Tennis and Golfers Elbow

 

Soreness or pain at the elbow on the bony bump on the outside is called “tennis elbow”.  Soreness or pain on the inside is called “golfers elbow”.

What causes golfers and tennis elbow?

Golfer Elbow

Soreness and pain occur when the tendons (tough tissue that connects muscles to the bone) on misaligned elbow bones are stretched and irritated by repeated movement of hand, wrist, and forearm.  This can cause tiny tears or inflammation in the tendon.  “Tennis” and “Golfer’s” elbow can also be caused by activities that nor sport related such as:

  • Painting
  • Computer work
  • Carpentry
  • Typing
  • Gardening
  • Knitting

Tennis Elbow

What are the symptoms?

The first sign of golfers or tennis elbow is usually tenderness and pain when pressing on the epicondyles (bony bumps) on either the outside or inside of the elbow.  this can progress to a dull, constant pain or sharp shooting pain.  other symptoms include:

  • Pain when the wrist or hand is moved.
  • Pain when lifting a heavy object.
  • Pain when making a first, gripping, or shaking hands.
  • Restricted supination of the forearm and full extension.

How long will my recovery take?

Recovery time depends on the severity of the injury as well as factors such as age, health, and previous injury.  Mild injuries can recover in a few weeks but more severe injuries can take several months to recover.

Treatments

  • Specific chiropractic treatments
    • Clear the subluxation in the spine first to turn on the nerve supply.  It is based on the author’s experience and clinical management that 5th and 6th cervical (neck) are usually the culprits.
    • Lateral radial head (one of the elbow bone) could be misaligned either forward or backward.
    • Lastly, check the wrist if the elbow is free of misalignment.
  • Pain Control
    • Apply ice to your elbow 15-20 minutes 3-4 times a day.
    • An elbow strap or “counterforce” brace is worn around the fullest part of the forearm muscle, just below the elbow.  It eases the pressure on the tendon and spreads the force throughout your arm.
  • Nutrition: Main goal is to supply the body with proper nutrition to enhance recovery time.
    • Omega 3’s: EPA, DHA, and AHA
    • Protein: undenatured whey, rice, or pea.
    • Proteolytic Enzymes, take with empty stomach
    • Chondroitin Sulfate
    • Glucosamine HCL: can be used if no analgesic been taken
    • Vit C
    • Magnesium
    • CoQ10
  • Rehab Exercises & stretch: 
    • Tennis Elbow Stretch: Start with the tender part of your forearm resting on a tennis ball, with your palm facing up. With your unaffected arm, apply a downward pressure onto your affected arm. Maintaining that pressure, move your wrist up and down. You should feel the sore spot moving back and forth across the tennis ball.
    • Golfer Elbow Stretch: Start with the tender part of your forearm resting on a tennis ball, with your palm facing down. With your unaffected arm, apply a downward pressure onto your affected arm. Maintaining that pressure, move your wrist up and down. You should feel the sore spot moving back and forth across the tennis ball.
    • Eccentric Wrist Flexion: Sit erect with your affected forearm supported on a table with your palm facing upward. Use your non affected hand to assist with flexing the wrist. Then let go of the support and slowly control the affected down eccentrically to the start position.
    • Eccentric Wrist Extension: Sit erect with your affected forearm supported on a table with your palm facing downward. Use your non affected hand to assist with extending the wrist. Then let go of the support and slowly control the affected hand down eccentrically to the start position

Dr. Wu DC is a Gonstead Certified Extremity adjuster and has been taking care of athletes for years.  As usual, feel free to contact us should you have any questions at all.

Yours in health,

Dr. Wu DC
ICON Chiropractic Center

 

Resources:

  1. Kaiser Permanente Physical therapy: 09342-033 (8-11)
  2. Dr. Mark Werking DC.  Werking on Extremities: A specific approach to extremity conditions and care.
  3. BlueJay Engage Health

 

Ankel Sprain

Most sprains are caused by rolling the foot inward.  This can stretch or even tear the ligaments that help support the ankle and foot.  Ligament damage can lead to instability of the ankle and frequent re-injury.  Ankle sprains may take from 6 weeks to several months to heal.  Early treatment, specific chiropractic care, exercises, and bracing can decrease the risk of re-injury.  The information below can help speed up your recovery, decrease your pain and help prevent re-injury.

