achilles-tendinitis

How to Fix My Achilles Tendinitis

How to Fix My Achilles Tendinitis

One of the most common sports injuries for runners or jumpers is an Achilles tendinosis or, to be more precise, tendinopathy, while it is the largest tendon. Nonetheless, it is poorly understood and one of the most challenging sports injuries to treat appropriately. Usually, it is due to a sudden load increase in intensity or length of time without proper training. It may take up to a whole year before recovering, and even more if a new injury occurs during healing.

From my experience as a physiotherapist and then a chiropractor, I can tell that I have felt very uncomfortable treating these kinds of injuries. Some professionals recommended stretching on the stairs for 3 minutes, others wearing walking boots to relieve the load on the tendon, and other modalities such as wearing orthotics, icing, massage or ultrasounds.

However, a breakthrough in the protocols to treat Achilles tendonitis has brought some solutions in exercising therapy.

Before entering into the details, we need to consider the two types of tendinopathy: midportion and insertional. For the latter, the discomfort or pain is triggered at the tendon's insertion onto the calcaneus or heel bone. If the symptoms are similar, the treatment is quite different, and we will focus on the most common, the midportion tendinosis.

FIGURE 1. Localization of Achilles tendinopathy: (A) midportion and (B) insertional.

Treatment for Achilles Tendinopathy

The management is moderated according to the symptoms, age and sex, disability and sports needs.
Eccentric exercise has been the reference in all the studies and should be done for 3 months before considering more invasive options. 3 sets of 15 repetitions are recommended with the knee straight or mildly bent.

The Eccentric Exercise

Exercise

Heel drop: knee straight (FIGURE 2)
Stand on the edge of a step on the involved side. Start with standing on the toes, then lower the heel as far down as possible. Rise back on the toes with the assistance of the other foot: 3 sets of 15 repetitions, 2 times per day, 7 days a week for 12 weeks. The exercise can be painful to a certain extent. When you feel no pain anymore, you can hold some weight.

Repeat the exercise by bending the knee moderately.


FIGURE 2. The heel drop: knee straight and heel drop: knee bent exercises.

Regarding the insertional tendinopathy, the deep fibres of the tendon are squeezed against the tubercle of the calcaneus, or sometimes the bursa. This is a compressive traumatism due to repetitive dorsiflexion, so exercising should be avoided.

In this view, a heel lift is recommended first during daily life activities. The calf should avoid the heel lower than the floor level. It is so better to avoid exercising on the stairs. The range of movement will increase with a reduction of the symptoms. Walking and running on flat ground will be reintroduced progressively. Running in the hills is the last stage when the pain is minimal.

Foot Manipulations

A combination of eccentric exercise and manipulations of the joints of the foot, such as subtalar articulation or midfoot mobilisation, have shown better outcomes during the studies. At Orewa Chiropractic, we have a large experience in treating sport injuries.

 

sitting

Should I Sit or Stand at Work?

Should I Sit or Stand at Work?

After 8 hours of sitting at work can hurt your back. Keeping sitting straight is not the solution.

Let me give you the explanations.

At the office, you will never find the perfect position for the back to be pain-free at the end of the working day.

Everyone should avoid slouching and stay upright when sitting.

However, visiting straight can create sour tensions as the same muscles would work a too long time.

The lumbar spine may accept some time reclining on the only condition it does not last too long either.

The Best Solution

The best solution is to regularly have a break and move around and change your posture. The idea is not to feel ache or pain or even tension before moving or altering the way you sit.

You can put a post-it on your computer screen, "Watch your posture!", "Have a break!", "Stretch out", etc.

You can also use the timer of your mobile to ring to get a break.

This is particularly important when you are doing some work demanding significant concentration. Your brain will ignore the signals and feedback from the body, indicating tension and suffering.

In an open office, bins and printers are more and more located in the centre of the room so that the staff need to walk.

You can walk to answer the phone.

Do not hesitate to stretch back, legs and shoulders meanwhile.

The Ideal Posture

The ideal posture would be to have lumbar support, such as the back chair in the hollow of the lower back or a half-roll, and not hunching without being upright.

