An Open Letter to our Medical friends.

462

In the past year, many trusted medical establishments including the FDA (1), CDC (2), Joint Commission (3,4), JAMA (5), and The American College of Physicians/ Annals of Internal Medicine (6) have encouraged medical providers to prescribe spinal manipulation as a first line treatment for acute, subacute, and chronic low back pain.

Most recently, The Lancet echoed that endorsement, and provided a unique perspective:

The reduced emphasis on pharmacological care recommends nonpharmacological care as the first treatment option and reserves pharmacological care for patients for whom nonpharmacological care has not worked. These guidelines endorse the use of exercise and a range of other non- pharmacological therapies, including massage, spinal manipulation, and acupuncture.

Gaps between evidence and practice exist, with limited use of recommended first- line treatments and inappropriately high use of imaging, rest, opioids, spinal injections, and surgery. Doing more of the same will not reduce back-related disability or its long-term consequences. The advances with the greatest potential are arguably those that align practice with the evidence. (7)

Unfortunately, personal experience skews our perception of each other’s merit, i.e., we primarily see each other’s failures since the successes don’t need to seek additional care. Regardless of our professional degree, we all have failed cases mixed into our many clinical successes. We must not lose sight of the evidence supporting each other’s overwhelming proven value for a given diagnosis. If we judge each other by our successes rather than our failures, we will work toward an integrated model where the patient wins. Together, we will help more patients than either working alone.

We are honored for the opportunity to co-manage your patients.

 

References
1. FDA Education Blueprint for Health Care Providers Involved in the Management or Support of Patients with Pain. May 2017. Accessed on May 12, 2017
2. Dowell D, Haegerich TM, Chou R. CDC Guideline for Prescribing Opioids for Chronic Pain- United States, 2016. MMWR Recomm Rep 2016;65(No. RR-1):1–49.
3. The Official Newsletter of The Joint Commission. Joint Commission Enhances Pain Assessment and Management Requirements for Accredited Hospitals. July 2017 Volume 37 Number 7. Ahead of print in
2018 Comprehensive Accreditation Manual for Hospitals.
4. Joint Commission Online. Revision to Pain Management Standards. http://www.jointcommission.org/assets/1/23/jconline_november_12_14.pdf
5. Paige NM, Miake-Lye IM, Booth MS, et al. Association of Spinal Manipulative Therapy With Clinical Benefit and Harm for Acute Low Back Pain; Systematic Review and Meta-analysis. JAMA. 2017;317(14):1451-1460.
6. Qaseem A, et al. for the Clinical Guidelines Committee of the American College of Physicians. Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians. Ann Intern Med. 2017;166(7):514-530.
7. Foster, Nadine EBuchbinder, Rachelle et al. Prevention and treatment of low back pain: evidence, challenges, and promising directions. The Lancet, Published Online March 21, 2018 http://dx.doi.org/10.1016/ S0140-6736(18)30489-6

Rotator Cuff Tears

A rotator cuff tear means that one or more tendons of a group of muscles stabilizing the shoulder – called the rotator cuff – is torn either partially or fully.

The rotator cuff consists of four muscles that help stabilize the humerus (upper arm bone), in the shoulder socket during arm movements.

The shoulder has great mobility but is prone to injury during falls or accidents, or in case of altered motor control.

A tear of the rotator cuff can cause but is not limited to, pain at the shoulder and sometimes the scapula, loss of strength and active range of motion, and sometimes localized swelling.

Pain or weakness is often felt when lifting the arm overhead or when lowering it from an elevated position. Pain may also be present at night. In more advanced cases, one may additionally feel pain during the day while at rest.

Relative rest is a good way to protect your shoulder and prevent further damage, but it’s important to avoid overprotecting your injury. A few days rest where you avoid pain-inducing movement and activities might be necessary. Returning to your activities of daily living, light cardiovascular exercise and specific mobility and strengthening exercises will allow better recovery.

Treatment of rotator cuff injuries consists of Acupuncture, Class IV Laser Therapy, management of any biomechanics stresses in the area and exercise rehabilitation to address any weaknesses that can be putting undue stress on the area. 

#LaserTherapy
#ShoulderInjuries
#Winnipeg
#Chiropractic
#Acupuncture
#RotatorCuff

Pubalgia Pain

Pubalgia is pain in the central point of the pubis, the pubic symphysis, which develops mainly after overexertion during sports activities. Repeated microtraumas or excessive strain on the abdominal and hip adductor muscles can cause slight shearing of this joint and generate pain felt in the groin area.

