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comox chiropractor

Knee Pain? Look to the Hip!

Anytime someone comes into my Comox Valley Chiropractic office with knee pain, I always will look at their hips and pelvis for dysfunction. It is a logical step that most chiropractors will take.

Now, new research is emerging which is showing that a measurable relationship does exist between patellofemoral joint (kneecap) pain and altered hip mechanics.

This study published in the Journal of Orthopaedic & Sports Physical Therapy found a link between women with kneecap pain, increased internal hip rotation and weakness with hip extension. These subjects consistently showed weaker single leg squatting and jumping abilities, and had improper hip mechanics when running.

A comprehensive treatment strategy would involve normalizing the hip and pelvic function with chiropractic adjustments, working on the muscular tension with soft tissue therapy, and addressing the hip weakness with a gluteus medius and maximus rehab program.

The incidence of knee pain is very high in our society, especially in younger women. There are ways to help this condition, and it is not necessarily something you have to live with!

Dr. Debbie Wright is a practicing Courtenay Chiropractor.

The Broken Spoke saves the day!

I’d like to extend a huge “Thank You!” to Mike and Tomiko over at The Broken Spoke in Courtenay. For those of you who have not had the pleasure of frequenting this new shop, its part coffee shop, part bike shop.

The coffee shop is superb, and in my opinion ranks very high on list of good coffee shops in Courtenay. If you’re ever bored on a Saturday, swing by the shop at 2 pm for a round of “Cupping”. Its like wine tasting but with coffee. You’ll leave educated, buzzed, and with a larger appreciation for a simple cup of coffee.

As for Mike in the bike shop, I have nothing but raves. Not only did he masterfully outfit my ancient 10-speed with paniers over the lunch hour, but he also managed to adjust my bike so I no longer get nagging leg pain. As a Courtenay Chiropractor, I knew that something about the bike’s setup was causing my pain – my knee was too bent when I started my downstroke. I didn’t think I could do anything since the bike is already pretty high for me, and raising the seat wasn’t an option. Mike took the time to watch me ride on my bike and adjust the handlebars and the seat. He somehow managed to move the seat further back and it instantly got rid of my problem. 5 months of pain gone in an instant – that’s even better than I can do!

I encourage you to support a great local business and head out to The Broken Spoke. It may even entice you to dust off your bike and get out on the trails, thereby decreasing the chance you’ll end up in my office!

Dr. Debbie Wright is a practicing Comox Valley Chiropractor.

Comox Valley Chiropractor joins Community Way!

I am pleased to announce that I have joined the Comox Valley Community Way program. The details of this program can be found at www.communityway.ca.

In short, it is a form of community currency that can be used at various local merchants and services, but through the design of the program also helps out local charities and non-profits. If you live in the Comox Valley I encourage you to check out the program and to begin participating. Different businesses will offer various forms of community way payment, such as the ability to pay a percentage of the total in community dollars. I am offering my chiropractic and laser therapy services at 100% community dollars.

A list of local businesses that are participating can be found here.

Dr. Debbie Wright is a practicing Courtenay Chiropractor.

Chiropractic Success in Hospitals

A great article (which can be found here) recently appeared in the Toronto Star talking about academic research and collaborative practice amongst Chiropractic doctors. With new Chiropractic research chairs being added each year (University of British Columbia, University of Alberta, McMaster University to name a few), more and more people are realizing that Chiropractors have a valuable contribution to make to understanding the spine and its problems.

One such contribution came in the form of a pilot project at St. Michael’s Hospital in Toronto, Ontario. This program saw chiropractors added as staff to treat patients in a collaborative way with other departments (such as the family medicine department). The project has been a huge success.

For those of us who see the results of chiropractic care first hand, it makes perfect sense to have chiropractors on staff in a hospital. The few times I’ve been to the ER with a bad sprain or broken finger, I can’t believe how many people I see waiting 8 hours with back pain. Most of those people will simply be given an X-ray, pain medication and discharged in the same state in which they came in.

