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Traumatic Injuries

These injuries can cause the debilitating type of problems often associated with trauma. Most of these injuries are usually to the ligaments, the tissue that connects bones to bones and or to muscles though fractures and dislocations do occur at times especially with the contact sports. A strain is any injury to either a muscle or its tendon and a sprain to ligaments. The most common areas for these types of injuries are the ankles, knees, and the shoulders though other areas can be affected including thelow back and neck. Of course, injuries to the neck and low back can be quite serious as the spinal cord or spinal nerves can also be involved.

Traumatic injuries can vary from a mild “muscle pull” or ankle twist to a serious problem requiring surgery. It all depends upon the degree of tearing of the tissues, the location, and the age of the person. Most sprains and strains are associated with some degree of swelling and sometimes internal bleeding especially with the ankles and knees. With all strains and sprains proper management is very important especially during the initial stages of the injury to insure proper healing and no future disability.

The following is an acronym for the post-injury management of sprains and strains especially if no professional help is available: PRICE
P -Protect the injury from further damage
R -Rest the injury
I – Ice the injury to reduce swelling, bleeding, muscle spasm and pain
C -Compress the injury with a specialised support or elastic bandage to support the injured tissues
E – Elevate the injury if necessary when dealing with ankles and knees.

Of course it is important to get the injury properly assessed by a chiropractor or other professional so to know the extent of damage. Most of these injuries can recover though do need proper care during the various stages of healing. If not manage carefully some sprains and strains can leave us with long lasting problems of joint instability, painful or weak joints and muscles, and lack of mobility. A Chiropractor who is trained in the management of sports injury can give you the proper advice and treatment to insure that your injury will heal in the best possible way.

Overuse or Repetitive Strain Injuries:

These injuries are becoming more and more common especially among people pursuing sports such as golf, tennis, bowling or any other activity that are requires one to do the same activity over and over. Even running, especially on a treadmill can cause such problems. Some of these problems have been discussed in greater detail in other sections of the website one beingtennis or golf elbow.

Basically these conditions occur when we are involved in a repetitive activity that causes a very slight strain to tissues especially tendons and muscles that alone would not cause a problem but done many times has an accumulative affect. carpal tunnel Syndrome is one of the most common types of overuse injuries. After some time the muscle or other affected tissue develops changes that no longer allow it to function properly resulting in pain, stiffness and disability. There are two types of factors that predispose one to these types of problems one being intrinsic or found within one’s own body and extrinsic or external factors that can often be changed or controlled by the individual.

Common Intrinsic factors of Injury:
Age – the older we are the easier it is to get injured
Congenital abnormalities – some people are born joint or muscle problems
Previous injuries – previously injured joints or muscles often lack proper function

Common Extrinsic factors of Injury:
Equipment – improper grip size of tennis racquet, worn out running shoes
Playing surface – playing soccer on hard surfaces, uneven treadmill
Improper technique – improper golf grip or swing
Poor conditioning – doing activity when out of shape
Lack of warm-up – not stretching or preparing for activity
Increased frequency or duration – not building up slowly
Flexibility – too stiff to do activity correctly
stress – being tired or stressed can cause number 3 or 7

As we can see there are more factor that are extrinsic and therefore within our control. However most of us need assessment by a qualified health professional to determine the nature of the injury as well as the solution to the problem as left untreated these injuries can greatly affect ones life and limit a favorite activity. Besides eliminating the cause treatment is often required to stabilize the condition. The treatment might include joint manipulation, massage, therapy modalities, bracing and specific exercises.

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Anatomy

To understand neck pain, it is necessary to have knowledge of the anatomy of the spine. The spinal bones or vertebrae of the neck consist of posterior joints, called facets, that connect vertebrae to one another and serve to guide the motion of the spine. Inter-vertebral discs, composed of strong cartilage, join the “bodies” of the vertebrae. This tough cartilage surrounds the nucleus, a soft material in the center of the inter-vertebral discs. The discs act as shock absorbers and spacers between the vertebrae. In a canal positioned between the body and the facets of the vertebrae is the spinal cord. The spinal nerves leave the spine between the vertebrae and supply the energy to make the muscles and other organs of the body function. They also carry impulses from the body to the brain concerning pain, touch, position, temperature, as well as other senses.  The nerves that exit from the neck are assigned to the entire upper extremity including the shoulder, elbow and hand, as well as structures of the head and neck. The natural forward curve of the neck balances the weight of the head and alleviates stress on neck vertebrae. For more information please feel free to visit your Chicago chiropractor.

