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Locations : Laurel Springs, Haddonfield, Mt Laurel, Somers Point, and Washington Township, NJ

All Posts in Category: Osteoarthritis

Achy Joints – More EVIDENCE that HIGH QUALITY Chondroitin Sulfate supplementation helps arthritis.

Direct Link:

While looking for pertinent and relative research to issues we deal with here at the office, I came across this article online which was very recently published in supplementation research.  PubMed is your basic search site for indexing research studies and usually one of the first places we look as doctors trying to stay ahead on the evidence based practice spectrum of chiropractic.

For about 15-20 years, Chriopractors, Nutritionists, and some other medical professionals have felt confident that Chondroitin and Glucosamine supplements from GOOD SOURCES help to keep arthritic joints moving freely.  Please note that we stress good sources with all supplements.  We don’t mind if you buy your supplements from other sources than our office, just be sure the source is reputable!

The best part of this study is this, the conclusion in a study basically tells you what the researchers what you want to know and this one goes right to the point in dealing with osteoarthritis, pain, and tightness in the joints.

CONCLUSION:  A 800 mg/day pharmaceutical-grade CS is superior to placebo and similar to celecoxib in reducing pain and improving function over 6 months in symptomatic knee osteoarthritis (OA) patients. This formulation of CS should be considered a first-line treatment in the medical management of knee OA.

Here at the office we of both a basic Chondroitin and Glucosamine from Anabolic Labratories, but also an even better version known as Nutra-Disc which contains several different natural anti-inflammatories like Turmeric, Bromelain, Curcumin and many others. Nutra Disc is a unique proprietary product for disc injuries and related connective tissue problems.  Nutra Disc contains a specialized blend of ingredients designed to support the body’s natural response to maintain good joint health, promote the production of collagen, and support the rebuilding of cartilage.

We previously published positive quality research about Chondroitin and Glucoasamine supplementation on our blog a few months back which you can see at the link below.


Direct link to the Nutra-Disc label:×9%20optimized.pdf

Direct link to the Nutra-Disc data sheet:

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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!


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


  • 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?




Need more info?  Ready to register?


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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:

CBS News:

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


Email us on our Contact Us Page!  

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New research shows that Omega-3 supplementation can help prevent childhood asthma!

If you listen to our docs long enough you will note that a very common theme in our office is “take your Omega 3’s, they pretty much have some benefit for everyone”.  With the new information presented in the YouTube video embedded above, the University of Waterloo has again helped the public health world proving more of what we already suspected.  In this case, some fairly new research has shown that Omega 3 supplementation in expecting mothers greatly reduces the prevalence of childhood asthma down the road.  Here at the office our docs fairly reguarly, if not daily take Clincal Omega 3’s from Anabolic Labs due to a handful of reasons.

So why should most of us who CAN take Omega 3’s take a HIGH QUALITY Fish Oil supplement?

First off, one of the very few preventative suggestions for possibly avoiding or preventing the amyloid plaques present in Alzheimer’s is DHA supplementation (one of the two most important contents inside a HIGH QUALITY FISH Oil supplement)  Look at the statement below,

From the NIA Website:

“Some scientists have focused on DHA (docosahexaenoic acid), an omega-3 fatty acid found in salmon and certain other fish. Studies in mice specially bred to have features of Alzheimer’s disease found that DHA reduces beta-amyloid plaques, abnormal protein deposits in the brain that are a hallmark of Alzheimer’s. Although a clinical trial of DHA showed no impact on people with mild to moderate Alzheimer’s disease, it is possible that DHA supplements could be effective if started before cognitive symptoms appear.”


Moving on, there is a growing body of evidence that when expecting mothers should supplement regularly with DHA (docosahexaenoic acid), an omega-3 fatty acid found in salmon and other cold water fish and measured accurately in all high quality supplements, good things happen for the babies in those pregnancies.

