What happens when a chiropractor can’t practice??

I recently spent some time out of practice due to an elbow injury. Long story short, I crashed my mountain bike trying to land the smallest jump (a bunny hop over a root) in the history of mountain biking. Had it not actually broken my arm, I would say that crash hurt my ego more than my arm. I quickly realized (like, within seconds) that there is practically nothing I can do as a chiropractor without both of my hands…and elbows. I was lucky enough to find a remarkably capable fill-in in Dr. Bradley Chmelar to help our patients while I was taking time off to heal. While we liked having Dr. Chmelar around, I was very glad to be back after only 4 weeks off.

What did I do with all that time off, you might ask? Take an impromptu vacation? Knit matching sweaters for our next family photos? Read a book? Write a book? No, I did none of those things. Well ok, I read a book. But besides that, I spent a lot of time in my office. Not my treatment room. My office. As in my desk, office chair, computer, my family picture on the shelf, my skeleton – what, you don’t have a skeleton in your office? My point is, I spent a lot more time sitting than I usually do. One thing I love about being a chiropractor is that I get to move all day. I sit some, but I also stand, squat, lunge, kneel, demonstrate exercises and stretches with our patients, etc. For 4 weeks, though, I found myself being more sedentary than usual, sitting in front of my computer, letting my head drift out in front of my shoulders, catching myself slouching – ALL THINGS THAT CAUSE NECK AND BACK PAIN IN OUR CHIROPRACTIC PATIENTS! And guess what, my back and neck started to hurt after not too long.

This reminded me of how I started as a chiropractic patient. As a kid, whenever I went on long car rides, my rear end would hurt. At the time I thought that made sense. The longer you sit, the more sore your butt should get, right? Then as I got older and spent more time sitting in classrooms and studying, especially in college, the more this would happen. It was typically just on one side. It wasn’t until I actually started working for a chiropractor that it dawned on me that this could be some sort of sciatica. I also noticed that I would get stiffness in my neck and headaches the more I sat and studied. Eventually I started chiropractic treatment and with a regimen of chiropractic adjustments, some advice on posture and ergonomics, and a home exercise program, both my sciatica and my headaches cleared up. 

One good thing that came out of not working was that I had time to take more care of myself. I saw my chiropractor to help with the neck and upper back pain I was getting from sitting in my office chair, and I made sure to get up out of my chair and work on some of my favorite posture exercises. In the video above, I demonstrate 2 mobility drills for the upper back and 2 strengthening exercises for the shoulders and upper back. The thoracic spine (the part of your spine between the top and bottom of your rib cage) can get very stiff and rigid if we don’t work on it. That’s why I include these two thoracic mobility drills into my routine. They help to lubricate the joints and make it easier to extend your upper back and get out of the slouched position that we tend to get into when seated a lot. The two shoulder exercises are important because prolonged sitting can cause our shoulder to roll forward and inward, and these exercises are meant to strengthen the muscles that pull them back and down to counteract that effect. As always, theses exercises are just examples of what you could do to help ease postural stress, but you should always consult a healthcare or exercise professional to see what exercises are best for you to perform. Enjoy and feel free to contact me with any questions or to set up a consultation at our chiropractic clinic in Beaverton, OR.

Chiropractic care for hikers with heel pain

We’re continuing our theme this month on hiking injuries. In the last video I talked about what can cause knee pain in hikers and how we treat it. Today I’m going to talk about another common hiking injury – heel pain. Heel pain is a very common complaint in both hikers and runners. A very common diagnosis for heel pain in hikers is Plantar Fasciitis, or inflammation of the connective tissue that supports the arch of your foot.

