Headaches / A Myriad of Causes

  Identifying the cause(s) of headaches, ranging from chronic, unrelenting headaches to acute ones, is a challenge faced by M.D.s and Doctors of Chiropractic alike.

There are many different types of headaches, and multiple causes. Nutritional issues should be considered---food triggers may be involved, in which a person gets headaches when they ingest certain foods or food additives. 

Stress, both biomechanical (e.g. postural stress, repetitive motion, injuries) and emotional / psychological, is often part of the picture. Tension headaches are among the most common.

Aberrances of the cranial rhythms is another frequent occurrence closely related to headaches. When I balance a patient’s cranial rhythms, their headaches often disappear.

Sleep apnea is also now recognized as another source of headaches, in which abnormal proportions of oxygen & carbon dioxide result from interruptions in breathing.  

A Secret to Relieving Sciatica

 Sciatica, pain down the leg, is caused by nerve impingement. Location of the impingement is commonly thought to be in the lumbar spine, where the nerves exit between the vertebrae and travel down to the legs, forming the large nerve “trunk” called the sciatic nerve.

If there are degenerative changes in the lumbar spine, and / or if there is history of injury, the lumbar region may indeed be the site of impingement.

But another, often overlooked, site of impingement that causes sciatica is in the gluteal region, where the sciatic nerve passes between the muscles, specifically underneath a muscle called the piriformis. If the piriformis is in spasm, it can cause sciatica.

Episodes of pressure on the piriformis, such as from sitting on hard surfaces, can also impinge of the sciatic nerve where it passes under the muscle, resulting in sciatica.

Orthopedic tests and X-ray can help discern the origin of impingement, but often a trial treatment of precise Activator Chiropractic adjustments, specific stretches, and home care counseling can solve the problem, making X-ray unnecessary. 

Fire Safe Council of Santa Cruz County

   

  I am proud to be a  Community Partner 

      with

Fire Safe Council of Santa Cruz County

A 501(c)(3) Nonprofit Corporation

Whose Mission is to Educate and Mobilize the People of Santa Cruz County

to Protect Their Community, Homes, and Environment from Wildfires 

Learn how your tax deductible contribution 

to become a Community Partner can help at:

https://www.firesafesantacruz.org/community-partners-2019

The Helpfulness of Hedgerows

    Throughout millennia, farmers have used linear plantings of trees and shrubs, or “hedgerows,” to create windbreaks to protect their crops. A “bonus” benefit was the plants’ roots holding the soil and protecting against erosion.

Today’s farmers know that these plantings of vegetation among their crop fields have multitudes of other benefits to the farm. 

With the right mix of plants, including flowering ones, hedgerows attract beneficial insects that prey on crop pests. They also serve to suppress weeds, because over time they out-compete the weed “seed bank,” and help keep out wind-blown weed seeds.

Hedgerows can be of linear, or other configurations, and can also include grasses and herbs. The root systems improve water quality by acting as filters to catch sediment and filter surface water before it drains into aquatic habitats such as ponds, creeks, or rivers.

Hedgerows create a sheltering habitat for wildlife, such as birds that feed on crop insect pests, and pollinators which fertilize crops.

California native plant hedgerows are said to be easy to establish, and once mature, are drought-tolerant.

Learn more at www.HedgerowsUnlimited.com 

  

Mysterious Shoulder Pain

 There are times when pain in the shoulder may not be due to a local problem in the shoulder, but may be originating somewhere else. To ease the pain, its specific origin must be determined.

Often a patient presents with an unimpeded range of motion, no soreness or tenderness to palpation of the shoulder, and no history of injury or stress to the involved shoulder. Yet the pain is unrelenting; the patient is unable to get relief by changing position or posture.

With this scenario---no signs of local trouble in the shoulder---my attention goes to the neck, where impingement of the nerves going into the shoulder region can cause “referred” pain. Referred pain shows up in one place, but its actual cause is somewhere else. 

My treatment for this kind of shoulder pain includes precisely clearing misalignments in the cervical vertebrae, appropriate neck stretches, and postural counseling. 

        Often a better cervical pillow is also key to lasting relief.

Excessive Extension in the Low Back

 The normal curve in our low back is an “extension,” or forward-facing curve.

In some people, this curve is abnormally pronounced, which can be due to chronic locking back the knees when standing, or the accentuated curve may be part of the congenital anatomy of the low back.

