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All Posts in Category: Mid Back Pain

ESPN Outside The Lines – Quality Of Care – Back Pain Strikes Down two Indiana University Athletes

While I was on the treadmill and working out yesterday at the gym ESPN’s investigative reporting journal, Outside The Lines, came on and showed a very interesting story (to a chiropractor who works on a good deal of young athletes at least).  The story started about the mismanagement and treatment of several young athletes at the Indiana University who developed a great deal of mid, low back and hip pain.  Two in particular had striking stories about the misdiagnosis of back pain that was very serious and one had to have a fairly serious surgery that might very well have been corrected using conservative measures if they were properly diagnosed and treated in the first place.  In the case of the football player, it seemed to some extent that he was “machoed” into continuing to suit up by the coaching staff. The simple fact is this, if you can barely walk across campus, you probably can’t withstand football practice.  If you are an athlete or the parent of an athlete, you should probably check out this podcast or look for a re-run of the episode on ESPN because it was saddening and informative about what happens when athletes quite simply push themselves too far.  While it was tough to say who is truly at fault, it was a poor choice of the coaches and trainers at the university who let these issues spiral out of control.

If you are in a situation where you are simply being told to rub some dirt on it and to play and something truly feels off, please seek outside medical care from a qualified healthcare practitioner.  In both of the cases shown in this article, it took far too long for the true problem to be identified, diagnosed and the proper treatment protocols activated.

Podcast Teaser: Indiana football coach Kevin Wilson lost his job in December and reports surfaced of players alleging medical care had been neglected. Our 3-month investigation found more.

Podcast Link: http://www.espn.com/espnradio/play?id=19223941

 

Struggling with a sports related injury?  Please give us a call at 856-228-3100 to see if we can help.

If email is easier, hit us up on our contact us page linked below!

 

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JAMA – Association of Spinal Manipulative Therapy With Clinical Benefit and Harm for Acute Low Back Pain

Title: Association of Spinal Manipulative Therapy With Clinical Benefit and Harm for Acute Low Back Pain – Systematic Review and Meta-analysis

My good friend who is a pediatrician in Wisconsin alerted me that JAMA produced a reasonable and sound systematic review and meta-analysis yesterday on spinal manipulation for acute low back pain which can be read at the following link!

Link: http://jamanetwork.com/journals/jama/article-abstract/2616395?utm_medium=alert&utm_source=JAMALatestIssue&utm_campaign=11-04-2017

Reading the entire post is great over at the JAMA site linked above, but for most of you the conclusion is what you are more concerned about so here it is.

Conclusions and Relevance  Among patients with acute low back pain, spinal manipulative therapy was associated with modest improvements in pain and function at up to 6 weeks, with transient minor musculoskeletal harms. However, heterogeneity in study results was large.

Spinal Manipulation is the basis of what most chiropractors perform on a daily basis, here at the offices we combine multiple techniques including chiropractic manipulation of the spine and extremities with other treatments like Active Release Techniques, McKenzie Mechanical Diagnosis and Treatment, Cox Flexion and Distraction Technique and Instrument Assisted Soft Tissue Manipulation.  In some cases we give patients take home Corrective Exercise’s or refer out for physical therapy when needed, recommendations for staying out of pain and avoiding future incidences and aggravation of back pain.  With articles like these being produced by JAMA (The Journal of the American Medical Association) we hope that more family doctors will refer you to our offices for better treatment and management of issues related to back pain.

If you are struggling with acute or chronic issues and would like to be seen in our office, please give us a call at 856-228-3100 or use the CONTACT US link below!

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Jake Arrieta’s Full-Body Pilates Workout and a bunch of NFL players who take Authentic Pilates lessons as well!

The Chicago Cubs pitcher transformed from a struggling young pitcher to Cy Young winner by doing this routine.  Strong statement we know, but that comes directly from Muscle and Fitness magazine!  Lets look a little closer however at the stats leading up to Jake Arrieta doing Authentic Pilates.

Directly from the article:  “Before discovering Pilates, Arrieta, 30, had never won more than 10 games in a season. So it’s fair to say that Pilates helped kick-start the Texas native’s career. However, a dedication to functional range conditioning, weight training, cardio training, massage therapy, and a healthy diet relying heavily on pregame smoothies didn’t hold him back, either.”