The plantar fascia attaches to the inside part of your heel, and that’s why this can be one cause of your heel pain. The problem is that not all heel pain is caused by plantar fasciitis. If you’re a hiker with heel pain, you may have tried or at least read online about several different methods of self treatment for heel pain – lacrosse balls, golf balls, heat, ice, kinesiotape, orthotic inserts, or special braces that stretch your foot while you sleep. If plantar fasciitis is not the cause of your heel pain, then perhaps none of those things will work. That is why it’s so important to see your healthcare provider for a proper examination and diagnosis, and your exam needs to include what we call the kinetic chain, or all the joints and tissues upstream from your foot. Your heel pain can be caused by anything from Achilles tendinitis, nerve entrapment at the ankle, peripheral neuropathy, stress fracture, or even a disc injury in your lower back.

Once we’ve gone through a thorough evaluation of a patient with heel pain, there are typically 3 areas we tend to focus on: The lower back, the ankle, and the foot.

If the lower back seems to be contributing to your heel pain, we have several different approaches to help with that. In the office, I can perform chiropractic adjustments as well as use a special table to apply traction to decompress your lower back and relieve pressure on irritated joints and nerve roots that can refer pain to your foot. I will also get you doing some stretches to relieve irritation on the same areas.

In the ankle and lower leg we typically see stiff joints, tight muscles and nerve irritation that contribute to heel pain and a potential diagnosis of plantar fasciitis. For that, we can do some adjusting and mobilization at the ankle, some neuromobilizations to help free up the nerves crossing through there, and deep tissue massage and stretching to loosen up tight muscles.

At the foot, we can also employ chiropractic adjustments, deep tissue massage to the plantar fascia, taping, orthotics, and strengthening exercises to improve the stability of the intrinsic muscles in your foot and reduce strain on the plantar fascia.

In the video above, I demonstrate a couple of mobility drills for the ankle and a strengthening exercise that, in addition to what we offer here at the clinic, can help you beat your heel pain and get back out on the trail.

What to expect on your first visit to Catalyst Chiropractic and Rehabilitation


 

Your first visit at Catalyst Chiropractic and Rehabilitation in Beaverton will consist of three parts: History, Examination, and Treatment.

We ask that you download your intake paperwork here and have it completed prior to your appointment time. Alternatively you can arrive 10-15 minutes prior to your appointment to complete your paperwork. It seems like a hassle, but this paperwork is a vital part of Dr. Thompson’s evaluation of your condition. You’ll answer questions about your current complaint as well as your past health history. Once the paperwork is complete Dr. Thompson will sit down with you in the treatment room, review your chart, and ask some more questions about your current complaint and past history.

After collecting all of the necessary information, Dr. Thompson will perform a chiropractic exam. This can include any/all of the following: Vital signs, range of motion testing, a movement assessment, orthopedic testing, neurological testing and an assessment of the alignment and quality of motion of the joints involved. Once finished with your exam, your diagnosis will be explained to you and a treatment plan will be laid out and any questions you have will be answered prior to beginning treatment.

Lastly, if you are a good candidate for chiropractic care, you will receive your first treatment the same day as your examination. This will be tailored to your individual needs and can include chiropractic adjustments/spinal manipulation, soft tissue massage, traction, therapeutic exercises and stretches, cold laser therapy, therapeutic ultrasound, or electrical muscle stimulation.

You will NOT be asked to pay up front for an extended number office visits nor will you be asked to enter into any sort of long term contract. A typical treatment plan consists of 2 office visits a week for 2-4 weeks. If significant improvement is not made during that time period, then additional treatment options, imaging, and/or a referral to another specialist will be considered.

Contact us today to get started on your personalized path to recovery!

Treatment for knee pain when hiking downhill


 

 

Hi this is Dr. Kip Thompson with Catalyst Chiropractic and Rehabilitation, your chiropractor in Beaverton, OR. We have a lot of hikers here in Portland. One of the most common complaints I hear from our hiker patients is knee pain when hiking downhill. The reason for that is when you are walking downhill you have 3-4 times more force on your legs than when walking on an even surface. We take 2 approaches to combat knee pain when hiking downhill: First, reduce the amount of load going through the joint. Second, make yourself more resilient by increasing your capacity to bear the loads placed on the legs when hiking downhill (strengthen your legs). 

