tag:typepad.com,2003:weblog-1250480 %ISSUE_DATE%T09:25:32-07:00 Research, treatment and patient care. TypePad tag:mpamedia.com,2008:post-56568 2013-07-01T12:00:32-07:00 2013-07-01T12:00:07-07:00

It is an exciting world that awaits us when we go to work every day. We deal with all types of people who present with varying health conditions we can (hopefully) help alleviate. The challenges we face are made easier by the recognizable patterns many patients present with; conditions that most of us would classify as our "bread and butter" or common, everyday problems. Low back pain, neck pain, headaches are just a few of these. Many of us also see a lot of upper/mid back issues that result in pain and poor posture.

By Kevin M. Wong, DC It is an exciting world that awaits us when we go to work every day. We deal with all types of people who present with varying health conditions we can (hopefully) help alleviate. The challenges we face are made easier by the recognizable patterns many patients present with; conditions that most of us would classify as our "bread and butter" or common, everyday problems. Low back pain, neck pain, headaches are just a few of these. Many of us also see a lot of upper/mid back issues that result in pain and poor posture. tag:mpamedia.com,2008:post-56558 2013-07-01T12:00:32-07:00 2013-07-01T12:00:07-07:00

The lateral femoral cutaneous nerve arises from the 2nd and 3rd lumbar nerves. It is formed in the psoas muscle and emerges from its lateral border to cross the iliacus muscle and exit the pelvis. The most common point for possible entrapment is as the nerve passes between the two slips of the inguinal ligament's lateral attachment to the anterior-superior iliac spine, where it exits the pelvis. The nerve is tightly bordered by the tendinous fibers of the inguinal ligament at this point and makes a right-handed bend to change direction from a horizontal course in the pelvis to a more vertical course in the lateral and anterolateral thigh. The lower slip of the inguinal ligament also gives origin to some sartorius fibers. The nerve may pass in front of or through the sartorius into the thigh.

By Scott Cuthbert, DC The lateral femoral cutaneous nerve arises from the 2nd and 3rd lumbar nerves. It is formed in the psoas muscle and emerges from its lateral border to cross the iliacus muscle and exit the pelvis. The most common point for possible entrapment is as the nerve passes between the two slips of the inguinal ligament's lateral attachment to the anterior-superior iliac spine, where it exits the pelvis. The nerve is tightly bordered by the tendinous fibers of the inguinal ligament at this point and makes a right-handed bend to change direction from a horizontal course in the pelvis to a more vertical course in the lateral and anterolateral thigh. The lower slip of the inguinal ligament also gives origin to some sartorius fibers. The nerve may pass in front of or through the sartorius into the thigh. tag:mpamedia.com,2008:post-56480 2013-05-15T12:00:32-07:00 2013-05-15T12:00:07-07:00

The temporomandibular joint is an interesting and dynamic articulation that can cause a lot of problems. Hoppenfeld notes that the TMJ is the most used joint in the body, and that it opens and closes 1,500 to 2,000 times a day during its various motions of chewing, talking, swallowing, etc. In modern society, the number of people who clench their jaw or grind their teeth must also be considered as stress factors on the TMJ.

By Douglas R. Briggs, DC, Dipl. Ac. (IAMA), DAAPM The temporomandibular joint is an interesting and dynamic articulation that can cause a lot of problems. Hoppenfeld notes that the TMJ is the most used joint in the body, and that it opens and closes 1,500 to 2,000 times a day during its various motions of chewing, talking, swallowing, etc. In modern society, the number of people who clench their jaw or grind their teeth must also be considered as stress factors on the TMJ. tag:mpamedia.com,2008:post-56247 2012-12-02T12:00:32-07:00 2012-12-02T12:00:07-07:00

During the course of this series of articles, of which this is the sixth and final installment, I have enjoyed teaching you about the kinematic chain from the ground up: feet, ankles, knees, hips, wrists and hands. From the beginning, I have tried to paint a clear picture of how biomechanical problems that begin in the extremities can affect the entire axial kinematic chain clear up to the head. I hope you have found the journey insightful and useful for your practice thus far.

