Archives for posts with tag: 85286

Your friendly Chiropractor in Chandler AZ, Dr. Dan Rae, is back at the computer this afternoon trying to catch up on all the things that got pushed aside during the holiday season.  Today I want to address a condition known as a Rotator Cuff Tear or a Strained Rotator Cuff.  This is something that I see quite often because I have come to be known in the community here as somewhat of a shoulder guru.

rotator_cuff_tear

The rotator cuff is made up of four different muscles known as the supraspinatus, infraspinatus, teres minor, and subscapularis, also known as the SITS muscles.  The most common tears occur in the supraspinatus.  There is typically two different areas where the tears occur in the supraspinatus.  One occurs where the arm and shoulder blade form a joint known as the articular sided tear, and the other occurs next the fluid-filled sac known as bursa, which would make it the bursal sided tear.  Most partial tears are articular sided and may be related to poor blood flow to the area.  Tears can be due to trauma, but most often they are due to chronic degenerative changes to the tendon.  Thus, leading to patients complaining of shoulder pain, but they do not know why they have shoulder pain because they have not experienced any trauma.

The patients that I see in my office generally give some sort of history of an acute traumatic event such as lifting a heavy object or a fall on an outstretched arm.  Older patients may not even recall any sort of traumatic event.  These individuals usually complain of pain with overhead activities or weakness in lifting the arm.

Partial tears can be treat in my office with great results.  We do this by implementing soft-tissue therapies such as Active Release Technique (ART) and Graston Technique to stimulate the healing process.  Kinesiology Tape is also used to help encourage the muscles to function properly as well as stabilize the shoulder.  Rehabilitation begins with isometric exercises gradually leading to to a strengthening program.  Complete tears usually require surgical repair in younger individuals.

If you are struggling with Shoulder Pain, call my office today (480) 366-4041.  We can Help!

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Your friendly Chiropractor in Chandler AZ, Dr. Dan Rae, is back at the computer this morning to review a disorder known as Adhesive Capsulitis or better known as Frozen Shoulder.  This is a very common disorder that I see on a regular basis in my office, and I would say that this is one of my favorite shoulder disorders to treat.

shoulder_adhesive_capsulitis_anat02

In the image above by MMG 2001, we are able to see the changes the occur with the joint capsule with Frozen Shoulder.  The cause of Frozen Shoulder is currently unknown, but the most accepted theory is that adhesions develop within the capsule of the shoulder.  However, this is not always seen at surgery.  Furthermore, the patient often respond favorably to stretching techniques that place very little stretch on the capsule.  There are certain groups of individuals that are predisposed to Frozen Shoulder including those with diabetes, hyperthyroidism, or chronic obstructive or other lung disease, and those who have had a heart attack.  It has been proven, contrary to common logic, this disorder is not due to immobilization of the shoulder.  This process begins as an inflammatory process that progresses to fibrosis.  The three phases include the following:

  • an acute inflammatory phase that causes a presentation that overlaps with some other condition
  • a stiffening phase
  • a thawing phase where some of the range of motion returns

These patients come into my office with varying symptoms based on the their current phase.  These patients are usually over the age of 40.  In the acute phase they complain of moderate to sever pain that limits all shoulder movement.  Usually they cannot recall any specific event that lead to the pain.  The pain interrupts their sleep, and in most cases leads these individuals to seek prescription pain medication.  In the stiffening phase these individuals tell of a history consistent with the acute phase ; however, now the pain is substantially less, but the range of motion in the shoulder is severely limited.  In the final phase there is an increase in the range of motion, but the range is still very limited.

Management for this condition is not the most comfortable thing to go through.  Soft-tissue therapies including Active Release Technique (ART) and Graston Technique are used to increase the range of motion in the shoulder by attempting to break the fibrous adhesions that have developed with the shoulder musculature and joint capsule.  Range of motion and stretching exercises are implemented as soon as possible.  If these conservative measures are not showing improvement after a couple of month, more aggressive procedures are utilized such as Manipulation Under Anesthesia.

