DISC HERNIATION: Is there life after a disc injury?

The answer, almost always, is YES.

As some of you may know, I ruptured a disc in my lower back when I was 13 years old.  We were playing a running & dodging game at recess, and after a quick cut to the side, my back and legs suddenly seemed to stop working and I hit the ground.

Many years later I saw x-rays of my lumbar spine, and it became clear what had happened back then on the playground: I had damaged my 2nd lumbar disc.

The evidence was easy to see.  My entire lumbar spine looked great, except for L2.  That disc was dramatically thinner than the rest of them, the vertebrae above & below were thickened and misshapen, and there were large, hooked bone spurs (osteophytes) surrounding that joint.

Your spine is made up of 24 bony vertebrae, and in between each of them is a disc.  The discs perform 3 functions:

1. They act as ligaments, by holding the vertebrae and spine together.
2. They act as shock-absorbers, by carrying the downward weight (axial load) of your body while you're upright.
3. They act as pivot points, allowing the spine to bend, flex and rotate.

The disc itself is designed like a jelly danish.  The outer rim (annulus) is tough and fibrous, while the   "jelly" center (nucleus pulposis) is about the consistency of toothpaste.  It's when the nucleus starts to protrude through the layers of the annulus that problems start.

When a damaged disc bulges outward, the "bubble" can compress or irritate spinal nerve roots, which can cause the numbness, radiation pain, weakness and tingling associated with disc injury.  This most commonly happens in the cervical or lumbar spine.

The good news is, most disc injuries (even old ones) can be dramatically improved without surgery.  Don't get me wrong -- we can't replace damaged disc material, or remove osteophytes.

But what we CAN do is rebuild the muscular support system around the damaged joint, training it to take over the job of the disc.  Functional rehabiitation, McKenzie exercises, core stabilization, joint mobilization and flexibility training can all help make your disc injury a non-issue.  Even more importantly, good spinal maintenance can help keep your pain from coming back.

If you're in pain, don't despair --  for the huge majority of our patients, there IS life after a disc injury.  Come see me and we can figure out the right treatment for you.

-Daniel Bockmann, DC

To learn more about herniated discs, click here: http://www.nlm.nih.gov/medlineplus/herniateddisk.html

chiropractor-austin-tx 

JOINT PAIN: Should I give it some time, or go see a doctor?

This is a VERY common question, and a good one.  We've all had "aches & pains" before, and most of the time they go away on their own, without any special treatment or doctor visits.

But how do you know when giving it some time might actually be making it worse?  Here are some good general rules.

When to call 911:

1. Bleeding
2. Exposed bone or tendon

When to seek immediate medical attention:

1. Joint deformity (it "doesn't look right")
2. Inability to use the joint (it won't bend, bear weight, etc.)
3. Intense pain (enough to make you "wince", limp, etc.)
4. Sudden swelling (ever sprained your ankle?)
5. "Weird" symptoms (numbness, tingling, "doesn't feel right")

When it's okay to wait:

1. Pain only happens once
2. Joint moves normally
3. All symptoms are mild (feels "stiff, sore or achey")
4. Moving the joint actually relieves symptoms
5. Symptoms improve quickly

NOTE: If your pain starts happening more often, is more severe each time you get it, or takes longer to go away, see a doctor!  You could be doing additional damage.

And if you're unsure whether or not you should get help, DO.  It's always better to get it and not need it, than to need it and not get it.

chiropractor-austin-tx

BODY MASS INDEX: Why your BMI may be lying to you

My BMI says I'm fat.  That's right.  My BMI is 25.7, which is well into the "OVERWEIGHT"  category.  And can you guess why?  It's because the Body Mass Index is literally a useless tool for measuring body fat.

And I'm not alone.  A Baylor study found that 1 out of 6 children who scored normal on the BMI actually had a high percentage of body fat.  And it found that 1 out of 4 children labeled as obese by the BMI actually had a normal percentage of body fat.

The problem?  It's too simple.  It tries to predict how much body fat you have, but only looks at your height and weight.  This would be like trying to predict how many people are in a building, but only looking at the dimensions of the building.  It's ridiculous.

But there is a much better solution.  Body composition testing.  If you want to get an accurate assessment of your body fat percentage, both skin fold caliper measurement and the Tanita scale will each give you quick & easy readings.  And both are a free service provided by most gyms.

