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I Trust Chiropractic Care

I Trust Chiropractic Care

Clinton Romesha

“When I first consulted a doctor of chiropractic for back pain, it was discovered that my pelvis was imbalanced – little surprise after many years of carrying military gear in all kinds of terrain. Aligning my hips and lower back, along with stretching and healthy living advice, made all the difference for me. Chiropractic is a natural alternative, and I am grateful for this car that has kept me away from having to mask my pain with addictive painkillers and their harmful side-effects. I encourage my brother and sister Veterans to consider chiropractic for healthier living.”   –  Clinton Romesha

 

In a 2013 ceremony, U.S.Army Staff sergeant Clinton Romesha received the Medal of Honor for acts of gallantry on 10/3/2009, during Operation Enduring Freedom in Afghanistan.

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Neck Pain Causes

Neck Pain Causes

By John H. Shim, MD, FACS

In order to effectively treat neck pain, it’s important to understand the underlying medical condition that’s causing the pain. This is especially true if the pain has lasted 4 or more weeks.

Cervical spine disorders.
Most Common Neck Pain Causes: Strains and Sprains

The most common causes of neck pain—strains and sprains—heal within a few days or weeks. A strain is when a muscle or tendon has been irritated by overuse or overextension. Similarly, a sprain is when a ligament has been irritated by overuse or overextension.

Common causes of neck strains and sprains include:

    • Sleeping in wrong position. Often referred to as a “crick” in the neck, a person might wake up in the morning with neck pain due to sleeping in an awkward or atypical position that overextended the neck.
    • Sports injury. A person could move the neck suddenly and/or in an unusual way in a new sport, or a player could have a collision or fall. A common sports collision injury is a stinger, which happens when nerves in the neck/shoulder are impacted and pain, numbness, and weakness can radiate down the shoulder, arm, and hand.
    • Poor posture. Whether it’s at work, home, and/or commuting, poor posture can lead to neck problems. If a person’s head is often tilted forward for long periods of time, then the neck’s muscles, tendons, and ligaments need to work harder. Poor posture can be problematic during any number of activities, including working at a computer, watching TV, riding the train, reading a book, gardening, and more. Text neck, for example, is an increasingly common problem that develops in anyone who spends hours looking down at the phone while texting.
    • Repetitive motions. Turning the head in a repetitive manner, such as side to side while dancing or swimming, may lead to overuse of the neck’s muscles, tendons, and ligaments.
    • Holding the head in unusual position. Anything that requires holding the head in an unusual way for long periods of time could cause neck strains and sprains. Some examples include having a long conversation while cradling a phone between the head and shoulder, or spending an afternoon looking up at an air show.
    • Whiplash. In a whiplash injury, the head and neck are forced suddenly backward and immediately forward with a great deal of force. The soft tissues along and near the cervical spine can be torn or ruptured as a result. This type of injury commonly occurs in an auto accident that involves a rear-end collision.

Causes of Chronic Neck Pain

Neck pain is considered chronic when it persists for more than 3 months. These conditions tend to stem from problems in the cervical spine either with a facet joint or disc. Common causes include:

  • Cervical degenerative disc disease.
    Everyone experiences wear and tear on the cervical spine over time. It’s natural for the discs to gradually lose hydration and the ability to cushion the spine’s vertebrae. If a disc degenerates enough, it can lead to painful irritation of a cervical nerve in various ways, such as a herniated disc, pinched nerve, or changes in the facet joints that can cause arthritis.
  • Cervical herniated disc A cervical disc is herniated when its jelly-like inner layer, the nucleus pulposus, leaks out through a tear in the disc’s protective outer layer. This could result from an injury or aging. A herniated disc may press against or pinch a cervical nerve, or the inflammatory proteins of the nucleus pulposus may come close enough to a nerve to cause irritation.
  • Cervical osteoarthritis
    When the cartilage in a cervical facet joint wears down enough, it can lead to cervical osteoarthritis, also known as cervical spondylosis. Rather than having the facet joints move smoothly along cartilage as intended, they might grind bone on bone. The joint could become enlarged from inflammation and bone spur growth, causing a nearby nerve to become pinched or pressed
  • Cervical spinal stenosis with myelopathy Spinal stenosis occurs when the spine’s degeneration leads to a narrowing of the spinal canal, such as from a herniated disc that pushes into the spinal canal or bone spurs that grow into the canal. When the spinal canal narrows enough to compress the spinal cord—a large bundle of nerves that runs inside the spinal canal—myelopathy can result. Myelopathy is when compression of the spinal cord starts causing symptoms, such as weakness or problems with coordination in the arms, hands, legs, or feet.
  • Cervical foraminal stenosis This condition occurs when the foramina—the holes in the vertebral construct through which nerve roots that branch off from the spinal cord can exit the spinal canal—become narrowed. This narrowing of the hole can cause irritation for the nerve root that runs through it. Foraminal stenosis is associated with radiating pains in a pattern specific to the nerve that is pinched by the narrowing. In some situations, there is a combination of the cervical stenosis causing myelopathy, as well as the specific nerve pattern associated with a cervical foramen being narrowed.

