Spinal Manipulation (also referred to as a chiropractic adjustment) is often used when a patient presents with a painful joint (in the back, neck, upper or lower extremity) that is not moving properly; this is commonly referred to as joint fixation.  In this type of manual therapy, a joint is moved beyond a passive range of motion with the goal of restoring proper motion, decreasing adhesion in the joint and decreasing pain. There are many techniques used when performing manipulation. Often, with this type of treatment, you will hear a cavitation which is a slight popping noise. This is a release of a gas within the joint as it is moved through a rapid range of motion.

Mobilization is a type of manual therapy where a restricted joint is gently moved within its usual range of motion. Mobilization is generally a repetitive and oscillatory movement performed by the practitioner, and no cavitation (popping) is heard with this type of therapy.

For many years it was thought that the autonomic nervous system (the part of your nervous system that controls the automatic functions of your body like your heartbeat, circulation and digestive function) is not subject to conscious control. However, through a method called biofeedback, these autonomic processes may be brought under voluntary control. There is a growing body of promising research that indicates the beneficial role of biofeedback.

Through biofeedback, individuals can take control of their body and in many cases restore health. By measuring processes of the body with equipment such as electromyography, electrocardiography, galvanic skin response meters, and thermometers, patients are provided with important physiological information with regard to blood pressure, muscle tension, heart rate, skin temperature and sweat gland activity. Biofeedback may be used for a variety of conditions such as headaches, hot flashes, Raynaud’s disease, irritable bowel syndrome, fibromyalgia, high blood pressure, TMJ disorders, ADD, epilepsy, and muscle disorders. Patients with conditions that are exacerbated by stress (which most conditions are) such a diabetes, heart disease, or chronic fatigue syndrome benefit from biofeedback. Additionally many performing artists and elite athletes use biofeedback for optimal performance techniques and relaxation.

What is Tennis Elbow?

Tennis elbow (technically known as lateral epicondylitis) is a condition of the extensor muscle and tendon fibers located at the outside (lateral aspect) of the arm at the elbow. If we break down the medical terminology, it makes sense: “lateral” (outside aspect) “epicondyle” (portion of bone to which the tendon adheres) “itis” (inflammation). Tennis players (or other athletes) who use back hand swings commonly suffer from this condition due the repetitive motion and stress placed on the extensor tendons. If you are suffering from tennis elbow, you will notice elbow pain/burning that increases with increased activity. The pain may radiate, and you might also notice that your ability to grasp is decreased.

Swing back at tennis elbow.

How is Tennis Elbow Diagnosed?

Tennis elbow is generally diagnosed by detailed history and physical exam. Your chiropractor will ask you questions like what makes it worse, what makes it better, how/when it began, and what it feels like. Next, an exam will be performed; your chiropractor will palpate (examine by touch) the anatomical structures of the elbow. He/she will then assess the elbow’s motion and perform specific orthopedic tests. Occasionally imaging will be ordered to rule out other conditions; however, tennis elbow cannot be seen on an x-ray or MRI.

What Are the Options for Treating Tennis Elbow?

Tennis elbow is commonly evaluated and successfully treated at Lehigh Valley Chiropractic. In most cases, conservative management is successful and most people who suffer from tennis elbow will not require invasive treatments like surgery. The chiropractors at Lehigh Valley Chiropractic will develop a treatment plan that will work for you. Joint manipulation and manual therapy (such as Active Release Technique), taping, bracing, ice massage, ultrasound, therapeutic strengthening/stretching exercises, and rest are often included in that plan. Swing back at tennis elbow; we get you out of pain and back into the game.

1. Manipulation of the wrist for management of lateral epicondylitis: a randomized pilot study. Struijs PA, Damen PJ, Bakker EW, Blankevoort L, Assendelft WJ, van Dijk CN. Phys Ther. 2003 Jul;83(7):608-16..
2. A rational management of tennis elbow. Kamien M. Sports Med. 1990 Mar;9(3):173-91. Review.

What are Shin Splints?

“Shin Splints” is commonly used as a general term to describe pain in the lower leg. That being said, there are several causes of shin pain (stress fractures, compartment syndrome) that may not be related to shin splints. Otherwise known as Medial Tibial Stress Syndrome (MTSS), shin splints are caused when the connective tissue that attaches the muscle to bone (tibia) is overused or used incorrectly. The area becomes inflamed which contributes to pain, tenderness and in some cases swelling that is located on the inner part of the front of your leg (shin). In some cases the symptoms are only present with exercise or activity; in others, pain is constant. Runners are especially prone to this condition. Exercising on hard surfaces, improper foot wear, uphill/downhill running, and over-training often contribute to the onset. In some cases the way you run may also increase your chances of getting shin splints.