Healthy body fat percentages, according to the American Council on Exercise:

• Men: 6-17% body fat
• Women: 14-24% body fat

And, staying within these ranges can dramatically reduce your risk of the following conditions:

1. Feeling miserable*
2. Dying young*

*( heart disease, stroke, high blood pressure, diabetes, cancer, gall bladder disease, gall stones, osteoarthritis, gout, sleep apnea and asthma)

So don't worry about your BMI.  Pay attention to your body fat percentage.  It's a much more accurate and helpful tool to help you get more out of life!

And if you don't know where to start, talk to a good personal trainer or fitness expert.  They can develop a do-able exercise and diet plan that works for you.

If you're not happy with where you're at, do something about it!  :)

chiropractor-austin-tx

PROPRIOCEPTION TRAINING: Making joints "bulletproof"

Ever sprained your ankle?  Did you notice afterward that the ankle didn’t feel stable under you, that it sometimes “gave way”, even after it stopped hurting?  Maybe you found that you kept spraining the same ankle, over and over, throughout your life.

Here’s why.

When you sprained your ankle, you also damaged its ability to protect itself.  This protection system is called proprioception (or kinesthetic awareness).  Proprioception is how your body “knows” where your limbs are, without looking.

By sensing your ankle’s exact position at all times, your brain coordinates the muscles around the ankle to make sure that the joint is always “snugged-up” and secure – never slack.  A joint without muscular support, even for an instant, is highly susceptible to injury.  (This is true for ALL joints – not just ankles).

This “awareness” of joint position is accomplished by thousands of small receptors in muscles & joints, all over your body.  These receptors keep track of how much tension is on a muscle, how fast the muscle is moving, and what position the joint is in.

If your proprioceptive system is damaged (like in a sprain), it may start to give your brain the wrong information about your joints.  Your brain becomes confused about what position your limbs are in, and can no longer coordinate safe movement.

Translation: your ankle feels wobbly & unstable.  And then you may sprain the ankle again.

But, here’s the good news: Proprioception is learnable. 

In fact, we use proprioceptive training in all of our rehab programs.  If you’ve been a patient of ours, you know what I’m talking about.  Proprioceptive exercises are complex, controlled movements that very often involve a balance challenge.  Although we use these exercises to help heal injured tissue during rehab, incorporating these same exercises into your own personal workout program can act as powerful protection for your joints.  Almost like surrounding your joints with Kevlar.

If you keep injuring the same joint over and over again, don't let it keep happening -- TAKE ACTION.  Each new injury may be further weakening the joint and leaving you susceptible to bigger and bigger injuries.  We can help you rebuild your "built-in" joint support system so you can start healing and get back to your life.

And then, most importantly, teach you how to stay healthy by "bulletproofing" your own joints.  It's easier than you might think!

-Daniel Bockmann, DC

To read research on how proprioceptive training prevents ACL injury, click here: http://ajs.sagepub.com/content/33/7/1003.abstract

chiropractor-austin-tx

LAMINECTOMY WITH FUSION: What can happen if you don't take care of your back

As a chiropractor and a rehab guy, I observe surgeries every chance I get.  This morning I got to scrub in with one of Austin's top neurosurgery teams, Drs. Mark Burnett and Kitt Fox of Neuro Texas Institute, as they performed an enormously complicated triple lumbar laminectomy with fusion.

Since it is tremendously invasive, risky and has long recovery times (9+ months), this procedure is basically a last resort for someone with advanced spinal degeneration.  Most of the back side of the spine is removed, including the lamina, pars and facet joints, which relieves pressure from the spinal cord and nerves.  Then titanium brackets are drilled into the spine across several vertebral levels, effectively "bolting" them all together.  These joints will never move again, but this is necessary to support the spine after much of it has been removed.

Over breakfast Dr. Burnett told me something that each of you should know.  He said that this patient's lower back problem was in fact "a whole-body problem". 

Here's what he meant.

This patient was diabetic, overweight and sedentary.  His progressively worsening lower back pain, numbness, weakness and eventual inability to walk was most likely avoidable.  This surgery was most likely avoidable.

Which means, you get to CHOOSE whether you'll ever need a surgery like this.  Eating sensibly, exercising moderately and taking care of your spine can MASSIVELY reduce your risks of permanent disability, chronic pain or even death on the operating table.

If you feel like you have a "whole-body problem" and would like to fix it, come see me.  Like I always say, 

• "It's easier to keep you healthy than it is to fix you when you're broken."

Taking care of yourself is an investment, but the payoff is BIG.  What will YOU choose?

-Daniel Bockmann, DC

To read more about the procedure I watched this morning, click here: http://www.webmd.com/back-pain/decompressive-laminectomy-for-spinal-stenosis

To learn about Dr. Mark Burnett and his team, click here: http://www.neurotexasinstitute.com/OurDoctors/neurosurgery/dr-mark-burnett.aspx

chiropractor-austin-tx 

NO PAIN, NO GAIN: Fact or fiction?

