Dr. Glenn Hyman’s Blog
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
“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?”
“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
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.
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
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.
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?
“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.
Denver Chiropractic Center is now scheduling appointments for Massage Therapy!!!!
According to Newsweek there are many beneficial reasons to choose massage therapy, here are the top 4:
1. Pick Your Spot: You don’t have to massage the part of the body that hurts most. If you’re shy about letting a massage therapist touch your aching lower back, for instance, she could help by massaging your shoulders instead. This is because massage creates chemical changes that reduce pain and stress throughout the body. One way it does this is by reducing a brain chemical called substance P that is related to pain. In a TRI study, for example, individuals with a form of muscle pain called fibromyalgia showed less substance P in their saliva (and they reported reduced pain) after a month of twice-weekly massages.
2. De-Stress, Stay Healthy. Massage may boost immunity. Several studies have measured the stress hormone called cortisol in subjects’ saliva before and after massage sessions, and found dramatic decreases. Cortisol, which is produced when you are stressed, kills cells important for immunity, so when massage reduces your stress levels and hence the cortisol in your body, it may help you avoid getting a cold or another illness while under stress.
3. Blood Pressure Benefits: Massage reduces hypertension, suggests a good deal of research. This may be because it stimulates pressure receptors that prompt action from the vagus nerve, one of the nerves that emerges from the brain. The vagus nerve regulates blood pressure, as well as other functions. In a 2005 study at the University of South Florida, hypertension patients who received 10 massages of 10 minutes each over three weeks showed significant improvements in blood pressure compared to a control group who simply rested in the same environment without any massage.
4. Technique Tactics: There’s little evidence to support one kind of massage over another, so don’t worry about whether your therapist is schooled in Shiatsu, Swedish or some other technique. The key is pressure firm enough to make a temporary indentation in the skin.
Schedule your appointment today! 303.300.0424
Question from a real patient:
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?
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.
The Question (from a real patient):
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.
I just finished up at the USA Traithlon Coaching
Certification clinic in Colorado Springs. Had a great
room for 2 nights at the Broadmoor. What a place.
But that’s not why I’m writing. During one of the breaks,
a coach from New York asked if I could take a look at
her shoulder. Somehow she had been googling Active
Release and found my website. It was kind of strange that
she knew who I was.
Anyway, she had been dealing with shoulder pain while
swimming for over a year. It hurt to raise her arm
over her head, hurt to put a shirt on, hurt at night,
Fear of needing surgery had kept her from saying
anything about the pain to anyone. She was hoping
maybe I could give her an opinion.
I put her through some ranges of motion and her
problem was obvious. Scar tissue in her subscapularis
was keeping that muscle from firing. This was causing
her humerus to ride a little too high in the joint.
Classic impingement syndrome.
I treated her during the first two days at the clinic,
mostly breaking up the scar tissue in the subscap.
On the third day she swam and reported it was
about 90% better. I referred her to an ART doc in
NY to finish up. She was so excited that she cried.
I love that kind of case.
This was no miracle. Many shoulder problems start in
the subscap. They can usually be fixed. The first step
is finding the right person to help. I’ve treated
hundreds, probably over a thousand.
So, I’m back in the office after the certification.
If you or anyone you know is having shoulder pain,
I can probably help. Call 303.300.0424.
You can read more about shoulder pain here:
One of the best things about being an Active Release provider is fixing patients who are already scheduled for surgery. I don’t keep formal score, but there are at least 2 of these cases a month. And I’ve been doing this for about 10 years. So that adds up to over 200.
Many of these cases involve carpal tunnel syndrome, and some involve rotator cuffs.
Carpal tunnel syndrome is caused by pressure on the median nerve. This nerve runs through the forearm and ends at the thumb and first two fingers. In many cases, the pressure in the nerve comes from scar tissue that’s accumulated in the muscles. By releasing the scar tissue with Active Release, the pressure on the nerve resolves. Then there’s no reason to do surgery.
Now, I can’t claim a 100% success rate. Sometimes surgery is indeed necessary. But most patients who come to me are willing to try. I’d estimate that 8/10 cases resolve with ART. It’s proabably higher, but I don’t want to run the risk of over-estimating.
So if you’ve been told that you need carpal tunnel surgery, maybe coming to see me is worth a shot? Check back soon for a video clip featuring a real patient who was scheduled for Carpal tunnel surgery and had her symptoms resolved by me.
We’re back in the office after a nice 2-week break. We
hope you enjoyed your holidays, too. Here are a couple
of things to look forward to in 2009:
1. As you know, Brittany is now running the office. She’s
been doing a great job and will keep doing a great job in ’09.
2. No price increase for 2009. Considering how bad the
economy seems to be, we’ve decided to keep our prices
the same this year.
3. Massage therapy starting February 2nd. We’re presently
interviewing therapists, and are looking forward to offering
massage therapy in the office. If you know of any we should
consider, please let us know.
4. A 1-week extension on the end of the year package
special. Many of you wanted to take advantage of the $50
discount on package renewals at the end of 2008. We decided
extend that discount until the end of business on Friday
5. The formation of the Denver Chiropractic Center
triathlon team (Team DCC). I’m looking for some beginner
level triathletes who are interested in coaching and
support. I’ll become a USAT certified level-1 coach next
week, and I’d like to specialize in working with beginners.
So, if you’ve thought about doing a triathlon, I might be
your guy. You should be willing to commit to doing either
the Buffalo Creek Xterra Short Course on June 20
or the Crescent Moon Sprint September 19
For $300, you will get a complete coaching program with
ongoing support, group training rides & runs, and a super-
cool Denver Chiropractic Center cycling jersey. All
profits will be donated to charity. I’ll accept a maximum
of 5 athletes for 2009. If you want in, let me know soon.
That’s it for now!