Dr. Ryan Reilly
7155 80th Street So Ste 110
Cottage Grove, MN 55016-3050
651-459-5585

By contactus
March 27, 2012
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Health Update: Neck Pain

Neck Pain Exercise Options

Exercise for the neck is very important since weak muscles are related to many painful conditions of the neck and, can contribute to fatigue, irritability, headache, sleep loss, and more.  When done correctly (perform slowly, staying within “reasonable” pain boundaries), they can increase your range of motion, reduce stiffness/tightness, and strengthen your neck muscles. 

The exercises below combine range of motion (ROM) against light/partial resistance in 4 directions (forwards, backwards, and L/R side bending).  To do these correctly: Similar to an arm wrestling contest: 1. Push your head into your hand while moving the head to the end of the range, “…letting the head win”.  2. Repeat this going back in the opposite direction by “letting the hand win”  again, moving through the entire range of motion.  ALWAYS push the head into the hands, Make sure you move the head against resistance in BOTH directions, 3 times each. The trick is doing this VERY slowly (to build motor control and coordination) and to move through the entire “comfortable” range of motion.  Repeat 3x slowly.  If pain worsens, lighten up on the amount of pressure used or, stop the movement just prior to the sharp pain onset. If you can’t make it to the end of the movement due to pain, make a note of how many reps it took before the onset or increase of pain and how far you could move your head. Do 3 slow reps and then move to the next exercise direction. 

These exercises can be performed 1 to 3x/day, according to tolerance, and will increase ROM, increase strength, and build coordination, all at the same time.

By contactus
March 22, 2012
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Health Update: Whiplash

What Really Causes Whiplash?


Whiplash is a non-medical term for a condition that occurs when the neck and head move rapidly forwards and backwards or, sideways, at a speed so fast our neck muscles are unable to stop the movement from happening.  This sudden force results in the normal range of motion being exceeded and causes injury to the soft tissues (muscles, tendons and ligaments) of the neck. Classically, whiplash is associated with car accidents or, motor vehicle collisions (MVCs) but can also be caused by other injuries such as a fall on the ice and banging the head, sports injuries, as well as being assaulted, including “shaken baby syndrome.”

The History Of Whiplash.  The term “Whiplash” was first coined in 1928 when pilots were injured by landing airplanes on air craft carriers in the ocean. Their heads were snapped forwards and back as they came to a sudden stop. There are many synonyms for the term “whiplash” including, but not limited to, cervical hyperextension injury, acceleration-deceleration syndrome, cervical sprain (meaning ligament injury) and cervical strain (meaning muscle / tendon injury). In spite of this, the term “whiplash” has continued to be used usually in reference to MVCs.

Why Whiplash Occurs.  As noted previously, we cannot voluntarily stop our head from moving beyond the normal range of motion as it takes only about 500 milliseconds for whiplash to occur during a MVC, and we cannot voluntarily contract our neck muscles in less than 800-1000 msec. The confusing part about whiplash is that it can occur in low speed collisions such as 5-10 mph, sometimes more often than at speeds of 20 mph or more.  The reason for this has to do with the vehicle absorbing the energy of the collision. At lower speeds, there is less crushing of the metal (less damage to the vehicle) and therefore, less of the energy from the collision is absorbed.  The energy from the impact is then transferred to the contents inside the vehicle (that is, you)! This is technically called elastic deformity – when there is less damage to the car, more energy is transferred to the contents inside the car.  When metal crushes, energy is absorbed and less energy affects the vehicle's contents (technically called plastic deformity).  This is exemplified by race cars.  When they crash, they are made to break apart so the contents (the driver) is less jostled by the force of the collision.  Sometimes, all that is left after the collision is the cage surrounding the driver. 

Whiplash Symptoms.  Symptoms can occur immediately or within minutes to hours after the initial injury.  Also, less injured areas may be overshadowed initially by more seriously injured areas and may only “surface” after the more serious injured areas improve. The most common symptoms include neck pain, headaches, and limited neck movement (stiffness). Neck pain may radiate into the middle back area and/or down an arm.  If arm pain is present, a pinched nerve is a distinct possibility. Also, mild brain injury can occur even when the head is not bumped or hit. These symptoms include difficulty staying on task, losing your place in the middle of thought or sentences and tireness/fatigue.  These symptoms often resolve within 6 weeks with a 40% chance of still hurting after 3 months, and 18% chance after 2 years.  There is no reliable method to predict the outcome. Studies have shown that early mobilization and manipulation results in a better outcome than waiting for weeks or months to seek chiropractic treatment. The best results are found by obtaining prompt chiropractic care.
 

