Sports Injury Rounds: 14-Year Old Gymnast with Low Back Pain

Depending on the source, gymnastics is considered one of the most dangerous sports.  It is not surprising that many of my sports injury patients come from this community of athletes.  Not surprisingly, back pain is, by far, the most common issue I see in gymnasts.  I recently treated a young athlete with a particular injury that, had it not been properly diagnosed, could have led to catastrophic consequences.

A 14-year old female gymnast entered my office with low back pain that started a month ago after doing a practice session on the balance beam.  The pain was sharp at first but eased up with OTC NSAIDs and rest.  But every time she went back to practicing, her back pain would return.  During our initial consultation, the patient revealed that she occasionally experienced shooting pain down her right leg, but that it doesn’t last very long.  Both the back pain and occasional leg pain would occur only when sleeping on her stomach, standing for long periods, or practicing gymnastics.  Sitting while at school or at home was not irritating.  There was no recent history of other illness.

At this point my differential diagnosis included Herniated Disc with Radiculopathy, Subacute Facet Syndrome with Sciatica, or Spondylolysis with possible Spondylolithesis.  Each of these diagnoses were plausible, however, a focused exam and proper imaging were essential to narrowing down the underlying injury and choosing the correct care path.  An NMS exam also included a postural exam, squat test, and flexibility evaluation.  Positive findings included a slight forward lean while standing, pain in the lumbar spine during a squat, tight hip flexors, pain during P to A palpation of the lumbar spine, positive Yoeman’s Test on the right, and a positive Stork Test bilaterally.  All other tests including Leseagues, Sitting Root Test, and SLR were negative.  All neurological tests were WNL.

It was unlikely that this athlete experienced a herniated disc because all of the space-occupying lesion tests were negative.  Considering the nature of this injury, the length of time the the patient had been experiencing symptoms, and the exam results, imaging was ordered.  Imaging may include x-rays, CT, MRI, or bone scan.  Each of these choices would be diagnostic in this case.  However, due to costs and potential authorization delays related to MRI and CT, I opted to move forward with x-ray as the best initial imaging option.  A good quality 5 view x-ray would reveal if a fractured pars interarticularis and Spondylolisthesis was present.  Alternatively, a bone scan would reveal if active metabolic activity in a fracture site was present.     

As a Sports Chiropractor, it is important to know the mechanisms of injury of all the most common sports.  If you have treated enough gymnasts (or football linemen), certain injuries resulting from repetitive extension of the lumbar spine should come to mind first.  In this case, the final diagnosis was Spondylolysis with a Grade 1 Spodylolisthesis.   With proper wearing of an immobilizing brace (up to 6 months), non-force chiropractic care, and physiotherapeutic modalities, a patient can experience a full recovery from this injury.  Self-care in the form of core strengthening and balance training will be required once it is determined through re-imaging that the area has healed.  In some cases, if the spine doesn’t heal well, or the Spodylolisthesis is severe, surgical consultation for fusion would be required.

Published in ANJC July 2019

Ankle Sprain/Strain- Active vs Passive Care

Often times I get a new patient that wants a second opinion about an ankle sprain/strain that occurred months to years ago. He/she received treatment, yet they are still in pain. Typically, the patient presents with pain after walking for a long period, after running for short distances, or they feel a sense of weakness or instability in the joint. This patient most likely was told to immobilize the ankle until the inflammation and pain subsides, and then go for some form of physical therapy to strengthen the muscles around the ankle.

Unfortunately, this type of outdated advise continues to be provided to patients. The truth is healing from an ankle sprain requires three stages of treatment to fully improve. When the initial evaluation is conducted the practitioner must first determine the severity of the injury- grade I, II, or III with grade I being more of a ligamentous and muscle stretch injury and grade III representing a frank tearing of tissue. For grades I and most grade II strains treatment should commence immediately (grade III strains may require an MRI and then surgery before rehabilitation begins). Initial treatment should incorporate passive treatments such as laser therapy, electric stimulation, and/or ultrasound therapy to control edema and accelerate healing. A slow deep manual flush from the foot up the leg can also be performed to move excess edema. However, scar tissue prevention, which is critical for rapid, complete healing must also be included. This can be achieved by incorporating Instrument Assisted Soft Tissue Mobilization (an external method to scrape early onset scar tissue out of the area of injury), Active Release Technique, and gentile ankle mobilization.