If you are struggling with Shoulder Pain or Frozen Shoulder, call my office today (480) 366-4041.  We can Help!

Your friendly Chiropractor in Chandler AZ, Dr. Dan Rae, is back at the computer this afternoon to start writing about some common shoulder injuries.  Today, I wil start with Impingment Syndrome.  This is a very common disorder of the shoulder.  I see this several times each week in my office making it a very important disorder to review.

Shoulder-Impingement-Syndrome

There are several different structures that can become impinged with Impingement Syndrome.  The biceps tendon, supraspinatus tendon, and the subacromial bursa are all susceptible to impingement at the front or outer portions of the shoulder.  There are some structural causes that account for this impingement including variations in the collar bone, degeneration on the under side of the end of the collar bone, and inflammation directly under the collar bone.  Instability in the shoulder is also a coexisting problem, allowing for excessive upward movement of head of the humerus bone.  There may also be some tightness on the backside of the shoulder capsule, which cause migration foward and up of the humerus bone when raising the arm.

Management of Impingement Syndrome is based on the severity of the symptoms; however, stabilization of the shoulder must occur with a progressive rehabilitation program, stretching the posterior capsule, and modification of inciting activities.

If you are struggling with some sort of Shoulder Pain, call my office today (480) 366-4041.  We can Help!

Your friendly Chiropractor in Chandler AZ, Dr. Dan Rae, is back at the computer this morning to review a condition called Ankylosing Spondylitis.  This is a condition that is not very common at all in my office, but I do see it, and therefore, I believe that it is important that I provide some information about it.

ankylosing spondylitis

The image above by Healthwise, gives a great representation of the stages of Ankylosing Spondylitis.  Ankylosing Spondylitis is an inflammatory arthritis that usually starts by affecting the sacroiliac (SI) joints in the pelvis with progression into the spine.  It is characterized by inflammation at the site where ligaments attach to the bone.  This condition affects men more than women at a 3:1 ratio with the severity of the condition being worse in men as well. Typically, the earlier in the life it starts, the more progressive the disease will be.  As it progresses, there is a gradual stiffening, loss of the curvature of the low back, increase in the curvature of the mid back, and decrease in chest expansion due to the ribs attaching to the spine.  There is involvement with joints in the extremities approximately 50% of the time, with permanent changes occurring 25% of the time.  The joints most affected outside the spine are the hips, shoulders, and knees.

These patients usually come into my office complaining of chronic low back pain and stiffness with the occasional radiation of pain into the buttock, back of the leg, or front of the leg.  They generally feel the stiffness when getting up and has some relief with light activity.

Ankylosing Spondylitis, like other rheumatoid and rheumatoid-variant diseases, is unpredictable in its course of remission and relapse.  Treatment include chiropractic manipulation to keep the spine flexible, stretching, and postural and breathing exercises.  Getting these individuals into a Posture Shirt as soon as possible is imperative.

IntelliSkin337_157

When performing manipulation to the spine, it must be gentle to prevent inflammation.

If you are suffering from low back, buttock, or leg pain, call my office today (480) 366-4041.  We can Help!

Your friendly Chiropractor in Chandler AZ, Dr. Dan Rae, is back at the computer this afternoon to discuss a problem know as Piriformis Syndrome that I see a lot in my marathon/ultra-marathon runners; however, we see it in other individuals quite frequently as well.

Piriformis Syndrome

In the image above, by RelayHealth, gives us a fantastic illustration of Piriformis Syndrome.  In Piriformis Syndrome the Sciatic Nerve is compressed by the piriformis muscle.  In most individuals, the Sciatic Nerve runs under the piriformis muscle; however, in approximately 15% of individuals, there are two muscle bellies with the Sciatic Nerve coursing directly between them, which leads to compression between the muscle bellies when muscle gets tight or goes into spasm.

These individuals generally come into my office with complaints of buttock and posterior leg pain with no apparent cause.

