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 By Frank M. Painter, D.C. in Chiropractic Care on April 23rd, 2013 at 11:55 am
Sports Management:
Leg, Ankle, and Foot Injuries
The Chiro.Org Blog
We would all like to thank Dr. Richard C. Schafer, DC, PhD, FICC for his lifetime commitment to the profession. In the future we will continue to add materials from RC’s copyrighted books for your use.
This is Chapter 27 from RC’s best-selling book:
“Chiropractic Management of Sports and Recreational Injuries”
Second Edition ~ Wiliams & Wilkins
These materials are provided as a service to our profession. There is no charge for individuals to copy and file these materials. However, they cannot be sold or used in any group or commercial venture without written permission from ACAPress.
Chapter 27: Leg, Ankle, and Foot Injuries
The lower leg, ankle, and foot work as a functional unit. Total body weight above is transmitted to the leg, ankle hinge, and foot in the upright position, and this force is greatly multiplied in locomotion. Thus the ankle and foot are uniquely affected by trauma and static deformities infrequently seen in other areas of the body.
Injuries of the Leg
The most common injuries in this area are bruises, muscle strains, tendon lesions, postural stress, anterior and posterior compression syndromes, and tibia and fibula fractures. Bruises of the lower leg are less frequent than those of the thigh or knee, but the incidence of intrinsic strain, sprain, and stress fractures are much greater.
A continual program of running and jogging is typical of most sports. The result is often strengthening of the antigravity muscles at the expense of the gravity muscles — producing a dynamic imbalance unless both gravity and antigravity muscles are developed simultaneously. An anatomic or physiologic short leg as little as an eighth of an inch can affect a stride and produce an overstrain in long-distance track events.
Bruises and Contusions
The most common bruise of the lower extremity is that of the shin where disability may be great as the poorly protected tibial periosteum is usually involved. Skin splits in this area can be most difficult to heal. Signs of suppuration indicate referral to guard against periostitis and osteomyelitis.
Management. Treat as any skin-bone bruise with cold packs and antibacterial procedures, and shield the area with padding during competitive activity. When long socks are worn, the incidence of shinbone injuries is reduced. An old but effective protective method in professional football that does not add weight is to place four or five sheets of slick magazine pages around the shin that are secured by a cotton sock which is covered by the conventional sock. A blow to the shin is reduced to about a third of its force as the paper slips laterally on impact.
GASTROCNEMIUS CONTUSION
This is a common and most debilitating injury in contact sports. It is characterized by severe calf tenderness, abnormal muscle firmness of the engorged muscle, and inability to raise the heel during weight bearing.
Management. Treat with cold packs, compression, and elevation for 24 hr. Follow with mild heat and contrast baths. Massage is contraindicated as it might disturb muscle repair. The danger of ossification is less in the calf than in the thigh, but management must incorporate precautions against adhesions.
TRAUMATIC PHLEBITIS
Contusion to the greater saphenous vein may lead to rupture resulting in extensive swelling, ecchymosis, redness and other signs of local phlebitis. Tenderness will be found along the course of the vascular channel. During treatment, referral should be made upon the first signs of thrombosis.
Management. Management is by rest, cold, compression, and elevation for at least 24 hr. Later, progressive ambulation, mild heat, and contrast baths should be utilized. Progressive exercises may begin in 4-6 days. When competitive activity is resumed, the area should be provided extra protection.
NERVE CONTUSIONS
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By Frank M. Painter, D.C. in Acupuncture on April 2nd, 2013 at 8:09 pm
Updated Reference Guide to Dr. Richard C. Schafer’s Articles
The Chiro.Org Blog
There are now 62 different Chapters from Dr. Schafer’s various best-selling textbooks for your review, available exclusively at Chiro.Org
These learned articles by Dr. Schafer can also be found again easily by selecting the EDUCATION Category, on the right-hand side of this page, just below Recent Comments. We hope you will find them of interest.
Our thanks to ACAPress for access to these materials!
Arm and Elbow Trauma
The Chiro.Org Blog
Clinical Monograph 17
By R. C. Schafer, DC, PhD, FICC
The shoulder girdle is a multiaxial intricately synchronized joint complex that has considerable power and an extreme range of motion. The anterior, superior, and posterior shoulder muscles provide the great power, and the collateral ligaments do not appreciably limit motion in any plane. Thus, stability must be provided by muscles: essentially the rotator cuff and subscapularis muscles of the arm, which are aided slightly by the glenohumeral ligaments.