When the injury has started healing and the inflammation has begun to subside (usually day 3-7 after injury) stage 2 of rehabilitation can commence. This stage focuses on laser therapy to provoke cell regeneration, and low impact strengthening and balance training. It is not enough to just strengthen. When ligaments and muscles go through the shock of an injury, these tissues lose their ability to perceive the bodies shift in position reducing a persons ability to stay balanced. Active range of motion of the ankle, slow, one foot toe raises with the shoe on, and low resistance exercise bands should be used. This stage can progress to more challenging exercises as stability is gradually restored. Using a Bosu Ball, or folded towels with shoe off is a good start. By the end of this stage a patient should be pain-free, inflammation-free, and feel confident about using the ankle.

The final stage of rehab involves reintroducing everyday fitness activities to a patient’s lifestyle. Using fitness ladders and jump boxes are just a couple examples of common tools to improve plyometric movements to the ankle. Starting slowly, a patient can reintroduce their favorite exercises back into their life. The total rehab time can be as little as 2 -3 weeks to 2 – 3 months. However, both active and passive forms of care are necessary immediately after injury to ensure full recovery.

I’ve Fallen and I Can’t Get Up!

Ever wonder why simply bending over at the waist could cause you to have intense, debilitating, low back pain? How many times have you bent over before and you didn’t have any pain at all? While you might think it’s a mystery why something like this could happen, there is actually a logical reason this may occur. Most people today are in two categories of “daily life physical activity”…repetitive movement or stationary position. If you are in construction, landscaping, a bartender, or athlete you fall in the category of repetitive movement. If you work in informational technology, finance, accounting, data processing, or banking you work long hours in a stationary position. The repetitive movement patient hurt their back while bending over because of wear, tear, and fatigue. The body finally couldn’t handle another minute of physical stress and the back gave out. The stationary position patient’s back becomes weak from poor posture AND not being physically active most of the day. So when this patient tries to bend over the weakened structures in the back aren’t strong enough to handle the physical stress. Most people will hurt their backs this way after being in one position for a long period of time- at the beginning OR end of a long day of heavy physical activity, or after sitting in from of the computer for hours on end. It could also happen in the morning while bending over in the bathroom to take something out of the vanity. To prevent acute back pain from what seems to be a meaningless movement ALWAYS keep your back straight when you bend over and bend the knees at the same time. Take frequent breaks from being in one position so you keep all the muscles and joints fresh and ready to respond to your demands. Make sure you incorporate core strengthening exercises into your fitness routine.

Proactive vs. Reactive

Do you wait until you are in a health crisis before seeking help from an illness care provider?  Or do you actively seek the advice from a “wellness” care practitioner to help you stay healthy and prevent dis-ease?  It is time for members of the community to change their perception of what health REALLY is.  Most dictionaries define health as being free from illness or injuries.  Yet most people embrace a definition of simply being symptom free.  It is well established that the diseases that are the most devastating in our country are those that are slow progressing and degenerative.  Heart Disease, Cancer, and Diabetes are deadly diseases that many people suffer from.  The reason is because the symptoms of these diseases don’t surface until long after the disease process has started.  Picture this scenario like an iceberg.  Normally, the tip of the iceberg is what you can see above water.  But what lies beneath the surface is much larger than what is visible.  This is the difference between dis-ease and disease.   Dis-ease is the struggle the body is going through to maintain health in a relatively symptom-free state.  This is the point at which blood chemistry starts to change (chronically high cholesterol or blood sugar), blood pressure starts to increase, or a tumor starts to grow but symptoms haven’t surfaced.  Disease is a state when the internal struggles become too great for the body to battle and systems begin to fail causing symptoms to surface.  At this point, health is a long way off and many people rely on medication provided by their illness care provider as a “reactive” approach to trick the body into feeling healthier.

