All posts in Posture

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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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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Advances Seen in Scar Tissue

By far the most common type of musculoskeletal pain is from repetitive stress injury or little traumas on top of another little trauma, on top of another little trauma, etc. These lead to scar tissue or adhesions underneath the skin in the fascia, joints and muscles. Soft tissue therapy is the most effective treatment for these types of injury.

I have been personally taught how to use the Deep Muscle Stimulator (DMS) by the inventor (Dr. Jake). I am also the only Doctor in Los Angeles with a class 3B laser, a class 4 laser, and two shock wave machines, and the DMS. I have innovative treatments available for patients with musculoskeletal disease, poor posture, tendon issues, scar tissue, sports injuries and movement limitations.
More patients than ever with chronic pain, lack of movement, and poor posture are regaining all or some function related mobility. The quicker a patient can be evaluated and appropriate treatment started, the greater the chances of movement improvement and preservation.
Call 310-444-9393 for an appointment.
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Pain & Posture

I’m a world-renowned Chiropractor, specializing in chronic musculoskeletal pain and sports injuries. I teach my patients about exercise, diet and injury prevention. I’m a specialist, an author, a patent holder, and I have a Diplomate Degree in Rehabilitation.

I’ve learned from healthcare professionals, physical therapists, trainers, coaches and other therapists from all over the world since 1982. My methods are a combination of all of my teachers, current research, and my own experiences working with my patients on a day to day basis in the office.

I’ve given hundreds of live presentations to thousands of health professionals in the US, China, Brazil and Canada, and you may have read about some of my pain relief recommendations and exercises in Dynamic Chiropractic, The American Chiropractor magazine, and more.

I enjoy my work helping people overcome acute and chronic pain. I embrace modern day technology for pain relief such as laser therapy, shockwave therapy, Deep Muscle Stimulator and soft tissue techniques.

What I’ve noticed in the medical field, is a lack of one on one attention, understanding, and useful HELP offered to people suffering from muscle and joint pain. I want to make care and treatment simple for people who desperately need it.

If you are not sure what to do, if you don’t know what exercises or movements are OK to do, or you even dread exercise, if you dread taking pain pills, if you can’t do what you want to do, if you feel fatigue or irritated by pain, I want to help you recover what was lost and perform at your peak level.

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Sit-Stand Desk Benefits

Prolonged sitting is a health risk. Sit to stand desk workstations allow you to have greater movement variations reducing postural stress. A sit-stand desk may help you burn more calories throughout the day.   

Workers who used sit-stand desks were 78% more likely to report a pain-free day than those who used regular workstations, according to a Stanford University back pain study by Ognibene published in the Journal of Occupational & Environmental Medicine, March 2016.

A 2015 study published in the Journal of Public Health shows that sit-to-stand desks in classrooms appear to be an effective way of reducing sedentary behavior (prolonged sitting) in a diverse sample of children (Clemes).

A 2011 study published by the Centers for Disease Control and Prevention shows that when workers are equipped with sit-stand workstations, prolonged sitting is reduced and mood states improve (Pronk NP),

During the 2013 meeting the American Medical Association adopted policy recognized the potential risks of prolonged sitting and encouraging employers, employees and others to make available alternatives to sitting, such as sit-stand desks.

If you need a doctors note for a sit-stand desk at your workplace, please call the office to make an appointment at 310-444-9393 so we can discuss your individual needs. I will share my posture recommendations and can help facilitate getting you a proper work station environment.

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Corrective Exercises for Excessive Thoracic Kyphosis Posture Evaluations, Part 8

In previous articles, I have written about normal postural alignment versus abnormal postural alignment, and how abnormal postural alignment can be detrimental to muscle function, is aesthetically unpleasing and might contribute to joint pain.

Since kyphosis is natural in the thoracic spine, we have to identify what excessive kyphosis is, which is typically the problem. Generally speaking, normal for a thoracic kyphotic curve measures 30-35.* Excessive kyphosis is greater than 35.* As doctors, we are used to looking at the static spine from the side to determine kyphosis. Using the Functional Movement Screen (FMS) or other movement analysis, we begin to see the interrelationships of muscle and fascial tissue attachments that may contribute to hyperkyphosis.