BACKGROUND
The proximal ulna forms the most important articulation in the elbow area, while the distal radius forms the most important articulation in the wrist.
Elbow area injuries are commonly the result of direct blows or falls. Avulsion-type injuries of the elbow are often seen as a result of acute or chronic strain at a site of tendon or ligament attachment. As in all traumatic injuries, the sooner the patient is examined after injury, the more accurate the diagnosis. Swelling, spasm, tenderness, and motion limitations rapidly cloud the picture. A list of common elbow injury syndromes is shown in Table 1.
Table 1. Common Elbow Injuries
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Pediatric News
The Chiro.Org Blog
The second edition of Dr. Claudia Anrig’s wonderful textbook
“Pediatric Chiropractic” will be available in early November. Pre-order a copy at a discount price on our Amazon Associate page and Amazon will tithe 4% of the proceeds back to chiropractic research.
With its academic and clinical approach, the second edition of Pediatric Chiropractic provides the Family Wellness Chiropractor the tools they need to adjust infants, children and pregnant women with confidence. Through the cooperation of over 40 international experts, this new edition adds several techniques including SOT, Thompson, Logan, Upper Cervical, Craniosacral, instrument assisted adjusting and remains the leading resource for the Gonstead technique as a method for adjusting children and pregnant women.
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By Frank M. Painter, D.C. in Blood Pressure on July 17th, 2011 at 11:30 am
Why Chiropractic Care Reduces Blood Pressure
The Chiro.Org Blog
Several news stories reported on a study performed at the University of Leeds in England, and published in the August 1, 2007 issue of the Journal of Neuroscience [1], that showed links between neck muscles and the brain and that this link plays a crucial role in controlling blood pressure.
One report by UPI on August 2, 2007 starts off by stating:
“A University of Leeds chance discovery in a British laboratory shows why a chiropractic adjustment for a pain in the neck may do wonders for blood pressure.“
This article quotes study leader Professor Jim Deuchars, who notes that his finding found pathways between the neck and the brain and shows how the neck muscles could play an important role in controlling blood pressure, and why chiropractic care works so well with blood pressure.
He states, “ By identifying the pathways we can see why these treatments might work and it could also explain why some people suffering whiplash injuries may experience a change in their blood pressure.”
As he mentions in the article, Professor Deuchars notes that the Leeds study further corroborates the work done at the Hypertension Center at the University of Chicago Medical Center and published in the March 2, 2007 issue of the Journal of Human Hypertension. In that previous study 25 people in the study group receiving the chiropractic adjustments all showed a significant reduction in blood pressure compared with groups in the study that did not get chiropractic adjustments.
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Chiropractic Technique Review: Pierce Results System
The Chiro.Org Blog
The Chiropractic Technique, known as the Pierce Results System, (formerly known as Pierce/Stillwagon, or PST) was developed by Vernon Pierce, D.C., Sr. It is a biomechanical analysis of spine kinematics (or spinal motion), utilizing “stress views” of the spine (flexion, extension, rotation, and/or lateral bending views where required) or videofluoroscopy (VF, or “moving x-ray” studies) to determine the loss of spinal function, which is at the core of the “vertebral subluxation complex”.
Structure and Function
Our spine is a “structural” unit. There are 4 curves to the spine. Loss of structural integrity and/or normal function of the spine is the basis for the evolution of the vertebral subluxation. Abnormal stresses occur in the facets, discs and supporting tissues when normal motion of the spine is impaired. The Pierce System analysis is aimed at locating the specific segments which are subluxated, as well as providing the means to “free” those segments.