There are three ways to reduce load while walking downhill. The first way is to just slow down. As you can imagine, the faster you are traveling, the more impact you will have on your legs and knees as you are stepping downhill. The second way to reduce knee pain while hiking downhill is to bend your hips and knees more. The straighter your legs are and the more upright you are, the greater the impact on your joints, particularly the knees. Putting a slight bend in the hips and knees as you are walking downhill helps your muscles absorb more of the shock, taking stress off the knee joint. Lastly, you can use a hiking stick or trekking poles. These tools have been shown to reduce impact on your lower extremities by up to 25% while hiking, and that is why they’re important, especially for hikers with knee pain while going downhill.

Here are some examples of things we’ve done with some of our patients suffering from knee pain to help them become more strong and stable in the knees. Again, these are just examples of exercise techniques. To find out what is right for your situation, we would need to perform a thorough examination and come up with an individualized treatment and recovery plan. On your first visit at Catalyst Chiropractic and Rehabilitation, one of the first things I look at is your ability to stand on one leg while keeping your hips level and not losing balance. It’s surprising how often we find someone who can’t stand on one foot for longer than 10 seconds, yet never even realized they have a balance problem. If you are not able to adequately stabilize your hips while standing on one foot, this can translate into abnormal stress on your knees and result in knee pain. What I could have you do is practice one leg stands. Stand on one foot for as long as you can without losing balance or letting your pelvis tilt to one side. The goal is to be able to do that for 60 seconds. If you can’t do it, you could work up to it by performing 3 reps on each side for as long as you can before losing control. Then repeat that daily to gradually improve stability and balance.

The second exercise I’d like to demo is called quad sets. This exercise is commonly used early in knee rehabilitation to strengthen the quadriceps muscles and add stability to the knee. Lie flat on your back and rest a pillow or rolled up towel under your knee. Then contract your quads, which will straighten your knee and push downward into the pillow. Hold this for 10 seconds at a time, performing multiple repetitions of 10 seconds each.

Ultimately you will need to progress to more functional movements that mimic what you will actually encounter on the trail. A more progressive way to strengthen your quads is to start doing some squats. We mimic the downhill motion by elevating the heels by placing an object underneath your heels. From there, slowly lower into a squat position, then quickly return to standing posture. I like to use the cadence of 2 counts going down and 1 count coming up to emphasize that lowering motion that happens with every step while hiking downhill.

One last, more difficult progression is a 1 leg decline squat. This is set up the same was as the two leg decline squat that I just demoed, but it is performed with only one leg in the lowering phase of the exercise. Then use both legs to come back to starting position. The lowering portion of this exercise is called an eccentric muscle contraction of the quadriceps. Eccentric strengthening exercises are great for rehabbing tendon injuries, which is much of the time part of the cause with knee pain in hikers.

For any questions or to set an appointment to see me, call 503-526-8782 or visit our website at catalystchiroandrehab.com

Chiropractic care for herniated discs

Herniated disc treatment Beaverton Oregon

Chiropractic Care for Herniated Discs

A guest post by Dr. David Bennett, DC

A herniated disc can cause pain and can progress into other issues, such as sciatica. Seeking treatment for a herniated disc as soon as possible can help to minimize the pain experienced and prevent the condition from worsening. Many patients that suffer from herniated discs wish to find treatment options besides surgery. In some cases, chiropractic care may be an effective alternative.

What Is a Herniated disc?

To understand how treatment for herniated discs works, it is important to first understand what a herniated disc is. The discs between the vertebrae are composed of a harder outer layer called the annulus fibrosus and a gelatinous center called the nucleus pulposus. A herniation occurs when the annulus fibrosus is cracked and the nucleus pulposus begins to spill out. The disc is no longer able to properly cushion the vertebrae, which causes pain and can cause misalignments to develop.

Diagnosing a Herniated Disc

Not all back pain is caused by a herniated disc, so a chiropractor will start by evaluating the entire spine. A chiropractor will test the reflexes, look for signs of muscle weakening or deterioration, and test sensory functions along the spine. Depending upon the symptoms, a chiropractor may also order scan tests such as MRIs or X-rays. If a herniated disc is identified, the placement and severity of the herniation will be assessed to determine the best treatment options.