This excessive extension can cause chronic low back discomfort, partly due to posterior compression between the lumbar vertebrae and / or compression between L5 and the sacrum.

My treatment plan for these patients includes precise, gentle adjustments to the spine and pelvis with the Activator instrument, accompanied by exercises to strengthen the abdominal muscles, specific stretches, activities of daily living (ADL) advice, and postural counseling.  

Head-Forward Postures

  Our head should be in line with the center of gravity of our body. Any position of the head that is forward of our center of gravity gets us in trouble.

For example, “craning” the neck / head to look upward / forward toward a TV or computer monitor, or tilting the head backward to see a monitor through the near-focus part of bifocals, is a common cause of neck pain, tension, and headache. 

This posture causes the occiput (the bone across the back of the head, just above the spine) to be stressed inferiorly. This inferiority may be more on one side or the other (unilateral) or global (bilateral). The result is tension across the back of the neck and head.

Working at a desk, at a kitchen countertop, etc., with the head bent forward of the body’s center of gravity leads to similar problems of neck & upper back pain, tension, and headache. 

Note also that when we are sitting, if we lean forward from our hips, our head in this position  is again out in front of our center of gravity; we immediately begin to feel the stress in our neck. Be mindful of this; rest your back against the chair, feel your head comfortably in line with your center of gravity. 

Hiatal Hernia

        In this condition, part of the stomach bulges or protrudes up through the diaphragm and into the chest cavity, at the opening (hiatus) where the lower end of the esophagus passes through the diaphragm into the stomach.

The muscle of the diaphragm becomes weak at this place, allowing the protrusion. This weakness can be congenital, age-related, due to some kind of trauma, or possibly post-surgery. Intense exercising that puts pressure on the diaphragm and abdominal muscles, or repetitive lifting of heavy weights can also cause the weakness. 

Symptoms that may present with hiatal hernia are “heartburn,” also called acid reflux, if food and stomach acid back up into the esophagus. Chest or abdominal pain can be accompanying symptoms, as well as shortness of breath. Obesity is often associated.

As an Advanced Proficiency Rated ACTIVATOR Chiropractor, I have an effective, comfortable adjustment for this condition. The adjustment usually brings immediate relief to the patient, but relief is temporary.   

Specific yoga can help this condition, and sometimes sleeping on a wedge that elevates the upper body can help, as can weight loss, nutritional changes and eating smaller meals.

Harmful Secrets of LED Light

         Many people are converting the lighting in and around their homes from incandescent bulbs to LED  ones, in the interest of energy savings and longer bulb life. This seems like a good idea, right? In fact, before making this conversion, we would do well to consider:

LEDs emit high amounts of blue light; they have very little red, and no infrared, light frequencies. The blue light, without the counterbalancing reds, can damage the cells in our eyes. 

  The red  frequencies, missing in LEDs, are important for repair and regeneration of cellular damage.

LED light impedes sleep because it suppresses melatonin production. Regular exposure, especially after sunset, may contribute to worsening of sleep. 

LED light negatively affects the mitochondria, the energy-producing components of our cells, impeding production of the energy needed for healthy metabolism. 

Incandescent lighting most closely resembles full-spectrum natural sunlight, which is the healthiest for us.

We can make our light environment healthier by using incandescent lighting in areas where we spend the most time---kitchen, office, etc., and only using LEDs in areas such as hallways, closets, garage, etc. 

Learn more at https://www.health.harvard.edu/staying-healthy/blue-light-has-a-dark-side , https://www.ncbi.nlm.nih.gov/pubmed/21164152,  https://academic.oup.com/jcem/article/90/5/2755/2836826

Thank You--To the Kneecap!

           Our kneecap, aka the patella, gives us a 30% increase in the power production of our quadriceps, the muscles in the front of our thigh that, when activated, extend, or straighten, the knee.

Embedded in the tendon of the quadriceps, the kneecap articulates against the front of the lower end of the femur, the thigh bone. 

Below the kneecap, the fibers of the quadriceps tendon continue as the patellar ligament. The patellar ligament starts from a “bump” on the front of the kneecap and goes down to attach to a “bump” on the front of the tibia, the large bone in the lower leg.

The kneecap holds, or raises, the patellar tendon off the femur, thus improving the angle of approach of the tendon to its lower insertion on the tibia. This is how it increases the power generation of the quadriceps. 

