Chiropractic / Musculoskeletal / Joint pain Q & A...

[bezoe]

Brinks, I dont know my man. Nothing really stands out for me in your answers except the broken elbow, which wouldnt cause the contralateral side to develop symptoms.

It may be some arthritic anomaly.. perhaps hereditary.

Only other thing I can think of is that your joints, elbows specifically, could be hypermobile, and have consequently developed arthritis.

My advice would be to walk into a PT clinic and get a free consultation. Get them to look at your elbows and see what they recommend.

 

[bezoe]

Hey doc-

I have always had elbows that get upset at me easily. I get pain on the medial aspect of both my elbows, and normally when I have elbow pain, my brachialis muscle shares in this pain. The pain is sharp, continuous, and only occurs after i overdo some sort of elbow flexion, and when I am at rest (in bed) it is the worst and gets a throbbing quality to it. When the pain occurs, so does a very eerie weakness in both my grip, brachialis and elbow extension/flexion. I take 10g fish oil daily as well as 2g cissus. I rode motorcycles for 14 years and have trained for about the same time. This most recent insult involved taking an atlas stone from ground to shoulder.

Any ideas or advice?

Regards

Sounds to me like nerve involvement strictly because of the "sharp" description and the fact that weakness accompanies it. Possibly the musculocutaneous peripheral nerve, or, taking into account your recent incident, a C6 or C7 nerve root injury.

Picking up a boulder would possibly push your head into a forceful lateral tilt and cause damage to the nerve roots in the cervical region.

Not much I can recommend you do (several measures would need to be taken to alleviate this- IF its the problem). These are just my assumptions given your info provided.

 

[EasyEJL]

Easy my man! Welcome bra!

Sounds like supraspinatus impingement. NEVER abduct and internally rotate your shoulder (dont raise your arm out to the side with your thumb down). This causes the small, fragile supraspinatus tendon to slide over the greater tubercle and under the acromium and can become frayed from doing so. The biceps long head can also be caught up this way.

You may have some inflammation of the supraspinatus tendon, OR worst case, it may be kind of "chewed" up from years of overhead activity. My recommendation, without performing several tests in person, is to do some internal and external rotations with theraband, with your elbow against your side. This strengthens the other 3 rotator cuff muscles, which assist in "inferior translation" of the humeral head during shoulder abduction and flexion- keeps the supraspinatus tendon from being smashed between the two bones.

Ok so if I don't have therabands, but do have powerblocks dbs so adjustable dbs from 2.5-95lbs would it be ok to do these same exercises as laying down on the floor or bed and do the rotations vertically instead? Like

and

 

[ScottyDoc]

subb'd for info!

Welcome, we are here to HELP!!! Like I said before, we have a really good team here!!!

 

[ScottyDoc]

Ok so if I don't have therabands, but do have powerblocks dbs so adjustable dbs from 2.5-95lbs would it be ok to do these same exercises as laying down on the floor or bed and do the rotations vertically instead? Like

and

Yes, but extremely light... I still like therabands and water better because of the constant and smooth resistance, also why I added to Bezoe's recommendation and added the whole while in the pool idea, smooth consistent resistance!

 

[EasyEJL]

Yeah, I can do the water once a week maybe, but the therabands i'll have to buy somewhere. I may go check out walmart, seem to recall them having something similar (probably some really crappy knockoff)

 

[ScottyDoc]

Yeah, I can do the water once a week maybe, but the therabands i'll have to buy somewhere. I may go check out walmart, seem to recall them having something similar (probably some really crappy knockoff)

Maybe not, I mean surgical tubing is surgical tubing! I've even seen some at surgical tubing, no handles of course, being sold at HomeDepot or as I like to call it The Ho-Po! You can always just buy so many feet of it and use multiple bands if it is too weak with a single band, but if it is sold at Walmart with handles I'm sure it will both be cheap enough and sufficient for therapy, not like you are trying to use it to get a total workout or anything!

 

[EasyEJL]

Maybe not, I mean surgical tubing is surgical tubing!

this one is in stock locally, and under $7 so worth the risk

http://www.walmart.com/ip/Gold-s-Gym-Long-Resistance-Tube/12167856?findingMethod=rr

 

[ScottyDoc]

this one is in stock locally, and under $7 so worth the risk

http://www.walmart.com/ip/Gold-s-Gym-Long-Resistance-Tube/12167856?findingMethod=rr

Hey... Looks good to me Bro!