The good news is that a healthier approach is available for people to reverse the process from disease to true health, and medication is not necessarily required long term.  Eighty to ninety percent of people get themselves into a health crisis by not exercising, sleeping poorly, eating unhealthy foods, and not managing stress.  Simply by cutting refined sugar and homogenized oil products (cakes, cookies, ice cream, chips, etc) out of your diet, eliminating gluten, only drinking water and limiting alcohol you can start a journey back to health. Increasing your vegetable and fruit intake, and increasing the consumption of foods with Omega 3 Fatty Acids like salmon,  almonds, walnuts, flaxseeds, chia seeds, and green leafy vegetables can significantly reduce inflammation in the joints and vascular system.  Losing excess weight is a big factor in restoring health.  Combining the above diet with cardiovascular exercise like fast pace walking, jogging, stationary bike, or the elliptical machine for 30 minutes 3 to 4 times weekly will detoxify the body and help you lose the weight that needs to be lost.  If you average 7 hours of sleep per night, and engage in activities you enjoy on a regular basis, along with the above exercise and nutritional recommendations you will be well on your way back to a healthy you.

Taking simple proactive steps to preserve or restore your health will prevent the desperate need to  be reactive and take potentially dangerous medications or risky surgeries to stay alive.  Talk to your chiropractor or call our office to discuss how being a chiropractic wellness patient can turbo boost your own healthy habits and live a long and active life.


Universal Intelligence…Huh???

I’ve probably already lost you with the title.  But if you read this post you will undoubtedly understand what Universal Intelligence is and how it pertains to human health and chiropractic.

It is hard to believe that everything that happens in the universe is by chance.  If you believe in god, not sure if he exists, or you simply believe god doesn’t exist it is impossible to refute that order and purpose exists in the universe.  For example, shapes repeat themselves throughout the universe.  The most basic is a sphere.  Planets, stars, fruit, and the human egg are just a few examples of objects in the universe that are naturally spherical.  A more complex shape is the spiral.  Galaxies, hurricanes, and spirochete microbes are a few examples from around the universe that form a spiral.  Laws of attraction are also universal in many ways.  The way planets orbit around stars (the sun) through gravitational pull is eerily similar to the electrostatic attraction of electrons around the nucleus of an atom.  Lastly, elements from the periodic table found here on earth (carbon, oxygen, hydrogen, and sodium) have been discovered on planets as far as 884.5 trillion miles away from earth.

So how does all this pertain to human health and chiropractic??  If you believe that the above examples of order and purpose in the universe are not by chance then you accept the idea that there is some kind of governing power in the universe.  Call it what you will.  Which means that the same powers that be designed the human body with purpose.  Did you know that the first organ that develops at the 19-22 day period after fertilization is the spinal cord (called the neural groove)?  By the end of that 3 day period cells called “Soma” are ready to start developing into all the organs of the human body, and the fetal brain begins to develop at the end of the neural groove!  Pretty amazing!

By the time the human body is fully formed and ready to be exposed to the outside world the spinal column is formed to protect the most vital organ of the body- the spinal cord.  However, from the time a fetus is developing in its mothers womb all the way through life the spine and spinal cord undergo constant stress jeopardizing communication from the brain to the organs.  Whether it is sleeping in a funny position, poor posture in front of the computer, a traumatic physical event, or advanced wear and tear in the form of arthritis the spine absolutely reduces the nervous system’s ability to control function of the organs at the highest level.  Before you know it you have a weakened immune system, have high blood pressure, incontinence, pronounced asthma, bowel problems, and more.  The universe gave us the ability to reproduce and function every second of the day without thought.  This Universal Intelligence that designed the body and flows through us as Innate Intelligence can be preserved by removing any nerve blockages caused by faulty spinal function with the help of chiropractic adjustments.  This is why chiropractic is so essential in a proactive healthy lifestyle along with healthy eating, exercise, ample sleep, and stress relief activities (having fun).

Magnetic Field Therapy- Magnesphere

Are you looking for a pain relieving treatment that is non-invasive, relaxing, and reduces inflammation in the body?  The new wave of energy medicine is here! The latest and most effective form of energy healing is full body, low level magnetic field therapy.  Unlike magnets themselves, or high intensity electromagnetic fields which interrupt the body’s natural energy systems, low level magnetic fields from the Magnesphere are used by the nervous system to reduce pain, inflammation, and the negative effects of stress.

