Whiplash: CARING FOR ATHLETES AND THEIR FAMILIES

Your friendly Chiropractor in Chandler AZ, Dr. Dan Rae, is back at the computer to discuss a topic that we have all heard about, but I believe that it does not get treated with the seriousness that it deserves.  I am talking about Whiplash.  In almost every car accident there is some sort of Whiplash injury, and a lot of times it just gets written off as something that occurs in a car accident, and we do not necessarily need to address it.  Today, I hope to dispel that myth.

The term “Whiplash” is used to refer to the hyperflexion injury of the neck, and the associated symptoms of this injury that occur during a motor vehicle accident.

This forward-flexion and/or backward-extension of the neck leads to a soft-tissue sprain/strain injury to the structures within the cervical and upper thoracic spinal regions.  When the initial impact occurs and the head is forced in either extreme flexion or extreme extension, protective reflexes cause the muscles of the neck to forcefully contract which “whips” the head back in the opposite direction.  The resulting injury more often than not leads to numerous symptoms, many of which are confusing and poorly understood.

Symptoms following a “Whiplash” accident include:

neck pain, tenderness, achiness and stiffness
cervical muscle spasms
tenderness and nodules in superficial cervical musculature
cervical reduced range of motion
post-traumatic headaches (including migraine and muscle-tension headaches)
shoulder and interscapular pain
hand and finger pain, numbness and tingling
blurred vision
difficulty swallowing/feeling of lump in throat
dizziness and balance problems
lightheadedness
post-traumatic depression and cognitive problems
Whiplash can damage just a few structures or many, depending on the severity of the accident and direction of the injurious forces, to name a few.

Some of the more common pain-sensitive structures that are damaged include:

outer layers of the intervertebral discs
intervertebral ligaments
capsule of the facet joints
anterior longitudinal ligament (runs down the front of the vertebral bodies-prevents excessive extension)
posterior longitudinal ligament (runs down the back of the vertebral bodies-prevents excessive flexion)
nerve root dura
extensor spinal musculature
flexor spinal musculature: the colli and scalene muscles
Damage to any of these structures results in tissue inflammation, tissue edema, microscopic hemorrhage, and the release of noxious chemicals such as histamine, prostaglandins, substance P, and kinins which further hypersensitize already painful and injured tissues.

The most important aspect of a successful treatment program involves active patient participation and patient compliance to the agreed upon program.  When treatments focus solely on pain relief and not tissue rehabilitation or when patients fail to comply with the prescribed treatment plan, developing a chronic condition becomes very likely.

My approach to treating Whiplash has proven to be very successful when compared with other health care professionals because I focus on rehabilitating the injured tissues and restoring function.  This is reflected in the high patient satisfaction scores that my office has received in “patient satisfaction surveys” performed on MVA patients.

Chiropractic Care is a safe, natural, noninvasive, and addresses the actual cause of the symptoms.  Our treatments also include active patient participation, and in some cases, lifestyle changes.  While we do focus on eliminating pain early on, we realize that in addition to pain tissue healing, restoration of normal function, and prevention of future recurrence and re-injury are equally important as well.

Our treatments are highlighted by the use of many gentle and highly effective spinal manipulative techniques.  When performed properly, these techniques allow us to safely and effectively reduce pain, reduce muscles spasms, eliminate inflammation, restore normal joint motion and biomechanics, prevent or minimize degenerative processes, and minimize the likelihood of future recurrence.

We also incorporate many natural and safe adjunctive therapies into our treatment plan to further assist in the healing process.  Some common adjunctive therapies include ice/heat, therapeutic modalities such as ultrasound and electrical muscle stimulation, spinal traction, soft tissue therapies such as Active Release Technique (ART) and Graston Technique, as well as spinal exercises and stretches.

As with any other injury, there are a number of factors which influence the treatment length of Whiplash:

the severity of the injury
when treatment was initiated
patient compliance to the treatment plan
the nature of the accident
the size and speed of your vehicle and other vehicles involved
whether or not seat belts were worn
whether you were aware of the impending accident
the height of the head rest
the age of the individual
the size and strength of the cervical musculature
the presence of preexisting spinal conditions
The easiest and most effective way of eliminating pain and preventing residual and chronic problems is to start care immediately following the accident.  As you allow time to slip by without seeking appropriate treatment, your injuries become more permanent and far more difficult to manage.

Numerous studies show that many Whiplash victims have a relatively poor outcome without immediate and appropriate treatment.  One such study found that 75% of patients with Whiplash still suffer from symptoms 6 months after the accident.  Experts agree that individuals with any degree of neck complaints following a motor vehicle accident dramatically improve their prognosis if they seek immediate evaluation and appropriate treatment within hours of the accident.