 

Early Treatment

  • Specific Chiropractic Adjustment: the first 24 hours of injury is considered to be the “golden window”.  The chance of full recovery will increase greatly if the ankle is adjusted within first 24 hours of injury after fracture and complete torn ligament been ruled out. Proper neurological supply, blood supply, and alignment are essential for optimal healing.
  • R.I.C.ERest: avoid painful activities to give your ankle time to heal.  Limited waling and other standing activities when the ankle is painful or swollen.
    • Ice: recommended 20 minutes on and 40 minutes off 3-4 times a day.  Place a thin towel between your skin and the cold pack to prevent a rash or burn.
    • Compression: Swelling is a normal response to an ankle sprain.  Applying an ace bandage can help decrease the swelling and help the healing process.  It is important to re-wrap the ace bandage on a regular basis starting at the toes and finishing well above the ankle.  Avoid wrapping the ankle too tight.  You should be able to easily put two fingers under the wrap.
    • Elevation: keep the ankle elevated above your heart as much as possible during the day.  this will help decrease the swelling and speed the recovery.
  • Walking Aid: use a walking aid like crutches, a cane, a walking stick or a walker until you can walk without a limp. Try to bear some weight on your injured ankle while using the walking aid if you can do so without increasing your pain.
  • Brace: a proper brace should be given based on your condition. Continue to wear this brace until your doctor directs otherwise.  After the ankle has healed, ask your doctor if you should continue to wear the brace with activity.

Early Exercises: Do these exercises without increasing pain or swelling.

  • Aerobic Exercises:
    • a stationary bike can be helpful in the healing process without adding stress to the ankle.  Start with 10 minutes with low resistance.
  • Gentle range of motion: repeat 2-4 times per day
    • Circle the foot clockwise, and then counter clockwise 10 times each direction.
    • gently bring your toes and foot towards your shin and then point your foot and toes away.  Repeat 10 times each direction.
  • Strengthening:
    • Arch raise in sitting/short foot exercises:
      • sit in a chair with both feet on the floor.  Try to raise the arch of your foot while keeping your goes and heel on the floor.  Work up to holding this position 30-60 seconds.  Repeat 5 times.
    • Arch Raise in Standing:
      • progress this exercises to standing when you can stand on the involved leg without increased pain.  stand on both feet; try to raise the arch of your foot while keeping your toes and heel on the floor.  Hold 30-60 seconds, repeat 5 times.
    • Tandem Standing:
      • Stand next to a chair or wall with on foot in front of the other.  Hold for 30-60 seconds.  Repeat 5 times with the right foot forward and 5 times with the left foot forward.
    • One foot standing:
      • standing on one foot keeping the arch of your foot raised.
      • Turning your head left and right while maintaining your foot position and your balance.
      • Closing your eyes while you maintain your foot position and your balance.
    • One foot standing on foam pad:
      • Repeat above exercises on the foam pad.

Nutrition: It is essential to supplement with proper trace minerals/vitamins so the body can heal at the faster rate.  Here are some of the suggestive supplements we recommended in our office:

  • Proteolytic enzymes such as bromelain.  Take with the empty stomach.
  • Chondroitin Sulfate
  • Glucosamine HCL
  • MSM
  • Omega 3’s: strong anti-inflammatory substance.
  • Magnesium.
  • Vit C.

It is recommended to take high-quality supplements rather than over the counter products for better absorption and usage.

 

Dr. Wu DC is a Gonstead Certified Extremity adjuster and has been taking care of athletes for years.  As usual, feel free to contact us should you have any questions at all.

Yours health,

Dr. Wu DC
ICON Chiropractic Center

 

 

Resource:

  1. Kaiser permanente Physical therapy: 012701-002
  2. Dr. Mark Werking DC.  Werking on Extremities: A specific approach to extremity conditions and care.

