All posts in Conditions

Gluten Intolerance

The inability to digest gluten, which is the protein found in wheat, rye, and barley, is affecting many patients. Celiac disease – an incurable immune reaction to gluten – is the extreme sensitivity to gluten. People who react to gluten but not as severe as Celiac Disease call  it gluten intolerance.

Celiac disease is incurable and a permanent conditions. Gluten Intolerance has some good treatment options. The only way to avoid their damage is to avoid eating even tiny amounts of wheat, rye, or barley.

I ask my patients with chronic digestive issues and chronic joint inflammation complaints to  go gluten-free for a 21 day challenge.

I recently had dinner with a friend at a local LA restaurant. The waiter and chef both knew what “no gluten” meant, and even left the bread off an appetizer plate we shared so that there would be no cross-contamination. There was no flour in anything he ate that I could see. Yet, shortly after dinner he began having digestive distress (bloating). Luckily we could walk back to my office where I had an enzyme to give him that digests gluten. Quickly his symptoms disappeared.

Going gluten free is a challenge –  even a smidgen of flour on a cook’s hands or a splash of soy sauce in a sauce can set off digestive problems or silent inflammation in some people.

Feel free to schedule an appointment to discuss if you need enzymes that digest gluten. Taking them can make the difference between being successful on a gluten-free diet and failing.

Meanwhile, watch out for the obvious: wheat, barley, rye; fish and chicken dusted with flour; and salad dressing made with soy sauce.


Coccyx Pain

Coccyx area pain can be constant and severe. This is one of the conditions that more people from far away places have contacted me for advice and treatment. It commonly results from a traumatic onset such as a fall, prolonged and repeated pressure to the area from sitting (improper position or hard surface chair), or a direct blow from a sports injury. Some Mom’s present with coccyx area pain after childbirth. During the last trimester of childbirth, the coccyx becomes more mobile, allowing for greater multidirectional movements. In my patients who have presented with a history of trauma, I have not seen many overt coccyx fractures on x-ray, but I suspect bone bruising and micro-fractures. I have seen on x-ray dislocation at the sacrococcygeal joint (usually an anterior coccyx) causing significant pain and discomfort during sitting, sitting-to-standing, and even walking.

My treatment approach has been very successful in giving patient’s the proper recommendations and the following modalities and hands-on therapy:

Warm laser to the joints and soft tissues

PhysioTouch negative pressure over the sacrolumbar region

Hands-on gentle soft-tissue and mobilization therapy


Shock Wave Therapy (Radial Shockwave Therapy)

Radial Pulse Therapy also known as Radial Shockwave Therapy has and is gaining popularity for the adjunct treatment of superficial orthopedic conditions especially myofascial conditions and tendinopathy. This is do to: some clients need overly dense fascia, scar tissue, soft tissue and joint adhesions broken up; doctors like using new technology; and some clients need a device with specific magnitude of forces (Joules) and a controlled speed (Hertz) applied to the muscle/tendon/bone unit in order to achieve the goals of restimulating the healing process.

As practitioners, it is important to correctly identify the patient’s biggest dysfunction. I often ask myself, “What’s the biggest issue?” Is it pain related to repetitive trauma, microtrauma, macrotrauma, obesity, poor nutrition, lack of motor control, poor strength, poor mobility, etc. Once the treatment plan is initiated, we must have positive short term responses from our treatment decision to obtain long term adaptation. In this regard, I have the experience of working with Radial Pulse Therapy for rotator cuff tendinopathy, achilles tendinopathy, plantar fasciitis, patellar tendinopathy, tennis elbow, iliolumbar and thoracolumbar fascial dysfunctions. I like being able to offer treatment options especially after patients have tried medications and glucocorticoid injection therapy for tendinopathy, trigger points and fascial adhesions.

To read the full article:


Lymphatic System & Fascial Treatments

The lymphatic system takes care of our immune system and dead cell removal; if there is injury, or tissue damage, even from surgery (a controlled trauma) there will be an extra accumulation of proteins, such as the GAGs (glycosoaminoglycans) that may be handled improperly by the tissue. The lymphatic system will participate in taking care of it. Even manipulation will produce body waste and the lymphatic system will take it away. The lymphatic system follows the fascial system. The fascia requires movement and the PhysioTouch offers a dimension I was not normally incorporating into my treatments. Chiropractors, PT’s, massage therapists and acupuncturists spend the majority of treatment pushing into the body. The device pulls tissue away from the body (fascial traction).

Read the full article here:


Knee Pain – Patello Femural Pain Syndrome (PFPS)

Dr. Tucker discusses simple, home-based routines for rehabilitation of PFPS that require little or no equipment and have the advantage of resembling activities of daily living. Read more…


Posture and Body Awareness

Day in and day out, we – and our patients – feel rushed and stressed. Is it any wonder we’ve all distanced ourselves from the body’s signals of discomfort in an effort to get things done? Such messages and signals may manifest as a particular ache or in overall stiffness in the body.

As people sit, stand and walk throughout their day, shouldn’t we provide them with greater consciousness of their poor habits?

