Thawing out the frozen shoulder: Why Sports Chiropractic and Physical Therapy is LITERALLY Your Best Option

I want to lead off this conversation about frozen shoulder by saying that there are few professions that are better at treating this condition than a sports chiropractor. It is a condition that, I personally, love to treat because it showcases the tenacity and perseverance of both the doctor and patient alike.

Frozen Shoulder Treatment in Knoxville

Frozen Shoulder Treatment takes considerable mental and psychological stamina due to its frequent slow response to care. Here at Knoxville Spine and Sports, we’ve seen many athletes go through this process. The warm fuzzies that come with seeing a patient leap and bound towards symptom resolution tend to be severely delayed compared to many other shoulder conditions causing shoulder pain.

It takes a firm understanding from the patient that when they sign up for care, they are going to war and that full restoration of shoulder mobility will take considerable work on their part as well as the doctors. But when the inevitable victory comes, boy is it sweet.

The Phases of Frozen Shoulder Treatment

Frozen Shoulder and the Anatomy of the shoulder at your chiropractor in knoxvilleAdhesive capsulitis, or more commonly, frozen shoulder presents in 3 stages; the acute inflammatory stage, the stiffening stage, and months to years later the “thawing” stage. During the acute phase, the shoulder is very painful and the range of motion is severely reduced in all planes. This could be traumatic, as from blunt trauma or rotator cuff strain, or insidious, meaning that it sort of came out of nowhere.

It is not uncommon for its victim to not remember anything happening that would have provoked it. Commonly, it will hurt bad enough to affect sleep and take pain medications. Activity is typically limited as the pain keeps you from significantly moving it. This phase is probably the most important with regards to future outcomes as “learned immobility” will set you up for disaster down the line.

It is pivotal to keep pushing your shoulder to move through those painful motions as immobility will lead to an even stiffer shoulder capsule continues to fibrose through the latter stages. During the stiffening phase, the inflammation of the capsule is mostly resolved and though the shoulder is not as painful, raising the arm to the side or externally rotating it is still severely limited compared to the other arm. This phase will come anywhere from 1-3 months after the acute phase.

In the final phase, you’ll notice that the pain is pretty much gone. You may even have a slightly better range of motion as compared to the first 2 stages, but it will still be markedly reduced. Doing overhead activities will be quite difficult. Golf swings will have been altered, throwing will be difficult, and your jump shot will look a lot different. Fortunately, there is hope. But you’ve got to MOVE IT.

Sports Chiropractor in Knoxville

When you have a sports chiropractor in Knoxville, don’t let them go! Sports chiropractic is so effective because of it of its multifaceted approach to the treatment of this condition. I say this because it is a difficult condition to treat and it must be done right! Here are a few of the weapons we utilize in the war against a frozen shoulder.

Chiropractic Manipulation

Chiropractor treats frozen shoulder in knoxvilleChiropractic Care is a wildly effective strategy in the restoration of shoulder mobility specifically in the stiffening and thawing phases. With frozen shoulder, the tissue of the glenohumeral joint (shoulder joint) capsule is rigid and fibrotic. You can think of it as a brand-new pair of stiff, heavy-duty, blue jeans.

The only way to get them to loosen up is to wear them and wash them extensively. This too is the case with restoring shoulder movement. Mobilizing the shoulder joint with an adjustment puts a fast stretch on the joint capsule helping to break down some of that fibrotic tissue.

Adjusting the cervical spine, thoracic spine and other joints of the shoulder helps to bring nervous system awareness to the musculature surrounding the tissue and helps it to maintain function.

Active Release Technique and PIR stretching

These are two manual ways of stretching the joint to allow for the maximal fibrotic release of the shoulder joint tissue. Active Release Technique (ART) utilizes a combination of deep focused pressure along the muscle or joint with a specific stretch to break up as much fibrotic tissue as possible.