Other Causes of Neck Pain

While not the most common causes of acute or chronic neck pain, other causes of neck pain could include:

    • Emotional stress. Sometimes muscles in the neck can tighten up and ache in response to stress, anxiety, or depression.
    • Infection. If part of the cervical spine becomes infected, then inflammation could cause neck pain. One example would be meningitis.
    • Myofascial pain. This chronic condition has trigger points, which result from achy muscles and surrounding connective tissues, typically in the upper back or neck. Trigger points can be chronically painful or only painful to the touch. The pain might stay in one spot or it can be referred pain that spreads to/from another area in the body.
    • Fibromyalgia. Fibromyalgia is hard to diagnose, but it typically involves pain in the muscles, tendons, and ligaments in several areas of the body, including in the neck.
    • Spinal tumor. A tumor, such as from cancer, could develop in the cervical spine and press against a nerve. These types of tumors more commonly occur as cancer that has started in another part of the body metastasizes.
    • Spondylolisthesis. This condition occurs when one vertebra slips over the one below it. It can be due to a tiny fracture in the vertebra, or possibly from advanced disc degeneration, or ligament laxity.
    • Ankylosing spondylitis. This progressive arthritis of the spine and pelvis can cause widespread inflammation, pain and stiffness throughout the spine, including the neck.

Risk Factors for Developing Neck Pain

Some research indicates that getting unhealthy amounts of sleep, being inactive, and smoking can all raise the risk of developing neck pain.2 In addition, working longer hours or being in a labor-intensive occupation, such as the military, health care support, or installation and maintenance, may increase the risk for neck pain.3

References

  1. Croft PR, Lewis M, Papageorgiou AC, et al. Risk factors for neck pain: a longitudinal study in the general population. Pain. 2001; 93(3):317-25.
  2. Yang, Haiou PhD; Haldeman, Scott DC, MD, PhD; Nakata, Akinori PhD; Choi, BongKyoo ScD, MPH; Delp, Linda PhD, MPH; Baker, Dean MD, MPH. Work-related risk factors for neck pain in the US working population. Spine. 2015. 40(3):184-192.
Neck Cracking and Grinding: What Does It Mean?

Neck Cracking and Grinding: What Does It Mean?

Most people at some point have heard cracking or grinding noises in their neck upon movement. These sounds, also called crepitus, are usually painless and typically do not represent anything serious.

However, if the neck cracking noise is accompanied by pain, swelling, or some other concerning symptoms, then it may represent a problem that should be checked by a qualified health professional.

Possible Causes of Neck Cracking

Crepitus, sometimes called crepitation or cavitation, refers to any type of noise or sensation such as a cracking, popping, snapping, or grinding sound that is heard during neck movement. For example, feeling a cracking sensation in the neck when turning the head to back up the car.

Crepitus can occur in any moveable joint in the body, and there are many moveable joints in the neck. The neck joints are bathed in an oily-like substance call synovial fluid, which allows motion to freely occur in between the bones.

The underlying cause of crepitus in the neck is still not yet fully understood.

