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All Posts in Category: Degenerative Joint Disease

Lower Back Injury and what you can do!

Every year thousands of people suffer some type of lower back injury. This often requires a visit to their chiropractor as a result of gardening or doing some other type of yard work. This happens a lot in the spring when people are anxious to get outside and tend to their yards after months of being penned indoors by the winter season.

It is relatively easy to injure your back, especially if you are moving heavy objects around the yard. While good chiropractic care is always one of the first things you should do after receiving such an injury, you also want to consider the fact that chiropractic care, which occurs on a fairly regular basis, may help to curb some of these injuries in the first place as does following some common safety precautions when you are working in your yard. Our team can help you improve your readiness for the spring season using Active Release Technique, Chiropractic Manipulation, home exercise strategies, and improving your stretching at home as well!

There are a number of tips that can help you when it comes to preventing back injuries while you are working in your yard. Perhaps one of the most important things to remember is that in most cases, the more fit you are the less likely you are to suffer an injury of this type. Fitness is a good idea in any case and this is especially true when you are performing any type of rigorous physical activity. Good muscle tone and flexibility will go a long way toward helping you stay healthy and free from back injuries that can be very painful.

In addition, you always want to lift properly. Always lift with your knees and keep your feet in front of you approximately a shoulder length apart or even slightly wider. Whatever you do, always avoid lifting with your back. This is one of the primary reasons that people receive back injuries in the first place. Another thing you can do to reduce your chances of injuring your back is to use tools that work well for you. If you are an individual with a smaller build, you need to use smaller tools and try not to move things that are too heavy without help.

Of course, if you do feel tightness in your back, or you have had an especially hard day, you can typically relieve much of the tension by icing the muscles appropriately. If you prefer, you may want to alternate ice and heat in order to reduce inflammation and then relax the muscles. Ensure that you do not apply ice directly to the skin and that you use caution when applying heat as well.

It is always a good idea to visit your chiropractor on a regular basis even if you are not currently experiencing any problems. Professional golfers in particular have recently shown that they stay in top shape with semi regular visits to the chiropractor. This can prevent you from suffering a back injury or some other type of injury while you are working in your yard.

In the event that you do suffer an injury our team would be more than happy to help and can be an integral part of the recovery process. Working in your yard and getting ready for spring is something that most people enjoy, but it is also something that you should do carefully in order to ensure that you do not injure yourself. Be safe and contact us with any questions you may have.

If you have questions, please use our CONTACT US page at the following link!

https://drmarkkemenoshandassociates.com/contact/

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Ice or Heat for Injuries – Is the medical standard changing

A very interesting article appeared over at Spartan.com posing the question “Is RICE all wrong?”, and jumps to the question of Ice or Heat for injuries and it caught the eye of Dr. Andrew Gross and Dr. Josh Sand at out office because when we were in Chiropractic around five years ago, the automatic correct test answer in a lot of cases for injuries was ICE, there were rumblings that possibly RICE was going to be changed to something different.

For the most part RICE isn’t totally wrong, we just don’t feel it is as correct as it once was for all major injuries. Simply put icing most injuries is not a bad idea and safe. The idea of RICE comes from Dr. Gabe Mirkin MD who published a book about sportsmedicine (The Sportsmedicine Book) and ever since then the standard has been RICE which stands for Rest, Ice, Compression and Elevation. For around forty years now, Dr. Mirkin has been thought of as the authority on immediately icing an injury (along with compression and elevation.

We thought for a long time that icing the injury stopped, or at least limited the flow of inflammation to the injured region but we now understand that it only delays the processes. The newest ideas that numbing the injury only dulls the pain and sometimes does not permit you to feel the warning signs of pain being caused by injured tissue. The article linked below showed that 22 seperate studies found that “ice is commonly used after acute muscle strains, but there are no clinical studies of its effectiveness.” A report in the Journal of Strength and Conditioning Research was even more alarming. Not only does icing fail to help injuries heal, the authors found, it may well delay recovery from injury. In 2017 The Journal of Athletic Medicine Research recently showed that icing actually kills muscle cells when they are iced for too long of a period post injury most likely from the direct effects of the inflammatory response of the injury being “held” directly on the injured tissue and not being pumped around due to the ice holding it there.

Taken directly from the article on Spartan.com —

“You might think that Dr. Mirkin would bristle at this blow to his erstwhile recommendations. Not so—he now openly rejects at least half of the RICE advice that helped make him famous. “I do not believe in cooling anymore,” he explained via email. Nor does he believe in the “R” component of his famous prescription either.
In a foreword to the second edition of Iced!, Dr. Mirkin says most athletes are far more concerned with long-term healing than transient pain relief. “And research,” he writes, “now shows that both ice and prolonged rest actually delay recovery.”

Check out the article for yourself at https://life.spartan.com/post/is-r-i-c-e-all-wrong

 

 

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

Direct Link: https://www.ncbi.nlm.nih.gov/pubmed/28533290

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.

