Delaying Physical Therapy Can be Costly

Gunnar Mossberg

Tuesday, August 14, 2012


Up to 80 percent of people will at some point experience acute low
back pain, and in most cases it will resolve on its own within four to
six weeks, but with a high recurrence rate. However, recent large
studies have shown that early start of physical therapy treatment may
lead to less need for additional health-care treatment down the road.

A new study led by physical therapist Julie M. Fritz, published in the
medical journal Spine, used a national database of employer-sponsored
health plans, where 32,070 patients had newly consulted a primary care
physician for low back pain. Those who were referred to a physical
therapist within 14 days of consultation were compared to patients who
had their physical therapy referral delayed until 15 to 90 days after
initial consultation with a physician.

During an 18-month follow-up, the researchers found that early
physical therapy treatment was associated with reduced likelihood of
subsequent surgery, injections, physician visits, opioid use, advanced
imaging, along with a corresponding reduction in related medical costs
relative to delayed treatment by a physical therapist. The total
health-care cost was $2,736 lower in the early treatment group.

Another recently published study, taken from data from the Centers for
Medicare and Medicaid Services, looked at 439,195 patients who
received treatment for acute low back pain, and who received physical
therapy in the acute phase (less than 4 weeks) versus in the chronic
phase (more than 3 months). This study also showed less subsequent
medical services among patients who received physical therapy early
after an episode of acute low back pain, versus later on. Fritz
suggested that early physical therapy may promote a greater sense of
self-reliance in managing low back pain and confidence in a positive
outcome. It may also prevent patients’ dependency on additional health
care services and medications.

Although the literature has shown evidence of moderate benefit of
exercise therapy for chronic and sub acute low back pain, a systematic
review has shown strong evidence that exercise can reduce the future
occurrence of back problems in adults.

Gunnar Mossberg, PT, MOMT, DPT, has practiced physical therapy in San
Diego since 1982


Early proper treatment can be crucial to be preventive of chronic
illness behaviors.

--
Hyunsuk Oh, DC, CCEP, CKTP, ART®, GT®

Dr. Hyunsuk Oh graduated from Life University in Marietta, Georgia. Dr. Oh currently holds licenses to practice chiropractic in Maryland and Virginia. He is a member of the Maryland Chiropractic Association, American Chiropractic Association and International Chiropractic Association. Dr. Oh has undergone extensive training and has earned the designate of Certified Chiropractic Extremity Practitioner (CCEP) from the Council on Extremity Adjusting. He has also obtained  certification as a Golf Rehabilitation Specialist through Blanchard Institution. Dr. oh has achieved Advanced Certification in the Graston Instrument Assisted Soft-Tissue Mobilization (GISTM) technique (or Graston Technique), a highly advanced and efficient technique developed for treating soft tissue pathology.  He also has achieved Advanced Certification in the SASTM (Sound Assisted Soft-Tissue Mobilization).   Dr. Oh is also a full body licensed provider of Active Release Techniques (ART).  This technique is highly effective for treating a whole host of soft tissue and nerve entrapment issues.   ART is a favorite technique of triathlon participants, volleyball players, marathon runners, and athletes of all sports. Dr. Oh is also a Certified Kinesio® Taping Practitioner (CKTP®). The Kinesio® Taping Method is one of the most sophisticated taping techniques in the world.  It allows for facilitation, inhibition, and functional corrections of the musculoskeletal system.

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Neuropathy and Spondylosis

Chiropractic Care Can Help Patients with Neuropathy and Spondylosis

We all see patients with chronic pain that may not be related to a
direct inflammatory process, and the examination reveals no hard
neurological signs (diminished reflexes, etc.). Gunn states that there
are functional and/or structural alterations within the central or
peripheral nervous systems, i.e., neuropathy. Neuropathic pain is
associated with abnormal nerve function and/or hyperactivity at some
level in the pain sensory system.