You can use this technique on the anterior and posterior joint capsule as well as the small stabilizing musculature of the shoulder. With this the tissue is maximally shortened, the pressure is applied over top of the tissue that you want to work, and then fully lengthened under that tension.

You can feel the adhesions slide under your finger as the tissue is moved through its range. Multiple passes here tend to be very helpful. Post-Isometric Relaxation (PIR) stretching can be used on the muscles that are inevitably spastic around the joint to coax them into submission.

Here you will contract the tissue for approximately 10 seconds or just enough time to override the mechanoreceptors in the muscle that are telling it to tighten up. Following this contraction, you will notice that you can move the area through a greater range of motion.

Dry Needling

Frozen Shoulder Treatment using dry needling in KnoxvilleDry needling is a fascinating modality, as the needles themselves are used to create a chain of events within the tissue that decrease trigger points. It is well known that myofascial adhesions and trigger points riddle the tissue around an immobile joint. With frozen shoulder, another musculature has to compensate for the decreased joint range of motion.

Commonly raising the arm will rely on shrugging the shoulder and bending the torso to get the arm up to it’s desired height. This means that the levator scapulae, upper trap, rhomboids, and neck muscles are getting far overworked.

Dry needling greatly helps to release out that tissue and decrease compensatory pain from the immobility of the shoulder joint. It will also release out the rigid deltoid and rotator muscles of the affected shoulder helping to increase the range of motion.

Visit Knoxville Spine and Sports for Frozen Shoulder Treatment

Frozen Shoulder Treatment is essential to athletes and non-athletes alike. These treatments mentioned have all been shown to increase shoulder mobility and help to restore function in a frozen shoulder. However, one the most important things that you can do will be your mobility homework.

No matter how much range we gain during a visit to the clinic, the patient MUST do their best to maintain those changes through routine stretching and end-range isometric strengthening exercises. 5 minutes of stretch and strengthening work at least 6 times a day will be pivotal to regaining mobility. With the combination of regular treatment and home exercises, the average patient will note considerable improvement within 1-3 months.

Call Knoxville Spine and Sports if you find your Shoulder Frozen

Shin Splint Treatment for Runners

Shin Splint Treatment for Runners

Runners, START YOUR ENGINES!!

Finally… most of the cold, dark, rainy days (especially here in Knoxville) are behind us and we are trading out our winter coats for running gear. The early season races are now upon us and it is time to make up for lost training days during the winter months. This is always a very popular time of year for us at the office as the injuries from training too hard on tissue that is still in hibernation mode are rearing their ugly heads. I wanted to take a few minutes to address one of the most common of these injuries, Shin splints.

What Are Shin Splints?

What are shin splints knoxville treatmentShin splints hold the clinical name of medial tibial stress syndrome (MTSS). This is a fairly accurate name as the most common place that people feel leg pain is deep on the inside of the shin bone. Pain can also be felt on the very front of the leg which is differentiated as an anterior shin splint. The muscles in these different compartments when excessively stressed, often for the first time in a while, can pull on the tibia harder than it is accustomed to and cause deep aching pain. The periosteum, or outer layer of bone that tendons and ligaments attach to, is rich with pain perceiving nociceptors and are quick to transmit that pain signal. This is typically accompanied by inflammation of the muscle, tendon, or in worse cases the actual periosteum itself.

Shin Splint Pain

The pain often sets in as a dull ache that grows to a throbbing type pain in the inside or front of the leg within 10-15 minutes of exercise. Runners will often be most acutely aware of the pain when running downhill, or for any length of time on a surface that isn’t flat or uphill. It is important to be able to differentiate this pain from other conditions that can be more malicious in nature. Compartment syndrome is a similar condition and is sort of like a shin splint on steroids. Similarly, there is pressure on the bone from the muscle but primarily the pain comes from swollen muscles trapped in the small and enclosed space of the deep compartment of the leg. This can be very dangerous if left untreated as it can destroy the blood vessels and nerves that live near that deep compartment. Stress fractures of the tibia can also present just like shin splints as do some high ankle sprains. The most important thing here is to see a professional if this pain isn’t going away.