 

 

 

Guatemala Chiropractic Mission Feb 2018

Dear readers,

Our bodies are truly amazing machines.  They are complexed, delicate and governed by an infinite internal wisdom called innate intelligence.  At any given moment, this innate intelligence is always striving to adapt and excel in the environment we are in.  A great example is if today we are up on the high mountain, your respiratory system will work harmoniously with high altitude to make sure you will have enough oxygen to keep you alive.  You don’t have to tell “it” to work harder, it just does for you.

In chiropractic profession, we work with this innate intelligence by restoring the nerve connection between the brain and body.  How we do it is to remove “Subluxation” (misalignment of the spine which causes nerve interference) so the body can repair at the most optimal condition.  When the spine is subluxation free, anything can happen.

With that, I would like to share one of my miracle cases with you during the Guatemala Chiropractic Mission trip.
The trip was from 2/2/18-2/11/18.  We had in a combination of 5 Gonstead doctors and 4 Gonstead dedicated students on this trip.  In 5 working days, we have seen over 2000+ patients.  Patients came to us with a variety of conditions because they knew the principle of chiropractic, which is to fix the subluxation and correct the nerve interference.  As I was taking the history of one of the Mayan ladies, she told me her left year has been deaf for over 10 years.  She couldn’t remember how it started but the hearing just gradually faded away.  I scoped her with a nervoscope (part of the Gonstead protocol) and found out there was a major reading on the top of the left neck.  I looked at her neck from behind and showed left ear lob was higher than right.  I palpated the neck, moved it around and range of motion was severely restricted turning left.  The verdict:  she has a subluxation on her first bone (called atlas) which stuck to the left.  I set her up, thrust and wham, the atlas just went “clunk-clunk”.  Right after the adjustment, she was a bit lightheaded, but after 2 minutes she starts rapid firing in Spanish to both the translator and me.   I couldn’t understand much of it but from the facial expressions and energy between them, I knew something has happened.   The translator turned around and told me: she can hear, she can hear!!  Three of us started jumping up and down and celebrate the moment of the truth, when the body is in a subluxation-free state, anything can happen.  There is no greater joy for a physician to know he has done his job to enhance a patient’s healing ability.   10 years of deafness, 1 adjustment, gone.

I like to finish this blog by quoting two prominent doctors in our profession, Dr. Christopher Kent, and Dr. Gilles LaMarche:

  1. The body is a self-healing mechanism.  Cut your finger, it heals.  Cut the fingers of a corpse; it does not.  Life heals.
  2. The nervous system is the master system of the body.  Every aspect of human experience is processed through the nervous system.  When there is interference with the function of the nervous system, not only can it compromise your physical well-being, but it can also have psychoemotional consequence because it distorts your perception of the world and limits your ability to respond to the environment.  When this happens to a significant number of people in a society, you have a sick society.
  3. What I do as a chiropractor is locate and correct the cause of that interference.
  4. Our ultimate goal is to maximize the expression of your perfection within, allowing your innate intelligence to be fully expressed throughout your life.

This is truly an amazing profession, and I am honor and blessed to be part of it.

Yours in health,
Dr. Wu DC

 

 

Does Adjustment Speed Up Post-Surgery Recovery?


Dear readers,

This article was published earlier this year, Jan.18, 2017 from Annals of Thoracic Surgery.  This elite group was established in 1989 and the main purpose is to serve as the benchmark for risk-adjusted outcomes in cardiac surgery and is the foundation for all quality measurement and improvement activities of The Society of Thoracic Surgeons.  The aim of this study was to assess whether osteopathic manipulative treatment (OMT, similar to chiropractic adjustments) contributes to post heart surgical sternal pain relief and “improves postoperative outcomes.”  They divided them into 2 groups: control group vs manipulated group.  Here are the results:

  • VAS pain scale

    • Control group 3 vs Manipulation group 1
  • Mean Inspiration Volume (ability to breathe):

    • Control group 1400 ± 588 mL vs Manipulation group 1781 ± 633 mL.
  • Hospitalization Days
    • Control group 22 ± 6 vs Manipulation group 19 ± 5
      days.

As a results, the paper showed patients got manipulated (similar to chiropractic adjustments) have significantly reduced pain, improved function, reduced hospital stay  and associated costs, and avoidance of drugs and all the risks.