Link: https://drmarkkemenoshandassociates.com/positive-studies-chondroitin-glucosamine-osteoarthritis-continue-grow/

Direct link to the Nutra-Disc label: http://www.anaboliclabs.com/User/Document/Labels/Nutra%20Disc%203629-180C%203.0×9%20optimized.pdf

Direct link to the Nutra-Disc data sheet: http://www.anaboliclabs.com/User/Document/Fact_Sheets/NutraDisc_DataSheet.pdf

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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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So tell me about these Aline Performance Insoles all you Docs are testing out!

So for about the past month we have been testing and tuning our own Aline Orthotics (Performance Insoles) as we prepare to start fitting them semi regularly for our patients.  For the first time in a long time we are excited about an orthotic because Aline truly has a product that works very well with MOST feet.  These orthotics are also affordable, making them even more enticing as an offering for our patients.

Here is some of what we have been testing and tuning the past few weeks since having a sit down training session with training and fitment team from Aline.

First off, here is the Aline base station.  It’s simple, effective and you can within a few moments if you will likely benefit from Aline performance insoles and where we can add in physical adjustments to help with pronation and supination.

Lets start with Dr. Josh Sand’s hiking setup.  As you can see in the following pictures, Josh just picked up a new pair of Merrell hiking boots and immediately started using his Aline Golf Insoles in them to test them against Aline Active Insoles in his older Merrell hiking boots to see how they both performed.  Josh said surprisingly both pairs felt great, he feels that he is only slightly more interested in wearing the golf model because they are in his new boots and that both pair have felt great for him other than some increased muscle soreness in his peroneal muscle groups (lateral  shin muscles that help to stabilize the foot).  The only slight complaint Dr. Josh has is that the golf insoles are slightly tacky due to the top layer of the insole being designed for feeling the ground underneath you as much as possible and gripping through during the golf swing.

 

I, Dr Craig Evans, have been testing the cycle models because our Aline rep alerted us that the Active and Cycle models are both designed for highly active individuals and were designed with running/tri-athletes/hikers in mind.  I have not been doing as good of a job with taking pictures of my orthotics testing as Dr. Sand and am admittedly an orthotic basher to some extent due to my past medical history.  Sometime around my freshman or sophmore year of high school my parents spent around $600 (or more) on hard orthotics for me to help curb some tendinitis issues that I was hard casted for several times during my high school basketball career.  I was permitted to play through the pain to some extent with prescription for NSAID’s but often spent the following spring and summer in a walking cast in an attempt to calm down my Achilles tendon.  Looking back now I’m guessing that walking boots were not invented at that time and I am almost glad because I would have probably taken it off.  For the most part however, I never wore those hard orthotics longer than a week because they were almost downright unbearable at least for me.  They felt like rocks and nothing that I could do could make it any better.  From that day forward I have been picky about what shoes I wore and was able to remain somewhat pain free in the Achillies tendon region by keeping up a strength training regimen and fell this is what greatly helped me leading into my senior year.  The summer before my senior year of high school a new Orthopedic, fresh out of med school from Canada saw me and forced me into a physical therapy regimen that I still keep somewhat going to this day.

Below you can see the Aline Cycle insoles that are currently in my Adidas Boost ESM 3’s.  It took an honest week of walking and three 5k runs on the treadmill for me to settle into them well.

The Aline Cycle performance insoles have an integrated fabric mesh that helps to keep the insole slim.  The orthotic is designed with sports like running, cycling, and soccer in mind!  These insoles feature the exact same support and technology as the Aline active models with a slightly different top coating.

Here are some of the other models we are actively keeping in stock as well.  The yellow models are the Aline Active + models and they offer support as well as comfort with just a bit more padding.  The Aline Active + models are popular with all types of athletes including tennis, runners and they work well in everyday footwear.

 

The Aline Active performance insoles are clear with red inserts.  They are designed for all day activity and used by many of the Aline professional athletes.  Aline Active performance insoles are the most popular Aline model by far.

 

Interested in some performance care or seeing if Aline orthotics can help you?  Please feel free to give our office a call at 856-228-3100 or you can email us at our Contact Us Page linked below!

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Running actually lowers inflammation in knee joints – Running may also slow the process that leads to osteoarthritis

Watch out!  Dr. Tim Legath just dropped this article on my lap from BYU (Brigham Young University) which is entitled “Running actually lowers inflammation in knee joints – Running may also slow the process that leads to osteoarthritis”.

From the article on Science Daily:

Summary: We all know that running causes a bit of inflammation and soreness, and that’s just the price you pay for cardiovascular health. You know; no pain, no gain. Well, maybe not. New research from exercise science professors finds that pro-inflammatory molecules actually go down in the knee joint after running.

Link:  https://www.sciencedaily.com/releases/2016/12/161209100236.htm

More from the article on Science Daily:

“What we now know is that for young, healthy individuals, exercise creates an anti-inflammatory environment that may be beneficial in terms of long-term joint health,” said study lead author Robert Hyldahl, BYU assistant professor of exercise science.