Risk Factors: Neck Pain and Computer Use

Computer use has risen dramatically over the years, at home and in the workplace. Nowadays, many people spend eight to ten hours a day, or more, bent over a keyboard and staring at a monitor. Sitting with the head in a forward bent position (the posture most computer users take on), puts immense strain on neck ligaments and muscles. In addition, the normal forward curve of the neck becomes reversed causing more stress upon all the surrounding tissues of the neck. Improper posture and repetitive stress can create spinal problems including disc herniation and subluxations, which are the primary causes of spinal nerve inflammation. Besides general pain, spinal nerve inflammation in the neck can produce symptoms such as headaches, eye problems, giddiness, arm and hand pain (and paraesthesia), as well as shoulder pain.

Headaches and Chiropractic Care

Headaches or migraines are frequently associated with disorders of the cervical spine. When the cervical vertebrae lose their natural position or motion, sensitive nerves and blood vessels that are related to structures in the head are stretched or irritated thus producing symptoms from a dull ache to throbbing pain. In many cases the tight knots in the muscles of the neck, called trigger points, can also refer pain to the head.  Of course there are other factors related to headaches including toxic fumes, certain foods, additives such as MSG, alcohol, caffeine, and stress. Still one must always look at the tissues and alignment of the neck when considering the origin of headaches and migraines. Chiropractic care has been shown to exceptionally helpful in the treatment of headaches. Your Chicago chiropractot can give you further information regarding treatment and pain relief.

Whiplash and Chiropractic Care

Unfortunately, many people are involved in car accidents. Almost certainly the most common auto accident is when one car collides into the rear-end of another car. During such a collision, the head of the passenger in the front vehicle is powerfully jerked back, and then forward, causing injury to the structure of both the front and back of the neck. This sort of injury is often called a whiplash. Even at low speeds, the amount of force arising from such an accident is very powerful and can cause damage to the ligaments, muscles, facet joints, discs, and spinal nerves. Besides neck pain and immobility, symptoms such as headaches, nausea, vertigo, arm and shoulder pain, tingling in the hands and fingers and weakness of the arm and hand are coincidental with whiplash injury. Immediate evaluation and x-rays are crucial in order to rule out a fracture. However in many cases, the injuries are primarily to the soft tissues and joints. Proper management is crucial in rehabilitation from the pain and symptoms of whiplash, and also to prevent future disability. your Chicago chiropractor is extremely knowledgeable in the area of whiplash injury, and is more than capable of managing the case from beginning to end.

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Anatomy

To understand back pain, it is useful to understand the anatomy of the spine. The spinal bones or vertebrae of the lower back are comprised of posterior joints called facets that join vertebrae to one another and serve to dictate the action of the spine. The inter-vertebral discs link the bodies of the vertebrae and are composed of a form of strong cartilage that encases a soft material in the center, called the nucleus. The discs act as shock absorbers and spacers between the vertebrae. Ligaments and muscles also join the vertebrae. The sacrum is a wedge-shaped bone at the bottom of the spine. It is connected to the two pelvic bones at the sacroiliac joint. The spinal cord is situated between the facets of the vertebrae. The spinal nerves exit the spine between the vertebrae.

Causes of Back Pain

A large number of back pain patients have not experienced any trauma, accidents or major injuries prior to the onset of their problem. The cumulative effects of improper sitting posture, harmful work habits, incorrect lifting, lack of regular exercise, and other unhealthy lifestyle-related factors create most back pain.  These cumulative factors produce stresses and imbalances on the spine and, therefore, people may injure their back just by bending over to pick up a piece of paper. The spine was already at risk and just the simple act of bending was enough to set off the problem. When this occurs, the surrounding back muscles go into spasm to protect the stressed or injured tissues of the back. Chiropractors are back pain specialists. Your **LINK** can help you to get out of pain quickly.

Disc Problems & Sciatica

Prolonged sitting, especially in a awkward position causes increased pressure on the intervertebral discs and imbalances in the muscles surrounding the spine. After a while the lower spine loses its ability to function normally during everyday stresses. Ultimately, the intervertebral disc develops small fissures, or cracks, allowing the soft nucleus to bulge the disc outward. If the disc pushes on sensitive tissues, it creates the pain that is often referred to as a slipped disc. Sciatica develops when the disc presses on the spinal nerve. The symptoms of sciatica include pain, tingling, numbness, and often weakness in the lower extremities. Regrettably, if the disc protrusion or herniation is large and the condition isn’t managed properly, surgery may berequired to dispose of the herniated disc material. With chiropractic adjustments and care, which often includes postural exercises, most disc complications, including sciatica, can be resolved. If you are experiencing any of the conditions defined above, it is very important for you to seek chiropractic treatment. Your your Chicago chiropractor is available to help you.

