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Calcific Tendonitis of the Shoulder (Rotator Cuff)

My experience using shockwave for shoulder problems are good outcomes. My patients see pain levels go down, range of motion improves, and activities of daily living (arm reaches, lifting, carrying, and sleeping) gets better. This suggests the treatment is helping and decreases inflammation associated with calcific deposits. I think the individualized protocols I use for treatment such as number of pulses, the variety of applicators I use, frequency of treatment, as well as having the use of 3 different types of pulse therapy machines makes a difference. I can also use Pulse EMF and laser light approaches to help difficult shoulder cases along.

Bannuru et al. (2014) conducted a systematic review (n=28 RCTs/1307 subjects) of the evidence to assess the efficacy of Extracorporeal Shock Wave Therapy (ESWT) in patients with calcific and non-calcific tendinitis. The outcome measures included pain, function and calcification resolution which was evaluated only in calcific tendinitis trials. High-energy Shock Wave Therapy was found to be statistically significantly better than placebo for both pain and function.

In a 2013 systematic review and meta-analysis, Loppolo et al. looked at ESWT compared to sham treatment or placebo for calcific shoulder tendinopathy.  Greater shoulder function and pain improvements were found at 6 months with ESWT over placebo.

Lee et al. (2011) performed a systematic review of RCTs examining the midterm effectiveness of ESWT for calcified rotator cuff tendinitis. The review found consistent evidence of midterm effectiveness of ESWT in reducing pain and improving shoulder function.

Call 310-444-9393 for an appointment. 

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Achilles Tendonitis

I have treated many cases of Achilles tendinopathy (tendonitis) using pulse wave therapy also known as shock wave therapy or extracorporeal shock wave therapy (ESWT).

In 2015, Mani-Babu et al. reported results that there is evidence for short-term improvements in Achilles problems with ESWT.

A 2017 Health Technology Assessment (HTA) review showed efficacy of ESWT for treating Achilles tendinopathy. They showed significant pain improvement while running or playing sports.

For patients with Achilles tendon pain or dysfunction I recommend a trial of therapy. This may involve the use of sound therapy (shock wave, pulse therapy, pulsed EMF, radial therapy) along with light therapy (laser). This is why I call my specialty sound & light therapy. I teach my patients stretches and strengthening exercises for this condition. I also use nutrition and topicals to help patients get out of pain as quickly as possible.  

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Shock wave therapy, Extracorporeal shock wave therapy (ESWT), also referred to as Pulse wave therapy.

Extracorporeal shock wave therapy (ESWT) is also referred to as Pulse wave therapy.

Pulse wave therapy is a noninvasive treatment that that uses the force of a sound wave with the goal of reducing pain and promoting healing of the affected area. The mechanism by which pulse wave therapy achieves a therapeutic intervention is that it may disrupt fibrous tissue allowing for the subsequent promotion of revascularization and healing of tissue. Controlled shock wave therapy may damage cell membranes so that nerve messengers (nociceptors pain receptors) cannot build up a potential to transmit pain signals. It is also thought that the shock waves (pulse waves) will break up fascial adhesions, scar or calcium deposits, loosen tight tissue structures, promote resorption of calcium, thereby decreasing pain and improving function. (Hayes 2016a)

I am the only doctor in Los Angeles with 3 different types of pulse wave therapy machines. This allows me to use the best evidence from each of the devices, plus my 7 years of experience using pulse wave therapy, and patient preferences to provide you with the best care.  

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Dizziness &/or Vertigo

Patients with asymmetric restriction in neck rotation and increased neck muscle tension have a tendency to have dizziness and/or vertigo.  

If you have a history of whiplash, or reduced neck range of motion, or shoulder (trapezius) muscle tension, or neck pain accompanied by headache and dizziness, these problems may result from lifestyle factors, habitual posture and neck muscle imbalance that can be helped by hands-on therapy and use of specific instrument tools that reduce muscle tension and joint dysfunction.

Studies of patients with dizziness suggest that primary anxiety disorders cause dizziness in about 30% of the dizzy population, anxiety and depression may be a result of dizziness as well (Staab JP, et al 2003). The rest may be related to the neck.

Dysfunction of the neck muscles (something you probably feel too) and neck joint dysfunction (something we can determine together) can be detected and treated by a visit with me.  Call 310-444-9393 to schedule.

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Post Concussion Nutrition

Question: Dr. Tucker, what supplements or nutrition do you recommend for someone with post-concussion symptoms?

I recommend the following top 10 supplements & foods:
Fish oils DHA, EPA approximately 3-10 grams per day
Boswellia & Tumeric together
N-Acetyl Cysteine
Magnesium threonate
Branch Chain Amino Acids
Green Tea Resveratrol 
Creatine
Eat plenty of fish, walnuts, flaxseed, dark leafy greens, pumpkin seeds, squash, beans, lentils, avocados

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Dr. Jeffrey Tucker – Chiropractor, Los Angeles

I am a specialist in biohacking, Sports Medicine, Exercise therapy, wellness concepts, diet and nutrition.  I have enhanced training as a hands on (high touch) practitioner and I continue to be an early adopter of advanced technology. I teach other practicing doctors around the world.

Your first office visit with me is about one hour of time together. My follow up visits are at least 30 minutes (with me). You might need 2-6 hours with me but we spread it apart because some people need the time to heal between sessions. I don’t have the time crunch other doctors have.

I embrace the team approach working with your other health care practitioners (trainer, doctors, Pilates, nutritionist, etc.)

I have a full time health coach in the office helping patients with diet if you need that help. We use the ketogenic diet if you need help to lose weight.

I have in the office a certified instructor in the ELDOA method to share with you what postures, poses, and exercises will help you be in better shape as you age.

