-being.

Examples of unhealthy stressors include inadequate recovery from physical, mental and emotional tension of any kind. This could be related to exercise, constant worrying and repetitive thoughts of a negative nature, and even emotions such as depression and anxiety (Cleveland Clinic, 2017).

Prolonged unease leads to hyper physiological levels of cortisol. This alters the effectiveness of cortisol to regulate both the inflammatory and immune response because it decreases tissue sensitivity to cortisol (Segerstrom, 2006).

As the human body heals, inflammation becomes a response to stressors. Like stress, inflammation is beneficial, although when inflammation becomes chronic, it can lead to constant tissue breakdown and impairment of the immune system.

“Stressed people’s immune cells become less sensitive to cortisol. They’re unable to regulate the inflammatory response, and therefore, when they’re exposed to a virus, they’re more likely to develop a cold” (Cohen, 2004).

Stress & Your Body

The Three Kinds

Management can be complicated and confusing because there are different types — acute, episodic acute stress, and chronic — each with its own characteristics, symptoms, duration and treatment approaches. Let’s look at each.

Acute

This is the most common form. It comes from demands and pressures of the recent past and anticipated demands and pressures of the near future. It is thrilling and exciting in small doses, but too much is exhausting. A fast run down a challenging ski slope, for example, is exhilarating early in the day. That same ski run late in the day is taxing and wearing. Skiing beyond your limits can lead to falls and broken bones. By the same token, overdoing on short-term stress can lead to psychological distress, tension headaches, upset stomach and other symptoms.

Fortunately, these symptoms are recognized by most people. It’s a laundry list of what has gone awry in their lives: the auto accident that crumpled the car fender, the loss of an important contract, a deadline they’re rushing to meet, their child’s occasional problems at school and so on.

Because it is short term, acute stress doesn’t have enough time to do the extensive damage associated with long-term stress. The most common symptoms are:

Emotional distress — some combination of anger or irritability, anxiety and depression, the three stress emotions.

Muscular problems including tension headache, low back pain, jaw pain and the muscular tensions that lead to pulled muscles and tendon and ligament problems.

Stomach, gut and bowel problems such as heartburn, acid stomach, flatulence, diarrhea, constipation and irritable bowel syndrome.

Transient over-arousal leads to elevation in blood pressure, rapid heartbeat, sweaty palms, heart palpitations, dizziness, migraine headaches, cold hands or feet, shortness of breath and chest pain. 

Acute stress can crop up in anyone’s life and is more or less inevitable.

Episodic

There are those who suffer acute stress frequently. They’re always in a rush, but always late. If something can go wrong, it does. They take on too much, have too many irons in the fire, and can’t organize the slew of self-inflicted demands and pressures clamoring for their attention. 

It is common for such people to be over aroused, short-tempered, irritable, anxious and tense. Often, they describe themselves as having “a lot of nervous energy.” Always in a hurry, they tend to be abrupt, and sometimes their irritability comes across as hostility.

The symptoms of episodic acute stress are the symptoms of extended over arousal: persistent tension headaches, migraines, hypertension, chest pain and heart disease. Treating episodic acute stress requires intervention on a number of levels, at times requiring professional help, which may take many months.

Chronic

While acute stress can be thrilling and exciting, chronic stress is not. This is the grinding stress that wears people away day after day, year after year. 

Chronic stress comes when a person never sees a way out of a miserable situation. It’s the stress of unrelenting demands and pressures for seemingly interminable periods of time. With no hope, the individual gives up searching for solutions.

The worst aspect of chronic stress is that people get used to it. They forget it’s there. People are immediately aware of acute stress because it is new; they ignore chronic stress because it is old, familiar, and sometimes, almost comfortable.

Chronic stress kills through suicide, violence, heart attack, stroke and, perhaps, even cancer.  Because physical and mental resources are depleted through long-term attrition, the symptoms of chronic stress are difficult to treat.

