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It’s that time again! Your ChiroUp research team has compiled clinical tips for 15 common conditions from this past month’s research. From concussions to plantar fasciitis, we’ve got you covered on the latest news.

Review the latest news:

✔ Valuable New Biceps Tendinopathy Test
✔ Scoliosis: Which Curve Is Worst?
✔ Two Overlooked Muscles in Rotator Cuff Pathology
✔ Acupuncture Relieves Carpal Tunnel & Lumbar Stenosis
✔ Best Diagnostic Criteria for Knee OA

Here’s what the research is saying:

Concussion

“Currently, complete rest following concussion is not recommended as it may actually be associated with longer recovery time; a gradual return to cognitive and physical activity appears to be most effective strategy.”

Blume HK. Posttraumatic headache in pediatrics: an update and review. Curr Opin Pediatr. 2018 Dec;30(6):755-763. Link

Migraine Headache

“In all, 45.7% of migraine without aura attacks were associated with osmophobia (odor hypersensitivity). No episodic tension-type headache attack was associated with osmophobia.” 

Terrin A, Mainardi F, Lisotto C, Mampreso E, Fuccaro M, Maggioni F, Zanchin G. A prospective study on osmophobia in migraine versus tension-type headache in a large series of attacks. Cephalalgia. 2019 Sep 19:0333102419877661. Link

Scapular Dyskinesis

Shortness of the pectoralis minor is a potential mechanism underlying shoulder impingement syndrome. Intervention with static stretching alone has no effect on pectoralis minor length. Kinesiotaping and proprioceptive neuromuscular facilitation (PNF) are beneficial for lengthening the pectoralis minor.

Lai CC, Chen SY, Yang JL, Lin JJ. Effectiveness of stretching exercise versus kinesiotaping in improving length of the pectoralis minor: A systematic review and network meta-analysis. Phys Ther Sport. 2019 Aug 9;40:19-26 Link

Shoulder Impingement

A recent study showed that during shoulder abduction, patients with impingement have significantly less activation of two potent humeral depressors, the latissimus dorsi, and teres major. Thus, strengthening the humeral depressors may be the best preventative strategy for impingement and rotator cuff syndrome.

Overbeek, C.L., Kolk, A., de Groot, J.H., Visser, C.P.J., van der Zwaal, P., Jens, A., et al., 2019. Altered co-contraction patterns of humeral head depressors in patients with subacromial pain syndrome: a cross-sectional electromyography analysis. Clin. Orthop. Relat. Res. Link

Biceps Tendinopathy

“For the detection of long head of the biceps injury, the Backward Traction Test was the most sensitive (74%) and accurate (68%).”

Backward Traction Test

Begin with the patient standing; arm relaxed at their side. The clinician stands on the patient’s affected side and stabilizes the glenohumeral joint by applying manual pressure over the superior joint line. With the other hand, the clinician grasps the patient’s affected wrist and passively extends the patient’s straightened arm backward approximately 30 degrees, then rotates the arm into full external rotation, followed by full internal rotation. Elicitation of pain or a painful click in the anterior shoulder suggests biceps tendon involvement.

Li D, Wang W, Liu Y, Ma X, Huang S, Qu Z. The backward traction test: a new and effective test for diagnosis of biceps and pulley lesions. Journal of shoulder and elbow surgery. 2019 Sep 13. Link

Lateral Epicondylopathy

“The surgical excision of the degenerative portion of the extensor carpi radialis brevis (ECRB) offers no additional benefit over and above placebo surgery for the management of chronic tennis elbow.”

Kroslak M, Murrell GA. Surgical treatment of lateral epicondylitis: a prospective, randomized, double-blinded, placebo-controlled clinical trial. The American journal of sports medicine. 2018 Apr;46(5):1106-13. Link

Carpal Tunnel Syndrome

“For both symptom relief and function improvement, manual acupuncture is superior to ibuprofen.”

Wu IX, Lam VC, Ho RS, Cheung WK, Sit RW, Chou LW, Zhang Y, Leung TH, Chung VC. Acupuncture and related interventions for carpal tunnel syndrome: systematic review. Clinical rehabilitation. 2019 Sep 26:0269215519877511. Link

Scoliosis

Single mid-thoracic scoliotic curves have no significant effect on quality of life, however, patients with thoracolumbar curves experience greater annual curve progression and have substantial low back pain with lower quality of life.

