Persistent Tendonitis

When bicipital tendonitis, which is inflammation of the tendon that attaches the biceps muscle in the upper arm to the shoulder, is not resolving with a full-component treatment plan, as an Advanced Proficiency Rated ACTIVATOR Chiropractor, I look for what may be keeping the patient’s healing from progressing.

Culprit #1 is biomechanical. Specifically, the humerus, the bone in the upper arm, can be rotated, causing stress on the bicipital tendon as it “rides” in a grove on the front of the humerus. The rotation can be medial or lateral. Both cause stress on the inflammed tendon. The solution is a precise, directional adjustment with the ACTIVATOR instrument to correct the rotation. The adjustment may need repeating over the course of several office visits.

The #2, and critically important, culprit is the patient’s nutrition. If (s)he is eating foods that cause inflammation, such a sugar, damaged fats, etc., this will significantly slow or even block healing.

Medicare and Maintenance Care

Medicare guidelines state that it will only pay for chiropractic treatment that is Medically Reasonable or Necessary (defined as treatment that yields a significant improvement in clinical findings and patient functionality). 

To you, and in the clinical judgement of your chiropractor, your treatment may be CLINICALLY APPROPRIATE:  it may enhance your life, relieve your symptoms, support your health and well-being, or prevent the deterioration of a chronic condition. 

But treatment that is CLINICALLY APPROPRIATE may not fit Medicare’s definition of MEDICALLY NECESSARY. 

Your chiropractor, by law. must inform Medicare when your care becomes maintenance care, thus clarifying to Medicare that this care is not reimbursable, and you will be responsible for payment.

Muscle Cramps

Those painful muscle cramps that awaken you at night will often be alleviated by magnesium (Mg). 

If you aren’t getting an absorbable form of magnesium----Mg citrate or Mg glycinate are good--- in your supplement regimen, and there are no contraindications, consider trying it.

The target dose is 400 mg / day, and it’s best to start with 100 mg / day, gradually increasing to  the target level. Slowly building to the target dose will help avoid diarrhea. 

Tale of a Wayward Sacrum

  Persistent pain in the low back may be due to a tilted sacrum. When this happens, it puts stress on the ligaments of the sacroiliac joints, which are broad, weight-bearing joints in the pelvis on either side of the triangular-shaped sacrum. 

The resulting stress on these ligaments causes pain.

When attending to this problem, careful balancing of the pelvic region is critical, and the sacrum must not be overlooked.

Precise, directional adjustments with the Activator instrument solve the problem and relieve the pain.

An Untrustworthy Knee

Patients often come in describing their knee as “feeling like it’s going to give way,” or “fees like I might fall.” 

This is often noticed most when going down stairs or steps.

The problem is likely a posterior proximal tibia----a backward misalignment of the large bone in the lower leg at its articulation at the knee. When this occurs, it causes a pulling on the achilles tendon in the back of the ankle, stressing the heel bone upward.

The adjustment is made to the proximal tibia, and also to the calcaneus, or heel bone. Both must be addressed to alleviate the problem.

Farmer's Footprint

Exposing the human & environmental impacts of chemical farming is the mission of “Farmer’s Footprint,” an organization encouraging and educating about better, healthier ways of food production.

                https://farmersfootprint.us

The guiding premise is that“a century of monocrop farming and reliance on pesticides has damaged our nation’s once-fertile soils and the health of every American. The rapid increase in pesticide use over the past few decades has coincided with this explosion of chronic disease.”

Awareness is growing that glyphosate, the active ingredient in the herbicide Roundup, is implicated in many chronic diseases.

Watch a 20-min. film about one farming family who are abandoning chemical farming, nurturing their soil back to health, and working in concert with Nature:

https://farmersfootprint.us/watch/  

Iliotibial Band Syndrome

Pain in the outer side of the knee or hip can be caused by friction against the knee / leg / hip by a thick band of connective tissue alongside the thigh called the Iliotibial Band (ITB).

This is common in runners, weight lifters, and activities at the gym, etc., that involve repetitive bending of the knee with resistance. The ITB becomes excessively tight with repetitive use, which exacerbates the friction.

