Concussions

Over the last few years, around this time of year, concussions have become a major topic of interest.  More and more research is coming to light about just how dangerous concussions really are.  While much of the focus has been done to better diagnose and prevent concussions (which needs to happen), very little has been done in the advancement of treatment.

Rest remains the most appropriate way to allow your brain to recover from a concussion, but what happens when symptoms remain even after weeks and months of rest?

Concussions are a brain injury.  Currently, there are 8 factors used to diagnose concussions.  In order to be diagnosed with a concussion, you only need to experience 3 out of the 8 factors.  Headaches, dizziness, changes in mood, sleep, concentration, personality, irritability, not managing stress, are all on the list.  Surprisingly, neck pain didn’t make the list!

As mentioned previously, concussions are a brain injury, but you can’t get a brain injury without neck (cervical) trauma.  Alarmingly, the spine is rarely evaluated!  What should, and needs to happen, is to find out how much influence the cervical trauma is playing in post-concussive symptoms.  While neck symptoms don’t need to be present, presence of neck pain and symptoms will delay recovery from concussion injuries.

The suboccipital muscles are a group of 6 muscles that attach to the top of the skull and neck.  Some of these muscles attach directly to the spinal cord. These are the most commonly injured structures with any neck and head trauma. Injury to these muscles can directly cause and increase concussion symptoms.  As a result of trauma to the head and neck, adhesion is most likely to appear in these muscles.

As a consequence, adhesion decreases flexibility and pain.  Adhesion in the suboccipital muscles can cause a variety of symptoms including, headaches and neck pain. It can be easily fixed by an expert trained to diagnose and treat this injury.  The only way to know if you have adhesion present is to be evaluated by one of these experts.

Concussions are always individual and each person recovers at a different pace.  If you have recently had, or been struggling with post-concussive symptoms it is vital to know how much of your injury is due to the brain, and how much is due to the cervical trauma!

While most of the recovery and treatment of concussions need to be focused around rest and managing activities, those that still suffer with symptoms weeks and months after need other solutions!  Otherwise, these symptoms can persist years down the road.  Concussions are always multifactorial, changes in diet and psychiatry may also help, but negating to treat the musculoskeletal component of the injury can be a huge mistake!

You owe it to yourself to explore all avenues of treatment to fully recover from injury and prevent long term damage!

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Integrative Diagnosis providers are musculoskeletal experts trained in the evaluation and treatment of neck pain and injury.  If you are fortunate enough to have an Integrative Diagnosis provider in your area, they can help with the recovery and treatment of concussions.  Use this link to find a provider near you => PROVIDERS

If you live in or around the Cedar Rapids area, let the experts at Thrive Spine and Sport help!  If you or someone you know are struggling to recover from a concussion we encourage you to call our office today at 319-423-0925 or schedule an appointment at www.thrivespineandsport.com/appointment-request/.

Thanks for reading!

Low Back Health Exam

Over 80% of the population will be affected by low back pain at some point in their life.  25% have suffered low back pain in the last 3 months alone!  Low back pain is one of the leading causes of disability and lost production in this country.  Solutions to the problem aren’t often easy and far too many people are left looking for answers for why their back always hurts.  Low back pain is a REALLY BIG DEAL!  Keeping your low back HEALTHY should be a PRIORITY!

If you struggle with low back pain, wouldn’t it be nice to know WHY your back always hurts?  Or maybe, if you’re one of the lucky ones not currently in pain, wouldn’t it be nice to know your low back pain risk and what you need to do to prevent it?

Now you can by taking the test and trying these 5 tests at home!  Why these 5 tests?  These 5 tests are the most basic, functional movements of the low back.  Every healthy person should be able to perform these tests!

So here’s how it goes.  Perform each test below – some may need the help of a partner.  Rate yourself by the grading chart for each test.  Add the scores together at the end to get your score.  Follow the directions to fix your low back!

Let’s get started!

TEST #1:  Straight Leg Raiser

You will need a partner for this.  Download a “bubble level” app on your phone.  Make sure the app measures angle as well.  There are a ton of free ones out there that work well for this.  I recommend “Clinometer” for Android and “iHandy Level Free” for iPhones.

Lie on your back with feet extended out in front.  Place the phone with the bubble app open in the middle of the shin.  One leg at a time, have your partner lift the leg with the knee straight.  Move the leg until it can no longer stretch or the hip or opposing leg starts to lift off the ground.  Record the degree.

20160706_182837

85-90 Degrees = 2 Points          75-84 Degrees = 1 Point          Less Than 74 degrees = 0 Points

 

TEST #2:  Knee-To-Chest

While still laying on your back, one leg at a time, pull your knee to your chest.  The front of the leg should touch the bottom of your rib cage without any pinch in the anterior hip.  If you cannot get the front of your leg to touch your chest, measure how far away by placing fingers between your chest and leg.  Record the distance.