Neuropathic Pain Begins in the Spine and Has a Gradual Origin

The most common cause of neuropathy is spondylosis. He states that
"the spinal origin of neuropathic pain is not always obvious because
spondylotic degeneration follows a gradual, relapsing and remitting
course that is silent. Pain can arise with no history of trauma, and
laboratory, radiological and other tests are unhelpful." Spondylosis,
which refers to the structural disintegration and morphologic
alterations in the intervertebral disc and pathoanotomic changes in
surrounding structures, can eventually cause simultaneous damage to
the nerve roots (radiculopathy) and cord (myelopathy). Gunn speaks of
a prespondylosis which may be symptomless until trauma occurs. A
neuropathy may appear. With an acute injury to a healthy nerve there
is no prolonged discharge of pain signals, whereas, the same injury to
a neuropathic nerve affected by a prespondylosis can cause a sustained
discharge. This may explain why people with spondylosis and no
symptoms can have minor injury and the pain can exist beyond a
reasonable period.

Spondylosis Increases with Age and is More Common among Middle Aged People

Because spondylosis increases with age, spondylotic pain is more
common in middle-aged individuals. They have accumulated an "injury
pool" or an accumulation of repeated major and minor injuries to a
segment leading to unresolved clinical residuals, which may or may not
produce pain. The most important manifestation of neuropathy, besides
sensory and autonomic findings, is the motor sign of muscle shortening
from spasm resulting in ropey bands in muscle, which may eventually
become fibrotic or focal areas of tenderness called trigger points.
Gunn states that in radiculopathy, these tender spastic muscles can be
found throughout the myotome, contralaterally, and in paraspinal
muscles. Gunn feels that shortened muscles can mechanically stress
muscle attachments leading to tendinitis, epicondylitis, and in
muscles crossing a joint which can increase joint pressure, upset
alignment, cause facet joint pressure, and precipitate pain in the
joint, eventually causing degenerative changes. He even believes that
shortening in paraspinal muscles acting across a disc space can
compress a bulged disc irritating the nerve root. Pressure on the
nerve root will cause more spasm and result in further nerve root
compression.

In radiculopathic pain, tender muscle bands will appear in myotomal
muscles supplied by both the anterior and posterior primary rami. For
pain in the knee, Gunn would seek the tender bands not only in the
quadriceps femoris muscles but also in the paraspinal muscles at the
same segmental levels (L2-L4). He states that while back pain is most
common at L5-S1 levels, more often than not, higher segmental levels
are involved, frequently reaching dorsal and cervical levels.

By Warren Hammer, MS, DC, DABCO

As we can see this article soft tissue treatment can help relieve the
pressure from nerve root which could cause ridiculer pain.
The treatment of this condition should be emphasized on not only
chiropractic manipulation for joints also soft tissue treatment for
surrounding structures including soft tissue and fascia.

For more information and health tips, visit the Laurel Chiropracticwebsite and “like” us on Facebook.  

Dr. Hyunsuk Oh graduated from Life University in Marietta, Georgia. Dr. Oh currently holds licenses to practice chiropractic in Maryland and Virginia. He is a member of the Maryland Chiropractic Association, American Chiropractic Association and International Chiropractic Association. Dr. Oh has undergone extensive training and has earned the designate of Certified Chiropractic Extremity Practitioner (CCEP) from the Council on Extremity Adjusting. He has also obtained  certification as a Golf Rehabilitation Specialist through Blanchard Institution. Dr. oh has achieved Advanced Certification in the Graston Instrument Assisted Soft-Tissue Mobilization (GISTM) technique (or Graston Technique), a highly advanced and efficient technique developed for treating soft tissue pathology.  He also has achieved Advanced Certification in the SASTM (Sound Assisted Soft-Tissue Mobilization).   Dr. Oh is also a full body licensed provider of Active Release Techniques (ART).  This technique is highly effective for treating a whole host of soft tissue and nerve entrapment issues.   ART is a favorite technique of triathlon participants, volleyball players, marathon runners, and athletes of all sports. Dr. Oh is also a Certified Kinesio® Taping Practitioner (CKTP®). The Kinesio® Taping Method is one of the most sophisticated taping techniques in the world.  It allows for facilitation, inhibition, and functional corrections of the musculoskeletal system.

Graston Treatment for Olympian Micheal Philps!

