Clinic newsletters now on the Denver Chiropractic Center site!

For those of you (and there are many) who’ve asked for copies of the paper and ink newsletters, we’ve decided to post the pdf files on the site. http://www.denverback.com/articles.html

The January issue is up, and February is coming soon.

Inside the January 2010 issue:

My New Year’s Resolution – to take time off!

Strengthening your feet with bodyweight exercises.

Mastering the Pushup for strength

The Top 10 problems that I treat in my office

Insurance we accpet / office hours

http://www.denverback.com/pdf/2010_Jan.pdf

How to avoid foot pain, calf pain, and knee pain

Today we’re going to discuss feet. I know, you have better things to do than think about feet but this is important.
 
Weakness in the feet can lead a wide range of problems up the line – shin splints, calf pain, knee pain, hip pain, back pain, etc. Strengthening your feet can reduce these injuries (and prevent them from coming back).
 
Sports like skiing, boarding, running, cycling and snowshoeing require strong feet to maintain good balance. Strengthening your feet will improve your performance in these sports.
 
Most people think that using the tired old calf-raise machine at the gym is all the foot strengthening they need, but that’s wrong. First of all, you’re locked into a machine. Unless there’s an earthquake, you don’t need to do any balancing at all. Secondly, your shoes essentially turn your feet into a block, cheating the your muscles of work. (Yes, there are many, many muscles in your foot).
 
So step one is to lose the shoes. If you’re in a gym I wouldn’t, but at home you can. This home exercise is a simple way to start strengthening your feet and lower legs in the comfort and provacy of your own home. I’ll have more exercises for you in the January paper newsletter coming soon to a mailbox near you, but for now get started with this one.
 
First you’re going to need someting called a balance pad. You can get this one on Amazon.com for about 20 bucks. Just go there and search for “Harbinger Core Trainer” and this will appear. Buy it. It’s inflatable so you can adjust it to your weight.
 
balance pad
 
There’s lots of research that shows that using these balance pads can strengthen your feet and prevent lower leg injuries. I’ve had patients buy these to use in conjunction with the Primary Pattern Rehab Protocols that I’ve developed and they get great results.
 
This exercise is called foot circles. It’s surprisingly simple, but it isn’t easy. And it is very effective. First try this on the ground to make sure that you have the stability to do this on a flat surface. Remember -no shoes!
 
Basically, you stand on one foot (the working foot) and make large sweeping circles with the other foot.
 
foot1
 
Make clockwise circles for 30 seconds and then counter clockwise circles for 30 seconds. If you need to keep tapping the circling foot on the ground to maintain your balance, that’s OK. But try to work up to not needing a foot tap.
 
foot2
 
If you can do this on flat ground, move to the balance trainer. Do 3 sets of one minute with each foot about 3 times each week. You’ll start to notice a difference pretty quickly.
 
Again, this is a great foot / calf strengthening exercise, but it’s also a great rehab exercise. If you or someone you know has foot pain, calf pain, shin splints, knee problems, hip pain or low back pain, I can help. Give us a call at 303.300.0424. Don’t put up with pain. 

 
 
 
 
 

How you sit says a lot

I just got the Denver Chiropractic Center Primary Pattern Rehab Protocols back from the printer. After all of these years, I finally put those protocols to paper and you’ll start getting them now at your appointments. Thanks to Otto the Hungarian Typesetter for doing the layout (really, he lives near Budapest).

Did you know that I can pretty much tell if you’re at risk for back problems based on how you sit down into a chair? It’s true. Since the glutes and back extensors, if properly firing and properly patterned, control your descent into a chair, I can tell if yours are working or not. If you tend to put a hand on your knee or an armrest when getting into a chair, you’re in trouble.

Using the arm to ‘build a bridge’ tells me that your glutes are not firing effectively. This means that you’re probably not using your glutes for other tasks, like picking objects up from the floor. Failing to use these muscles is a recipe for future back problems.

