2013 – Fixated on chiropractic

Posted by on Oct 18, 2013 in Body Talk | 0 comments

Sonia Bowers studied chiropractic at Durban University of Technology and currently practises in Tokai, Cape Town. Apart from human patients she also treats dogs, horses and the occasional cat. Bobbie Maree asked her a few questions. Bobbie Maree: What is chiropractic? Sonia Bowers: The term chiropractic means “done by hand”. Chiropractor’s evaluate movement between articular segments and look for restrictions or loss of movement which are called fixations or subluxations. Chiropractors evaluate movement of the spine, ribs, pelvic girdle which encompasses the sacro-iliac joints and pubic symphysis, and the extra-articular joints. BM: What is the purpose of relieving restrictions and/or subluxations? SB: In order for movement to occur, our brain sends impulses to our muscles. The decision the brain makes is based on the information it receives from the peripheral system composed of proprioceptors in muscles, ligaments, joints, and skin, to name a few. Therefore, any dysfunction of joints, capsules, muscles, etc. will send information to the brain which will process it and create a series of adaptive responses in the whole nervous and musculoskeletal systems. Function is therefore based on proprioceptive input interpreted by the central nervous system and it is accepted that the sensory system is intimately tied up with the motor system. The central nervous system and the musculoskeletal system are one functional unit. Every active movement that we perform is affected by information coming from our peripheral structures. The eventual quality of movement performed by our bodies first depends on the information from the joints, muscles, ligaments, skin, etc., that reaches the sensory portion of the parietal lobe which is the highest motor level in our cortex. From the parietal lobe the information is transferred to the frontal lobe and then along efferent pathways and movement occurs. The movement eventually becomes automatic on a subcortical basis, so we don’t have to think about it. Changes of proprioceptive input from joints, for example, will send altered information to the central nervous system causing us to move in a different way and eventually stress the joint. Altered proprioception from a chronic tight muscle will affect the range of joint motion and, as in joints, compensatory hypermobility will occur. While a painful facet joint or active trigger point will probably have a greater effect on our central nervous system, a painless fixation or latent trigger point or a chronically tight muscle will also have an adverse effect. Therefore it is important to relieve restrictions. BM: What qualifications are needed to become a chiropractor?   SB: Chiropractic education varies by country but typically involves five to seven years of university-level education. In the , for example, entrance requirements include a minimum of two years college credits in qualifying science and other subjects, then...

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2013- Teens & flip-flops

Posted by on Oct 18, 2013 in Body Talk | 0 comments

According to Scott Schumacher, president of the British Columbia Association of Podiatrists in , flip-flops can be particularly hard on young, apparently sturdy teenaged feet. This is because even into the mid-teens, new bone is growing in the heel. The Achilles tendon and the plantar fascia attach to a growth plate. Walking causes the connective tissues to pull, and in the mid-teens, the weak point is the growth plate. Wearing flip-flops exacerbates the problem. As a result, kids 14 to 15 – a prime flip-flop-wearing population – are especially susceptible to heel pain. A few years ago, the American College of Foot and Ankle Surgeons noted growing reports of heel pain among 15- to 25-year-olds and blamed the trendy everyday use of flip-flops as the key cause. It goes without saying that overweight or sedentary people put more strain on their feet when they walk. References: Lee, J. (2008) Flip-flop Fuss, Vancouver Sun...

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2013 – Snapping hip syndrome