We’ve all heard this expression.  But is it true?

This motto was first aired in 1982, when actress Jane Fonda produced a series of workout videos (you know the ones!), in which she used phrases like “No pain, no gain,” and “Feel the burn” to encourage her fat-burning viewers to work harder during exercise.  And it’s still used today.  Thousands of personal trainers repeat this mantra to their clients daily, reminding them that there is no meaningful reward without sacrifice.

There’s only one problem. Pushing yourself through pain can actually be dangerous.

Here’s a quick example.  A young woman came in to our office with pain in her right hip.  She had been training to run a marathon, and her speed and endurance were improving nicely.  Out of the blue, her hip started hurting when she ran – even during the first few steps.  The pain progressively worsened, eventually preventing her from running at all.

Her doctor had told her that she had a tendonitis in her hip, and said she should be fine after a little stretching, rest & ice.  That didn’t seem to help.

After performing an exam & x-ray of her hip, i suspected a stress fracture.  An MRI confirmed this.  Less than two months of rehab later, we had her running again, and her hip was healthy.

Here’s the take-home point.  If this young woman had followed the “No pain, no gain” theory and continued to run, she could have developed avascular necrosis (AVN) of the hip, which could lead to a catastrophic fracture of the hip, and then required her to have a total hip replacement surgery.  Not a very pleasant experience.

In fact, joint pain is never normal.  Pain is like the red light on your dashboard, telling you when something is going wrong & needs attention.  If your engine was overheating, would you keep on driving?  Would stomping on the accelerator solve the problem?

We have a simple pain rule for our patients, called the “wincing” rule.  Following this rule can help you avoid injury during exercise or everyday life.  Here’s how it works:

The "Wincing" Rule
During any activity, if you have enough pain to make you "wince" (like the guy in the picture!), that means you may be doing actual damage to yourself.  Immediately stop what you're doing and see if your pain subsides.  If it does, resume your activity but at a lower intensity that allows you to work comfortably.  If you're running, for example, try running at a slower speed, or a shorter distance, or on flat ground instead of an incline.  Anything lower than a wincing  level of pain is generally okay to work through -- like an exercise "burn", or stiffness, tightness or soreness.

And, if you find yourself having to modify or eliminate activities on a regular basis, it’s time for you to come see me or another qualified health professional.  Pain that occurs routinely, or pain that becomes more frequent or severe, is a sign that some underlying problem needs to be corrected.  And with many conditions, the sooner you get the proper treatment, the easier it is to correct.

In summary, pain high enough to make you wince means STOP.  Pain levels below that are generally okay to work through.  And remember: Your body is pretty good about telling you what it likes and doesn't like.  Listen to it!

-Daniel Bockmann, DC

To see a list of the causes of joint pain, click here: http://www.mayoclinic.com/health/joint-pain/MY00187/DSECTION=causes

To learn more about avascular necrosis of the hip, click here: http://www.mayoclinic.com/health/avascular-necrosis/DS00650

chiropractor-austin-tx

BAREFOOT-STYLE RUNNING: How to make the switch without hurting yourself

So you've decided to change from your usual heel-pounding stride to the super-smooth barefoot-style stride.  You already know that BF style runners experience 7 times less impact than the heel-strikers.  You know that research suggests that landing on your forefoot can help you avoid repetitive stress injuries like runner's knee, stress fractures, plantar fasciitis and Achilles tendonitis. You know that BF style running requires less effort than traditional style because it is more efficient.

And you've had your eye on the sexy new Minimus trail runner from New Balance -- perfect for your new running style.

Making the switch can be a smooth & easy transition, or it can be grueling & painful.  Here's how to do it the easy way.

1. Build up slowly!  BF style running requires you to use muscles in your feet that are probably very weak, even though you may be an experienced runner.  Respect that.  For the first week, run no more than a quarter-mile to 1 mile every other day in BF style, then complete the remainder of your run in your usual style.  After a week, increase your BF style distance by a half-mile at a time.
2. Listen to your body!  Mild to moderate muscle aches are fine to push through, but a "wincing" level of pain means you may be doing damage.  Dial back your training until it diminishes, then resume at a comfortable intensity.  If you're limping due to calf soreness, that means you overdid it!  Persistant or increasing pain?  Stop training and come see me.  We'll get you back on track.
3. Continue with your usual mileage.  If you're a regular runner, understand that transitioning to BF style does NOT mean you have to decrease mileage.  Simply start each run in BF style, and finish in your usual style.  After several weeks (or months even) you'll be using BF style exclusively.
4. Less shoe is MORE.  So-called "minimalist" running shoes let your feet move more freely in BF style running, and there are a whole fleet of new ones coming out.  "Test drive" a couple, then pick one that feels the most natural and comfortable as you run in your new style.  (I wear the Nike Free, but I'm excited to try the New Balance Minimus!)