Some likely causes of the neck cracking sound include:

Synovial joint fluid pressure changes
Various studies have been performed purposely cracking the synovial joints of the fingers, but the conclusions in medical literature as to what is actually making the noise have been mixed. In particular, a study published in 1971 indicated that the cracking sound of a joint was caused by the bursting of a gaseous bubble in the joint’s synovial fluid.1 However, a study published in 2015 reported that the cracking sound was actually from the bubble being created.2

Ligament or tendon moving around bone
Another possible factor in neck cracking could be the snapping sound of ligaments and/or tendons as they move over bones or other muscles or tendons located in the neck region.

Bone on bone grinding
While an uncommon cause of neck cracking, it’s possible for bone to grind against bone if the cartilage has worn down. This condition is called osteoarthritis. It occurs gradually with the normal aging process, or it can be accelerated if there has been a traumatic injury such as whiplash or a sports-related injury

This type of crepitation is typically accompanied by pain, limited neck motion, and the cracking sound is usually repeated over and over with each movement. This experience is in contrast to the typical gas bubble formation crack, where it typically takes about 20 minutes before cavitation, or the cracking, can again occur.

The Positive Effects of Chiropractic Care!

The Positive Effects of Chiropractic Care!

We know that our patients who get adjusted regularly see the wonderful side effects! Their backs are not the only beneficiary of their adjustments! Here is a study that confirms that keeping the spine adjusted has more positive effects than just your back or neck feeling better!:

A retrospective study conducted in Sweden [1] has determined that about one in four chiropractic patients experiences some form of “positive nonmusculoskeletal side effect” after spinal manipulative therapy (SMT).

In addition, the percentage of patients who experience positive side effects increases with the number of spinal regions adjusted. The Swedish researchers asked all members of the Swedish Chiropractors Association (SCA) to participate in the study. Eighty-one percent of the SCA membership complied. Each doctor of chiropractic gathered data from 20 patients over a three-week period for a total of 1,504 valid patient questionnaires. Patients were included if they had been previously adjusted within the last two weeks for musculoskeletal complaints. The patients were asked if after their previous visit they ìexperienced any positive changes that do not seem to have anything to do with your back problem?

At least one positive side effect or reaction was reported by 23 percent of the respondents. The more spinal areas that were adjusted, the better their chances of experiencing at least one positive reaction:

The positive, nonmusculoskeletal reactions appear to cluster into a number of system/organ-related classifications. Of those patients who experienced them, here is the breakdown by percentage:

 

  • Respiratory System: 26%

  • Digestive System: 25%

  • Circulatory System/Heart: 14%

 

  • Eyes/Vision: 14%

The benefits experienced can also be broken down into subcategories:

 

  • Easier to Breathe: 21%

  • Improved Digestive Function: 20%

  • Clearer/Better/Sharper Vision: 11%

  • Better Circulation: 7%

  • Changes in Heart Rhythm/Blood Pressure: 5%

 

  • Less Ringing in the Ears/Improved Hearing: 4%


The authors, as is typical in research papers, are careful to point out the limitations of extrapolating the findings. They note that the study does not demonstrate whether the statistical link between treatment and reaction is causal. They assert that ìthe absence of an untreated control group makes it impossible to say whether these reactions are treatment-specific, or if they simply represent normal fluctuations of common symptoms of physiologic function. While these results are very exciting, it is clear that additional research is needed.

Reference:

The Types of Improved Nonmusculoskeletal Symptoms Reported After Chiropractic Spinal Manipulative Therapy
J Manipulative Physiol Ther 1999 (Nov);   22 (9):   559–564

The Abstract

OBJECTIVE:   To investigate the frequency and types of improved nonmusculoskeletal symptoms reported after chiropractic spinal manipulative therapy.

DESIGN:   Retrospective information obtained by chiropractors through standardized interview of patients on return visit within 2 weeks of previous treatment.

SETTING:   The private practice of 87 Swedish chiropractors (response rate 81%).

SUBJECTS:   Twenty consecutive (presumably naive) patients per chiropractor (1504 valid questionnaires returned, 86% of optimal number of replies).

INTERVENTION:   Spinal manipulation with or without additional therapy provided by chiropractors.

MAIN OUTCOME MEASURES:   Self-reported improved nonmusculoskeletal symptoms (reactions).

