Balanced Body Soft Tissue & Spine | Ankeny, Iowa Chiropractor Balanced Body Soft Tissue & Spine | Ankeny, Iowa Chiropractor

At Home Assessments: The Neck

Neck pain is the fourth leading cause of disability, with an annual prevalence rate exceeding 30%; what this means is that nearly 1 in 3 people reading this blog will experience neck symptoms this year¹. Because neck pain is so common, especially with desk workers, we tend to discount these symptoms as ‘normal’ but these terms aren’t interchangeable. Seemingly trivial symptoms such as morning stiffness, neck muscle tightness, and loss of range of motion are indicators of future neck problems.

Neck pain and its associated symptoms (arm tingling, numbness, muscle spasms) are rarely benign and most have a common underlying problem that almost no one is talking about it in healthcare today. Do this self-assessment below to find out if this big problem exists in your neck!

 

The Assessment:

 

To start, find a wall and stand with your heels, butt, and back of your head against the wall (left picture).

Next, slide the back of your head up the wall as you tuck your chin in, creating a “double chin” (right picture).

Note any symptoms you feel in the chin tucked position: pulling, aching, tension, sharpness, tingling, pinching anywhere in the head, neck or mid-back.

 

 

 

 

To proceed with the next test keep your chin tucked, then bring your head as far forward as possible without bringing your shoulder blades off the wall. Again, note any symptoms you feel with this (left picture).

For the last test you’ll continue with the chin tucked and head moving forward, this time let your back leave the wall until only the very bottom of your shoulder blades are still touching the wall (right picture). Take note of what you feel in this position.

 

 

So what did you feel? All three of these ranges of motion are the baseline required to have a healthy neck. You should be able to move through these assessments with ease and symptom-free. If you felt anything other than a faint or light pull at the end of these motions then your neck function is being compromised.

So back to the underlying problem that’s not being addressed: adhesion. Adhesion is a common culprit in limiting range of motion, especially in the neck and spine. Adhesion can accumulate in a variety of ways and makes the muscles less flexible and weaker. If left untreated, your body will place significantly more stress on the muscles in the surrounding areas like the commonly blamed ‘traps’ in neck pain. (Did you just rub them as you read this?)

Fortunately, at Balanced Body Soft Tissue & Spine we specialize in finding and fixing adhesion. Dr. Hommer is the only certified Integrative Diagnosis™ provider in central Iowa for treating chronic muscle, nerve, and joint problems. If you are experiencing neck pain and want a long term solution call our office today! (515) 963-1641

 

Cohen, S. P. (2015). Epidemiology, diagnosis, and treatment of neck pain. Mayo Clinical Proceedings,2(90), 284-299. Retrieved January 16, 2017, from http://www.mayoclinicproceedings.org/article/S0025-6196(14)00833-7/abstract

 

 

 

SaveSave

SaveSave

Role of Your Doctor

The role of your doctor seems pretty straightforward and simple: accurately diagnosis your condition and recommend the most effective treatment to resolve it. Unfortunately in musculoskeletal medicine, it’s rare that either of these are performed due to lack of solid diagnostic skills, educational bias or both.

Regardless of specialty (chiropractor, physical therapist, orthopedic, primary care physician), your provider should correctly diagnose your problem based on your case history and objective exam findings. Every diagnosis should include a tissue-specific dysfunction or pathology; otherwise, how can they proceed with treatment or care recommendations? If your doctor isn’t able to identify the cause of your condition then they should either a) recommend further testing or b) refer you on to someone who can.

Many patients show up at my office after unsuccessful treatment elsewhere and aren’t really sure what previous treatment was intended to resolve. When patients do recall, they usually relay things such as:  ‘one hip higher than the other’, ‘rotator cuff problem’, ‘forward head posture’, ‘tendinitis’, ‘anterior pelvic tilt’, ‘muscle spasm’, ‘decreased neck curve’ or ‘misalignment/subluxation’. Just to be clear the aforementioned are not accurate or specific, they are either examination or imaging findings or incomplete diagnoses. When providers base care on guesswork, the patient will suffer in lost health, time, money or all three

Now let’s assume you have found a knowledgeable musculosketeal provider and they have properly diagnosed you with a structure-specific dysfunction, (yay!) There’s still one very important hurdle to clear:  appropriate treatment for your condition. As previously mentioned in our Integrative Diagnosis blog post many providers become biased when it comes to treatment options. When this happens, patients don’t get what they deserve and the providers only treat based on what they are trained in, instead of what the patient truly needs. A ‘cookie cutter’ approach in healthcare leads to poor outcomes, leaving the patient suffering even more. In our office, the objective measures within Integrative Diagnosis™ system ensure appropriate clinical application of treatment as well as measurable and accurate results. These safeguards allow us to get a full resolution of your injury and pain or refer to another provider if necessary.