Dr. Jerry Jacobson, the scientist who helped design the Magnesphere has been studying magnetic fields for over 50 years.  Some consider him the modern day Einstein for his work on completing Einstein’s Theory of Relativity.  It took him and his team 30 years to determine the right field intensity to improve human health, and develop an intricate system of protocols to treat various diseases that are common today.  Each protocol uses different frequencies of energy at the same intensity to target a disease.  Now, over 100 different protocols have been developed helping migraine headaches, arthritis, neuropathy, Parkinson’s Disease, addiction, and many other ailments.

The proof is in the pudding…right?  Well, outcome measures are available by using a special heart rate monitor before and during treatment to reveal how the nervous system is effected with the Magnesphere treatment.  In addition, Heart Rate Variability (a marker that evaluates how the body works under stress) is calculated as an additional way to determine if the Magnesphere is improving a patient’s health.

The treatment lasts for 30 to 60 minutes, is relaxing (no noise or movement), and is very affordable at $65-$75 per hour of treatment.   FDA approved for safety, there have been no negative side effects from this treatment reported, and there are very few contraindications to using the Magnesphere.

If you are interested in a complementary session give the office a call today to set up your potentially life changing treatment- (201)670-7661.

Chiropractic Cuts Blood Pressure- WebMD Says!

Chiropractors have know for years through first hand experience that spinal adjustments to specific vertebrae can directly affect how internal organs function.  For example, adjusting the vertebrae in the lower mid back can improve the function of the kidneys and bladder.

In a recent study, lead by George Bakris, MD, chiropractic adjustments performed by Marshall Dickholtz, Sr, DC had, on average, reduced blood pressure in 25 patients compared to the 25 research subjects who were given a sham adjustment.  According to Dr. Bakris, “This procedure has the effect of not one, but two blood pressure medications given in combination.  We saw no side effects or problems”.  To read the original article click on the link below.

Wanna Try Healing Your Cancer Naturally?

For decades different organizations have tried raising money to find cures for cancer.  For the most part, much of the research has identified genes that are common in cancer patients, or new immunotherapy/chemotherapy/radiation treatments, but medical cures seem to be a long way off.  If we continue to look at chemicals  that are toxic to the human body, true healing will never occur.

For over a century brave doctors and non-medical healers have been thinking outside the allopathic box treating cancer victims with drastic, but effective, natural means.  For example, in 1902 the English scientist, John Beard, proposed an anticancer use for the digestive enzyme Trypsin.  Although Beard was discounted for his hypotheses regarding the origin of a cancer cell, in 2002 (100 years after Beards original work) multiple scientists are agreeing with his findings that cancer cells originate from stem cells that lose their regulatory restraint.  In 1902 Beard tested his theory by injecting Trypsin into mice who had cancer.  Remarkably, the two mice that he injected had tumors that completely regressed.  In 1906, doctors started treating their patients with two types of Trypsin in various applications and achieved favorable results.  For more than a decade doctors were using digestive enzymes as a cure for cancer.  But, like most doctors who come up with effective treatments that aren’t mainstream, the “establishment” ridiculed Beard, and the momentum of his enzyme treatment petered out.  Several doctors caught on to Beards work over the next 40 years and applied his enzyme treatments to their own patients.  However, once they tried to publish their work, the mainstream medical community veraciously squashed their efforts.  Finally, as Dr. Nicolas Gonzalez accounts in his publication “The History of the Enzyme Treatment of Cancer”, Dr. Donald Kelly (professionally an orthodontist) engrossed himself in the study of Dr. Beard’s work after being diagnosed with advanced pancreatic cancer.  By combining large doses of pancreatic enzymes with largely an organic raw food, vegetarian diet, nutritional supplements, and coffee enemas he saw his tumors, that were once palpable through the abdominal wall, regress significantly.  After his own personal experience, Dr. Kelly dedicated the rest of his life to being an Alternative Cancer Therapist and wrote the book “One Answer to Cancer” in 1969.  Dr. Gonzalez, one of the foremost MDs who successfully treats cancer patients in New York City naturally, had the pleasure of interviewing and evaluating over 1000 of Dr. Kelly’s patients.  He found that 455 of those patients did well, and in some cases, beat the odds and went into remission even in stage four of some of the most aggressive forms of cancer.