I know that if they had come to my office instead, I could have at the very least made them feel better than when they arrived. More importantly, chiropractors are educated in differential diagnosis, which means we can determine when someone should go to the ER instead of being in our office. On two different cases this year I sent someone back to the ER or their family doctor only to find out that the diagnosis was ureter cancer and a tumor of the nerve sheath.

Including chiropractors in a hospital setting is a great way to ensure patients get quick and effective relief from their pain, and also to save time and money on needless diagnostic tests or harmful medications.

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Dr. Debbie Wright is a practicing Comox Valley Chiropractor (soon).

Chiropractic Care for Neck Pain – Is it Safe?

A current study published in Spine set out to determine the relationship between benign adverse events (reactions to treatment) and outcomes (neck pain and disability, perceived improvement) in a group of people who received chiropractic care for their neck pain.

529 patients participated in the study. 56% of the participants reported an adverse event during the first 3 treatments, and only 13% graded it as “intense”. Muscle or joint pain events were the most common types reported, and none of the events were considered serious.

The researchers found that if someone reported an “intense” adverse event during any one of the first 3 visits, they were less likely to report recovery on the fourth visit. What is interesting about this is that they didn’t have significantly more neck pain or disability than those who didn’t experience an adverse event.

At a follow-up 3 months later, those who had “intense” adverse events experienced the same recovery and pain reduction as those who didn’t have any adverse events.

The bottom line here is that even if someone reports an adverse event or reaction after treatment, it did not negatively affect their outcomes or recovery at 3 months. Moreover, it was only those who had an “intense” adverse events that reported less recovery in the short term (13% of participants).

It is also important to note that out of 4,891 treatments, no serious adverse events occurred. This adds validity to the current view that “the benefits of chiropractic care for neck pain seem to outweigh the potential risks.”

Dr. Debbie Wright is a practicing Comox Valley Chiropractor.

Easing Chronic Muscle Pain – What works?

Myofascial Pain Syndrome can be defined as chronic muscle pain. This pain originates around certain points of pain and sensitivity in your muscles called trigger points. A recent study was published in the Journal of Manipulative and Physiological Therapeutics that sought to identify and review the most common treatments for myofascial pain syndrome.

This study identified many different types of treatment used, and some of them are as follows:

  • Spray and Stretch – vapo-coolant spray followed by muscle stretch
  • Soft Tissue Massage
  • Ischemic Compression – compressing the trigger point in the muscle
  • Occipital Release Exercises – a form of massage and mobilization for the occiput (base of skull)
  • Strain/Counter-strain – stretching a muscle and then having the patient contract that muscle
  • Myofascial Release – compressing and tensioning the trigger point while stretching the muscle through its full range
  • Chiropractic Spinal Adjustments

Immediate (after treatment) benefits were demonstrated with the chiropractic adjustments, spray and stretch, compression, massage and strain/counter-strain. The authors therefore concluded that there is moderately strong evidence to support the use of these manual therapies for the treatment of trigger point pain. These treatments, however, didn’t show as strong benefits as long term solutions.

Recommendations for other types of treatment for trigger points and myofascial pain syndrome can be drawn from this review.  They are as follows:

  • There is strong evidence that laser therapy is effective.
  • There is moderately strong evidence that electrical therapy is effective on a short term basis.
  • There is moderately strong evidence that acupuncture is effective for up to 3 months after treatment.
  • There is limited evidence for modalities such as muscle stimulation, interferential current, an other such stims.

Dr. Debbie Wright is a practicing Comox Valley Chiropractor.

Routine X-rays Not Needed

Following up on my previous post about the necessity of X-rays, I came across a review of the literature for low back imaging.

In 1994, the AHPR began recommending against imaging of the low back in the early stages of acute low back pain. This study was undertaken to investigate the relationship between the use of immediate X-rays for the low back and the clinical outcome of the case.

479 articles were identified and reviewed. The authors found no differences in long term and short term outcomes between those who were X-rayed immediately and those who simply received treatment.

They concluded that for patients who present with simple uncomplicated low back pain (no red flags present), X-raying their back did not lead to any greater improvements. Since there is no benefit to imaging the back, but there are draw backs (radiation exposure, cost), routine imaging should be avoided.