20160706_183142_001

3 Finger Restricted Knee-To-Chest
3 Finger Restricted Knee-To-Chest

Leg Flat On Chest W/ No Anterior Hip Pinch = 0 Points        Leg 1-3 Fingers From Chest = 1 Point          Leg  More Than 4 Fingers From Chest = 0 Points

TEST #3: “Cat Stretch”

You will need a partner and a pencil.

With hands and knees on the floor arch your low back as much as possible by trying to bring your hips to your chest.  Have your partner place a pencil on your lower back.  What does it look like?

Healthy "Cat Stretch" Test
Healthy “Cat Stretch” Test

                                            Pencil Ends Off Back = 2 Points                                              

Flat Pencil Test
Flat Pencil Test

Pencil Flat = 1 Point

Severely Restricted "Cat Stretch" Test
Severely Restricted “Cat Stretch” Test

Pencil Ends Touching, Middle Not = 0 Points

 

TEST #4: Lunge

Standing up, take a large step forward and drop the back knee to the ground.  Keep your body upright.  Place a ruler under your back leg.  Measure how far the front of the hip extends out from the ruler.

Lunge Test
Lunge Test
Overhead View of Healthy Lunge Test Of The Ruler
Overhead View of Healthy Lunge Test Of The Ruler

More Than 12” = 2 Points          9-11.5” = 1 Point          Less Than 9” = 0 Points   

 

TEST #5: Toe Touch

Standing upright bend forward and try to touch the floor in front of your toes.  Use a ruler to measure how far away the tip of your finger is away from the floor.

Healthy Toe Touch Test
Healthy Toe Touch Test

Finger Touching Floor or Palming Floor = 2 Points

Fingers Less Than 2” From Floor = 1 Point

Limited Toe Touch Test
Limited Toe Touch Test

Fingers More Than 2” From The Floor = 0 Points

 

Now that you have gone through all of the tests, add the score of each test together.  What did you get?

9-10 Points = 90-100% Low Back Function = Congratulations!  You have a VERY healthy back!

7-8 Points = 70-80% Low Back Function = Chances are you may not have low back pain now, but you should try to improve the tests that are lagging with some simple daily mobility, stretching, and exercise.  In pain currently?  See below.

Less Than 6 Points = Less Than 60% Low Back Function = Your back is in trouble!  Most of these tests are limited or restricted.  You have less than 60% function of your low back!  That’s a failing grade in school!  Just like in school when you failed a test and you looked for some help to get better grades, you should seek the help of a local musculoskeletal expert for solutions to fix these movements and solve your low back pain!

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It is important to note these 5 tests above are assessments used in the Integrative Diagnosis system.  The most common cause of limited range of motion and pain for these tests are due to muscle adhesion.  Integrative Diagnosis is the most advanced diagnosis and treatment system for solving musculoskeletal problems.

At Thrive Spine and Sport, we are currently the only full body Integrative Diagnosis providers in the State of Iowa. Our treatment fixes adhesion!  If you have been looking for answers to your low back pain, click the appointment request here, or call us at 319-423-0925.

3 Rules For Staying Healthy

Unlike many of articles and blog posts we write, this one takes a different theme!  Instead of talking about how to get out of pain, we take a look at how to STAY out of pain!  It is important to note that this is not for those reading that are currently experiencing pain.  If you are reading this and are struggling to get out of pain, you need an expert diagnosis and the best treatment to fix your problem.  If you are looking to get to the bottom of your problem, I invite you to call our office at 319-423-0925 today for an appointment or find out if you are a candidate for our care.

Now for those of you still reading that are currently NOT in pain….CONGRATS!  You are most likely already doing a lot of things right to take care of yourself.  I think we can all agree that being in pain is a horrible, no good, very bad thing!  Pain either limits what we can do, or stops it all together, and when it is present, we want it gone just as fast as it came!  Unfortunately, that isn’t always the case, as most cases of pain often contain layers of dysfunction that must be worked through.  Treatment is not always a “one hit wonder.”

Rule #1: STOP ABUSING YOUR BODY.  This isn’t just for the gym rats.  Sitting all day long has the same detriment on your body as grinding away at the gym for 3 hours every day at 100% effort.  In both situations it is only a matter of time before things break down!  At the office make sure to take frequent breaks (once or twice an hour).  Get up from your desk and move around!  At the gym it’s ok to back down the effort level sometimes or skip a workout if you are feeling beat up.  Feeling stiff and tight all the time is an early warning sign of a bigger problem.

Rule #2: CHANGE THINGS UP.  Unless you’re training for competition changing things up in your training routine helps to keep you healthy.  Same goes for sitting all day and not getting up (see above).  The body needs variation of activities and movements.  Prolonged positions and frequent repetitive motions is the most common reason for all overuse injuries.  Change your activity up to avoid this.