Don’t let shin splints get in the way of your training goals.

How are shin splints diagnosed?

Shin splints are generally diagnosed by history and physical exam. Your chiropractor will ask you questions like what makes it worse, what makes it better, how/when it began, and what it feels like. An exam will be performed that will consist of orthopedic and in some cases neurologic tests to determine the cause of the pain. Your chiropractor may also provide a biomechanical assessment (watching you in action)  to establish if there are any abnormalities of gait and movement. In some cases, further testing such as an X-ray, bone scan or MRI will be ordered.

What Are the Options for Treating Shin Splints?

Shin splints are commonly evaluated and successfully treated at Lehigh Valley Chiropractic. Some cases will require only minimal intervention and may be treated at home with ice massage, changes in foot wear, arch support, rest, elevation, and over the counter pain relievers. Other cases require rehabilitative treatment. The chiropractors at Lehigh Valley Chiropractic are trained to provide high quality and individualized treatment that will get you out of pain and improve your performance. Many active patients have reaped the benefits of chiropractic care. Schedule your appointment with one of our chiropractors and ride, run, dance, skate or ski your way to the top.

1. Tibial stress injuries: decisive diagnosis and treatment of ‘shin splints’. Couture CJ, Karlson KA.Phys Sportsmed. 2002 Jun;30(6):29-36.
2. Medial tibial stress syndrome: conservative treatment options. Galbraith RM, Lavallee ME. Curr Rev Musculoskelet Med. 2009 Oct 7. The effects of active release technique on hamstring flexibility: a pilot study. George JW, Tunstall AC, Tepe RE, Skaggs CD. J Manipulative Physiol Ther. 2006 Mar-Apr;29(3):224-7.

What is Plantar Fasciitis?

Plantar fasciitis is a condition of the connective tissue located at the plantar (bottom) surface of the foot that causes irritation, swelling and pain. Repetitive stress of the plantar fascia (layer of connective tissue) results in microtears of the tissue. The pain is most pronounced after rest; for example, the first few steps of the morning are notoriously uncomfortable. That being said, overuse, stair climbing and prolonged standing may also result in increased pain. The discomfort is generally located at the heel and is characterized by stiffness, burning, aching, and/or stabbing pain. There are many factors that may contribute to the onset. If you are on your feet a lot, you are more likely to develop this condition.  Increased or excessive physical activity, improper foot wear, high arch, diabetes, excess body fat, pregnancy, arthritis, and changes in gait are predisposing factors that may increase your risk of developing plantar fasciitis.

Don’t let plantar fasciitis stand between you and the activities you enjoy.

How is Plantar Fasciitis Diagnosed?

Plantar fasciitis is generally diagnosed by detailed history and physical exam. Your chiropractor will ask you questions like what makes it worse, what makes it better, how/when it began, and what it feels like. An exam will be performed that will consist of orthopedic tests. Your chiropractor may also provide a biomechanical assessment (watching you in action) to establish if there are any abnormalities of gait and movement. Although the plantar fascia cannot be seen on an x-ray, this type of testing may be ordered to rule out other conditions such as stress fractures.

What Are the Options for Treating Fasciitis?

Plantar Fasciitis is commonly evaluated and treated at Lehigh Valley Chiropractic. Some cases will require only minimal intervention and may be treated at home with ice, massage, changes in foot wear, arch support, rest, elevation, and over the counter pain relievers. Other cases require rehabilitative treatment. Myofascial therapy applied to the plantar fascia is highly effective; your chiropractor may also recommend specific therapeutic exercises designed to speed your recovery. The chiropractors at Lehigh Valley Chiropractic are trained to provide high quality and individualized treatment that will get you out of pain and improve your performance. Many active patients have reaped the benefits of chiropractic care. Schedule your appointment with one of our chiropractors. Don’t let plantar fasciitis stand between you and the activities you enjoy.

1. Conservative therapy for plantar fasciitis: a narrative review of randomized controlled trials. Stuber K, Kristmanson K. J Can Chiropr Assoc. 2006 Jun;50(2):118-33.
2. An approach to the diagnosis and treatment of plantar fasciitis. Glazer JL. Phys Sportsmed. 2009 Jun;37(2):74-9.