Determining the Proper Care

Chiropractic care is not always the most practical or effective way to treat a herniated disc. If a disc injury is causing issues with reflexes, mobility, or sensory functions, it may be necessary to undergo surgery. If a disc injury is associated with incontinence, a different treatment approach may also be necessary. Aside from these issues, however, herniated discs can generally be treated using chiropractic techniques.

Chiropractic Treatment Options

Spinal manipulation is the type of treatment that is most commonly associated with chiropractic care. Spinal manipulation can sometimes be helpful for treating herniated discs, as it can help to ease pain symptoms and can temporarily alleviate some of the pressure on the vertebrae. If pain sensations associated with the herniated disc are extreme, a chiropractor may recommend that spinal manipulation be performed while you are under anesthesia.

Flexion-Distraction Treatment

A flexion-distraction table can be used to stretch and cushion the spine so that the herniated disc or discs can be addressed directly. A gentle motion is used to push on the affected disc. This motion can help to reposition the leaked nucleus pulposus within the vertebrae. This may temporarily correct misalignments and alleviate pain.

If you suspect that you have a herniated disc, contact your local chiropractor to schedule an evaluation and begin treatment as soon as possible.

Author, Dr. David Bennett, DC, is a practicing chiropractor in Altamonte Springs, FL, and the owner of Physical Health and Rehabilitation clinic.

Our new table is here!

Chiropractic table | Low back pain treatment in BeavertonIntroducing our new Flexion-Distraction table from Hilllabs.com! Our chiropractor, Dr. Thompson, will be using this table for all of the usual treatments and adjustments he does in his routine chiropractic visits, but he will now have the ability to provide flexion-distraction therapy to patients with certain conditions.

Flexion-distraction is a method of adjusting the spine by gently stretching the lower back or neck as the table flexes. This movement creates space between specific vertebrae in the back or neck, which can reduce pressure on any pinched nerves, decrease the size of disc herniations, lessen the effects of stenosis (a narrowing of the space around the spinal cord and/or nerve roots), and forces vital nutrients into injured disc tissue to facilitate healing.

Conditions that can benefit from flexion-distraction treatment can range from neck and radiating arm pain to sciatica, stenosis, herniated discs, failed back surgery, and even the everyday mechanical back and neck pain that almost everybody has had at some point in their life.

Many people consider chiropractors to just be “back crackers.” Flexion-distraction therapy is just one of the many tools in our tool belt in addition to traditional manual adjustments (the twisting and “popping” that most people think of). A typical treatment plan at Catalyst will include education about your condition and what to do/what not to do to aid in recovery; adjustments to joints that aren’t moving well or are misaligned; soft tissue massage to relax tight muscles; and therapeutic exercises and stretches to stabilize affected area and make you more resilient to re-injury. Research is showing us that this type of multi-modal approach achieves superior results when compared to treatment involving just adjustments. Take spinal stenosis, for example. This is a condition that is commonly treated in chiropractic offices. In one study posted previously on the blog, stenosis symptoms responded better to flexion distraction therapy combined with an exercise program compared to flexion distraction alone. In another study, flexion distraction combined with typical therapeutic modalities (heat, e-stim, ultrasound), achieved larger reductions in pain and disability than the therapies alone. Studies like these are important because they show that there is not one silver bullet that works better than all other treatments, but it is usually a combination of treatments that achieves the greatest effect.

At Catalyst Chiropractic and Rehabilitation, your treatment is guided by the best available evidence combined with our chiropractor’s clinical experience in order to deliver you the most effective solution for your individual condition. Contact us today to get started on your comprehensive path to recovery.