Treatment for Piriformis Syndrome is quite simple.  It has been shown in many cases that individuals with foot pronation or pelvic rotation are prone to this condition.  Simple solutions for both of these include arch supports for the pronator and for the individual with pelvic rotation chiropractic manipulation is implemented to correct the rotation, and soft-tissue therapies such as Active Release Technique (ART) and Graston Technique are utilized to lengthen the shortened piriformis muscle.

If you are struggling with low back, buttock, or leg pain, call my office today (480) 366-4041.  We can Help!

Your friendly Chiropractor in Chandler AZ, Dr. Dan Rae, is back at the computer this morning to talk about an injury that I see on a daily basis in my clinic, and that is the Sacroiliac Sprain.  This is something that a good majority of us have suffered from, but we have just never put the proper name to it.  We call it Low Back Pain, Low Back Sprain, or Low Back Strain, take your pick.

sacroiliaclig

In the image above, we can easily see the ligaments that attach our pelvic bones to the sacrum, and dysfunction on the Sacroiliac (SI) Joint probably accounts for around half of all Low Back Pain cases.  The SI ligamentous support is very strong; however, in younger individuals, those that are pregnant, or those with degenerative joint disease (osteoarthritis) in their low back, prolonged or sudden lifting or bending may irritate or sprain the ligaments.  Movement at the SI joint is small but existent in younger patients.  The movement is primarily a front to back rotary movement around a transverse axis.  This is an accessory movement that is involuntary occurring mainly when moving to a standing position.

These patients come into my office complaining of pain over one of the SI joints (upper portion of the buttock and lowest portion of the low back) after straightening up from a stooped position, often after lifting an object or even coughing violently.  The pain may radiate down the back of the leg.  With a sprain the pain will often be a sharp stabbing pain that some by sitting or lying down.

An acute SI sprain are usually best managed with an SI support (brace).

sacroiliac-support-belt-71114-146223

Chiropractic manipulation of the SI joint is performed to correct any asymmetries.  Kinesiology Tape can be applied as a support depended on the severity of the sprain.

low back sprain

If you are struggling with Low Back Pain, call my office today (480) 366-4041.  We can Help!

Your friendly Chiropractor in Chandler AZ, Dr. Dan Rae, is back at the computer this morning trying to squeeze this article in thanks to a patient that had to cancel today.  Today, I am going to address a condition that I generally see in my older patients known as Spinal Stenosis or Canal Stenosis.  This is a condition that is very common, and there is a lot of argument as to what is the best treatment.

Stenosis

Spinal Stenosis, as seen from the image above, is a narrowing of the spinal canal.  The stenosis (narrowing) can occur centrally or at the side of the spinal cord.  It can be caused by bony or soft tissue encroachment, and it can be something that is acquired during life or something we are born with.  As a result, the signs and symptoms for Spinal Stenosis vary widely.  For symptoms in the legs to occur, there is generally several different vertebral levels of stenosis involved.  The acquired stenosis occurs from bony outgrowths from different part of the vertebra and other degenerative changes.  Postoperative stenosis may occur as a result of decompressive surgeries such as a Laminectomy.

These patients come into my office, generally being over the age of 50, complaining of back and leg pain.  The pain can be effecting only one side or both sides and is usually diffuse pain.  It is common for these patients to complain of leg pain when walking that subsides after 15-20 minutes or rest or maintaining a bent over posture.

As stated before, there are mixed reviews on how to best treat this condition.  Surgeons want to perform surgery, pain management doctors ant to perform injections, and guys like me want to try and treat it conservatively.  In most cases I manage this condition with the other two doctors.  I have a great relationship with the doctors in my community, and I encourage my patients to get the injections from the pain management doctors to control the pain so that I can perform therapies to the back that will help to correct the problem by decompressing the low back.  However, I encourage the patient to follow up with the surgeon to make sure we are achieving the results necessary to avoid surgery.

If you are struggling with low back and leg pain, call my office today (480) 366-4041.  We can Help!