Tuesday, July 25, 2017

Shoulder Pain and Dysfunction

shoulder pain.jpg

The shoulder is a common area that is prone to injury due to the makeup of the freely movable joint which provides excessive ROM. There are many ways that you could injure your shoulder; any repetitive overhead arm use or unsupported reaching, such as painting, throwing, or even lifting objects out in front of your body, and shoveling snow. Sports have a huge impact on the shoulder due to the repetitive motions during practices and games. If there are muscular imbalances or fixations in the muscles that surround the shoulder and shoulder blade, you have a higher likelihood for an overuse injury. Athletes are also at a higher risk of direct impact to the shoulder when playing sports.

The shoulder has a smaller number and size of muscles that surround it compared to the hip joint. It is surrounded by the 4 rotator cuff muscles that form a cuff around the humerus (the bone in the upper arm) and work in combination with the scapula (shoulder blade) to move and lift your arm. It is made up of the supraspinatus, infraspinatus, teres minor, and subscapularis, with the supraspinatus tendon being the most commonly injured or torn. There are also manybursa (fluid filled sacs) in your shoulder that protect the tendons and other soft tissue from rubbing on the bone or over each other which could cause inflammation and pain in your shoulder as well.

The muscles in your arms and shoulders are also supplied by the nerves that exit the spinal cord through your neck. Therefore, if you have impingement or dysfunction in your neck and upper back, it could be causing shoulder/arm pain, achiness, or weakness. When students are on their phones, studying, or on computers for long periods of time, it can put stress and strain on their neck, upper back, and shoulders causing pain and stiffness.

As sports chiropractic specialists, we not only realign your spine and clear irritation on the nervous system, we also have many different soft tissue tools and therapeutic techniques to get you “back in the game.” At Pro Chiropractic we have techinques such as Graston Technique (instrument-assisted soft tissue mobilization), myofascial release, and Pulse Wave Therapy (a.k.a. pressure or shock-wave therapy) that break up adhesions that form in the muscular tissue from sports or overuse injuries. Modalities such as ultrasound, electrical muscle stimulation, cold laser therapy, and dry needling help to activate the healing process at a cellular level and decrease inflammation. Other modalities including cupping and kinesiology tape can be used to lift the tissue and stimulate blood flow and accelerate healing into the affected areas.

Proper alignment of the glenohumeral joint is important in order for the bones to glide smoothly when using our arm and shoulder. One thing that most people do not realize is the importance of the mobility of the shoulder blade. If it is fixated or lacks proper ROM, it can put stress on the rotator cuff muscles and the overall function and mobility of the humerus and shoulder. It is important to clear the shoulder blade of adhesions and check/adjust the mid and upper back so the spine and ribs are able to articulate smoothly and take excessive pressure off the shoulder and rotator cuff muscles.

Another great advantage about seeing the doctors at Pro Chiropractic is that if our patients need more stabilization and strengthening in their shoulder, we can walk them over to our physical therapy partners Pro Physio for a well-rounded treatment approach. Our patients are able to receive the optimal care and rehab they need without having to drive to a whole new location.

This blog post was written by Dr. Jenny Noordmans.

Pulse Wave Therapy (Pressure Wave Therapy)

The body is always changing and adapting through our experiences in life. There are over 640 different muscles in the body made up of 3 types: visceral, skeletal, and cardiac. The skeletal muscles are the muscles that move our body and keep us in an upright position and are the main focus in this article. The muscles are surrounded by an intricate network of thin tissue called fascia. When we have sports injuries, motor vehicle accidents, or are undergoing repetitive motions throughout our lives, our bodies can tighten up in that poor posture or in a protective position. When we break up myofascial adhesions and unwind the fascia it allows the muscle fibers to stretch and also glide past each other which allows our bodies to go through normal ranges of motion. When we break up the adhesions it also relieves the muscle aches and pains.
As sports chiropractic specialists, we are exposed to many individuals who have had traumatic injuries and/or have done repetitive motions causing abnormal muscular patterns. One of the many ways that we break up the myofascial adhesions at Pro Chiropractic is with our Pulse Wave Therapy also known as pressure wave therapy. The D-Actor 100 therapy is made in Switzerland and is a air-operated pulsed generator. It has a precise ballistic mechanism that has a projectile object accelerated back and forth by compressed air producing kinetic energy. The kinetic energy is converted into sound energy and transmitted into the tissue with the help of ultrasound gel. There is a pressure wave that helps break up the tissue but also an ultrasound effect that can help decrease inflammation through the sound waves.
We are privileged at Pro Chiropractic to have the 1st pulse wave therapy unit in the state of Montana. The treatment breaks up deep fascial adhesions and is able to reach tissue that more superficial soft tissue therapies are unable to reach. There are all sorts of soft tissue injuries that pulse wave therapy can help with such as rotator cuff injuries, hamstring injuries, plantar fasciitis and shin splint. The pulse wave helps stimulate blood flow and will also help the muscles recover as it affects the tissues at a cellular level.