Pubalgia can produce, but is not limited to, pain in the pubic area and towards the groin area, difficulty in tolerating weight bearing and impacts during walking and running.

Relative rest is a good way to protect yourself and prevent your pubalgia from getting worse, but it’s important to avoid overprotecting. A few days of rest by reducing activities that cause pain may be needed. A progressive return to your activities of daily living, light cardiovascular activities that do not cause pain, and strengthening exercises will allow for better recovery.

#Chiropractic #PainRelief #Healthyliving #LaserTherapy #Winnipeg #BackPain #NeckPain #Headache #Fitness #Athlete #Wellness

Contact us for treatment in Winnipeg

Find and Follow us on Twitter and Instagram!

Laser Therapy For Tennis Elbow

Laser therapy, also known as low-level laser therapy (LLLT) or cold laser therapy, is a type of treatment that uses low-level lasers or light-emitting diodes (LEDs) to stimulate healing and reduce inflammation. It is thought to work by increasing blood flow to the treated area, which can help to reduce inflammation and promote healing.

Tennis elbow, also known as lateral epicondylitis, is a condition that causes pain and inflammation in the elbow and forearm. It is often caused by overuse or repetitive strain on the muscles and tendons in the elbow and forearm. Laser therapy may be used to help reduce pain and inflammation in people with tennis elbow, and may also help to improve range of motion and function.

It is important to note that laser therapy is not a standalone treatment for tennis elbow and should be used in combination with other treatments such as physical therapy and rest. It is also important to consult with a healthcare professional before starting any new treatment.

Plantar Fasciitis

Plantar fasciitis is a lesion that generally occurs during significant and repetitive stress on the plantar fascia.

It can occur in people who perform activities or sports that involve jumping, running, or sprinting.

Typically, this injury occurs during a period in which training intensity or volume has been increased too quickly with inadequate recovery. The practice of a new activity, a change of training surface, and a rushed transition to another type of shoes can be risk factors.

Plantar fasciitis can produce, but is not limited to, pain on weight bearing and sometimes edema under the arch of the foot near the heel.

The pain is often characterized as a needle-like sensation. Symptoms are usually present upon waking up, particularly during the first few steps.

Treatment of plantar fasciitis consists of Class IV Laser Therapy, management of any biomechanics stresses in the area and exercise rehabilitation to address any weaknesses that can be putting undue stress on the area. 

#LaserTherapy
#footpain
#Winnipeg
#Chiropractic
#LegInjury

Benefits of Exercise

Regular exercise has many benefits, including:

  1. Improving physical fitness – Exercise can improve your muscle strength, flexibility, and endurance.
  2. Maintaining a healthy weight – Exercise can help you burn calories and maintain a healthy weight.
  3. Reducing the risk of chronic diseases – Exercise can help reduce the risk of developing conditions such as heart disease, diabetes, and certain cancers.
  4. Strengthening the bones and muscles – Regular exercise can help build and maintain strong bones and muscles.
  5. Improving mental health – Exercise has been shown to improve mood, reduce stress, and improve mental health.
  6. Promoting better sleep – Regular exercise can help improve sleep quality and duration.
  7. Enhancing cognitive function – Exercise has been shown to improve cognitive function, including memory and concentration.
  8. Boosting energy levels – Regular exercise can help increase energy levels and reduce fatigue.
  9. Improving quality of life – Exercise can help improve overall quality of life by increasing self-esteem, reducing the risk of falls in older adults, and improving overall physical function.

Weight Lifting For Weight Loss?

Lifting weights is an important aspect of any weight loss program. While it may seem counterintuitive to lift weights when trying to lose weight, it can actually be an effective way to shed pounds and keep them off. Here are some reasons why lifting weights is important for weight loss:

