All posts in Knee pain

Tailbone Pain

The Zimmer EnPuls and the PiezoWave system is intended to relieve pain, improve circulation and reduce inflammation of myofascial pain. It is especially helpful for coccyx pain, tailbone pain, knee pain, low back pain, hip pain, plantar fasciitis and tendon injuries.

Other indications for the Zimmer EnPuls and PiezoWave include chronic painful muscular hardening, myofascial trigger points in the areas of the: Upper extremities; Cervical spine; Shoulder girdle; Thoracic spine and lumbar spine; Hip area; Lower extremities.
If you have tried other therapies and been disappointed or did not get the results you expected, please call the office at 310-444-9393 to experience the pain relief effects of the Zimmer EnPuls and the PiezoWave technology.
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Deep Muscle Stimulator (DMS) massage is better than a deep tissue massage

Both massage and DMS release muscle tension, body aches, and helps you to relax.

Deep Muscle Stimulator massage is a technique that focuses primarily on the deeper layers of muscle and fascia. The DMS method uses a hand-held vibration percussion device that oscillates to provide soothing pressure that gets difficult muscle ‘knots’ to release. DMS massage is for people who like massage and want a slightly more intense focused approach. DMS therapist are trained to target the taut, tender, and sore spots and hold the device to target the sore muscle and myofascial layer. The DMS massage is not painful yet it reveals the tender and sore spots.

Deep Muscle Stimulator massage eases pain

Deep Muscle Stimulator massage releases pain and increases blood flow. Deep Muscle Stimulator massage has been shown to decrease pain in chronic low back patients, shoulder pain, calf muscle tightness, plantar fasciitis, tennis elbow, tailbone pain, hip pain, and sports injuries.

Deep Muscle Stimulator massage increases range of motion

Most people don’t like stretching but if you have scar tissue from old injuries or prolonged and poor posture (sitting slumped over) you need to make the scar tissue softer and more pliable. And that’s what DMS helps to do. Muscle tissue should resemble raw meat, and not be dried out like beef jerky! The surfaces underneath the skin should slide and glide. If everything is stuck together, and it doesn’t slide and glide, it needs to be changed.

DMS helps to remix the water (circulation) with the taut and tight muscles so they can slide and glide again, releasing tension in the stuck muscles. DMS helps regain softness in the muscles, so they contract and release better to increase your range of motion.

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Chiropractic & Sports Medicine

Chiropractic manipulation does not reposition a vertebra from a misaligned position to an aligned position. Rather, it is likely that manipulation breaks up adhesions present in the joints of the spine, which improves movement asymmetries and/or stimulates mechanoreceptors – thereby reducing spinal muscle excitability, enhancing proprioception and reducing pain.

While manipulation has been proven effective for the management of acute low back pain, a prospective placebo-controlled study by Senna and Machaly demonstrates that long-term chronic low back pain sufferers respond best to maintenance manipulations performed bimonthly for up to nine months. The authors suggest the occasional (Chiropractic) manipulations may allow for the “early treatment of any emerging problem, thus preventing future episodes of low back pain.”

My sports medicine and chronic pain therapy approach of using the DMS (vibration, percussion), EnPuls (radial shockwave), Piezowave (acoustic shockwave) and massage  in conjunction with chiropractic enhances the breaking up of disruptive and painful scar tissue.

