Posts

Did a rib pop out?

Another Denver Chiropractic Center blog:

Today I had another new patient who came to me thinking she had
popped a rib out of place. She had severe mid back pain that traveled
under her shoulder blade. It started on Saturday while she was
shoveling snow.  She called first thing in the morning today (Monday)
and of course we got her in as soon as we could.

Here’s an article on the site:

http://www.denverback.com/q_midscapulae.html

Ribs rarely actually move out of place unless there is a severe
trauma, like a car accident. For some reason, people with mid
back pain almost always thing that a rib is out place.

Think about it for a second. Those ribs are there to protect
your heart and lungs. They’re strongly attached to both your
spine and sternum, and are very difficult to move ‘out of place.’

There are several layers of muscle between the shoulder blades,
also known as the scapulae. These muscles include the traps,
rhomboids, and spinal muscles.

Sharp mid back pain is almost always muscular, and usually is
dramatically better with just one Active Release treatment, and it’s
almost always gone after two or three sessions.

Chronic mid back pain can frequently be traced back to those
same muscles. I regularly see patients who’ve had pain between
the shoulder blades for years. These cases require a few more
treatments, but they also resolve nicely with Active Release. And
yes, these people also think that they have a rib that’s out.

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.

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.

Changes for 2009 at Denver Chiropractic Center

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
January 9.

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
http:// www.youtriit.com
or the Crescent Moon Sprint September 19
http://www.racingunderground.com/crescentmoontri/

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!