I address this by adjusting the hip, the knee, and releasing tension in the ITB with the Activator instrument. It is important for the patient to stretch before and after workouts, if running to stay on level surfaces, and to wear supportive shoes.

A distorted pelvis can contribute to this condition, so it is important for the patient to check in with me periodically for pelvic balancing.

Groin Pain

Patients presenting with pain in their groin have a particular kind of pelvic distortion involving the joint in the front of the pelvic girdle, called the pubic symphysis.

It is a movable joint which has a disc, like the discs in our spine. 

In most people, this joint is stable unless complex, usually severe, pelvic distortion occurs, or  if a mother who has carried a baby and given birth. In these instances, the pubic symphysis often becomes misaligned, and 99% of the time, a consequence is groin pain. 

As an Advanced Proficiency Activator Chiropractor, my job is to determine the nature of this misalignment, and correct it gently & precisely with the Activator instrument. The adjustment brings immediate relief. 

Protection From Blue Light

The blue light from computer screens, TVs, & cell phones causes eye fatigue, and is often a source of headaches and sleep disturbances.

The best solution I have found for this is BPA-free plastic glasses from Northland Outpost whose orange lenses block 95% of blue light. These are comfortable worn alone, and they also fit easily over my corrective lenses for watching TV.

These glasses, available on Amazon,

https://www.amazon.com/Blue-Light-Blocking-Glasses-Insomnia/dp/B076GTTQLJ/ref=sr_1_5?dchild=1&keywords=northland+outpost+blue+light+blocking+glasses&qid=1612016903&sr=8-5

are very lightweight and reasonably priced. Since I’ve been using them my eye fatigue, especially from computer use, is significantly reduced.

Ouch! At The Elbow

You’re chopping vegetables, making a salad, brushing your hair, stacking kindling for the fireplace, hammering a nail---any of a multitude of actions that involve bending your hand backwards at your wrist---and you notice pain at your elbow.

What’s going on?

The muscles that bend your band backward at your wrist connect to the bone in your elbow. The tendon that attaches these muscles, called the “wrist extensors,” at the elbow can become irritated & inflammed, often due to overuse.

The result is that every time you activate your wrist extensor muscles when using your hand, there is a pull on the inflammed tendon at your elbow, and it hurts. 

What’s the solution? 

This situation can be very persistent of not treated. My protocol includes precise, gentle adjustments of the forearm and wrist with the Activator instrument, protection of the irritated tendon by use of a compressing band, anti-inflammatories including ice and topical arnica, and soft tissue therapy to the involved muscles.

New Medicare Deductible

We have cycled into a new “year” with Medicare, and there is a new annual deductible that must be met before reimbursement will kick in.

The 2020 deductible, $198, has increased to $203 for 2021. 

Compared to typical private health insurance deductibles, Medicare continues to be fair and reasonable, in my opinion, and Medicare continues to cover Chiropractic care for the spine. 

Regenerative Agriculture

 

“Just transitioning 10 percent of agricultural production to best practice regenerative systems will sequester enough CO₂ to reverse climate change 

and restore the global climate.” 

 Reversing Climate Change through Regenerative Agriculture - Regeneration International

Regenerative Agriculture uses farming and grazing methods that rebuild the soil’s organic matter, restore soil biodiversity (organisms and microorganisms), sequester more carbon in soil, and increase the amount of water the soil can hold.

It’s done by:

---disturbing the soil as little as possible; aka “no-till” farming. No plowing, which disturbs healthy soil fungi & microorganisms & increases erosion,

---cover crops, composting, & crop rotations to feed nutrients into soil,

---managed grazing to stimulate plant growth & increase soil fertility. 

Learn more here:   www.regenerationinternational.org/why-regenerative-agriculture/

Neurovascular Compromise

 A common example of neuromuscular compromise is Thoracic Outlet Syndrome (TOS), when the nerves and / or blood vessels (brachial plexus) coming from the neck and going down the arm are subjected to pressure or abrasion (impingement) that compromises their normal function. 

Symptoms include numbness & tingling, reduced or altered sensation, or pain in the arm or hand.