 

[TheKanezzi]

Thanks guys for the help. I can normally beat it by not using my arms much, lol, but I was hoping that there was an exercise that I could do to strengthen and prevent these occurances from happening.

The list of things that could have damaged that region of my body are numerous so i hope that there isnt some sort of long standing, permenant damage to them. Im only 26!!

Regards

 

[bezoe]

Maybe not, I mean surgical tubing is surgical tubing! I've even seen some at surgical tubing, no handles of course, being sold at HomeDepot or as I like to call it The Ho-Po! You can always just buy so many feet of it and use multiple bands if it is too weak with a single band, but if it is sold at Walmart with handles I'm sure it will both be cheap enough and sufficient for therapy, not like you are trying to use it to get a total workout or anything!

agreed

Thanks guys for the help. I can normally beat it by not using my arms much, lol, but I was hoping that there was an exercise that I could do to strengthen and prevent these occurances from happening.

The list of things that could have damaged that region of my body are numerous so i hope that there isnt some sort of long standing, permenant damage to them. Im only 26!!

Regards

I hope they arent either bra. Since it sounds intermittent, I wouldnt think it would be any permanent damage. You may just need some stretching of the scalenes or some realignement of your cervical vertebrae. Again, I cant come to a conclusion without running alot more diagnostics.

Nerves are pretty resiliant.. the peripheral nervous system can regenerate if the nerve cell body is intact. Maybe try a few nerve glides:

 

[TheKanezzi]

thanks bezoe, ya i kow that assessment is more art than science and it wont translate over the internet, lol. Ha, i tried those two movements and felt some bonafide fatigue with maybe 60-70% ROM.

Yikes

 

[bezoe]

thanks bezoe, ya i kow that assessment is more art than science and it wont translate over the internet, lol. Ha, i tried those two movements and felt some bonafide fatigue with maybe 60-70% ROM.

Yikes

http://www.hy-q.com/cooper/pdf/NCS Exam/Neurology 07.pdf

Nerve gliding (or mobilization) is a self-directed technique of breathing, positions, and movements to improve the mobility and decrease symptoms of an injured peripheral nerve?O Peripheral nerves are longer than (by up to several centimeters) the distance between any two points along the limb.4 All nerves glide to some degree to accommodate the change in length during joint motion in order to ensure that the nerve remains tension-free at all times.',20 Several factors can limit the ability of a nerve to glide such as trauma, surgery, posture, bone or soft tissue changes or anomalies, or adhesions. As is true with most other physical therapy interventions, patient instruction and education are key to obtain optimal results in the shortest time frame. The patient is instructed to prevent provoking the symptoms of numbness, tingling, or pain during the glide technique. The nerve glide is halted when resistance is first encountered prior to the production of symptoms. Caution is advised to prevent nerve irritability, when the nerve is quick to flare up and is slow to recover from symptoms. It is also important to advise on home care and daily activities that can mimic over-tension nerve gliding and produce irritability.

So basically, you wanna avoid reproducing the symptoms. If a certain movement or position causes the pain and weakness to occur, abstain from doing it.

 

[JohnBrinks]

Brinks, I dont know my man. Nothing really stands out for me in your answers except the broken elbow, which wouldnt cause the contralateral side to develop symptoms.

It may be some arthritic anomaly.. perhaps hereditary.

Only other thing I can think of is that your joints, elbows specifically, could be hypermobile, and have consequently developed arthritis.

My advice would be to walk into a PT clinic and get a free consultation. Get them to look at your elbows and see what they recommend.

Thanks again.
:kiss:

 

[EasyEJL]

The band has been helping, trying to do it more or less daily. But I noticed a new oddity in my shoulder issues today. Although the pain has been less on shoulder + chest days, it was pretty painful today in that same spot doing chinups. Any ideas as to why?

 

[bezoe]

The band has been helping, trying to do it more or less daily. But I noticed a new oddity in my shoulder issues today. Although the pain has been less on shoulder + chest days, it was pretty painful today in that same spot doing chinups. Any ideas as to why?

can you refresh my memory bro. Where exactly is the spot?

