Graston techechnique

Soft-Tissue Injuries: Better, Faster Healing

Beyond “hands only”The early Chinese may have been the first to promote health through using “instruments” on the soft tissues of the body. Those first devices were made of buffalo horn and jade.

Interest in instruments to extend the “reach” of chiropractors, massage therapists, and others got a boost in the ’80s when David Graston suffered a debilitating sports injury. Graston’s disappointment with the rehabilitation methods of the day caused him to create several stainless steel instruments with various shapes and angled surfaces. These instruments were designed to augment hands-only approaches to healing.

Chiropractors and massage therapists have always worked their fingers into injured soft tissue to increase blood flow and break up restrictions. But fingers alone cannot detect restrictions at deeper levels, nor can they match the ability of the right instruments to treat the full range of restrictions.

Today, several companies produce hand-held devices used to perform what’s known as instrument-assisted soft-tissue mobilization (IASTM).


What do the instruments look like?

Most instruments are stainless steel. Others are made of aluminum or polymer.


Which parts of the body can develop soft-tissue injuries?

Soft-tissue injuries, such as strains and sprains, often affect the extremities—the legs or arms. Because “soft tissue” refers to anything that isn’t bone, neck and back injuries fall into this category, as well.

How do soft tissues become injured?

Athletes who suffer a traumatic injury will often need soft-tissue-specific rehabilitation to get back full range of pain-free motion. Many soft-tissue injuries, however, are the result of repetitive motion.

People who may suffer from such injuries include:

Assembly-line workers

Golfers and other athletes

People who spend long hours at a computer without regular stretch breaks

Mothers who hold their babies only on one hip

Students who overfill backpacks or who hang heavy backpacks over one shoulder

Sedentary people who allow their muscles to atrophy


Where do soft-tissue injuries originate?

A soft-tissue injury can occur anywhere that ligaments, tendons, muscles, or myofascia are found. Ligaments connect two or more bones and help stabilize the joints. Tendons attach muscles to bones. Ligaments, tendons, and muscles provide a natural brace to protect the bony skeleton from injury. A ligament can be injured, for example, by making a movement that would take a joint outside of its normal range.

What is a “healing cascade”?

When the body is injured, it works to repair itself through a three-phase “healing cascade” process of inflammation, proliferation, and maturation.
In the inflammatory (“acute”) phase, the body releases chemicals that start the healing process. This process continues through the proliferative phase, during which the body migrates materials it needs to create scar tissue at the site of injury.
During the maturation phase of healing, scar tissue forms in the soft-tissue injury site. In this phase, the injury becomes chronic. Scar tissue helps the body form a “patch” at the site of an open wound or internal injury. Scar tissue, however, is much less flexible than normal tissue. It restricts movement, leading to pain when, for example, an athlete with a sprained ankle tries to return to running.

Why is a second healing cascade important?

Most patients with soft-tissue injuries come to a doctor of chiropractic after injuries have become chronic (weeks, months, or even years post-injury). By that point, the body has completed most if not all of the healing tasks of the original healing cascade. A second healing cascade is needed to restart the healing process, bringing to the site, among other things, oxygen and nutrients.

How is a second healing cascade created?

Although healthy soft tissue is longitudinal (laid out all in the same direction) and flexible, the body lays out scar tissue in a haphazard fashion. Scar tissue is fairly rigid. Pain results when movement stresses scar tissue. The doctor of chiropractic presses his instruments into damaged tissue to help release restrictions created by scar tissue and get a chemical healing cascade started. The goal is the normalization of the tissue. “Normalization” probably does not mean that the instruments force the underlying tissue to re-form longitudinally. It refers instead to the release of restrictions. Treatment, which includes stretching out muscles, helps patients build flexibility and strength in the area.

What is a treatment like?

When doctors of chiropractic trained in IASTM use the instruments, they first spread a light gel film over the patient’s skin. Then, they press into and move the instrument around the site to locate restrictions. Treatment breaks down scar tissue and encourages the body to remodel the underlying tissue. During treatment, smaller capillaries in the area are broken. Bruising is a normal response, signifying that a healing cascade is underway.

How does treatment feel?

IASTM can cause minor discomfort. You may wish to arrange a signal that will tell your chiropractor that the degree of pressure has become too uncomfortable. Treatments are typically short—often just three to five minutes.
The level of discomfort typically is reduced with repeated treatments. Chronic soft-tissue injuries are not healed overnight, but your willingness to perform home stretches and exercises as prescribed by your chiropractor will hasten the process.

What side effects can I expect?