Hyldahl said the study results indicate running is chondroprotective, which means exercise may help delay the onset of joint degenerative diseases such as osteoarthritis.

This is potentially great news, since osteoarthritis — the painful disease where cartilage at the end of bones wears down and gradually worsens over time — affects about 27 million people in the United States.

“This study does not indicate that distance runners are any more likely to get osteoarthritis than any other person,” Seeley said. “Instead, this study suggests exercise can be a type of medicine.”

Link:  https://www.sciencedaily.com/releases/2016/12/161209100236.htm

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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.”

Link:  https://www.nia.nih.gov/alzheimers/publication/preventing-alzheimers-disease/search-alzheimers-prevention-strategies

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.”

Link:  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2621042/

One of the best, concise, medically referenced uses of Omega 3 information is located at the University of Maryland Medical Center hosted at UMM.edu, 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.

Link:  http://umm.edu/health/medical/altmed/supplement/omega3-fatty-acids

The following is taken from the UMM.edu 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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The Dan Patrick Show – Dan Patrick brings a Chiropractor to the studio for low back pain with sciatica!

You should probably know know who Dan Patrick is, but if you don’t, he has his own sports talk show that is nationally syndicated across the country and currently hosts NFL Sunday Night pre-game and post-games shows on NBC.  Before that however, we worked several years as one of the ESPN anchors who more or less built the mother ship.  Just recently another Chiro shared this video because someone called into The Dan Patrick show asking about chiropractors and sports teams and they actually shot this behind the scenes video for YouTube!  The first video below is very short and sweet and the second video is about three times as long and shows you some more.  Being that Dan Patrick is a big star on both radio and television, he was lucky enough that Dr. Lee Rumley came to his studio in Connecticut to treat him!

Video:  Behind the scenes (DP’s Chiropractic visit)

Video:  Dr. Lee Rumley treats Dan’s sciatica in the Man Cave

While what is shown in this videos is good, I believe they played up some of this to an extent for TV.  If you suffer with low back pain, sciatica, or any other form of issue, you should probably think over giving us a call!  We can do everything you saw in this video and so much more.  These videos showed very little soft tissue work being done to help correct low back pain and sciatica long term.  We would also follow up after a few visits with recommendations for physical therapy or home based corrective exercise.

Need to speak with us?  Give us a call at 856-228-3100

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Would you like the original link to The Dan Patrick Show for the video?

Trying to fix Dan’s back during the show

If you are familiar with The DP Show, you should probably note how The Dannette’s huddle around the entire time, it’s pretty cute when you watch it from that view point.

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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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The Canadian Armed Forces has thrown out dated fitness testing in favor of real-world tasks. Sit-ups tossed out.

The Toronto Star published a story recently (January 20th, 2016) with the headline, “The Death of the Sit Up”.  The article immediately popped up on my social media feeds because one of the consultants mentioned in the article is Stuart McGill, PhD.  Dr. McGill is a professor of spine biomechanics at the University of Waterloo.  Dr. McGill is also widely known as one of the best researchers around for prevention of low-back-injuries.

Original Article Link:  http://www.thestar.com/news/gta/2016/01/20/the-death-of-the-sit-up.html

The article discusses that once a staple of physical fitness in gym classes and military fitness tests, the Canadian Armed Forces have thrown out using sit-ups as a measure of physical fitness.  Dr. McGill has been researching spines for over 30 years and has shown several times over that flexion of the spine, the motion used in a sit-up can statistically put you at a great risk for developing a low back disorder.  Dr. McGill is quoted in the article that he has now been contacted by the US Military and asked to show his findings that doing repeated traditional situps causes damage over time and as repetitions increase, the more likelyhood of a disorder of the spine develops allowing the spine to become damaged.  The largest problem with the traditional situp are that if a disc bulge begins to form, repeated sit up motions can actually increase the size of the bulge due to simultaneous compression and bending of the discs and spine.

The article goes on to talk about ways other exercises are being used now to evaluate physical fitness and military training.

The last few words on the article more or less sum up most of McGill’s findings and our advice as well:

“McGill says every exercise is a tool to achieve a goal. “If (your goal) is to become faster, stronger, or if it’s to become injury-resilient and have less pain in life and make yourself generally fit to enjoy life, then the answer is don’t do sit -ups,” he says. Exercises such as planks, he notes, are safer for lower backs and better engage core muscles.

“But if you’re a UFC fighter or a jiu-jitsu master and you have to do groundwork to fight an opponent off your back, you should probably do a few sit-ups.”

We highly encourage you to check out the original article at the Toronto Star authored by Mary Ormsby:

http://www.thestar.com/news/gta/2016/01/20/the-death-of-the-sit-up.html

stick-figure-sit-ups-hard-on-the-back-dr-craig-evans

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