Link:  http://www.muscleandfitness.com/features/edge/jake-arrietas-full-body-pilates-workout

With the addition of Jill Kemenosh we hope to have Authentic Pilates and ELDOA Method lessons running very soon at the office!

Need even more reasons to try out Pilates and get your core right?  Check out the link below!

Link:  http://drmarkkemenoshandassociates.com/antonio-brown-martellus-bennett-brandin-cooks-michael-campanaro-chris-givens-common/

Antonio Brown, Hunter Pence, Matt Forte, Brandon Marshall, Martellus Bennett, Brandin Cooks, Michael Campanaro, and Chris Givens all regularly do Pilates and we have some video to prove it!

If you are looking for a Pilates instructor, give our office a call!

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What’s the opposite of a push-up? This pilates routine.

Dr. Kemenosh and his daughter Jill have been jumping back into Pilates with a vengeance of late!  Between the ELDOA Method and several different takes on Pilates, we have been watching videos from all walks of life improving their lives with exercise!  Check out Denver Broncos CB Kayvon Webster’s AM workout with True Pilates Miami!  Yes, that’s an NFL player doing Pilates during the off season to keep his core rock solid!

Who is Jill Kemenosh? A previously internationally ranked equestrian, Jill began practicing Pilates at fourteen, as it was a perfect supplement to her riding regiment. After graduating with a B.A. in Communication from the University of Delaware, and trying a corporate job on for size, she decided to pursue a different career path. Her love for Pilates and desire to stay fit directed her to the New York Pilates Studio® Teacher Certification Program headed by Brett Howard. Jill became a graduate of the program in 2016 and takes great pride in the precision of the Authentic Pilates™ method and the amazing results that it produces. Outside of the studio, Jill enjoys traveling, cooking and exploring New York City as an accomplished foodie, one up-and-coming restaurant at a time.

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Calling all Philadelphia and South Jersey manual therapists! We are hosting SMART Tools with The Training Room!

Dr. Mark Kemenosh and Associates with the help of our good friends at The Training Room Physical Therapy group of South Jersey are proud to announce we are hosting the SMART Tools Level 1 IASTM certification at our shared facility in Washington Township aka Sewell, NJ.  We are putting the word out to everyone in manual medicine who would like to come out to feel welcome!  We plan to have DPT’s (Doctors of Physical Therapy), DC’s (Doctors of Chiropractic),  ATC’s (Athletic Trainers), and possibly more attending this event!  The course is a full two days and will be held on July 29th and 30th, a little down the road in the middle of summer!

SMART TOOLS – LEVEL 1 CERTIFICATION – SEWELL, NJ

Date: Sat July 29 – Sun July 30, 2017

Time: 8am – 5pm (each day)

Venue: The Training Room of Washington Township (Inside Velocity Sports Performance)

309 Fries Mill Rd
Sewell, NJ 08080

This course lays the foundation for how to properly use the SMART Tools most effectively with respect to movement. The tools were made specifically for these technique protocols to produce superior patient outcomes compared to other IASTM technique. This is an evidence-based technique that stresses early loading exercises and kinesiology tape after SMART Tools treatment.

The goal of therapy is to provide an optimal environment for the healing, by either modifying physiologic responses to injury (e.g., inflammation, muscle spasms, pain) or enhancing components of the normal musculoskeletal function (e.g., increase range of motion, increased muscular strength). No single therapeutic approach in isolation will completely resolve an impairment of musculoskeletal function. Smart Tool Plus® represents an approach to soft tissue manipulation that uses five different stainless steel instruments to release scar tissue, adhesions, and fascial restrictions. SMART Tools are designed to be used in conjunction with a thorough medical evaluation, movement based examination and other modalities to help patients overcome injuries.

Therapeutic stretches and exercises (preferably eccentric exercises) are necessary to promote tissue lengthening and collagen fiber realignment, which help to prevent the released tissue from becoming restricted again.