This blog was written by Dr. Jenny Noordmans

Friday, June 2, 2017

Do Chiropractors Get Hurt Too?

Being a chiropractor is a very physically demanding job; especially if you do more than just adjust, like soft tissue work, taping, etc.  Not only are you moving and positioning people all day, but you also put yourself into awkward and unnatural positions to treat your patients.  For example, if I am treating a patient for plantar fasciitis, you’ll often times find me crouched on the floor with an instrument wedged under the patient’s foot while they perform calf raises.  Another example is when I am adjusting patients larger than myself.  Granted, I’m not a small woman by any stretch of the imagination…I’m 6’0 tall for crying out loud, but I do have several patients that are difficult for me to maneuver into proper adjusting positions.  So it goes without saying that it is not uncommon for chiropractors to get injured themselves.  And as a habitually accident prone person, I have had my fair share of injuries in and out of the office.  Here is the story of my most recent chiropractic-related injury and recovery.

It was a sunny Tuesday morning here at Pro Chiropractic and I was the only doctor working in the Bozeman office.  I had just completed the adjustment on my first patient of the day and was assisting that patient into the regainer chair to help restore her natural cervical curvature.  As I bent forward to tighten the tension on the chair, I felt a very sharp pain on the right side of me lower back; so sharp and severe that my right knee buckled beneath me.  I stood up very slowly and assessed my condition.  It was next to impossible to stand up completely straight and even harder to bend forward more than about 10 degrees.  I made my way back to my desk and sat down to try to relieve the pressure in my lower back.  It helped a little bit, but did not completely relieve the pain.  As the morning went on, my lower back muscles continued to get tighter and tighter.  I still had patients to see so it was not an option for me to go home at that time.  I was somehow able to grit my teeth through adjusting a few more people and did so without further injury (thank goodness!).  By the end of the morning, I was beginning to question my effectiveness in not only keeping myself safe, but in keeping my patients safe as well. 

Luckily, Dr. Wilhelm was a few doors down working on the new Pro Physio Bozeman office and was able to treat me before I went home for lunch.  He did some extensive soft tissue mobilization and adjusted my hip.  Unfortunately, the treatment did not do much to relieve the pain.  My lower back muscles were in severe spasm by then.  When I got home for lunch, I decided it was necessary to take some ibuprofen if I wanted to have a chance to make it through the afternoon seeing patients.  As I bent down to grab a cup of water to take the pills, I felt like I had been struck by lightning in my lower back and immediately hit the floor.  I have never in my life felt back pain like this before.  As a person who suffers from chronic sacroiliac dysfunction, I often have lower back/pelvic pain, but this pain in my lower back was at a whole new level.  It took me about three minutes to get myself up off the floor into a standing position.  I knew at that moment that I was in trouble and would not be able to tough it out for my patients in the afternoon. 

I rushed back to the office and was happy to see that Dr. Wilhelm was still there.  I talked to him about what happened and how the pain was getting worse.  We agreed that it would be unsafe for myself and my patients to try to work the afternoon.  He recommended that I wear a back brace and seek treatment at Pro Physio; specifically non-surgical spinal decompression to try to release the spasms.  The Pro Physio team was fantastic in getting me in immediately and on the DRX machine for 30 minutes.  Once I finished on the DRX, I felt mild relief and was able to stand more upright.  I was then treated with electrical muscle stimulation and moist heat, manual soft tissue manipulation and kinesiology tape to further release the spasm in the lower back muscles.  Following the treatment, I sought out Dr. Bradley for an adjustment.  He informed me that I had a severe rotation of my L4 vertebrae in my lower back.  Once he adjusted it, I had instant relief and went home to rest for the rest of the day. 