Posted by on Oct 18, 2013 in Body Talk | 0 comments

By Erika Kruger Snapping hip syndrome (SHS) (coxa saltans, iliopsoas tendinitis or dancer’s hip) is characterized by an audible snap or click that occurs in or around the hip while walking, getting up from a chair, or swinging the leg around. It is a condition which affects mostly young athletes whose sport involves repetitive twisting such as dancing, gymnastics, horse riding and soccer. 1, 2) The condition is also known to occur with heavy weightlifting and excessive running where the cause is usually attributed to extreme thickening of the tendons in the hip region. 1) SIGNS & SYMPTOMS Patients typically present with reports of an audible snap or click in the hip, which may be either painless or painful. The location may be described as lateral (indicating the iliotibial band or gluteus maximus) or anterior and deep in the groin (indicating the iliopsoas tendon). Occasionally, the sensation of the hip subluxing or dislocating is described and is associated with the iliotibial band. Patients reporting anterior groin pain usually note that the pain is dull or aching in nature and is exacerbated by extension of the flexed, abducted, and externally rotated hip. The pain and snapping may subside with decreased activity and rest.  The duration of symptoms at presentation more commonly is several months or years rather than days or weeks.  The syndrome occurs most often in individuals aged 15-40 years and affects females slightly more often than males. 2,3) DIFFERENT TYPES OF SHS According to Dr Joseph P Garry, MD of the East Carolina University Brody School of Medicine, different biomechanical mechanisms are responsible for different types of SHS – the first involves the iliotibial band and/or the gluteus maximus and the second involves the iliopsoas musculotendinous unit. The condition is usually described according to the location of the mechanism namely external, internal, or posterior SHS. 2) Even more specific, clinicians also distinguish between lateral and medial external SHS. 1) Lateral external SHS Lateral external SHS is primarily caused by 1) subluxation of the iliotibial band over the greater trochanter of the femur or 2) the snapping of the outer border of the gluteus maximus over the greater trochanter. This normal action leads to SHS when one of these connective tissue bands thickens and catches with motion. 1) Popping occurs when the thickened posterior aspect of the ITB or the anterior gluteus maximus rubs over the iliopectineal eminence or the femoral head as the hip is extended. Lateral external SHS may result from an acute injury leading to subsequent bursitis, tendinitis, or biomechanical changes resulting in pain and discomfort. More commonly, SHS is the result of repetitive overuse. 2) It may also be associated with increased varus of the...

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2013 – Plantar fasciitis

Posted by on Oct 18, 2013 in Body Talk | 0 comments

Plantar fasciitis refers to inflammation of the connective tissue between the heel bone and the toes caused by lack of support in the arch. Patients suffering from this condition usually complain of plantar pain along the entire length of the plantar fasciae as well as where these ligaments attach to the heel bone in the rear foot and to the five metatarsal bones. It is generally localized to an area 1-2 cm distal to the medial calcaneal tuberosity. Sometimes the pain occurs only on the sole and heel of the foot. Patients often report severe pain on the bottoms of their feet in the morning, especially the first steps out of bed.  Once the foot limbers up, the pain of plantar fasciitis normally subsides, but it may return after long periods of standing or after getting up from a seated position. The reason for the sharp pain in the morning on taking the first steps, is because while asleep, the foot relaxes and drops. In the morning when the patient sets his/her foot on the floor, the plantar fascia is stretched. Pain can be avoided or minimized by gently stretching or massaging the bottom of the foot before getting out of bed. People with high-arched feet are at risk because the plantar fascia is constantly in a stretched position while flat feet can result in a person pronating as there is very little support at the arch. Other biomechanical factors are tight Achilles tendons, and too much or too little movement in the joints of the foot and ankle....

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2013 – Home care rehabilitation exercises for snapping hip syndrome