The main thing to remember is PATIENCE.  By switching to BF style you're now asking your calf muscles to do something they virtually never do: DECELERATE you. In traditional heel-strike running, your calf's only job is to ACCELERATE you forward by pushing off.  In BF style your calf now acts as a shock absorber, soaking up the impact of each landing.  And while BF style drastically reduces that impact, deceleration (or eccentric contraction) is a completely new job for your calves, so you have to work up to it.

Make the switch to BF style.  A safe transition means you'll soon be running softly & silently -- no more "pounding the pavement"!

Post your progress!

-Daniel Bockmann, DC

For more info on safe transitions to BF running, click here: http://www.barefootrunning.fas.harvard.edu/5BarefootRunning&TrainingTips.html

To check out the latest "light as air" minimalist running shoes, click here: http://www.barefootfootwear.com/

chiropactor-austin-tx 

BAREFOOT-STYLE RUNNING: Why it's better.

One year ago this month I changed to barefoot-style running, and it has been one of my best decisions ever.  I made the change after reading the book, Born to Run, by Christopher McDougal, which should move to the very top of your must-read list if you're a runner.

Here's a quick summary of my year-long test of this style: Running is "smoother", it hurts less and it's more fun.  But don't take my word for it.  Research backs me up 100%.

First of all, here's the definition of barefoot-style running:

• Running with no heel-strike.  Just as if you were running in place, only moving forward.

BF style running does not mean you ARE shoeless.  It means you are running AS IF you were shoeless.  If you were running barefoot on a sidewalk you would automatically run only on your forefoot, because landing on your heel would HURT.  The heavy landing on your unprotected heel bone would quickly leave you painful and gimpy.

BF style running means landing on your springy forefoot (the front part of the foot, starting at the natural "bend"), allowing your calves to act as shock absorbers and eliminating the "shock-wave" that occurs every time you land on your heel.

NOTE: You can run in barefoot style WITH or WITHOUT shoes. You do NOT have to wear the Vibram 5-Finger shoes.  :)

Did you know that the running world NEVER used a heel-strike technique until 1972?  EVERYONE ran in barefoot style back then, and all running shoes were thin-soled and slipper-like.

In 1972 Nike came out with the Cortez shoe, which for the first time ever sported a hugely cushioned heel, and encouraged runners to lengthen their stride by landing on their heels instead of their forefeet.  It seemed good on paper, but running injuries have steadily increased EVER SINCE.

Runners are hurting themselves more than ever, even in more and more technologically advanced shoes.

And it's all because we're taking away our foot's built-in ability to absorb impact safely.  "Motion control", "multi-angle forefoot gel pods", "midfoot thrust enhancers" and even microprocessors that automatically adjust cushioning for every stride -- all of these shoe features cause MORE injuries -- not LESS.

Over a decade ago a Swiss study found that wearing top-of-the-line running shoes made you 123% more likely to get injured than wearing cheap ones.  What's the difference between expensive shoes & cheap ones?  MOTION CONTROL.  The high-dollar shoes are expensive precisely because of all the technology added to the shoe. These fancy features all prevent your foot from protecting itself.  Which means more injuries.

Need proof?  Read the research I've linked below.  And stay tuned -- in my next article we'll explain how to transition from traditional heel-strike running over to barefoot-style running -- SAFELY.  It's easy, but you have to do it right.

Are you running barefoot style already?  Check in!

-Daniel Bockmann, DC

To see Harvard research on barefoot style, plus video comparisons, click here: http://www.barefootrunning.fas.harvard.edu/4BiomechanicsofFootStrike.html

To read more about the re-discovery of barefoot style, click here: http://www.chrismcdougall.com/barefoot.html

chiropractor-austin-tx 

SKETCHERS SHAPE-UPS: Do they really work?

Skechers makes some pretty impressive claims about their shoes: weight loss, firmer muscles, reduced cellulite, improved circulation and posture.  Getting a pair for Christmas might be the perfect way to start firming that booty for the New Year, right?

Sadly, no.  No matter what the Kardashians might tell you, Skechers Shape-Ups are  no better for you than regular shoes.

