The Shoulder

 

 

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One of the more common areas we treat here at Classic Chiropractic is the shoulder. 

Shoulder Anatomy

The shoulder is a complex region made up of muscles, bones, ligaments, bursa and joints.  The primary muscle group is the rotator cuff, the bones are the humerus, clavicle, and the scapulae, and the joints include the AC joint and the Glenohumeral joint (the ball and socket joint).  

Shoulder Injuries

The beauty of the shoulder is it's incredible range of motion that allows us to perform an array of tasks and actions.  However, the downside this increased capacity brings is an increased risk and rate of injury.  Common shoulder injuries include:  rotator cuff tears, shoulder impingement, AC joint sprain, tendinitis, bursitis, and tears to the labrum.  With so many possible causes for pain and injury is is vital to get the diagnosis correct.  Therefore a detailed history and comprehensive exam is very important.  In complicated cases it may be necessary to include imaging such as an MRI or X-ray.  

Shoulder Treatment

Treatment will vary depending on your diagnosis.  Our most frequently used approaches are chiropractic manipulation for improved movement, IASTM/Faktr aka: scraping for improving the orientation of collagen tissue (scar tissue) in the direction of muscle contraction for a stronger healing outcome, Kinesio taping for structural support and for inflammation control, and functional rehabilitation for improved flexibility and strengthening of the damaged tissue.  

At Classic Chiropractic we have had great success with many different injuries surrounding the shoulder and would be happy to be of service.  

Hip Flexors

Pain of the hip flexors is a common presentation we see in the clinic. I want to take a little time to go over what constitutes the hip flexors, what causes pain in the hip flexors and how we treat them. 

What are the hip flexors? 

The hip flexors are the muscles that attach to the front of the hip and are involved in bringing your knee up towards your chest. The primary muscle known as a hip flexor is the Illiopsoas. The Illiopsoas is made of up two muscle bellies (the Illiacacus and the Psoas major).  This muscle originates in the lumbar spine (lower back) and inserts onto the anterior side of the femur (thigh bone). Other muscles associated with hip flexion are the Sartorius, Rectus Femoris, and the Tensia Facia Lata. Any and all of these muscles can be involved in causing your pain since they are all involved in flexing your hip.  You can palpate your hip flexors by locating the bony point in the front of your pelvis that is just under your belt and going due south an inch or two. If you press in and find the tissue is unusually tender your hip flexors are under some duress.

What causes pain in your hip flexors?

First off we need to determine if you have a strain or just have overly tight hip flexors. Each condition can cause discomfort. Usually a strain is going to be found after exertion such as sprinting or kicking.  Therefore hip flexor strains are really common for football and soccer players. It is also common to have a more chronic strain in those athletes who are involved in repetitive exercises, such as long distance runners. Pain from overly tight hip flexors can be found in the very active, but surprisingly can also be found in the desk jockey. The person who sits all day for work will often be found to have tight and painful hip flexors because their lack of use causes the muscle to shorten and tighten. This lack of motion shows up when they ask their hip flexors to work. It is also common for hip flexor tightness to cause lower back pain since the Illiopsoas attaches to the lower back. A lack of abdominal strength can also put a lot of stress on your hip flexors and exacerbate them, as well. 

How do we treat hip flexor pain?

How do we treat hip flexor pain in the clinic? If your pain is caused by a strain we will need to determine how severe the strain is. With severe strains we will need to utilize a period of rest from the causative activity and concentrate on reducing inflammation. With mild strains we can usually utilize the same protocol as overly tight hip flexors. We will often manipulate the hip which causes a dynamic stretch to the hip flexors. We will likely utilize a manual therapy treatment such as Instrument-Assisted Soft Tissue Mobilization (we use the technique known as FAKTR). This technique involves utilizing a stainless steel tool to break up scar tissue and improve mobility. It is common to support the muscles with an application of Kinesio tape. And lastly a stretching program is essential. It doesn’t matter if the problem is a strain or a just overly tight muscles we need to get more mobility into the region. 

Three popular stretches for the hip flexors are:

 

Kneeling Hip Flexor Stretch

Glute Bridge Stretch

Supine Hip Flexor Stretch

Kinesio Tape

At Classic Chiropractic we tape a lot of people using Kinesio tape.  For most patients unless they have recently been involved in athletics it's their first exposure.  This raises a lot of questions:  What is it?  How is it different from normal tape?  How does it work?  How long do I leave it on?  I thought it would be good to take a moment and give some answers.
 

What is Kinesio tape?  
Kinesio tape is an elastic cloth tape with a rigid hypo-allergenic adhesive.  It is cut and placed in different patterns depending on the injury or need.  It was developed  in 1979 by Dr. Kenso Kase, a Japanese chiropractor.  The tape really came to the forefront at the 2008 Summer Olympics when Kerri Walsh (US gold medal beach volleyball player) was seen wearing it to support her surgically repaired right shoulder. 

How is Kinesio tape different from normal sports tape?
Traditional tape and taping methods sought to immobilize the injured area.  However, Kinesio tape seeks to allow full range of motion of the effected area while giving support and pain relief.  This allows the patient or athlete to heal faster and form less scar tissue.  
 

How does Kinesio tape work?  
Kinesio tape works by pulling up lightly on the skin and causing an increased separation  in the layers between the skin, fascia, muscles, and circulatory system.  This increased layering allows better blood and lympahtic flow to and away from the injured area.  By decreasing inflammation you speed up healing times.  Kinesio tape also reduces pain by reducing the amount of pressure exerted on the pain receptors where it is applied.  
 

How long do I leave it on?  
You can leave Kinesio tape on for four days.  The tape is cloth so yes you can shower/bathe.  The removal of the tape can be a little tricky but some lotion or oil can help.  

Kinesio tape has had a huge impact on the athletic world.  We believe our patient's should get the same great care.