Causes can be impingement between the scalenes (vertical muscles on the sides of the neck), between the clavicle & 1st rib, or a posterior distal clavicle (result of a direct frontal blow). Sometimes this is a sequela of whiplash injury; or chronic stress & tension affecting the neck, including postural stress; or from repetitive motion / overuse syndrome.  

I have precise, gentle adjustments to relieve the impingement, and give the patient stretches, exercises, and ergonomic counseling.

5 Secrets of the Right Pillow

IT PROVIDES CONSISTENT, RESISTIVE SUPPORT

to maintain the normal curve of the neck,

IT KEEPS THE HEAD IN LINE WITH THE SPINE

not bent up, or bent down,

IT DOES NOT SQUASH FLAT OR DEFORM

with movement during the night,

IT IS ORTHOPEDICALLY DESIGNED

to normalize posture during sleep,

IT WORKS FOR BOTH SIDE OR BACK SLEEPING

so you can change position.

Rotator Cuff

  Sometimes mistakenly thought to mean bones in the shoulder, the Rotator Cuff actually consists of 4 muscles which help maintain shoulder mobility, stability, & function.

These muscles are called the “S.I.T.S.” muscles, an acronym for the 4 components---the Supraspinatous, Infraspinatous, Teres minor, and Subscapularis muscles.

Of these 4, the Supraspinatous is most commonly injured. It attaches across the top of the scapula to the top of the humerus, the upper bone of the arm. “Swimmer’s shoulder” is an injury to the Supraspinatous tendon, caused by repetitive forceful adduction of the arm against the resistance of the water.   

How To Get A Headache

Some very common postures can give you a headache!

        Here's what to watch out for:

Leaning your head back to look upward toward a TV or computer monitor, or tilting the head backward to see a monitor through the near-focus part of bifocals, are common postural producers of headache. 

These postures causes the occiput (the bone across the back of the head)  to be stressed inferiorly. This inferiority may be more on one side or the other (unilateral) or global (bilateral). 

When patients present with this in my office, it may be in combination with a superiority of the posterior part of the second cervical vertebra, an additional complication which makes the headache even worse.

I make gentle, focused, precise adjustments that correct the problems without discomfort to the patient, and I provide ergonomic counseling to help keep this from happening again.  

A Piriformis Predicament

When there is pain, or numbness / tingling going down the leg, a patient’s first thought is often, “Uh-Oh. It must be a disc.”

Impingement of nerve(s) by a bulging disc can be the cause of these symptoms, but in the absence of any history of injury, such as a lifting strain or a fall or accident, or of disc problems, it is not necessarily the first thing suspected.

A common cause of such symptoms is impingement of the sciatic nerve underneath the piriformis muscle in the buttock. The piriformis may be in spasm, or the patient may have been sitting for prolonged times, or on hard surfaces, causing pressure on the sciatic nerve.

I release a piriformis spasm with the Activator instrument, and give the patient home care instructions and stretches to alleviate the problem.  

When The Kneecap Goes Awry

The kneecap (patella), which is embedded in the tendon of the quadraceps (quads) muscle(s) on the front of the thigh, “tracks” in a groove on the front of the femur, or thigh bone. The quadraceps tendon attaches below the knee to the tibia.

As the knee bends back & forth, the kneecap, which effects a mechanical advantage of 30% increase in the power production of our quads, slides in the bony groove.

If the kneecap becomes misaligned, as it slides there is abnormal wear & tear against the groove, and this can be the beginning of arthritis in the knee. There may be an audible “crunch” in the knee with squats. 

As an Activator Chiropractor, I have an effective adjustment for this condition, and I give the patient exercises that will help the kneecap stay in alignment. 

5 Key Facts About the Shoulder

(1)  It is the most complex and most mobile part of the body.

(2)  It consists of 4 articulations---the glenohumeral joint (top of the arm connects at the shoulder), the sternoclavicular joint (the collarbone connects near the throat), the acromioclavicular joint (outer end of the collarbone connects with a bony projection off the shoulderblade, and the scapulothoracic articulation (the scapula, or shoulderblade, contacts the rear chest wall).          