From a research paper published in the journal of Obstetrics and Gynecology stated the following:

“Recommendations:  There is little doubt that pregnant women need at least as many omega- 3 fatty acids as nonpregnant women, and likely need more DHA. The recommendations for dietary omega-3 fatty acids should be adopted at the onset of pregnancy, but there may be benefits for all women who are considering becoming pregnant. Given concerns for mercury toxicity with overconsumption of certain fish, in order to meet these recommendations, pregnant women will need to consume omega-3 fatty acids from 3 sources: vegetable oils, 2 servings of seafood per week, and omega-3 fatty acid supplements containing EPA and DHA or DHA alone. Intake of omega-6-rich oils found in sunflower, corn, and cottonseed oils should be minimized because they are converted to substrates that compete with EPA. Pregnant women should reduce their intake of these oils and substitute others that are rich in omega-3 fatty acids like flaxseed, canola, and soybean oil.”


One of the best, concise, medically referenced uses of Omega 3 information is located at the University of Maryland Medical Center hosted at, some of the topics covered on this site are high cholesterol, high blood pressure, heart disease, diabetes, rheumatoid arthritis, systemic lupus erythematosus (SLE), osteporosis, depression, as well as others.


The following is taken from the supplementation of Omega 3’s website:

“Research shows that omega-3 fatty acids reduce inflammation and may help lower risk of chronic diseases such as heart disease, cancer, and arthritis. Omega-3 fatty acids are highly concentrated in the brain and appear to be important for cognitive (brain memory and performance) and behavioral function. In fact, infants who do not get enough omega-3 fatty acids from their mothers during pregnancy are at risk for developing vision and nerve problems. Symptoms of omega-3 fatty acid deficiency include fatigue, poor memory, dry skin, heart problems, mood swings or depression, and poor circulation.”

If you are looking for some help with an issue in the south Jersey regions, we would be glad to offer our opinion.  You can call our main office at 856.228.3100.

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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.


— 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:

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:

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


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Research Roundup – Habitual running ‘may protect against knee osteoarthritis, not cause it’ states new study.

Well would you look at that!  Times are a changing in the old medical world and this time we are getting it right.  We feel pretty strongly here at the office that often times, bones are not thought of as living  objects and that most people feel that bones are just hard, solid pieces of calcium that are ridged and dead.  This is not true, bones adapt to stress by actually becoming denser and this is why keeping active as you get older is very important.  Julius Wolff postulated in the late 1800’s that bones in a health person or animal will adapt to the loads under which it is placed.  This is now known as Wolff’s Law, and is very important in those concerned with keeping bone density increased as we grow into our twilight years.  We also know that when bones and joints are stressed, they actually remodel themselves in some cases to help cope with the stress placed on them.

For better than 50 years, a lot of old, dogmatic ideas have clung to the running world that “running is probably bad for your knees” and even worse yet, “squatting is probably bad for your knees”.  Please understand that both of these activities are contraindicated in someone who already has osteoarthritis, however someone without issues related to arthritis should not avoid running or squatting.  When the website, posted the article “Habitual running ‘may protect against knee osteoarthritis, not cause it’ “ we were VERY excited that someone had taken on the stigma that running is probably NOT bad for your knees! 

Running article related to Arthritis:

The article jumps right into the thick of it with an opening statement of “Contrary to previous research, a new study suggests that engaging in running on a regular basis does not raise the risk of developing osteoarthritis of the knee.  In fact, it may even help protect against the condition”.  As a company that primarily works on runners, we already knew that this article was getting to get right after it!

In the study, 2,683 participants were analyzed with a mean age of 64.5 years of age.  The participants were part of a study named the Osteoarthritis Initiative.  The patients in the study were assessed at baseline for symptoms of osteoarthritis and had x-rays of the knee taken.  The patients also took a standardized survey.  Knee x-rays were then taken two years later and were assessed for signs of radiographic knee osteoarthritis.  ROA – Radiographic Knee Osteoarthritis is a term used for when the patient has findings on x-ray to support the findings of arthritis, but pain is not present.  If the patients had regular pain in the knee as well radiographic findings of osteoarthritis, they were considered to have symptomatic osteoarthritis, which is what we think of as arthritis in the everyday sense.  Any participants who had undergone a complete knee replacement were categorized as having frequent knee pain, and SOA (symptomatic osteoarthritis).

So, after all this is said and done, the study had found some decent evidence that habitual running at any point in life “is not harmful to the knee joint”.  This is a pretty big win for those of us in the running crowd because for years we have been subjected to the idea that “running is bad for your knees”.  When I told my own father I was shooting to train for my first marathon, the first thing he responded with was “isn’t that much running going to be hard on your knees?”.  I looked at him and smiled and said well, there is only one way to find out.