What Causes Shin Splints

What causes shin splints with image of two runners at sunsetShin splints can be caused by a number of things but the most important place to start is with foot and gait during running. Runners that strike primarily with their heel first are immediately predisposed to this condition. In order to keep your foot from smacking the ground as your heel hits the ground, the muscles of the shin must fire and eccentrically lower the foot to the ground. This puts huge stress on those muscles as well as the periosteum where they attach.

So now the question is how do we unload those muscles during the gait cycle. Commonly heel striking comes from a “reaching” type of running pattern. This means that the feet are landing far out in front of the body when you run and almost pulling you forward instead of primarily pushing off. Ideally, the foot would land as close to directly underneath the body as possible to shift the load from the rearfoot (or heel) to more of the midfoot and thus more evenly distribute the impact force of landing among all of the muscles of the leg.

How to Alleviate Shin Splint Pain

Ok Matt, got it. Land with my foot underneath my body and avoid shin splints. Easy. Hopefully, it is, but very commonly the reason that you are reaching with that front foot, to begin with, is a restriction at the hip that is shortening the stride. As you shift your weight forward in your stride to make sure to land on the proper area of your foot, the back leg (push off leg) must be able to move farther back behind you into extension. With tight hip flexors at full-blown epidemic status, it’s likely that these are certainly contributing to your lack of hip extension when running. This, in turn, is shifting your center of gravity back and causing you to have to reach with your front leg, thus landing with a mighty thud on your heel and jarring the deep muscles of the leg. The culmination of this, shin splints.

So, here’s some guidance to avoiding these buggers and hopefully staying healthy through this training season. First, ease back into training. We are amazing, adapting machines but our tissues do need time to adjust to the barrage of new stressors that we put on them once the weather is fit. Next, pay attention to the surface you are running on. If you frequently run on a sloped or cambered road, make sure that you run back on the same side so as to stress those muscles evenly on both legs.

Shin Splints and Track Running

0150415001554823961.jpgThe same thing goes for the track. Be sure to change direction halfway through your workout as always turning one direction will asymmetrically tax those structures the same way. Also, check your hip flexor extensibility. When laying on your back and you pull one knee to your chest, does the other stay on the ground with little to no movement in the low back and hips? If not, STRETCH.

Finally, be cognizant of your gait. Do you feel your feet smacking when you run downhill? Are the heels of your shoes wearing more than the forefoot? Is it hard to shift your center of mass forward to get your feet underneath you as you run? If you answered yes, let us know so that we can pinpoint the exact cause of this and get you running safely and efficiently through the rest of the season.

Shin Splint Treatment in Knoxville

If you are one of our avid runners or just feeling the pain when you run, it’s best to consult with those who work day in and day out with Shin Splint Treatment in Knoxville. Our chiropractors are highly skilled at treating athletes and non-athletes alike. All of our patients receive a free consultation. This is so we can determine what your problem is before we begin any sort of treatment by our chiropractors or physical therapists. Call or contact us today!

Happy Trails.

-Dr. Matt

Prenatal and Postpartum Care in Knoxville

Prenatal and Postpartum Care in Knoxville

There are few times in life as beautiful and transformative for a family as bringing a child into the world. It is an acknowledgment to yourself that you are capable and ready to pass on that which has made you who you are to another being so that it will live on. For mom, it is also an acceptance that her body is going to go through some fairly significant changes over the coming year and a half.

The Nine Months

The first roughly nine months of this transformation will be dedicated to the baby. During this time mom is merely a vehicle for allowing the child to grow, develop, and prepare the platform that everything will be built upon over the course of its life. The second nine months, on the other hand, are dedicated to mom. Once the baby has been born her body goes through just as many changes to lead her back to a similar place that she started before the baby was conceived. If she takes this second nine-month window seriously, she may even find herself in a better place mentally, emotionally and even physically than before this whole journey began.