RESULTS:   At least I reaction was reported after the previous treatment in 21% to 25% of cases. Of these responses, 26% were related to the airway passages (usually reported as “easier to breathe”), 25% were related to the digestive system (mostly reported as “improved function”), 14% were classified under eyes/vision (usually reported as “improved vision”), and 14% under heart/ circulation (about half of these reported as “improved circulation”). The number of spinal areas treated was positively associated with the number of reactions.

CONCLUSION:   A minority of chiropractic patients report having positive nonmusculoskeletal reactions after spinal manipulative therapy but such reports cluster predominantly around specific symptoms. It would be interesting to find out if these can be verified objectively and, if so, to investigate if they are caused by the treatment or if they are signs of natural variations in human physiology.

 

Top 5 Workouts for Increasing Range of Motion in Your Back

Top 5 Workouts for Increasing Range of Motion in Your Back

man-jumping-on-balcony

Back pain can have a truly negative effect on your professional life as well as your lifestyle. It can be difficult to get out of bed and make the morning commute.  Then—depending on what you do for a living—pain and limited mobility can take a huge toll on your productivity while you’re at work. And when you return home, you may also find that you’re not able to do the active things you enjoy with your family and friends.  It’s no wonder that chronic back pain can lead to depression.

If you or someone you care about is suffering from back pain, the good news is that there are things that can be done about it. First of all, it’s essential that you get proper medical attention so that your condition can be diagnosed and an appropriate treatment plan can be put in place. Dr. Oblander and other chiropractic physicians are experts at diagnosing and treating musculoskeletal problems as well as problems with the nervous system. Depending on your specific situation, he or she may recommend a variety of in-office treatment options to help relieve pain and restore function.  Your doctor may also prescribe a series of at-home exercises or stretches designed to increase the range of motion in your back.

Range of motion is the movement of a joint from full flexion (flexed) to full extension. Certain back problems, ranging from spinal misalignment and muscle imbalances to sprains, strains and pinched nerves (just to name a few), can significantly limit how much you can move. Here are workouts that can help improve your back’s mobility. Remember—use these only after consulting with your chiropractor!

  • Aquatic exercise. Perfect as a low-impact exercise that’s gentle on your joints and muscles, swimming and other water exercises are a great way to ease your back into working out. It is especially beneficial when the water is warm—say, between 83 and 88 degrees Fahrenheit. If you don’t have access to a heated pool, check out the gyms in your town. Many of the big-name gyms feature not only heated swimming pools, but also hot tubs and steam rooms, which can help relax your joints and muscles, giving them a much-needed break.
  • As simple as it sounds, walking is a great way to get simple, accessible exercise. It also strengthens your heart, lungs and overall endurance. Make sure you wear appropriate footwear and take it easy—there’s no need to start out walking miles a day unless you’re up to it. Again, ask your chiropractor for his or her advice.
  • Strength and resistance training. According to Harvard Medical School, not only is resistance training good for increasing range of motion, but it also strengthens your heart, lungs, and overall endurance.
  • Tai chi. An ancient form of Chinese exercise, tai chi is practiced through a series of slow moving poses that can be very effective at extending your range of motion. In addition to increasing flexibility, it is also purported to strengthen muscles, and develop balance and coordination.
  • Like tai chi, yoga is another very old form of exercise. Developed in India over a great many years, yoga eases stiffness in muscles and encourages greater range of motion. Just be careful not to overdo it—it could be detrimental to your condition.

If you need help with addressing your back pain, be sure to give our office a call at 406-652-3553 to schedule an appointment with Dr. Oblander!

 

Fear or Phobia: What’s the Difference?

Fear or Phobia: What’s the Difference?

frightened-woman

It’s normal to have fears. Fear is a useful emotion that keeps us from doing things that may be harmful or dangerous. Our species continues to exist today because our earlier ancestors had a healthy fear of certain types of predators, environments and situations. In the modern world, many of those primal fears have become much less relevant. Nevertheless, quite a few of us still have a lingering apprehension of spiders, snakes, darkness, heights or other things that we perceive to be dangerous. For most people, this instinctive fear is just quirky or uncomfortable—something we can usually avoid or overcome without too much effort. But what if this apprehension becomes all-encompassing and interferes with daily life? When this happens, you may be dealing with a phobia.