Rule#3: SELF-MAINTENANCE.  Maintenance for your body should be no different than brushing and flossing for your teeth, or an oil change for your car.  Stretching, yoga, foam rolling, mobility drills, maintenance exercise, and self-evaluation to monitor your health are all great tools to use.  We recently wrote an article over some basic movements all runners should have – these same tests apply to everyone else.  I invite you to check it out here.  The other tools mentioned are all designed to increase blood flow through the body and allow you to move better.  It is VITAL to note that stretching, yoga, foam rolling, exercise, and mobility drills are NOT treatment and should not be treated as such.  Do these things regularly though and these decrease your probability of struggling through pain.

 

Thanks for reading!

3 Reasons For Tight Hamstrings You Dont Know About

If your hamstrings are always “tight” there is a reason behind it – and it’s not because you’re not stretching.  In fact, if you are stretching, it may be making it worse!  While this may sound like crazy talk, allow me to explain.

The hamstrings are a group of 3 different muscles.  They originate on the pelvis and insert on the lower leg, just below the knee.  They are primarily responsible for extension of the hip and flexing the knee.  The hamstrings play a vital role in most of our daily activities, which include standing, walking, running, and jumping, but they also play a protective role for nerves and joints.

The Hamstrings

While there can be many different reasons for “tight” hamstrings, the 3 most common I see in my office are the following:

Nerve Entrapment.  The sciatic nerve runs from the lower back down into the foot.  This nerve moves and flosses through many different structures on its route.  Often times this nerve will get glued down, and stick to some of the muscles it comes into contact with in the hip and upper thigh – this includes the hamstrings.  When this nerve is prevented from moving properly, and we try to stretch, the body will engage the hamstrings sooner than it would if the nerve wasn’t glued down to protect the nerve from potential harm. This is give off the feeling of “weak and tight.”

Hip Joint Dysfunction.  Place your hand on the outside of your hip. Do you feel the bone there? Now, more than ever with our modern day lifestyles, this joint can become compromised by adhesion and scar tissue.  The femur is held into the hip socket by a group of ligaments.  These ligaments will often form loads of scar tissue after performing repetitive activities or keeping it in place for prolonged periods of time.  This scar tissue will then restrict hip motion.  With this reduction in movement, the joint is more prone to future injury, the hamstrings help to protect this joint by activating earlier than normal and reduces the range of motion.

Hip Capsule

Disc Injury.  Unfortunately, far too many people are walking around with disc injuries, whether they know it or not.  When a disc becomes injured, many simple day to day tasks become more difficult, like trying to stand from a seated position, or bend forward.  Any flexion movement, places more stress on the injured disc.  Part of the job of the hamstrings is to extend the hip and keep you upright.   If we have an injured disc, the hamstrings will try to keep you upright to protect the disc and avoid any unwanted load.

A Few Common Disc Issues

So what can you do?

Often the answer to your problem is simpler than you think.  “Tight” hamstrings are a common problem, but can lead to bigger, chronic issues. Catch all solutions like stretching are rarely ever the answer.  Start by contacting a local expert to get the correct diagnosis for your problem.   Only with the right diagnosis can you finally fix your problem!

If you live in Cedar Rapids or surrounding areas and are constantly struggling with “tight” hamstrings, we invite you to check out our office.  The experts at Thrive Spine and Sport can easily diagnose and provide you with the right plan to fix your problem!  Call our office at 319-423-0925 or fill out an appointment request by clicking here

Thanks for reading!

3 Easy Tests To Help Figure Out Low Back Pain

According to the National Institute of Health (NIH) lower back pain will affect 8 out of every 10 people at some point in their life.  On top of being the leading cause of disability worldwide, lower back pain will cost Americans $50 billion dollars this year!  While some cases of low back pain will go away after a couple days on its own, a majority of cases will become chronic in nature!  So why do some cases go away, while others become chronic? Let take a look!

If you do any kind of research online, you will likely find the same recommendations for pain relief repeated – rest, ice, stretch, warm up better prior to activity, NSAIDs, maintain good posture, get better shoes, etc.  While this may sound like sound advice, none of it really works, otherwise we wouldn’t find so many of us in pain.

Since most people start treatment of low back pain by visiting their PCP, or Primary Care Provider, they are often recommended rest and NSAIDS.  After a couple weeks of inactivity, these same people often find themselves right back where they started once they get back to their daily routine.  Sound familiar? So what went wrong?

The problem is that the rest and NSAIDs temporarily raised your symptom threshold, but did nothing to address the real issue. Stretching may provide temporary relief but no long term benefits. The shoes may have taken some stress off your feet, but didn’t touch the low back pain.  None of the above recommendations address long term fixes!

