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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...
Imaging Considerations

Imaging Considerations

According to Chou et al. in Annals of Internal Medicine 2007; “providers should not consider X-rays, MRI’s, or CT’s unless there is nerve damage or other red flags.  We should focus on the results of our history and examination to guide us through treatment and...
Who Benefits Most From Cervical Traction

Who Benefits Most From Cervical Traction

Raney (1) identified 5 variables to predict the success of cervical traction: 1. Peripheralization with lower cervical spine (C4–7) mobility testing 2. Positive shoulder abduction test (relief of symptoms with arm overhead) 3. Age ≥55 4. Positive upper extremity nerve...

Cost Effective Option

Peterson CK, et al. concluded that patients with radicular low back pain and magnetic resonance imaging–confirmed disk herniation, reported significant and similar improvements through either SMT or Nerve Root Injection- however, SMT was less expensive. Clinical...

Where Do Lumbar Disc’s Herniate?

In a soon to be published Spine Journal study of 181 subjects (1), Rajasekaran found that Lumbar Disc Herniation (LDH) due to End Plate Junction Failure (EPJF) was more common (65%) than annulus fibrosis rupture. The EPJF presented radiographically as a vertebral...

Use These Four Tests for Improvement in Lumbar Stabilization

Hicks et al. submitted patients with LBP to an 8-week stabilization exercise program. Eighty-three percent of the subjects reported functional improvement in terms of the Oswestry score. The predictors of success were: age lower than 40 average straight-leg raising...

What’s In Your Toolbox?

Have you ever heard the question, “Will my disc ever heal?” Well the answer may be yes. According to a JMMT case report by Takasaki in 2010; migration of the nucleus pulposus is possible using McKenzie Directional Therapy. “The McKenzie management strategy of...

Does Your Evaluation And Treatment Carry Over To Real Life

If your patient has pain upon standing up; then watch them stand up. In this study from David Frost it becomes apparent that people choose different movement patterns to perform different tasks.  In this study, fifty-two firefighters performed a battery of general and...
Practice Safe Tech

Practice Safe Tech

While cell phones and other modern technology devices have given us the ability to be productive from almost anywhere, it has also transformed the way we hold our bodies. You may not be aware of how much strain you are placing on your neck while using these devices....