For treatment of hyperkyphosis, I often take the “bottom up” approach and teach patients how to lengthen the lateral column of the body, the peroneal group, iliotibial band, tensor fascia lata, lateral gluteal complex, quadratus lumborum, oblique complex, latissimus dorsi, and shoulder musculature to influence the kyphosis. When treating hyperkyphosis, always check the flexibility of the ankles, hips, adductors and anterior shoulder complex. The hip flexor tissue is fascially attached to the abdominal fascia, which connects to the external obliques, connecting to the pectorals, joining to the deltoids. As these structures become tight, they can influence thoracic kyphosis.

Read More… http://www.dynamicchiropractic.com/mpacms/dc/article.php?id=55374

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Functional Movement Analysis (Part 6)

Do you ever feel weird when new patients come in who have been to other chiropractors and say, “Adjustments only provide temporary relief”? I’m sick of hearing it. Don’t get me wrong: I love seeing new patients, but I feel bad that this person almost gave up on chiropractic care altogether! Most chiropractors I meet are warm and caring, and they have a curious presence about them.

There’s also the business side, of course, and I’m just like you: I need new patients and I want them to stick around for the care and treatment they need. Posture analysis, movement analysis and anti-aging strategies are methods I focus on in my “rehab” practice to create long-term relationships. As we walk this pathway and journey of chiropractic – engaging the study of posture – we cross the broad terrain of static posture into functional movements. Using functional movement analysis, I see more clearly who patients are and how their individual range of flexibility and strength within a single body segment is connected to the greater whole.

Read more… http://www.dynamicchiropractic.com/mpacms/dc/article.php?id=55184

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The Shoulder and Scapula Posture Evaluation, Part 3

Let’s discuss normal shoulder resting posture so we can determine if there is a link between a postural deviation and pain. Static postural analysis is performed before range-of-motion examinations, orthopedic testing, movement pattern assessments and palpation analysis. When I perform a static posture evaluation, I focus on subtle asymmetries or deviations from normal patterns to aid my diagnostic decisions and treatment transition decisions (passive care to active therapy). I allow myself the time to pause and focus on what I see posturally before beginning other procedures. The changes I see in static posture and functional-movement assessments, visit to visit, help me navigate through the treatment process.

I ask the patient to stand with their shoes off, hands at their sides, in their normal, relaxed position. The evaluation is done with the person in a standing position, which accounts for the normal effect of gravity on the individual. I observe the patient from the front, side and posterior. I look to see the person’s chronic holding patterns.

Look for postural deviations, including forward head, forward shoulders (scapular protraction), humeral internal rotation, and increased thoracic kyphosis. All of these deviations have been implicated in the development of shoulder pain.1-4 

Read More…. http://www.dynamicchiropractic.com/mpacms/dc/article.php?id=54845

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Forward Head Posture Part 2

According to Dr. Al Sears, muscle is the first physical sign of aging, in the sense that people who age well are often well-muscled, which protects them from age-related ailments including pain and disease.

Evaluating Posture Distortions

I know that evaluating forward head posture leads to one of those “chicken and egg” questions. Is it ascending or descending; from top to bottom or bottom to top? Sometimes I know the answer and sometimes I have to guess. I just look for patterns and sequences of how all this stuff works together in my patient’s big picture. For example, have them sit on a chair or a stool; observe from the side as they sit down and stand up. Watch the head and neck area only. The normal pattern is for them to lead with the posterosuperior aspect of the head. If the SCMs and suboccipitals are dominating, they will lead with the chin. This is a faulty pattern…Read more…  http://www.dynamicchiropractic.com/mpacms/dc/article.php?id=54719

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Improving Posture

Like you, I keep looking for better ways to help patients out of their ill-health predicaments. Specifically, I look for that deep meaning of what the person’s musculoskeletal system is trying to say to me while I look at their posture.

So much gets revealed to me through posture evaluations. Standing in front of us is a person – usually feeling pain, loss, fear and anger, and with or without acceptance of the distortions they have become. I understand; I have fear about losing my ability to be a recreational athlete and move around without pain. The loss of physical function terrifies me. Looking into the eyes of my patient while I begin to look at their posture creates a “real moment.”

Read more: www.dynamicchiropractic.com/mpacms/dc/article.php?id=54530  (Posture Evaluations, Part 1)

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