How to prevent back pain

Personal Injury Back Pain (2)

Around 80% of people will have a significant back pain episode at some point in their life. Once you have an episode of back pain, it is likely to recur, oftentimes within 1 year of first onset. What a horrible thing! It’s no wonder that billions of dollars are spent on back pain treatment every year, and that professions such as chiropractors have a good outlook for job growth in the near future – everybody is getting back pain and not getting rid of it very effectively. So, what about those billions of dollars? Are they being well spent? Are they curing the pain with the expensive drugs, surgeries, and devices they are paying for? In general, no. The rising costs of back pain treatment have not been directly associated with lower occurrences of back pain. On the contrary, the problem just keeps getting worse. Thus the need for studies such as this one, which investigates the usefulness of several methods of back pain prevention. It compared exercise, education, back belts, and shoe insoles and found that the only decent evidence of ability to reduce risk of low back pain episodes came from exercise combined with education. By education, I mean in-office education from the healthcare provider about what causes low back pain and strategies to avoid re-injuring the spine.

Knowledge is power. When you come to our office, our goal is not to just deliver expert, personalized treatment, but to give you tools through proper education to avoid what harms your back and help it to heal properly. I will not just put you on a table, adjust you, and send you on your way, because if I don’t tell you how to take care of your spine you will be right back in my office for the same reason wondering why treatment isn’t helping. I will help empower you to make better choices and start better habits to help you stay out of my office and stay feeling well. You’ll also notice that I don’t push a lot of products on my patients, or prescribe back belts and insoles very often. That is because they have limited utility in preventing back pain. We only use them when absolutely necessary. If you continue to injure your back time and time again and are looking for more answers, contact us to set up an appointment.

 

Photo credit: www.sandiegopersonalinjuryattorney.net 

Radiating arm or leg pain? Perseverance pays off

Pinched nerve Beaverton | Chiropractic treatment for sciaticaIf you have had neck and arm pain (cervical radiculopathy) or low back and leg pain (sciatica), you know that it can be debilitating. I see patients with these conditions often and here are some observations I’ve had over the years when treating them.

-It’s not as simple as a vertebra being out of place and causing a pinched nerve. The nerves in your arms and legs originate from the spinal cord at the level of your neck and your lower back, or lumbar spine. Those nerves exit the spinal column through gaps between each vertebrae, and that is where they can become pinched by either bulging discs or bone spurs. Disc bulges and bone spurs are much more complicated problems than a theoretical bone slipping out of place and pinching a nerve. In that scenario, the bone could be put back into place to take pressure off of the nerve and the pain would resolve quite rapidly. Don’t get me wrong, we do get some people better quite quickly. In the case of cervical radiculopathy or sciatica, though, it isn’t often that simple. Some people give up on treatment too soon because they want it to be that simple.

-Even though it is not just a bone out of place, a chiropractor can still help. Adjustments do more than just move bones. Adjustments can decrease the pressure inside the discs, which are soft and squishy and made mostly of water. Chiropractic adjustments can also relieve pressure on the pinched nerve by temporarily opening up the space where it passes between the vertebrae. Perhaps most importantly, adjustments affect the communication of pain signals from your arm or leg to your brain. In essence, getting adjusted can turn the volume down on the pain signal. Adjustments are just one tool in a chiropractor’s tool box. While they might not cure sciatica or radiating arm pain alone, they can help make the rest of your rehab more effective.

-If you end up needing surgery, doing it later rather than sooner shouldn’t affect your outcome. I’ve had patients give up after not seeing results after 1 or 2 treatments, only to consult with a surgeon and move forward with surgery. If the pain is caused by a bulging disc, and it is bearable and you aren’t progressively losing function in your arms or legs, it is safe to wait for surgery while you give conservative care a real chance at helping you. This study shows that even 1 and 2 years after the onset of symptoms, patients have a relatively equal chance of good surgical outcomes as those undergoing early surgical intervention. So when I recommend a trial of care lasting 4 weeks with 2 visits/week, I’m not doing it to pad my pocket book. In my experience, that is giving conservative treatment a fair chance before considering more invasive options. It’s enough time and enough visits to make a change, but not too much time that it could affect your surgical outcome if it comes to that.