The primary objective of the Level 1 Certification course is to develop an understanding of the STP and how to apply it into the full spectrum of the musculoskeletal treatment approaches. By the end of the training, students will be able to:

Demonstrate a working knowledge of the STP Instruments, STP treatments and potential effects and benefits.
Identify and discuss the indications, contraindications (relative and absolute) of IASTM.
Review and develop a better understanding of soft tissue injury, healing and potential reactivity to instrument-assisted soft tissue mobilization (therapeutic and adverse).
Develop skill and competence in the STP application of the IASTM to the major regions of the spine and extremities.

Treatment effects of IASTM

  • Breakup abnormal densities in tissue
  • Stimulate nervous system
  • Reinitiate first-stage healing in the body via proliferation
  • SMART Tools IASTM techniques aim to treat the following Tissue Extensibility Dysfunctions

(TEDS):

  • Scarring & Fibrosis
  • Facial Tension & Densification
  • Neural Tension
  • Muscle Shortening
  • Neurologic Restriction
  • Trigger Points

This isn’t Gua Sha, nor is this another general IASTM course. This is a movement-based IASTM course unlike anything currently offered. Our training course addresses the neurological component, as well as the physiological component of the IASTM and corrective exercises in ways other courses do not.

This course is designed for clinicians that either have never used tools or have been using tools for years. Each will come away with new, innovative material.

So if you want faster patient outcomes, quicker recovery time, improved clinician ergonomics to save your hands, and last but not least, no patient bruising, then register for a course today and add a powerful technique to your toolbox… no pun intended.

Need more info?  Ready to register?

LINK:  http://www.smarttoolsplus.com/product/level-1-sewell-nj

 

 

Need more info?  Ready to register?

LINK:  http://www.smarttoolsplus.com/product/level-1-sewell-nj

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How come your office works so well with other doctors? We were trained this way!

One of the hallmark reasons most of the associates here at Dr. Mark Kemenosh and Associates are excited to work on this team is because we do our best to adhere to the mantra of “do best by the patient”.  As you can see on this article from our alma mater, the National University of Health Sciences further down, one of the fundamental lessons we learned was to treat the conditions you can treat and to refer out, ask for help, or even further research who can help the occasional issue we run into here at the offices.

At NUHS in Chicago, we had a pathologist on staff who was an MD and often times another MD and DO who floated around our clinic a few days each week.  This helped introduce us to many different treatments and helped us to always remember that the answer may not always be purely Chiropractic oriented.  We know that the future of better patient care is integrated healthcare and we do our best to help that process along at this office.

Just recently I received an email that a new MD would be helping out at our whole health clinic in Lombard, IL, please see the title and link below!

NUHS Whole Health Center welcomes Asad Zaman, M.D., to its clinical staff

Link:  http://www.nuhs.edu/news/2016/12/whole-health-center-welcomes-asad-zaman,-md,-to-its-clinical-staff/

So when you look around our website and notice that often times our office is sent referrals from pediatricians, orthopedics, family practice doctors, and many more, you can rest assured that we have earned the trust and respect of many in our field.

If you have questions or need help with issues that are holding you back, please give our office a call at 856-228-3100 or fill out a contact us request at the link below!

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New guidelines outline how to handle back pain – American College of Physicians say the first line of therapy should be non-drug treatments

From the CBS News Review:  

New guidelines from the American College of Physicians say the first line of therapy should be non-drug treatments. For pain lasting less than three months, those include heat wraps, massage, acupuncture and spinal manipulation (hey, that is what we do here at the office, combined with Active Release Technique). The authors stress that clinicians should avoid costly and potentially harmful treatments like narcotics.

For pain lasting more than three months, treatments include stretching and strengthening exercises, tai chi, yoga, acupuncture, and mindfulness techniques like meditation to relieve stress.

If those fail, anti-inflammatories such as ibuprofen should be considered first, then medications that can dull nerve pain, like tramadol or duloxetine.

“Some of these treatments such as yoga or massage are often offered outside the traditional healthcare system,” said Dr. Steven Atlas of Massachusetts General Hospital, who wrote an editorial about the guidelines.

“Some of these guidelines may be a shot across the bow to insurers to say that maybe we should be covering them better,” Atlas said.

From the Wall Street Journal Review:  

The new guidelines could influence how doctors treat patients with complaints of back pain. They are an update from 2007’s and include a review of more than 150 studies. Recommendations were broken down into acute and subacute lower back pain, which is pain lasting less than 12 weeks, and chronic pain, which is pain lasting more than 12 weeks. They don’t apply to radicular low back pain, sometimes referred to as sciatica, which is caused by compression of the nerves in the spine and can result in leg pain.