The American Council on Exercise, a non-profit fitness organization, and a USA Today report both found that Skechers' high-flying claims of effortless fitness were essentially hogwash.

A large-scale study done by the ACE found that wearing Shape-Ups, as well as 2 other similar brands -- Reebok EasyTone and Masai Barefoot Technology -- is no more beneficial than wearing regular shoes.

Which is probably why Skechers has been named in a federal class-action lawsuit over allegedly exaggerating the health benefits of their shoes and "reaping millions of dollars in profit" through running misleading ads.

But don't despair!  There are plenty of very effective ways to lose weight, firm your muscles, reduce your cellulite and improve your circulation and posture!  None of those ways are "effortless", but a little hard work never hurt anyone.  :)

The best way to kick off your New Year's resolutions is by contacting someone who knows what they're talking about, like elite trainer Barron Jackson at VO2 Fitness.  There aren't any shortcuts to feeling & looking great, but it's not as hard as you think.  :)

-Daniel Bockmann, DC

To read the American Council on Exercise study on Skechers Shape-Ups, click here: http://www.acefitness.org/getfit/studies/toningshoes072010.pdf

To see the actual class-action lawsuit documents in the case against Skechers, click here: http://www.courthousenews.com/2010/08/27/Skechers.pdf

chiropractor-austin-tx 

EXERCISE AND ILLNESS: Should I exercise when I'm sick?

Whether it's a cold or an allergy attack, being sick can interrupt your exercise schedule and make you feel flabby as well as sniffly.  But is it safe to exercise when you're sick, or should you force yourself to rest?

The short answer is, sometimes exercise is good when you're sick, other times it's not.  Here's the rule of thumb you should use:

• Proceed with your workout if your signs and symptoms are "above the neck" — such as runny nose, nasal congestion, sneezing or sore throat. Be prepared to reduce the intensity of your workout if needed, however.
• Postpone your workout if your signs and symptoms are "below the neck" — such as chest congestion, hacking cough or upset stomach. Likewise, don't exercise if you have a fever, fatigue or widespread muscle aches.

Our bodies are pretty good at letting us know what they like and don't like, so pay attention to what yours is saying.  If you have a fever or feel feverish, you need rest -- not exercise.  Once your fever breaks, try starting off with light exercise first, letting your body become accustomed to movement again.

Giving yourself a reasonable dose of light or moderate exercise when you're sick can actually help speed recovery from a cold or allergies by stimulating circulation and clearing the sinuses.  Next time you're under the weather, try it!

-Daniel Bockmann, DC

To read more about exercise and illness, click here: http://www.mayoclinic.com/health/exercise/AN01097

chiropractor-austin-tx 

NEW STUDY: Simple changes in jumping technique prevent ACL injuries

 Knee injuries are the scourge of the jumping athlete, whatever their sport.  A new study from UC Davis finds that the risk of sustaining these injuries can be greatly reduced, simply by changing the way you jump & land.

The changes are simple:

1. Jump straight up (no broad jumping)
2. Land on your toes (not your heels)
3. Bend your knees more deeply on landing

These 3 changes reduced shear forces in the knee by 56% in the female basketball players tested, significantly reducing strain on the ACL ligament.  Researchers also found that players jumped an inch higher on average when using these techniques.

Interestingly enough, we've been teaching our athlete patients these rules of jumping for years.

For the full article, click here: http://www.sciencedaily.com/releases/2010/08/100811093013.htm

chiropractor-austin-tx

NECK PAIN: The cause of the "crick"

It's very common, and it almost always presents the same way:

"I woke up, turned my head a bit, and got this sharp pain in my neck.  What's up with that?  Now I can't turn or tilt my head to the left, and I get a sharp pain down into my shoulder blade!"

If this sounds like something you've experienced, you probably had a condition called 'torticollis'.  Torticollis covers a range of neck conditions, but the particular version we're talking about here is usually caused by damage to ligaments in your neck.

Ligament damage is called a sprain (just like when you sprain your ankle), and can happen from a sudden trauma -- like a whiplash injury -- or by a slow overstretch of the ligament -- like sleeping with your head turned awkwardly to the side.

Here's how it can happen.

Your neck supports your 10-15 lb. head by way of 7 bony vertebra, which are all connected together by ligaments.  Ligaments are like tough, fibrous ropes -- not very flexible, but great for holding bones together.  Quickly overstretching these ropes can cause them to fray or snap (think whiplash), but a slow stretch over time can also cause them to weaken.

When you fall asleep on the couch with your head bent to the side, or if your pillow is too thick, this slow overstretch causes the ligaments to become weakened, inflamed, and painful.  As soon as you try to lift your head off your pillow, these damaged ligaments are now asked to hold the weight of your head, and that's when you feel the pain.  Not a nice way to start your day.