The Right Pillow

  For many patients, changing to a better pillow is a critical key to a healthy and comfortable cervical spine, a solution to chronic neck pain & tension, and relief for headaches.

         I have personally experienced this. After five whiplash injuries in my youth, I found that regaining full and reasonably comfortably functioning involved using the right pillow.

What is the “right” pillow? 

Our pillow should give us consistent, resistive support during sleep. A down pillow will not provide this because, no matter how carefully you shape & place it when you first lie down on it, it will deform during the night.

Likewise, a memory foam pillow, which indents when you lie on it, does not give consistent support---its softness is appealing, but it is not serving the health of your cervical spine.

The “right” pillow supports the normal curve of your neck, whether you lie on your back or your sides to sleep. It allows your head & cervical spine to remain in alignment with the rest of your spine, not bent up or down.

The pillow that I sleep on, and that I recommend for my patients, provides this, and patients can get this pillow in my office.

Trigger Points

  A persistent, recurring painful spot in a muscle that does not respond to adjacent osseous (bone / joint) adjustments may be a trigger point.

Often the patient reports “the pain came back the next day,” or “it still hurts” after a Chiropractic treatment, and they may have trouble locating the exact site of their pain. Palpating muscles in the general area will often cause the patient to jump or flinch when the painful locus is pressed.

A distinguishing characteristic of trigger points is that they “refer,” or send out, pain in predictable patterns distant from their origin in a muscle. They often develop after muscle strain, repetitive motion, poor posture, or when a patient is chronically stressed or anxious. 

Also referred to as “myofascial pain,” trigger points were famously discovered and treated by Janet Travell, M.D., who authored two extensive textbooks on trigger points in the muscles of the body, mapping trigger point patterns of referred pain.

Dr. Travell also served as White House Physician for Presidents John F. Kennedy and Lyndon B. Johnson.

Dr. Travell relieved trigger points with application of cryotherapy and injections. I treat them with the Activator instrument, and have the patient apply ice at home. 

Headache Solutions

  Headaches can have many causes, including problems in the upper cervical spine and / or the cranial rhythms. Adjacent misalignments at the C1 and C2 vertebrae are often involved, as are concomitant aberrances in the cranial rhythms.

As an Advanced Proficiency Rated ACTIVATOR Chiropractor, I address these problems gently and precisely. My patients receive whole-body balancing, including cranial balancing, at each appointment..

       Related tension in the suboccipital muscles often leads to, complicates, or perpetuates  headaches, and this should be addressed as a critical part of the solution. 

       To relieve the tension I “re-set” the muscle tone with the ACTIVATOR instrument, prescribe stretches, and give ergonomic counseling to keep this tension from becoming re-established.

Farmers Markets Are Open

  Our local Farmers’ Markets, offering the freshest possible, nutrient-rich produce, are open during COVID-19. 

Deemed “essential,” there are markets open on Sunday in Live Oak, Saturday in Westside Santa Cruz and at Cabrillo, Wednesday downtown Santa Cruz, and Tuesday in Felton.

Farmstands, such as Everett Family Farm on Old San Jose Road and Natural Bridges Farm at the Homeless Garden in westside Santa Cruz, are also open. All offer organic vegetables, and some fruits, in season.

Produce at these local Farmers’ Markets is fresh-out-of-the-ground, and as loaded with nutrient power as you can get. As well as a key way to support our general health and immune systems, buying our produce at Farmers’ Markets provides needed support to our local farmers.

       Check websites for current hours.

What Causes Scoliosis?

 Abnormal lateral spinal curves, called scoliosis, develop for reasons that are largely unknown. Although there are various theories, about 80% of scoliosis is considered idiopathic---of unknown cause. 

Statistically, about 4 adolescent girls in 1000 may develop it, and about 1 in 2500 boys. Roughly 2% of the adult population has some degree of it.

Schools offer scoliosis screening for good reason; the earlier it is detected and addressed, the better chance that conservative care can be effective. 

My treatment plan, the earlier began the better, includes precise Chiropractic balancing of the entire frame, accompanied by specific exercises. 

Special attention must be given to the pelvis, which is the biomechanical foundation for the spine. An unlevel pelvis must be corrected and monitored, because it results in an unstable foundation for the spine.

Medicare 2020

  Every year in October, Medicare allowances and deductibles are updated by the Centers for Medicare and Medicaid Services (CMS https://www.cms.gov).