Comments from Dr. Alan Wu DC:

What a great study.  This paper supports the fact patients went thought chest operation would received tremendous benefits from manipulated/adjustments.  Adjustments should start within 5 days postoperative along with rehabilitation.  Not only it reduced pain, increased function, and it also reduced financial cost as well.   While Chiropractic has been stigmatized into musculoskeletal issue only, this is certainly not the case.  The foundation of chiropractic is based on fixing Subluxation (mis-position of the bone), restore nerve communication between the brain and body in order to achieve highest bodily functions and healing.  It is really a wonderful health care profession to keep us living optimally.  As usual, should you have any questions, feel free to reach out to us at info@ICONChiropractic.com and we will get back to you as soon as we can.

Yours in health,

Dr. Wu DC
ICON Chiropractic Center

References: 

  1. Recca V., et all. Osteopathic Manipulative Treatment Improves Heart Surgery Outcomes: A randomized Controlled Trial.  Ann Thorac Sure. 2017 Jul;104(1):145-152. doi: 10.1016/j.athoracsur.2016.09.110. Epub 2017 Jan 18
  2. Thanks To Dr. Dan Murphy DC for sharing this article.  As usual, your work and dedication to this profession is tremendous and greatly appreciated.  

These Ratios Are One of the Most Accurate Indicator for Heart attack

Dear readers,

Recently a new patient was referred to me because of her lower back discomfort during cycling.  She is a 27 years old female athlete with good diet and exercise regiment.  During the consultation, she told me her MD was about to put her onto cholesterol lowering drug because her cholesterol test came back higher than 200 from her last blood test.  She doesn’t want to take mediation and also doesn’t want to have heart attack, she asked me what to do.  While I personally don’t have the power(outide of our practice scope) to prescribe OR take her off medications, what I can do is giving rightful information to educate her as well as rest of the community.  Here is a great article about cholesterol myth written by Dr. Ronald Grisanti DC, the director of Functional Medicine University:

“The published evidence is quite clear in documenting that the actual total cholesterol level itself is not the most important risk factor of cardiovascular disease.

It is the ratio between the level of HDL-“good” cholesterol and total cholesterol

that we need to be concerned about.

Therefore, in adults, the HDL-“good” cholesterol/total cholesterol ratio should be higher than 0.24 (just divide your HDL level by your cholesterol).

Or more precisely, the HDL/total cholesterol ratio:

  • 0.24 or higher is considered ideal
  • under 0.24 – low
  • less than 0.10 – very dangerous.

Generally speaking, the higher the ratio, the better (the lower your risk of a heart attack).

However, HDL is closely related to triglycerides. It appears common for people with
high triglycerides to have low HDL’s, and these same people also tend to have high levels of clotting factors in their blood stream, which is unhealthy in protecting against heart disease.

Therefore, in adults, the triglyceride/HDL-“good” cholesterol ratio should be below 2  (just divide your triglycerides level by your HDL).


Or more precisely, the triglyceride/HDL ratio:

  • 2 or less is considered ideal
  • 4 – high
  • 6 – much too high
And, since HDL (high density lipoprotein) is protective against heart disease, the lower the ratio, the better.

In other words, the lower your triglycerides, or the higher your HDL, the smaller this ratio becomes.  It is now believed that the triglycerides/HDL ratio is one of the most potent predictors of heart disease.

 

A Harvard-lead study author reported:

“High triglycerides alone increased the risk of heart attack nearly three-fold.

And people with the highest ratio of triglycerides to HDL — the “good” cholesterol — had 16 times the risk of heart attack as those with the lowest ratio of triglycerides to HDL in the study of 340 heart attack patients and 340 of their healthy, same age counterparts.”

Dr. Wu DC’s comment:

Just like my last functional medicine blog stated, looking at the total cholesterol number alone doesn’t mean you are about to have heart attack.  It is really the ratio that speaks all.  A 200 lbs body builder is going to have a completely different cholesterol level than 100 lbs high school kid.  Using one standard method to measure cholesterol level is wrong to start with;  and further to put everyone on statin (cholesterol lowering drugs) because they are out of the range is even worse.  This simple and more accurate measurement serves better indicator for your general health, along with other bio markers such as Hs-CRP, BMI and glucose level.  Drop us a line if you have health challenges or questions, we will be more than happy to see what we can do to help get your health back on track.