  1. Tullberg T, Blomberg S, Branth B, et al. Manipulation does not alter the position of the sacroiliac joint: a roentgenstereophotogrammetric analysis. Spine, 1998;23:1124-1128.
  2. Cramer G, Tuck N, Knudsen J, et al. Effects of side-posture positioning anti-posture adjusting on the lumbar zygopophyseal joints as evaluated by magnetic resonance imaging: a before and after study with randomization. J Manip Phys Ther, 2000;23:380.
  3. Nansel DD, Peneff A, Quitoriano J. Effectiveness of upper versus lower cervical adjustments with respect to the amelioration of passive rotational versus lateral-flexion end-range asymmetries in otherwise asymptomatic subjects. J Manip Phys Ther, 1992;15:99-105.
  4. Nansel D, Waldorf T, Cooperstein R. Time course effect of cervical spinal adjustments on lumbar paraspinal muscle tone: evidence for facilitation of intersegmental tonic neck reflexes. J Manip Phys Ther, 1993;16:91-95.
  5. Lehman GJ, McGill SM. Spinal manipulation causes variable spine kinematic and trunk muscle electromyographic responses. Clin Biomech, 2001;16:293-9.
  6. Childs JD, Fritz JM, Flynn TW, et al. A clinical prediction rule to identify patients with low back pain most likely to benefit from spinal manipulation: a validation study. Ann Intern Med, 2004;141:920-928.
  7. Cleland J, Fritz J, Whitman J, et al. The use of a lumbar spinal manipulation technique by physical therapists in patients who satisfy a clinical prediction rule: a case series. J Orthop Sports Phys Ther, 2006;36:209-214.
  8. Senna M, Machaly S. Does maintenance spinal manipulation therapy for chronic nonspecific low back pain result in better long-term outcomes? Spine, 2011 Aug 15; 36(18):1427-37.
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ERGONOMICS: #1 Tip to Prevent Knee Pain

Look at what you are doing right now when it comes to your knee. Are you sitting down with your knees bent? Are your feet crossed? Are your feet behind you and under your chair?

All of these positions put greater stress on the knee, leading to irritation of the knee, which leads to knee pain.

The happiest position for your knee is when it is straight. As the knee joint bends, greater stress is put on the joints and ligaments. Basically as you bend your knee, your kneecap presses against your knee, leading to anterior knee pain. If your knee is bent, you increase the tension in the ligaments in the knee, such as the ACL, which can lead to ligamentous knee pain. Lastly if you have internal knee pain, the greater the knee is bent, the more it puts unnecessary stress inside the knee joint.

If you sit in this bent knee position for hours, it will progressively make your knee pain worse.

Quick Fix: While you are sitting at your desk, on the couch, in a meeting, or watching a movie, remember to keep your knees straight when you can to decrease stress on the knee.

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Knee Pain

First, laser the knee area. Laser is a deep heat that does provide pain relief.

Next lets talk about weight loss if needed. Every pound you lose reduces stress across the knee by 3-4 pounds, even higher if you climb stairs or attempt to run. Don’t run, jump, or do anything that involves impact to your knee.

Next lets talk about natural remedies like fish oil and Bosweillia as effective and helpful. Use BioFreeze cream to rub on the knee! Let me put kinesio-tape on your knee.

Next let me teach you the proper exercises. The best long-term method to relieve pain and restore function is consistent low impact exercise. Exercises that stretch and strengthen the muscles around the knee, not only provide support and maintain motion of the joint, but stimulate endorphins and intrinsic growth hormone release — both of which help to relieve the pain of arthritis.

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My approach to chronic pain, muscle pain, joint pain, and  weight loss

Chiropractic. The goal of this treatment is to significantly decrease symptoms such as pain, tightness, stiffness, soreness, aches, and improve athletic performance, mobility, and your ability to perform general activities.

Laser. Evidence for the effectiveness of laser is strong. Patients feel the relief especially for knee pain and TMJ pain

Shockwave therapy. This form of medical treatment is acknowledged as a means for enhancing scar tissue mobility and breaking up muscle tightness and muscle and joint adhesions. It is also helpful for chronic pain reduction and improved mobility. It helps osteoarthritic symptoms with improved functional mobility and quality of life.

Along with laser, Deep Muscle Stimulator (DMS), shockwave therapy is effective for pain control of osteoarthritis of the knee, neck pain, low back pain, and increasing mobility.

Deep Muscle Stimulator Massage. Followed by hands on therapy, DMS is the most commonly utilized treatment in my office. Patients feel better after this type of massage than receiving a regular hand massage. They have significant improvements in pain, stiffness, and physical function.

Dietary supplements. I use a variety of products from Metagenics, Xymogen, Designs for Heath, and Standard Process for joint pain, arthritis, inflammation, and weight loss.

Widening the integrative approach to treatment

There is emerging evidence that integrating multiple conventional and alternative therapies such as chiropractic, exercise, laser, shockwave, DMS, lymph therapy provide the best results for patients.