Spondylosis

Increased erosion and weight-bearing stress on the spine occurs when there is repetitive damage to the discs, facet joints, and surrounding ligaments. Bone spurs are formed when the cartilage around the joints is adversely affected by stress that engenders calcium to deposit in the tissues around the vertebrae. These spurs can constrict adjacent nerves, blood vessels and soft tissue resulting in symptoms ranging from minor pain and numbness to gross sensory loss and muscular atrophy. This condition – known as Spondylosis – is a form of arthritis that seems to affect almost everyone at some point in life, as it is a common part of the aging process of the spine as well. Nevertheless, determinants such as previous trauma, unhealthy lifestyle, and repetitive stress injury influence the time of onset in life. Regular chiropractic care and overall chiropractic management is very effective in slowing the aging process of the spine, and in helping Spondylosis sufferers manage their condition. Your Chicago chiropractor has helped many Spondylosis sufferers.

Sacroiliac Problems

Another common area of dysfunction or injury in the low back are the sacroiliac joints. These weight-bearing joints link the upper part of the body to the lower pelvic portion and are normally very strong and stable. However with trauma such as falls, sports injuries and lifting heavy objects, the joints can become unstable and move to an abnormal position.  This condition is called a sacroiliac subluxation. Women may get this condition during or after their pregnancy. Sacroiliac subluxation causes imbalances in the lower extremities giving a person a functional long and short leg. Pain occurs particularly with prolonged standing, walking, or during and after physical activity, and the individual may experience a lack of energy and fatigue.  Other symptoms such as neck and shoulder pain, as well as headaches, can develop further up the spine. Chiropractic adjustments establish the proper alignment of the joints and are extremely affective in correcting sacroiliac problems. Ask your Chicago chiropractor how you can get affective pain relief.

Spinal Subluxation

A very common disorder of the lower back, as well as the entire spine, is subluxated or misaligned facet joints. Subluxations can exist on their own or in conjunction with disc problems and Spondylosis. They not only cause pain, but they can also compromise the spinal nerves as they exit the foramen or spaces between the vertebrae, and create nerve compression, known as paraethesia. Paraesthesia is an alteration of sensation described as a tingling, burning or “funny feeling.” Paraesthesia in the upper extremities usually originates from nerve problems in the neck, while paraesthesia in the lower extremities is most often associated with nerve problems in the lumbar region (lower back). Visceral problems such as asthma and gastric conditions can also be associated with, or complicated by, spinal subluxations and nerve compression. Subluxations are best corrected with chiropractic adjustments.

Trauma

Trauma such as a fall, car accident, or sports injury can cause over-stretching or tearing of the tissues of the spine and lower back and create considerable pain and immobility. Proper chiropractic management at the onset of symptoms is very important in order avoid long term disability and the development of any of the above conditions. If you experience a trauma, call your Chicago chiropractor as soon as possible.

Scoliosis

Scoliosis is often associated with low back pain. Chiropractic care offers exceptional pain relief.

When it comes to the spine, chiropractors have more education and training than medical doctors. Your Chicago chiropractor provides state of the art diagnosis and skilled treatment for any of the above mentioned conditions of the spine and lower back.

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Osteoarthritis and chiropractic Care

Osteoarthritis, degenerative arthritis, or degenerative joint disease (DJD) are the labels for the most common form of arthritis, which is also called, spondylosis, if it occurs in the spine. Primarily, the condition is due to the wearing out of the cartilage that lines the joint surfaces, and it is found not only in humans, but also in all mammals. Degenerative changes in the joint occurs when joint cartilage is damaged and causes stress to the sensitive bone tissue that is usually guarded by the cartilage. Sometimes the bone around the joint will proliferate and make osteophytes, or what are familiarly called bone spurs. These spurs can cause painful irritation to other tissues surrounding the joint, in this way complicating the already distressing condition.

Degenerative joints principally occur in the lower neck and lower back, the knees, hips, and fingers. Everyone may experience DJD at one point in their lives, though previous trauma, ones occupation, activities, weight, diet, and heredity affect the degree of the condition and its onset.