A typical patient with a back crisis thinks that it was caused by the bag of dog food he stooped over to grab. Or perhaps that patient was trying to get that squirming child into her car seat.

The reality is, almost all back problems are cumulative. Bad motor habits cause important muscles, like the glutes and spine extensors, to work less and less. If you’re not firing these muscles, you’re using other muscles, probably smaller spinal muscles, to take up the slack. This is what wears out spines and causes big back problems. The dog food and squirming kid are just the straws that break the camel’s back.

A great way to protect yourself is to start working on the squat pattern and getting it right. The Chair Squat Protocol is a Phase 1 Primary Pattern exercise that will help you. Remember of course to check with your doctor first.

Start with a sturdy chair, ideally with its back against a wall (1).

1

With your calves barely touching the chair, maintain a slight arch in your back and move your rear down and backwards into the chair(2).

2

Without shifting all of your weight onto the chair, use your glute muscles (by pushing your heels into the floor) to come back up (3).

3

My arms are extended in the pics as a counter-balance, but you don’t need to do that. Using this little exercise, every time you sit into a chair, you can work on protecting your back over the long run by using your glutes and spinal extensors.
This will help ensure that you continue using these important muscles and supporting your spine functionally. Yes, there are even more aggressive ways to work these muscles (that’s Phase 2 and Phase 3).

If you’re putting up with pain, whether it’s back pain, shoulder pain, headaches, shin splints or anything else, give us a call 303.300.0424. We’re here to help you.

Glenn Hyman

Insurance we accept
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

We are in-network providers for the following plans:

Aetna
Anthem – Blue Cross / Blue Shield

Cigna
Great West
Humana
United Healthcare and its subsidiaries
Kaiser PPO

 

We process all insurance paperwork for you!

If you don’t see your plan on this list, call us 303.300.0424, and Robyn will help you figure out if you have coverage in our office. Discount packages are available for those without insurance coverage.

Office Hours
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Monday – 9-5
Tuesday – 9 -5
Wednesday – 9-5
Thursday – 9-5
Friday 9-4

Quick Links…
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Our Website

Contact Information
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
phone: 303.300.0424
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Denver Chiropractic’s Top 3 Hips Stretches

‘Tis the season to get outside and start running, riding, hiking, climbing, etc. Here are 3 critical stretches that, if performed daily (or almost daily), will keep your hips happy all summer long. Tight hips can evolve into hip problems, knee pain, and plantar fasciitis.

For more info, look for the May-June issue of the newsletter coming soon to a mailbox near you.

 

Glute Stretch
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

glute stretch

The glutes are the biggest muscles in your body. They propel you forward in all athletic endeavors. If they start to scar up, they lose power, and other muscles start to take up the slack, particularly the hammies and the hip rotators. Back pain and hamstring problems usually follow.

To stretch: Just lay on your back and flex your hip to around 90 degrees. Use your left hand to pull your right leg across your body. Reach that right arm away to maximize the pull on the fascia. Hold for about 20 seconds and switch sides.

 

Hip Rotators
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Hip ro 1

The hip rotators include muscles like the piriformis. Problems in these muscles lead to sciatica and lateral knee pain.

To stretch: Lay on your side, preferably on a bench or the edge of a bed. Flex your hip to 90 degrees, grab your left knee with your left hand, and rotate your shin with your right hand. Make sure that your knee doesn’t move up towards the sky/ ceiling. Hold for 20 seconds, then flip over and do the other side.

hip ro 2

 

Hip flexors ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

The hip flexors oppose the glutes. They bring your leg forward in running, are obviously important in climbing, contribute to 360 degree pedaling, and more.

As they are overused, they totally screw up mechanics, leading to hip pain, knee pain, and back pain.

To stretch: get down on one knee, keep your torso upright, and move forward. See how  I maintain that arch in my back instead of rounding forward? That’s how you get the hip flexors to stretch.

Hip flex 1Hip flex 2

 

 
Remember- a tight muscle will become a scarred muscle. And noting breaks up scar tissue like Active Release Technique. So, you if need help, come on in. I can help you.