Management

  • Try to keep a positive attitude.
  • Accept that there are events that you cannot control.
  • Be assertive instead of aggressive. Assert your feelings, opinions, or beliefs instead of becoming angry, defensive, or passive.
  • Learn and practice relaxation techniques; try meditation, yoga, or tai-chi for stress management.
  • Exercise regularly. Your body can fight stress better when it is fit.
  • Eat healthy, well-balanced meals.
  • Learn to manage your time more effectively.
  • Set limits appropriately and learn to say no to requests that would create excessive stress in your life.
  • Make time for friends, hobbies, interests, and relaxation.
  • Get enough rest and sleep. Your body needs time to recover from stressful events.
  • Don’t rely on alcohol, drugs, or compulsive behaviors to reduce stress.
  • Seek out social support. Spend enough time with those you enjoy.
  • Seek treatment with a psychologist or other mental health professional trained in stress management or biofeedback techniques to learn healthy ways of dealing with the stress in your life.

Dr. Smith encourages his clients to seek mental health care when appropriate and helps his patients manage their physical symptoms through a combination of Chiropractic, Massage, Reiki, Craniosacral, Improved Nutrition & a host of other services. 

References

Cleveland Clinic (2017) Stress. Retrieved from: https://my.clevelandclinic.org/health/articles/11874-stress

Cohen, S., (2004) 5 Studies of behavior, biology, and the common cold: A data repository. The Common Cold Project. Retrieved from: https://www.cmu.edu/common-cold-project/

Segerstrom, S., Miller, G., (2006) Psychological stress and the human immune system: A meta-analytic study of 30 years inquiry. Psychological Bulletin, 130(4), 601-630. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1361287/

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Acute vs. Chronic Pain/Inflammation

by Blog ArticlesPainful Conditions, Syndromes & Physiology

Acute vs chronic pain/Inflammation

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What was the mechanism of injury?  When did it start?  What have you done at home to address it?

When you ask someone for advice about pain, you tend to get a slew of questions rather than anything constructive.  A good first step is to understand the difference between acute pain and chronic pain and how the approach to treating them differs.

Pain is almost inevitably related to and associated with inflammation.  Treating pain, in large part, requires managing and resolving inflammation.  So what’s inflammation?

Inflammation is the body’s generic, first line of defense against any type of injury.  It helps to rally the body’s resources and bring factors necessary for healing to the area.  It increases circulation to the area and is classically described as having 5 cardinal signs (pardon the latin): rubor (redness), dolor (pain),  calor (heat), tumor (swelling), and functio laesa (loss of function).

Acute vs. Chronic

Acute Pain Albuqeurque & Santa Fe

Acute Injuries & Inflammation

Maybe you woke up in a wonky position and you have a sharp pain in the neck.  You might have been bending down to tie your shoes and your low back went out.  Towards the end of your run your knee started to hurt, but you were too close to home to stop.  Whatever the circumstances, you are having a sudden onset of pain.

Acute inflammation is a healthy response that serves to protect and repair the body.  It occurs from something damaging, whether that be an infection in a cut or a strained muscle. The key here is that it is the body’s expected and necessary response to an injury.

Management: 

While a certain amount of inflammation is necessary for the body to heal, sometimes the body gets a little over-enthusiastic with the inflammation.  Reducing the level of inflammation can help to manage the pain, stiffness, and loss of function associated with an injury.  However, a certain amount of inflammation is necessary and appropriate.  So what do we do? 

Well there are two schools of thought.  One is to use the RICE method.  The other is to actively engage the damaged structures (albeit carefully). Joint movement and muscle contraction are how your body naturally processes inflammation and keep it from becoming stagnant around the injury.  It seems a bit counterproductive to cut them out of the equation.

Since there is no consensus, I recommend a hybrid of the two approaches.  Let’s call it RICEM.    

  • Rest
  • Ice
  • Compression
  • Elevation
  • Movement

I find that the first four are appropriate in the earliest stages of an acute injury (first 1-4 days-ish).  After that, try replacing the compression with something more dynamic (such as kinesio tape) and gently get your body back into motion.