And on top of that, your muscles may go into spasm.  This is a natural response by your body, and it's called muscle splinting.  Splinting happens when your body senses an injury, and tightens up the muscles around the injured joint to protect it from further harm (much like you'd splint a jammed finger).  Only thing is, muscle splinting HURTS.  Ever had a 'charley horse'?

So, how do you fix it?

The key is re-introducing safe & comfortable movement to the injured joint.  We use supported range-of-motion exercises, low-force manual joint mobilization, and isometric neck exercises to start.  Axial traction can be particularly helpful, too, and pain-relieving therapies like interferential current or ultrasound may also be used.  For most cases, we're able to get 80-90% improvement in a week.  Left untreated or undertreated, torticollis can linger much longer, or heal incompletely.

As painful and inconvenient as it may be, torticollis is fixable.  If you think you may have torticollis, give it a couple days to get better.  If you're still hurting, come see me or another health care professional. 

-Daniel Bockmann, DC

To see a list of possible causes of neck pain, click here:http://www.mayoclinic.com/health/neck-pain/DS00542/DSECTION=causes

chiropractor-austin-tx

TENNIS ELBOW: There is a ridiculously easy solution.

If you've ever had pain at the outside of your elbow that's worse when shaking hands, opening jars or even brushing your teeth, you've probably had tennis elbow.  Although you don't have to be a tennis player to get it, the name arose because so many tennis players get it during their careers.

Tennis elbow (or lateral epicondylitis) is notorious for being an extremely stubborn condition to treat, often lasting months or even years.  And the pain can be excruciating.

Thanks to a recent breakthrough in sports medicine, there is an amazingly effective and simple solution: The Tyler Twist. 

Tennis elbow occurs when the muscles and tendons at the outer edge of the elbow are overused -- either all at once or slowly over time -- and become inflamed & painful.  The outer edge of the elbow is known as the lateral epicondyle, and this is where the muscles that extend your wrist are found.

In the sports medicine community we have always known that eccentric exercises (or "negatives")  make tendons capable of carrying greater loads.  I routinely use eccentric drills with my patients to help them recover from tendon injuries like jumper's knee or Achilles tendonitis.  But for some reason no one had developed an easy way to eccentrically load wrist extensors.  Until Tim Tyler, PT.

He developed a simple tool called a Flexbar which makes eccentric loading of wrist extensors very simple.  And you can buy a Flexbar for about $15.

In the first research study he performed using his new technique, researchers actually had to end the study prematurely because the "Tyler Twist" exercise group was improving so rapidly that it became an ethical problem to deprive the control group of this treatment. 

How much better was it?  The Tyler Twist exercise group saw 79% improvement in 5 weeks, while the traditional physical therapy group saw only 15% improvement.  Pretty dramatic.

Below you'll find a link to both the research study and a video demonstration of the exercise, BUT...

If you have persistent or severe elbow pain, GET YOURSELF CHECKED OUT FIRST.  Come see me or another sports medicine professional to make sure you don't have a more serious injury or condition.  Elbow pain can be caused by many things, and prompt diagnosis can make all the difference.

If you have tennis elbow, try the Tyler Twist, then post your results on our page!

-Daniel Bockmann, DC

To read the research article on the Tyler Twist, click here:http://www.biomedsearch.com/nih/Addition-isolated-wrist-extensor-eccentric/20579907.html

To see a video demo of the Tyler Twist in action, click here:http://www.youtube.com/watch?v=gsKGbqA9aNo

chiropractor-austin-tx

LOW BACK PAIN: 3 signs that you need to go to the emergency room

Low back pain is a big deal in this country.  One half of all working Americans admit to having back pain EVERY YEAR.  In fact, back pain is the second most common reason for visits to the doctor's office, outnumbered only by upper respiratory infections. 

And although there are many possible causes of back pain, there are only 3 types of back pain that need to be treated as a true  emergency.  TRANSLATION: If you don't seek immediate help from a doctor, you could be permanently disabled, paralyzed or even die.