Psychologists define a fear as being “an emotional response to a real or perceived threat,” whereas, according to the Oxford English Dictionary, a phobia is “an extreme or irrational fear of or aversion to something.” Note the words extreme and irrational. A phobia keeps you from living your life as you normally would if the feared situation were not present. For example, you may become nervous or agitated in small or confined spaces and generally avoid taking the elevator. But if that fear is severe enough that it keeps you from taking your dream job because you’d need to use an elevator every day to get to your office, then you likely have a phobia (“claustrophobia”).

Symptoms of a phobia can be both mental and physical. In some cases, just thinking about the thing you fear can bring on the fight-or-flight response. Phobia symptoms often include general anxiety, trembling and feelings of nausea. Your heart may begin pounding and you may start sweating, feeling lightheaded, and breathing so quickly that you begin to hyperventilate. You may also feel an intense need to escape, feel like you are going to die, or fear losing control. Even though you may understand that your phobia is irrational, you still have no ability to stop it.

Not all phobias interfere with the everyday lives of people who have them. A phobia of snakes (called “ophidiophobia”), for example, probably won’t matter much to a city dweller unless he or she visits the reptile house at the zoo. However, a phobia of crowds (“enochlophobia,” “demophobia” or “ochlophobia”) could be a big problem on city streets or in the subway.  Other phobias can have a significant impact on anyone who has them. For about 3% of the population, their fear of doctors (“iatrophobia”) is so great that they avoid any form of healthcare whatsoever, including preventive care. Obviously, this can put their health and even their lives at risk.

If a phobia is affecting your day-to-day activities, then it may be time to seek professional help. Therapy for phobias has been shown to be remarkably effective, and you may also be able to use some self-help strategies on your own to combat the problem.

One of the best ways to begin conquering a phobia is to expose yourself to the thing you fear in a gradual, controlled manner. For example, if you have a phobia of spiders (“arachnophobia”), first look at a few pictures of spiders. Then watch a short video featuring spiders. When you are comfortable with that, perhaps visit a zoo and look at them through the glass. Relaxation techniques such as slow, deep breathing and meditation can help when you are confronting your fears. The more frequently you are exposed to the thing you fear without actually being harmed, the more quickly your phobia is likely to disappear. This doesn’t necessarily mean that you are going to become a fan of spiders, but at least you will have conquered the irrational part of your fear that gets in the way of you living your life.

 

What Is Immunotherapy and How Can It Help with Food Allergies?

What Is Immunotherapy and How Can It Help with Food Allergies?

young-parents-feeding-child

Food allergies affect over 15 million Americans, including 1 in every 13 children under the age of 18. The symptoms of these allergic reactions can range from minor (e.g., itching, swelling of the lips, intestinal cramps, diarrhea, and vomiting) to major or even life-threatening (e.g., development of hives and rashes, tightening of the throat to the point of being unable to breathe, significant drops in blood pressure).

Having such an allergy—or being the parent of a child with such an allergy—can impose unwelcome lifestyle limitations and cause a great deal of anxiety. At present, there is no known cure for serious food allergies that works for everyone. This means that the best approach for the time being is to completely avoid the food product to which you or your child has an allergic reaction. However, this is not always practical or possible to do. That’s why the majority of “treatments” currently available focus on managing the symptoms after an attack has taken place. For instance, individuals with serious food allergies may carry an auto-injector filled with epinephrine (adrenaline) with them at all times, just in case.

Naturally, because of the seriousness and the prevalence of food allergies, a great deal of research is being conducted on treatments to desensitize individuals to the foods they are allergic to. This may effectively “cure” the allergy for some sufferers. One of the fields that shows promise is the study of immunotherapy (more precisely, low-dose immunotherapy), in which extremely small amounts of the allergen are administered to allergy sufferers over time. The basic idea behind the experimental treatment is that the body will develop a tolerance to these low doses and that the allergic reaction will gradually cease.

The first work in immunotherapy was undertaken in the 1960s in England by Dr. S. Popper, who was trying to cure allergic reactions to pollen by injecting patients with low doses of the allergen in combination with the enzyme beta-glucuronidase in an approach called “enzyme potentiated desensitization” (EPD). While the then-experimental treatment showed early success, its use in the U.S. was suspended by the FDA for administrative reasons in 2001. However, follow-up work continued and an enhanced American version of the EPD injection called Low Dose Allergens (LDA) was later introduced.