Chronic Pain

Chronic Injuries & Inflammation

Maybe you hurt yourself years ago, and over time you progressively got worse.  Your whole body hurts for no apparent reason.  Maybe the foods that you eat are secretly plotting to kill you.  Whatever the case may be, you hurt on a regular basis and quite often nothing seems to help.

Unlike acute inflammation, chronic inflammation is not a part of the body’s natural healing process.  What was supposed to be a useful healing mechanism has spun out of control and is instead causing damage.  There is a wrench in the machine. 

Chronic inflammation is a condition where dilated blood vessels and a hyped up immune system become the new norm. The human body isn’t designed to cope with this unfocused immune activity, and eventually chronic inflammation will cause organ damage. White blood cells usually protect the body from disease, but the unchecked white cell activity of chronic inflammation can make you more prone to non-infectious conditions such as cancer, asthma, allergies, arthritis, and autoimmune disorders.

Managing Chronic Inflammation

So what do you do? 

It all comes down to lifestyle.  Let’s consider triggers for chronic inflammation.

  1. Improve what you eat.  If you don’t know what that means, try an anti-inflammatory diet.
  2. Get some movement into your body.  Be it through yoga, stretching & exercise, chiropractic or massage movement helps to decrease inflammation.  It may be uncomfortable at first, but it will get better with consistency.
  3. Learn to manage your stress!  But don’t let the fact that you’re stressed stress you out.  Meditation and other mindfulness practices will not only help you feel better, they may even help you live longer while feeling better. 

Managing inflammation can seem like a daunting proposition, but like all major undertakings just take it one step at a time. 

Golfer’s Elbow and Tennis Elbow

by Blog ArticlesPainful Conditions, Syndromes & Physiology

GOLFER'S AND TENNIS ELBOW: TWO COMMON CAUSES OF ELBOW PAIN

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While many people are familiar with the names of these conditions, there is less widespread understanding about how they differ. Both tennis elbow (lateral epicondylitis) and golfer’s elbow (medial epicondylitis) are injuries to the tendons attaching your forearm muscles to the bone at your elbow. The “epicondyle” part of epicondylitis refers to the bony bumps or protrusions at your elbow.

Distinguishing Your Elbow Pain

Elbow pain

Lateral Epicondylitis (Tennis Elbow)

Common symptoms of tennis elbow include:

  • Pain that radiates from the outside of your elbow and down your forearm
  • Tenderness on the outside of your elbow
  • Weakness in your forearm or a weak grip
  • Pain when you grip things, twist something or, if you play tennis, especially with backhand strokes
Golfer's Elbow Albuquerque & Santa Fe

Medial Epicondylitis (Golfer’s Elbow)

Golfer’s elbow symptoms are similar, but occur on the inside of your arm and include:

  • Pain and tenderness on the inside of your elbow
  • Pain that radiates down your arm from the inside of your elbow
  • Weakness in your hand or wrist
  • Numbness or tingling in your ring and little fingers
  • Pain when you grip or twist things
  • Pain when you flex your wrist

Both tennis elbow and golfer’s elbow symptoms usually start gradually and get worse over time.

Causes of Golfer’s Elbow and Tennis Elbow

Both conditions are types of tendonitis, or inflammation of a tendon, and both are commonly caused by overuse. This may be due to excessive force on a regular basis (like hitting a tennis or golf ball) or due to other repetitive activities that involve the forearm muscles. The tendons over time can progress from inflammation, to partial thickness tears, and finally full thickness tears. Painters, plumbers, and carpenters or anyone performing repetitive gripping and lifting activities are also prone to both tennis and golfer’s elbow.

Treatment of Tennis Elbow and Golfer’s Elbow

Fortunately, most cases of tennis elbow and golfer’s elbow respond well to conservative treatments. Dr. Smith incorporates home stretching routines, muscle scraping, microcurrent point stimulation, dry needling, myofascial release techniques, deep tissue massage, and extremity adjustments to address both painful syndromes. 

Surgery is usually not necessary, although complete recovery can take weeks or even months, depending on the severity of the condition. As with other forms of tendonitis, one of the most important aspect of treatment is to reduce the amount of strain on the affected tendons. This may include resting the arm, using a brace or athletic taping, wrist splints, and once healed, correcting improper technique/form to prevent the recurrence of the injury.