Amounts that will be reimbursed for visits to your Chiropractor changed in October, 2019 for the ensuing year, effective until October, 2020. There was a slight increase in what Medicare pays for Chiropractic care.

The annual deductible increased from $185 to $193.

For now, Medicare only covers adjusting the spine. If you are having a problem with your shoulder, knee, arm, wrist, foot or ankle, for example, Medicare will not pay.

However, Chiropractic professionals are actively lobbying and educating Medicare about the benefits and efficacy of Chiropractic treatment of the whole body. We hope that in the near future Medicare will provide comprehensive coverage of Chiropractic care for our patients. 

Muscle "Splinting"

  Your body will respond to an instability or an injury by tightening muscles to protect you. This is an involuntary, autonomic response that I see every day in my practice; I call it muscle “splinting.”

The effect is similar to when the doctor puts a splint on an injured limb to protect it. The splint stabilizes and protects the area from further disturbance and pain.

A common site of muscle “splinting” is in the low back, alongside the vertebrae in the lumbar spine. Autonomic tightening of these muscles accompanies misalignments of the lumbar vertebrae, as well as soft tissue injuries or stresses such as accompany a strain-sprain.

When vertebral misalignments, whether from overuse, one-time biomechanical stress, or an injury, are corrected by precise adjustments with the Activator instrument, the muscles are then able to start to relax. 

A Painful "Crunch"

  A "crunching” in your knee when you crouch or squat may signal that you have the start of a degenerative condition called chondromalacia patella, a form of arthritis. 

This is a condition of abnormal wear-and-tear, and Is commonly caused by aberrant tracking of the patella, or kneecap. The kneecap is embedded in the tendon of the quadraceps (quads) muscles, and every time you bend your knee back or forth, which activates these muscles, the kneecap slides in a grove in the bone underneath.

Misalignment of the patella causes it to rub too far sideways in that groove. What causes this misalignment? Commonly, it is uneven action in the quads.

My treatment is two-fold---correction of the patellar misalignment with the Activator instrument, and teaching the patient how to do daily exercises to correct the action of their quads.

Whiplash Side Effects

 An acceleration / deceleration neck injury, aka whiplash, is not only painful, but can also result in weakness in the neck, loss of normal cervical curvature, hypertonic muscles, and impingement of nerves that exit the spine in the cervical region. 

This nerve impingement may manifest as Thoracic Outlet Syndrome (TOS), with symptoms including pain traveling down the arm, alteration of sensation in the arm and / or hand such as numbness, tingling, and lack of normal perception of touch---hypoesthesia (diminished sensation) or hyperesthesia (accentuated sensation) in the upper extremity.

Symptoms may not be immediately noticeable, but may appear slowly following the injury, and often take a while to resolve.

Proper treatment, including precise, gentle adjustments with the Activator instrument as soon as possible after the injury; rest; a neck brace if needed; ergonomic counseling; anti-inflammatory soft tissue therapy, including ice & topical arnica; and appropriate introduction of gentle stretches + exercises will assist healing and recovery.

A Painful Snap! at the Elbow

  Disturbance of the upper part (head) of the radius, the outermost bone in the forearm, where it attaches at the elbow, can cause a sudden sharp pain with movement of the forearm or hand.

The upper end of the radius is encased by, and rotates within, an annular ligament, which encircles it and holds it snug against the joint complex at the elbow. 

Misalignment of the head of the radius causes painful stress at this joint, and can cause abnormal wear & tear on the annular ligament.

Careful assessment and precise adjustments with the Activator instrument will re-align the bone, relieve the abnormal stress and ease the pain. A compression band should be worn just below the ligamentous attachment to protect the area as it heals. 

Tips to Stay Healthy / COVID-19

Include ORGANIC, UNREFINED COCONUT OIL in your diet---coconut oil is loaded with lauric acid, which is effective against viruses, as well as being anti-bacterial. Use it when sauteing vegetables, put it in your coffee or tea, use it in soups or stews.

QUERCETIN is a plant pigment that is an antioxidant, & it has anti-viral properties. The best way to get it is to eat foods high in quercetin. Foods high in quercetin include:

Red Onions—BEST source

Organic apples, grapes, and tomatoes

Dark berries like cherries, blueberries, and blackberries

Taragon, chives, coriander, and dill

Spinach and kale 

 AVOID SUGAR in all forms. Sugar suppresses our immune system.