Feeling Better with Chiropractic

Feeling better with chiropractic during pregnancy and postpartumThat last statement is no joke. It is entirely possible for mom to be healthier and have more vitality after postpartum recovery than she was before, it just takes some planning. The prenatal period is a vital one not only for ensuring the optimal health of the baby but also for preparing mom for the changes that she will be going through. The plan, therefore, is pivotal. It starts shortly following conception and must be maintained over the course of pregnancy. It consists of three main categories that we call the prenatal pillars: Nutrition, mental/emotional wellbeing, and structural maintenance. This looks like maintaining a diet that promotes adequate consumption of the nutrients necessary for growth, taking part in fun, oxytocin inducing, stress-reducing activities and taking steps to ensure that her body (specifical pelvis) remains well balanced so that the baby has ample room to grow and thrive.

How Chiropractors Help in Prenatal and Postpardom Times.

As a chiropractor, I have the unique privilege of helping with all three of these avenues, but especially the structural piece. In my opinion, there is not a technique better suited for bringing balance to the prenatal pelvis than the Webster Technique. It has proven to be the most well accepted and comprehensive chiropractic technique in the birthing community and I have gotten to see it work in amazing ways.

Chiropractic Techniques Used

The technique consists of a series of very specific structural releases unique to the prenatal pelvis that starts by addressing and restriction or subluxation of the sacrum. From there, a series of other joints, muscles, and ligaments around the low back and pelvis are released that contribute to imbalance. When the pelvis is restricted or rotated into an abnormal position, tension will be put on the uterus via the various ligaments that anchor it to the pelvis. This will frequently contribute to pain that mom may be having but more importantly, it creates a less hospitable environment for the baby to grow and develop and can even lead to mal-presentation of the baby.

In the clinic, I’m able to use my background in sports medicine and injury rehabilitation to elaborate on the Webster Technique to include therapeutic exercises and further soft tissue treatments that compliment as well as enhance its effects. Bringing balance to an area often involves both structural releases as well as strengthening to some extent. Strengthening and understanding proper bracing is absolutely crucial given the hormones that are now being produced to relax the ligaments and allow for expansion as the baby develops.

This is a critically important phenomenon however it does make these structures around the low back and pelvis even more vulnerable to malposition. Understanding how to functionally brace during movement will teach mom to spare vital structures such as the expanding sacroiliac joints or the pelvic floor that is so commonly affected postpartum. As it turns out, peeing on yourself when running after having a baby isn’t something that you have to subject yourself to, and specific strengthening and bracing can help to prevent things like this from happening.

Prenatal and Postpardom Chiropractic Exams

Mom with baby in mountains uses chiropractor to helpSo, what does all of this actually look like? The initial exam is intended to get a snapshot into where mom currently is with regards to meeting those 3 prenatal pillars; nutrition, mental/emotional and physical. A woman that is clearly under considerable stress will necessitate a different approach than one that is managing that area well. Sometimes a more thorough understanding of what it looks like to be consuming adequate nutrients is necessary. Sometimes it’s walking through various coping strategies.

The list goes on. The exam will also include a full biomechanical analysis so that we know precisely how best to bring balance to your body. The first adjustment utilizing Webster will always take place on the same day as the exam so as to maximize the efficiency of mom’s time. In consecutive visits, we will begin to add more strengthening and bracing work as we continue to bring further balance to the pelvis.

Once we have made sufficient headway in reaching the goals we have laid out, maintenance care will be highly encouraged to ensure the changes that we’ve made will be preserved over the course of the pregnancy. From 35 weeks to birth I’d like to see a mom every week as we gear up for their big day. This time is incredibly valuable as the risk for the baby to move into malpresentation increases. It will then be imperative that the pelvis is in as optimal a position as possible to attempt to avoid that from happening.