When normal function returns, the neurologic and other components of the subluxation complex resolve by the normal healing power referred to historically as “innate intelligence” or “vis medicatrix naturae” (the healing power of Nature).
| Neutral Lateral Film Analysis: |
The picture on the left is an example of perfect cervical lordosis. All segments should be on Georges’s line (one curved line). There should be an even spacing between each spinous process. Positioning of the head and spine should also be assessed for anterior head placement (also known as Forward Head Posture). The normal cervical lordosis (which extends from C1 to T2) should have a 17-24 cm. radius, based on the patient’s height. This is easily measured with the AcuArc ruler. The posterior arch of Atlas should be centered in the space between occiput and the C2 spinous process. If C1′s posterior arch “crowds” occiput, it is labelled as an “inferior” Atlas. If it crowds C2, it is labelled “superior”. The normal Atlas Plane line would be 18-24 degrees superior to the bottom of the film. A line under the bottom of the C2 body (Whitehorn’s line) should be parallel with the floor.
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Chiropractic Techniques
The Chiro.Org Blog
The following list contains the 15 techniques most frequently used by doctors of chiropractic (DCs). Although this list is dated, it still accurately reflects the most commonly-used techniques. The most recent reviews suggest that Instrument Adjusting use is even more common (~46%) The following list is from the Job Analysis of Chiropractic, created by the National Board of Chiropractic Examiners in January 2000.
Following this list is a brief explanation of each of these manipulative/ adjustive procedure. Every chiropractic college teaches one or more of the following techniques. Many of the rest may be offered as Electives that can be taken by students while they are still in school over a 15-week trimester, under supervision of Technique instructors.
Chiropractic graduates undergo a National Board examination that requires the student to demonstrate competency in the top five manipulative/ adjustive techniques, plus the techniques taught at his/her chiropractic college.
Most Frequently Used Techniques:
| Technique/Procedure |
% of DC Use |
| 1. Diversified |
95.9% |
| 2. Extremity manipulating/adjusting |
95.5% |
| 3. Activator Methods |
62.8% |
| 4. Gonstead |
58.5% |
| 5. Cox Flexion/Distraction |
58.0% |
| 6. Thompson Technique |
55.9% |
| 7. Sacro Occipital Technique |
41.3% |
| 8. Applied Kinesiology |
43.2% |
| 9. NIMMO/Receptor Tonus |
40.0% |
| 10. Cranial |
37.3% |
| 11. Adjustive Instruments |
34.5% |
| 12. Palmer Upper Cervical |
28.8% |
| 13. Logan Basic |
28.7% |
| 14. Meric |
19.9% |
| 15. Pierce-Stillwagon |
17.1% |
Continue reading …
Advising on Prevention in Chiropractic:
A Look at Public Health Promotion
The Chiro.Org Blog
SOURCE: Topics in Integrative Health Care 2011: 2 (1)
There are more articles like this at the:
Health Promotion & Wellness Page
Harrison Ndetan, M.Sc., MPH, DrPH, Michael Ramcharan, DC, Marion Willard Evans, Jr., DC, PhD, MCHES, CWP
The Abstract:
Chiropractic care is among the more commonly used Complementary and Alternative Medical (CAM) therapies. Spinal co-morbidities include many of the most common causes of premature death and disability. Health promotion and disease prevention have been used in the profession and taught in educational settings but not yet fully embraced in usual practice. This manuscript reviews areas in which health promotion has been emphasized in chiropractic education along with instances in which health behavior theories (HBTs) have been applied. Chiropractic clinical and educational programs should consider application of HBTs to move clinicians and interns forward regarding better advising roles with patients related to prevention and health promotion.
Introduction
The actual causes of death in the United States include many chronic diseases that are attributable to modifiable behavioral risk factors such as tobacco use, physical inactivity or sedentary lifestyle, alcohol consumption, poor nutrition or eating habits. [1] An increased emphasis on prevention, health promotion (HP), and education has been recommended for decades but has failed to reduce many of the threats related to premature morbidity and mortality. [2,3] Complementary and alternative medicine (CAM) use has also increased; in many cases aimed at chronic disease management. [4-7]
Chiropractic care is one of the most frequently used professional CAM health care systems in the U.S. [4,5,7] Musculoskeletal conditions such as low back and neck pain, which are among the most common reasons patients visit medical physicians in the U.S., [8] are also among the conditions most frequently treated with chiropractic care. [7-9] The relative efficacy and cost effectiveness of chiropractic and medical care have emerged as important issues in the broader debate on evidence-based healthcare. [10,11]
Chiropractors and health promotion
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Live and Let Live?
