Archives for posts with tag: Dr. Dan Rae

Your friendly Chiropractor in Chandler AZ, Dr. Dan Rae, is back at the computer this morning trying to fit this article in prior to seeing patients today.  In keeping with the hip theme I am going to review a condition called Snapping Hip Syndrome.  A question that I get asked several times each day is why is my hip popping or snapping.  Well, today you will find out one of the main reasons for this.

internal-snapping-hip-syndromeexternal-snapping-hip-syndrome

In the images above by MendMeShop, we are able to see the structures involved in Snapping Hip Syndrome as well as a little bit of how it happens.  Snapping at the hip is most often due to tendons that are tight and snap over a bony prominence or or a fluid-filled sack called bursa.  In some cases, moving the leg away from the body may cause a suction effect similar to joint gapping with manipulation, and even less frequently, a loose body may be found in the joint.  However, with loose bodies, there are also signs of mechanical movement blockage.

These patients are generally in my office for something else when they ask about there hip snapping because it does not generally cause them pain.  The location of the snapping is a good indication of the offending tendon.

Usually this is not a problem, and it is typically position dependent.  If painful or irritating strengthening exercises have proven to be more beneficial than stretching.  However, if the irritation persists stretching can be implemented as well as soft-tissue therapies such as Active Release Technique (ART) and Graston Technique.

If you are struggling with Hip Pain call my office today at (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 write about Hip Stress Fractures.  I do not see Hip Stress Fractures a lot in my practice, but I have dealt with them on occasion making it something that I feel I should address.

hip_stress_fracture

 

In the image above by MMG 2000, we are able to see the different types of Hip Stress Fractures that occur at the femoral neck.  Within the bone we have different types of cells one of which is an osteoclast and the other an osteoblast.  Osteoclasts in a sense eat bone or destroy it, and osteoblasts on the other hand create bone.  With repetitive stress to the femoral neck, microfractures occur.  This damage leads to increased bone remodeling, or the removal of old bone by osteoclasts and the formation of new bone by osteoblasts.  When osteoclastic activity surpasses osteoblastic activity, the bone becomes weakened leading to fracture.

In most cases that I have had in my office the patient is usually young and active, often participating in cross country, gymnastics, dancing, or marching band.  The pain comes on rather slowly and is worse when standing.  The pain is normal felt on the front and deep into the leg.

Treatment for the Tension/Transverse Stress Fracture is different from that of the Compression Stress Fracture.  With the Transverse Stress Fracture surgical pinning is required to stabilize the hip.  With the Compression Stress Fracture an elastic support is necessary as well as rest for 2 weeks.  After the two weeks non-weight-bearing exercises are implemented such as cycling and swimming.  The Displaced Fracture require surgical pinning as well.

If you are struggling with Hip 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 write about Carpal Tunnel Syndrome.  Carpal Tunnel Syndrome is one of those syndromes that we have all heard about, but we seem to be hearing less and less about it every year.  A few years ago it was the diagnosis everyone got when their wrists hurt, which lead to a lot of misdiagnosis, which in turn, lead to a lot of people having surgery for something they did not have.  Furthermore, Carpal Tunnel Syndrome can generally be treated without surgery.

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The image above by MMG 2003 clearly shows compression of the Median Nerve in the right hand, which is the cause of Carpal Tunnel Syndrome.  The reason I mention that it is the right hand is because the image below by 2004 MedicineNet, Inc. will demonstrate the area of pain and numbness, but it is showing it in the left hand.

carpal_tunnel

The Median Nerve runs through runs through the Carpal Tunnel created by the Transverse Carpal Ligament and the carpal bones, which are the bones of the hand.  Carpal Tunnel Syndrome can occur through compression from ganglions, fractures, and dislocations; however, it is more common to have a history of direct pressure on the tunnel or a history of extended periods of wrist use in full flexion or extension.  The pressure in the tunnel will increase with these extreme positions.  Other additional factors have to do with fluid retention such as with pregnancy, RA, diabetes, and connective tissue disorders.  It has also been shown that individuals who are deficient in vitamin B may be predisposed.

Treatment for Carpal Tunnel Syndrome does not have to include surgery.  Initial treatment involves night splinting in in extension of neutral positions, avoiding the compressive or overuse activities such as resting the wrists on the desk while typing, and perhaps the use of a B-complex vitamin.  It has been shown that adjustments to the lunate bone, one of the carpal bones, is extremely helpful.  Myofascial release techniques such as Active Release Technique (ART) and Graston Technique are also utilized to help relieve the pressure within the Carpal Tunnel.

If you are struggling with Carpal Tunnel Syndrome or any other form of Wrist Pain or Hand 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 trying to squeeze this article in between patients this afternoon.  Today I am going to focus on a tendinitis in the wrist known as de Quervain’s Tenosynovitis.  This is a very common condition, but most doctors just says you have Wrist Tendinitis or Thumb Tendinitis, but the actual name is de Quervain’s Tenosynovitis also known as Stenosing Tenosynovitis.

