Royal Chiropractic & Sports Injury Clinic
100 Westcreek Blvd, Unit 1 L6T 5V7 Brampton, ON, Canada

The neck muscles aid in the stability and normal functioning of the cervical spine. An impairment in the size of these muscles can lead to the likelihood of radiating neck pain. Evidence has suggested an atrophy of the deep muscles of the neck as a risk factors of neck pain. Radicular neck pain is defined as a pain that stems from the compression or irritation of a nerve root which exists the neck that radiates to the upper extremity. A recent study has shown there was a sign...ificantly higher change in deep neck muscle size between patients who had chronic radiating neck pain and controls. The deep neck muscles for patients were significantly less in size than those without neck pain, which suggests an inefficient muscular system would present with this patient population. A mechanism by which this may occur is through fear avoidance behavior in those with chronic neck pain. As one develops pain in their neck, the fear to move develops and atrophy of muscles becomes prominent thus potentially leading to nerve related syndromes producing pain. Furthermore, a leading cause of nerve injuries to the neck is from cervical disc herniations, and another study has shown an asymmetry between the deep neck muscles sizes in patients who present with cervical disc herniations. Thus, neck pain is associated with impaired muscle function that leads to disuse atrophy and increased neck pain, and the potential risk of neurological pain. Effective management of disuse atrophy as it relates to neck pain is essential in rehabilitation. The multifidi and longus colli muscles are the deepest tonic and postural paraspinal muscles of the neck, and deserve attention when developing rehabilitation programs. The specific training of atrophied deep cervical muscles may lead to an increase in size and reduce asymmetry thus improving patient outcomes in neck pain. Two great exercises worth noting to help improve the activation of deep neck muscles are 1) the bird dog exercises and 2) supine chin tuck and lift otherwise known as the craniocervical flexion with or without cervical flexion technique. Ref: Amiri-Amiri et all 2018 thesleepjudge.com #neckpain #chiropractor #chiropractic

Ulnar nerve compression in cyclists, also known as Guyon Canal Syndrome, is not as commonly diagnosed, and often missed! The ulnar nerve sits between the bony prominence of the wrist and the pads of your palm, and the nerve splits into two giving off sensory and motor output to the hand. During long distance cycling, the position of the wrist for prolonged period of time can cause compression of the ulnar nerve. A prospective study by Patterson et al. (2003) showed a 70% spik...e in transient ulnar neuropathies over a 4 day 600km bike ride. Nerves can regenerate and recovery if the offended area is removed from injury. There are 3 types of nerve injury 1) Neupraxia - transient compression, days to weeks to recover; 2) Axonotomesis - prolonged compression that leads to Wallerian Degeneration, complete cessation of activity and removal of compression is absolutely needed with months for nerves to heal; 3) Neurotemesis - serious nerve injury, nerve transected, surgery needed. The clinical symptoms include hand pain, numbness and grip weakness, but also can present with atrophy of the hypothenar (pinky region), and adductor pollicis (thumb) and the hand can present like a claw. While there exists much ambiguity in the therapeutic management of Guyon Canal Syndrome, your Doctor can take a conservative approach with soft tissue, modality, laser, acupuncture, soft tissue release and extremity adjustments and mobilization, and the use of padding/splinting as needed. References: Brown et al. 2014 pintrest #chiropractor #sportsinjury #sportsmed #physiotherapy #wristinjury #cyclist #handinjuryprevention #cycling

Lower back pain is one of the most common symptoms in the general population affecting 80% at some point in ones life. The spino-pelvic rhythm is a contributing factor to back pain and can be disrupted by tight hamstrings (Esola et al.). The spino-pelvic rhythm has 4 main phases: first phase of forward bending are dominated by the lower back, then the middle phases are relatively equal between the pelvis and the lower back, and the end phase is dominated by pelvis. The ranges... are 40 degrees of lower back and 70 degrees at the hip joint. In patients with lower back pain, researchers showed a increases in lower back motions relative to pelvic motions, that suggests overloading the lower back thus leading to lower back pain. Hip motions are shown to be restricted and one big impact from this is tight hamstrings! The Spino-Pelvic Rhythm is affected by tightness of hamstrings. Therefore a possibility of normalizing the ratio between the spino-pelvic rhythm can reduce lumbar (low back) stress, ultimately reducing lower back pain. The goal is to use DYNAMIC stretching techniques to stretch the hamstrings. In fact a recent study by Hasebe et al. showed that a 6 week dynamic stretching program improves hamstring flexibility thus improving pelvic mobility during the late phase of bending, further reducing lower back compensatory flexing and aberrant changes to the spino-pelvic rhythm. The researchers used the theory of reciprocal inhibition by using quadriceps strengthening to dynamically stretch the hamstrings. In general, a dynamic stretching activation of hamstrings can help reduce tension and assist in normalizing spino-pelvic motions. Coupled with this approach, in our clinic we use breathing techniques in supine, acupuncture of the glutes and hamstrings, pelvic / hip mobility exercises and spinal adjustments to further normalize the mobility of the spino-pelvic rhythm. Ref: Hasebe et al. 2016 : Physioleeds, oldschoollabs

The Better You - https://mailchi.mp/038f9c08a3e9/the-better-you Improve your Back Health with these easy steps

Trigger finger is a disorder in which a thickening or inflammation of the ligamentous flexor tendon sheath causes painful snapping. Pain is often associated with the pathognomonic feature of a flexed finger that is stuck! Causes commonly include overuse of the digit. Acupuncture has been a proposed treatment in reducing inflammation and improving function of the triggered finger. A recent study by Inoue et al. (2016) Demonstrated the analgesic effects (pain relief) noticed in... trigger finger when acupuncture was used at the site of the flexor pulley that is triggered (A1 Pulley, yellow dots in pic 2). We then see increased blood circulation of the area which give this pain reduction. The study also found that acupuncture is better when the duration of disorder is caught earlier, as thickening and scarring is less likely. Thus the authors concluded that acupuncture is successful in reducing inflammation, swelling and reducing pain, while improving functional. #acupuncture #overuseinjury #rehabilitation #injuryprevention #chiropractor #sportsmed Ref: Inoue M et al. Acupuncture for the treatment of trigger finger in adults: a prospective case series. Acupuncture Med. 2016. 34:392-397. handsurgeonmd.com Fig1 from Inoue et al. 2016 @ Royal Chiropractic & Sports Injury Clinic See more

Planter heel pain (bottom of the foot pain) is one of the most common musculoskeletal pathologies of the foot, which has a lifetime prevalence of 10%. In those that seek out conservative care, 90% often find relief, but if you’re willing to live with it, chances are 80% of those with plantar pain will have resolution in 12 months without any therapy. A systematic review by Salvioli et al. (2017) reported on the effectiveness of non-pharmacological treatment and found a modera...te quality of evidence that dry needling (Acupuncture) was effective in reducing heel pain. They study had patients come in for 6 visits (1/week) and offered great relief of pain! How does Acupuncture work?: 1) reduces pain markers, 2) increases endorphins, 3) improves the body’s analgesic response, 4) improves oxygen saturation. Together these effects reduce pain and improve function. Some of the other therapies that may also help are heel taping, which can be used with acupuncture, Low Level Light Laser therapy and orthotic use. References: Salvioli S, Guidi M, and Marcotulli G. (2017). The effectiveness of conservative, non-pharmacological treatment, of plantar heel pain: A systematic review with meta-analysis. The Foot. 33: 57-67. Credit: stlee000 - Fotolia