Monday, August 30, 2021

Hinge Joints

   Our knees, the joints in our fingers, & our elbows are “hinge” joints—-similar to door, window, etc. hinges---meant to move in one geometric plane.

Introducing a rotating force in these joints causes injury, sometimes mild with a relatively easy recovery, but sometimes serious sprains that are not only difficult to recover from, but may leave lasting damage to the joint tissues.

Another force these joints are not meant to tolerate is hyperextension. Taking a hinge joint  past its end point of tolerance for extension will cause injury. I often see this in patients who have propped their heel on a stool or ottoman, causing hyperextension of the knee.

       Lateral forces such as sometimes happen in football to players’ knees, often also injure & can permanently damage a hinge joint. 

Distant or Local?

Tingling or numbness in the hand or arm is a sign of nerve impingement, and finding a solution requires differentiating between a local origin, i. e. in the arm, wrist, or hand, or an impingement happening further away, perhaps in the neck or shoulder region.  

The patient’s presentation, orthopedic tests, and careful assessment of the neck and involved upper extremity will reveal the source of the the problem.

In some instances, there is more than one site of impingement, e.g., symptoms in the hand may be due to a “double crush”—-impingement in both the new and the wrist. 

Monday, August 23, 2021

Twist & Lift---A Bad Combination

  Lifting when the body is twisted to the side—either left or right—is a recipe for back pain, often in the thoracic region. 

An example is lifting a child into or out of a carseat. The lift + twist action often necessary to do this can torque the rib cage, stress and misalign vertebrae, & set off muscle spasms, 

As soon as the child is able to climb in and out of the carseat on their own, give your body a break and let them do it.

In the interim, take care to twist as little as possible when getting them in / out, and try to keep your body as close to them as possible while doing it. This creates shorter-lever stresses on the back and spine, helping to make it less likely that you will injure yourself.

Monday, August 16, 2021

Chronic Neck Pain

Successful treatment plans for chronic neck pain should include home care counseling for postures and ergonomics.

There are usually modifications that can be made in the patient’s positions & pastures during different activities—e.g., computer use, kitchen chores, sitting, standing, and sleeping—that will help.

An important key to change is the patient’s developing an awareness of their body’s positioning, and this may take some practice. I often recommend setting a timer, using it as a reminder to “check in”—where is my head? am I slumping? leaning in to see my computer monitor?

Using the right pillow for sleeping, changing the height of one’s computer monitor so that it is at eye level, getting computer glasses with corrective lenses if one is having a hard time seeing the screen, raising the height of one’s work space on the kitchen counter—-all are simple things that can make a big difference.

Monday, August 9, 2021

Accentuated Curve in the Low Back

  An abnormally accentuated lumbar curve, whether congenital or acquired, can result in disequilibrium and vulnerability in the lower back.

Sometimes this is partially alleviated with postural counseling, Activator adjustments, and specific exercises. If the patient habitually “locks back” their knees when standing, changing this habit often helps a lot.

Ergonomic counseling about sitting, sleeping, etc. can also help.

But often these are only partial solutions. A patient with this condition may need more consistent chiropractic treatments, the frequency of which can be judged according to what works for each individual. 

Monday, August 2, 2021

A Torqued Tibia

Rotational stresses acting on the proximal tibia (where the large bone in the lower leg, the tibia, articulates at the knee) are common in people who drive a lot, e.g. for a job.

The tibia is not meant to rotate at this joint, but will tolerate some rotational stresses for short periods of time or if the stress is not repetitive or chronic.

Patients whose work requires a lot of driving often come in with aberrance and pain in their right (gas / brake foot) knee. Usually I find, and adjust to relieve / correct, rotational stress of the involved proximal tibia.