The symptoms of DJD invariably involve some degree of pain and/or stiffness in the body part involved. If the weight-bearing joints, such as the hips or knees are involved, ones mobility can be affected notably in the more advanced stages of the condition.  In some cases, if the joint is appreciably worn and the person can no longer walk without severe pain, the joints are surgically replaced with synthetic devices. Of course, one should attempt to manage the condition early on in ones life to avoid the need for surgery.

The best management of DJD is, without exception, prevention that involves taking care of ones joints at an early age.

• One should always make sure that, especially when young, all injuries to joints are properly managed to insure proper healing to avoid future disability.
• Shoes with good support and shock absorption should be worn by those whose jobs demand extended periods of standing or walking.
• Weight loss through proper diet will help to lessen stress on weight-bearing body joints.

• Avoid kneeling on hard surfaces, such as when doing housework, as this can put strain and cause knee pain.

• Eat a diet high in fruits and vegetables as they contain natural vitamins, minerals, and antioxidants that are vital for the health of the joints, as well as the rest of the body.

Recent studies have shown that long-term use of the nutritional supplement, Glucosamine, can not only assist with DJD symptoms, but may actually help to rebuild joint cartilage.

Chiropractic adjustments are not only safe, but an effectual treatment for arthritis, and can assist in restoring proper mobility and function to the spinal joints, thereby giving patients great relief. Your Chicago chiropractor has many of years of training in helping people with arthritis pain. In addition, chiropractic modalities such as joint mobilization, ultrasound, cold laser therapy, massage and electro-therapy may be used to aid in the treatment of painful and stiff joints. Occasionally a brace is used to help stabilize the joint in an effort to alleviate pain. Your Chicago chiropractor may suggest exercises such as stretching, yoga, tai chi and other gentle mobilizing activities to help maintain arthritic joints.

Gout

Gouty arthritis is caused by high levels of uric acid in the blood and the accumulation of uric acid crystals in the joints. The most common joints are the big toes, the knees, ankles and wrists, and is often characterized by excruciating pain and swelling. Many people who develop gout are predisposed through heredity, though episodes are more often than not brought on by binge eating of agitative foods, when dehydrated or fasting, or after a major surgery or illness. Certain foods such as red meat (especially organ meat), certain seafood, legumes, and mushrooms have the natural substance, Purines, that are metabolized in the liver to form uric acid. Since individuals with gout cannot effectively metabolize uric acid, the buildup in the bloodstream causes joint problems. In addition to the foods specified and additional foods containing Purines, other dietary restrictions must be followed including the avoidance of alcohol.

Rheumatoid Arthritis

Rheumatoid arthritis is a chronic inflammatory disease of systemic origin. The direct cause is not known, but it is thought to be associated with a problem with the immune system. The most common joints affected are the small joints of the hands and fingers, the feet, knees, and shoulder, while other areas of the body can be affected as well. The condition is most often associated with morning stiffness that is aggravated by motion. Other symptoms can consist of general malaise and fatigue, and in its more advanced stages other systems of the body may be affected. There are particularized blood tests to help identify Rheumatoid arthritis that can be easily run. Management includes medication and vitamin and diet therapy, as well as chiropractic treatments. In addition, joint mobilization and modalities such as ultrasound, heat, electro-therapy and massage can help with the pain and stiffness associated the condition. Your Chicago chiropractor is dedicated to assisting people in getting relief from the pain and suffering associated with arthritis.

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Anatomy

The carpal tunnel is positioned in the underside of the wrist and is a passageway in which the median nerve travels through on its way to innervate the hand and fingers. Along with the median nerve, the carpal tunnel is comprised of the nine tendons of the forearm muscles that are responsible for bending and flexing of the fingers and thumb. Also within the tunnel are arteries and lymphatic vessels that deliver circulation to the hand. Wrist bones form the bottom and sides of the tunnel, while the top is shaped by the transverse carpal ligament, a robust band of connective tissue. The carpal tunnel is a densely-packed space about the size of an index finger. The flexor tendons, arteries and median nerve are designed to glide easily past each other during wrist and finger movement.

If the tendon size increases from inflammation or hypertrophy (growth), or if the carpal tunnel size dimenishes because of  a mechanical dysfunction of the carpal bones, the median nerve can become squeezed or entrapped by the carpal tunnel. The initial symptoms of carpal tunnel syndrome commonly include pain, numbness, paraesthesia (pins and needles) and tingling in the fingers and hands especially the thumb and adjacent two fingers.  These symptoms are especially noticeable in the night and often wake people from their sleep as the individual has to sit up in bed and shake-out and/or rub the hands in order decrease these unpleasant feelings.  In addition, activity can cause the hands to feel clumsy or weak, and fatigue easily. Over time, the ability to hold small objects using the thumb and fingers can be affected dangerously and if left untreated, can lead to total dysfunction of the hand.