Chiropractor Chandler AZ: Hip Stress Fracture

Your friendly Chiropractor in Chandler AZ, Dr. Dan Rae, is back at the computer this morning to write about Hip Stress Fractures.  I do not see Hip Stress Fractures a lot in my practice, but I have dealt with them on occasion making it something that I feel I should address.


In the image above by MMG 2000, we are able to see the different types of Hip Stress Fractures that occur at the femoral neck.  Within the bone we have different types of cells one of which is an osteoclast and the other an osteoblast.  Osteoclasts in a sense eat bone or destroy it, and osteoblasts on the other hand create bone.  With repetitive stress to the femoral neck, microfractures occur.  This damage leads to increased bone remodeling, or the removal of old bone by osteoclasts and the formation of new bone by osteoblasts.  When osteoclastic activity surpasses osteoblastic activity, the bone becomes weakened leading to fracture.

In most cases that I have had in my office the patient is usually young and active, often participating in cross country, gymnastics, dancing, or marching band.  The pain comes on rather slowly and is worse when standing.  The pain is normal felt on the front and deep into the leg.

Treatment for the Tension/Transverse Stress Fracture is different from that of the Compression Stress Fracture.  With the Transverse Stress Fracture surgical pinning is required to stabilize the hip.  With the Compression Stress Fracture an elastic support is necessary as well as rest for 2 weeks.  After the two weeks non-weight-bearing exercises are implemented such as cycling and swimming.  The Displaced Fracture require surgical pinning as well.

Author Bio:
Dr. Rae's professional interests lie in helping the community reach their health potential.  Through hundreds of hours of post-graduate training, Dr. Rae has studied different soft-tissue therapies, studying the muscles and how to help them function appropriately. He specialize in Hip pain.

Chiropractor Active Release Technique: Snapping hip Syndrome

Your friendly Chiropractor in Chandler AZ, Dr. Dan Rae, is back at the computer this morning trying to fit this article in prior to seeing patients today.  In keeping with the hip theme I am going to review a condition called Snapping Hip Syndrome.  A question that I get asked several times each day is why is my hip popping or snapping.  Well, today you will find out one of the main reasons for this.

In the images above by MendMeShop, we are able to see the structures involved in Snapping Hip Syndrome as well as a little bit of how it happens.  Snapping at the hip is most often due to tendons that are tight and snap over a bony prominence or or a fluid-filled sack called bursa.  In some cases, moving the leg away from the body may cause a suction effect similar to joint gapping with manipulation, and even less frequently, a loose body may be found in the joint.  However, with loose bodies, there are also signs of mechanical movement blockage.

These patients are generally in my office for something else when they ask about there hip snapping because it does not generally cause them pain.  The location of the snapping is a good indication of the offending tendon.

Usually this is not a problem, and it is typically position dependent.  If painful or irritating strengthening exercises have proven to be more beneficial than stretching.  However, if the irritation persists stretching can be implemented as well as soft-tissue therapies such as Active Release Technique (ART) and Graston Technique.

Chiropractic Chandler AZ: Osteitis Pubis

Your friendly Chiropractor in Chandler AZ, Dr. Dan Rae, is back at the computer this morning to discuss a condition called Osteitis Pubis.  This is a condition that you want to avoid like the plague if possible because it is quite painful, and many people spend a lot of time trying to get the proper diagnosis all the while being in a substantial amount of pain.

In the image above by RelayHealth, we are able to see the effected structures with Osteitis Pubis.  This occurs as a result of direct compressive or distractive injury causing pain at the pubic joint.  There is usually tenderness at the pubic joint and sometimes there is pain when squeezing the pelvis together.  Muscles tests of the adductor muscles, the muscles the bring the leg toward the mid line, are extremely painful.

These patients come into my office reporting either a sudden forced adduction injury or repetitive minor trauma as seen with kicking or running.  Pregnant women have been shown to be susceptible to this injury during childbirth.

Management of this condition when diagnosed properly is not very difficult.  Treatment includes rest with slow return to activity, and gradually increasing flexibility.  Avoiding the inciting activity is absolutely necessary, especially side-foot kicking or maneuvers that require squeezing the legs together.  An SI belt as seen in the image below can often help to stabilize the pelvis.

If the joint becomes unstable surgical stabilization is required.

