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ChiroUp’s data collection team has harvested several research gems this month. Check out the top 14 quotes that you can use to positively impact your management and outcomes.

Review the latest news:

✔ Vitamin D Deficiency is Linked to Migraines: What to Prescribe
✔ Cervical Degeneration Slows Post – Whiplash Recovery
✔ Little League Elbow – Curve Balls Don’t Matter
✔ Skip the Ultrasound for Carpal Tunnel
✔ Begin Knee Rehab on a Treadmill… Calves & Achilles on the Track

Here’s what the research is saying:


1. Vitamin D Deficiency is Linked to Migraines
“In this study, we demonstrated a significant association between hypocalcemia and vitamin D deficiency with migraine attacks.”

Patel U, Kodumuri N, Malik P, Kapoor A, Malhi P, Patel K, Saiyed S, Lavado L, Kapoor V. Hypocalcemia and Vitamin D Deficiency amongst Migraine Patients: A Nationwide Retrospective Study. Medicina. 2019 Aug;55(8):407. Link

2. Optimal Vitamin D for Migraines

“The present findings show that supplementation with vitamin D in a dose of 1000-4000 IU/d could reduce the frequency of attacks in migraineurs.”

Ghorbani Z et al. Vitamin D in migraine headache: a comprehensive review on literature. Neurol Sci. 2019 Aug 3. Link

Cervical Spine


3. Deep Neck Muscle Weakness Is Associated with Neck Pain

“The idiopathic neck pain group demonstrated:

  • significantly less strength and endurance for the cervicothoracic flexors and extensors
  • significantly less endurance time for the cervicothoracic and craniocervical flexors”

Check out the ChiroUp 15-minutes to excellence webinar on Upper Crossed syndrome to learn more.

O’Leary S et al. Comparative Strength and Endurance Parameters of the Craniocervical and Cervicothoracic Extensors and Flexors in Females With and Without Idiopathic Neck Pain. J Appl Biomech. 2019 Jun 1;35(3):209-215. Link

4. Whiplash Recovery Slows with Cervical Degeneration

“In the group with moderate facet joint degeneration, 69.6% reported non-recovery compared with 23.6% among patients without any signs of degeneration. We hypothesize that whiplash trauma can be a trigger for painful manifestation of previously asymptomatic facet joint degeneration.”

Rydman E et al. Association between cervical degeneration and self-perceived non-recovery after whiplash injury. Spine J. 2019 Aug 5. pii: S1529-9430(19)30899-X. Link


5. Older Shoulders Recruit Differently

“We found that in contrast to young individuals, middle-aged individuals have a high degree of teres major and latissimus dorsi activity during shoulder abduction. These two adductor muscles have a crucial contribution to counteracting deltoid forces, depressing the humerus and ensuring free passage of subacromial tissues underneath the acromion during abduction. The age-related increase in adductor co-contraction observed in our study, suggests a shift in muscle activation patterns during ageing, that may be crucial for maintaining pain-free shoulder function.”  

Hik, F., Ackland, D.C., 2019. The moment arms of the muscles spanning the glenohumeral joint: a systematic review. J. Anat. 234, 1–15 Link



6. Little League Elbow- It’s Pitch Count, Regardless of Type of Pitch

“Pitching to the age-restricted pitch count limit did not result in altered pitching mechanics or muscle activations, and no differences occurred between the 3 pitches (fastball, curveball, and change-up). These results support previous research that indicate the curveball pitch is no more dangerous for youth than the other pitches commonly thrown.”

Oliver GD et al. Effects of a Simulated Game on Upper Extremity Pitching Mechanics and Muscle Activations Among Various Pitch Types in Youth Baseball Pitchers. J Pediatr Orthop. 2019 Sep;39(8):387-393. Link

Hand/ Wrist

7. Skip the Ultrasound for Carpal Tunnel

“We found no clinically significant benefit from ultrasound treatment for CTS”

Jothi KP, Bland JD. Ultrasound Therapy Adds No Benefit to Splinting in Carpal Tunnel Syndrome. Muscle & nerve. 2019 Jul 30. Link

Lumbar Spine

8. Another Confirmation: Disc Herniations Spontaneously Resorb

In 40 patients with lumbar disc herniation: “Based on MRI disc volume; 10% did not show any regression, 15% had a partial regression, and 75% had a complete resolution. Patients with complete resolution showed a significant improvement in the pain score and the ODI score over time.”

