This is another common muscle to get trigger points. It originates on the spinous processes of the T2-T5 vertebrae. It inserts on the medial border of the scapula. It’s main actions are to adduct the scapula pulling it back toward the spine, and to rotate the glenohumeral joint downward. This muscle also prevents wining of the scapula. This muscle is often overloaded by a sitting posture where the shoulders are rolled forward such as when using a computer. The Rhomboids are often weak and under trained in people. Trigger points in this muscle cause pain and ache in the upper back between the shoulder blade. Strength trading for this muscle is necessary to help prevent postural overload. 
Back Pain
Our Exercise Of The Month: Dead Bug
Begin lying on your back with your right arm reaching overhead and your left leg flat on the table. Your right knee should be bent 90 degrees and your hip 45 degrees. Place your left wrist beneath your back to prevent your back from flattening against the ground. Slowly begin by raising your left knee and right arm at the same time until your hand touches your knee. Be sure not to lift your head or allow your spine to flatten against the floor. Return to the start position and repeat for three sets of 10 repetitions on each side, twice per day or as directed.
When Are My Shoes “Done”?
Running shoes need to be replaced every 250 miles. There are three basic options:
✓ Motion Control Shoes – Designed for people with low or no arches, these shoes are for runners who strike the ground on the outer edge of their foot. Avoid overly stiff shoes as these decrease you perception of ground strike and lead to new injuries.
✓ Stability or Neutral Shoes – Designed for people with normal or average arches and running mechanics. The shoe contains some cushioning to absorb shock and prevent injuries and some rigidity to avoid pronation.
✓ Cushioned Shoes – Designed for people with high arched feet. Their footprint will typically leave a thin band along the foot’s edge. As they run weight is distributed from heel strike to the outer edge of the foot and small toes that bear the brunt of “lift off.” This shoe is more flexible and absorbs the shock created by the lack or rotation (under-pronation) created by their running style.
Workers compensation cases highlight the value of chiropractic care
A newly published analysis of 5511 workers compensation cases highlights the value of chiropractic care: “those injured workers who first saw a chiropractor experienced shorter first episodes of compensation (vs. physical therapy alone)”.
If you or someone you know has suffered a job-related injury, call us today. Our goal is to provide the most effective care that gets you back to work ASAP!
Trigger points in the trapezius muscle.
The trapezius muscle is a large diamond shaped muscle in you mid/upper back and neck. This muscle is one of the most common sites where trigger points can form. This muscle originates on the Nuchal ligament and the spinous processes of C6-T12. It inserts on the spine of the scapula, the acromion process, and the distal clavicle. The upper fibres elevate the shoulder and rotate the glenoid fossa (shoulder socket) upward. The lower fibres assist this motion as well as help depress the shoulder. The middle fibres of this muscle strongly adduct the scapula. This muscle is susceptible to postural overload such as sitting at desk all day. Trigger points on the lateral upper edge refer into the lateral neck and temples, causing “tension neck ache”as well as headache pain.Trigger points in the middle and lower fibres refer pain into the posterior neck and shoulder. 
Our Condition of the Month: ITB Syndrome
Iliotibial Band Syndrome
Your iliotibial band is a fibrous band of tissue running from the crest of your hip, down to your knee. A muscle near the crest of your hip called the tensor fascia lata, attaches to this band to help control movements of your leg. Your iliotibial band passes over the point of your hip and over another bony bump on the outside of your knee called the lateral epicondyle. When the band is too tight, it can become painfully inflamed as it repeatedly rubs over the top of either of these bony projections. Irritation at the bony bump near the knee is called iliotibial band friction syndrome.
The condition usually presents as pain on the outside of your knee that becomes worse with repetitive knee flexion or extension. This condition is the leading cause of lateral knee pain in runners, especially slower “joggers.” The pain usually develops 10-15 minutes into the workout. You may sometimes feel or hear a click during movement. Symptoms generally ease at rest. Running on slick “wintry” surfaces may aggravate the condition. Excessively worn running shoes may be a culprit.
This problem is commonly caused by weakness in your gluteal muscles. When these muscles are weak, the muscle that attaches to your iliotibial band must contract harder to stabilize your hip. Having one leg longer than another is a known aggravating factor.
Runners should minimize downhill running and avoid running on a banked surface like the crown of a road or indoor track, as well as wet or icy surfaces. Runners should reverse directions on a circular track at least each mile. Bicyclists may need to adjust seat height and avoid “toe in” pedal positions. Avoid using stair climbers or performing squats and dead lifts. Sports cream and home ice massage may provide some relief of symptoms.
My back hurts, why look at my feet?
Improperly supported feet can affect the alignment of all of the structures above. To improve your overall comfort:
✓ Choose shoes with good arch support.
✓ Avoid going barefoot or wearing shoes that lack support (i.e. flip-flops). The following brands of sandals provide better than average arch support: Naot, Fit Flops, Orthoheels, Abeo, Vionic and Yellow box.
✓ Avoid high-heeled shoes or boots (keep heels to a maximum of 1½ inches, especially if you are going to be doing a lot of walking).
✓ “Cross-trainer” athletic shoes tend to provide the best all around support and shock absorption for daily activities.
✓ Patients with fallen arches should consider adding arch supports or orthotics.
✓ Repair or replace shoes with worn soles or heels.
Lifting Mechanics Made Simple
Here are some tips to help you lift safely:
✓ Avoid lifting or flexing before you’ve had the chance to warm up your muscles (especially when you first awaken or after sitting or stooping for a period of time).
✓ To lift, stand close directly facing object with your feet shoulder width apart.
✓ Squat down by bending with your knees, not your back. Imagine a fluorescent light tube strapped to your head and hips when bending. Don’t “break” the tube with improper movements. Tuck your chin to help keep your spine aligned.
✓ Slowly lift by thrusting your hips forward while straightening your legs.
✓ Keep the object close to your body, within your powerzone” between your hips and chest. Do not twist your body, if you must turn while carrying an object, reposition your feet, not your torso.
An alternative lifting technique for smaller objects is the golfers lift. Swing one leg directly behind you. Keep your back straight while your body leans forward. Placing one hand on your thigh or a sturdy object may help.
Trigger points in the Levator scapula
The Levator scapula is a muscle in your neck that originates on the transverse processes of C1-C4 and inserts on the superior part of the medial border of the scapula. The primary actions of this muscle are to elevate the scapula and rotate the glenoid fossa downward. It also rotates the neck to the same side and assists in extension. When this muscle is tight it restricts neck rotation resulting in the classic “stiff neck”. With a forward head position the Levator is often stretched and over worked. To help combat this you must get the head back by releasing the anterior chest and neck muscles. Trigger points in this muscle refer pain into the angle of the neck and down the shoulder blade.
Hip Abductor Weakness
* The gluteus medius contributes approximately 70% of the abduction force required to maintain pelvic leveling during single leg stance.
* Hip abductor strength is the single greatest contributor to lower extremity frontal plain alignment during activity.
* There is no “typical” presentation for hip abductor weakness, but the problem must be considered in any patient with lower chain symptomatology, particularly those with hip tendinopathy, greater trochanteric pain syndrome, iliotibial band syndrome, patellofemoral pain syndrome, ACL injury, medial knee pain, and lower back pain.
*Hip abductor weakness is often accompanied by lower crossed syndrome – a larger pattern of biomechanical dysfunction involving weakness of the abdominal wall and hypertonicity in the hip flexors and paraspinal musculature. Evaluation should include a relatively global assessment of lumbopelvic muscle and joint function. Additionally, clinicians should assess for the presence of foot hyperpronation in patients with hip abductor weakness.