---The amount of sugar in one soft drink suppresses immune function for up to 12 hours.

---There is a 50% decrease in the effectiveness of your white blood cells to fight infection for up to 4 hours after eating just 2 teaspoons of sugar.

---Read labels; divide the number of grams of sugar by 4 to tell how many teaspoons of sugar a product contains.

VITAMIN D is a key nutrient for supporting immune function. Your body makes Vit D  when you’re exposed to natural sunlight, so try to spend some time outdoors. You can supplement with Vit D---4,000 or 5,000 iu (international units) is recommended per day. Have your Vit D status checked if possible, and in the meantime get it in foods rich in Vit D, such as fatty fish (tuna, salmon, herring, sardines, mackerel), egg yolks, and mushrooms.

Rib Cage Distortion

  Distortion, or twisting, of the entire rib cage is something I see quite often in my practice. The subaxillary (under the arm) ribs on one side become stressed inferiorly, while the opposite subaxillary ribs are stressed superiorward.

Patients who present with this distortion, or torquing, of their rib cage range from youngsters who are active in sports, those who do active work with their upper bodies such as housecleaners, carpenters, plumbers, food service workers, etc., to those who may have reached too far or fast for something, twisted to grab something in the back seat of their car, or may have been securing a small child in a carseat. 

Regardless of the biomechanical cause, I correct the distortion quickly, gently, and comfortably with the Activator instrument.

Toe Cramps

  Ever had one or more of your toes start to cramp while walking or hiking?

This is often caused by overly enthusiastic “toe-off” during the gait cycle. “Pushing off” a bit too hard as one moves from one foot forward to the other when walking can stress a toe or toes, and start a cramp.

Try easing back on the force with which you use your toes to propel you as you walk. If you do get a cramp, take off your shoe, give your foot a rest, and massage the involved toe(s).

If the problem persists, I’ll be happy to check and adjust your feet, including your toes. Precisely and gently correcting misalignments may be necessary for the issue to completely resolve.

 

Nerve Impingement in the Neck

  Our shoulders, arms, and hands have sensory nerves that originate in the neck. These nerves exit the spine and pass through openings, called foramen, between the vertebrae on each side, then travel down through the shoulder and upper extremity all the way to the hand.

Numbness, tingling, pain, altered sensation (hypoesthesia, which is a decrease of normal sensation, or hyperesthesia, abnormally heightened or pronounced, sensations) are signs that the nerves originating in the neck are experiencing interference, or impingement.

Impingement of nerves may to due to physical encroachment such as  pressure, abrasion, or stretching, and can be caused by abnormal misalignments of cervical vertebrae or by degenerative changes in spinal structures.

When patients present in my office with these problems, an appropriate course of conservative Activator Chiropractic care, including gentle, precise, directional adjustments with the Activator instrument, ergonomic and postural counseling, prescribed stretches and exercises, and sometimes application of gentle traction, is often the solution.

Post-Traumatic Headache

 Headache following some kind if trauma, such as whiplash or a blow to the head, has a special classification as post-traumatic. 

Diagnostic codes are unique for this type of headache, and distinguish it from other headaches, such as migraines, tension headaches, sinus headaches, etc.

A post-traumatic headache may require a more extensive course of treatment. Your doctor’s use of the pertinent diagnostic codes alerts insurance companies and auxiliary caregivers, and are important to justify additional care that may be needed by the patient.

What is An Activator Chiropractor?

   Distinctions between Chiropractors who use an Activator instrument and Chiropractors who are trained and Certified in Activator Method protocols are often not clearly understood.

Any Chiropractor can purchase an Activator instrument----so if you were to call 50 Chiropractic offices today and ask if the doctor uses Activator, they would tell you, “Yes.”

This does not mean, however, that the doctor is trained in Activator Chiropractic Technique, a research-backed, carefully developed and tested, specifically designed protocol for restoring normal balance to the entire body.

Qualified Activator Chiropractors are highly trained, required to complete courses of study in the protocol, and must pass written and practical exams in order to obtain Certification. They must complete an annual Continuing Education course in Activator Chiropractic Method to maintain their Certification. 

All Certified Activator doctors are listed on the website www.activator.com.  A doctor not listed here either does not have proper Activator training to become Certified, or has discontinued keeping up with their training and allowed their Certification to lapse.

What is Pelvic Complexity, & Why Should You Care?