Graston Technique Helps to Normalize Your Body from Damage Due to Overuse

When the body does not get appropriate recovery time, damaged tissue
is not able to rebuild stronger than it was before. The body remains
in a state of breakdown, and the accumulation of micro tears in
tissues will eventually result in an overuse injury. Graston technique
helps to normalize your body through breaking scars from micro
tears in tissues for your perfect recovery.

Graston Technique is part of an integrated whole body recovery treatment program; we use in conjunction with other methods of chiropractic care to ensure athletic patients can train harder and recover faster.

U.S.A. Olympic Champion Uses Graston Technique for Sports Recovery

By: Selene Yeager, August 12, 2012

MICHAEL PHELPS: THE GREATEST AMERICAN HERO

AFTER THE SCANDALS AND THE SETBACKS, THE GREATEST SWIMMER EVER IS RECHARGED, RELAXED, AND READY TO TAKE HIS FINAL SHOT IN LONDON. THE INSIDE STORY OF HOW A SKINNY KID FROM BALTIMORE ASSEMBLED THE BEST BODY OF WORK—AND BODY—IN U.S. OLYMPIC HISTORY.

BY SELENE YEAGER,

AUGUST 2012 ISSUE

Age: 27 Height: 6'4" Weight: 195 lb Hometown: Baltimore Most athletes follow a regimen that builds endurance, strength, and power over the course of a year. Under coach Bob Bowman, the mastermind of the long-term view, Michael Phelps mapped out a 16-year plan for world domination—the entire duration of his career. In the years before the 2004 Athens Games, Phelps focused on building a massive aerobic capacity, logging 50 miles a week in the pool. Leading up to his record-smashing performance in Beijing in 2008, he added four days a week of weight-intense dry-land training—Keenan Robinson, Phelps' trainer, rotates through a bottomless bag of routines to keep Phelps at the top of his game—and 10 pounds of water-slicing muscle. Fourteen gold (and two bronze) Olympic medals later, he's all about power as he prepares to storm London. In addition to knocking out four sets of five pull-ups while wearing a 40-pound vest, "I'm doing more Olympic-style lifts, like power cleans and snatches and plyometric push presses and box jumps, to get explosive power for jumping off the block and pushing out of turns," Phelps says. "At this point in my career, everybody has caught up. So I'm fine-tuning the little things that add up to make a huge difference."

DETAILS: So what do you do for recovery? Michael Phelps: My trainer, Keenan [Robinson], uses Graston tools, these little metal crowbars. He carves them into my shoulder blades, my back, my knee, my hamstrings—wherever I'm really tight—to loosen things up. It's pretty intense. Obscenities fly out of my mouth the whole time, and I'm usually bruised for two days after it. I also use ice tubs. And when I'm back home, I sleep in an altitude chamber set to about 8,000 feet. All these things help me to be close to my best every time I jump in the water.

Michael Phelps' Workout Tips

ON THE IMPORTANCE OF RECOVERY "Compared to Beijing, I think the biggest thing is just trying to find ways to recover faster. Going into the weight room three times a week, it can be harder to swim, it can be harder to get up and to feel fresh and do this. So it's like you have to find different exercises or different routines that you go through." Here are some of Phelps' activities.

Graston Technique® A modern yet medieval-looking form of soft-tissue manipulation in which the practitioner, in this case Phelps' strength trainer, Keenan Robinson, uses a series of stainless-steel instruments to comb over muscles, find adhesions, and break down scar tissue and stretch connective tissue and muscle fibers. "He takes those little crowbars and carves them into my shoulder blades and I go crazy, letting obscenities fly the whole time," Phelps says. "I bruise for two days. It's pretty intense." But it works. "We used it before a mid-season meet in Missouri in 2007," Robinson recalls. "He was locked up through his rhomboids and lats and external rotators. We went in there and worked it out and he broke the world record in the 200 butterfly. It's amazing."

Note to patients: While Phelps treatment results in some discomfort and bruising, this is not a typical response for GT

For more information and health tips, visit the Laurel Chiropractic website and “like” us on Facebook.  