Do not cross the legs that freeze the way you sit, certainly slouching.

You can ask your workmate and colleagues to watch your back and reciprocally.

A current trend is to get a standing desk. This is not the panacea.

Prolonged standing can also create disorders in the back and the legs because of blood circulation.

The basics of ergonomics, working on a computer, are to fit the top of the screen at the level of the eyes and avoid working on laptops.

I highly recommend you plug a wire into a large screen or put the laptop on a book pile and plug in a keyboard.

Do not hesitate to ask for more details when visiting our chiropractors during your next chiropractic session.

Spinal-Fusion

Is Spinal Fusion the Solution For My Low Back Pain

Is Spinal Fusion the Solution For My Low Back Pain

Spinal fusion is the extreme operation for back pain. Its aim is to lock a part of the spine and may be recommended for debilitating scoliosis, spine fractures or type IV of spondylolisthesis. But these reasons are rarely the motivations for the spine fusion.

It is primarily considered and presumed that the degeneration of the disk and osteoarthritis, creating instability and inflammation, are the apparent cause of the low back pain, most of the time at the level of the lombo-sacral junction. The surgeon will remove the deteriorated disk between the vertebrae and stick the bones together. The purpose is to stabilise the hyper-mobile spine area, and the pain will logically disappear.

However, as we have seen in a previous blog, a majority of people in their middle age have degenerated disks and are primarily free of pain. Reversely, a majority undergoing a spine fusion regarding a dehydrated disk resent more pain after the operation!

According to a study carried out at Oregon Health and Science University, half of the patients undergoing a spine fusion used opioids before being operated, and only 9% ceased afterwards. Ironically, 13% used them after the operation while they did not before. Another study showed that hardly half of the patients after surgery reported a decrease of 30% in pain and the third improvement in function. Despite this, spine fusion remains very popular.

If one part of the spine is fused and rigid, the forces applied to the lumbar spine during daily tasks are directed to other segments above or below this part, leading to early degeneration of the other disks and creating some osteoarthritis.

Instead of a spine fusion, it is admitted that an advanced rehabilitation is more appropriate, accompanied by behavioural therapy to reconsider low back movements.

chiropracticbenefits

Why Seeing a Chiropractor

Seven Reasons to See a Chiropractor

We can't wait to show you how naturally incredible you can feel with chiropractic care. Curious? Give us a call.

1. Chiropractic focuses on your health. Your nervous system controls every part of your body, from the cell to the organ and the whole system. The original purpose of chiropractic is to restore the integrity of the general nervous system. When the nervous system functions correctly, your body works better.

2. Chiropractic does not use medication. Chiropractic is holistic care focusing on natural resources to assist the body to function and heal better without adding chemical substances. Chiropractic care uses hands-on therapies and exercises and ergonomic and diet recommendations.

3. Chiropractic is internationally recognized as a safe therapy. Chiropractors adjust babies, seniors or moms throughout the world every day. The treatment is tailored to any person's age, condition and needs.

4. Chiropractic adjustments lead to minimal discomfort. If the muscles ache after the first session, the benefits are instantly felt, such as improved balance, better sleep, increased energy and vitality, and other endurance and coordination.

5. Chiropractic, since its discovery in 1885, has spread throughout the world and is now professionally accredited in most countries despite criticism from people who would not accept the evidence of chiropractic's benefits, mainly due to ignorance. Chiropractic has become more and more popular because of the high level of satisfaction and the spread of the word.

6. Chiropractic is logic. Pain is your friend, telling you that you have to do something to help and rather than wanting to kill, it makes sense to correct the underlying cause to prevent its recurrence. Evidence has shown that intense and flexible spines are less exposed to accidents and injuries.

Do not hesitate to share the knowledge of chiropractic's benefits as chiropractors can help your family and friends.

chiropractic adjustments' benefits

Benefits of Chiropractic Adjustments

The Great Benefits of Chiropractic Adjustments

Chiropractic has been more and more popular throughout the world as it brings real benefits thanks to the adjustments.