The Chiro.Org Blog
Editorial Commentary:
Here’s a question I don’t have an answer for:
Do chiropractors need to adjust people while the patient is under anesthesia (a.k.a MUA)?
I have no experience to guide me. I have never met a patient whose muscle spasm (or spinal “fixation”) was so great that I was not able to adjust them. Of course, that doesn’t mean that they might not be out there somewhere. I can only assume that’s why someone came up with the idea of MUA in the first place. Until now this never seemed relevant to me, and I didn’t pay attention to the evolution of this practice.
What I do know is that organized medicine is in a huge uproar about MUA.
Continue reading …
Proprioceptive Neuromuscular Training Reduces Sports Injuries
The Chiro.Org Blog
Thanks to ChiroAccess for this information!
A March 2010 systematic review conducted in Germany underscores the value of neuromuscular training in preventing sports injuries. [1] They concluded that “On the basis of the results of seven high-quality studies, this review showed evidence for the effectiveness of proprioceptive/ neuromuscular training in reducing the incidence of certain types of sports injuries among adolescent and young adult athletes during pivoting sports.”
The pivoting sports included basketball, hockey, handball, volleyball, soccer and floorball. Multiple high quality studies now support the use of training programs to improve proprioception and the research further supports that this proprioceptive improvement translates to reduced risk of sports associated injuries. [2–4] The benefit is even greater for those with a previous history of sports injury.
Continue reading …
Headache: The Management of Pain and Disability
The Chiro.Org Blog
We would all like to thank Dr. Richard C. Schafer, DC, PhD, FICC for his lifetime commitment to the profession. In the future we will continue to add materials from RC’s copyrighted books for your use.
This is Chapter 5 from RC’s best-selling book:
“Clinical Chiropractic: The Management of
Pain and Disability: Upper Body Complaints”
These materials are provided as a service to our profession. There is no charge for individuals to copy and file these materials. However, they cannot be sold or used in any group or commercial venture without written permission from ACAPress.
Chapter 5: HEADACHE
CLINICAL BRIEFING
Headache is one of the most common complaints presented in a chiropractic office. It is not unusual for a few adjustments to correct a problem for which the patient has suffered for years and sought relief from a score of allopaths in vain. Nevertheless, headache is not a simple problem. Its origin may be traumatic, inflammatory, neurologic, psychologic, vascular, endocrine, metabolic, neoplastic, degenerative, deficiency, congenital, allergic, autoimmune, or toxic.
Continue reading …
Sports Management:
Physiologic Therapeutics in Sports
The Chiro.Org Blog
We would all like to thank Dr. Richard C. Schafer, DC, PhD, FICC for his lifetime commitment to the profession. In the future we will continue to add materials from RC’s copyrighted books for your use.
This is Chapter 13 from RC’s best-selling book:
“Chiropractic Management of Sports and Recreational Injuries”
Second Edition ~ Wiliams & Wilkins
These materials are provided as a service to our profession. There is no charge for individuals to copy and file these materials. However, they cannot be sold or used in any group or commercial venture without written permission from ACAPress.
Chapter 13: PHYSIOLOGIC THERAPEUTICS IN SPORTS
Chiropractic physiologic therapeutics is defined by the ACA Council on Physiotherapy as the application of forces and substances that induce a physiologic response and use and/or allow the body’s natural processes to return to a more normal state of health.
This section is not intended to be instructional in specific modality application, but rather to bring to attention commonly utilized procedures and their rationale within the management of sports injuries. For this reason, emphasis will be on application-rationale within athletics, indications, and contraindications, rather than technique.
Physiologic Therapeutics
Physiologic therapeutics make use of the therapeutic effects of mechanotherapy, hydrotherapy, electrotherapy, light, heat, cold, air, soft-tissue manipulation, and massage. The rational application of these natural forces requires a knowledge of the actions and effects on pathophysiologic processes.
The use of physiotherapy to facilitate basic chiropractic care has been popular within the profession since the turn of the century. However, any therapeutic agent possesses a potential for effectiveness and a potential for danger. Each modality has its indications and contraindications, and certain precautions must be observed if the modality is to be applied safely and effectively in line with the biophysics and physiologic responses involved.
Continue reading …
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Introduction to Sports-related Health Care