The problem with all of this, and why your pain has become chronic, is that there was not a single, specific diagnosis made to identify the real problem initially!  In my experience, most people with low back pain have some limiting range or motion in their low back, hips, or both. This limited range places extra stress on the low back, causing weakness and pain!

So how do you know if this limited range affects you and your low back pain?  Fortunately, there are some at-home tests that you can do right now to find out where you’re limited and options to finally get your low back pain under control!

The first test is the Standing Toe Touch.  While this may seem simple, most people with low back pain are unable to bend at the waist and touch the toes to the floor without pain or tension in the back of the knees and calves.  The test should be effortless and without pain.

SLPF
Full Standing Toe Touch

 

Knee-to-chest is the easiest way to test hip flexion.  Lie flat on the floor with both legs extended out in front of you.  Bring one knee up to your chest until the front of the thigh is flat with the chest.  If the opposing leg raises up, pinching is felt in the front of the hip, groin, or outer leg, or the thigh falls short of the chest, the test is limited and a possible cause of low back pain.

Hip Flexion Test
Hip Flexion Test

Hip Extension is vital to the stability of your spine.  To test, start in a lunge position, leaning as far forward onto one hip.  Place a ruler in line with the rear leg just in front of the knee.  Drop a plumb line from the front of your hip to the ruler below.  Normal range should fall between 10-12 inches.  Decreased range or pain with this test is a positive finding for this test.

Kneeling Hip Extension
Kneeling Hip Extension

If you or someone you know suffers from low back pain and cannot perform these very simple tests, there is a good chance they can find relief in our office.  At Thrive Spine and Sport, these tests, and a few others from the Integrative Diagnosis system, are used to gain a clear picture and full diagnosis of what causing your low back pain.  By obtaining a full diagnosis and applying the correct treatment, resolution for your pain is possible!

Simply fill out the appointment request on this page or call our office at 319-423-0925 to get to the bottom of your pain today!  Any questions can be sent to Dr. Cody at dr.cody@thrivespineandsport.com.

Thanks for reading!

 

 

***Special thanks to Ally Thompson of Heat Yoga and Dr. Carl Nottoli of Functional Spine and Sport for the photos****

Chiropractic, PT, or an Educational Booklet: Which Is Better Treatment For Low Back Pain in Cedar Rapids?

Would you believe me if I told you that an educational pamphlet is just as effective as chiropractic care or physical therapy in relieving low back pain?

In 1998, a study published in the New England Journal of Medicine looked to compare the effectiveness of chiropractic, physical therapy, or an educational pamphlet for low back pain.  The conclusion of the study fueled a lively debate.  What the study found was that there was little difference in outcomes between low back pain patients treated with standard chiropractic manipulation, McKenzie exercises, or the educational booklet!  Not surprising, chiropractors and physical therapists alike were outraged from the findings.

While many previous studies done prior have shown chiropractic and physical therapy to be effective for helping with low back pain, why did this study show an educational pamphlet was just as effective?

To start, let’s look at the study design.  The patients were diagnosed with a regional diagnosis, low back pain, after pathology had been ruled out (herniation, cancer, etc.).  This would be no different than saying someone has shoulder pain.  Patients were randomly assigned to either chiropractic, physical therapy, or the educational readings.  This is where things got interesting.

Patients sent to a chiropractor were diagnosed with a sprain/strain 50% of the time, and another 30% of the chiropractic group was diagnosed with facet syndrome, or misalignments of the spine.  The same group of low back pain patients sent to the physical therapist were diagnosed with disc derangement 92% of the time.  This should raise some alarm!  The same group of randomly assigned patients sent to two different providers had significantly different diagnoses!

While it is entirely possible that the provider’s diagnoses were correct, it is highly unlikely that the difference was that dramatic.  It has often been demonstrated that nearly 70 percent of low back pain arises from 3 different sources; disc (39%), facet (15%), and Sacroiliac (SI) joint (13%).  This is where the study inherently failed.

While the study was not specific enough to sub classify low back pain patients into their respective groups, the providers themselves seemed to have classified patients based on what they can fix, not what the patient necessarily had.  McKenzie exercises have been shown to be effective in treatment of pain arising from the disc.  Likewise, chiropractic manipulation would be most effective in treating those struggling with facet and SI joint complications.

While this was not the intent of the study, this ultimately showed where modern day health care has gone wrong!  Too often, providers of any profession try to categorize patient’s problems into what they can fix, and not what the patient actually has.  It comes without saying that patient outcomes would be much higher if patients were given the treatment they need, and not the treatment the provider is certified to practice.   When providers try to fix patients by classifying them into what they can fix and not what the patient actually has, an educational pamphlet has just as much value as chiropractic and physical therapy.

Reference:

Excerpt modified from [Original DC article] by William Brady, DC. Used with permission. www.integrativediagnosis.com