Redness of the skin, followed by bruising, is common. These side effects show that your practitioner has been working to get at troublesome areas and help start the healing process. You may also be asked to apply ice as part of your at-home treatment.
Doctors of chiropractic are trained to effectively address your musculoskeletal complaints. If you have further questions about soft-tissue injuries, your doctor can help.

Sources from "www.acatoday.org"

Knee Pain (Patellar Tendinitis)

What is Patellar Tendinitis (PT)

A common complaint of athletes is pain in the front part of the knee. The medical term for this pain is patello-femoral pain syndrome, runners knee, anterior knee pain, extensor mechanism disorder, or patellar tendonitis (PT).

People with PT frequently complain of dull pain, which is worse running, squatting, jumping, or walking up or down stairs. Pain may feel worse after bending your knee when sitting. Sometimes the knee clicks or locks. Sometimes it feels like it is buckling under you when you walk. Sometimes it is swollen. This pain is usually chronic in nature.

Occasionally, direct trauma to the knee can cause PT, but usually it is caused by repetitive strain from overuse during activities. Knee pain is typically secondary to foot or hip dysfunction. Flat feet alter normal muscle relationships, and can force the knee into the wrong position while you are walking, running, or jumping. Even wearing the wrong shoes may cause stresses on the muscles around the knee. Repetitive movements in sports or work activities may exaggerate these imbalances and lead to PT.

When should you see a doctor?

Even though PT may be caused by a wide variety of conditions, usually it can be treated without surgical intervention. If your pain is so severe that you have difficulty with your normal activities, you should see a doctor. The healthcare provider you select will help you with ways to better control your pain and to improve your ability to perform desired activities.
What can you do for yourself?
Even though you are in pain, it is important for you to stay active. Being active can help prevent long-term problems.

If your pain is acute, ice or anti-inflammatory medication may help. Use the R.I.C.E. formula:

• Rest: Avoid putting weight on the painful knee. Some athletes temporarily switch to a non-weight bearing activity, such as swimming.
• Ice: Apply cold packs or ice wrapped in a towel for short periods of time, several times a day.
• Compression: Use an elastic bandage such as a simple knee sleeve with or without the kneecap cut out that fits snugly without causing pain.
• Elevation: Keep the knee raised up higher than your heart.

Ways to Increase your activity.

Evaluate what you can do, how long you can do it without increasing your pain, and what is too painful to do. Record how long you can participate in the activity without increasing the pain in your sore leg. Continue those activities you can do without pain. Temporarily avoid those activities, which are too painful to do at all. For those activities which cause “flare-ups” after some use, try the following guidelines:

• Look at how long you can comfortably perform the activity, and reduce the time you do it by 20%. (In this way you should avoid the “flare-up”.)

• Over several sessions, gradually increase the time spent doing the activity.
If another “flare-up” occurs, don’t panic! You may have tried to do too much too soon. Once again reduce your activity level by 20 %, and keep active.

Ways to modify your activity.

In sports
• Check your athletic shoes. How long have your worn them. As a rule of thumb, frequent runners should change their running shoes about every 6 months.
• During the beginning of your healing process, it may help to use a knee brace or patellar strap while exercising.
• Check your posture and the rhythm of your movements. Are you moving in a coordinated and balanced way?

At work and home
• Try to change your activities frequently.
• When gardening, sit in a low chair to avoid repetitive squatting.
• Minimize trips up and down stairs.
• Take frequent breaks.

Rehabilitation

A rehabilitation specialist will perform a functional examination to rule out serious conditions, discover functional weaknesses, and help you identify specific goals of treatment. This is important. There may be restrictions in your foot, hip or low back, which cause you to put unnecessary stresses on the knee. These stresses make it difficult to successfully complete your desired tasks. Your rehab exam will uncover these hidden causes to your problem.

Once your pain is under control, and your doctor has ruled out serious conditions, there are simple exercises, which may help you balance the muscles, correct your posture, and free the entrapped nerves. By increasing your function, these exercises become the key to your healing.
One of the most basic knee exercises to improve the “tracking” of the knee cap (patella) is called the pillow push. Simply push the back of your knee into the pillow and hold it there for 5-6 seconds. Then release. Repeat 8-10 times. Perform twice a day.

Pillow Push – start position Pillow Push – final position

If the exercises you are doing, increase your symptoms, do not continue them. Consult your rehabilitation specialist.
Along with rehabilitation exercises, your rehab specialist may perform gentle mobilizations to the restricted joints and muscles, myofascial release, as well as recommend simple changes to your work or play activities. The goal of treatment is to relieve your pain and increase your function. Remember try not to focus on pain. Throughout the treatments, try to focus on your functional improvements. It is the improvements in what you can do and how long you can do it, which allow you to increase your activity level, and return you to your normal activities.