What is Iliotibial Band Syndrome?

The iliotibial band (aka I.T. Band) is layer of strong and fibrous connective tissue (fascia) that runs from the hip-down the outside of the thigh-to a point just below the knee. The band functions in coordination with the quadriceps to stabilize the knee. With overuse or injury, the connective tissue becomes inflamed and painful resulting in iliotibial band friction syndrome (ITBFS). Runners, dancers, cyclists and other athletes who engage in repetitive exercise are prone to developing this syndrome. The pain can be located anywhere along the lateral aspect (outside) of the thigh. Generally, the pain increases with increasing activity and is worse when running down hill or traveling down stairs. In some people the pain is constant, but typically the pain is felt with movement.

Runners, dancers, cyclists and other athletes who engage in repetitive exercise are prone to developing this syndrome.

How is Iliotibial Band Syndrome diagnosed?

Iliotibial band syndrome is generally diagnosed by history and physical exam. Your chiropractor will ask you questions like what makes it worse, what makes it better, how/when it began, and what it feels like. An exam will be performed that will consist of orthopedic tests designed to provoke the pain. The chiropractor will use his/her hands to palpate for abnormalities along the outside of your thigh. Your chiropractor may also provide a biomechanical assessment (watching you in action) to establish if there are any abnormalities of gait and movement. Rarely, further testing such as an x-ray or MRI will be ordered.

What Are the Options for Treating Iliotibial Band Syndrome?

Iliotibial band syndrome is commonly treated at Lehigh Valley Chiropractic. You may experience relief with the conservative treatments rendered by our chiropractors. For this condition, treatments such as myofascial release (including foam roller myofascial release), therapeutic ultrasound, strengthening exercises, and stretching are safe and effective. Our chiropractors may also recommend RICE (rest, ice, elevation, compression), reduced training, cross training and changes in footwear. Don’t let pain prevent you from the activities you enjoy. Contact Lehigh Valley Chiropractic to schedule your first appointment and get on the road to recovery.

1. Iliotibial band friction syndrome–a systematic review. Ellis R, Hing W, Reid D. Man Ther. 2007 Aug;12(3):200-8. Epub 2007 Jan 8. Review. Treatment of an individual with piriformis syndrome focusing on hip muscle strengthening and movement reeducation: a case report. Tonley JC, Yun SM, Kochevar RJ, Dye JA, Farrokhi S, Powers CM. J Orthop Sports Phys Ther. 2010 Feb;40(2):1.
2. Practical management of iliotibial band friction syndrome in runners. Fredericson M, Weir A. Clin J Sport Med. 2006 May;16(3):261-8.
3. Relief of internal snapping hip syndrome in a marathon runner after chiropractic treatment. Konczak CR, Ames R. J Manipulative Physiol Ther. 2005 Jan;28(1):e1-7.

What is a Hamstring Strain?

A hamstring strain (otherwise known as “pulled hamstring”) is an injury to the one or more of the muscles that are collectively known as the hamstrings. The semitendinosus, semimembranosus, and biceps femoris (long and short heads) are located at the back of the thigh. These muscles work together to flex the knee and extend the hip. The muscles are commonly strained, stretched or torn while running (especially sprinting) and jumping. Certain athletic endeavors that involve bursts of activity such as football, basketball, dance, track, soccer, field hockey, and baseball are more likely to result in this type of injury. Injuries may be acute (sudden onset), or they may be chronic (especially seen in distance runner who consistently stress the area). This type of injury may result in mild pain and limited disability or may cause severe pain and debilitation. Unfortunately, these types of injuries heal slowly and athletes are prone to re-injury without the appropriate treatment. Proper warm-up, stretching and conditioning of the muscles may prevent the injury. The chiropractors at Lehigh Valley Chiropractic provide strategies for optimum athletic performance that will speed recovery and prevent recurrence.

ART is a unique soft tissue treatment that will enable the injury to heal faster and allow you to perform at your peak.

How is Hamstring Strain diagnosed?

Hamstring strains are classified by a grading system. A grade of 1 means there are micro-tears that have occurred within the muscle which cause pain and tightness in the back of the thigh. Generally there is little visual evidence of the injury (swelling, bruising, or redness).  Grade 2 injuries are characterized by a loss of muscle strength against resistance due to a partial tear. Swelling, stiffness, decreased range of motion, and bruising are often present. With a grade 3 injury, there is a complete tear of muscle fibers which causes a great deal of pain and complete weakness. Inability to walk, discoloration, bruising and a bulge of muscle (where the tear occurred) are characteristic of grade 3.