I am well trained to treat chronic pain. I have laser therapy, pulse wave therapy, lymphatic therapy and PEMF.

I am helpful at decreasing pain, decreasing muscle stiffness, improving your disc hydration, losing weight, helping you get active and stay active,  and improving overall performance.

I want to help people reach their greatest (fullest) potential.

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Weight Loss

“Its poor dietary advice that’s contributed to making my generation overweight” says Dr. Jeffrey Tucker.

“With my Ideal Nutrition & Weight Loss program we teach you to understand what’s a good protein, a good fat, and a good carbs. Our goal is to help you lose weight and get healthy right now!”

You’ll learn to eat foods that help you lose weight and lower your risk of heart disease, stroke and type 2 diabetes.

Everyone is finally talking about the real cause of obesity and heart disease and other undesirable aging consequences i.e. dementia, Alzheimer’s disease, memory loss. The primary culprit is chronic inflammation. And that inflammation is triggered, in part, by consuming not the hamburger… but the bun, the French fries and all the other processed foods loaded with refined carbohydrates.

We recommend you do these 3 things to help get started:

  • Stop worrying…call the office and learn about fat metabolism, and how to eat more of the ideal foods, such as vegetables and very little refined carbs and sugar.
  • Do whatever it takes to cut down the stress in your life. It’s known that stress can raise levels of the hormone cortisol, which, in turn, creates inflammation and weight gain. You’ll see that having a weight loss coach to talk to really does decrease stress.
  • Make walking a part of your daily routine, trying to get at least 20 minutes a day.

Jim Nicastro is the weight loss coach working with Dr. Jeffrey Tucker. They will help you get the right weight loss advice, which is built on the groundwork of the most beneficial components of the Ketogenic diet — something that includes lots of good fats, proteins and very little carbs.

Call for an appointment 310-444-9393

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Is Shockwave therapy and laser therapy the right treatment for damaged discs and bulges?

Contact the office at 310-444-9393.
Both Shockwave and laser help damaged disc and bulges by:
• Stimulating stem cells to inhibit disc degeneration and disc herniation. It’s a pretty complex interplay between the stem cells and the immune system cells but the result can be disc tissue regeneration.
• Light and sound therapy may promote regeneration of the outer tissue of the disc and help contain and lessen the bulge (scar tissue formation).
• Light and sound therapy may increase the number of stem cells and other healing white blood cells to the area which brings more oxygen to the damaged disc and accelerates healing by reversing the low-oxygen (degenerative or dying) environment in the spine. Everything heals better and faster with increased oxygen.
• Sound and light therapy reduces and prevents herniation by suppressing the non-healing inflammation.

Cunha C, Almeida CR, Almeida MI, Silva AM, Molinos M, Lamas S, Pereira CL, Teixeira GQ, Monteiro AT, Santos SG, Gonçalves RM, Barbosa MA. Systemic Delivery of Bone Marrow Mesenchymal Stem Cells for In Situ Intervertebral Disc Regeneration. Stem Cells Transl Med. 2016 Oct 11. pii: sctm.2016-0033.

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ELDOA Los Angeles

“I teach and encourage my patient to do a little movement training, a little cardio, improve their nutrition a little, and perform a little brain-train (including meditation, breathing, balance)”. 

Here is an example of a healthy aging plan I will offer a patient who presents with on-going low back pain, is a little overweight (and knows it), and is deconditioned:

  • Goal: Reduce LBP and lose 10 lbs.
  • Analyze the patient and provide treatment that includes hands-on  therapy, fascial manipulation, shock-wave therapy, ELDOA, deep muscle stimulation, etc.
  • Create in-office time to train the patient in what exercises to perform at home on their own (based upon their performance).
  • Provide a prescription for future ELDOA fitness sessions.
  • Perform body composition analysis, and recommend diet and nutrition that is leveraged to achieve weekly fat-loss goals.
  • Establish a time frame; for example, three months. The big goal is subdivided into small weekly increments.
  • Establish weekly mini-goals; if each weekly mini-goal is attained, we eventually end up at the predetermined overall goal.
  • Continually issue “report cards” via assessments to keep the patient motivated and on track.

To read more…

http://www.dynamicchiropractic.com/mpacms/dc/article.php?id=57541

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Hip pain treatment options

Patients often come see me to get second or third opinions about hip pain. They may have been told by another doctor that they need injections or hip replacement surgery. They tell me that there orthopedic surgeon said “it’s the only way” or “I have bone on bone rubbing.” Nobody wants a surgery that they are unsure of having. The risks, the time out of work and play… I get it!

In the Journal of Medical Internet Research they say (1) “Despite the availability of evidence?based guidelines for conservative treatment of osteoarthritis, management of degenerated joints is often confined to the use of painkillers and waiting for eventual total joint replacement.” There are many treatment options available to you before surgery and we should not just wait it out. If injections or surgery is right for you, I am the first person to suggest it. BUT, I still like to offer non-invasive therapies along with education and possible gentle exercise to do (2).

STEM CELL stimulation is OPTION
If you are middle age or older and enjoying good health but diagnosed with osteoarthritis (degenerative hip disease) in your hip(s) using x-rays or MRI and experience pain, discomfort, and/or stiffness, you will want to examine all treatment options.

Pulse Wave Therapy (Storz, MiracleWave, PiezoWave) is effective to stimulate STEM CELLS
Laser Therapy (Class 3B, Class 4)  is effective in treating hip osteoarthritis pain

PEMF (MagnaWave) is also helpful in cell regeneration and decreasing pain

The combination of the above is helping many patients take surgery and injections off the table.

To schedule an office visit call 310-444-9393

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