The following are general causes and corresponding conditions:

• repetitive and forceful grasping with the hands

• prolonged computer usage especially with poor wrist position

• activities that require repetitive bending of the wrist

• broken or dislocated bones in the wrist which produce swelling

• arthritis, especially the rheumatoid type

• thyroid gland imbalance

• sugar diabetes

• hormonal changes associated with menopause or pregnancy

Although any of the above can make one susceptible to Carpal Tunnel Syndrome, in many cases the cause is unknown. However, people who perform jobs that require use of vibration tools and machinery, and/or work in extreme temperatures are often subjected to this condition.  In addition, repetitive housework as seemingly inconsequential as wringing clothes by hand, can bring on carpal tunnel symptoms. By far the most significant reason for the increase of people suffering with CTS is the continuous rise in the use of computers. The repetitive motions of typing on the keyboard and moving the mouse over extended periods of time is a primary indicator for many people with CTS.

Treatment

Competent diagnosis and treatment is vital to relieving the painful and debilitating symptoms of CTS. Your Chiago Chiropractor is highly skilled in the diagnosis and managment of CTS. Chiropractors are well-trained in treating CTS.  In addition to chiropractic adjustments of the wrist joints, treatment by chiropractor may include inflammation reduction therapy such as ultrasound or low level laser. Electromusclestim can often help to strengthen the weak muscles of the forearm and soft tissue massage is effective in stretching contracted tissues. Your chiropractor may suggest that you wear a splint or support, particularly at night, to aid in the decompression of the carpal tunnel. Your Chicago Chiropractor will also give you specific exercises to stretch and/or strengthen muscles of the forearm and hand.

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Causes

There are many causes for Epicondylitis – not just tennis & golf – as any activity that involves repetitive gripping of objects can result in this affliction. Some individuals develop tennis or golfer’s elbow from prolonged carrying of heavy bags, knitting, chopping food, and/or computer work using improper wrist and arm posture. With sports, the problem arises when we are new to the game, use an improper technique, try out new racquets or clubs, or increase the intensity or duration of exercise without the proper preparation.

Sometimes the condition can be so severe that it is difficult to even grip and lift one’s coffee cup!

Some cases involving epicondylitis can be attributed to problems further up the arm or even in the neck. If someone has a disc condition or spinal subluxation, the nerves that control the forearm muscles may become irritated causing the muscles to tense and put marked strain on the tendon attachment(s). In these circumstances, this predisposes an individual to elbow pain from any of the above mentioned causes. If left untreated it is possible that the joints of the elbow can become subluxated further and even arthritis can be a complication the condition.

Treatment

Epicondylitis is a condition that rarely resolves of its own accord and so requires proper health management. A qualified professional such as Your Chicago chiropractor can determine the exact cause of the problem and initiate the proper care and treatment. In my clinic this would include modalities such as ultrasound, electrotherapy, massage, hot and cold treatments, bracing and home stretching and exercises. chiropractic adjustments have proven extremely effective in the overall management of this problem.

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Good balance is essential to being able to control and maintain your body’s position while moving and remaining still. Good balance helps you:

• Walk without staggering

• Arise from chairs without falling

• Climb stairs without tripping

You need good balance to help you stay independent and carry out daily chores and activities. Problems with sense of balance are experienced by many people as they age.

A feeling like you or the things around you are spinning is called “vertigo.” About 40 percent of Americans will experience dizziness that is serious enough to go to a doctor, and among older adults, falls are the leading cause of injury deaths.

There are many types of balance disorders. Two types are:

1. Benign paroxysmal positional vertigo

2. labyrinthitis

The most common balance disorder is benign paroxysmal positional vertigo that occurs as a brief, intense feeling of vertigo when you change the position of your head. Benign paroxysmal positional vertigo is also experienced sometimes when rolling over to the left or right, upon getting out of bed in the morning, or when looking up for an object on a high shelf. This condition is more likely to occur in adults 60 and older, but also occurs in younger people.

The causes for benign paroxysmal positional vertigo are varied. It may be caused by an inner ear infection, head injury or simply aging. While it can be associated with other disease processes, many times a simple Epleys procedure can many times correct the problem. If you are in the Ventura area, I’d be happy to evaluate you if not, see your local Chiropractor.