(3)  Pain in the shoulder may not be a shoulder problem, but be referred pain from 3 common sites---the heart, the lungs, and the neck. 

(4)  Shoulder dislocation involving the humerus (bone in the upper arm) is common because of the shallowness of the “cup” holding the humeral head. 

 (5)   Bursitis is common in the shoulder, caused by inflammation due to repetitive motions (e.g. painting, drywalling, throwing sports).

Services Medicare Doesn't Cover

       As it currently stands for chiropractic services, Medicare only covers adjusting the spine.

No coverage is provided for extraspinal treatment, e.g., for knee, shoulder, wrist, ankle, etc., problems. This is expected to change; chiropractors anticipate Medicare will eventually cover extraspinal problems.

Other essential services provided by chiropractors, also not currently covered by Medicare, are exercises; supports; home care, nutritional, or ergonomic counseling; stretches; and supplements.

Your chiropractor may prescribe / provide these services for you because they are essential to resolving your problem(s), but Medicare will not reimburse; you are responsible for payment.

Sacral Vertebrae

  An occasional variant in the anatomy of the lower spine is the failure to fuze of the 1st sacral vertebra with its neighbor below.

This results in an additional vertebra inferior to L5, where normally the sacrum is one bone consisting of several fuzed, no longer separate, vertebrae.

In some patients with this anatomical variant, it presents no problems, whereas in others the anomaly creates a vulnerability to low back stresses. 

These patients may need more frequent intermittent spinal balancing to maintain comfort and normal function. 

Is It the Meniscus??

  Pain in the knee may be due to any one or more of various possible misalignments or articular aberrances. 

The knee is a hinge joint, and as such it is not meant to move in other than an approximate sagittal plane.

However, slight rotation of the tibia at the joint with the femur, posteriority or anteriority of the proximal tibia, misalignment of the fibula, medial or lateral tibial-femoral joint compression, etc., can occur. These aberrances, even to the slight extent of millimeter(s), can cause discomfort or affect the knee’s range of motion.

If pain persists after all the “usual suspects” of misalignments / aberrances are screened & corrected, an Activator chiropractor looks to the medial and / or lateral meniscus. Often a carefully-vectored Activator adjustment on the inside or outside of the knee solves the problem and stops the pain.

Unilateral Head Pain

  Pain on just one side of the head, in the jaw region or near the ear or cheekbone, can be a simple headache, a TMJ problem, or a dental issue.

However, for these patients it is important to include a condition called vasculitis in the list of possible diagnoses.

Vasculitis is an inflammation of blood vessels. When this occurs in the side, or temporal, region of the head, it is called “temporal arteritis,”  an inflammation in the temporal artery. There may be swelling as well as pain, and the area may be tender to the touch. Often there is a fever.

This is a serious condition, and can have serious consequences. It can spread to the blood vessels of the eyes and possibly cause blindness. If suspected, the patient should immediately be referred to an M.D.

Medicare--Allowed # of Visits

  Medicare typically allows 12 chiropractic treatments (visits) per year.

However, certain things that often go along with aging are considered by Medicare to justify an extended, or longer term, of chiropractic care.

These conditions, called “co-morbidities,” may complicate, or impede healing, making the number of treatments necessary to resolve a chiropractic problem greater.

A common co-morbidity is spinal disc degeneration, usually associated with spondylosis, or bony spur formation around vertebral edges. Another term for this is DJD, or degenerative joint disease. 

Sciatica, spinal stenosis (narrowing of the spinal canal), and foraminal encroachment (narrowing of the opening(s) where the nerves exit the spine) are also co-morbidities, as are health conditions which may complicate or impede healing such as diabetes and osteoporosis.

Unrelenting Rib Pain

  Pain that starts in the front of the chest or in the back, near the spine, and develops along the path of a rib, and that is unresponsive to chiropractic treatment, may be an outbreak of shingles.

The patient will describe no injury or trauma, no upper respiratory infection or cough, which might be affecting the region. Yet the pain persistently worsens.