DeQuervainsTenosynovitis

The image above gives a great example of what we see with de Quervain’s Tenosynovitis.  There is chronic microtrauma to either the tenosynovium or the tendon sheath causing a narrowing of the area surrounding the abductor pollicis longus and extensor pollicis  breveis muscles.  Pollicis meaning thumb.

These patients come into my office complaining of pain on the thumb side of the wrist with a history of activities that require forceful gripping with bent towards the little finger or repetitive use of the thumb such hitting the space bar all day long typing.

Treatment for this condition is rather simple.  Modification of the inciting activity is a must along with ultrasound therapy, Kinesiology Tape to relieve pressure on those muscles, and ibuprofen.  If this does not relieve the pain within 2-3 weeks use of a thumb spica may be necessary.  If none of these conservative efforts are successful referral for a local steroid injection would be made.

If you are struggling with Wrist Pain or Hand 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 in preparations for Spring Training and the start of the Little League baseball season I thought it would be could to write about Little League Elbow, which is becoming more and more prevalent with the specialization in sport that kids are moving to these days.

little league elbow

In the image above by MK Carlton, we are able to see the possible injuries in young baseball players sustained from pitching all called Little League Elbow.  In all reality Little League Elbow is a syndrome.  The repetitive valgus (a valgus deformity is a term for outward angulation of the far end of a bone or joint) stress brought on by pitching causes a stretch injury to the inner portions of the elbow and a possible compression injury to the outer portions of the elbow as seen in the image above.  Pain at the inner aspect of the elbow is due to microtrauma to the medial anterior oblique ligament as well as causing accelerated growth and fragmentation of the medial epicondylar growth plate.  On the outer aspect of the elbow osteochondritis dissecans (Osteochondritis Dissecans of the elbow is a condition that causes pain in the elbow of children 8 to14 years of age. It most commonly involves the portion of the humerus called the capitellum, which helps to form the elbow joint and allows the forearm to rotate, turning the palm up or down.) of the capitellum with the possibility of injury to the head of the radius bone, including premature closure of the growth plate.

These patients usually come into my office as teenage baseball pitchers complaining of pain on either the inner or outer aspects of the elbow.

Two different routes can be taken depending on the severity of the injury.  If the x-rays show changes to the bones and growth plate an orthopedic consultation is necessary; however, if the x-rays are normal, rest from pitching needs to happen immediately.  Also, modifications to pitching mechanics must be made, specifically to how the curve ball is pitched.

If you are struggling with Elbow Pain, contact 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 write a little bit more about injuries to the elbow.  Today, I will be reviewing a condition called Posterior Impingement Syndrome.  We hear more about Shoulder Impingement Syndrome, but it can also occur in the elbow as well.

postimpingement

 

In the image above we have a clear picture of the elbow joint.  Posterior Impingement Syndrome is caused by the repetitive extension of the elbow that leads to compression on the back side of the elbow between the ulna, which is the bone on the bottom and the humerus, which is the bone on the top.  This may cause what is called a reactive synovitis (Synovitis is the inflammation of a synovial (joint-lining) membrane, usually painful, particularly on motion, and characterized by swelling, due to effusion (fluid collection) in a synovial sac.) or progress to degeneration and the production of osteophytes (bone spurs) or loose bodies as seen in the image above, which is seen by the top arrow.

These patients usually come into my office complaining of sharp pain on the back side of the elbow, especially on rapid extension of the elbow.  There may be associated complaints of popping or clicking with extension of the elbow or an occasional locking of the joint.

Management of this condition varies depending on if there are loose bodies or not.  If there are loose bodies, the individual will be referred to an orthopedic surgeon for surgical consultation.  In all other cases rest and ice is needed, and the patient is taped in a manner so as to not be able to fully extend the elbow.

If you are struggling with Elbow 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 evening to talk about an injury that we do not hear about too often in Triceps Tendinitis.  It is also known as Posterior Tennis Elbow.  Triceps injuries have been getting a little more publicity over the past few weeks with the Baltimore Ravens star middle linebacker Ray Lewis having torn his, and star defensive tackle Justin Smith of the San Francisco 49ers injuring his triceps as well.

triceps tendinitis

In the image above by MMG 2000 we are able to clearly see the triceps tendon.  Irritation or strains of the triceps tendon are usually due to common athletic skills performed by boxers, weight lifters, pitchers, shot-putters, and some tennis players.

These patients typically come into my office complaining of pain at the tip of the elbow after performing an activity that required repetitive straightening of the elbow, or one single event that required forceful straightening of the elbow.

Treatment for Triceps Tendinitis is quite simple.  Myofascial release techniques such as Active Release Technique (ART) and Graston Technique are implemented to encourage healing and to prevent scar tissue formation.  Ice and rest from the activity that caused the pain is essential.  If the individual is working out the amount of weight utilized during elbow extensions needs to be reduced.

If you are struggling with Elbow Pain, call my office today (480) 366.4041.  We can Help!