Dr. Hyunsuk Oh graduated from Life University in Marietta, Georgia. Dr. Oh currently holds licenses to practice chiropractic in Maryland and Virginia. He is a member of the Maryland Chiropractic Association, American Chiropractic Association and International Chiropractic Association. Dr. Oh has undergone extensive training and has earned the designate of Certified Chiropractic Extremity Practitioner (CCEP) from the Council on Extremity Adjusting. He has also obtained certification as a Golf Rehabilitation Specialist through Blanchard Institution. Dr. oh has achieved Advanced Certification in the Graston Instrument Assisted Soft-Tissue Mobilization (GISTM) technique (or Graston Technique), a highly advanced and efficient technique developed for treating soft tissue pathology.  He also has achieved Advanced Certification in the SASTM (Sound Assisted Soft-Tissue Mobilization).   Dr. Oh is also a full body licensed provider of Active Release Techniques (ART).  This technique is highly effective for treating a whole host of soft tissue and nerve entrapment issues.   ART is a favorite technique of triathlon participants, volleyball players, marathon runners, and athletes of all sports. Dr. Oh is also a Certified Kinesio® Taping Practitioner (CKTP®). The Kinesio® Taping Method is one of the most sophisticated taping techniques in the world.  It allows for facilitation, inhibition, and functional corrections of the musculoskeletal system.

Strengthening, Not Stretching, to Deal With Iliotibial Band Syndrome

New Research on Iliotibial Band Syndrome Suggest Stretching Can Help!

There is a interesting new research suggesting that strengthening, not
stretching, is the best way to deal with iliotibial band syndrome:

They call it the “other” runner’s knee injury. Iliotibial band
syndrome was the topic of a special session at the annual meeting of
the American College of Sports Medicine earlier this month, and for
good reason: While it’s less familiar than the cartilage problems that
cause the classic “runner’s knee,” it remains the second most common
running injury , accounting for about 25 per cent of overuse injuries,
and also afflicts many cyclists.

While Traditional Rehab has Focused on Lengthening and Loosening the Stubborn Band, New Studies Show that Strengthening the Hip Muscles May Be More Effective Treatment for Iliotibial Band Pain

The results presented at the meeting suggest a new approach to dealing
with iliotibial band pain. While traditional rehab has focused on
lengthening and loosening the stubborn band, early results from a
study by the University of Calgary’s Running Injury Clinic show that
strengthening the hip muscles may be more effective – not only for
rehab, but for preventing the injury in the first place...

The article describes a neat study from Reed Ferber at the University
of Calgary's Running Injury Clinic. He's had 100 percent success with
23 patients so far with a six-week hip strengthening program. The key
exercises (as you might be able to see below in the thumbnail of the
graphic that Trish McAlaster did for the Globe article) use a
theraband to strengthen the hip abductors, hip extensors, and gluteus
medius:

Dr. Oh, Suggest a Combination of Stretching First Then Strengthening Excercises for the Treatment of Iliotibial Band Pain at Laurel Regional Chiropractic

But I think that It is still important thing to get my patients who
have iliotibial band pain should be done with streching and breaking scar
tissue to normalize the surrounding tissue for ready to re-educate
before this exellent exercises.

For more information on chiropractic care and treatment visit the Laurel Regional Chiropractic website and "Like" us on Facebook.

Golfer? Did you know your Swing can play an Affect on Your Back Health?

The Impact of a Golf Swing on Your Back

If you have ever been on a golf course, you know there are a variety of twist and turns involved in the game. Overtime, these twist and turns can have a negative impact on your back health. Fortunately, chiropractic care can help to alleviate many of the problems that occur on the green.

A Reverse Spinal Angle and its Impact on your Back

A Reverse Spine Angle refers to any excessive upper body backward bend or excessive left (for right handed golfers) upper body bend during the backswing. This awkward motion will make it difficult to initiate the downswing in the proper sequence, because the lower body is in a position that usually limits its ability to initiate the downswing. It's different than a Reverse Pivot.

A Reverse Spine Angle is one of the prime causes of low back pain among amateur golfers. The upper body tends to dominate the swing due to reversed bend, and it limits the lower-body movement. This pattern of movement puts excessive tension on the low back because it will inhibit the abdominal musculature during the backswing.