Watanabe K, Ohashi M, Hirano T, Katsumi K, Mizouchi T, Tashi H, Minato K, Hasegawa K, Endo N. Health-Related Quality of Life in Non-Operated Patients with Adolescent Idiopathic Scoliosis in the Middle Years: A Mean 25-Year Follow-up Study. Spine. 2019 Aug. Link

Lumbar Disc Lesion 

“Patients who had previously undergone a lumbar discectomy were roughly three times more likely to undergo a lumbar fusion procedure than a patient with a lumbar diagnosis, but had not undergone a lumbar discectomy.”

Castillo H, et al. Lumbar discectomy is associated with higher rates of lumbar fusion. Spine J. 2019. Link

Lumbar Radiculopathy 

Disc patients who rated their radicular leg pain as “severe” (vs. mild or moderate) had the highest disability, distress, and comorbidity. This group is responsible for over 80% of all disc surgeries; and demonstrate the lowest reported global change and the smallest proportion of patients with a successful surgical outcome at two years. 

Stynes S, Grøvle L, Haugen AJ, Konstantinou K, Grotle M. New insight to the characteristics and clinical course of clusters of patients with imaging confirmed disc‐related sciatica. European Journal of Pain. 2019 Aug 27. Link

Lumbar Spondylolysis

“The results of this study suggest that, in patients with symptomatic spondylolysis and grade I spondylolisthesis, pain relief and restoration of function can be achieved using conservative management techniques without use of a brace.” 

Boyd ED, Mundluru SN, Feldman DS. Outcome of Conservative Management in the Treatment of Symptomatic Spondylolysis and Grade I Spondylolisthesis. Bulletin of the Hospital for Joint Disease (2013). 2019 Sep;77(3):172. Link

Lumbar Stenosis

“Acupuncture provided immediate functional recovery and pain relief for degenerative lumbar spinal stenosis.”

Qin Z, Ding Y, Xu C, Kwong JS, Ji Y, Wu A, Wu J, Liu Z. Acupuncture vs Noninsertive Sham Acupuncture in Ageing Patients with Degenerative Lumbar Spinal Stenosis: A Randomized Controlled Trial. The American Journal Of Medicine. 2019 Sep 13. Link

ITB 

“We conclude that relatively small decreases in step width can substantially increase ITB strain as well as strain rates. Increasing step width during running, especially in persons whose running style is characterized by a narrow step width, may be beneficial in the treatment and prevention of running-related ITB syndrome.”

Meardon SA, Campbell S, Derrick TR. Step width alters iliotibial band strain during running. Sports Biomech. 2012;11:464-472. Link

Knee Osteoarthritis 

The results indicate that the NICE criteria are relevant and appropriate to identify individuals treated for knee OA in primary care. According to the criteria from NICE, patients can be diagnosed with knee OA if they:

  • Are 45 years or older
  • Have movement-related joint pain
  • Either no morning knee stiffness or stiffness of 30 minutes or less

National Institute of Health Care Excellence. Osteoarthritis: Care and Management in adults. London, UK: NICE; 2014. doi: 10.1007/s11606-019-05086-4. Link

Plantar Fasciitis

“Our study results suggest that both shock wave therapy (ESWT) and low-level laser therapy (LLLT) seem to be effective on pain, foot functions, and fascia thickness in the treatment of plantar fasciitis.”

Sanmak ÖD, Külcü DG, Mesci N, Altunok EÇ. Comparison of effects of low-level laser therapy and extracorporeal shock wave therapy in plantar fasciitis treatment: A randomized, prospective, single-blind clinical study. Turkish Journal of Physical Medicine and Rehabilitation. 2019 Jun;65(2):184. Link

…And One to Boot 

“Corticosteroid injection is not more effective than placebo injection for reducing pain or improving function (in patients with plantar fasciitis).”

Glen A. Whittaker, Shannon E. Munteanu, Hylton B. Menz, Daniel R. Bonanno, James M. Gerrard & Karl B. Landorf. Corticosteroid injection for plantar heel pain: a systematic review and meta-analysis. BMC Musculoskeletal Disorders. Volume 20, Article number: 378 (2019) Link

Now here’s the thing…since you’re reading this blog, we know you care about the research. We also know that you probably want to apply it in practice. But these things take time.

Unless you’re using ChiroUp.

With ChiroUp, you’ll have the resources to deliver the best possible treatment to every patient, every time, then educate your patients with reports that hold their prescribed exercises & ADL’s, and even track your overall patient compliance & satisfaction.

No other system does what ChiroUp does.

So, what’s next? I’m going to include the link to ChiroUp’s 14-day trial. Getting started with the trial is as simple as plugging in your name & email. (no credit card required) Check it out right now, and see how ChiroUp impacts your practice outcomes — we think you’re going to like what you see.

About the Author

Dr. Tim Bertelsman

Dr. Tim Bertelsman

DC, CCSP, DACO

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 past president of the executive board.

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