  Patients with pelvic disequilibrium often exhibit nuances in the various articulations of their pelvic girdle. The pelvis is a multi-jointed, weight-bearing, essential foundation for the spine, and is integrally related to the status of the body above and below. 

Imbalances in the pelvis not only cause pain, but frequently result in one of the patient’s legs being shorter than the other. When this happens, it is a functional short leg, not an actual short leg. Correcting the imbalances brings the legs back to even.

Trouble-making pelvic imbalances are often quite complex, consisting not just of inferior /superior components, but also having internal or external rotational, or medial / lateral components to the aberrant pelvic pattern.

As an Advanced Proficiency Rated Activator Chiropractor, I am trained to precisely assess and correct the complex components of pelvic aberrance, reintroduce balance, relieve discomfort, even the legs, and restore normal functioning.    

Medicare and Chiropractic

  Medicare covers chiropractic, but only treatment to one or more regions of the spine. So, if you have a knee problem, for example, you must pay your chiropractor "out of pocket" for helping you with your knee.

The Chiropractic profession is diligently and consistently working to have Medicare cover Chiropractic care for the entire human frame, all the bones and joints. We hope this will happen soon.

Activator Chiropractic care is excellent support for seniors’ health, wellness, vitality, and function. Low-force and gentle, precise and specific, Activator Chiropractic is comfortable and effective.

As an Advanced Proficiency Rated Activator Chiropractor, I welcome Medicare patients in my practice, and am happy to be of service to seniors. 

Status of the Feet Affects the Whole Body

  What’s happening at our feet is integrally related to the state of our entire frame---our skeleton, our bones, our joints---to its overall equilibrium or disequilibrium.

For example, people who have fallen arches or who pronate need to support their feet with orthotics, not just for comfort, but also because these conditions in the feet reverberate up into the knees, hips, and pelvis and cause problems. 

Some may need prescription orthotics, but many people will find over-the-counter orthotics can do the job.

When the inside of your foot drops inward toward the floor when you’re standing, it’s called “pronation,” and is often seen in combination with fallen arches, or “flat feet.” This often creates abnormal stress on the Achilles tendon, causing a visible and abnormal inward curving. You can see this by standing behind someone who pronates and looking at the backs of their ankles. 

Pronation can cause foot pain and fatigue, but it also negatively affects the knees, and can reverberate upward to cause abnormal stresses in the hips and pelvis.

These abnormal stresses cause wear and tear that can lead to instability, pain, impairment of function, and eventually to osteoarthritis.

     Abnormalities at the feet should be properly addressed. My treatment plan includes precise assessment of feet, ankles, knees, hips, and pelvic joints and gentle, precise corrections with the  Activator instrument,.

Five "Secrets" About Fender Benders

1.  Despite insurance companies’ using it as the main criterion, the visual damage to your car is not necessarily an indicator of the consequences of the collision on your body.

2.  Feeling confused, "fuzzy," disoriented, and irritable often follows even a minor collision.

3. Symptoms may have delayed onset; you may "feel fine" for the first few days, or even longer. Be cautious about signing off on an insurance claim too soon; give yourself time for any consequences to your body to show up.

4. The sooner you receive proper care, the sooner you will recover. I encourage patients to come in as soon as possible after (an even minor) collision, to get their entire body checked & balanced, to better their chances for a speedy recovery.

5.  If you don't have Medpay on your auto policy, get it. If you have it, and you're in an accident, your own insurance will cover your care, so you or your doctor won't have to wait for the other party's insurance to pay. It's insurance that's reasonably priced and really worthwhile.

A Fall That Affects the Shoulder

  Instinctively in a fall, we reach out to brace our body’s impact with our arm(s) and hand(s). Among the upper extremity consequences of this instinctive reaction are injuries to the shoulder(s), which can be serious and painful.

Depending on the angle and direction of impact, forces driven up the arm may cause the head of the humerus, the bone in our upper arm, to misalign from its normal position at the glenoid fossa, a shallow “cup-like” socket which is part of the scapula.

This painful misalignment is commonly posterior, or backwards, occurring in falls forward such as tripping or stumbling, but can be anterior / superior, as when one’s foot slips forward and the body falls backward, with arm(s) instinctively extended backward to break the fall.

Carelul assessment of the shoulder after a fall and gentle, precise corrections of misalignments are essential to relieve pain, support healing, maintain normal range of motion, and prevent future degenerative changes that lead to arthritis.