By contactus
March 20, 2012
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Health Update: Low Back Pain

Low Back Pain and Balance Exercises

You may recall last month, we talked about the relationship between low back pain and balance, particularly our unfortunate increased tendency to fall as we “mature.”  This month, we’re going to look at ways to improve our balance by learning specific exercises that utilize the parts of our nervous system that regulate balance or, proprioception.  Particularly, our cerebellum (back of the brain that regulates coordination), the vestibular system (the inner ear where the semi-circular canals are located), the ascending tracts in our spinal cord (the “highways” that bring information to the brain from our feet and the rest of our body), and the small “mechano-receptors” located in our joints that pick up our movements as we walk and run and sends that information through our nerves, up the spinal cord tracts to the brain.  Here are some very practical exercises to do, “…for the rest of our lives.” Start with the easy ones!

1. Easy (Level 1): Standing eyes open/closed - Start with the feet shoulder width apart, look straight ahead to get your balance and then close the eyes and try not to sway counting to 30 by, “…one thousand one, one thousand two, one thousand three, etc.” Repeat this with your feet closer together until they touch each other.  You can make this harder by standing on a pillow or cushion -- but don’t start that way!

2. Medium (Level 2): Lunges - from a similar starting position as #1, step forwards with one leg and squat slightly before returning back to the start position. Repeat this 5x with each foot/leg.  As you progress, you can take a longer stride and/or squat down further with each repetition. You can even hold onto light dumbbells and/or close your eyes to make it more challenging.

3. Hard (Level 3): Rocker or wobble board exercises - use a platform that rocks back & forth or, wobbles in multiple directions.  Rock back and forth, eyes open and then closed, once you get comfortable on the board.  You can rotate your body on the board, standing straight ahead (12 o’clock) followed by 45 degree angles as you work your way around in a circle at 45 degree increments (12, 1:30, 3, 4:30, 6, 7:30, 9, 10:30 and back to noon). Repeat these eyes open and closed.  The Wii Balance board is a fun way to exercise – check that out as well.

You can “improvise” and mix up different exercises and create your own routine.  Just remember, stay safe, work slowly until you build up your confidence and keep challenging yourself. 
 

By contactus
March 15, 2012
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Health Update: Whiplash

Car Accidents and Mild Traumatic Brain Injury

When you woke up today, you thought this was like any other Friday. You’re on your way to work, and traffic is flowing smoother than normal. Suddenly, someone crashes into the back end of your car and you feel your head extend back over the headrest and then rebound forwards, almost hitting the steering with your forehead. It all happened so fast. After a few minutes, you notice your neck and head starting to hurt in a way you’ve not previously felt. When the police arrive and start asking questions about what had happened, you try to piece together what happened but you’re not quite sure of the sequence of events. Your memory just isn’t that clear. Within the first few days, in addition to significant neck and headache pain, you notice your memory seems fuzzy, and you easily lose your train of thought. Everything seems like an effort and you notice you’re quite irritable. When your chiropractor asks you if you’ve felt any of these symptoms, you look at them and say, "…how did you know? I just thought I was having a bad day – I didn’t know whiplash could cause these symptoms!"

Because these symptoms are often subtle and non-specific, it’s quite normal for patients not to complain about them. In fact, we almost always have to describe the symptoms and ask if any of these symptoms “sound familiar” to the patient.

As pointed out above, patients with Mild Traumatic Brain Injury (MTBI) don’t mention any of the previously described symptoms and in fact, may be embarrassed to discuss these symptoms with their chiropractor or physician when they first present after a car crash. This is because the symptoms are vague and hard to describe and, many feel the symptoms are caused by simply being tired or perhaps upset about the accident. When directly asked if any of these symptoms exist, the patient is often surprised there is an actual reason for feeling this way.