Your doctor should clinically correlate your diagnosis and treatment options to recommend the best resolution for your case, regardless of their ability to perform the treatment. If you have symptoms from an unresolved muscle, joint or disc issue, please give our office a call at (515) 963-1641 to obtain an accurate diagnosis and effective plan of care.

 

 

 

 

Why Manual Adhesion Release™ is not Active Release Techniques®

Throughout college I had neck tension and headaches from studying that vastly increased when I started Palmer due to the rigorous class and studying load. Some students had been attending ART (Active Release Techniques®) seminars and I received some treatments from them in the student clinic. This was an eye opening experience as my headaches did so much better than with manipulation alone. I was immediately sold on the value of soft tissue treatments in musculoskeletal care and knew that’s where I needed to focus my training.

Fast forward a few years into practice as a certified ART® provider and I found myself becoming increasingly frustrated with the lack of sustained results from Active Release Techniques®. Patients got a lot better under my care (and they raved about the treatments) but the results never lasted.  I was working much harder than a lot of my colleagues and found myself exhausted after a 20 minute session of countless muscle protocols. I decided to nearly abandon soft tissue treatments and rely on my traditional chiropractic training as the results were just as fruitful with less stress on my body. In the meantime, a classmate from Palmer had been getting great results in his office from a technique called Integrative Diagnosis™. Honestly, I was skeptical because I had been performing the “gold standard of soft tissue treatment”.

Let’s go back a little bit….when ART® was pioneered over 20 years ago it was ground-breaking and helped bring soft tissue treatments mainstream. Unfortunately, ART® got a few things wrong, the most substantial being no importance on a proper diagnosis. Seminar attendees are taught to treat based on symptoms charts which leaves out the most important piece of solving any health problem — a proper diagnosis. Where else in the world can you fix a problem without knowing what it is first?

Symptoms are an important but small part of the clinical picture; the symptom is rarely the main issue and is usually the area that’s overloaded due to something else not working correctly. It is far more effective to combine history, biomechanical analysis and palpation to identify adhesion which is the foundation of  the Integrative Diagnosis™ system. Assuming pain is due to an adhesion and not a disc injury, stress fracture, etc. is a huge mistake and can be very costly to a patient’s health. Rarely is adhesion the only pathology involved in musculoskeletal problems.

In my office I now utilize Manual Adhesion ReleaseTM, which is only applied after a complete and accurate diagnosis is made. Training in the Integrative Diagnosis™ system has given me the tools to perform a detailed history, joint-specific examination, and identity the presence of adhesion before treatment is rendered. Once adhesion is identified, MAR is rendered at that specific spot, unlike ART® which unnecessarily treats entire structures. This focus means you get consistent results in less than 10 minutes of treatment time per patient. After all, patients should hire their doctor to solve a problem, not perform a technique.

 

If you have had limited results with ART® in the past, I urge you to give our office a call.

 

Ankeny chiropractor Dr. Hommer continues to study and train under Dr. Brady in order to refine treatment and stay on the cutting edge of musculoskeletal treatment.

 

 

Integrative Diagnosis™

In musculoskeletal medicine, patient diagnosis and treatment tends to be heavily biased based on the training of the provider. For instance, you start having low back muscle spasms and seek out treatment from different providers. If you end up in a traditional chiropractor’s office they will find a ‘misalignment’ and manipulate. Should you seek out help from a physical therapist they will target ‘weak areas’ and recommend strength exercises to manage symptoms. If you visit an orthopedic doctor you’ll likely be offered a cortisone shot and be assured it will ‘decrease inflammation’. In all these scenarios the patient ends up receiving whatever treatment their provider specializes in, rather than a complete and objective assessment followed by a function-based treatment plan. Success from treatments that improve symptoms and not function is often due to chance more often than not. These quick-fix ‘improvements’ can fool the patient into believing they are getting better while their condition continues to quietly deteriorate over days, months or years.

Treatments in the function-based Integrative Diagnosis™ model ensures all patients get what they deserve – a specific treatment to fix their problem which includes:

  • A thorough history, relevant and detailed examination and joint-specific motion assessments
  • A specific and accurate diagnosis (‘tendinitis’ is overgeneralized and misdiagnosed, ‘forward head posture’ is a finding not a diagnosis, and sacroiliac joint dysfunction doesn’t exist without severe trauma to that joint)
  • If warranted, treatment targeting the priority pathology utilizing a test-treat-retest method to track progress from initial visit to discharge

Integrative Diagnosis™ treatment targets and favorably impacts the most important motions in the human body which in turn restores function, and improves conditions without drugs or surgery. It’s imperative that function is restored, even in the absence of symptoms, for the best chance at resolution of the condition.  What this means for you as a patient is no more wasted time with ineffective treatment plus faster and full pain relief.