Generally, hamstring strains are diagnosed by history and physical examination. The chiropractors at Lehigh Valley Chiropractic will ask you questions about the mechanism of your injury and perform orthopedic tests to evaluate the condition. In certain cases an MRI or other tests will be ordered to determine the extent of the injury.

What Are the Options for Treating Hamstring Strain?

Hamstring strains are commonly treated at Lehigh Valley Chiropractic. Depending on the extent of the injury, you will be provided with a treatment plan that will include Active Release Technique (ART), myofascial release and therapeutic exercise. ART is a unique soft tissue treatment that will enable the injury to heal faster and allow you to perform at your peak. Many active patients have reaped the benefits of chiropractic care. Schedule your appointment with one of our chiropractors and ride, run, dance, skate or ski your way to the top.

1. Hamstring strain injuries: recommendations for diagnosis, rehabilitation, and injury prevention. Heiderscheit BC, Sherry MA, Silder A, Chumanov ES, Thelen DG.J Orthop Sports Phys Ther. 2010 Feb;40(2):67-81.Mangialardi R, Mastorillo G, Minoia L, Garofalo R, et al. Lumbar disc hernation and cauda equina syndrome. Considerations on a pathology with different clinical manifestation. Chir Organi Mov. 2002 Jan-Mar; 87 (1):35-42.
2. The effects of active release technique on hamstring flexibility: a pilot study. George JW, Tunstall AC, Tepe RE, Skaggs CD. J Manipulative Physiol Ther. 2006 Mar-Apr;29(3):224-7.

What is Groin Strain?

A groin strain (otherwise known as adductor muscle strain or tear) is an injury to the one or more of the muscles that are collectively known as the adductors. The pectineus, adductor longus, adductor brevis, adductor magnus and gracilis are located at on the inner part of the thigh. The muscles work together to adduct (or approximate the thigh) toward the midline (toward to opposite thigh). One or more of these muscles are commonly injured in sports that require explosive and dynamic movements such as sprinting, hurdling, basketball, field hockey, ice hockey, soccer, or football. In addition to ballistic movements, repetitive stress (engaging in the same movement over and over) injuries of this muscle group are also common. Injuries may be acute (sudden onset), or they may be chronic (especially seen in athletes who consistently stress the area). This type of injury may result in mild pain and limited disability or may cause severe pain and debilitation. If you are suffering from a groin strain, you will feel discomfort (ranging from a dull ache to a sharp pain) in the inner part of the thigh. Often, movement is difficult and you may notice weakness. Your groin strain may prevent you from engaging in the activities you enjoy. Proper warm-up, stretching and conditioning of the muscles may prevent the injury.  In the event that you are suffering from this type of injury, the chiropractors at Lehigh Valley Chiropractic provide strategies for optimum athletic performance that will speed recovery and prevent recurrence.

Our treatment methods speed tissue recovery and increase performance–meaning less down-time for you.

-Dr Scott Bentson

How is Groin Strain diagnosed?

Groin strains are classified by a grading system. A grade of 1 means there are micro-tears that have occurred within the muscle which cause pain and tightness in the inner part of the thigh. Generally there is little visual evidence of the injury (swelling, bruising, or redness).  Grade 2 injuries are characterized by a loss of muscle strength against resistance due to a partial tear. Swelling, stiffness, decreased range of motion, and bruising are often present. With a grade 3 injury, there is a complete tear of muscle fibers which causes a great deal of pain and complete weakness. Inability to walk, discoloration, bruising and a bulge of muscle (where the tear occurred) are characteristic of grade 3.

Generally, groin strains are diagnosed by history and physical examination. The chiropractors at Lehigh Valley Chiropractic will ask you questions about the mechanism of your injury and perform orthopedic tests to evaluate the condition. In certain cases an MRI or other tests will be ordered to determine the extent of the injury.

What Are the Options for Treating Groin Strain?