Usually, chiropractic is conceived as the most effective treatment for back pain, but do you know other great benefits of the adjustments?

Chiropractors focus on spine disorders and poor posture. The medical term is called segmental dysfunction due to injuries, inadequate posture or lack of exercise.

Sports performance and Chiropractic Adjstments

international athletes and professional players receive regular adjustments not only to prevent injury and increase their body’s flexibility but also their precision.

For example, the swing of golfers has been shown as more natural and effective by golfers followed by chiropractors.

Spine Flexibility

Segmental dysfunctions lead to a certain level of stiffness like difficulties putting on pants, impossibility to sit correctly or bending forward.

This is very debilitating at home or work, even reducing the quality of daily and social life.

Chiropractic adjustments greatly benefit your personal life, which you can enjoy again.

Pain Management and Spinal Manipulations

Chiropractic adjustments are ideal to treat acute and chronic pain.

They do not only "align" the spine but also stimulate the nervous system to inhibit the pain inputs from the body to the brain in conditions like nerve entrapments or fibromyalgia.

In a certain way, "pain killers" without the reverse effects can provide some medicine.

Headache Relief

Headaches, tensional or cervicogenic, and migraines have terrible effects on people's lives, creating times when they have to do things slower or even stop any activities and lie down in a dark room.

Chiropractic adjustments have terrific results, and people suffering are the most ecstatic about chiropractic. They experienced many sorts of treatments but never had such improvement.

Sleep Quality

Pain or ache continuously stimulates the nervous system, including the brain.

The part controlling awakening and sleep receives permanent inputs and has no time to recover. This severely affects another part of the brain controlling the mood.

In the case of chronic pain, the patient feels even more depressed. Chiropractic helps to improve the quality of your sleep and emotions.

 

Chiropractic adjustments are not just about getting relief from back pain but also about improving your well-being. You will feel surprised at how better you are after a chiropractic visit.

chiropracticadjustment

Chiro Adjustment and Disc Bulge

Chiropractic Adjustment and Disc Bulge

Chiropractic adjustments are the treatment of choice to relieve most back pain and disc bulge.

Most people suffer from their back during their life. However, they have little idea of what is happening in their spine and what should be done to get some relief and heal properly. It is even expected that they make mistakes damaging their condition.

Disc and Spine Lesions

It is essential to know that most people have a lesion such as a disc degeneration or osteoarthritis, and nonetheless, they do not resent any pain from it. A study published in 2015 in the American Journal of Neuroradiology has shown that a large majority not complaining from back pain show:

Thirty-three articles reported imaging findings among 3,000 asymptomatic persons. Disk degeneration soared from 37% of 20-year-old individuals to 96% of 80-year-old individuals, and disk bulge from 30% of those 20 to 84% of those 80 years of age. Interestingly, disk protrusion prevalence climbed from 29% of those 20 to 43% of those 80 years of age. An annular fissure was surprisingly at 19% of those 20 years of age than 29% of those 80.

Disc Bulge

Investigations showing spine degeneration are widespread even with people not suffering at any time from their back and are the norm after 65, likely part of normal aging. The medical profession often picks the degenerative process as the explanation of the back pain that is asymptomatic most of the time. MRI and X-Ray are not good indicators of the cause. Between 5 to 10% of them will be diagnosed thanks to the spine imagery, most of the time invisible to them.

Ligament or muscle injuries and nerve irritation by some inflammation are common causes. This leads to muscle spasms and segment dysfunctions, reducing the range of movement and flexibility. As the vicious cycle, the inflammation remains irritating the nerves, so the muscles spasm.

Chiropractic Adjustment Mechanism

Chiropractic adjustments are highly effective and safe for back pain. Their aim is not to put a bone in place to align it. It is more of a rapid mobilisation providing a short stretch, stimulating some receptors, and in response, the spasms release, freeing up the joints, disc and segment. The chemical substances of the inflammation are taken away by an increased flow of blood and less irritate the nerves.

The spine is then more mobile and pain-free.