Posted by on Oct 18, 2013 in Body Talk | 0 comments

Quadriceps stretch: Stand an arm’s length away from the wall, facing straight ahead. Brace yourself by keeping the hand on the uninjured side against the wall. With your other hand, grasp the ankle of the injured leg and pull your heel toward your buttocks. Don’t arch or twist your back and keep your knees together. Hold this stretch for 15 to 30 seconds. Repeat 3 times. Hamstring stretch on wall: Lie on your back with your buttocks close to a doorway, and extend your legs straight out in front of you along the floor. Raise the injured leg and rest it against the wall next to the door frame. Your other leg should extend through the doorway. You should feel a stretch in the back of your thigh. Hold this position for 15 to 30 seconds. Repeat 3 times. Piriformis stretch: Lying on your back with both knees bent, rest the ankle of your injured leg over the knee of your uninjured leg. Grasp the thigh of your uninjured leg and pull that knee toward your chest. You will feel a stretch along the buttocks and possibly along the outside of your hip on the injured side. Hold this for 15 to 30 seconds. Repeat 3 times. Iliotibial band stretch (standing): Cross your uninjured leg in front of your injured leg and bend down and touch your toes. You can move your hands across the floor toward the uninjured side and you will feel more stretch on the outside of your thigh on the injured side. Hold this position for 15 to 30 seconds. Return to the starting position. Repeat 3 times. Iliotibial band stretch (side-leaning): Stand sideways near a wall, your injured leg toward the inside. Place the hand of your injured side on the wall for support. Cross your uninjured leg over the injured leg, keeping the foot of the injured leg stable. Lean into the wall. Hold the stretch for 15 seconds and repeat 3 times. Prone hip extension: Lie on your stomach with your legs straight out behind you. Tighten up your buttocks muscles and lift one leg off the floor about 8 inches. Keep your knee straight. Hold for 5 seconds. Then lower your leg and relax. Do 3 sets of 10. Side-lying leg lift: Lying on your uninjured side, tighten the front thigh muscles on your injured leg and lift that leg 8 to 10 inches away from the other leg. Keep the leg straight. Do 3 sets of 10. Source: Tammy White McKesson Provider Technologies...

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2013 – Hammertoes: Flip-flops make for gripping stuff

Posted by on Oct 18, 2013 in Body Talk | 0 comments

According to Shroyer of Austin University “(w)hen you wear flip-flops, you kind of scrunch your toes to keep the flip-flop on your foot. 1). Hence the characteristic flip-flop shuffle that can be described as an unnatural, toe-gripping, foot-slapping gait, he explains. It is this gripping action that leads to the following signs and symptoms of hammertoes: Contracture and eventually flexion deformity of one or both interphalangeal joints of the second, third, fourth, or fifth (little) toes. The first joint or metatarsophalangeal (MTP) joint is cocked upward (mild hyperextention), middle joint or proximal interphalangeal joint (PIP) bends downward as well as the tiny joint at the end of the toe or the distal interphalangeal (DIP) joint are curled downward like a claw 2). Depressed top of toe deformity. Second toe involvement most common especially when the second toe is longer than the great toe. Associated hallux valgus deformity at the great toe. Corns or plantar calluses develop secondary to abnormal pressures and are located at the distal toe, the dorsum of proximal interphalangeal joint (ITP) and beneath the metatarsal heads that leads to pain or irritation when wearing proper shoes causing people to revert to plakkies for comfort. High longitudinal arch and a rigid foot 3) Pain over the dorsal aspect of the PIP joint. Occasional pain over the plantar area of the metatarsal head, especially if the MTP joint is hyperextended, subluxed, or dislocated. In addition, patients with MTP instability often complain of pain over the dorsal part of the MTP joint, and they may describe the sensation of a lump in the plantar area of the MTP joint. Patient assessment It is important that the visual assessment is done while the patient is standing. This is to appreciate its functional significance 4). Accompanying deformities, such as hallux valgus, combined hammertoe and rotational deformity, and cavus foot deformity, must be recorded. 5) Passive correction of the deformity should be attempted, because this will help determine which treatment options are appropriate for the patient. 6) References: Auburn University . AU study shows that overuse of flip-flops can lead to orthopaedic problems http://wireeagle.auburn.edu/news/359 http://www.eorthopod.com/public/patient_education/6482/claw_toes_and_hammertoes.html http://www.fpnotebook.com/Ortho?Foot?HmrT.htm Houglum, P.A. (2005). Therapeutic Exercise for Musculoskeletal Injuries.  Champaign, Ill. : Human Kinetics  http://book.google.co.za http://www.emedicine.com/orhoped?TOPIC457.HTM...

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