Author Bio:
Dr. Rae's professional interests lie in helping the community reach their health potential.  Through hundreds of hours of post-graduate training, Dr. Rae has studied different soft-tissue therapies, studying the muscles and how to help them function appropriately. He specializes in Hip pain or Pelvic pain.

chiroprator active release technique: Hamstring Strain

Your friendly Chiropractor in Chandler AZ, Dr. Dan Rae, is back at the computer as we are starting to warm up outside to talk about Hamstring Strains as runners start to get back out on the roads and so forth.  This is a condition that I see a lot in the spring months as people begin to become more active to try and get those beach bodies

In the image above by MendMeShop, we are able to to clearly see a Hamstring Strain of the biceps femoris muscle.  This condition call also occur in the semitendinosus and semimembranosus muscles.  The reason this injury occurs is from an overcontraction of the hamstring while it is in a position of being stretched.  Tearing occurs most often at the junction of the muscles and aponeurosis (A sheet of pearly-white fibrous tissue that takes the place of a tendon in sheetlike muscles having a wide area of attachment). An Avulsion Fracture (An avulsion fracture is a bone fracture, which occurs when a fragment of bone tears away from the main mass of bone as a result of physical trauma) is possible at the ischial tuberosity (sit bone) in younger athletes whose growth plates haven’t closed yet.

These patients are usually what we would call “weekend warriors” all the way to the serious athlete who feels a sudden pull or pop at the back of the thigh following some sort of forceful knee extension maneuver.

Treatment for this condition consists of rest, ice, use of crutches for several days, gentle stretching as soon as possible as well as soft-tissue treatments such as Active Release Technique (ART) and Graston Technique, and a long-term goal of restrengthening beginning when 75% of the normal range of motion is available.  Kinesiology Tape can be applied to decrease the amount of tension being placed on the hamstring.  Prevention of future injury should focus on preevent stretching, maintaining a proper strength ratio between the hamstrings and the quadriceps (0.6:1), and strength balance between the two hamstrings.

Kinesiology tape: Adductor Strain/ Groin Pull

Your friendly Chiropractor in Chandler AZ, Dr. Dan Rae, is back at the computer this afternoon to talk about the Adductor Strain also known as a Groin Pull or Pulled Groin.  This is an injury that happens quite often, and I would have to say I see it mostly in individuals who do not warm up properly.

The cause of the Adductor Strain is generally from a sudden contraction of the adductor muscles (the muscles that pull the leg back to mid line) from a stretched position where the hip abducted out away from the body or in a flexed position.  The most common site of this injury is at the junction of the muscle and the tendon of the adductor magnus muscle.

These patients usually come into my office complaining pain in the groin area after performing movements such as kicking, sprinting, water skiing, or jumping such as high jumps or hurdles.  They also say that the pain in the groin came on immediately after the movement and was incapacitating.

Treatment for this condition sometimes includes an elastic figure eight strapping around the hip with slight extension and internal rotation of the hip.  Kinesiology Tape is often applied to decrease the amount of tension being placed on the adductor muscles, and myofascial release techniques such as Active Release Technique (ART) and Graston Technique are utilized to prevent scar tissue formation and encourage proper healing.

Chiroprator Chandler AZ: Quadriceps Muscle Strain

Your friendly Chiropractor in Chandler AZ, Dr. Dan Rae, is back at the computer this morning trying to pump out this article prior to patients arriving.  Today, I am going to continue with the thigh and address the Quadriceps Strain.  This injury is not seen as much in my office as the Hamstring Strain, but I do still see it quite frequently.

In the image above by MendMeShop, we are able to clearly see the muscles the form the quadriceps muscle group and more.  The cause of a Quadriceps Strain is due to sudden contraction of the quadriceps, which results in what we often here as a pull, or less commonly, a full rupture of the muscle.  Some reasons that would predispose someone to this injury is tight quadriceps, which generally stems from not properly warming up prior to activity as well as imbalance between the quadriceps of the opposite leg, or one leg being shorter than the other.

These patients generally come into my office complaining of a sudden pulling pain at the front of the thigh after attempting to sprint, whiffing on a kick, or stopping very rapidly.

Treatment for this condition is not very difficult, but must be done properly to avoid more serious problems.  Ice should be applied as soon as possible to control the inflammation and swelling coupled with neoprene or some sort of elastic support.  Kinesiology Tape can be applied to reduce the tension being placed on the quadriceps musculature.  Stretching should be initiated as soon as possible with very gentle stretching.  Myofascial release techniques such as Active Release Technique (ART) and Graston Technique can be implemented to prevent scar tissue formation and chronic shortening of the muscle.  Complete tears or ruptures of the muscle or tendon require surgical repair.

Author Bio:
Dr. Rae's professional interests lie in helping the community reach their health potential.  Through hundreds of hours of post-graduate training, Dr. Rae has studied different soft-tissue therapies, studying the muscles and how to help them function appropriately. He specializes in knee pain, thigh pain and hip pain.