Bursitis, tendonitis (the “itises”)
When a patient reports that they have bursitis, tendonitis, arthritis or any other “itis” the question that needs to be answered is “why?”. The suffix “itis” indicates inflammation so the terms accurately tell us that the bursa, tendon or joint is sore and inflamed but is the inflammation due to increased mechanical friction, trauma, or a disease process. In order to do more than calm the symptoms, we need to determine what is causing the inflammation. Manual therapy is a quick and effective way of finding the core issue so that the inflammation can be controlled in the long term.
Headaches can be very complicated and come from a variety of sources, we have divided the most common headaches into two categories. 1) Upper C/S headaches 2) Tension headaches.
Upper C/S headaches occur because of pressure created by a restriction of the C1 or C2 vertebra. Headaches originating in the upper C/S generally cause pain behind the eyes and in the temporal area. This type of headache responds very well to mobilization. These headaches often resolve during the first treatment but self mobilization and exercise is required to maintain the relief.
Tension headaches typically develop because of tightness in the upper back and neck muscles. Pain is primarily referred to the back of the head. Tension headaches commonly come from a rounded or curved upper back and tight C/S musculature. Treatment focuses on improving the mobility of the upper back which takes the tension off of the muscles.
Cervical spine pain is typically caused by compression of the disc or small joints on the side called facets. The pressure on these structures is often relieved by stacking the bones on a level base of support and then reinstating motion at each level. We have found that a commonly overlooked portion of treatment is mobilization of the upper back and rib cage. Quick and easy mobilizations to the upper back make all of the difference on chronic neck problems.
TMJ pain can be very complex because treatment involves creating a stable base of support in the neck, mobilizing cranial bones and balancing the strength and mobility of the jaw from side to side. Manual therapy is an effective tool to accomplish these goals. We commonly work with many physicians and dentists in the area in treating TMJ pain.
When treating the shoulder it is very important to screen the neck for nerve irritation. To the person experiencing the pain, nerve and shoulder pain can feel exactly the same but a 30 second screen can focus treatment and let you know if the pain originates at the shoulder. Once you have established the pain is coming from the shoulder manual mobilization can rapidly relieve any impingement or pinch you may have. We can typically relieve the pain within a few visits. Compare that to the 12-15 visits required by other approaches and the benefits of manual therapy become clear.
The most common problem in the rib cage is scoliosis. There are two categories of scoliosis. Rotoscoliosis is a genetic condition in which the bones are the wrong shape. All other scoliosis are compensatory meaning that the body creates a sideways shift to balance the body in response to a problem somewhere else in the system. Correcting scoliosis is like untying a knot. If you randomly pull or push it hurts and doesn’t get any better. If you correct the problem that caused the original shift and then mobilize at the correct angle, the back straightens. Complete correction is only limited by the degeneration of the discs and joints.
Many patients arrive at our office with a pain in their buttock and down their leg. This is often referred to as sciatica. This pain can either originate in the nerves of the low back or pelvic ligaments. Once the source of the problem has been identified manual therapy can be used to treat the effected area.
Our experience has shown that pelvic ligament pain is often overlooked. Pelvic ligaments refer pain down the leg and to the patient feel identical to nerve pain. A few manual tests can quickly differentiate nerve and ligament pain and dramatically speed up recovery time. If injections or other low back treatments aren’t working it is often because the problem isn’t coming from the nerve.
Hip, Knee, and Ankle pain
Most chronic hip, knee and ankle problems are a result of poor alignment which results in misuse. It is very important to observe how the joints stack up and how they work together with functional activities like running. Manual treatment of each of the joints of the leg helps it to function more efficiently and have fewer injuries.
Plantar fasciitis develops when a person has a tight calf and a rigid foot. In the literature we have read plantar fasciitis takes up to 6 months to resolve. It is our experience that if mobility is restored to the calf muscle and the foot is mobilized plantar fasciitis resolves within weeks not months.