Yours in health,Dr. Wu DC

Reference:

  1. The ratio of triglycerides to HDL was the strongest predictor of a heart attack, even more accurate than the LDL/HDL ratio (Circulation 1997;96:2520-2525).”
  2. http://www.functionalmedicineuniversity.com/public/796.cfm

 

 

Pelvis Is More Balanced After One Gonstead Adjustment?

Dear Readers,

This is a pretty nifty article published in 2015 of the Journal Physical Therapist Science.   In this paper, the author wanted to measure the impact on pelvis position and balance after ONE Gonstead adjustment. The results were significant!  Here are the details:
  1. There is a strong correlation between pelvis imbalance and joint degenerations, especially in the hip, knee, ankle and spine.
  2. Subjects were 30 female university students WITHOUT pain.
  3. Subjects were divided into pelvis adjusting group and control group (stretching group).
  4. The adjustment was consist of Gonstead theory.
  5. Varies measurements were used to asseses the outcome, which included: BackMapper, trunk inclination (TIN), trunk imbalance (TIM), the inclination of the coronal plane, pelvis position (PPO), the left and right inclination of the pelvis; ;pelvic torsion (PTO), the degree of declination of the hip bone, pelvic rotation (PRO), the declination of the pelvis on the horizontal
    plane, and the position of the scapulae (PSA).
  6. The adjusting group had significant improvement compared to the control group in all aspects.

Dr. Wu Dc’s comment:

What a great study! Here are few take away pearls from this paper.  

  1. Gonstead system rocks!  I am a proud to say I am a Gonstead exclusive chiropractor.  The precise analysis, examination and the specificity of adjustment is really the key to enhance patient’s healing and health.  This system is so great that even physical therapist profession are implemen
    ting it, what a honor!
  2. Never, I repeated, never judge your health based on how you feel.  These 30 students were asymptomatic (no pain) when they got evaluated and had pelvis imbalanced.  This is crucial because how many of us will only go to doctor when we are in pain?  “Wait and see” approach for your health is never a good idea and we should be more proactive about it. Pain is usually the last one to show and first one to go.  Before you reached the pain stage, there is usually some sort of degeneration happened already.   Make sure go see your chiropractor, acupucntirest, medical doctor and other health care professionals periodically to keep your health in top notch so you can live and function at your fullest.

 

Yours in health,
Dr. Wu DC
ICON Chiropractic Center

 

Reference:

Correlations among pelvic positions and differences in lower extremity joint angles during walking in female university student.  J Phys Ther Sci. 2015 Jun;27(6):1941-4. doi: 10.1589/jpts.27.1941. Epub 2015 Jun 30.

Cholesterol Struck Again! For Good!!

Dear Readers,

For the longest time, we have heard saturated fat is bad for you and it can clogged up your artery which leads to heart attack.  Well, the science is in (for one more time) and apparently this is not the case.  A study was released August 29, 2017 in one of the most prestige cardiology journal.  It  examined the dietary habits of 135,000 people and came to the resounding conclusion that “high fat intake – including saturated fat – was associated with a REDUCED risk of mortality.” Furthermore, this study found that a high carbohydrate (didn’t distinguished refined or not) diet increased the risk of mortality (1).   Shocking? perhaps not.  Look into human anatomy and chemistry than you will know how important these fats are.  Human bodies need fat for many different reasons, such as to create hormones, maintain healthy cell membranes, and have excellent neurological function.  In addition, approximately 60% of brain is composed of fat (2).  Why would it make sense to cut down good quality fat intake and replace with carbohydrates?   Besides the benefit of the intake fat, here are three other take away from this articles.

  1. Three or four daily portions of fruit and vegetables appear to have similar benefits as the current recommendation of five. Meaning, it’s unnecessary to over-stress about getting exactly five servings of fruits and veggies each day. In this study three to four servings worked out to be 375-500 grams. Just for reference, 100 grams of fruits and veggies is about the equivalent of two cupped hands of raw, diced fruit or veggies. This means you should try and get at least 8 cupped handfuls of fruits and vegetables per day.
  2. The benefits of the fruits, vegetables, and legumes is greater if they are consumed raw. The science behind the idea that raw is better is fairly complicated. But what’s most important is that you’re eating plenty of vegetables and fruits, so if cooking them means you’ll eat more, then by all means, cook ‘em
  3. Replacing saturated-fatty-acid intake with carbohydrates had an adverse effect on blood lipids. This study examined the impact of fats, carbohydrates, and proteins on total cholesterol, LDL (“bad”) and HDL (“good”) cholesterol, and apolipoprotein A1 (apoA1) and B (apoB).