Manual Adhesion Release (MAR) is one of two treatments we offer to remove adhesion in our office. MAR is the premier form of soft tissue treatment and is primarily utilized in our office. Treatment is rendered with the doctor’s hands to manually break down adhesion . MAR is used in the majority of conditions seen in the our office including neck and low back pain, thigh and hip conditions (bursitis, ITB syndrome), and shoulder issues (rotator cuff tendinitis, impingement) to name a few.

Instrument Adhesion Release (IAR) is an instrument based form of manual treatment that is designed to selectively remove adhesion without damaging the adjacent healthy tissue. It’s also one of the only instruments on the market that has a proper hands-on training program to instruct the provider on exactly how and where to treat your problem. Common conditions in which IAR works efficiently are tendinitis and tendinosis of the Achilles and elbows, forearm pain, carpal tunnel syndrome, shin splints, and foot conditions such as plantar fasciitis.

Dr. Danielle Hommer is the only chiropractic physician in the Des Moines Metro certified through Integrative Diagnosis to accurately diagnose and provide you with cutting edge soft tissue treatment.

Call Balanced Body Soft Tissue & Spine today at (515) 963-1641 today to set up an appointment, and fill out our new patient intake to if you would like your problem accurately diagnosed.

 

 

Adhesion: It’s silently wrecking your joints.

Although you probably haven’t heard of adhesion, it’s the most common problem in the musculoskeletal (muscles and joints) system. A prevalent cause of joint pain, muscle weakness and limited motion, it’s unfortunately frequently misdiagnosed by the majority of providers. The good news is, adhesion is the most reversible condition when treated effectively.

What is adhesion?

Adhesion, or scar tissue, is an abnormal area of dense collagen fibers found in soft tissue structures such as muscles, tendons and ligaments. It prevents normal lengthening of these structures which leads to pain, weakness and limited range of motion. Adhesion can also act like glue between adjacent soft tissue structures, limiting necessary glide or entrapping (‘pinching’) nerves that need to pass through.

When adhesion is present, muscles and joints will have to work harder to perform activities they once were able to do with less effort. Areas effected by adhesion at first appear as ‘tight, stiff, or achy’ and symptoms come and go. As the amount of adhesion increases, symptoms become more frequent, more intense and become intrusive to your daily life. These symptoms can manifest in a variety of ways including but not limited to: low back pain, headaches, foot pain, tendinitis, or shoulder pain.

How does adhesion occur?

  1. Acute injury or trauma
  2. Overuse or repetitive motion
  3. Constant pressure and tension for extended periods of time

If you’re one of the few familiar with scar tissue, you’re probably surprised to find out you don’t need a tear, like from an acute injury, to get adhesion. The latter two processes are the most insidious and thus grossly misdiagnosed. Repetitive trauma or overuse, like typing 40 hours a week or training for a race, creates micro-trauma that leads to large problems over time. Prolonged position, like standing at your desk for 8 hours or driving 300 miles a day, decreases blood flow to the area due to sustained contraction of muscles required to accomplish these tasks which leads to the collagen build-up referred to as adhesion.

How is it removed?

Adhesion can only be identified via a thorough history and detailed assessment by an expert in soft tissue treatment such as an Integrative Diagnosis™ provider. When adhesion is found, it has to be physically broken down with precision in order for it to be effectively removed and resolve your condition. No other self-treatments (stretching, foam rolling, ‘smashing’ with lacrosse balls) or non-specific treatments (lasers, ultrasound, kinesiotape) will provide long lasting results or resolution of your problem.

Our office treats adhesion via MAR (manual adhesion release) and IAR (instrument adhesion release). These techniques are non-invasive and done exclusively through a skilled doctor’s hands. Once adhesion is broken down over a series of visits, the muscles will regain normal function. They can then lengthen and contract with the appropriate force which allows for normal joint motion resulting in less pain and symptoms for you.

As with all conditions, there is a window of opportunity to fix adhesion and prevent further damage. If left untreated long enough, adhesion can lead to more serious problems such as disc herniation and degeneration, stress fractures, cartilage or ligament tears, muscle tendinitis or tendinosis, and early arthritic changes. If you have been to multiple doctors (physical therapist, chiropractor, orthopedic, pain management) without resolution, we may be able to help. Please fill our our new patient intake and call to set your appointment today at (515) 964-1641.