By Kevin M. Wong, DC During the course of this series of articles, of which this is the sixth and final installment, I have enjoyed teaching you about the kinematic chain from the ground up: feet, ankles, knees, hips, wrists and hands. From the beginning, I have tried to paint a clear picture of how biomechanical problems that begin in the extremities can affect the entire axial kinematic chain clear up to the head. I hope you have found the journey insightful and useful for your practice thus far. tag:mpamedia.com,2008:post-55870 2012-04-22T12:00:32-07:00 2012-04-22T12:00:07-07:00

"Hundreds of thousands of patients around the world may have been exposed to toxic substances after being implanted with poorly regulated and potentially dangerous hip devices, a BMJ / BBC Newsnight investigation reveals this week. Despite the fact that these risks have been known and well-documented for decades, patients have been kept in the dark about their participation in what has effectively been a large, uncontrolled experiment."

By Donald M. Petersen Jr., BS, HCD(hc), FICC(h), Publisher "Hundreds of thousands of patients around the world may have been exposed to toxic substances after being implanted with poorly regulated and potentially dangerous hip devices, a BMJ / BBC Newsnight investigation reveals this week. Despite the fact that these risks have been known and well-documented for decades, patients have been kept in the dark about their participation in what has effectively been a large, uncontrolled experiment." tag:mpamedia.com,2008:post-55869 2012-04-22T12:00:32-07:00 2012-04-22T12:00:07-07:00

The extremities are often overlooked during physical exams and diagnoses. While patients may seek chiropractic because of a pain only in one area, the burden lies on us, as chiropractors, to give a thorough evaluation to determine if that pain is a result of a problem somewhere else in the body (e.g., back pain that actually stems from the hips).

By Kevin M. Wong, DC The extremities are often overlooked during physical exams and diagnoses. While patients may seek chiropractic because of a pain only in one area, the burden lies on us, as chiropractors, to give a thorough evaluation to determine if that pain is a result of a problem somewhere else in the body (e.g., back pain that actually stems from the hips). tag:mpamedia.com,2008:post-55706 2012-01-15T12:00:32-07:00 2012-01-15T12:00:07-07:00

Routine radiographic examination of the wrist is not difficult, but does require some attention to positioning. Keep in mind that to evaluate a joint on X-ray, one must be able to visualize the joint in two planes at 90 degrees to one other. The routine series for a wrist includes PA and lateral views. For further evaluation, oblique projection may also be necessary if trauma or arthritis is evident.

By Deborah Pate, DC, DACBR Routine radiographic examination of the wrist is not difficult, but does require some attention to positioning. Keep in mind that to evaluate a joint on X-ray, one must be able to visualize the joint in two planes at 90 degrees to one other. The routine series for a wrist includes PA and lateral views. For further evaluation, oblique projection may also be necessary if trauma or arthritis is evident. tag:mpamedia.com,2008:post-55692 2012-01-01T12:00:32-07:00 2012-01-01T12:00:07-07:00

In any given year, more than one in five runners will sustain a stress fracture. In the U.S. alone, this translates into nearly 2 million stress fractures annually. In a study of 320 patients presenting with stress fractures, Matheson, et al., note that 4 percent of these patients incurred the injury while playing basketball, 5 percent while playing tennis, 8 percent while in aerobics class, and a surprising 69 percent while running.

By Thomas Michaud, DC In any given year, more than one in five runners will sustain a stress fracture. In the U.S. alone, this translates into nearly 2 million stress fractures annually. In a study of 320 patients presenting with stress fractures, Matheson, et al., note that 4 percent of these patients incurred the injury while playing basketball, 5 percent while playing tennis, 8 percent while in aerobics class, and a surprising 69 percent while running. tag:mpamedia.com,2008:post-55638 2011-12-02T12:00:32-07:00 2011-12-02T12:00:07-07:00

This is a retrospective, single-case study of a pediatric patient presenting to a chiropractic practice with extremity dysfunction and related pain. The approach to chiropractic care was based upon the level of training in chiropractic colleges as it relates to extremity management.

