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 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.

Chandler Chiropractor AZ: Active Release Technique

Your friendly Chiropractor in Chandler AZ, Dr. Dan Rae, is back at the computer during the lunch hour try and crunch out the article on Popliteus Tendinitis.  You are probably thinking to yourself, “What is this guy talking about.  I have never heard of Popliteus Tendinitis.”  Well, it is a lot more common than you think.


The popliteus muscles acts an an internal rotator (rotates the knee inward) when the knee is non-weight bearing.  Furthermore, it plays a very important role in supporting the Posterior Cruciate Ligament (PCL) and the Lateral Collateral Ligament (LCL), preventing the femur from sliding forward over the tibia as well as preventing varus angulation (inward angulation of the distal segment of a bone or joint).  The popliteus muscles also pulls the posterior lateral meniscus backwards during knee flexion.

These patients generally come into my clinic complaining of symptoms almost identical to Iliotibial Band Syndrome, which is pain on the outer portion of the knee after running or walking downhill.  Many times this injury is confused with Iliotibial Band Syndrome, and the patient does not get better because he/she is being treated for the wrong injury.

Rest and ice is needed in the initial stage of the injury; however, they are quickly replaced by myofascial release techniques Active Release Technique (ART) and Graston Technique to prevent scar tissue formation and chronic shortening of the muscle.  Orthotics have also been shown to be beneficial in the prevention of this injury.

Kinesiology tape as one of the treatment for jumper's knee

Your friendly Chiropractor in Chandler AZ, Dr. Dan Rae, is back at the computer this morning after missing out on writing articles this past week due to a hectic schedule.  Today I am going to address an injury that is very common known as Patellar Tendinitis, or better known as Jumper’s Knee.



In the image above by MendMeShop, we are able to see the inflammation in the patellar tendon just below the knee cap (patella).  The pain is felt at the at the patellar tendon or at the attachment to the patella or at the attachment of the patellar tendon to the tibia at the tibial tuberosity.  Pain is increased when attempting to straighten the leg against resistance when bent beyond 90 degrees.  This injury is usually caused due to repetitive stress to the patellar tendon from activities such as jumping and running.

These patients come into my office, generally athletes, complaining of pain just below the patella when running and jumping.

Treatment for Jumper’s Knee is very simple including RICE (rest, ice, compression, and elevation).  Kinesiology Tape is often applied to decrease the amount tension being placed on the patellar tendon.  Gradual return to full activity is highly recommended with initial avoidance of plyometric type exercises.  Those who do not follow the aforementioned protocol may accrue a chronic, difficult, often career-limiting disorder.

Why Choose Chiropractic Care for Back Pain

Today, natural treatment for back pain is the most sought after alternative by many as opposed to traditional medical treatment. About 22 million Americans are now seeking chiropractic care annually, 35% of which are people who are experiencing back pain due to automobile accidents, sports injuries and more. Other concerns include neck pain, arms, legs and even headaches.

Chiropractic Care Explained

Chiropractic care is a health care and not a treatment for any disease. This type of modality mainly focuses on disorders of the musculoskeletal system and the nervous system including its effect with regard to one’s general health.

Chiropractic care is an alternative solution to ease the pain particularly in the muscles, bones, joints, and connective tissue. This is also sometimes practiced in conjunction with conventional medication.

Chiropractors or chiropractic physicians are well-trained individuals who practice a drug-free and hands-on approach towards all aspects of a person’s health. Primarily, they will ask for the patient’s history. Then performs physical examination, diagnosis, and lastly, determining the proper treatment plan appropriate to each individual’s back pain concerns.

They are also trained to provide and recommend rehabilitative and therapeutic exercises, nutritional and dietary counseling and lifestyle counseling to address back pain. The therapeutic procedure includes “spinal manipulation”, also known as “chiropractic adjustment.”

How is spinal manipulation performed? By simply applying manual and controlled force to hypomobile joints due to a tissue injury, it will help restore mobility thus alleviating muscle tightness and pain. Doing so will allow the tissues to heal and eventually stop the pain completely.

Why Choose Chiropractic Care?

• The use of spinal manipulation or chiropractic care is guaranteed to be safe and effective especially in treating acute back pain. Acute lower back pain is usually caused by sudden injury resulting from lifting furniture or moving hefty items in the house.
• Chiropractic is also effective in treating neck pain and headaches.
• The moderate pressure applied through deep tissue massage may also ease the pain of osteoarthritis and fibromyalgia.

Chiropractic treatment is done with accurate diagnosis of your back pain, therefore, it is vital that your chiropractor is knowledgeable of your medical history, current medical conditions, ongoing medications, and of course, your present lifestyle. Informing your doctor about this information will assure you of great results and fast recovery. 


About the Author:
Dr. Dan 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.