  1. Increases muscle mass: Lifting weights can help to increase muscle mass, which can boost metabolism and help the body burn more calories. This is because muscle is more metabolically active than fat, meaning that it requires more energy to maintain. By increasing muscle mass, you can increase your resting metabolism and burn more calories throughout the day.
  2. Burns calories: Lifting weights can also help to burn calories during the actual workout. While it may not burn as many calories as cardio exercises like running or cycling, it can still be an effective way to burn calories and contribute to weight loss.
  3. Increases strength: Lifting weights can help to increase strength and improve overall physical fitness. This can be especially beneficial for people who are new to exercise or have been inactive for an extended period of time.
  4. Improves body composition: Lifting weights can help to improve body composition by increasing muscle mass and decreasing body fat. This can lead to a leaner, more toned appearance and improved overall health.
  5. Reduces risk of injury: Lifting weights can help to reduce the risk of injury by increasing muscle strength and improving balance and coordination. This can be especially beneficial for people who participate in high-impact activities or sports.
  6. Enhances weight loss: While lifting weights alone may not lead to significant weight loss, it can be an important component of a weight loss program when combined with a healthy diet and regular cardio exercise. By lifting weights and increasing muscle mass, you can boost metabolism and burn more calories, which can help to enhance weight loss.
  7. Increases bone density: Lifting weights can also help to increase bone density, which can reduce the risk of osteoporosis and other bone-related conditions.
  8. Improves mental health: In addition to the physical benefits, lifting weights can also have a positive impact on mental health. It can help to reduce stress and improve mood, which can be beneficial for people who are trying to lose weight.

It is important to use proper technique when lifting weights to avoid injury and get the most out of the exercise. Here are some additional tips to keep in mind:

  1. Use a weight that is appropriate for your fitness level: It is important to start with a weight that is appropriate for your fitness level and gradually increase the weight as you become stronger. Using too much weight can lead to poor technique and increase the risk of injury.
  2. Keep your form consistent: Maintain proper form throughout the exercise to ensure that you are targeting the correct muscles and reducing the risk of injury.
  3. Focus on good posture: Good posture is essential for proper weight lifting technique. Keep your shoulders back and down and avoid rounding your back or leaning too far forward or backward.
  4. Don’t rush the movement: Take your time with the exercise and focus on good technique rather than trying to lift the weight as quickly as possible.
  5. Warm up properly: It is important to warm up properly before lifting weights to help prevent injury. This can include dynamic stretches and a few warm-up sets with lighter weights.

Kneecap Pain

Patellofemoral syndrome is an irritation of the articular surface between the kneecap and the femur, your thigh bone, that causes pain under and around the kneecap.

Climbing stairs, running and walking for a prolonged period of time often increases pain. Pain can also be felt after sitting for a long time or squatting.

Patellofemoral pain is more prevalent among young women than men, and more prevalent in the active population.

Patellofemoral syndrome can cause, but is not limited to, pain at the front of the knee, difficulty with weight-bearing and squatting and sometimes swelling. Pain can also irradiate under and around the knee. Creaking or grinding sensations can occur during physical activity.

Treatment of Patellofemoral Syndrome consists of Class IV Laser Therapy, management of any biomechanics stresses in the area and exercise rehabilitation to address any weaknesses that can be putting undue stress on the area. 

#LaserTherapy
#KneeInjuries
#Winnipeg
#Chiropractic
#SportsInjury
#Athlete

Contact us for treatment in Winnipeg

Find and Follow us on Twitter and Instagram!

Why Add Squats?

Squats are a compound exercise that targets the muscles in the legs, hips, and core. They are an effective exercise for building strength and power, and they can be modified to suit different fitness levels. Here are some of the benefits of adding squats to your workouts:

  1. Improved muscle strength and power: Squats are an excellent exercise for building muscle strength and power in the legs, hips, and core. By performing squats regularly, you can increase your muscle strength and improve your overall athletic performance.
  2. Enhanced mobility and flexibility: Squats can help to improve mobility and flexibility in the hips, legs, and lower back. This can be especially beneficial for people who sit for long periods of time and have limited mobility as a result.
  3. Improved balance and coordination: Squats can also help to improve balance and coordination, which can be beneficial for people who participate in sports or other physical activities.
  4. Increased bone density: Squats can help to increase bone density in the legs, which can reduce the risk of osteoporosis and other bone-related conditions.
  5. Improved overall physical fitness: Squats are a great exercise for improving overall physical fitness. They can help to increase cardiovascular endurance, improve muscle endurance, and enhance overall strength and power.
  6. Enhanced functional movements: Squats are a functional exercise that can help to improve everyday movements, such as lifting and carrying objects.
  7. Versatility: Squats can be modified to suit different fitness levels and goals. They can be performed with body weight, with dumbbells or a barbell, or with other types of equipment, such as a Smith machine or a TRX suspension trainer.