Ultimately, every clinician has to rationalize their decisions when it comes to the assessment and treatment of their patients. I will often explain my decision not to X-ray with the fact that the X-ray result will not change my clinical management of their case. We know already from previous studies that many things are seen on X-ray and MRI that don’t have clinical relevance and may actually confuse the issue.

If you would like to read the original article, it can be found here.

Dr. Debbie Wright is a practicing Comox Valley Chiropractor.

Healing Elbow Pain

Golfer's Elbow
Golfer

Tennis elbow and Golfer’s elbow are the common names for conditions that involve the elbow. Tennis elbow tends to affect the outer elbow, while golfer’s elbow affects the inner elbow. These two spots correspond to where the forearm muscles attach into the elbow – the muscles that extend the wrist on the outside and the muscles that flex the wrist on the inside.

There are several theories as to why these conditions develop, but the most commonly cited cause is that of overuse. Using the example of tennis, the stress to the forearm muscles of hitting hundreds (if not thousands) of balls leads to small micro-trauma of the muscle attachment point. This causes tiny micro-tears which do not get a chance to properly heal before they are stressed again – a typical repetitive strain injury.

Symptoms of this condition include pain over the outer or inner elbow, point tenderness over the bone in that area, weakness or soreness of the muscles with use, morning stiffness and in some cases pain or tingling spreading down the arm towards the wrist. A good examination must be done to differentiate this problem from a nerve or joint irritation in the neck that is referring pain to the elbow.

In my office, I tend to see more of these conditions arising from computer and mouse use as opposed to the traditional sports-related causes. In these cases, I find it is imperative to assess and treat the neck and shoulder as well as the elbow and wrist. Treatment will often involve chiropractic adjustments to the neck, mid-back, shoulder, elbow and wrist. Other good options include soft tissue therapy, kinesiotaping and low intensity laser therapy. I am not a huge fan of splints as they are often over-used and will further weaken the muscles you are trying to rehabilitate. However, there are certain cases where they are helpful.

Because the offending activity that caused the problem cannot always be stopped (i.e. computer work), a good stretching and strengthening plan is essential. Below you will find some videos of basic forearm stretching, as well as a good mobilization for tennis elbow. The key with any repetitive strain injury is to be able to stretch and relax the muscles on a regular basis. I recommend stretching out the forearms once every 20 minutes when on the computer. It takes less than a minute and can spare you from months of recovery if you let the problem get too big.

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Dr. Debbie Wright is a practicing Comox Valley Chiropractor.

Improve Your Golf Game

Proper spine flexibility and strength is essential to a good golf game. Increasing either of these variables will more than likely lead to longer drives and strokes off your game. That is why most professional golfers know that chiropractic care is a necessity to keep them healthy and give them a competitive edge.

In addition to chiropractic care, a proper warm-up and stretching can ensure you have the best day possible out on the course. I regularly refer patients to the Canadian Chiropractic Association‘s golf stretching pamphlet. These quick and easy exercises will help to prepare your body for the increased forces that occur during your game.

You can download the Golf Stretches pamphlet by clicking on the following link:

Golf Stretches

Dr. Debbie Wright is a practicing Comox Valley Chiropractor.

Stretching For Runners

Running is a great form of exercise – easy, cheap and great for your cardiovascular system. However, running can also be very hard on your joints. Your joints are subjected to higher than normal forces with each stride, and this can compound any minor flaw in your biomechanics or your body. A tight hip or strained hamstring can alter your running position enough to cause significant pain.

As I have said before, prevention is the key. Its way easier to prevent something than to fix it once its happened. Apart from ensuring you have a good pair of running shoes, the second most important preventative step is to stretch out your body at the end of your run. This will help to loosen up any muscles that have tightened up, and will help your body recover faster.

The Canadian Chiropractic Association has created a brochure outlining some easy and effective running stretches. Again, these are to be done at the end of your run. The brochure can be downloaded by clicking on the following link:

Running Stretches

Dr. Debbie Wright is a practicing Comox Valley Chiropractor.