Orewa Chiropractor

What is Spondylolisthesis?

What is Spondylolisthesis?

It is a name derived from the Greek language: spondylos is a vertebra, and listhesis means slipping.

We call this phenomenon spondylolisthesis when a vertebra slips forward over another vertebra. The lumbar spine is the most common area of location. The complaint is usually pain or ache in the low back, buttocks and sometimes thighs. It may be accompanied by muscular tightness and/or weakness in the glutes and hamstrings. However, young individuals do not report any symptoms in general, or rather some discomfort. X-Rays are the predominant investigation to diagnose its presence. The scale grades it in a range of 1 to 4, according to the slippage measure.

Stress Fracture

Most of the time, it is developed during childhood. However, it can be present at birth (it is said then congenital) or in adulthood after an accident or repetition of movements. The widespread cause of spondylolisthesis is a stress fracture during growth. The recurrence of backward movements like bridges puts a severe load on the parts of the vertebra not strong enough to cope with this charge, and they "crack". The sports often implied are gymnastics, dance, judo and martial arts, rugby, and weightlifting. The stability of the spine is then modified and creates severe tensions around.

Degenerative Spondylolisthesis

The degenerative process is another cause of spondylolisthesis. The slippage can be forward, anterolisthesis, or backwards, retrolisthesis. This happens after 40 or 50, primarily due to a genetic history of heavy lifting during working time. The nerves which go through between the vertebrae may be impinged by the narrowing of the canals (holes), and then pain, numbness, weakness are resent in the lower limbs. The walking perimeter is reduced, and to open the canals, the individual feels the need to sit to "open" the canals and relieve the nerves from the pressure.

Treatment of Spondylolisthesis

Spondylolisthesis can be "silent", which means that the person does even not know about their condition and does suffer from it. On the opposite, the symptoms can be severe and may demand a surgical operation before significant compression of the nerves. Regarding ache, stiffness and tensions, chiropractic adjustments are recommended but not regarding the slipping vertebra. At Orewa Chiropractic, we have long experience with sports injuries and degenerative spinal conditions and assist the patient in reducing the level of ache/pain and increasing the flexibility of the spine. Visit us.

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young male holding his back in pain

Chronic Low Back Pain Case

A Chronic Low Back Pain Case

 

Sue, a 45-year-old lady, came to Orewa Chiropractic referred by a GP to evaluate and manage her complaint of chronic low back pain.

She had been suffering for about one year, and the symptoms worsened.

After slipping on a wet surface at home, she fell and landed on her right hip. X-rays were unremarkable.

The pain varied from 4/10 to 9/10 at its worst.

While she reported being very active before the accident, she had very little physical activity since then.

Rising from a chair, putting shoes on and turning over the bed was painful, and cleaning and gardening impossible.

Driving and walking for more than 15 minutes were excruciating.

 

Chronic Low Back Pain Examination

The examination showed that the lumbar spine was reversed sitting, but the arch increased standing contrarily.

Additionally, the gait was very short, with little strength around the hips.

Lumbar paraspinal and gluteal muscles were tight and tender with moderate pressure.

The range of motion was considerably restricted at the lumbo-pelvis junction.

 

Back Pain Management

We started the course of chiropractic sessions per week, including adjustments and muscular release techniques.

After three weeks, Sue was more mobile, dealing better with daily activities, sleeping deeper and walking for 15 minutes with little hindrance.

Accordingly, our chiropractor prescribed specific stabilisation exercises for the lumbar spine and hips. After four weeks, Sue complained of intermittent aches, 4/10 at worst.

Most activities were pain-free except gardening. From then, Sue started more advanced strength, mobility and endurance exercises and still receiving adjustments weekly.

Happily, after 12 weeks, Sue returned to her previous life, free of chronic low back pain and enjoying all the physical activities she loved and being much more optimistic about her life.

She visited her chiropractor monthly to receive adjustments until the end of the year to settle down the progress.

 

If you suffer from chronic low back pain, do not hesitate to book an appointment with one of our experienced chiropractors.

Clinic

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16 Florence Ave, Orewa

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