Foam Rolling, Myofascial Release and Stretching: What’s the Difference?

by Blog ArticlesPainful Conditions, Syndromes & Physiology

Foam Rolling, myofascial release, stretching...what's the difference?

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Foam Rolling, Myofascial Release, Stretching…What’s the difference really?  Most of us will instinctively try to loosen a tight muscle.  This is especially true when it causes pain.  Many different techniques have been developed to fulfill this need.  They fall into two broad categories: things that we can do to ourselves and things that are done to us by someone else (such as massage).  Let’s focus on things that we can do for ourselves.

Stretching, Foam Rolling, and Myofascial Release

Stretching and self-care are ubiquitous in the Animal Kingdom.  You don’t have to look beyond your favorite four-legged friend to see an example.

Stretching, Foam Rolling, & MRT

STRETCHING

Most people, when they refer to stretching, are thinking of a static stretch.  This basically means that you put your body into a certain position which forces a muscle to lengthen.  Muscles get tight from overuse, underuse, repetitive stress, and injury.  Needless to say, at some point you have most likely experienced a tight muscle. 

Tight muscles often result in pain.  In the neck tight muscles can result in tension headaches.  Tight muscles in the low back can contribute to low back pain.  The list is long, but you get the idea.

When we perform a static stretch, the force of the activity is distributed across the length of the muscle, tendons included.  This makes it hard to isolate a specific section of a muscle, especially if the muscle is long. 

The hamstrings are a great example.  They run from the very top of the back of the leg down past the knee.  Not only are they long, but they are also bulky.  The hamstrings are comprised of three large muscle bellies and their associated tendons.  You may have noticed that bending down to touch your toes doesn’t always do the best job to stretch the hamstrings. 

One option is to rotate the leg so that you isolate a single aspect of the hamstrings.  This is known as doing the stretch “with isolation.”  Now the stretch is spread across a smaller section of the muscle, but it still doesn’t single out a specific part.

Need some ideas on how to stretch? Learn more…

What if you have a knot in a specific section of the muscle.  Doing a static stretch is like stretching a rubber band that has a knot tied in it.  This is where myofascial release comes in.

MYOFASCIAL RELEASE

Myofascial release is the application of direct force to a specific section of muscle fibers (or tendon) to address the myofascial tightness or scar tissue in that area.  You can use your hands, a massage tool, a shoe horn, or whatever happens to be within grasp.  The idea is that you are working on a small section of the muscle rather than the whole thing.  Many different myofascial techniques exist, but at the end of the day they all have the same goal: to release tension in the muscles, tendons, and fascia.  You also wind up getting improved flexibility, decreased pain, and improved circulation in the area.  This is also known as a good thing.

FOAM ROLLING

Foam rolling is a type of myofascial release that uses a specific tool…you guessed it!  A foam roller is a cylindrical piece of dense material.  You lay your body across it and use your weight to apply pressure to specific areas of muscle.  It is very effective for longer, more expansive structures such as the IT Band.  However, if the area is cramped or far from your center of gravity the effectiveness is diminished.  People often overcome this limitation by augmenting such areas with a smaller stretching prop such as a tennis or lacrosse ball.

Simple Right?!

 

Frozen Shoulder

by Blog ArticlesPainful Conditions, Syndromes & Physiology

FROZEN SHOULDER

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Frozen shoulder is a condition that affects your shoulder joint. It usually involves pain and stiffness that develops gradually, gets worse and then finally goes away. This can take anywhere from a year to 3 years. 

FROZEN SHOULDER Albuquerque & Santa Fe

Your shoulder is made up of three bones that form a ball-and-socket joint. They are your upper arm (humerus), shoulder blade (scapula), and collarbone (clavicle). There’s also tissue surrounding your shoulder joint that holds everything together. This is called the shoulder capsule.

The capsule becomes so thick and tight that it’s hard to move. Bands of scar tissue form and there’s less of a liquid called synovial fluid to keep the joint lubricated. These things limit motion even more.