Sometimes I fail

Yesterday I had to tell a new patient that I couldn’t
help him. It’s a tough thing to do, but it happens,
even at Denver Chiropractic Center; even with
Active Release.
.
This particular patient was referred to me by
another chiropractor. He had low back pain
that radiated down the back of his thigh since
last November. He rated it as a 9 on a scale of
10 (10 is the worst). It started when
he was hiking in the Andes with a very heavy pack.
.
This is a classic herniated disc.
When I treat disc cases with Active
Release, the goal is to relieve the tension on the
muscles that cross the involved joint.
I was his last hope. I worked on him for about 30 minutes.
.
If Active Release is going to help, usually the
patient will feel a little better right away. This
man felt exactly that same. Considering that
he’d tried just about everything under the sun,
and considering that his pain had been the same
for 5 months, I told him he should speak to
a surgeon.
.
I hate to do that, but sometimes giving a
person an honest opinion, even if it’s one they
don’t want to hear, is the best I can do.
I never try to work with someone if I don’t
think that I can help. Luckily, it doesn’t happen
often.
.
This man was grateful that I was honest with him.
He left my office understanding why it was time to
speak with a surgeon. In the long run, he’ll
recover and move on with his life.
.
Just thought I’d share that one with you.
.
Glenn Hyman
Denver Chiropractic Center

16 Years of hip pain? Really?

OK, so all of the staffing chaos is behind me. The new
office manager, Amy, is on board and doing a great job.
Massage therapist Erin has been seeing clients and
getting rave reviews. So, on to this week’s question.
Once again, the person is real, and the question is
too:

“I was in a car accident 16 years ago, and I’ve
had hip pain ever since. I’ve had X-rays, and the
bone is fine. I have trouble lifting my leg to
climb in and out of the bathtub. Is this something
that you can help me with?”

The answer:

“Yes, I can probably help you. When muscle gets
injured, whether it’s a car crash, sports injury,
or repetitive motion, the healing process creates
scar tissue. This scar tissue changes the way that
muscle works – it doesn’t contract and relax as
efficiently as it used to. This leads to pain,
tightness, weakness, and other problems.

This condition can linger on for years, even decades.
Since nothing breaks up scar tissue as effectively as
Active Release, patients with long term problems
start to finally get relief. I have actually treated
injuries that were 20 years old and made dramatic
improvements.”

In this case, I treated the lumbar muscles, hip flexors,
glutes, and the piriformis. They were heavily scarred,
and the patient started noticing improvement after
the first visit. I’m still treating her (3 times as
of this wiriting) so I can’t yet claim success, but
I’m confident this patient will feel about 90% better
when we’re done.

2 Surgeries ruined at once

I recently had a patient, Jenny (real person, fake
name) come to me as a last resort.
This happens a lot.

This particular lady was scheduled for two carpal
tunnel surgeries – one on each hand.

She’d had symptoms for a few years (tingling in
the thumb and first two fingers) but lately, her
symptoms had become worse. So she saw her doctor,
who sent her to a surgeon, who naturally told her
that she needed surgery. The surgeon was booked
for the next 4 weeks, so she had some time to
start having second thoughts.

Second thoughts usually lead to the internet. A
simple google search of “Carpal Tunnel Denver”
led Jenny to me.

With my on-site work at 2 manufacturing facilities
over the last five years, I’ve treated hundreds
of carpal tunnel cases, and have sent exactly four
to surgery.

Carpal tunnel syndrome is an entrapment of the nerve
to the thumb and first two fingers – the Median Nerve-
in the hand. Since that nerve runs through the muscles
of the forearm, there are many places that the nerve
can get trapped. If surgery is done at the hand, but
the nerve is trapped in the muscles, there’s no change.

So Jenny came to see me, hoping her median nerves
were trapped in her forearms. And they were. After
just 4 Active Release treatments, she was feeling
much better. After about 8 she was symptom free.