Dr. Wu DC’s comment:

Part of the reason I am posting this blog was because American Heart Association (AHA) released an article lashing out on saturated fat not long ago (3).  That publication, of course, back-fired them as physicians around the world were questioning the motivation behind it.  I am still baffled why they would recommended replace good saturated fat (coconut oil) to monounsaturated fat (canola oil) while science clearly stated otherwise.

The other point I would like to point out is the total cholesterol level.  We have been told higher cholesterol could potentially lead to heart attack that’s why doctors put almost every body on statin (cholesterol lowering drug).  In fact, statin drugs are one of the most profitable drugs which has made over 22 billions per year.  This, in some degree is true but that’s not everything.  While it is important to make sure one’s cholesterol level in check, not everyone should have the same cholesterol level.  A man weights 200 lbs should have different cholesterol level compare to 100 lbs woman, that makes sense right?  Using one standard method to measure cholesterol level is wrong to start with;  and further to put everyone on statin because they are out of the range is even worse.  Cholesterol is extremely important in our body for proper nerve functioning, hormone production and wound healing.   It is imperative not to undercut them.  I would highly recommend to consult with your physician or qualified functional medicine practitioner to go over this issue, and oh yeah, go ahead take that spoonful of coconut oil.

One last thing about this article; while consuming vegetables, it is worth the effort to go out and get organic produces.  The nutrients in there are much higher with less pesticides compared to conventionally grown.

Yours in health,

Dr. Wu DC
ICON Chiropractic

 

References:

  1. Dehghan M, Mente A, Zhang X, et al., Fat and Carbohydrate Intake and CV Mortality. American College of Cardiology. Aug 29th 2017.
  2. Chang Cy, Ke DS, Chen JY., Acta Neural Taiwan. 2009 Dec;18(4):231-41.
  3. Http://news.heart.org/advisory-replacing-saturated-fat-with-healthier-fat-could-lower-cardiovascular-risks
  4. Sources: www.functionalmedicineuniversity.com/public/1266.cfm  (Thanks to Functional Medicine University for the majority of sources).

 

 

Can Chiropractic Care Naturally Enhance Your Immunity?

Chiropractic and Immunity

In this study, seventy-six asymptomatic subjects were randomized to receive an upper thoracic (upper mid-back) spinal manipulation (chiropractic adjustments) with cavitation (sounds) or without cavitation, or were included in a control group. All subjects had their blood drawn before, 20 minutes and two hours after the intervention. Production of IL-2 in mononuclear cell (key element of immune system) cultures was activated with staphylococcal protein A (SPA). Induced secretion of IL-2 increased significantly in manipulation with and without cavitation.

The paper concludes that in vitro T lymphocyte (immune) response to a SPA stimulus became enhanced after spinal manipulation. Therefore, this effect may be independent of joint cavitation/audible. This finding suggests manipulation may influence IL-2 immune-regulated biological responses.

Dr. Wu DC’s comment:

We all know how wonderful chiropractic adjustments can be for sore neck, lower back pain and joint issues.  But do you know chiropractic adjustments can also enhance your immune system as well?   In this study, researches evaluate effects of upper mid back spinal manipulation (chiropractic adjustment) on the production of interleukin 2 (IL-2) – a key element of innate immune system signal response to foreign body infections such as bacteria, viruses and parasites.  IL-2 also play a major role with T-cell-dependent immune response system which helps you to fight off these nasty and gnarly microbial infection.  Pretty cool stuff, isn’t it?

Teodorczyk-Injeyan JA, Injeyan HS, McGregor M, et al.
Enhancement of in vitro interleukin-2 production in normal subjects following  a single spinal manipulative treatment.
Chiropractic & Osteopathy 2008;16:5.