For acute and subacute pain, the guidelines recommend nondrug therapies first, such as applying heat, massage, acupuncture or spinal manipulation, which is often done by a chiropractor. If a patient requests drugs, the first line of treatment should be nonsteroidal anti-inflammatory drugs (NSAIDS)—over-the-counter, such as Advil, or prescription, such as celecoxib (brand name Celebrex), or muscle relaxants, such as cyclobenzaprine (brand name Flexeril).

Links to Articles:  

Wall Street Journal:  https://www.wsj.com/articles/no-drugs-for-back-pain-new-guidelines-say-1487024168?mod=e2tw

CBS News:  http://www.cbsnews.com/news/new-guidelines-how-to-handle-back-pain/?ftag=CNM-00-10aab7e&linkId=34463543

Questions about what we can and can’t help out with?  Feel free to call us at 856-228-3100

OR

Email us on our Contact Us Page!  

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Up late, but always thinking, possibly dreaming, about running, so I did a search about the Hoka One One’s…

REPOST:  This blog was originally posted on 10/07/2014!

I should probably be sleeping, but with all these local cross country runners from all over South Jersey and Philly coming in for Active Release treatment and performance tune ups, I just can’t help myself from reading and researching about running.  While I was searching, I found a blog, written by Podiatrists talking about the HokaOneOne shoes and I just could not help myself from reading.

The blog itself can be found here:  http://www.podiatrytoday.com/blogged/hoka-one-one-marketing-hype-or-another-running-shoe-revolution

The last line of the blog is the actual reason that I stumbled onto this blog, because it mentions “sesamoiditis” which is something that my wife suffers from and we can treat very well conservatively using Active Release Technique, however, but the mileage per week for marathon training goes above about forty miles per week, her feet slowly start to fight back.  Currently we are starting to explore possibly having the sesamoid bone surgically removed or if possibly a pair of “maximalist” shoes could benefit her long range training marathons.

The last paragraph from the Podiatry Today blog states:

Fortunately, I am not seeing the injuries with Hoka One One that I saw with FiveFingers. However, similar to FiveFingers, maximalist cushioning isn’t going to benefit every runner’s foot type or heel strike. Also, not every model is designed for the same foot or supports the foot the same way. My favorite Hoka One One model is the Bondi as it hourglasses the least in the waist of the shoe. If the fit is correct (width, depth, etc.), I have prescribed Hoka One One for runners experiencing sesamoiditis and hallux limitus/rigidus as the shoe may be beneficial for those conditions.

With Dr. Kemenosh feeling pretty good about running in his Hoka One One Bondi 3’s after years of avoiding hard surfaces, we may possibly be picking up a second set of Hoka’s in the Dr Mark Kemenosh and Associates running stables.  We will keep you posted on how things go down because Dr. Mark is actually meeting with Hoka’s rep at the Sneaker Shop in Ocean City tomorrow night.  Stay tuned runners!

Wondering about where you can find the Ocean City Sneaker Shop?

Google Maps – Ocean City Sneaker Shop Link

Wondering what all the hype is about with the HokaOneOne running shoes?

HokaOneOne Technology and Info Link

the-winner-hokaoneone-infinite dr-craig-evans-hoka-clifton-3-pic-1 dr-craig-evans-hokaoneone-bondi-heel-spurs-1 dr-craig-evans-hokaoneone-bondi-heel-spurs-5

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If you have been diagnosed with a disc herniation and you want to get better, you better not smoke!

While reading and trying to stay up to date on some research on intravertebral disc herniation, I came across a study by Tsarouhas et al in 2011 which stated that smoking resulted in more severe pain with disc injury which then also was coupled to a longer resorption time of herniated disc material and that smokers also have a longer duration of symptoms. 

The exact statement we found particularly powerful in the study was:

— Smoking habits were found to have a negative dose-dependent effect on the transcript levels of MMP-3 and MMP-13 and a positive correlation with pain intensity, suggesting an unfavorable role for smoking in the regression process of herniated disc fragments.