By Nancy Martin-Molina, DC, QME, MBA, CCSP This is a retrospective, single-case study of a pediatric patient presenting to a chiropractic practice with extremity dysfunction and related pain. The approach to chiropractic care was based upon the level of training in chiropractic colleges as it relates to extremity management. tag:mpamedia.com,2008:post-55284 2011-04-22T12:00:32-07:00 2011-04-22T12:00:07-07:00

Diabetes mellitus (DM) is the most common acquired cause of peripheral neuropathy in developed Western countries. According to the WHO, it is the most common neuropathy worldwide, with 10 million cases in the U.S. alone. Approximately 45-60 percent of patients with diabetes will develop manifestations of peripheral neuropathy. More importantly, several studies document clinical and subclinical signs of diabetic neuropathy even before neurological impairment and symptom development). These cases substantiate the importance of early and intensive glycemic control as the most important preventable risk factor in the development of neuropathy. Prevention and early detection is crucial, especially in light of the estimated increase in worldwide diabetes to approximately 366 million by 2030.

By Marco Lopez, DC, CCEP Diabetes mellitus (DM) is the most common acquired cause of peripheral neuropathy in developed Western countries. According to the WHO, it is the most common neuropathy worldwide, with 10 million cases in the U.S. alone. Approximately 45-60 percent of patients with diabetes will develop manifestations of peripheral neuropathy. More importantly, several studies document clinical and subclinical signs of diabetic neuropathy even before neurological impairment and symptom development). These cases substantiate the importance of early and intensive glycemic control as the most important preventable risk factor in the development of neuropathy. Prevention and early detection is crucial, especially in light of the estimated increase in worldwide diabetes to approximately 366 million by 2030. tag:mpamedia.com,2008:post-55179 2011-02-26T12:00:32-07:00 2011-02-26T12:00:07-07:00

The answer to the above question is still in doubt. According to Wong, et al., if clinicians based their decision to use ultrasound on clear demonstration of effectiveness in the scientific literature, then many would not use it based on lack of supporting evidence. How many times have we heard this statement about much of what soft-tissue clinicians do, or for that matter, about what practitioners do in all of the healing professions? Yet ultrasound has been widely used and well-accepted as a physical therapy adjunct modality throughout the world since the '50s.

By Warren Hammer, MS, DC, DABCO The answer to the above question is still in doubt. According to Wong, et al., if clinicians based their decision to use ultrasound on clear demonstration of effectiveness in the scientific literature, then many would not use it based on lack of supporting evidence. How many times have we heard this statement about much of what soft-tissue clinicians do, or for that matter, about what practitioners do in all of the healing professions? Yet ultrasound has been widely used and well-accepted as a physical therapy adjunct modality throughout the world since the '50s. tag:mpamedia.com,2008:post-54875 2010-08-26T12:00:32-07:00 2010-08-26T12:00:07-07:00

Throughout the history of manipulative therapy, three major professions, osteopathy, chiropractic and physiotherapy, have incorporated their own significant variations of spinal manipulative therapy into practice. Currently, chiropractic literature lacks the evidence-based studies of the caliber that Burns, Cervero, Bonica, Beal and Korr have presented. Osteopaths, medical doctors and physical therapists have contributed greatly to the scientific validation of the role spinal manipulation plays in early detection, diagnosis and clinical management of visceral diseases.

By Tariq Faridi, BSc, MEd Throughout the history of manipulative therapy, three major professions, osteopathy, chiropractic and physiotherapy, have incorporated their own significant variations of spinal manipulative therapy into practice. Currently, chiropractic literature lacks the evidence-based studies of the caliber that Burns, Cervero, Bonica, Beal and Korr have presented. Osteopaths, medical doctors and physical therapists have contributed greatly to the scientific validation of the role spinal manipulation plays in early detection, diagnosis and clinical management of visceral diseases. tag:mpamedia.com,2008:post-54622 2010-05-06T12:00:32-07:00 2010-05-06T12:00:07-07:00

As discussed in previous articles in this series, cross-fitness programs tend to advocate exercises that require maximal shoulder end-range motions: pull-ups (often with a kip or a jerk motion at end range), handstand presses, press squats, push-presses, clean and presses, kettlebell overhead lifting, gymnastic ring work and other similar exercises. To perform these motions without injury requires unfettered shoulder range of motion and optimum shoulder stability. While an argument may be made that these exercises help to create coordinated athletic patterns of strength, agility, and stamina, they still have a strong potential for causing shoulder injuries. Often not included in the explanation of the workout of the day in cross-fitness programs is the need for the participant to have flawless shoulder mechanics and strength.