Several Physical Limitations or Weakness can Result from a Reversed Spine Angle

Reduced spinal mobility
Limited hip joint or muscles
Lack of spinal stabilization
Too much pelvic tilt at address
Lack of forearm rotation on the backswing
Improper pelvic side-bend at address

Chiropractic adjustments have been used by professional and amateur golfers for years to improve health and enhance performance. If you are suffering from pain due to golfing, we can help! Regular chiropractic adjustments can also prevent many golf related back injuries from occurring.

For more health tips and to schedule a consultation, visit our Laurel Regional Chiropractic website and like us on Facebook. 

Lets Talk Water!

Water Talk 1 - Why Water?

Why do your doctors of chiropractic, physicians, and other healthcare
professionals keep telling you to drink plenty of water? Why is it
essential to keep yourself hydrated? Can you stay hydrated with
coffee, soda, juice, or other drinks? How much of water should you
drink a day? Let's talk about water, and benefits of water.
When you were born, you are approximately 75 to 80% water. As you
grow, the percentage of water decreases until it gets to 60 to 65% if
you are a male, and 50 to 60% if you are a female. An average adult is
anywhere from 55% to 78% water depending on body size. Basically, two
third of your body is water. What does that mean? Water is the main
component of your body; cells, tissues, and organs inside of you are
made up of water. Let's take a closer look at the percentages of water
inside of your body.

Your BRAIN is 85 to 90% water
Your BLOOD is 83% water
Your MUSCLES are 75% water
Your SKIN is 44% water
Your BONES are 22% water

What do the percentages tell you? You need water to maintain your
organs healthy. Healthier organs directly affect your overall health.
If your organs don't contain enough of water, your organs cannot
function well. If your organs don't function properly, your overall
health starts to collapse. Disease starts from mal-function of organs.
For example, if your brain does not get enough of water, your brain
cannot function properly and give you trouble such as headache or
fatigue.

Now, let's see what water can do for your body. Believe or not, it is
not wrong to say that water keep you alive.

There are so many benefits
of water, but here are a few of them.

Transpsort nutrients and oxygen into cells
Moisturizes the air in lungs
Helps with metabolism
Protect your vital organ
Helps your organs to absorb nutrients better
Regulates your body temperature
Detoxifies your body
Protect and moisturizes your joints

Not enough for you to get motivated? Let me give you what water can do
for your health. A major benefit of drinking water is maintaining the
body Ph level balanced to prevent and cure diseases. Researchers found
a fair amount of water consumption each day can prevent diseases. It's
better than expensive medications, dietary supplements, and all the
pills!!! Diseases listed I listed below are just a few that can be
prevented by drinking water.

Arthritic Diseases
Disc Related Diseases and Pain
Heart Disease / Stroke
High Blood Pressure / Cholesterol Level
ADHD
Obesity
Depression
Vision / Eye Problems
Sleeping Disorders
Lack of Energy
Multiple Sclerosis
Parkinson's Disease
Alzenheimer's disease
Osteoporosis
Cancer

Are you still looking for a miracle medication or herb that can make
you healthy?

Don't be a fool and spend your money when you have the
best natural health source right next to you for free! Open your
refrigerator and drink water!

Food Pyramid Gets a Facelift

New Food Pyramid Shaped as a Plate Makes Choosing Healthy Meals Easier

The new food pyramid, called MyPlate, was introduced to show people how a typical meal should look.  Fruits and vegetables contain important nutrients such as fiber and potassium that help reduce the risk of developing heart disease, type 2 diabetes, and high blood pressure. 

Whole grains should be consumed, allowing the food to be broken down slowly while preventing sharp spikes in blood glucose while also helping to lower cholesterol.  Protein sources should consist of lean meats including at least 8 oz of fish per week. Calcium, phosphorus, and vitamin D are some of the reasons that having dairy at each meal is very beneficial.

The new MyPlate also shows the proper portion size when compared to your standard dinner plate.  This differs from the food pyramids of the past that gave recommendations as to how many servings one should consume from each individual food group with no attention paid to portion size.