Why Weak and Tight Doesn’t Mean Strengthen and Stretch

One of the most common misconceptions in health care is this principle – “weak and tight” means “strengthen and stretch.”  If there is one problem or complaint I hear the most it’s, “I’m always tight.”  Usually, in the same breath, the same person will report that they just need to stretch, or they don’t stretch as often as they should.  It usually comes as a surprise when I then tell this person that stretching won’t help them, and if you’re reading this and you always feel “stiff” it probably won’t help you either.

Stretching is the most overprescribed treatment in healthcare, and also the least beneficial.  Now, don’t get me wrong there is a time and a place for stretching – yoga is fantastic – but fixing your stiffness and pain, it’s not going to happen!

Allow me to explain.

Our bodies were not programmed to handle the modern day lifestyle. Whether you work in a 9-5 desk position or work in a factory doing manual labor 40+ hours a week, both will have the same thing in common.  Overuse.  Overuse happens when we sit in prolonged positions or do repetitive activities, if we are not taking care of ourselves.

When we overuse our bodies, and fail to take care of it with proper rest, recovery, nutrients, this will often create a phenomenon called protective tension.  Protective tension is created to help the body adapt to overuse.  The body will make muscles spasm and contract to help protect any overloaded structure from further injury.  Over a period of time, this gradually leads to adhesion formation.

Overuse Cycle

 

If you are unfamiliar with adhesion, adhesion is the most common problem in the human body, but also the most misdiagnosed.  Fortunately, it can be fixed easily with the right diagnosis and treatment.  When present, it acts like glue on soft tissue structures like muscles, ligaments, and nerves.  This glue then binds muscles and nerves together and decreases your flexibility and strength.  Overtime, adhesion leads to altered joint mechanics and pain.  Without the proper treatment, adhesion will eventually lead to chronic pain, chronic muscle sprain/strains, arthritis, and or spinal disc injuries (think herniation).

 

Adhesion

Check out this video below for a better demonstration and explanation.

We have been conditioned since elementary school days to think weak and tight means to strengthen and stretch.  In reality, weak and tight is often a result of a problem!  All of the stretches and strength exercises in the world will not help adhesion, in fact, it may make things worse.  The most important thing that you can do is figure out why a muscle is weak and tight!

If this sounds familiar, it’s time to get some answers!  At Thrive Spine and Sport, we are trained through the Integrative Diagnosis system to provide the most accurate and advanced diagnosis and treatment to chronic pain and overuse injuries.  Many patients of our office have tried numerous providers before finding relief in our office. 

Simply fill out the appointment request on this page, or call our office at 319-423-0925 to start feeling better today! 

Thanks for reading!

Before You Get A Cortisone Shot: What You Should Know

Cortisone.  We have all heard the name.  Some of you probably know someone who has been treated with it – It may have been you.  But what is cortisone and what does it actually do?  Could cortisone actually make things worse? Let’s dive in and find out.

The emergence of cortisone started in the late 1940’s and it was immediately heralded as the safest and most reliable means to treat pain and inflammation.  Cortisone shots very quickly became the standard for overuse injuries, like “Tennis Elbow,” Achilles “Tendonitis,” “Bicep Tendonitis” and “Plantar Fasciitis.” Cortisone remains the standard today.

Cortisone, closely related to cortisol and also produced naturally in the body by the adrenal glands in response to stress, acts to suppress the immune system resulting in reduction of inflammation, pain, and swelling at the site of injury.  Cortisone is primarily used in the short term and typical results provide several weeks to months of relief.  Sounds good, right?

Not so fast.  A recently published review examined the results of several randomized trials, involving thousands of participants with overuse injuries.  These studies did find that, in the short term, cortisone did work to relieve pain better when compared to doing nothing (no shock there) or physical therapy. But what the review also states is that when the same participants were reexamined 6 and 12 months later, not only did they have a LOWER rate of recovery than the other test group, they also had a significantly HIGHER chance of RELAPSE!

So why is this? Cortisone shots are used for the treatment of INFLAMMATION!  Overuse injuries do not involve INFLAMMATION!  More research is now showing overuse injuries (“Tennis Elbow,” “Golfer’s Elbow,” “Achilles Tendonitis,” “Plantar Fasciitis,” etc.) to be DEGENERATIVE!  That means that the tendons of the involved structures actually begin to fray with overuse.

But why does cortisone work in the short term then?  Cortisone has an undeniable effect on the nervous system.  Cortisone increases the body’s pain threshold, increasing it in the short term.  This is why you no longer have pain and can return to regular activity.  But this is also why the pain returns after the cortisone wears off! Pain is a protective mechanism of the body.  Pain is the body’s way of telling you to stop doing what you are doing.  When pain is overridden, the degeneration of the overuse injuries continues to occur leaving you worse off than when you started.

So what should you do?  With any degenerative injuries, the tendons and other soft tissues must be restored.  The best way to do this is by getting a proper diagnosis!  Far too often these injuries are misdiagnosed.

Once a proper diagnosis has been established, you can begin the right treatment for your problem.  Most often this treatment includes, manual therapy and at-home exercises.  Bracing and load management are possible options for those responding to care slower than usual. Cortisone injections should be the LAST place to start with treatment!