By Chris Feil, DC and William E. Morgan, DC As discussed in previous articles in this series, cross-fitness programs tend to advocate exercises that require maximal shoulder end-range motions: pull-ups (often with a kip or a jerk motion at end range), handstand presses, press squats, push-presses, clean and presses, kettlebell overhead lifting, gymnastic ring work and other similar exercises. To perform these motions without injury requires unfettered shoulder range of motion and optimum shoulder stability. While an argument may be made that these exercises help to create coordinated athletic patterns of strength, agility, and stamina, they still have a strong potential for causing shoulder injuries. Often not included in the explanation of the workout of the day in cross-fitness programs is the need for the participant to have flawless shoulder mechanics and strength. tag:mpamedia.com,2008:post-54496 2010-02-26T12:00:32-07:00 2010-02-26T12:00:07-07:00

Abnormal force accumulation and altered biomechanics or trauma frequently affect a joint that, when injured, can contribute to chronic pain and considerable disability. It is my opinion that the PTF joint is an underappreciated and infrequently diagnosed cause of chronic leg and foot pain.

By Manuel Duarte, DC, DABCO, DACBSP, CSCS Abnormal force accumulation and altered biomechanics or trauma frequently affect a joint that, when injured, can contribute to chronic pain and considerable disability. It is my opinion that the PTF joint is an underappreciated and infrequently diagnosed cause of chronic leg and foot pain. tag:mpamedia.com,2008:post-54476 2010-02-26T12:00:32-07:00 2010-02-26T12:00:07-07:00

With researchers at the Palmer Center for Chiropractic Research at Palmer College of Chiropractic already hard at work on several research projects, including the recently reported study investigating whether a specialized chiropractic adjustment can help reduce blood pressure in hypertensive patients, the center is taking on another major project, this one a study that will explore the feasibility of chiropractic care for treatment of temporomandibular disorders (TMD). Palmer researchers are working in collaboration with the University of Iowa College of Dentistry and Institute for Clinical and Translational Sciences on the project, one of three research investigations being funded courtesy of the $2.8 million grant awarded to the Palmer Center in 2008 by the National Center for Complementary and Alternative Medicine, a branch of the NIH.

By Editorial Staff With researchers at the Palmer Center for Chiropractic Research at Palmer College of Chiropractic already hard at work on several research projects, including the recently reported study investigating whether a specialized chiropractic adjustment can help reduce blood pressure in hypertensive patients, the center is taking on another major project, this one a study that will explore the feasibility of chiropractic care for treatment of temporomandibular disorders (TMD). Palmer researchers are working in collaboration with the University of Iowa College of Dentistry and Institute for Clinical and Translational Sciences on the project, one of three research investigations being funded courtesy of the $2.8 million grant awarded to the Palmer Center in 2008 by the National Center for Complementary and Alternative Medicine, a branch of the NIH. tag:mpamedia.com,2008:post-54386 T12:00:32-07:00 T12:00:07-07:00

In a recent Dynamic Chiropractic PracticeINSIGHTS poll, we asked doctors of chiropractic: "What role does adjustment equipment play in your practice?" Nearly 60 percent of the 210 doctors who participated in the poll said that adjustment equipment plays a very large or important role in their practice. For example, James Wehner, of Pittsburgh, Pa., said, "Adjusting equipment (tables, etc.) are vital to a chiropractic practice."

By DCPI Staff In a recent Dynamic Chiropractic PracticeINSIGHTS poll, we asked doctors of chiropractic: "What role does adjustment equipment play in your practice?" Nearly 60 percent of the 210 doctors who participated in the poll said that adjustment equipment plays a very large or important role in their practice. For example, James Wehner, of Pittsburgh, Pa., said, "Adjusting equipment (tables, etc.) are vital to a chiropractic practice." tag:mpamedia.com,2008:post-53904 2009-07-01T12:00:32-07:00 2009-07-01T12:00:07-07:00

The subscapularis muscle is an internal rotator and therefore is overused by almost every patient, especially those involved in throwing sports such as baseball. When a patient complains of shoulder pain, this is usually one of the factors that causes shoulder dysfunction.