The obvious drawback of this type of therapy is that the doses have to be injected by a physician. It is also necessary for patients to avoid outside exposure to larger doses of the allergens and to many medications while the treatment is underway. However, other researchers have continued to study desensitization via immunotherapy with the goal of finding other mechanisms of administering the low-dose allergens, such as oral medications, sublingual (under the tongue) medications, and others.

Some of the most promising work in this field is being performed at Stanford University School of Medicine by Kari Nadeau, Associate Professor of Allergies and Immunology. Nadeau is working with children afflicted with peanut allergies. Her approach is to give them minute doses of the peanut allergen and gradually escalate the doses over a period of months in the hope of them eventually developing immunity. Up to this point, Nadeau’s technique has produced positive results for many patients, but it does appear to have limitations. First, the therapy doesn’t seem to offer a permanent “cure”. Patients must continue to take low doses of the peanut allergens or risk losing their immunity. If they stop for more than a few days, the allergies can come back. Second, the treatment itself is time-consuming and often expensive.

While the jury is still out on immunotherapy, the concept shows promise. However, progressing from concept to proven treatment is clearly going to take much more work. As it stands today, some immunotherapy approaches work for some patients but don’t work for others. Plus, there are questions about how long immunity actually lasts and whether it must be maintained or periodically boosted. This is clearly a very important consideration since patients could run the risk of unknowingly losing immunity and coming into contact with the allergen, allowing it to trigger an unexpected—and potentially serious—attack.

So if you suffer from food allergies and are looking for a way to diminish them, the best advice we can offer at this time is to continue following the research and to consult with your own healthcare providers about the potential benefits and risks in your own case. If you do decide to pursue immunotherapy, be sure that it is being administered and overseen by well-trained medical professionals who can monitor progress and watch for side effects.

 

Second Impact Syndrome Explained

Second Impact Syndrome Explained

The Mayo Clinic describes second impact syndrome (SIS) as a complication arising from a concussion. It occurs when someone experiences a second concussion prior to fully recovering from the initial one. With SIS, “typically fatal brain swelling” occurs. R.C. Schneider first described this condition in 1973, but it wasn’t until 1984 that someone gave it the name, “second impact syndrome”. The condition is rare enough that only 21 cases had been cited in the literature up until 2003.

When a concussion takes place, the levels of various chemicals in the brain are changed. This altered state is believed to contribute to a person’s susceptibility to second impact syndrome. Because it normally takes approximately one week for the chemical levels in the brain to return to normal after a concussion, the patient should wait at least this long before returning to any activity that might result in another concussion. But one week is a minimum. The time it takes to recovery fully from a concussion is highly variable and depends on both the nature of the injury and the patient involved. For this reason, it is vitally important that athletes not return to sports while symptoms of a concussion persist and that they receive clearance from an appropriately trained healthcare professional before resuming any sort of risky activity.

NHL star Sidney Crosby learned a lot about concussions first-hand. While playing with the Pittsburgh Penguins in January 2011, he received a concussion. He suffered from a second one only four days later. It took him 11 months to fully recover. Crosby said, “With concussions there is not generally a time frame or a span where you’re feeling better. You feel like you’re getting better and it can be one day and you’re back to where you started. It’s a frustrating injury.” It wasn’t until he was treated by chiropractic clinical neurologist, Ted Carrick, DC, that Crosby recovered from all his symptoms.

Even the mildest of concussions can lead to second impact syndrome, because it’s not the strength of the impact that is the greatest danger. An impact of any force while the brain is still recovering can result in the catastrophic swelling attributed to the syndrome.

Most cases attributed to SIS occur in those who are not yet fully grown. Children and adolescents are thought to be the most susceptible with adolescent athletes at greatest risk for second impact syndrome.

Some researchers have recently raised questions about whether or not SIS actually exists. In their own analysis, they concluded that a majority of cases they examined did not actually meet the diagnostic criteria for SIS. They also found that in some cases the reports of first impact were incorrect or unreliable. While their findings have led to some controversy in the medical community, it should be pointed out that no one has disproven the existence of the syndrome.