Here are the 3 categories of "Emergency Room" back pain, and the signs that help identify them:

1. POSSIBLE FRACTURE.  Red Flags:  Major trauma, like a vehicle accident or a fall from height; minor trauma or even strenuous lifting (especially in older or possibly osteoporotic people).
2. POSSIBLE TUMOR OR INFECTION.  Red Flags:  Under 20 or over 50 years old.  History of cancer.  Fever, chills, unexplained weight loss.  Recent bacterial infection (i.e., a UTI).  Immune suppression (i.e., steroid use, drug abuse or HIV).  Pain that worsens when you lay on your back.  Severe nighttime pain.
3. POSSIBLE CAUDA EQUINA SYNDROME (a type of spinal cord compression).  Red Flags:  Numbness around the genitals or anus.  Recent onset of bladder dysfunction (can't make it to the bathroom in time, can't go, or going more frequently than normal).  Severe or worsening neurologic deficit in the lower extremities (i.e., radiating numbness or pain in the leg or muscle weakness in the hip, leg or foot).  Fecal incontinence (can't restrain bowel movement).

Memorize these red flags so that if you see them, you'll get help right away.  If you're still not sure whether or not you need immediate care, CALL ME.  Here's my personal cell number -- program it in your phone so you'll have it in an emergency: (512) 619-6393.  By asking you a few questions I'll be able to tell you over the phone whether or not you need emergency care.

Fortunately most cases of lower back pain do NOT require emergency care.  These injuries can, however, be hugely debilitating and life-limiting.  The good news is that most cases of mechanical  (or non-emergency) back pain respond extremely well to a combination of chiropractic care and physiotherapy. 

As with any injury or symptoms, if it's not getting better, or if it's getting worse over a month's time, get help from a chiropractor or an MD.  Limiting your life, or living a life of pain is not worth it.  The solution may be easier and quicker than you think.

-Daniel Bockmann, DC

To read more back pain facts & statistics, click here:http://www.acatoday.org/level2_css.cfm?T1ID=13&T2ID=68

To read more about back pain "red flags", click here:http://www.chirobase.org/07Strategy/AHCPR/ahcprclinician.html

chiropractor-austin-tx

PLANTAR FASCIITIS: Heel pain have you on the sidelines?

If you’re a runner, chances are you may experience something called plantar fasciitis.  It’s a pesky and painful condition that’s not the end of the world, but it can certainly slow you down if left untreated.  Here’s how you can recognize it:

• Sharp or burning pain on the underside of the heel
• Heel pain after getting out of bed, while climbing stairs or when standing on tiptoe
• Heel pain from standing for long periods, or when getting up from a chair
• heel pain during or after running, especially during push-off

Plantar fasciitis (PLAN-tur fas-e-I-tis) is an inflammation of the plantar fascia – a tough, leathery sheath that covers the sole of your foot.  The plantar fascia serves a very important purpose.  It is a ligament that stretches from your heelbone to your toes like a bowstring, and helps absorb the impact of walking or running.  It also helps maintain the arch in your foot. 

If this ‘bowstring’ is overstretched by an aggressive new exercise program, small tears can form in the tendon.  These tears can become inflamed and painful, and turn even the most leisurely run into a nightmare.

Here are the two biggest causes of plantar fasciitis:

1. Too much, too fast, too soon!  Big increases in your running pace, distance or frequency can overload the plantar fascia and make for some painful feet. 
2. Bad foot mechanics.  Losing the arch in your foot, excessive pronation (walking on the inside of your foot), or having an irregular gait can all contribute to plantar fasciitis.

The good news is, plantar fasciitis is almost always fixable without drugs or surgery.  This is one of the more common injuries I see in our office, and we see exceptional results from our rehab programs.  If you've researched this condition you've probably heard horror stories about people who can't run for 6 months or even a year.  This is NOT the case in my office.  We routinely get runners back in action within 1 month.

Remember -- even though plantar fasciitis usually responds well to conservative treatment, if left untreated it will most likely worsen.  If you think you may have this condition, limit any painful activities and COME SEE ME.  With the right prescription of physiotherapy, flexibility and soft tissue therapy we can have you running the trails at Town Lake again before you know it!  

-Daniel Bockmann, DC



To read more about plantar fasciitis, click here:http://www.mayoclinic.com/health/plantar-fasciitis/DS00508

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HEAT VS. ICE: Which one should I use?

Most athletes know to use ice for an acute injury (like a sprained ankle), but aren't really sure when to use heat.  Here are some good general rules on self-treatment with heat and ice.

In general, use ice for an acute injury, and use heat for a chronic injury.  Here's why.

ACUTE injuries are sudden, traumatic events that cause pain or other symptoms immediately (or within hours).  If you have sharp pain, redness, swelling, tenderness or warmth to the touch of the affected area, you probably have an acute injury.

CHRONIC injuries are more subtle and can be slow to develop.  They may come & go and the symptoms tend to be milder (stiffness, soreness, achiness, etc.).  They may be the result of overuse, or of an acute injury that wasn't properly treated and didn't heal correctly.