By Todd Turnbull, DC, CCSP The subscapularis muscle is an internal rotator and therefore is overused by almost every patient, especially those involved in throwing sports such as baseball. When a patient complains of shoulder pain, this is usually one of the factors that causes shoulder dysfunction. tag:mpamedia.com,2008:post-53897 2009-07-01T12:00:32-07:00 2009-07-01T12:00:07-07:00

Fractures of the proximal fifth metatarsal are often separated into two types: those involving the tuberosity and those involving the diaphysis just distal to the tuberosity. It is important to appreciate this distinction because these two fractures respond differently to treatment. Fractures involving the tuberosity treated conservatively usually heal clinically within three weeks and radiographically within eight weeks. Fractures through the proximal diaphysis just distal to the tuberosity - the classic Jones fracture - do not heal as quickly, often taking more than 11 weeks. The Jones-type fracture may not respond to conservative treatment, with delayed union or non-union occurring 40 percent of the time and requiring surgical intervention.

By Deborah Pate, DC, DACBR Fractures of the proximal fifth metatarsal are often separated into two types: those involving the tuberosity and those involving the diaphysis just distal to the tuberosity. It is important to appreciate this distinction because these two fractures respond differently to treatment. Fractures involving the tuberosity treated conservatively usually heal clinically within three weeks and radiographically within eight weeks. Fractures through the proximal diaphysis just distal to the tuberosity - the classic Jones fracture - do not heal as quickly, often taking more than 11 weeks. The Jones-type fracture may not respond to conservative treatment, with delayed union or non-union occurring 40 percent of the time and requiring surgical intervention. tag:mpamedia.com,2008:post-53893 2009-07-01T12:00:32-07:00 2009-07-01T12:00:07-07:00

Running injuries are caused by a variety of factors. In addition to spinal and lower extremity subluxations, contributory elements often include footwear problems, gait asymmetries, muscle imbalances and training errors. During my nearly 30-year chiropractic career, I have had the opportunity to treat many patients for injuries related to running. I have found that one of the most effective forms of adjunctive care, especially when gait biomechanics are altered, is custom-made, flexible orthotics.

By Mark Charrette, DC Running injuries are caused by a variety of factors. In addition to spinal and lower extremity subluxations, contributory elements often include footwear problems, gait asymmetries, muscle imbalances and training errors. During my nearly 30-year chiropractic career, I have had the opportunity to treat many patients for injuries related to running. I have found that one of the most effective forms of adjunctive care, especially when gait biomechanics are altered, is custom-made, flexible orthotics. tag:mpamedia.com,2008:post-53379 2008-08-26T12:00:32-07:00 2008-08-26T12:00:07-07:00

Fosamax (alendronate sodium) often is prescribed to treat and prevent osteoporosis. Fosamax works by inhibiting osteoclastic activity. Normally, old bone is removed by osteoclasts and then replaced with new bone by osteoblasts. While Fosamax does, in fact, increase bone density, it does not particularly increase bone strength. It's similar to trying to repair an old house by nailing new boards to a rotted structure; the walls are denser, but not a whole lot stronger.

By Daniel Hough, DC Fosamax (alendronate sodium) often is prescribed to treat and prevent osteoporosis. Fosamax works by inhibiting osteoclastic activity. Normally, old bone is removed by osteoclasts and then replaced with new bone by osteoblasts. While Fosamax does, in fact, increase bone density, it does not particularly increase bone strength. It's similar to trying to repair an old house by nailing new boards to a rotted structure; the walls are denser, but not a whole lot stronger. tag:mpamedia.com,2008:post-53373 2008-08-26T12:00:32-07:00 2008-08-26T12:00:07-07:00

When we consider osteoporosis, we almost always think of women. However, men also are at risk for osteoporosis. Common risk factors include age-associated hormone changes, alcoholism, smoking and some medications, including those used in the treatment of prostate cancer.

By Deborah Pate, DC, DACBR When we consider osteoporosis, we almost always think of women. However, men also are at risk for osteoporosis. Common risk factors include age-associated hormone changes, alcoholism, smoking and some medications, including those used in the treatment of prostate cancer. tag:mpamedia.com,2008:post-53338 2008-07-29T12:00:32-07:00 2008-07-29T12:00:07-07:00

Are today’s chiropractic practitioners suitable specialists for the referral of complex medical problems?