 

[EasyEJL]

can you refresh my memory bro. Where exactly is the spot?

I guess its more an area, but its at the shoulder joint slightly below the center of the joint on the front side.

 

[bezoe]

On the outside of the arm, under the armpit, front of arm? Is it somewhere you can palpate and reproduce pain?

 

[ScottyDoc]

On the outside of the arm, under the armpit, front of arm? Is it somewhere you can palpate and reproduce pain?

From what I remembered him saying it was more in the superior/anterior aspect of his shoulder, but based on the location, I'm surprised it didn't hurt before doing pull-ups (I forget did you say under-handed pull-ups or just close-grip pull-ups?). OK, I see you just said Chin-Ups, well what was your hand position? I think of chin-ups as under-handed & close grip!

 

[EasyEJL]

thats pretty close, maybe slightly above inside of armpit level. Its hard to get good pressure on it because its covered with the front delt + subscapularis, but is somewhat sensitive to touch

 

[bezoe]

Still sounds like bicipital tendonitis. Remember what i said about the biceps tendon becoming impinged and inflammed under the acromium.. During chin ups, the biceps brachii contracts vigorously.

 

[bezoe]

You may have someone do some ART (active release technique) to break up any scar tissue, or some MFR (myofascial release) to loosen up those tissues around the area. You can possibly do these but would have to reach across the body and it would be difficult to relax.

 

[EasyEJL]

Hmm yeah, that makes sense. I guess I have to give it time to lower the inflammation

 

[ScottyDoc]

Hmm yeah, that makes sense. I guess I have to give it time to lower the inflammation

That is definitely a good idea, ICE it brotha, to reduce the inflammation! Bezoe is right, some deep tissue to the area would most definitely do it some good, definitely some inflammation going on in there, not to mention all the great advice we are giving you... The massage therapist, assuming they are good, will locate your problem and should be able to give you an even better diagnosis of exactly what & where your problem is and from there you, with your knowledge, should be able to figure out why it is happening... over-use, etc.

 

[EasyEJL]

You may have someone do some ART (active release technique) to break up any scar tissue, or some MFR (myofascial release) to loosen up those tissues around the area. You can possibly do these but would have to reach across the body and it would be difficult to relax.

I suppose that would be a tennis ball spot rather than foam roller? I need to get back in the habit of using my foam roller, I keep slacking

should be able to figure out why it is happening... over-use, etc.

I think its mostly getting old

 

[ScottyDoc]

I think its mostly getting old

Bull$hit Bro, never too old, listen to your body and take care of your body and you can do this for many, many years to come!

Also, what I meant by the Massage Therapist being able to locate your problem more accurately is because he/she will actually have their hands on you, and nothing compares to some good hands-on when diagnosing something like a sprain/strain musculoskeletal injury, no X-Ray or even an MRI can diagnose a problem better than hands-on, unless it is a break, fracture of the bone or a tear/rupture of the muscle, which from what you are saying is extremely doubtful!

 

[ScottyDoc]

Bull$hit Bro, never too old, listen to your body and take care of your body and you can do this for many, many years to come!

Also, what I meant by the Massage Therapist being able to locate your problem more accurately is because he/she will actually have their hands on you, and nothing compares to some good hands-on when diagnosing something like a sprain/strain musculoskeletal injury, no X-Ray or even an MRI can diagnose a problem better than hands-on, unless it is a break, fracture of the bone or a tear/rupture of the muscle, which from what you are saying is extremely doubtful!

Unfortunately, that is what makes some of what Bezoe and I are trying to do on this thread so difficult, we are both very good at what we do, but what we do on a daily basis is hands-on with our patients. Just had to throw that in there!

 

[EasyEJL]

Hmm yeah, it looks like I have a chiropractor who does ART within about 3 miles. I guess I ought to check the cost and get an appointment.

 

[-2z-]

Great info here. I'll have to come back and read this from the beginning.

 

[bezoe]

I suppose that would be a tennis ball spot rather than foam roller? I need to get back in the habit of using my foam roller, I keep slacking

A foam roller will work just fine

I think its mostly getting old

LOL i was gonna say arthritis

 

[EasyEJL]

going to a chiro today. Couldn't find a local ART practicioner who takes my insurance, but found one who does Miyodac at least, which is related but tool oriented. We'll see how it goes.

