Wellness

What is Fibromyalgia?

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Fibromyalgia, although often misdiagnosed and misunderstood, is the second most common musculoskeletal disorder behind osteoarthritis. The condition affects nearly 12 million Americans and is ten times more common in women.

The diagnosis of fibromyalgia is made when a certain set of symptoms has been present for at least three months. The most common symptoms include wide-spread muscle and joint pain, achiness or soreness- especially in the neck, shoulders, back, and hips. Your muscles may constantly feel overworked and tired. Fibromyalgia patients often exhibit a set of predictable “tender points” spread throughout the body. Some patients have trouble sleeping and feel as though they are in a “brain fog” most of the day. This can lead to fatigue or mood changes, like anxiety and depression.


Stress is a known contributor to fibromyalgia, and patients should seek ways to de-stress, including yoga or meditation. Fibromyalgia patients should minimize their caffeine intake, as this is a known stimulant for nervousness, anxiety, and insomnia. Breathing exercises are sometimes helpful.

Although your sleep may be restless, you should try to establish a bedtime routine that gives your body the best chance for recovery. Try to avoid late night electronics, like the television or computer. Keep your bedroom dark, quiet, cool, and distraction-free. Be sure to take time for yourself each day for relaxation or to do something you enjoy. Combat “brain fog” by carrying a notebook or a phone to make notes for important things. Some patients report decreased muscle tightness by applying moist heat or a taking warm bath. The American Pain Society recommends conservative treatment, including chiropractic, along with moderate aerobic exercise.

Trigger points in the piriformis muscle

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The piriformis muscle is a small muscle deep to glute max and lies over top of the sciatic nerve. It originates on the anterior sacrum, and inserts on the greater trochanter of the femur. It’s main action is to laterally rotate the femur. When trigger points developed in this muscle they will refer pain into the sacro-iliac region, across the posterior hip and down the leg. This muscle can also be a cause of sciatic nerve irritation if it gets tight, causing “sciatica” symptoms.

Did you know that you can breathe “wrong”?

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Your “diaphragm” is the dome shaped muscle beneath your lungs. When it contracts and flattens, you breathe in. When it relaxes, you breathe out. But do you know your diaphragm plays an important secondary role in protecting your trunk and spine by controlling abdominal pressure?

The muscles that support your trunk form a “canister.” The front and sides of the canister are created by your abdominal and rib muscles. The back of the canister includes those muscles attached to your spine. The bottom of the canister is formed by the muscles of your pelvic floor, while your diaphragm serves as the roof. Together, these muscles control your abdominal pressure and core stability.


A well-braced core provides a stable foundation for moving your arms, legs, and head – in much the same way that when firing a canon, a large ship serves as a better platform than a rowboat.

During normal breathing, your upper chest should remain relatively still. Patients with “dysfunctional” patterns frequently overuse their upper chest muscles instead of their abdomen and lower rib cage. This depressurizes and destabilizes your core, leading to other problems like back pain.

You should not need to always think about proper breathing – this should happen subconsciously. Unfortunately, many of us have “learned” poor mechanics and need to re-learn proper breathing. One of the easiest ways to re-train proper breathing is to sit or lie still with one head on your breastbone and the other hand on your abdomen. When you breathe in, only the hand on your abdomen should move, while the hand on your chest remains still. Your normal breathing rhythm should be about there seconds of inhalation followed by six seconds of exhalation. If you find that you are exhaling too quickly, you may try “pursing” your lips to gradually increase the length of your exhalation.

The exercises that follow are essential for your recovery. Once you have restored normal breathing mechanics, you will enjoy increased core stability and your treatment will be much more successful. It is important to perform your breathing exercises consistently, as repetitive exercise will allow your body “re-learn” to subconsciously move in a safe and a coordinated fashion- thereby reducing your risk of injury.

Trigger points in the gluteus minimus

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The gluteus minimus is a small but important muscle that lies deep to the gluteus medius. It originates on the gluteal surface of the ilium, and attaches on the greater trochanter of the femur. It’s main actions are to abduct and medically rotate the hip. Trigger points in this muscle refer pain into the buttock and down the lateral and posterior leg, mimicking sciatica. This muscle should be the first to be examined if a straight leg test turns out negative.