Groin strains are commonly treated at Lehigh Valley Chiropractic. Depending on the extent of the injury, you will be provided with a treatment plan that will include Active Release Technique (ART), myofascial release, kinesiotaping, ultrasound and therapeutic exercise. ART is a unique soft tissue treatment that will enable the injury to heal faster and allow you to perform at your peak. Your chiropractor may also recommend P.R.I.C.E. (protection, rest, ice, compression and elevation) which will enable you to heal more quickly. In the event that a full muscle tear (grade 3 injury) is suspected, you will be referred to the appropriate health care provider. Many active patients have reaped the benefits of chiropractic care. Don’t let a pulled groin keep you down! Get back in the game with the help of the LVC chiropractors.

• Diagnosis and management of adhesive capsulitis. Manske RC, Prohaska D.Curr Rev Musculoskelet Med. 2008 Dec;1(3-4):180-9.A rational management of tennis elbow. Kamien M. Sports Med. 1990 Mar;9(3):173-91. Review.
• Comparison of the early response to two methods of rehabilitation in adhesive capsulitis. Guler-Uysal F, Kozanoglu E. Swiss Med Wkly. 2004 Jun 12;134(23-24):353-8.

What is Golfer’s Elbow (medial epicondylitis)?

Golfer’s elbow (technically known as medial epicondylitis) is a condition of the flexor muscle and tendon fibers located at the inside (medial aspect) of the arm at the elbow. It is a specific type of tendonitis. If we break down the medical terminology, it makes sense: “medial” (inside aspect) “epicondyle” (portion of bone to which the tendon adheres) “itis” (inflammation). Golfers and throwing athletes (baseball, football, etc.) commonly suffer from this condition due the repetitive motion and stress placed on the flexor tendons. This condition may also develop with a single action. Although it can occur at any time, it is more common at the beginning of the season; individuals who are inadequately conditioned are prone to this injury. If you are suffering from golfer’s elbow, you will notice elbow pain/burning that increases with increased activity. The pain may radiate, and you might also notice that your ability to grasp is decreased.

How is Golfer’s Elbow Diagnosed?

Golfer’s elbow is generally diagnosed by detailed history and physical exam. Your chiropractor will ask you questions like what makes it worse, what makes it better, how/when it began, and what it feels like. Next, an exam will be performed; your chiropractor will palpate (examine by touch) the anatomical structures of the elbow. He/she will then assess the elbow’s motion and perform specific orthopedic tests. Occasionally imaging will be ordered to rule out other conditions; however golfer’s elbow cannot be seen on an x-ray or MRI.

What Are the Options for Treating Golfer’s Elbow?

Golfer’s elbow is commonly evaluated and successfully treated at Lehigh Valley Chiropractic. In most cases, conservative management is successful and most people who suffer from golfer’s elbow will not require invasive treatments like surgery. The chiropractors at Lehigh Valley Chiropractic will develop a treatment plan that will work for you. Joint manipulation and manual therapy (such as Active Release Technique), taping, bracing, ice massage, ultrasound, therapeutic strengthening/stretching exercises, and rest are often included in that plan.

References

1. Diagnosis and treatment of medial epicondylitis of the elbow. Ciccotti MC, Schwartz MA, Ciccotti MG.
2. Comparison of two methods for the evaluation of treatment in medial epicondylitis: pain estimation vs grip strength measurements. Rosenberg N, Soudry M, Stahl S. Arch Orthop Trauma Surg. 2004 Jul;124(6):363-5. Epub 2004 Apr 24.

Are you wondering if that pain, tightness and difficulty chewing is related to temporomandibular joint dysfunction (TMD or TMJD)? Here are the most common TMJ disorder symptoms that the patients of Lehigh Valley Chiropractic have reported.

• TMJ Symptom 1: Pain (usually on one side) located in TMJ region (in the cheek by the ear)
• TMJ Symptom 2: Pain in the temples, around the ear, head and/or the upper part of the neck
• TMJ Symptom 3: Difficulty opening or closing the mouth (this may or may not also cause pain)
• TMJ Symptom 4: A hard time chewing and chatting due to pain or restricted movement
• TMJ Symptom 5: A feeling like that side of the face is “tired”
• TMJ Symptom 6: A feeling like the jaw is “stuck” or locked”

In addition, many of our TMJD sufferers report a feeling of fullness in the ear, a difficulty hearing or ringing in the ear which often resolves with chiropractic treatments provided at Lehigh Valley Chiropractic like chiropractic adjustments (spinal manipulation) and myofascial/manual therapy.

Many people find relief with chiropractic treatments and are better able to manage their TMJD symptoms with chiropractic care.