Prenatal and Postpartum Care Provided at Knoxville Spine and Sports

At the end of the day, the birthing experience that mom wants to have is always going to be the right one for her and her family. Having people around to help get her to get there will be one of the most important aspects of achieving this goal. Allow us to come alongside to give mom the experience she deserves.

-Dr. Matt Campbell, D.C.

Shin Splint Treatment for Runners

Runners, START YOUR ENGINES!!

Finally… most of the cold, dark, rainy days (especially here in Knoxville) are behind us and we are trading out our winter coats for running gear. The early season races are now upon us and it is time to make up for lost training days during the winter months. This is always a very popular time of year for us at the office as the injuries from training too hard on tissue that is still in hibernation mode are rearing their ugly heads. I wanted to take a few minutes to address one of the most common of these injuries, Shin splints.

What Are Shin Splints?

What are shin splints knoxville treatmentShin splints hold the clinical name of medial tibial stress syndrome (MTSS). This is a fairly accurate name as the most common place that people feel leg pain is deep on the inside of the shin bone. Pain can also be felt on the very front of the leg which is differentiated as an anterior shin splint. The muscles in these different compartments when excessively stressed, often for the first time in a while, can pull on the tibia harder than it is accustomed to and cause deep aching pain. The periosteum, or outer layer of bone that tendons and ligaments attach to, is rich with pain perceiving nociceptors and are quick to transmit that pain signal. This is typically accompanied by inflammation of the muscle, tendon, or in worse cases the actual periosteum itself.

Shin Splint Pain

The pain often sets in as a dull ache that grows to a throbbing type pain in the inside or front of the leg within 10-15 minutes of exercise. Runners will often be most acutely aware of the pain when running downhill, or for any length of time on a surface that isn’t flat or uphill. It is important to be able to differentiate this pain from other conditions that can be more malicious in nature. Compartment syndrome is a similar condition and is sort of like a shin splint on steroids. Similarly, there is pressure on the bone from the muscle but primarily the pain comes from swollen muscles trapped in the small and enclosed space of the deep compartment of the leg. This can be very dangerous if left untreated as it can destroy the blood vessels and nerves that live near that deep compartment. Stress fractures of the tibia can also present just like shin splints as do some high ankle sprains. The most important thing here is to see a professional if this pain isn’t going away.

What Causes Shin Splints

What causes shin splints with image of two runners at sunsetShin splints can be caused by a number of things but the most important place to start is with foot and gait during running. Runners that strike primarily with their heel first are immediately predisposed to this condition. In order to keep your foot from smacking the ground as your heel hits the ground, the muscles of the shin must fire and eccentrically lower the foot to the ground. This puts huge stress on those muscles as well as the periosteum where they attach.

So now the question is how do we unload those muscles during the gait cycle. Commonly heel striking comes from a “reaching” type of running pattern. This means that the feet are landing far out in front of the body when you run and almost pulling you forward instead of primarily pushing off. Ideally, the foot would land as close to directly underneath the body as possible to shift the load from the rearfoot (or heel) to more of the midfoot and thus more evenly distribute the impact force of landing among all of the muscles of the leg.

How to Alleviate Shin Splint Pain

Ok Matt, got it. Land with my foot underneath my body and avoid shin splints. Easy. Hopefully, it is, but very commonly the reason that you are reaching with that front foot, to begin with, is a restriction at the hip that is shortening the stride. As you shift your weight forward in your stride to make sure to land on the proper area of your foot, the back leg (push off leg) must be able to move farther back behind you into extension. With tight hip flexors at full-blown epidemic status, it’s likely that these are certainly contributing to your lack of hip extension when running. This, in turn, is shifting your center of gravity back and causing you to have to reach with your front leg, thus landing with a mighty thud on your heel and jarring the deep muscles of the leg. The culmination of this, shin splints.