The following day, the Pro Chiro team was set to volunteer to do sports physicals at Manhattan Christian School and I was needed to help with those.  I returned to Pro Physio that morning and repeated the treatment from the previous day.  Afterwards, I felt sore, but better overall.  I still had to wear the back brace during physicals, but was able to complete the task.  I spent the remainder of the day at home resting.  I returned to work Thursday in the back brace and made it through the day and Friday with only mild to moderate soreness.  Friday after work, I was lucky enough to get in for a massage with Amy Hessen who is a massage therapist that works in the Pro Chiropractic Belgrade office.  She did a phenomenal job working through the muscle spasms in my lower back and all surrounding areas.  I woke up Saturday morning with very little pain at all and have returned to my normal work schedule and activities.

I’m sure you’re asking yourself, “Why are you telling this story?”  Well here’s the answer!  As a chiropractor, I see people in pain every day.  It is my job to help them get out of pain.  But I thought it was important to show what happens when the shoe is on the other foot and give a personal account of what it takes to get out of pain.  I am lucky enough to have an amazing group of chiropractors, physical therapists, physical therapy assistants and a massage therapist on my team.  The great news is…SO DO YOU!  When the injury first happened, I had family members and friends tell me that I needed to go to the hospital or go see a medical doctor to get muscle relaxers, pain killers or an injection.  But I didn’t need to do any of that!  I was able to feel better and heal without those unnatural means.  I was able to feel better and heal using conservative care and you are no different!  Sure, it takes a little longer, but in the long run, it is more effective and less expensive.  Who wouldn’t want that? 

To experience any of the treatments I had, please call Pro Chiropractic at 406-219-2462 or call Pro Physio at 406-388-8118.

If you or someone you know in the Gallatin Valley area is looking for a chiropractor, please call Dr. Shea Stark with Pro Chiropractic at 406-219-2462 to schedule an appointment in our Belgrade or Bozeman office.  Dr. Stark is a board certified chiropractor and the author of this blog post.  To learn more about Dr. Stark and the many benefits of chiropractic care, please visit our website: www.prochiromt.com.

Thursday, January 5, 2017

The Importance of a Chiropractic Exam Part 1: The Neck

Flowchart: Alternate Process: The Importance of a Chiropractic Exam Part 1: The Neck


When you visit a chiropractor for the first time, you will be put through a series of tests and activities to help determine the nature of your issue/injury.  This process is called a chiropractic examination.  It is a vital part of not only the diagnosis, but the treatment plan as well.  The information the chiropractor can gather from the exam allows them to diagnose properly thus helping them formulate an appropriate plan of action to get you better.  At Pro Chiropractic, our exams are quite thorough.  They include state of the art scans, digital x-rays and hands-on testing. 

The first test that will be done is range of motion.  This will allow the chiropractor to see if there are any visible restrictions during movement.  Restrictions can be caused by muscle strain, muscle tightness, ligament sprain, joint restriction or pain caused by disc herniation.  Once range of motion is completed, the exam will move on to orthopedic testing.  Movement restrictions and/or pain will be noted by the chiropractor.

The next aspect of the examination is orthopedic testing.  These tests help to determine what structures are involved in the issue/injury, such as muscle, joint, or nerve.  Each test is designed to rule in or rule out possible causes of dysfunction.  Every chiropractor has their own set of tests they use during the exam and will perform them in an order that works for them, so exams vary from chiropractor to chiropractor.  After completing range of motion and orthopedic tests, the chiropractor will have a good working diagnosis for what they think the problem is. 

The next step in the examination is x-rays.  The chiropractor may or may not recommend x-rays depending on the age of the patient, mechanism of injury or if the patient is pregnant.  X-rays are taken to either determine if a break or dislocation has occurred or to determine structural integrity of the spinal region.  The above picture shows a normal cervical (neck) curvature versus an abnormal curvature.  Abnormal curvatures can be caused by a traumatic incident such as a fall or car accident or can occur over time due to poor posture. 

The chiropractic examination is important for every patient to help reach the proper working diagnosis whether the diagnosis is as simple as a segmental dysfuction or as complicated as a herniated disc.  Without the examination, the chiropractor is essentially “shooting in the dark” when it comes to  treatment which can be harmful to the patient, not to mention a waste of the patient’s time and money. 


If you or someone you know in the Gallatin Valley area is looking for a chiropractor, please call Dr. Shea Stark with Pro Chiropractic at 406-219-2462 to schedule an appointment in our Belgrade or Bozeman office.  Dr. Stark is a board certified chiropractor and the author of this blog post.  To learn more about Dr. Stark and the many benefits of chiropractic care, please visit our website: www.prochiromt.com.