Labyrinthitis is an infection or inflammation of the inner ear causing dizziness and loss of balance. It affects adults of any age and the cause is unknown.

Ménière’s disease is a balance disorder that causes:

• vertigo

• hearing loss that comes and goes

• tinnitus (ringing or roaring in the ears)

• full feeling in the ear

Treatment for balance disorders varies upon the cause, sometiems exercise for vestibular rehab can be the answer. Consult your health care professional if you experience dizziness, vertigo or other problems with balance. Older people are more likely to experience balance disorders. Age is not the only reason these problems occur.

While some balance disorders are caused by problems in the inner ear, others may involve another part of the body like the brain or the heart. Other factors include:

• aging

• infections

• head injury

• certain medicines

• problems with blood circulation

• upper respiratory infections

• viral infections

• stress

• fatigue

• allergies

• smoking

• alcohol use

• diseases of the circulatory system such as stroke can cause dizziness and other balance problems

• low blood pressure

• high blood pressure

• heart disease

To make the symptoms of dizziness less severe eat low-salt or salt-free foods and stay away from caffeine and alcohol. Balance disorders caused by high blood pressure can usually be managed by eating less sodium, maintaining a healthy weight and exercise.

Balance disorders are serious and one cause of falls and fall-related injuries in older people. It is important to have a possible balance disorder diagnosed and treated as soon as possible.

If you can answer yes to any of the following questions you should discuss the symptom with your Chiropractor:

• Do I have the feeling of being “unsteady?”

• Does the room seem to spin around me?

• Is there ever a time when you feel as if you are moving when you know you are standing still?

• Do you lose your balance and fall?

• Do you feel as if you are falling?

• Does your vision ever become “blurred?”

• Do you ever feel disoriented lose a sense of time, place or identify?

Source: National Institute on Aging

Disclaimer: These statements have not been evaluated by the Food and Drug Administration. The information in this article is not intended to diagnose, treat, cure or prevent any disease. All health concerns should be addressed by a qualified health care professional

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Hallux Valgus – Bunions

Hallux valgus is a condition when the big toe or hallux deviates towards the outside of the foot often almost overlapping or bumping in to the adjacent toe. It is a slow developing condition that usually develops a bump on the inside of the big toe often called a bunion.

The pain associated with Hallux Valgus is usually felt during weight bearing activities such as walking or prolonged standing. However if someone has developed a bunion the pain can be present at rest and if often described as a “numbing” or “burning” sensation in the big toes.

To be exact, the actual problem is not in the bone itself but in the joint between the big toe and the 1st metatarsal bone, the 1st metatarsal-phalangeal. It is the damage to this joint that causes the pain and deformity associated with Hallux Valgus. The condition is usually the result of wear and tear over a long period of time from factors such as over-pronation which causes abnormal pressure on the big toe and first metatarsal during walking. Other causes of hallux valgus include inflammatory arthritis that can damage the joint and cause degenerative changes. A broken toe that does not heal properly can also predispose a person to hallux. However one of the more common causes of the problem is the high heeled and pointed shoes that women often wear. These shoes not only put extra stress upon the joint but also help to push the big toe to the outside.

If you have hallux valgus, your Chicago chiropractor can examine your foot to determine which factors contributed to your condition. He or she can then use a number of techniques and modalities to decrease pain and improve your foot’s function.

Plantar Fasciitis ( Heel Pain )

One of the most common of the foot ailments is heel pain and the cause is usually inflammation of the plantar fascia or plantar fasciitis. The plantar fascia, is a band of connective tissue that surrounds the muscles on the bottom of the foot . It connects the heel bone to the ball of the foot, supporting the arch, protecting the foot and absorbing shock.

Patients with plantar fasciitis often complain of pain in the morning after first standing when they get out of bed and when the stand after they sat for a while. The pain originates just in front of the heel bone, but can spread over the entire bottom of the foot.

Over time, inflammation associated with the condition can lead to the development of scar tissue, calcium deposits and eventually heel spurs. These spurs are a bony growth on the front part of the calcaneus of heel bone where the plantar fascia attaches and can sharp stabbing pain with walking.