Whatever the controversy, it’s difficult to argue against prevention and an abundance of caution given the potential dangers associated with concussions (and multiple concussions). If you’re an athlete, the first step is to wear appropriate safety equipment for the sport you’re playing. For certain activities (such as football, baseball and cycling), a helmet is essential. On-field awareness and proper technique can also go a long way toward preventing head injuries. However, it’s important for players, parents and coaches to recognize that even helmets, good supervision and expert training are no guarantee against initial concussions. They are a risk that can be managed but never wholly eliminated.

When it comes to preventing subsequent concussions, though, there are three additional steps many communities have taken to protect young athletes:

  • Requiring responsible adults to receive concussion-awareness training so that they can recognize the signs of a potential concussion.
  • Requiring officials, coaches and managers to remove injured players from the field when a concussion is suspected.
  • Requiring the approval of an appropriately trained healthcare professional before allowing any athlete with a suspected/actual concussion to return to sports-related activities.
What Are “Manual Therapies” and How Are They Used?

What Are “Manual Therapies” and How Are They Used?

Manual therapies have been used to treat musculoskeletal disorders for thousands of years. Practitioners around the world—in countries with many different cultural influences and diverse medical traditions—have used their hands to manipulate various parts of the body to stimulate healing. “Manual” literally means “by hand.” Thus, manual therapies consist of healing techniques that use the hands. There are more than two dozen techniques used worldwide. Among the most commonly known are acupressure, chiropractic, massage therapy, physiotherapy, reflexology, Rolfing and shiatsu.

There are also dozens of other, lesser-known manual therapies, including the Bowen technique, cranio-sacral therapy, the Dorn method, manual lymphatic drainage, muscle energy technique, myofascial release, myotherapy, naprapathy and zero balancing. We examine the most common therapies here:

Acupressure

Using the hand, the elbow or various devices, an acupressure practitioner applies a light force on various parts of the body following the patterns found in traditional Chinese medicine and acupuncture. More than half of the scientific studies on acupressure showed that this technique was effective, but some critics have claimed “a significant likelihood of bias.”

Chiropractic

Most chiropractic work involves manipulation of the spine to achieve better vertebral alignment. Lower back pain is perhaps the primary complaint which leads patients to a chiropractor. Chiropractors are expert at treating musculoskeletal conditions without the use of drugs or surgery. Among others, many top athletes swear by their chiropractor’s hands to keep them performing at their best and help them avoid injuries.

Massage Therapy

This is perhaps the oldest of the manual therapies. Massage was (and still is) used in ancient Egypt, China, Mesopotamia, and other parts of the world that gave rise to early civilizations. Massage practitioners chiefly use their hands, but also other parts of their body to apply pressure, rolling motions and other techniques to muscles and joints, to stimulate circulation and relax the patient. In today’s high-stress world, massage is proving ever more popular.

Physiotherapy

Physiotherapy has been used for years as standard treatment for patients suffering from musculoskeletal conditions. A physical therapist uses a variety of techniques to help their patients regain function—particularly mobility. Repetitive, assisted motion can help the patient strengthen muscles that have been damaged through injury or disease. Assisting the patient in the performance of targeted exercises can help a patient regain greater range of motion.

Reflexology

A trained reflexologist applies pressure to various parts of the feet, hands or ears to stimulate organs within the body associated with the part to which pressure is being applied. It is a Chinese therapy with a philosophy that is similar to acupuncture—using points on the body to restore energy flow. Although there is not yet much scientific evidence to support its effectiveness, anecdotal evidence shows that patients are happier and more relaxed after treatment.

Rolfing Structural Integration

Rolfing specifically targets the body’s connective tissue to release tension, realign and balance the body. Rolfing techniques involve deep-tissue massage to achieve therapeutic benefits such as better posture and greater freedom of movement, including reducing stress and relieving pain.

Shiatsu

A traditional Japanese therapy, the term Shiatsu means “finger pressure,” but can include palm pressure and other approaches to massage. A Shiatsu practitioner uses touch, comfortable pressure and manipulative techniques on specific points of the body (similar to the meridians of Traditional Chinese Medicine) to adjust the body’s physical structure and balance its energy flow. Anecdotal evidence shows it to relieve patients of stress, nausea, muscle pain, depression and anxiety.