The team in this study agreed to present the results of the study at the American College of Rheumatology’s Annual Meeting in Boston, MA.  The team also agreed that this study showed us two things.  Runners with a lower BMI (Body Mass Index) were more likely to engage in running and that results suggest that regular running does not raise the risk of knee arthritis among the general population and that it may actually protect against the disease.  The team was also adamant that this study does NOT prove that where regular running may cause harm to individuals who already have knee arthritis.  The lead researcher stated this, “However, in people who do not have knee osteoarthritis, there is no reason to restrict participation in habitual running at any time in life from the prospective that it does not appear to be harmful to the knee joint.”.

The article and study are great news for those of us in the running community.  The article online at was written by Honor Whiteman.

The study referenced is as below:

American College of Rheumatology news release, accessed 14 November 2014.

Additional source: Centers for Disease Control and Prevention, osteoarthritis, accessed 14 November 2014.
The reference to Honor Whitemans article is found at:

Whiteman, H. (2014, November 16). “Habitual running ‘may protect against knee osteoarthritis, not cause it’.” Medical News Today. Retrieved from

If you have questions about running, running related injuries, osteoarthritis, or Sports Medicine, Dr. Kemenosh and Dr. Gross have both treated everything from the occasional weekend warrior to the professional athlete.  Give us a call at our office so we can see if our methods are right for you.  We keep regular hours in Laurel Springs (Clementon), Haddonfield, Washington Township (Sewell) and Somers Point New Jersey!

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Just when you think you have cholesterol all figured out, a study/article like this happens!

Outside of muscular / skeletal issues, one of the biggest complaints we hear about at our office is our patients having troubles with cholesterol medications and cholesterol levels.  A very interesting article on The New York Times popped up on my news feed this weekend discussing the results from a new cholesterol drugs trial that did not go as planned but in theory was supposed to help so many.  The results were discussed at this past weekends American College of Cardiology’s annual meeting.  This article is one of the main reasons we stress to our patients that they must push to stay on top of cholesterol issues with their family doctor and to stress at least one follow per year.

The moral of this story, talk to your family doc regularly about your cholesterol and a cardiologist if need be!

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“Walking is not a very good back exercise” mentioned on PBS this weekend, not a very good opinion

I was slightly shocked listening to a show on PBS this weekend discussing all forms of exercises to help with aging.  On the the show they were discussing a wide variety of exercising from a large panel and the topics of discussions were yoga, pilates, stretching routines, swimming, cycling, running and many other forms.  A statement was made on the show however that “Walking is not a very good back exercise” and I almost dropped my pain brush in the garage, loaded with white paint!

Hold on and prepare yourself  on why this is a poor attitude to have towards “talking a walk”.  While I feel the person making this statement was comparing walking against pilates or aerobics and basing their statement on muscle activation and stretching, walking is actually a good exercise for the back.  When you look at walking from a stance of worrying about the deepest areas of the spine, and not just your “back muscles”, then you realize quickly that walking is very essential to spinal health and is actually a good exercise for the back.

Spinal mobility is intimately related to the health of the spinal discs.  If you take the flexibility out of the disc itself, spinal mobility and flexibility will be decreased greatly.  This means, the discs help to provide a great deal of rotating levels and bendable materials so that we can move.  If the discs in our spines were not flexible, we would feel like we had a stiff board for a back and not a system of joints that permits movement.  Disc hydration is what allows the discs to remain mobile.  Around ages 18 – 22, the spinal discs ability to self hydrate starts to steadily reduce.  This means that about the time you truly become a skeletal mature adult, lets say by age 25, the only way that the core of your discs can be lubricated, watered, and fed with nutrients is through a process known as imbibition.

Bare with me on this in relation to the original point that “Walking is not a very good back exercise”.  The opening and closing action of intradiscal spaces (space the disc resides in between two bones known as vertebral bodies), applies and then releases pressure on the disc causing a pumping process with feed and nourishes the disc with water and nutrients.  This pumping motion sucks fresh spinal fluid in and compress old spinal fluid out.  This process is very critical to the health of the discs, keeping them soft, compressible and flexible.  To take this point even further, when a person sits still, the process of imbibition is stopped completely.  So yes, sitting in an office chair for long periods of time does negatively impact your spine in most cases when looking at the spinal discs.