And

— Specifically, smoking was found to be negatively correlate to the duration of symptoms and positively correlated to the intensity of pain.

You can read the entire study for free on PubMed:

http://www.ncbi.nlm.nih.gov/pubmed/?term=Tsarouhas+smoking+2011

We share this information primarily to help our patients realize that smoking is bad (Yeah, we know you already knew that, it says so right on the package doc!  However, this specific study shows the correlation with disc issues and smoking which is something a lot of patients present to us for.)  We also have Dr. Andrew Gross and Dr. Tim Legath in our office who are Chiropractors certified in the McKenzie Method for treating the spine which is a very strong system for diagnosing and treating disc herniations.  Dr. Craig Evans has also completed post grad work in the Cox Technique which is a system of treating and diagnosing cervical and lumbar disc issues.

We plan to blog more in the future about the use of the McKenzie Method, however if you would like bit of reading in the mean time, you can get the basics at:

http://www.spine-health.com/wellness/exercise/what-mckenzie-method-back-pain-and-neck-pain

In closing, we just had to share this angry little guy to remind you that smoking is bad for everything!

no-smoking-smoking-is-bad-for-your-back-disc-herniation

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Research Round Up: Excessive Progression in Weekly Running Distance and Risk of Running-Related Injuries: An Association Which Varies According to Type of Injury

Wow, what a study!  I’m sure we all are reading the running journals coming out of Denmark, but in case you missed it, a study was published this past month in the Journal of Orthopaedic & Sports Physical Therapy, Volume 44, Number 10, October 2014.  The title of the study was Excessive Progression in Weekly Running Distance and Risk of Running-Related Injuries:  An Association Which Varies According to Type of Injury.  The study itself was an explorative, 1 year prospective cohort study.

To save our readers and patient’s time, we will only skim over the high points of the study.  The overall sample size was 874 healthy novice runners who started just about any type of running program.  The reason for the study is because it is widely accepted that a sudden or drastic increase in running distance is strongly related to injury in runners, however the scientific knowledge used to support this knowledge is somewhat anecdotal and lacks a strong statistical analysis to support those findings.

The runners in the study were supplied with a GPS (Global Positioning System) watch.  They used to track when the runners made large increases in distances ran.  During the study, a total of 202 runners sustained a running related injury.  They researchers noted an increase in the following conditions:  Patellofemoral pain, Iliotibial Band Syndrome (ITB Syndrome), Medial Tibial Stress Syndrome (Shin Splits ARGH!), Glut Medius Injury, Greater Trochanteric Bursitis (Hip Bursitis), unspecificed injury to the tensor fascia latae (ITBand Syndrome, the TFL is the muscle which pulls on the ITBand), and Patellar Tendonopathy.  The researchers noted that injuries like those above occurred existed in RUNNERS WHO INCREASED THEIR DISTANCE BY MORE THAN 30% COMPARED WITH THOSE WHO PROGRESSED LESS THAN 10%.  These results had a confidence interval of .96 which means there is a good deal of significance when tested statically.

So, how does this affect me?  Do I even care about this study?  Well, if you are runner, yes you should!

The study proved that NOVICE (First year runners) who progressed their running distance by more than 30% over a 2 week period seem to be more vulnerable to a distance-related running injury.  This is when compared to runners to who only increased their distance by 10% over a two week period.  Please note that the researchers and authors admit that this was more of an explorative study and that an RCT (Randomized Clinical Trial) needs to be done to validate the assumptions made in this article.

So, Dr. Kemenosh and Associates, what are you trying to tell me about running in regards to this study?  Should I stop running?

Absolutely not!  The study validates to some extent that old adage of “slow and steady wins the race” when it comes to running and training.  We hear novice runners asking us all the time about “running hacks, life hacking, and marathon hacking” and while those systems have helped changed traditional marathon training, we still need to look into issues commonly caused by running too much, too hard, too soon.  The take away here is that true novice runners should be advised to progress their weekly distances by less than 30% per week over a two week period, to avoid the types injuries I listed above (which are all very common in runners).

Looking for help with muscle and tendon related issues?  Hamstring, calf pain?  Sore shoulders or low back pain?  Those are the things we most commonly work on here at the office!  Give us a call – 856-228-3100

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