The Nuts and Bolts of Frozen Shoulder

SYMPTOMS

The main symptoms are pain and stiffness that make it difficult or impossible to move the shoulder.

With this condition you’ll likely feel a dull or achy pain in one shoulder. You might also feel the pain in the shoulder muscles that wrap around the top of your arm. You might feel the same sensation in your upper arm. Your pain could get worse at night, which can make it hard to sleep.

You’ll typically go through three phases with a frozen shoulder. Each has its own unique symptoms and timeline.

THE FREEZING STAGE

  • You develop a pain (sometimes severe) in your shoulder any time you move it.
  • It slowly gets worse over time and may hurt more at night.
  • This can last anywhere from 6 to 9 months.
  • You’re limited in how far you can move your shoulder.

THE FROZEN STAGE

  • Your pain might get better but your stiffness gets worse.
  • Moving your shoulder becomes more difficult and it becomes harder to get through daily activities.
  • This stage can last 4-12 months.

THE THAWING STAGE

  • Your range of motion starts to go back to normal.
  • This can take anywhere from 6 months to 2 years.

CAUSES OF FROZEN SHOULDER

It’s not clear why some people develop it, but some groups are more at risk.

Freezing of the shoulder happens more often in women than men, and you’re more likely to get it if you’re between the ages of 40 and 60. Your risk might also go up if you’re in the process of recovering from a medical condition like a stroke, or surgery like a mastectomy that keeps you from moving your arm.

Certain medical conditions can increase your risk too. You may also be more likely to get frozen shoulder if you have diabetes. About 10% to 20% of people with diabetes get frozen shoulder. Other medical problems like heart disease, thyroid disease, or Parkinson’s disease are linked to frozen shoulder, too.

A physical exam is usually enough to diagnose frozen shoulder, but your doctor may also order imaging tests such as X-rays, ultrasound, or MRI to rule out other problems like arthritis or a torn rotator cuff that can also cause pain and limit how far it moves.

A Doctor of Chiropractic can help with the pain and stiffness related to frozen shoulder through a combination of joint manipulation, fascial stretching, massage, and by addressing inflammation in the area.  Sometimes dietary changes are necessary to help your body minimize inflammation.

What is Rotator Cuff Syndrome?

by Blog ArticlesPainful Conditions, Syndromes & Physiology

What is Rotator Cuff Syndrome?

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 The rotator cuff is a group of muscles and tendons that surround the shoulder joint.  It keeps the head of the humerus firmly within the shallow socket of the shoulder. A rotator cuff injury often causes a dull ache in the shoulder.  This often worsens when you try to sleep on the involved side.

Rotator Cuff Syndrome Albuquerque & Santa Fe

A wide variety of techniques can be used to address Rotator Cuff Syndrome. These include sports massage, myofascial release, assisted stretching, extremity adjustments, and appropriate home care.

Understanding Rotator Cuff Syndrome

1. Common Causes of Rotator Cuff Injuries

Rotator cuff injuries occur most often in people who repeatedly perform overhead motions in their jobs or sports. Examples include painters, carpenters, and people who play baseball or tennis. The risk of rotator cuff injury increases with age.

Many people recover from rotator cuff injuries with physical therapy exercises.  These attempt to improve the flexibility and strength of the muscles surrounding the shoulder joint.

Sometimes, rotator cuff tears occur as a result of a single injury. In those circumstances, medical care should be provided as soon as possible. Extensive rotator cuff tears may require surgical repair, transfer of alternative tendons, or eventual joint replacement.

2. Symptoms of Rotator Cuff Syndrome

The pain associated with a rotator cuff injury may:

  • Be described as a dull ache deep in the shoulder.
  • Disturb sleep, particularly if you lie on the affected shoulder.
  • Make it difficult to comb your hair or reach behind your back.
  • Be accompanied by arm weakness.
Many types of Shoulder Pain begin with a rotator cuff imbalance.  Frozen shoulder, impingement syndrome, and rotator cuff syndrome all often harken back to a rotator cuff muscular imbalance.  