 

[ScottyDoc]

going to a chiro today. Couldn't find a local ART practicioner who takes my insurance, but found one who does Miyodac at least, which is related but tool oriented. We'll see how it goes.

Keep us posted how that goes, please?

 

[ScottyDoc]

going to a chiro today. Couldn't find a local ART practicioner who takes my insurance, but found one who does Miyodac at least, which is related but tool oriented. We'll see how it goes.

I just wanted to post this so anyone visiting this THREAD can see exactly what you are talking about when you say Miyodac technique... http://www.miyodac.com/

 

[EasyEJL]

I went, he did some graston technique, it hurts like hell. We'll see how it goes.

 

[ScottyDoc]

I went, he did some graston technique, it hurts like hell. We'll see how it goes.

I know this should probably be a question for me, but considering I only know of these two techniques and do not personally use them in my practice (why I have a Massage Therapist on payroll), what is the difference between Graston & MiyDac techniques? From what I see and have read, they are basically the same thing, just slightly different stainless steal tools, but both accomplishing the same ultimate goal in almost the exact same fashion!

http://www.grastontechnique.com/FAQs.html

 

[EasyEJL]

they do seem the same, looks like miyodac tools are cheaper, and don't require the specialized training graston does.

 

[ScottyDoc]

they do seem the same, looks like miyodac tools are cheaper, and don't require the specialized training graston does.

I guess it just goes to show that everyone wants their fair cut of the $-PIE-$. I say good for them as long as it works and is beneficial to the patient!

 

[EasyEJL]

for sure. He kinesiology taped me too, i'm banking this will hurt even worse in the morning

 

[ScottyDoc]

for sure. He kinesiology taped me too, i'm banking this will hurt even worse in the morning

"No Pain... No Gain!" Unfortunately... when breaking up Scar Tissue, this is 100% TRUE!

Here's a little Inspiration for your PAIN!

​

 

[celc5]

I'm gonna do my best to be an objective observer here. But my gut is uneasy with purposely instigating inflammation with blunt instruments.

 

[ScottyDoc]

I'm gonna do my best to be an objective observer here. But my gut is uneasy with purposely instigating inflammation with blunt instruments.

I agree with that statement, but the purpose of what we have been talking about is breaking up scar-tissue and muscle adhesions, the cause of the inflammation itself, could it cause an inflammatory response, yes & probably, but a little ice, drinking the hell out of some water and that will be flushed away with the cause of the inflammation gone, less likely to return. For a lack of better words, "A Means to an End!"

 

[bezoe]

Agreed^^^. The breaking up of scar tissue promotes rehealing. You just have to move the joint around afterwards to assure that the tissues heal in a fashioin that allows joint mobility.

And do gradual strengthening to reestablish the stability. I have never heard of either of these techniques, but it all works the same i suppose- as manual physical agents. Laser therapy would be completely different approach.

 

[sapentia]

Scotty,

I don't have a specific problem that I need an answer to, but I would like your feedback on the following. About a year and a half ago I started doing heavier lifting in my squats, deads, RDL's etc. where before I was always overly precautious in not wanting to risk injuring myself. Since then my strength has gone up considerably in those lifts but I feel much tighter than I used too with it being most obvious in my lower back and hamstrings. Following a heavy squat or deads day I may feel some minor achiness in my low back the next day for example. To help with flexibility I have begun doing some short yoga sessions again to help regain some of that looseness.

I guess what I would like to hear from you is should a chiropractic visit be a part of my efforts to counteract stiffening etc. from heavy lifting? I know some chiropractors are very much against squatting as they feel it is bad for the spine. I wouldn't want to have to justify weightlifting which is one reason I am reluctant to consider a chiropractor. Thanks in advance.

 

[ScottyDoc]

Scotty,

I don't have a specific problem that I need an answer to, but I would like your feedback on the following. About a year and a half ago I started doing heavier lifting in my squats, deads, RDL's etc. where before I was always overly precautious in not wanting to risk injuring myself. Since then my strength has gone up considerably in those lifts but I feel much tighter than I used too with it being most obvious in my lower back and hamstrings. Following a heavy squat or deads day I may feel some minor achiness in my low back the next day for example. To help with flexibility I have begun doing some short yoga sessions again to help regain some of that looseness.