A shingles viral outbreak follows the path of the related sensory nerve, called a “dermatome.” Dermatomes wrapping around in the thoracic region resemble the paths of our ribs, so initial symptoms of shingles are often misinterpreted as rib pain.

Anyone who has had chicken pox carries the herpes zoster virus in the nerve ganglia alongside their spine. The virus is dormant until conditions such as hyperthermia or stress trigger an outbreak.

Low Back Compression

  Patients who present with central low back pain, especially if the lumbar curve is accentuated, often exhibit compression between the sacrum and the 5th, or lowest, lumbar vertebra.

The patient will often say they “just can’t get comfortable,” even in bed. Sometimes pulling the knees to the chest is relieving, but standing, as well as sitting, cause worsening of the pain.

I relieve the compression by appropriately-vectored adjustments with the Activator instrument, and give the patient stretches & exercises. 

Ergonomic counseling for correct sitting & standing postures is helpful to prevent recurrence of the compression.

OUCH!!--I've Got Gout!

  You wake up with severe, burning pain in the joint at the base of your big toe, and it’s swollen and red.

Chances are, you may have gout!

This is a type of arthritis that is of metabolic origin---too much uric acid in the blood causes sharp crystals to collect in a joint, usually the big toe, and more commonly in men than in women.

This happens because you consume too many foods high in purines, organic water-soluble compounds that oxidize to form uric acid. 

Meats are high in purines; so is beer, seafood such as scallops & sardines, beans such as garbanzos or lentils, vegetables such as asparagus or mushrooms, & wheat bran & wheat germ. Inflammatory foods such as sugar and wheat (all wheat in the U.S. is highly hybridized, thus containing foreign polypeptides that are highly inflammatory) are also culprits.

Your chances of getting gout are higher if you are overweight, drink too much alcohol, eat too many foods containing purines, or drink beverages sweetened with fructose (fruit sugar) or foods with high-fructose corn syrup (soft drinks, ice cream, sports drinks, breakfast cereals).

Gout is successfully treated by changing what you eat and drink. It is important to drink lots of pure (devoid of chlorine or other chemicals) water to help your body flush out waste products and toxins. 

Plantar Fasciitis

   Pain in the bottom of the foot, usually in the arch further back toward the heel, may be plantar fascitis. It is caused by injury or inflammation of the plantar (bottom of the foot) fascia. The plantar fascia is a band of fibrous connective tissue on the sole of the foot.

The pain may come on slowly, related to chronic pronation (a falling inward of the inside of the arch) combined with a “fallen” arch, or be more acute, due to an injury---landing hard on the sole of the foot, quick acceleration / deceleration when walking or running, or repetitive shock of hard heel strike during the gait cycle.

My treatment includes carefully aligning the bones of the foot with the Activator instrument, support of the arch with orthotics, exercises to strengthen the arch, stretches to maintain flexibility, and ice and other applications for inflammation.

The patient must not go barefoot---there must be NO weight-baring without orthotic support.

Could It Be My Pillow??

   No, not the My Pillow advertised an infinitum on TV---I seriously doubt those provide proper and adequate support for the cervical spine.

If you aren’t sleeping on a proper pillow, one that correctly supports the curve of the neck, this may be the reason you have persistent neck and upper back pain.

When the pillow you sleep on allows your head to tilt downward toward the mattress, or pushes your head upward at an angle, it is not serving you. Your neck should be parallel with your mattress when you are lying on your side, and if on your back, your head should not be angled abnormally up or down.

The right pillow gives consistent, resistive support to the spine throughout the night.

It doesn’t compress, as does a pillow filled with down or feathers. 

It doesn’t deform, as a buckwheat pillow will.

It doesn’t squash down where your head and neck press on it, creating a depression that discourages movement during the night, as a memory foam pillow does.

Look for an orthopedically-designed pillow, such as the one I sleep on----I have them available in my office for patients.

Bench Pressing / Ergonomics

   Dropping the elbows too low while bench pressing heavy weight can cause stress injuries to the acromioclavicular joint in the shoulder.