3. Risk Factors for Rotator Cuff Syndrome

  • Age. As you get older, your risk of a rotator cuff injury increases. Rotator cuff tears most often affect people older than 40.
  • Certain sports. Athletes who regularly use repetitive arm motions, such as baseball pitchers, archers and tennis players, have a greater risk of having a rotator cuff injury.
  • Construction jobs. Occupations such as carpentry or house painting require repetitive arm motions, often overhead, that damage the rotator cuff over time.
  • Family history. There may be a genetic component involved with rotator cuff injuries as they appear to occur more commonly in certain families.

4. Complications & Prevention

Without treatment, rotator cuff problems have the potential to cause permanent loss of motion or weakness.  They may also result in progressive degeneration of the shoulder joint. Although resting your shoulder is necessary for your recovery, keeping your shoulder immobilized for a prolonged time can cause the connective tissue enclosing the joint to become thickened and tight (frozen shoulder).

If you are at risk of rotator cuff injuries or if you’ve had a rotator cuff injury in the past, daily shoulder stretches and strengthening exercises can help prevent future injury.

What is Runner’s Knee?

by Blog ArticlesPainful Conditions, Syndromes & Physiology

What is Runner's Knee?

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Runner’s knee hurts, limits your mobility, makes it hard to get comfortable, and takes forever to heal.  The term runner’s knee is sometimes used a bit loosely.  It may be used to describe either tendinitis of the Ilio-tibial Band (ITB) tendon where it attaches on the lateral side of the knee.  More often it is used to describe patello-femoral syndrome which describes tendinitis and pain related to the patella and its surrounding/supportive structures.  Both are caused by repetitive overuse and what may be described as inappropriate stress on the knee.  

Runner's Knee SF

A wide variety of techniques can be used to address Runner’s Knee including: sports massage, myofascial release technique, assisted stretching, extremity adjustments, orthotics, and  appropriate home care.

What Do you Do about Runner's Knee?

1. Running Surface Matters

As we run there is a fair amount of force generated by the impact of our feet striking the ground.  Depending of the firmness of the ground, more or less of that force is transmitted up through and absorbed into our bodies.  That force is absorbed into our ligaments, tendons, muscles, and ultimately the discs in our backs.

You can think of there being a hierarchy of stress.  

  • Concrete:  Concrete is the worst.  It does not have any give.  If you are trying to aggravate your back or give yourself shin-splints, go run on concrete. 
  • Asphalt:  Asphalt is better than concrete.  There is some space between the particulates and there is a bit of give under your weight, especially when it is warm outside.
  • Track:  It was made for running.
  • Turf/Trail:  These are ideal as long as you have good balance & coordination.  The natural springiness of the earth is what we were made to run on, and it will absorb a fair amount of force.  If your balance is questionable, you may sprain an ankle.
  • Sand:  This is heaven if you can stand it.  It absorbs force, provides resistance, and the shifting surface is great for proprioceptive stimulation (improving balance).

2. Arch Support for Runner’s Knee

Poor arch support is the root of many of the problems that we suffer in the legs, knees, ankles, and feet.  You can think of the entire lower extremity as being one big sheet of connective tissue.  Inadequate medial arch support causes most people to pronate (feet roll in when walking/running) which rotates the hips and knees putting excess stress on many soft-tissues including the ITB.  Excess stress leads to inflammation.  Tendinitis literally means inflammation of the tendons.

3. Stretching for ITB Syndrome

The IT Band is the great human design flaw.  It crosses too many joints for us to stretch it effectively, and it gets tight from just about everything that you do.  The list of activities that aggravate the IT Band is extensive:  sitting, standing, walking, running, crouching, you get the idea.  If you are breathing and not in a half-fetal position, your IT Band is probably getting tight.

The ITB is very hard to stretch (but here’s a good one), but the combination of foam rolling and using a lacrosse ball on the TFL and Glut Minimus is quite effective.  If your tendon is already inflamed ice, rest, and kinesio tape go a long way.  For chronic ITB issues, you might consider arch support and an ITB strap.