There are many factors that contribute to the development of plantar fasciitis though people who have other foot conditions, especially pes planus (flat feet) and over-pronation are most susceptible. One of the most important factor is muscle imbalances between the calf muscles and the muscles on the bottom of the foot which both attach to the calcaneus or heel bone. Often the calf muscles get short and tight exerting a strong pull upon the back of the calcaneus. This causes undo stress upon the smaller and weaker plantar muscles and its fascia that attach to the other side of the calcaneus. Wearing high heels will cause a shorting and tightening of the calf muscles as well as running and jumping activities. Other factors that stress the plantar fascia include: sudden strenuous activity after a period of long-term inactivity, abnormal walking patterns, improper footwear, walking on hard or uneven surfaces especially barefooted, and obesity.

People who are constantly on their feet, such as nurses, teachers and waiters, are more susceptible, as are athletes who participate in foot-stressing activities such as aerobics, volleyball, running, basketball and tennis.

Once one develops plantar fasciitis, it is often difficult to manage and can become very painful and persistent. A chiropractor will be able to determine the cause of your problem and what treatments are best suited. These might include ultrasound therapy, laser, joint manipulation, muscles stretching and strengthening exercises, special taping and in some cases orthotics.

Achilles Tendonitis

Achilles tendonitis is a painful and often debilitating inflammation of the Achilles tendon, also called the heel cord. This large tendon is an extension of the two biggest calf muscles and runs down the back of the lower leg attaching to the heel bone or calcaneus. Injury to this important tendon can make it difficult or even impossible to walk. The problem may be caused by a sudden single incident such as jumping, but more commonly it results from an accumulation of smaller stresses that produce small tears in the tendon over time. In most cases, the appearance of symptoms is gradual. The discomfort may be relatively minor at first, but gradually worsens if the patient tries to “work through” the pain. Many Achilles tendonitis sufferers attribute their initial discomfort to the aches and pains that accompany age or fatigue. In severe cases, a total rupture of the tendon can occur, resulting in traumatic damage and severe pain. Such injuries can make walking virtually impossible and may even require corrective surgery.

Achilles tendonitis is often associated with athletes and performers such as dancers who are involved in running and jumping activities especially involving sudden starts and stops. However, women who typically wear high-heeled shoes are also at risk especially if they switch to sport shoes for exercise. In these cases, the Achilles tendon and muscles gradually adapt to a shortened position created by wearing high-heels, as the heel does not have to stretch all the way to the ground. When this occurs, the switch to exercise or flat shoes forces the Achilles tendon to stretch further than it is accustomed to causing stress and inflammation. For these reasons, high heels should not be worn everyday. If they are deemed necessary, stretching should be done every morning and night to keep Achilles tendon lengthened.

Achilles tendonitis often appears in middle-aged people, especially men who are athletes, due to the changes that occur in the foot as we age. Our arch tends to flatten as we grow older causing over-pronation and increased stress upon the Achilles tendon and the calf and foot muscles. Similarly, problems are also is common in the “weekend warrior” who exercises infrequently, and those who are just starting to exercise. In such people, the muscle and tendon have little flexibility due to inactivity and overdoing exercise in the beginning can cause tendonitis. Therefore, people who are just starting to exercise after a long layoff should stretch properly, start slowly, and increase gradually.

Regardless of the cause of the problem if one is experiencing the symptoms of Achilles tendonitis they should consult a qualified professional such as a chiropractor to manage the problem before it becomes severe.

Pes Planus ( Flat Feet )

Flat feet or Pes planus as it is called by the medical community is very common and it is estimated that at least one quarter of the population has flat feet. We are all born with flat feet and somewhere between the ages 3-10 we develop and arch. However in certain people this development never occurs. Besides genetic causes, there are a number of factors that can cause flat feet or predispose people to the condition. Sometimes people develop arches only to have them collapse later in their life. This often depends upon their lifestyle, job and level of activity. Age and weight also play a role in the condition’s development. Middle-aged people who have been working on their feet for years often experience flat feet, as do overweight people who are placing added stress on their feet and legs.

Having flat feet does not necessarily mean you will have pain as it’s possible for people to have the condition and never feel any discomfort. For people who do develop pain, it usually occurs in the feet and knees, and possibly in the hips and lower back. If you suspect you have flat feet and do experience pain you should see your chiropractor especially to determine a plan of management that can ease pain or prevent symptoms from developing. A number of options, including prescribing arch-supporting insoles called orthotics and performing joint adjustments can improve foot function and alleviate any symptoms.

Metatarsalgia ( Pain in the ball of the foot )

Metatarsalgia is sometimes called ball-of-foot pain, a pain in the area on the sole of the foot just behind the toes where the foot bends during walking. The pain is actually caused by a problem in one or more of the five metatarsal bones that extend from about half way up the foot to the toes.