So, here’s some guidance to avoiding these buggers and hopefully staying healthy through this training season. First, ease back into training. We are amazing, adapting machines but our tissues do need time to adjust to the barrage of new stressors that we put on them once the weather is fit. Next, pay attention to the surface you are running on. If you frequently run on a sloped or cambered road, make sure that you run back on the same side so as to stress those muscles evenly on both legs.

Shin Splints and Track Running

0150415001554823961.jpgThe same thing goes for the track. Be sure to change direction halfway through your workout as always turning one direction will asymmetrically tax those structures the same way. Also, check your hip flexor extensibility. When laying on your back and you pull one knee to your chest, does the other stay on the ground with little to no movement in the low back and hips? If not, STRETCH.

Finally, be cognizant of your gait. Do you feel your feet smacking when you run downhill? Are the heels of your shoes wearing more than the forefoot? Is it hard to shift your center of mass forward to get your feet underneath you as you run? If you answered yes, let us know so that we can pinpoint the exact cause of this and get you running safely and efficiently through the rest of the season.

Shin Splint Treatment in Knoxville

If you are one of our avid runners or just feeling the pain when you run, it’s best to consult with those who work day in and day out with Shin Splint Treatment in Knoxville. Our chiropractors are highly skilled at treating athletes and non-athletes alike. All of our patients receive a free consultation. This is so we can determine what your problem is before we begin any sort of treatment by our chiropractors or physical therapists. Call or contact us today!

Happy Trails.

-Dr. Matt

How to How Rehabilitation of an Achilles Tendonitis Works

How to How Rehabilitation of an Achilles Tendonitis Works

Achilles tendinopathy (Achilles Tendonitis) injuries are commonly treated here at your Knoxville chiropractors’ office in the sporting realm but occur just as frequently outside of it. We have probably seen just as many cooks, merchandisers, waiters with foot pain as we have runners, jumpers and other athletes. The type of injury that our chiropractors will be addressing in this article will be the Achilles tendinopathy, formerly known as Achilles tendonitis. Tendinopathy is a more general but complete term as it takes into account the small tears that may develop in conjunction with the inflammation.

Anatomy of the Achilles Tendon causing pain.Anatomy of the Achilles Tendon

The Achilles tendon is the thick ropey tendon that is located at the back of the heel. The large strong muscles of the calf, the gastrocnemius, and soleus, are the 2 muscles that form the Achilles tendon. This group makes it possible to raise up on your toes, and push off when walking and running. When the musculotendinous junction (an area that the gastrocnemius/soleus muscle fibers begin to turn into the connective tissue fibers of the tendon) and/or the bony attachment of the tendon to the heel becomes irritated and inflamed a condition known as Achilles tendonitis develops.

Achilles Tendinopathy

A number of things contribute to the development of this condition. It is an overuse injury that, in athletes, is commonly seen in jumpers, sprinters, and those that are repeatedly maximally loading the tendon. However, one of the most important things to consider with this condition is the mechanics of the foot. Overpronation, high arches, collapsed arches, and rigid feet are all aspects that can directly affect this condition. We bring this up to explain why far more than athletes are affected by this condition.

The non-athlete that is on their feet all day with improper foot mechanics is putting undue strain on various aspects of the foot for hours and hours every day. Over time this will cause dysfunction of the tendon which leads to foot pain. This person is just as likely, if not more likely, to develop Achilles tendinopathy as a runner or other alleged athlete.

Yep… Sounds like me. Now what?

Addressing Foot Biomechanics

As was explained earlier, ensuring that the structures in the foot are functioning and moving like they should is immensely important when addressing this condition. With a foot that has a collapsed medial longitudinal arch (seen with overpronation), it is common to see bowing of the Achilles tendon medially. As you can imagine, when the tendon bows it puts different stress on both the tendon itself and also the area of attachment that it is aberrantly pulling. Addressing these biomechanical changes through chiropractic manipulation of the bones of the feet will be incredibly important.