There are a number of prominent doctors in the field that are either strictly treating cancer naturally, or using a combined approach of medicine and nature.  Drs. such as Stanislaw Burzynski, James Forsythe, Russell Blaylock, and Jonathan Wright are just a few brilliant, successful physicians paving the way for naturalists to make their mark in the field of oncology.

There are so many natural substances that are known to thwart the growth of cancerous tumors.  Some basic anti-cancer principles include drinking purified water, and eating green leafy vegetables like Kale, Wheat Grass, Spinach, and Blue-Green Algae. Other superfoods such as Chlorophyll, Green Tea, Reishi Mushroom, Tumeric, Blueberry, Red and Orange Vegetables, and Acai Berry are also known to help your body resist cancer.  Some supplements that have been recommended include DHEA, Glutathione, Resveritrol, and other high level Antioxidants like OPC3.

To educate yourself about how to TREAT and PREVENT cancer naturally I highly recommend you buy the books “Knockout” by Suzanne Somers, and the highly acclaimed book “Radical Remission: Surviving Cancer Against All Odds” by Dr. Kelly A, Turner.   These books are sure to empower even the most desperate patients in the most dire situation.


Patient Health vs Insurance Coverage

As insurance policies become more costly, healthcare coverage continues to stay the same or become less comprehensive.  Over the years I have been challenged dozens of times with the task of explaining to patients that treatment needs rarely coincide with the number of treatments the insurance company allows.  I am often asked by the patient, “How many visits do I have left?”, or “How many visits does the insurance company cover?”.  Unfortunately, it is quite common for people to take better care of their cars than their bodies.  Somehow people with insurance coverage began to think that if insurance only allows “x” number of visits, then that is all they should need.

Over the years I’ve had to be very direct with my patients telling them that they will most-likely need care beyond their insurance policy limits, and they will have to invest in improving and maintaining their health.  Those who are health oriented typically follow my recommendations and are rewarded with a better quality of life experiencing noticeably fewer episodes of pain.  Those who are medically minded only come for crisis or “illness” care and wind up having more episodes of debilitating pain that become more frequent and severe with age.

So, the take home here is to use insurance to “supplement” your personal investment in your health, but don’t allow insurance to dictate what health and wellness related services you receive.  Within reason, always incorporate services that enhance your health to avoid health crises in the future.

Why Is My Back So Stiff In The Morning???

So many patients come in complaining that they don’t really have severe pain, but over the last several years their back has gotten increasingly stiff upon waking in the morning.  This is very common and usually occurs in people whom are above the age of 40.

As you age, and the repetitive stress that is endured from daily activities accumulates in your body, supportive tissues in and around the joints slowly wear down.  The types of activities that you engage in over the first 40 years of your life defines what tissues in your body wear down first.  For example, if you sit in front of a computer all day at work, and you’ve been doing it for 20+ years, the hands, neck, and back wear down first.  If you are a construction worker or manual laborer your shoulders, low back, hips, and knees will wear down first.

Increasing low back stiffness upon waking in the morning occurs because the intervertebral discs in your back are progressively wearing down.  Physiologically, when the connective tissue that makes up the disc (glucopolyglycans) begins to lose its strength and structure it is no longer able to hold on to its normal water content.  It is the fluid in the disc that gives you movement between spinal bones.  When the water content of the disc reduces the disc becomes a dry sponge-like structure creating the stiffness many people feel when they get up in the morning.  This condition is called “Degenerative Disc Disease” (DDD).

There is no way to rejuvenate the disc.  Don’t panic…there’s hope! Chiropractic care can dramatically help slow down the degenerative process and ensure that your nerves do not get damaged as seen below.  In addition, there are natural supplements (Nutra Disc by Anabolic Labs as an example) and exercises that help to maintain what disc remains, and reduce the inflammation commonly associated with the degenerative process.  To find out if you have DDD, or obtain information about chiropractic, supplements, and the exercises click on the “Make an Appointment” tab, or call my office to set up an appointment- (201) 670-7661.