By Nancy Martin-Molina, DC, QME, MBA, CCSP Are today’s chiropractic practitioners suitable specialists for the referral of complex medical problems? tag:mpamedia.com,2008:post-53324 2008-07-15T12:00:32-07:00 2008-07-15T12:00:07-07:00

During my 40-year career, I gradually developed a protocol of treatment for medial meniscus problems that was highly successful in pain relief.

By Brian E. Beaudry, DC, FACCH During my 40-year career, I gradually developed a protocol of treatment for medial meniscus problems that was highly successful in pain relief. tag:mpamedia.com,2008:post-53319 2008-07-15T12:00:32-07:00 2008-07-15T12:00:07-07:00

Have you ever treated a plantar fasciitis that did not respond? It might be a nerve entrapment.

By Warren Hammer, MS, DC, DABCO Have you ever treated a plantar fasciitis that did not respond? It might be a nerve entrapment. tag:mpamedia.com,2008:post-53313 2008-07-15T12:00:32-07:00 2008-07-15T12:00:07-07:00

Carpal tunnel syndrome (CTS) is one of the more common neurological diagnoses we are likely to encounter in our office.

By Edgar Romero, DC, DACNB Carpal tunnel syndrome (CTS) is one of the more common neurological diagnoses we are likely to encounter in our office. tag:mpamedia.com,2008:post-53285 2008-07-01T12:00:32-07:00 2008-07-01T12:00:07-07:00

JMPT Abstracts for May 2008.

JMPT Abstracts for May 2008. tag:mpamedia.com,2008:post-53267 2008-06-17T12:00:32-07:00 2008-06-17T12:00:07-07:00

Every sports fan continually reads about their favorite athletes getting injured. Every team has a list of players on the disabled list. While there is a great deal of research promoting stretching and strengthening for injury prevention, there is conflicting opinion as to its validity. In a review of the literature to determine the effects of stretching - before and after exercising - on muscle soreness, risk of injury and athletic performance, the results did not prove favorable. The authors stated further research was necessary.

By Warren Hammer, MS, DC, DABCO Every sports fan continually reads about their favorite athletes getting injured. Every team has a list of players on the disabled list. While there is a great deal of research promoting stretching and strengthening for injury prevention, there is conflicting opinion as to its validity. In a review of the literature to determine the effects of stretching - before and after exercising - on muscle soreness, risk of injury and athletic performance, the results did not prove favorable. The authors stated further research was necessary. tag:mpamedia.com,2008:post-53254 2008-06-03T12:00:32-07:00 2008-06-03T12:00:07-07:00

One only needs look at people in the world around them to wonder why one shows signs of degenerative changes at an early age while another demonstrates minimal degenerative change despite being much older. Consider the fate of two professional baseball pitchers: The first has a long career of comparatively injury-free play, while the second is plagued with constant shoulder or elbow problems that might be career-ending.

By Manuel Duarte, DC, DABCO, DACBSP, CSCS One only needs look at people in the world around them to wonder why one shows signs of degenerative changes at an early age while another demonstrates minimal degenerative change despite being much older. Consider the fate of two professional baseball pitchers: The first has a long career of comparatively injury-free play, while the second is plagued with constant shoulder or elbow problems that might be career-ending. tag:mpamedia.com,2008:post-53230 2008-05-20T12:00:32-07:00 2008-05-20T12:00:07-07:00

No, this article is not about my place in my home. Recently, a patient presented to my office two weeks prior to hip-replacement surgery.He had suffered left hip pain for more than four years with no resolution, even after many therapies, adjustments, shots, medications and exercises. He came limping into the office with a walker and was in obvious major distress. Although he was rather advanced in years, you could tell just by looking at him there was still a strong man behind all that pain.

By Edgar Romero, DC, DACNB No, this article is not about my place in my home. Recently, a patient presented to my office two weeks prior to hip-replacement surgery.He had suffered left hip pain for more than four years with no resolution, even after many therapies, adjustments, shots, medications and exercises. He came limping into the office with a walker and was in obvious major distress. Although he was rather advanced in years, you could tell just by looking at him there was still a strong man behind all that pain.