The outer end of the collarbone, near the front and top of the shoulder, articulates with the acromion process, a bone projecting forward from the scapula. The clavicular part meets the acromion part, forming the “acromioclavicular, or AC, joint.

One of several joints making up the shoulder complex, the AC joint is particularly subject to injury because it is essentially two bones butting together, held by ligaments.

Recently a patient who had come from working out at the gym presented with shoulder pain due to over-stressing the AC joint while bench pressing.

Precise adjustments with the Activator instrument, combined with home care & ergonomic counseling, were the solution.

It's a Veggie! It's a Fruit! It's Full of Vit. C!

         Often thought of as a vegetable, red bell peppers are actually classified as a fruit, because they have seeds.

        Red bell peppers are an excellent source of Vit. C---one cup contains 117 mg---and they are low in sugar.

They also contain multiple antioxidant compounds---a single red bell pepper has 30 different antioxidants. They are one of the most nutrient-dense foods one can eat.

https://www.organicconsumers.org/news/veggie-thats-a-fruit-more-vitamin-c-than-an-orange?utm_medium=email&utm_source=engagingnetworks&utm_campaign=OB+673&utm_content=OB+673

Yep, It's All Connected

  “The thigh bone’s connected to the knee bone, the knee bone’s connected to the.....” as the saying goes. 

And it’s true. The technical term is “a kinematic chain.” Meaning the movement of one part affects or is linked to movements of the other parts.

Thus a problem at the hip affects the knee and possibly the foot, a problem at the ankle affects the knee & in turn the hip, a distorted pelvis reverberates down into the lower extremities, etc.

So if you come in with hip pain, I'm going to also check your pelvis, knees, ankles, and feet. If you have knee pain, I will likewise check your lower extremity above and below your knee, as well as your pelvis. 

Unless the whole kinematic chain is addressed and corrected, you're not likely to get lasting relief.

A Common Issue at the Base of the Neck

        Stress at the juncture of the cervical spine with the thoracic region, at the lower neck, may cause compression between the parts of the vertebrae that touch each other and the neighboring soft tissues.

The vertebral parts that touch are called the facets. Here the compression causes a “jamming” of the bone areas together. The adjacent soft tissues become involved, and the result is similar to a clenched fist. 

This causes pain to be referred out into the shoulder, and it can be persistent, usually needing precise intervention to resolve.

Most often the patient presents with complaints of a shoulder problem. However, the real cause of the problem is not in the shoulder at all, but in the neck.

I see this problem often in my office. Specific, precise adjustments with the Activator instrument release the compression and bring patients relief.

Distortion of the Rib Cage

  Often when patients present with pain in the thoracic region, an underlying, global aberrance of the rib cage is involved. 

The patient may say, “I feel twisted,” or “Something feels pulled.”’ They may have been coughing, may have tripped on a curb, fallen, or lifted something while their upper body was turned to one side.

After adjusting misalignments in the thoracic spine, including relieving jammed ribs at their articulations with vertebrae, I always check the status of the rib cage.

Nine times out of ten, I find a torquing of the ribs, in which one side is stressed superiorward, while ribs on the opposite side are stressed downward.

Precise, vectored, subaxillary adjustments with the Activator instrument correct the global rib cage distortion, and put the “finishing touch” on relieving the patient’s discomfort. 

Got Toxic Oils??

If you have grapeseed oil or rice bran oil or canola oil in your kitchen cabinet, you have TOXIC OILS. 

     "Designer oils" such as rice bran and grapeseed oil, commonly promoted as "healthy," are, in fact, extremely toxic. Here's why: these oils are highly processed. Canola oil, which many people assume is healthy because, like olive oil, it is monounsaturated, is also in the HIGHLY PROCESSED category. 

     Processing is necessary to extract the oil from rapeseed (canola), rice bran, and grape seeds, and may include extraction with heat and solvents, as well as chemical bleaching, degumming, and deodorizing. 

     Because the raw oils have monounsaturated and polyunsatured components, when exposed to heat, they readily oxidize. Oxidized oils are toxic and very inflammatory to our bodies.

     Avoid these oils, and use cold pressed, extra virgin olive oil instead.