Kesikburun B et al. Spontaneous regression of extruded lumbar disc herniation: Correlation with clinical outcome. Pak J Med Sci. 2019 Jul-Aug;35(4):974-980. Link


9. Lumber Wedging and Disc Herniation

“A wedge-shaped vertebra is an independent risk factor for Upper Lumbar Disc Herniation (ULDH).”

Wang F et al. Wedge-shaped vertebrae is a risk factor for symptomatic upper lumbar disc herniation. J Orthop Surg Res. 2019 Aug 22;14(1):265. Link



10. Spinal Mobilization with Leg Movement Improves Sciatica

“In patients with lumbar radiculopathy, the addition of spinal mobilization with leg movement (SMWLM) provided significantly improved benefits in leg and back pain, disability, SLR ROM, and patient satisfaction in the short and long term.”

Satpute K et al. The Effect of Spinal Mobilization With Leg Movement in Patients With Lumbar Radiculopathy-A Double-Blind Randomized Controlled Trial. Arch Phys Med Rehabil. 2019 May;100(5):828-836. Link

11. Braggards Test Differentiates Sciatica from Hamstring Strain

“Ankle dorsiflexion resulted in significant strain and distal excursion of the sciatic nerve at all ranges of hip flexion during the straight leg raise. In contrast, the ankle movement did not affect the strain in biceps femoris at any position of the hip.”

Bueno-Gracia E et al. Differential movement of the sciatic nerve and hamstrings during the straight leg raise with ankle dorsiflexion: Implications for diagnosis of neural aspect to hamstring disorders. Musculoskelet Sci Pract. 2019 Oct;43:91-95. Link


12. When to Operate On FAI?

A study of more than 1000 Femoroacetabular Impingement patients found that delaying surgical intervention for up to twelve months has little effect on outcome, however, longer delays lead to worse outcomes.

Kunze KN et al. Early Hip Arthroscopy for Femoroacetabular Impingement Syndrome Provides Superior Outcomes When Compared With Delaying Surgical Treatment Beyond 6 Months. Am J Sports Med. 2019 Jul 15:2038-2044. Link



13. Hip Weakness is Closely Linked to Knee Pain

“Women with Patellofemoral Pain Syndrome had 33% lower hip abduction peak strength. They also had significant 70% lower knee extension force steadiness and 60% lower hip abduction force steadiness than pain-free women. Evidence-based treatments aiming at improving force steadiness may be a promising addition to PFP rehabilitation programs.”

Ferreira AS et al. Knee and Hip Isometric Force Steadiness Are Impaired in Women With Patellofemoral Pain. J Strength Cond Res. 2019 Jul 22. Link 

Check out the ChiroUp 15-minutes to excellence webinar on Hip Abductor Weakness to learn more.



14. Begin Knee Rehab on a Treadmill, but Achilles on the Track?

“In terms of muscle force, treadmill exercise requires lower loading on knee extensor, yet higher loading on plantar flexor, especially on Gastrocnemius. The findings and the methodology can provide the basis for rehabilitation therapy customization and sophistic treadmill design.”


Yao J et al. Lower limb joint motion and muscle force in treadmill and over-ground exercise. Biomed Eng Online. 2019 Aug 22;18(1):89. Link

That’s a lot to keep track of… But here’s the good news. Your ChiroUp team has already updated the resources in your ChiroUp account to reflect the latest research. As a subscriber, you can have the confidence that you are delivering the best possible treatment to every patient, every time.

Thanks for being in our community of rockstar providers, worldwide.

About the Author

Dr. Tim Bertelsman

Dr. Tim Bertelsman


Dr. Tim Bertelsman graduated with honors from Logan College of Chiropractic and has been practicing in Belleville, IL since 1992. He has lectured nationally on various clinical and business topics and has been published extensively. He has served in several leadership positions within the Illinois Chiropractic Society and currently serves as President of the executive board.

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