The cause of MTBI is due to the brain actually bouncing or rebounding off the inner walls of the bony skull during the “whiplash” process, when the head is forced back and forth after the impact. During that process, the brain which is suspended inside our skull, is forced forwards and literally ricochets off the skull and damages some of the nerve cells most commonly of either the brain stem (the part connected to the spinal cord), the frontal lobe (the part behind the forehead) and/or the temporal lobe (the part of the brain located on the side of the head). Depending on the direction and degree of force generated by the collision (front end, side impact or rear end collision), the area of the brain that may be damaged varies as it could be the area closest to initial impact or, the area on the opposite side, due to the rebound effect. Depending on which part of the brain is injured, the physical findings may include problems with walking, balance, coordination, strength/endurance, as well as difficulties with communicating (“cognitive deficits”), processing information, memory, and altered psychological functions.

The good news is that most of these injuries will recover within 3-12 months but unfortunately, not all do and in these cases, the term, “post-concussive syndrome” is sometimes used.

Health Update: Carpal Tunnel

Carpal Tunnel Syndrome - What Can You Do For It?

Carpal tunnel syndrome or, CTS, is a common condition that drives many patients to chiropractic clinics asking, “…what can chiropractic do for CTS?” As an overview, the following is a list of what you might expect when you visit a Doctor of Chiropractic for a condition like CTS:

1. A thorough history is VITALLY important as your doctor can ask about job related stressors, hobby related causes (such as carpentry or playing musical instruments), telephone work, or factory work – especially if it’s fast and repetitive. Your doctor will also need to learn about your “co-morbidities” or, other conditions that can directly or indirectly cause CTS such as diabetes, thyroid disease, certain types of arthritis, certain medication side effects, and others.

2. A Physical Exam to determine the area(s) of nerve compression degree of severity. This may include ordering special tests such as EMG/NCV, if necessary.

3. Treatment can include manipulation, soft tissue release, PT modalities (eg., electric stim., ultrasound).

4. Home Therapies are the main topic for this Health Update. What can YOU do for CTS?

Here are some of the things that you, the CTS sufferer can self-manage:

A Carpal tunnel splint is primarily worn at night, keeping your wrist in a neutral or straight position. This position places the least amount of stretch on the nerves and muscle tendons that travel through the carpal tunnel at the wrist.

Exercises (Dose: 5-10 second holds, 5-10 repetitions, multiple times / day) such as: A. The “Bear claw” (keep the big knuckles of the hand straight but bend the 2 smaller joints of the fingers and thumb and alternate with opening wide the hand) B. Tight Fist / open hand (fully open – spread and extend the fingers and then make a fist, with the hand). C. The upside down palm on wall wrist and forearm stretch (stand facing a wall; with the elbow straight, place the palm of your hand on the wall, fingers pointing down towards the floor. Try to bend the wrist to 90 degrees keeping the palm flat on the wall. Feel the stretch in the forearm – hold for 5-10 seconds. Reach across with the other hand and gently pull back on the thumb for an added stretch! D. Wrist range of motion (dorsiflexion/palmar flexion) – Place forearm on a table with wrist off the edge, palm down. Bend hand downward as far as possible, then upward. Repeat 5 or 10 times. E. Wrist range of motion (pronation/supination) – Place forearm and whole hand on table-- elbow bent 90°, palm flat on tabletop. Rotate the wrist and forearm so the back of hand is now flat on tabletop. Repeat 5 or 10 times. F. Neck Stretch. Sit or stand with head facing forward. Side bend as far to the right as possible (approximate the right ear to right shoulder) and hold for 5 seconds. Reach over with the right hand to the left side of the head and gently pull further to the right to increase the stretch. Reverse instructions for the other side. Repeat 3 to 5 times. Consider other neck exercises if needed. G. Shoulder shrug and rotation. Stand with arms at the sides. Shrug the shoulders up toward the ears, then squeeze the shoulder blades back, then downwards and then roll them forward. Do the whole rotation slowly and reverse the direction. Repeat 3 to 5 times. If you cannot comfortably do the whole rotation, just shrug the shoulders up and down. H. Pectoral stretch. Stand in a doorway (or a corner of a room). Rest your forearms, including your elbows, on the doorframe, keeping your shoulders at a 90-degree angle. Lean forward until a stretch is felt in the chest muscles. Do not arch your back. Hold 20 seconds; repeat 5 times.

Job modifications are also VERY important but unfortunately, a topic for another time! In short, rotate job tasks (if possible), take mini-breaks, and use tools with handles that fit easily into the hands. Have a job station analysis completed if the above are not enough.

If you, or someone you know is needlessly suffering from carpal tunnel symptoms, call 651-459-5585 today for a carpal tunnel relief consultation.





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