A Sports chiropractor trained in the specific manipulation of the extremities, especially the feet will know what areas need to be mobilized, and what areas need to be reciprocally strengthened to avoid further damage to the area. In some instances, after foot mobility has been addressed, orthotics may be utilized to make up for any further compensations in the feet. This is when we can start addressing issues regarding foot pain

  • Treating Achilles Tendonitis

This will require you to get down and dirty with the nasty bits of the muscle and tendon that are restricted and causing your foot pain. A health care provider with an understanding of functional movement analysis and assessment will be able to spot the areas of restriction, likely in the gastrocnemius, hamstrings, or hip flexors.

Also, the tissue in the plantar aspect of the foot is commonly involved as that thick band of fascia continues up into the Achilles tendon and calves. Once the area has been assessed and deemed the culprit, extensive trigger point work and soft tissue manipulation should be employed. Much of this you can do yourself with the right tools.

  •  A foam roller can often be employed for the calves, slowly rolling until you find that exquisitely tender spot and then camp out on it for about 45 seconds. While here, you can gently play with plantar and dorsiflexing the foot to allow the muscle to gently slide underneath the pressure and ensure that you are fully addressing the entire area.

  • Lacrosse balls and golf balls make excellent tools for accessing those tough points on the bottoms of the feet. Even if you don’t have plantar fasciitis type symptoms in addition to the Achilles pain, it will be just as important to get in there as the fascia connects to the Achilles. Roll your foot over the ball with adequate pressure stopping when you’ve reached a tender spot. The idea is the same here pausing on the sore spots for 45 seconds or so but this time flex your toes and then pull them up with your hand. This slightly moves the fascia underneath the point of pressure allowing you to get deeper into the area.

  • Gentle stretching of the calves and Achilles can help to pump some of the swelling and inflammation out. The key here is Gentle. Too much will have the exact opposite effect. Seeing as the mechanism of the injury is too much pulling of the tendon on the bone or muscle belly, it can be very easy to irritate those healing tissues. However stretching little bits will help to combat the over adhesive nature that scar tissue tends to have. Mild pulling at the area where it is being laid down will help it meld with the flexible tissue around it instead of getting bunched up and causing a weak point in the tendon.

  • Gentle Movements of the ankle will also be helpful here such as writing the alphabet with your foot. This should be done about a week after the initial incident. Too much movement too soon can slow down the healing process (same goes with stretching) but as the area begins to heal, movement of the area is imperative not only to ensure proper healing of the tendon but also to restore some the neuromuscular connection that has been altered due to the injury.

Treating Foot Pain and Achilles Tendinopathy at Knoxville Spine and Sports

These are all solid pieces of advice for maximizing the healing time for an Achilles tendon injury, but remember, seeing a Chiropractor that understands these sorts of conditions should always be your starting point. If you are currently experiencing foot pain, you may be experiencing Achilles Tendinopathy. Try these out and let us know what you think. If your foot pain continues, please give us a call so we can use non-surgical and drug free methods to alleviate your discomfort.

Can I go to the gym with a herniated disc?

Can I go to the gym with a herniated disc?

So, you’re at the gym doing your last set of deadlifts. They’re heavy. You approach the bar, wrap your hands around it, and attempt to pull the bar into position. The fatigue that you’re feeling in your legs and glutes make it difficult to pull yourself into an adequate start position with a proud chest and flat back.

Instead, you sort of halfway back your shoulders and let your low back round slightly before you start to pull. You begin to pull and the bar moves about a foot off the ground before coming crashing back to the earth as your legs buckle and fall to the ground holding your low back.

Hopefully, this hasn’t been you but unfortunately, this is a common story with many people getting back in the gym after the holidays. However, It’s not just the over ambitions New-Years-Resolution-ers that this happens to.