If you or a loved one are suffering from cervical radiculopathy or sciatica, give conservative treatment a chance before doing anything more invasive. Contact us with any questions or to schedule a visit. (503) 526-8782

Whiplash, chronic neck pain, and chiropractic care infographic

Here’s a great infographic on whiplash injuries put together by Tampa car accident attorneys at http://denmon.lawyer

Most people associate whiplash with neck pain, but even “low impact” motor vehicle collisions can wreak all kinds of havoc on your body. We are currently treating quite a few patients with auto injuries who suffer from everything from headaches to neck and back pain, knee injuries, and even a rotator cuff tear. A lot of people will put off seeing a doctor after a motor vehicle accident in hopes that the pain will eventually go away. As this illustration shows, a significant number of people who suffer whiplash injuries will develop chronic pain.

Don’t leave it up to chance. If you have been injured in a car accident, see a chiropractor or other healthcare provider and get treatment ASAP. Contact us if you have any questions at 503-526-8782.

 

Whiplash | Auto injuries and chiropractic care

Is there a movement professional in the house?!

Caution sign | Consult your chiropractor

We’ve all seen the disclaimer on the exercise videos or the newest home gym that more or less reads: “Consult your healthcare provider before beginning this or any other kind of workout…” It’s your run-of-the-mill liability disclaimer and is usually suggesting that there is risk involved in physical activity and you should be checked for any medical indication that you shouldn’t be participating in this activity. Does anyone really ever consult their doctor before beginning a workout plan? Ok, I’m sure some do. If you did, you would surely be checked for any cardiovascular complications that could limit your activity and the doctor might perform a brief physical exam to check for range of motion and any pain in the extremities. Barring anything too serious, you’d be given a clean bill of health to begin your high intensity home exercise videos, your Bun-master, a Zumba class, etc.
Let’s say you get your clean bill of health, begin your workout, and somewhere along the way develop back pain, or shoulder pain. Did your doctor’s exam give you any indication that this might happen? Probably not, and here’s why. Your general medicine doc or internist are experts at the physical exam – as taught at medical school. You can trust them to pick up on potential cardiovascular issues, but if you are going from sedentary to exercising at a moderate intensity, you will be moving your body in ways it hasn’t moved in a long time. Your body doesn’t move like it used to, and as a result of a sedentary lifestyle, previous injuries, deconditioning, excess weight, poor posture, etc, your body has learned to compensate in order to get through your daily routine. When you go to the gym or do your home workout with your limited range of motion, poor movement patterns and compensations, your body will do what it takes to get the job done, but it might be at the cost of safety of the muscles and joints that are asked to do the job.
Here’s an example of what I’m trying to explain. Let’s say you go to a group exercise class and the instructor has you put a bar on your back and start squatting. The squat is a very good exercise and an important movement to master. It is something toddlers are great at, yet as we get older and more sedentary we lose the ability to squat safely and efficiently. If your glutes aren’t firing well, your knees will cave in. If your hips are stiff, or hamstrings tight, your low back will bend when your hips hit their limit. If your ankles are stiff, your heels will come off the floor or you’ll turn your feet out. These are all compensations, and possible ways to develop knee pain or low back pain while squatting. The devil is in the details, and these are details that might not be caught by your general practitioner.
 For that reason I believe that the medical disclaimers that come with workout equipment and exercise routines should encourage you to consult with a movement specialist as well. What is a movement specialist, you ask? A number of people can serve as a movement specialist to identify your inefficiencies and injury potential: Chiropractors (of course!), physical therapists, and personal trainers. These are all professionals who have been trained to spot poor movement patterns and prescribe exercises and stretches to improve how you move and help prevent injury as you begin your exercise plan. If you have questions about what kind of exercises you should or should not be doing and want to learn more about how to move better and safer, contact us at (503) 526-8782. Dr. Thompson has undergone post-graduate training in movement assessment and corrective exercise prescription and would be glad to help you on your way to a healthier you!