I guess what I would like to hear from you is should a chiropractic visit be a part of my efforts to counteract stiffening etc. from heavy lifting? I know some chiropractors are very much against squatting as they feel it is bad for the spine. I wouldn't want to have to justify weightlifting which is one reason I am reluctant to consider a chiropractor. Thanks in advance.

OK, honestly, I think anyone that participates in sports should see their Chiropractor on a fairly regular basis, depending on the activity like a Football player (hitting and getting hit, similar to a daily car accident) should go at least 1 x per week, but your average athlete 1 x month is just fine.

Now with that being said, your problem sounds to me like it is a lack of flexibility in your hamstrings, which when they get tight will pull directly on your low back making it get sore, stretch out the Hammies daily and work on increasing their flexibility and that problem should go away!

 

[sapentia]

OK, honestly, I think anyone that participates in sports should see their Chiropractor on a fairly regular basis, depending on the activity like a Football player (hitting and getting hit, similar to a daily car accident) should go at least 1 x per week, but your average athlete 1 x month is just fine.

Now with that being said, your problem sounds to me like it is a lack of flexibility in your hamstrings, which when they get tight will pull directly on your low back making it get sore, stretch out the Hammies daily and work on increasing their flexibility and that problem should go away!

Thanks for the quick feedback Scotty!

 

[warhammer44]

Dr. Scott,

Very cool thread! I am a chiropractic student at Logan College of Chiropractic in St. Louis. Im in my 2nd trimester. Ive been a chiropractic patient my whole life through high school and collegiate football and track and field. I am very excited to be a doctor soon. Any tips, tricks or just conversations you would like to have, I am all ears! Thanks

 

[Rahl]

OK, honestly, I think anyone that participates in sports should see their Chiropractor on a fairly regular basis, depending on the activity like a Football player (hitting and getting hit, similar to a daily car accident) should go at least 1 x per week, but your average athlete 1 x month is just fine.

Now with that being said, your problem sounds to me like it is a lack of flexibility in your hamstrings, which when they get tight will pull directly on your low back making it get sore, stretch out the Hammies daily and work on increasing their flexibility and that problem should go away!

This right here. ^^ I've had that issue and getting more flexibility in my hammies made all of the difference in the world.

 

[ScottyDoc]

Dr. Scott,

Very cool thread! I am a chiropractic student at Logan College of Chiropractic in St. Louis. Im in my 2nd trimester. Ive been a chiropractic patient my whole life through high school and collegiate football and track and field. I am very excited to be a doctor soon. Any tips, tricks or just conversations you would like to have, I am all ears! Thanks

Chiropractic is AWESOME, just realize it is a hard way to make a living in this day and age and economy! If you don't already know, there is no $-Money-$ in working for another doctor, the money is in owning and running your own practice which is hard to start in this economy, but well worth the efforts! So with that being said, make sure you are not just limited to Chiropractic, most successful Chiro's incorporate something else into the mix to guarantee their success! For example one friend has an MD working in his office and does all different sorts of Bioidentical and Hormone Replacement therapies as well as a bunch of different vitamins, nutrients and therapies for the Adrenals. Another friend of mine is also a certified Trainer & Massage Therapist with his Bachelors in Sports Medicine, he incorporates all that and mainly treats athletes (high school, college, & Pro's). I myself am in the part-time Nursing program at a local college and once I achieve my bachelors I will further it to my DNP (Doctor of Nurse Practitioner) That way I will pretty much be able to do anything a general practitioner MD can do and I would like to work along side a Orthopedic Surgeon or Group and incorporate all I know to that office or group! That is my advice, Good Luck to you my friend!


:soapbox:

 

[tromcom]

ScottyDoc

Thanks for the thread. I'm also in the ATL. I saw your gyno surgery photo and was wondering if you could advise where you had it done?
Thanks

 

[warhammer44]

Thanks Doc! I plan on getting a Masters in Nutrition and I also want to get certified in acupuncture. I plan on getting in with a Dr. that is getting ready to retire, or start up a clinic with several other docs. And yes chiropractic is awesome!