Trigger points in the gluteus medius muscle

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The gluteus medius muscle plays an important role in hip and pelvic stability. It originates on the gluteal surface of the ilium, deep to the gluteus Maximus. It inserts on the greater trochanter of the femur. It’s main actions are to abduct the hip and to assist in internal rotation of the hip. It also maintains pelvic stability during walking and running. Trigger points in this muscle will refer pain into the sacrum, the iliac crest, and down the lateral hip and into the thigh. This muscle is often a cause of lower pack pain.

Knee Arthritis; Who, Where, Why and How?

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The bones in your knee have a slick protective covering called “cartilage” on the joint surfaces that touch each other. This cartilage serves as a friction reducer and shock absorber, thereby helping to extend the life of your joints. “Arthritis” means that your cartilage has begun to thin or crack and may eventually wear away, leading to a painful “bone on bone” situation.

Knee arthritis is very common, affecting more than 1/3 of adults over age 65. People who are overweight or have a history of knee injury or surgery are more likely to develop arthritis. Jobs and activities that require repetitive squatting, kneeling, pivoting or stair climbing may cause increased wear. Contrary to popular opinion, runners have no increased risk of developing knee arthritis. Women are two to three times more likely to develop knee arthritis as compared to men.

The pain of knee arthritis is often described as a “deep ache” that is aggravated by activity and relieved by rest. You probably notice morning stiffness that goes away after a short period of activity, but returns after sitting for long periods of time. Some patients have difficulty squatting, bending and walking stairs. You may notice that your knees pop and crack. Eventually, knee arthritis can cause you to walk slower, lose your balance and even fall more often. Many patients notice that their symptoms increase with weather changes.

Although there is no cure for the irreversible wearing associated with arthritis, there is help for your symptoms. Performing your home exercises is very important. The way that your knee is aligned (and wears) is largely based upon how your hip and foot function, so many of your home exercises will target those regions. Our office may prescribe arch supports or orthotics, since people with flat feet are almost twice as likely to suffer from knee arthritis.

Overweight patients should begin or increase low-impact aerobic exercises like walking, stationary cycling, elliptical exercising, water walking or swimming. Be sure to take frequent breaks from prolonged sitting and avoid overly painful activities.

Achilles Tendonitis: The Details

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Your Achilles tendon is the strong fibrous band of tissue that connects your calf muscles to your heel. The tendon is named after “Achilles” who was a powerful, yet vulnerable warrior in Greek mythology. Likewise, our Achilles tendon, being the largest and strongest tendon in the body, is susceptible to injury from the high demands placed on it. (Running can generate forces over 12 times your bo

dy weight on the Achilles tendon.)

The tendon may be strained or even ruptured from excessive stretch or forceful contraction of the calf muscles. More commonly, the tendon is repeatedly overloaded and suffers tiny “micro tears.” Damage usually occurs either directly behind the heel, or near the weakest area of the tendon- one to two inches above the heel.

Achilles tendon injuries affect between 250,000 and 1 million people per year. Most are middle-aged males, between the age of 30 and 50. Interestingly, Achilles tendon injuries occur more frequently on the left side. If you have suffered a prior Achilles tendon injury, you are at greater risk of injuring the opposite side. Two-thirds of all Achilles tendon injuries involve athletes. Runners are up to 10 times more likely to suffer Achilles tendon problems. You may at increased risk if the arch of your foot is too high or too flat.

Symptoms may begin abruptly following a strain but more commonly develop slowly from repeated irritation. Morning pain and stiffness are common. Your symptoms will likely increase with activity, especially walking or running. You may notice pain when you rise up on your toes. Walking down stairs stretches the tendon and usually increases symptoms. Some patients notice that the irritated area becomes firmly swollen. Ongoing irritation to the spot on your heel where the tendon inserts can cause a painfully elevated “pump bump.”

Research has shown that conservative care, like the type provided in this office, can produce “excellent results” in over 85% of patients. Initially, you may need to limit or stop activities that cause pain. Runners may need to switch to swimming or cycling for a short period of time. Be sure to introduce new activities slowly and avoid increasing your activity by more than 10% per week. Runners should begin on a smooth, shock-absorbent surface and start at a low intensity – first increasing distance, then pace. Avoid training on hard or unlevel surfaces like hills. Make sure you warm up properly and avoid over training. Avoid wearing high heels or shoes with an excessively rigid heel tab. One of the most important and effective treatments for Achilles tendinopathy is performing “heel drop exercises” as outlined below.