Ice is prescribed for acute injuries for 2 reasons:

1. Reduces swelling by constricting blood vessels
2. Reduces pain by numbing nerves

Apply ice for 10-20 minutes to the painful area, up to once every 2 hours.  Keep a thin layer of fabric between the ice and your skin (like a pillow case) for comfort.  Gel-type ice packs work best because they apply the cold evenly and conform to body parts better. 

Heat is prescribed for chronic injuries for 2 reasons:

1. Increases blood flow
2. Loosens tight tissues

Sore, stiff, "nagging" muscle or joint pain can respond well to heat therapy.  Moist heat is most effective since it penetrates more deeply and doesn't dehydrate the tissue like dry heat does.  A damp, hot towel or washcloth applied for 15-20 minutes works well.  Just make sure the heat is comfortable -- not "burning" hot. 

The beneficial effects of heat and ice are temporary, of course, and are NO substitute for seeing a Doctor.  If you are concerned that you have a serious injury of any kind, do the smart thing and see a qualified health professional.

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THE PRE-EXERCISE WARM-UP: Does it make a difference?

You'd probably agree that you should be warming up before exercise.  But do you?  And if so, what should you be doing in your warm-up? 

I've got two words for you: Protection and Performance. 

Here are some benefits of a proper warm-up:

• "Pre-heating" muscles.  Studies show that increasing muscle temperature makes muscles more resistant to tearing.  Hamstring or calf pulls?  Try warming up beforehand!
• Reduces muscle stiffness.  "Looser" muscles handle load better, and are less likely to "snap" during heavy exercise.  Again, protecting you against muscle and joint injuries.
• Rehearsal!  A good warm-up "tunes up" the neuromuscular connection, familiarizing your brain and motor systems with the complex series of movements you're about to do.  Translation: you can run faster, jump higher, throw farther.

So what makes up a good warm-up?  It's pretty simple, actually.

It needs to be at least 10 minutes of continuous, sub-maximal exercise.  This increases muscle temperature and activates your cardiovascular system. 

"Train like you play" by choosing drills that mimic the movements in your sport.  Focus on the joints you'll be using in your workout or sport, gradually increasing intensity, eventually reaching the intensity of the most red-hot moments in your upcoming workout. 

"Mix it up", by choosing some drills or movements that you may not encounter in your workout.  Runners, when's the last time you backpedaled or shuffle-stepped?  How about high-knees, or a tire run?

NO STRETCHING!  It's a waste of time, and it actually hurts your performance.  (See my previous article!)

Bottom line, get creative and have fun with your warm-up!  Make sure to budget time for it, too.  The most cited reason for not warming up before exercise is, "I didn't have enough time."  Set aside an extra 10 minutes for your workout.  Your warm-up will help keep you healthy, and it'll make you a better athlete.

-Daniel Bockmann, DC

To read research on how muscle temperature affects tensile strength, click here: http://www.ncbi.nlm.nih.gov/pubmed/8368411

To read research on flexibility and its effects on injury and performance, click here: http://www.ncbi.nlm.nih.gov/pubmed/9368275

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RUNNERS: Stretching doesn't help.

Believe it or not, this isn't actually news.  Research has been saying this for a decade or more. 

A pre-run stretch has been proven, over and over, to have absolutely NO usefulness in preventing injuries.  The CDC came out with a study back in 2001.  USA Track and Field -- the governing body for the sport -- published a study 2 months ago.  And there have been many, many studies in between.

So why do runners keep stretching? 

For lack of a better explanation, old habits die hard.  Doctors and sports medicine professionals started recommending stretching generations ago and, well...just never stopped.  They just assumed stretching must be helpful, and virtually no one since has bothered to read the research. 

And here's the kicker.  Stretching before exercise can actually hurt your performance.  Studies have found that an athlete's vertical jump is lower after a bout of stretching than with no stretching at all.  The reason?  Static stretches (like the one in the picture) reduce your ability to generate power.  In physics terms, power is the ability to do work quickly.  Translation: power is a measure of "explosiveness".  It's what makes you fast.

Takeaway point: Stretching makes you slow.

QUESTION: "If stretching doesn't prevent injuries, what should I be doing?"

ANSWER: A pre-run warm-up.

We'll be discussing how to warm up properly in the next note.  Stay tuned!

-Daniel Bockmann, DC

To read the 2001 CDC study, click here: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1071358/

To read about the 2010 USA Track and Field study, click here: http://well.blogs.nytimes.com/2010/09/01/phys-ed-does-stretching-before-running-prevent-injuries/

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