Source from "clinicalrehabsepcialists.com"

Chiropractic Treatment of Sciatica

Chiropractic Treatment of Sciatica

Chiropractic Treatment of Sciatica

-Susan Spinasanta

Doctors of Chiropracticmedicine regularly treat sciatica. Sciatica is characterized by pain that originates in the low back or buttock that travels into one or both legs. Sciatic nerve pain varies in intensity and frequency; minimal, moderate, severe and occasional, intermittent, frequent or constant.

Pain is described as dull, achy, sharp, toothache-like, pins and needles or similar to electric shocks. Other symptoms associated with sciatica include burning, numbness and tingling sensations. Sciatica is also called radiating or referred pain, neuropathy, or neuralgia. A misconception is that sciatica is a disorder - however, sciatica is really a symptom of a disorder.

Caused by Nerve Compression
Sciatica is generally caused by sciatic nerve compression. Disorders known to cause sciatic nerve pain include lumbar spine subluxations (misaligned vertebral body/ies), herniated or bulging discs (slipped discs), pregnancy and childbirth, tumors, and non-spinal disorders such as diabetes, constipation, or sitting on one's back pocket wallet.

One common cause of sciatica is Piriformis Syndrome.

Piriformis syndrome is named after the piriformis muscle. The piriformis muscle is located in the lower part of the spine, connects to the thighbone, and assists in hip rotation. The sciatic nerve runs beneath the piriformis muscle. This muscle is susceptible to injury from a slip and fall, hip arthritis, or a difference in leg length. Such situations can cause cramping and spasm to develop in the piriformis muscle, thereby pinching the sciatic nerve and causing inflammation and pain.

Sciatic nerve compression may result in the loss of feeling (sensory loss), paralysis of a single limb or group of muscles (monoplegia), and insomnia.

Proper Diagnosis Since there are many disorders that cause sciatica, the chiropractor's first step is to determine what is causing the patient's sciatica. Forming a diagnosis involves a thoughtful review the patient's medical history, and a physical and neurological examination. Diagnostic testing includes an x-ray, MRI, CT scan and/or electrodiagnostic tests (nerve conduction velocity, electromyography). These examinations and tests help to detect possible contraindications to spinal adjustments and other chiropractic therapies.

Treatment Approach The purpose of chiropractic treatment is to help the body's potential to heal itself. It is based on the scientific principle that restricted spinal movement leads to pain and reduced function and performance. Chiropractic care is non-invasive (non-surgical) and drug-free. The type of chiropractic therapy provided depends on the cause of the patient's sciatica. A sciatica treatment plan may include several different treatments such as ice/cold therapies, ultrasound, TENS, and spinal adjustments - sometimes called manipulation.

1. Ice/Cold therapy reduces inflammation and helps to control sciatic pain.

2. Ultrasound is gentle heat created by sound waves that penetrates deep into tissues. Ultrasound increases circulation and helps to reduce muscle spasms, cramping, swelling, stiffness, and pain.

3. TENS unit (transcutaneous electrical nerve stimulation) is a sma

ll box-like, battery-powered, portable muscle stimulating machine. Variable intensities of electrical current control acute pain and reduce muscle spasms. Larger versions of the home-use TENS units are used by chiropractors, physical therapists and other rehab professionals.

4. Adjustments (Spinal Manipulation) At the core of chiropractic care are spinal adjustments. Manipulation frees restricted movement of the spine and helps to restore misaligned vertebral bodies to their proper position in the spinal column. Spinal adjustment helps to reduce nerve irritability responsible for causing inflammation, muscle spasm, pain, and other symptoms related to sciatica. Adjustments should not be painful. Spinal manipulation is proven to be safe and effective.

In college and during their training, students of chiropractic learn many different adjustment techniques enabling them to treat several types of subluxations and disorders. Techniques vary from a swift high velocity thrust to those that combine minimal force and gentle pressure. Mastery of each technique is an art that requires great skill and precision. Spinal manipulation is the treatment that differentiates chiropractic care from other medical disciplines.

To prepare a patient for adjustment, the chiropractor may instruct the patient to sit up or lie down. It is not uncommon for the chiropractor to use a totally different adjustment technique during the patient's subsequent visit. Treatment tables differ too. Some are stationary, flat padded tables and others are elaborate with electrically or manually operated head and foot rests.

Sciatica can be caused by other disorders beyond the scope of chiropractic practice. If the Doctor of Chiropractic determines the patient's disorder requires treatment by another type of doctor, then the patient is referred to another specialty. In some cases, the referring chiropractor may continue to treat the patient and co-manage the patient's care with the specialist.