It is important to use proper technique when performing squats to avoid injury and get the most out of the exercise. Here are some additional tips to keep in mind:

  1. Use a weight that is appropriate for your fitness level: It is important to start with a weight that is appropriate for your fitness level and gradually increase the weight as you become stronger. Using too much weight can lead to poor technique and increase the risk of injury.
  2. Keep your form consistent: Maintain proper form throughout the exercise to ensure that you are targeting the correct muscles and reducing the risk of injury.
  3. Focus on good posture: Good posture is essential for proper squat technique. Keep your chest up and your shoulders back and down, and avoid rounding your back or leaning too far forward or backward.
  4. Don’t rush the movement: Take your time with the squat and focus on good technique rather than trying to lift the weight as quickly as possible.
  5. Warm up properly: It is important to warm up properly before performing squats to help prevent injury. This can include dynamic stretches and a few warm-up sets with lighter weights.

By adding squats to your workouts and practicing proper technique, you can enjoy the numerous benefits of this effective exercise. Remember to consult with a trained professional, such as a personal trainer or physical therapist, if you have any concerns about your form or if you are new to the exercise. They can help you develop a safe and effective training program that includes squats and other exercises that are suitable for your fitness level and goals.

Pain on the inside of the knee?

Pes anserine bursitis is the irritation of the bursa on the inside of the tibia, near the knee joint. This bony area constitutes an insertion zone for three muscles: the sartorius, the gracilis and the semitendinosus.

Sports and activities that require these muscles to be repeatedly contracted or stretched while running, hiking, or any other extended activity can cause irritation of the bursa and sometimes inflammation. Pes anserine bursitis may be associated with an injury to the tendons in that area. It can occur as a result of trauma directly to the knee. Muscle imbalance in the hip or knee may also contribute to the onset of symptoms.

Pes anserine bursitis can produce, but is not limited to pain on the inside of the knee, localized edema due to swelling of the bursa and reduced mobility in the knee. Symptoms are usually worse while running, walking on a sloping surface and climbing stairs.

Treatment of hamstring injuries consists of Class IV Laser Therapy, management of any biomechanics stresses in the area and exercise rehabilitation to address any weaknesses that can be putting undue stress on the area. 

#LaserTherapy
#KneeInjuries
#Winnipeg
#Chiropractic
#LegInjury

Contact us for treatment in Winnipeg

Find and Follow us on Twitter and Instagram

Deadlifting

The deadlift is a compound exercise that targets the muscles in the legs, hips, and back. It is an effective exercise for building strength and power, and it can be modified to suit different fitness levels. Here is a step-by-step guide on how to properly perform a deadlift:

  1. Stand with your feet shoulder-width apart and point your toes slightly outward. Position your hands on the barbell just outside of your legs.
  2. Engage your core by contracting your abdominal muscles and pulling your shoulder blades down and back. This will help to stabilize your spine and protect it from injury.
  3. Take a deep breath in and brace your core. As you exhale, push through your heels and lift the bar off the ground. Keep the bar close to your body as you lift, and avoid leaning too far forward or backward.
  4. As you lift the bar, keep your elbows close to your body and focus on squeezing your glutes and driving your hips forward. This will help to engage the muscles in your legs and hips and help you lift the bar more efficiently.
  5. Once the bar is at mid-thigh level, pause for a moment and then push your hips forward to complete the lift. At the top of the lift, your hips and knees should be fully extended, and your shoulders should be back and down.
  6. To lower the bar back down, reverse the movement by hinging at the hips and pushing your butt back. Keep the bar close to your body as you lower it back down to the ground, and avoid rounding your back.
  7. Once the bar is back on the ground, take a moment to reset your posture and take a deep breath in before beginning the next rep.

It is important to use proper technique when performing the deadlift to avoid injury and get the most out of the exercise. Here are some additional tips to keep in mind:

  1. Use a weight that is appropriate for your fitness level: It is important to start with a weight that is appropriate for your fitness level and gradually increase the weight as you become stronger. Using too much weight can lead to poor technique and increase the risk of injury.
  2. Keep your form consistent: Maintain proper form throughout the exercise to ensure that you are targeting the correct muscles and reducing the risk of injury.
  3. Focus on good posture: Good posture is essential for proper deadlift technique. Keep your shoulders back and down and avoid rounding your back to protect your spine and improve the effectiveness of the exercise.
  4. Don’t rush the movement: Take your time with the deadlift and focus on good technique rather than trying to lift the weight as quickly as possible.
  5. Warm up properly: It is important to warm up properly before performing the deadlift to help prevent injury. This can include dynamic stretches and a few warm-up sets with lighter weights.

By following these tips and practicing proper technique, you can properly perform the deadlift and get the most out of this effective exercise. Remember to consult with a trained professional, such as a personal trainer or physical therapist, if you have any concerns about your form or if you are new to the exercise. They can help you develop a safe and effective training program that includes