Patellofemoral (PF) pain (or pain in the area of the knee cap) is a very common problem, especially in women because they naturally have a wider pelvis. A wider pelvis can cause a “knock-knee” effect, which can be exacerbated by flat feet and ankle pronation (rolling in at the ankles). The net result is that outward pressure increases on the patella, which can be quite disabling and interfere with weight bearing activities. So, what can be done for individuals with patellofemoral pain?
Because we cannot change the width of the pelvis, the focus must shift to the foot/ankle and hip/knee muscle balance. A 2014 study set out to prove (or disprove) that exercises that target BOTH the hip and knee vs. the knee only would yield better long-term outcomes.
Here, researchers randomly assigned 31 women with PF pain to one of two treatment groups: Group A participated in BOTH hip & knee exercises for eight weeks and Group B engaged in ONLY knee exercises for eight weeks. Following the completion of each eight-week exercise program, the researchers examined each participant, followed by a re-examination three months later. The investigators found that patients in Group A experienced greater improvements with regards to pain and function.
The authors of the study concluded, “An intervention program consisting of hip muscle strengthening and lower-limb and trunk movement control exercises was more beneficial in improving pain, physical function, kinematics, and muscle strength compared to a program of quadriceps-strengthening exercises alone.”
The “take-home” message hereis that patients obtain the best results when treatment—in this case, exercise—is applied to more than just the area of complaint. Chiropractic care includes assessment of the whole person, not just a localized area where the patient feels pain. Perhaps this is why chiropractic almost always scores highest in “patient satisfaction” surveys when compared with other healthcare delivery systems.
At East Sacramento Chiropractic we specialize in Active Release Technique which is a state of the art movement based massage which helps to reduce adhesions and tight spots in muscles that cause pain and inflexibility of joints and muscles. We also do biomechanical assessments to determine the cause of your pain so it doesn’t come back! Click here to schedule and appointment to see if your pain can be helped conservatively with our care.
Low back pain (LBP) from a herniated disk often leads to surgical intervention. However, there are patients with this painful malady who can successfully “ride it out” and repeat MRI imaging six to twelve months later often fails to show little, if any, evidence of the original herniated disk that was initially very obvious. How is this possible?
The proposed theory is that there must be some unique interplay between molecular signals that might explain why some herniated disks heal themselves while others do not. Researchers at Vanderbilt University Medical Center are investigating this and published a report on their progress in the January 2016 issue of the Journal of Clinical Investigation.
LBP affects 60-80% of Americans during their lifetime, and there are upwards of 300,000 surgeries for herniated disks annually in the United States alone. A disk can herniate when its outer fibers tear or give way, allowing the semi-fluid center to leak out. If the herniated disk material hits the nerve root exiting the spine, the classic sciatica, or pain down the leg, can result.
Dr. Dan Spengler states that about 50% of patients with disk herniation will improve within six weeks, and the actual herniated material may completely resorb over time. What troubles Dr. Spengler and other researchers is why this doesn’t occur with everyone.
Looking specifically at the molecules that are frequently present when disks herniate, researchers have identified a group of proteins called matrix metalloproteinases (MMPs). Certain MMPs have the ability to act like “Pac-Man” and literally chew through other proteins making it highly suspect that MMPs may be at the forefront of why some disks resorb while others do not! Additionally, when a disk herniates, bleeding occurs and white blood cells—specifically macrophages, which are immune system cells in our blood that ingest foreign materials and bacteria—also flood into the area.
What most surprised the authors was the interplay between the macrophages and the MMPs. They found that when the blood/macrophages and one of two specific MMPs interacted in a very specific manner, disk resorption occurred and they were even able to replicate this process in a lab. They concluded the following, “These enzymes are more complicated and interesting than we originally thought. Rather than being big bulldozers, they’re a fine pair of scissors that cut certain things.”
The TAKE-HOME MESSAGE here is unless you are having progressive neurological loss (meaning muscle weakness or sensory pain that is progressing, and/or especially bowel or bladder weakness), there is NO RUSH to run and have surgery! Doctors of chiropractic can offer natural, non-invasive treatments to manage pain while you let your body manage the herniation!
Here at East Sacramento Chiropractic we specialize in caring for your spine and everything attached. We also care about your overall health and wellbeing. To learn more about how chiropractic care can help you get relief from your back pain give us a call to schedule your appointment.
Our new website is finally up. We’ve worked hard to get a beautiful new site ready and we’re proud to show it off. Thanks for reading our blog. We have lots of great blog posts in the works. Please check back or contact us now to find out how we can help you.