While many patients with metatarsalgia feel pain where their metatarsal bones join their toe bones, some also feel pain along the entire length of the metatarsals and possibly between them. Problems in this area can vary from a stiff and stiff feeling when you move these bones to a burning or stinging sensation. This depends upon whether the problem is due to a dysfunction in the joints or an irritation to the nerves as they travel along the metatarsals.

The cause of the condition can vary but the cause is due to either structural or functional reasons. An example of a structural causes is when the metacarpal bones are either too long or too short causing abnormal mechanics in the feet and too much stress upon this area. Flat feet or excessive arch can also alter the stresses on the metatarsals causing similar symptoms.

There are other factors that can affect these bones that are often in the control of the individual. These include excess body weight, tight or high-heeled shoes, and excessive or poor running or athletic training. Excess weight and wearing high-heeled shoes increases stress upon the metatarsal which leads to joint pain and nerve irritation. Repetitive foot activities, like running, directly stress the metatarsals by exposing them to constant trauma.

Regardless of the cause, your chiropractor can effectively care for metatarsalgia. After determining what factors are underlying your condition, he or she can offer a variety of non-invasive therapies including orthotics as well as advice on how you can avoid future pain.

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Patella Femoral Syndrome ( Knee Cap Pain )

Poor mechanics of the knee joint and the associated stress upon the soft tissues of the knee is by far the most common cause of non-traumatic pain. The most common part of the knee affected by this is the patella or knee-cap. Often the patella does not move smoothly or does not move sufficiently on the femur during bending of the knee causing abnormal stresses upon the tendons cartilage and ligaments. This condition is often called chondromalacia patella or CMP though a better term is patella femoral syndrome. The problem usually originates when there are imbalances in the quadriceps muscles of the thigh which attach to and move the patella.

The associated pain is experienced during activity, especially stair climbing, running, jumping and after getting up from prolonged sitting. Women are more predisposed to this problem for anatomical reasons and also the use of high heels.

Repetitive Knee Strain – Overuse Injury

Imbalances in other muscle groups that attach to the knee can also lead to pain and dysfunction. As an example, the muscles on the inside of the thigh when strained and tight can cause pain on the medial or inside side of the knee.

Lower back problems especially in the sacroiliac joints, are one of the main reasons for imbalances in the muscles associated with knee movement and subsequent knee problems. Foot problems that cause gait abnormalities such as pronation, are another cause of mechanical knee pain.

The main treatment for mechanical or overuse injuries to the knee is to re-establish proper balance of the muscles, restore proper movement to the patella and other joints of the knee, and correct any subluxations of the sacroiliac joints and foot problems. In certain cases, a brace is used to help with the alignment of the patella or to stabilise the joint. Chiropractors are ideally trained to provide the proper diagnosis and management of these problems.

Trauma

Traumatic injuries often occur during sports that involve running and jumping, such as football and basketball, and with activities such as skiing. When the knee is stretched or twisted beyond the strength of the ligaments that hold the joint together, tearing of these tissues can occur causing a sprain. The muscles that move the knee can also be torn during injury causing a strain or pull of the muscle. As with a sprain, a muscle strain can vary from a minor injury that requires little care to a severe injury requiring surgery. The knee also contains two special “cartilages” – the menisci – between the tibia and the femur that provide for smooth movement and cushioning. These cartilages can also be torn during trauma and often require surgical repair or removal if damaged severely. Traumatic knee injuries can cause severe pain and swelling and require immediate evaluation and attention. In most cases a qualified chiropractor can manage these conditions, though there are some injuries that do need the expertise of an orthopaedic surgeon. In any case, it is important to stabilise the injured joint and ice if possible until you can get the injury evaluated. Please see the section on sports injuries for additional information regarding this topic.

Treatment

If poor mechanics or traumatic injuries are not corrected at an early age, the tissues of the knee joint especially the cartilage will eventually begin to wear out. As a result the bones rub upon one another and changes such as bone spurs can occur. This painful condition is known as degenerative joint disease or osteoarthritis and is often progressive with age. Common treatment often involves medications such as NSAIDS (non-steroidal anti-inflammatory drugs) though conservative treatment such as chiropractic can be helpful in alleviating some of the pain. There is some evidence that nutritional substances such as Glucosamine and Chondroitin can be helpful in the long term management. People can often help themselves by keeping their weight down, doing exercises especially in the pool, and wearing cushioned shoes or insoles.

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