If you are a person who still has pain and diminished mobility who has already explored other therapies and doctors but have been disappointed, I would like the opportunity for you and I to meet. I continuously evaluate the increasing body of evidence in support of new therapies, and I am confident in offering my patients a wider range of choices than standard chiropractic care.

Call 310-444-9393 for an appointment

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Knee Pain & Osteoarthritis Treatment

I coined the term POLITE Method for how I treat my patients. The ‘P’ is for improving posture and creating a plan of treatment.

The ‘OL’ is optimal loading. This means figuring out self-management activities  for knee pain that are not too easy and not too difficult.

The ‘I’ in instruments that I use in the office for knee pain such as laser, DMS, and shockwave therapy that give effective short- and long-term pain relief benefits.

‘T’ is for taping  the knee and I’ll teach you how to apply simple kinesio-tape to the knee for pain relief.

‘E’ is for education regarding the progressive nature of osteoarthritis (OA) and for pain management education; joint-sparing exercise advice including daily walking, balance tips, and falls prevention; and emotional and cognitive skills to improve quality of life; Eating for weight loss for those who are overweight or obese. Weight loss has been shown to improve mobility and reduce pain. For every one pound of weight lost, there is a 4-pound reduction in the load exerted on the knee for each step taken during daily activities. A weight loss of only 15 pounds can cut knee pain in half for overweight individuals with arthritis.

A low-carbohydrate diet has been shown to reduce weight in obese patients by ?10% and lead to improvements in self-reported scores for overall progress and functional ability.

If you like my POLITE approach call 310-444-9393 for an appointment.

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Chronic Pain, Foot Pain, Hip Pain, Inflammation, Neck Pain, Shoulder Pain, & TMJ Pain

If you have any of the above, have you tried Pneumatic Lymphatic Pump Therapy?

One of the most neglected systems of the body is the Lymphatic system. An innovative treatment for chronic pain, foot pain, hip pain, inflammation, neck pain, shoulder pain, & TMJ pain is Lymph Drainage Therapy (DLT). In my office I use state of the art technology called LymphaTouch for DLT. Benefits of the LympaTouch Pump Therapy include reduction in limb circumference, pain, increase in range of motion, scar mobility and improved functioning of the immune system. The immune system is stimulated through increased lymph flow. The additional flow carries more antigens to the lymph nodes, thereby increasing antibody/antigen contact. This has been found to help with chronic or subacute inflammatory processes — chronic fatigue syndrome, autoimmune disease, bronchitis, sinusitis, tonsillitis, laryngitis, arthritis, acne and eczema.

Call 310-444-9393 to schedule an appointment

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DMS

DMS can be applied to all soft tissues in the body resulting in a focused, precise, deep tissue massage. During the initial contact on the body, the device is used to scan for areas within the soft tissues that feel dense, taut, ropey, tender, and overactive. You might feel areas that present a lack of motion and contain trigger points. These areas may be sensitive or painful but the DMS itself is not causing the pain, rather it is revealing tender or painful structures. DMS therapy is highly amenable to myofascial trigger point pain. The vibration and percussion will promote relaxation within the muscle system and lymphatic drainage that helps move trapped fluid that has a tendency to accumulate in some individuals. Breaking up trigger points and providing relief from fluid stagnation are two important benefits of DMS.

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Pain Relief with PiezoWave Shock Wave Therapy

We are the first office in Los Angeles to offer the PiezoWave therapy. The PiezoWave machine supplies an acoustic wave used to target tissues at varying depths (0 to 20 mm). It is a very focused, precise, deep tissue therapy. The device locates myofascial trigger points in the muscles. These are hyper-irritable spots located in a taut band of skeletal muscle. They generate pain, both locally and in referred pain patterns, and often accompany chronic musculoskeletal disorders. PiezoWave is being used for regional pain, especially in the neck, shoulders, low back and hip areas. If you know you have tension headaches, temporomandibular joint pain, decreased range of motion in the legs, and low back pain, even if you have tried other therapies like laser I would suggest a trial of PiezoWave.

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