At Thrive Spine and Sport, we pick up where others have failed.  If you have been debating on whether or not to get a cortisone injection, and you live in the Cedar Rapids or surrounding areas, I invite you to fill out the appointment request on this page or call our office today at 319-423-0925 and get to the bottom of your pain!  If you have any questions, please feel free to reach out to Dr. Cody Scharf at dr.cody@thrivespineandsport.com.

 

Thanks for reading!

Is It Tendinitis?

Does this sound familiar?

You develop pain, and it’s getting worse. You pull out your computer and search for what’s wrong. The search reveals “tendinitis.”

Looking at the treatment options, you decide to take a couple weeks off, ice twice a day, stretch as often as you can and take pain relievers when needed.

Things are going great, the pain has disappeared and you decide to get back to regular activity. You start your warm up. You begin to play or run, then uh-oh, the pain is back.

It hasn’t left. Now what do you do? Cortisone shot? Surgery?

Why did the pain return? The answer is simple. The diagnosis and treatment were wrong.

What we are finding now is that most cases of tendinitis are misdiagnosed and are actually tendinosis. While tendinitis is believed to be an inflammatory process, tendinosis is a degenerative one.

With return of activity and lack of proper recovery, we often see overuse of muscles and joints commonly used in that activity. With overuse, tendons and muscles become weak and degenerate. Once the muscles and structures are weak, adhesion will form to try to stabilize the area. This also alters joint motion and leads to further weakness and pain. If left untreated, this can lead to torn muscles, tendons and ligaments. Rest, ice and stretching do nothing to repair damage to injured soft tissue.

Overuse Cycle

Treatment of tendinosis takes a different approach. Try these four steps:

Manual therapy. Adhesion is the most common result of overuse. To remove adhesion, you need therapy from someone certified to treat the condition.

Eccentric exercise. When a tendon or ligament is degenerated, rest will not fix it. It needs to be regenerated and strengthened. Eccentric exercise does this by helping improve blood flow into the origin and insertion points of muscles where degeneration is common.

Load Management.  I hate the word “rest” when treating injuries, because in most cases it gives you false hope – that something is actually being fixed – when in reality it isn’t.  In tendinosis cases, rest helps the damaged soft tissue recover from treatment faster and reduces the risk of more severe injury. 97% of all soft tissue (muscle, ligament, tendon) tears happen in degenerated tissue.  This is tendinosis!

Get a brace. Using a brace reduces stress on the injured area and allows treatment to be more effective and can help speed up recovery time.

Recovery time depends on how long symptoms have been present and how much damage has been done to the soft tissue.

At Thrive Spine and Sport, we specialize in the diagnosis and treatment of adhesion, a primary cause of tendinosis and tendinitis.  If you or someone you know has been struggling to find relief from “tendinitis” it’s time to find out what’s really wrong!  You deserve real solutions to your problem.  Fill out the appointment request on this page or call our office at 319-423-0925 today!

Thanks for reading!

Tingling, Burning, Numbness? Here’s What You Need To Know!

If you are currently suffering from symptoms of tingling, burning, or numbness, there are some things you need to know.  “Pinched nerve” is a term thrown out all too often and over diagnosed.  Nerve entrapment is a term that is used far less, but much, MUCH more common.

A true “pinched nerve,” is when a nerve is compressed between 2 structures.  Most often, this happens in cases of disc derangement where the disc protrudes into the spinal cord compressing the nerve roots.

An example of a protruding disc creating a “true” pinched nerve.

This happens in less than 3% of patients.  When the nerve is compressed by a protruding disc, the pain is usually constant and severe – think pain levels above 8 out of 10. This problem persists for weeks without relief.

Nerve entrapment, as previously mentioned, is a less popular diagnosis but far more common. Nerve entrapment is a condition in which nerves get stuck to surrounding structures.  As nerves pass through our body, they floss and move between muscles, tendons, and other soft tissue.  Healthy nerves slide and glide between these structures without issue.

Through “wear and tear” and “use and abuse,” nerves can become entrapped and glued to the structures it moves along.  When this happens, this can lead to symptoms of tingling, burning, and numbness many people struggle with.  In cases of nerve entrapment, most people will note also feeling “tight” or the feeling of dull, achy pain.  Pain is often not constant.  Sometimes the dull, achy pain can be in other areas of the body as well.  In these cases, adhesion is most frequently the “glue” that binds the nerve to the surrounding soft tissue.

While you may not have heard of nerve entrapment, you are probably familiar with carpal tunnel syndrome, sciatica, piriformis syndrome, tarsal tunnel syndrome, or thoracic outlet syndrome.  These are examples of nerve entrapment conditions.

These conditions are unfortunately labeled as such, without a complete diagnosis of what is causing the symptoms in the first place. Rest, ice, ultrasound, stim, kinisiotape, bracing among other treatments are often prescribed and used without finding much long term relief.  Far too often these conditions will lead to cortisone injections and surgery.

Adhesion, which is the most common cause of nerve entrapment and is also the most frequently missed when dealing with these conditions.  Adhesion can be fixed with specific manual therapy at the site of the entrapment.

At Thrive Spine and Sport, we are certified in the diagnosis and treatment of adhesion which can cause nerve entrapment in 156 different areas of the body!  If you are starting to experience, or have been struggling with the above listed syndromes without relief, it’s time to get to the bottom of your pain. You deserve real solutions to your problem.  Fill out the appointment request on this page or call our office at 319-423-0925 today!

Thanks for reading!