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L5 Motor Reflex Testing?

L5 Motor Reflex Testing?

  Until recently, clinicians had not typically tested for an L5 motor reflex. A study published by Esse et al (1), introduces a simple reliable alternative utilizing the Medial Hamstring Reflex (MHR). According to the authors: “The MHR is highly precise with an...
Stroke Update

Stroke Update

You will want to review a tremendous new study (1) concerning the association of chiropractic care and stroke. The authors extracted 3 years of commercial insurance and Medicare advantage plan data for approximately 39 million insured patients. This represents...
Orthotics For Posterior Tibial Tendon Dysfunction?

Orthotics For Posterior Tibial Tendon Dysfunction?

Arch supports and orthotics are mainstays of management for Posterior Tibial Tendon Dysfunction (PTTD), but have shown varying degrees of success. (1,2) The intended purpose of orthotics is to correct “flexible” deformities, i.e. maintain the medial arch and correct...
Want More MD Referrals?

Want More MD Referrals?

Step one: Be a patient-centered, evidence-based clinician. The first question I often ask myself during an initial visit is: Am I the best person to treat this condition? It is not possible for any single provider to answer yes for EVERY presentation. This is why the...

The Why

Every day we encounter patients with problems. I always ask my patients why they are in my clinic. Frequently, I hear “I want to be pain-free.” However, I also hear things like: I want to reach up to the top cupboard, lift up my grandchildren, throw a baseball, and...
What is a Medial Branch Neurotomy?

What is a Medial Branch Neurotomy?

  Medial Branch Neurotomy, aka Facet Rhizotomy, is a procedure to de-innervate the facet joints. The process involves cauterization of the medial branch of the dorsal ramus via Radiofrequency ablation (RFA) or other means. The procedure is intended to damage the...
Iliotibial Band Syndrome Ditched “Friction”

Iliotibial Band Syndrome Ditched “Friction”

Iliotibial band syndrome describes an irritation of the tissues near the distal attachment of the iliotibial band (ITB). This overuse syndrome is particularly common in runners and cyclists. (1-3) Earlier etiological theories (4) suggesting that ITB syndrome was a...
Proprioception

Proprioception

As illustrated, joint mechanics are influenced by the nervous system as well as the capacity of surrounding passive and active tissues. Diagnosing chronic sprains, muscle tightness, tendonitis and joint pain are not necessarily getting to the cause of the patient’s...
Does Your Treatment Match the Problem?

Does Your Treatment Match the Problem?

This week, we are honored to be speaking at the American College of Chiropractic Orthopedists conference in Las Vegas. Our presentation, “Mastering the Rotator Cuff” will cover the current evidence-based diagnosis and management of this common problem. The attached...
Rotator Cuff Decisions – MRI or Surgery?

Rotator Cuff Decisions – MRI or Surgery?

                    A patient walks into your office with lateral shoulder pain as their chief complaint.  Assuming that your clinical suspicion leads to a diagnosis of a rotator cuff tear— What are the next two decisions that need to be made? Q1. Is An MRI Necessary?...
Just How Critical is Codman’s Critical Zone?

Just How Critical is Codman’s Critical Zone?

                    Welcome to shoulder month.  This month, ChiroUp will take a closer look at shoulder dysfunction and share some evidence-based evaluation and treatment tips to help you heal patients quickly. As clinicians, we must be willing to continually refine...
Tendinopathy

Tendinopathy

In Review of: Elisa Tetschke et al, Autologous Proliferative Therapies in Recalcitrant Lateral Epicondylitis In Press Am J Phys Med Rehabil 2014 This is another helpful article for managing patients with chronic lateral epicondylar pain.  However, when we take a...

We All Love Stu McGill

I personally enjoy the work of Dr. McGill. His research is instrumental in patient management and clinical decision-making. Most of all, I enjoy his passion for identifying WHY he performs research. If you have never listened to him speak, I encourage you to do so. It...
Foot Hyperpronation

Foot Hyperpronation

Excessive foot pronation has been associated with the occurrence of low back pain, possibly for generating changes in lumbopelvic alignment. However, the influence of foot pronation (measured as calcaneal eversion) on pelvic alignment during standing had not been well...
Referred Pain

Referred Pain

Following peripheral nerve injury, there is an invasion and activation of macrophages, T-lymphocytes and satellite glial cells in the DRG.  Inflammatory mediators released from these immune cells may result in ectopic activity of DRG neurons. Given the close proximity...