So my response to the idea that “Walking is not a very good back exercise” is that the statement is completely false and while walking does not strengthen your back musculature, it is imperative to discal health deep inside the spine.  Furthermore, when compared to a daily activity of sitting in a desk chair for long periods of time, walking for a sore back can be just what the doctor ordered.

Looking for more information about your spine or need some old low back looked at?  Give us a call and we will try and help you as much as possible.  856-228-3100 


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Plantar Fasciitis and Shin Splints – Why doesn’t Active Release and Instrument Assisted Soft Tissue Manipulation pop up on Google sooner?

Listening to Dr. Kemenosh, Dr. Gross, and a patient converse today, a very good point was brought up that for the sake of patient care, it’s sad that Active Release and IASTM (Instrument Assisted Soft Tissue Manipulation i.e. Graston, FAKTR) doesn’t come up sooner when sufferers are surfing Google looking for help.  Right now if you go to Google and search for “plantar fasciitis treatment” the results are somewhat abstract and trying to sell you items like the socks that pull up on your toes while you sleep, devices that stretch out or roll out the middle of your foot, as well as other devices.  These are probably great, however in a chronic case of plantar fasciitis, you need more.

We have found that the results are slightly better for “shin splints treatment”, but again, a good hands on treatment like Active Release and using an instrument on the areas like Graston/FAKTR/SMART Tools don’t come up.  In both of these cases, you have to treat the other areas around the actual pain, usually the calf muscles in these cases.  We also then use corrective exercises and other items like RockTape to help strengthen the areas, remove inflammation, and give you a long term fix with the ultimate goal of greatly improving and removing your pain.

Regardless, if you are fighting an uphill battle with Plantar related pain or shin splints, give us a call and we will gladly set you up with an examination and if we feel we can get you back on your feet with less or with out pain, we will treat you!  856-228-3100


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Positive studies for Chondroitin and Glucosamine on osteoarthritis continue to grow!

We often hear around the office from patients that they had tried Chondroitin and Glucosamine supplements for osteoarthritis and had not better results, however upon questioning them, we find that they had only been taking it for a short time.  In most cases, supplementation is needed to be done for weeks on a regular basis before the effects are truly felt.  The study reviewed today further strengthens that when chondroitin sulfate and glucosamine are taken for painful knee osteoarthritis regularly, the results are comparable to a prescription drug, celecoxib.

A recently published study in the Annals of Rheumatic Disease, titled “Combined chondroitin sulfate and glucosamine for painful knee osteoarthritis: a multicentre, randomised, double-blind, non-inferiority trial versus celecoxib.”  The head of author of this study was Professor Marc C Hochberg who is at the University of Maryland School of Medicine in Baltimore, MD.  A free copy of the study can be found ONLINE HERE.

The objectives of this study was to “compare the efficacy and safety of chondroitin sulfate plus glucosamine hydrochloride (CS+GH) versus celecoxib in patients with knee osteoarthritis and severe pain”.

The overall conclusion of this study found that “CS+GH has comparable efficacy to celecoxib in reducing pain, stiffness, functional limitation and joint swelling/effusion after 6 months in patients with painful knee osteoarthritis, with a good safety profile.”

While we can only follow this study for its data found in knee osteoarthritis, it seems fair that when taken regularly, should effectively help decrease pain and tenderness from all other areas of osteoarthritis to an acceptable extent.

Taking this study a step further, we commonly keep a product from Anabolic Laboratories called Nutra-Disc.  Nutra-Disc contains Chondroitin Sulfate, Glucosamine Sulfate.  Nutra-Disc also contains Turmeric, a natural anti-inflammatory and an enzyme blend.  The enzymes found in this product are Bromelain, Protease 6.0, Protease 4.5, Serrazimes, Chymotrypsin, Papain.


At our office, we use a few different techniques for treating pain and tenderness from osteoarthritis, including, Active Release Technique, IASTM (Instrument Assisted Soft Tissue Manipulation), Chiropractic Manipulative Therapy, and supplemental and nutritional support, as well as many others.

Nutra Disc Label Zoomed In (Easy to read!) – nutra-disc-label

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