Both surgeries were cancelled.

Many cases of Carpal Tunnel can be treated without
surgery. If you or someone you know is suffering
with this problem, give us a call.

A patient’s question about sciatica

Dear Glenn,

Here’s another question from a patient:

Hello Dr. Hyman,

I’ve been experiencing an annoying pain that originates
in my glute and goes down the back of my leg. You treated
a friend of mine for sciatica (I’m assuming that’s what
this is). Can you help me and how?

The answer:

“Sciatica” refers to pain in the sciatic nerve’s
distribution, down the back of the leg. It’s caused
most commonly by one of two problems:

Pressure on the nerve from a bulging disc.
Pressure on the nerve from the muscles in the area.

The muscular cause is way more common.

The first step is to perform a thorough examination
and make sure your problem is not caused by a
herniated disc. If it is, that can be treated,
but treatment is different.

If I determine that the pain comes from the muscles,
I will identify the muscles involved and release them.
I do this by applying gentle tension to the muscle and
combining that with specific movements. This is
known as Active Release Technique®, which I am
certified to provide (I’m also an ART instructor).

If the joints in your low back and pelvis
are stiff and contributing to the problem,
they may be adjusted. Adjustments are a
gentle way to loosen joints. Very little
force is used with adjustments and they
usually feel great.

The first step is to make an appointment and let
me determine what’s causing your sciatica, then
we can determine the correct treatment plan.

On average, 4-8 visits are required.
……….

If anyone that you know is suffering from
sciatica, tell him or her to call us at
303.300.0424. We can help.

Glenn Hyman
http://www.denverback.com

A back pain question from a triathlete

Question from a real patient:

Dr. Hyman,

My name is (deleted) and I’m a member of the (deleted) Triathlon Club. I noticed you are a sponsor and are very familiar with the athletic world who has worked with all types of athletes. I’m in my fourth year of racing Tri, which is remarkable due to a back injury in 2001 that resulted in a bulging disc. In 2006 I had a skiing accident that resulted in an avulsion facture of the L5 vertebrae. I was all healed up and good until a week ago when for some reason, a drive to Breckenridge aggravated my back. This resulted in crawling around for a couple of days. My back is very stiff and the pain is now tolerable. I want to consult your services in hopes of a speedy recovery to get back to training. Can you help me and how?

Answer:

A patient with this type of injury history is susceptible to aggravations of back pain. These may be severe and these may be minor. Since this patient had no pain radiating into his legs, and no other neurological symptoms, I was comfortable working with him. In this case, a simple move in the wrong direction led to a fairly significant muscle spasm. It’s likely that this person’s existing herniated disc received excessive pressure as a result of his posture in the car. This led to a painful guarding response that stopped him from skiing and doing further damage to his low back. After 2 – 3 weeks of treatment and some reasonable range of motion exercises, this patient should be able to return to full activity. His triathlon training should be normal, but core strength is definitely going to be a priority.

Note: This article is for informational purposes only. Don’t use it to diagnose yourself. See a qualified licensed health care practitioner.

A Question about knee pain

The Question (from a real patient):

Hi, Glenn

You sucessfully treated me over a year ago for tarsel tunnel syndrome. I had my left knee scoped about four months ago to remove torn cartilage. I went through several months of PT and regained reasonable strength (it took me longer than some people because I had lots of edema and the VMO had been shut down for months.) However, I still have tightness, localized tenderness and restricted range of motion when I attempt to get back into certain yoga poses or do deep squats. My ortho and PT suspect that I have some scar tissue. I’ve been receiving deep tissue massage, which is helping but feel I need to do more to recover normal function. Have you treated similar issues before and do you think that ART would be helpful in my situation?

Dr. Glenn’s answer:

Residual scar tissue often follows arthroscopic surgeries. In my experience, the targeted techniques of Active Release are the best way to access and break up this scar tissue. On average, 4-8 sessions are required, but the results are usually good.