This is something that I have seen occur with some of the most well-trained athletes around. Typically, the injury comes from a lapse in concentration and improper form due to fatigue, and almost always from an activity involving loading a flexed spine.

Knoxville Chiropractor describes: What’s a herniated disc?

Bulging discs or herniated discs can present in multiple different ways. Our Knoxville chiropractors, Dr. Matt and Dr. Solomon, have seen many cases. Frequently you will have increased pain with coughing, sneezing or straining. Often bending forward will cause sharp, breath-taking pain. Bending backward is usually painful as well but doesn’t have the same “catching” type pain.

The pain can be localized or involve one of the main nerves running into your leg. When this happens the pain can be felt into the gluteal region, thigh (front or back), and in severe cases down to the foot. Numbness and tingling can be involved as well.

Bulging Disc

When a disc bulges, the inside material of the disc (which can be thought of as super viscous jelly within a jelly doughnut) is put under an immense amount of pressure and presses up against the outer material (a super rigid, durable, fibrotic capsule around the jelly) with so much force that it causes this rigid layer to deform and bulge.

The most common types of disc bulge are the posterior and posterolateral bulge. When the disc bulges in this manner it presses backward onto the nerve roots located directly behind the disc. This causes many bad-news-bears types of symptoms such as leg or foot weakness, numbness, tingling, and in worst case situations, loss of bowel or bladder function. In the event that you ever begin to lose bowel or bladder function along with severe low back pain don’t pass go and collect $200, go straight to the ER as this is an emergency situation.

Ok, Now What?

It is important to note here that disc bulges are nothing to take lightly. True, in time they will likely resolve on their own but there can be residual effects like weakness, atrophy and loss of sensation and likely much longer recovery time. For the initial, acute phase it is recommended to see a Chiropractor that can conservatively treat a disc bulge or herniation.

I will say that as a Chiropractor, I would almost rather treat someone with acute disc pain than anyone else, simply because they respond so well to our type of care. A Chiropractor or Doctor will work with you to generate a strategy for getting you functional. Once through the acute stage of the disc, you can start talking about things like the gym.

Getting back to the gym and in shape after a herniated disc

In the event that you are cleared to go to the gym after a herniated disc (nerve sensations are decreasing far away from your spine, pain is decreasing, the function is being regained) there are certain things that you should and shouldn’t do. Flexion based exercises are to be avoided as much as possible.

Some examples of these are sit-ups, deep squats (below leg parallel), cable rows, etc. The basic premise here is that when you flex the spine, such as nodding the head or bending forward such as to touch your toes, you put pressure on the front of the disc thus pushing it further back and into the nerves.

So, by this same manner of thinking, an extension such as looking up at the ceiling or bending backward will put pressure on the back part of the disc thus moving it forward, away from the nerves and back to its pre-existing location. Therefore, press ups, the cat-cow movement, pelvic tilts, and some types of glute bridges are a few that would be great for getting past the condition.

The hip hinge is a movement that needs to be practiced as well as it teaches you to bend at the waist while maintaining a braced and neutral spine. Check this video for an example of what I’m talking about.


A Note on your first time back

The first few times in the gym should be thought of less as a way to burn calories and build muscle and more of a therapy session so that you can get back to exercising safely and effectively. Be sure to clear with your Chiropractor or Doctor before beginning to do exercises that may have started the condition in the first place. The gym can be an incredibly useful place in the rehabilitation of a disc injury, it just has to be used to right.

Call your Knoxville Herniated Disc Doctor for Non-Surgical Treatment

Here at Knoxville Spine and Sports, all of our Doctors practice Chiropractic. Chiropractic is a non-surgical method to approach treating herniated disc disorders and relieving pain. Using a chiropractor for herniated disc treatment is more common than many think.

We have successfully treated hundreds of patients, athletes and not, who experience the discomfort of a herniated or bulging disc. Our office also utilizes a full body approach to make sure that you have a program in place to prevent this issue from recurring again in the future.