Faulty Repeated Movements

One of the first important concepts I try to educate patients on is that repeated movements (especially faulty movements) and prolonged postures result in changes in tissues and movement patterns. This results in a segment developing a susceptibility to move in a specific direction, and this may cause pain because of microtrauma from the stress on the tissues.

For example, consider failure of the stability muscle to hold the lower-limb segments in good posture during the stance phase of running or walking. If the gluteus medius, vastus medialis and tibialis posterior are not functioning optimally, there will be an increase in internal rotation of the femur and valgus positioning of the tibiofemoral joint from heel contact to mid-stance phase. The patella will track laterally, leading to an increase in activity of the tensor fascia latae and vastus lateralis, and the foot will excessively pronate. Such faulty mechanics can be the precursor for Achilles tendinopathy, medial tibial stress syndrome (MTSS) or iliotibial band syndrome.

Read More…


Radial Shockwave Therapy

Shockwave Therapy is a non-invasive treatment involving the delivery of acoustic shockwaves to affected areas of the body to trigger natural repair mechanisms and stimulate healing. I am now using this in my practice for Achilles tendonopathy, plantar fasciitis, shoulder tendonopathy, calcific tendinitis, patellar tendonosis.



Plenty of depressed patients respond using omega-3 fatty acids. Brain cells are coated with fats. And when the fats are omega-3 fatty acids, the cells simply function better. That includes brain cell receptors that process serotonin, the hormone that regulates our sense of well being.  I recommend at least two grams per day. I recall reading one studty that suggested one gram of EPA (an omega-3 fatty acid found in fish oil), taken daily, significantly reduced depression symptoms in patients who had been diagnosed with “persistent depression.”

And here’s the best part: Before the study began, all the patients had been unable to control their depression symptoms with SSRI drugs such as Prozac. If depressed patients followed the EPA protocol for 3-4 months — adding at least 2,000 I.U. of vitamin D3 and a good multi-B vitamin (especially B-12) daily –they often feel improvement without any side effects compared to the drugs.


What to expect on your first visit

My staff will give you forms to fill out – symptom forms, health history forms, insurance forms, etc.
We meet and talk about what brought you into the office. We talk about your past history, and current goals. The most common reasons people come in to see me are for chronic pain relief, acute pain relief, sports medicine, to learn an exercise program, and weight loss startegies.
I start to perform a comprehensive postural evaluation; I’ll watch you walk; I’ll watch you perform range of motion and we will perform other assessments that will give us information about your muscles and joints. Some clients get the Functional Movement Screen (FMS) on the first session.
I might perform a Body Composition Analysis that will tell us your percentage of body fat, lean muscle mass, your water content, how many calories you burn a day along with many other important biomarkers.
I will use my skilled hands to perform the examination.
I might use the warm laser, Deep Muscle Stimulator, Scenar device, or other modalities if you are in pain.
I will most likely begin to talk to you about exercises, stretching, sleep improvement, and nutrition.
Sometimes cases are complex, each session is personal, customized and individual therefore it may take a session or two just to get through the comprehensive evaluation I perform.
Plan on being in the office about 90 minutes on that first session. Follow up sessions are half hour long.


Omega-3 supplements boost bone mineral density in older women

A joint U.S.-Iranian study says that combining exercise with omega-3 supplements may boost the bone mineral density in older women and reduce markers of inflammation.

A daily supplement of 1,000 mg omega-3s in combination with aerobic exercise was associated with increases in bone mineral density (BMD) of up to 19% in post-menopausal women, according to findings published in Nutrition & Metabolism.

In addition, markers of inflammation such as interleukin 6 (IL-6) and tumor necrosis factor alpha (TNF-alpha) were significantly reduced following 24 weeks of supplementation plus exercise, report researchers from Urmia University in Iran and the University of Missouri in the U.S.

These findings are significant for women at risk of osteoporosis, characterized by low bone mass, which leads to an increased risk of fractures, especially of the hips, spine and wrists. Women are four times more likely to develop osteoporosis than men.

Clients (especially post menopausal women) need to commit to the use of long-term omega-3 supplementation and aerobic exercise. 

Seventy-nine healthy post-menopausal women were recruited and randomly assigned to one of four groups: The first group acted as the control and did not receive supplements or an exercise plan; the second group received the exercise plan only; the third group received omega-3 supplements only (1,000 mg omega-3 per day, of which 180 mg was EPA and 120 mg was DHA); and the final group received both supplements and exercise.

The exercise plan involved walking and jogging three times a week at up to 65% of the maximum heart rate.

Twenty-four weeks later, and the researchers found that the combined omega-3/exercise group displayed BMD increases of 15% in the lower back and 19% in the neck of the thigh bone (femur) at the hip.

In addition, the combination group had decreased levels of the pro-inflammatory compounds IL-6 and TNF-alpha by 40% and 80% respectively.

I recommend Metagenics EPA-DHA 720 as part of your daily supplements.


Nutrition & Metabolism; 8(1):71, 2011