Eccentric Achilles Strengthening
Begin standing up on your toes with the affected foot on the edge of a step. Do not place weight on your good leg, but you may use it for stability. Slowly lower your affected heel, at a count of 4 seconds, until you reach a fully stretched position and can drop no further. Use your good leg to return to your toes. Repeat 3 sets of 15 repetitions with your knee straight and 3 more sets of 15 repetitions with your knee slightly bent, twice daily or as directed. Moderate pain during this exercise is acceptable but if pain is excessive, you should assist downward motion with the non-injured leg.
Here is a brief description of the treatments we may use to help manage your problem.

Joint Manipulation
Your chiropractor has found joints in your body that are not moving freely. This can cause tightness and discomfort and can accelerate unwanted degeneration i.e. arthritis. Your chiropractor will apply a gentle force with their hands, or with hand held instruments, in order to restore motion to any “restricted” joints. Sometimes a specialized table will be used to assist with these safe and effective “adjustments”. Joint manipulation improves flexibility, relieves pain and helps maintain healthy joints.
Therapy Modalities
We may apply electrotherapy modalities that produce light electrical pulses transmitted through electrodes placed over your specific sites of concern. These comfortable modalities work to decrease your pain, limit inflammation and ease muscle spasm. Hot or cold packs are often used in conjunction, to enhance the effect of these modalities. Another available option is therapeutic ultrasound. Ultrasound pushes sound vibrations into tissues. When these vibrations reach your deep tissues, heat develops and unwanted waste products are dispersed.
Myofascial Release
Overworked muscles often become tight and develop knots or “trigger points”. Chronic tightness produces inflammation and swelling that ultimately leads to the formation of “adhesions” between tissues. Your chiropractor will apply pressure with their hands, or with specialized tools, in order to release muscle tightness and soft-tissue adhesions. This will help to improve your circulation, relieve pain and restore flexibility.
Therapeutic Exercise
Muscle tightness or weakness causes discomfort and alters normal joint function, leading to additional problems. Your chiropractor will target tight or weak muscles with specific therapeutic stretching and strengthening to help increase tissue flexibility, build strength, and ease pain. Healthy, strong, and flexible muscles may help prevent re-injury.
Elastic Therapeutic Tape
Your chiropractor may apply a special elastic therapeutic tape in order to support injured areas or encourage better movement. This tape is thought to decrease pain and swelling, improve circulation and limit muscle soreness.
Foot Evaluation
Fallen arches and faulty foot mechanics are common problems that can perpetuate your condition. Our office will carefully evaluate your feet and consider the need for a change in shoe style, arch supports or even custom orthotics.
Ankle Brace
Our office may recommend using a support brace to protect your ankle from further injury. Your doctor will discuss the specific type of brace and provide instructions for use.
After this initial course of treatment we will reassess your progress. We will determine the need for any additional care after your reassessment.

Trigger points in the gluteus Maximus

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The gluteus Maximus is the buttock muscle. It originates on the gluteal surface of the ilium, lumbar fascia, sacrum and sacrotuberous ligament. It inserts on the gluteal tuberosity of the femur and the iliotibial tract. Extension and lateral rotation of the hip are it’s main actions. This muscle is heavily involved in activities like ice skating and is a common area to develops trigger points. When trigger points do develop they can refer pain in a crescent pattern from the gluteal fold to the sacrum. Trigger points can also refer pain deep into the buttock itself making it feel like other deeper muscles are involved. These symptoms can sometimes be mistaken for s.i. Joint problems.

Trigger points in the supraspinatus

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The supraspinatus is a muscle of the rotator cuff. Is sits above the infraspinatus and originates on the supraspinous fossa of the scapula. It’s insertion point is the superior facet of the greater tubercle of the humerus. It’s main function is to abduct the arm at the glenohumeral joint working with the deltoid. All rotator cuff muscles act to secure and support the head of the humerus in the glenoid fossa during arm movements acting as a sling. This muscle often gets impinged during overhead movements such as painting a ceiling. When trigger points form in this muscle they primarily refer a deep achy pain into the mid deltoid area with spillover pain radiating down the arm into the elbow.

Where should you turn when back pain strikes?

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Shrug

Where should you turn when back pain strikes?

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Chiropractic should be a first line defence when back pain strikes. We are special trained to recognize the cause of back pain and treat when appropriate. When the cause is outside the scope of our practice, we are able to educate you on where you should go next.