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The Biceps Tear…What You Should Know

The Biceps Tear…What You Should Know

There are two heads to the biceps brachii, the long head (that goes from the labrum to just past the elbow…the outside one in the picture) and the short head (that goes from the coracoid process to just below the elbow…the inside one in the picture).  We rely on each muscle for shoulder flexion, elbow flexion, and some supination (hand rotated upward) of the forearm/wrist/hand.  Of the two heads, the long head tends to tear more as it thins out as it travels into the shoulder and it is more susceptible to damage at its attachment on the shoulder labrum.

The muscle can tear due to age-related wear and tear, labral tearing, overuse and trauma.  Generally, muscles tear from either the origin (where it begins proximally), or the insertion (the distal attachment).  When the biceps tears from the insertion, it will tend to roll up the arm and form a ball in the middle of the biceps region.  This type of tear tends to be very noticeable. Continue Reading →

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The Major Reason Why Your Knee Hurts and What You Can Do About It

The Major Reason Why Your Knee Hurts and What You Can Do About It

As a sports rehabilitation doctor, I get the benefit of seeing all types of sports injuries.  One of more common injuries I see is a ‘knee tracking’ issue.  I’ll go as far as saying about 75% of all people presenting with knee pain have this condition as either a primary issue or issue that is causing a more serious situation.  So, what exactly is this funny sounding condition?

As humans, we are the ONLY animal to be upright and on two legs as a primary means of ambulation.  Although our evolution has allowed us to do this, it is not without issues.  It just so happens that the muscles on the outside of the thigh tend to get stronger/tighter than the muscles on the inside.  Now, it’s a bit more complex than this but this should help give us a general idea of what is occurring. Continue Reading →

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Dr. Manison is now Selective Functional Movement Assessment (SFMA) Certified

Dr. Manison is now Selective Functional Movement Assessment (SFMA) Certified

Doctors learn how to assess and treat based on their specialization. Chiropractors are taught how to diagnose neuromusculoskeletal problems and how to properly treat them.  If a patient presents with a condition that a chiropractor cannot handle, then an appropriate referral should be made.

Dr. Manison has acquired skills in most of the highest level treatment approaches in his field.  In fact, he now teaches part of the Certified Chiropractic Extremity Practitioner (CCEP) program nationally.  This program, developed by Dr. Kevin Hearon, is regarded in the field as the highest level program on the assessment and treatment of extremity injuries. Continue Reading →

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Introducing the InBody 570 Body Composition Analyzer Part 3

Introducing the InBody 570 Body Composition Analyzer Part 3

The 3rd and final part of our discussion about the incredible InBody 570 covers 3 more studies that further validate its accuracy.  I know blogs that discuss studies aren’t always the most ‘fun’ to read, but it is important to have evidence readily available to show others that your InBody 570 bioelectrical  impedance analyzer assessment is vital to your health and should be part of your medical health history.  It can be used to help your primary care doctor (PCP) figure out ways to help you…hopefully many times through dietary intervention (like caloric restriction and intermittent fasting) vs. just administering drugs. Continue Reading →

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Introducing the InBody 570 Body Composition Analyzer Part 2

Introducing the InBody 570 Body Composition Analyzer Part 2

Part 2 of the discussion on the InBody 570 covers two of five important studies (and there are more) that help to validate the accuracy and legitimacy of the InBody 570.  This technical and may I say, ahem, somewhat boring information is important to discuss as your healthcare providers like to see objective health data. It’s time for the entire healthcare industry to understand and embrace what improvements in body composition can do not only for the individual patient, but also for the healthcare system as a whole.  Figure it this way: the more healthy we are, the less disease we will have.  This translates to less healthcare costs and this is good for everyone!  This blog and the next one serve to help educate not only our patients and those who will want to come to our office to get assessed, but also their healthcare providers who will be viewing these results.  Body composition is SO important.

Whether you are on our body modification program (caloric restriction and intermittent fasting…and most all of you should be interested in this to optimize your health) or are an athlete looking to improve your performance and recovery in your respective sport, the 570 is unmatched on the market, it is FDA approved, and it provides data that is vital to your health.  This is about your health.  It’s time to think of your future and what you should be doing to live longer and healthier!

The first study of interest is from 2004 and the lead author is Shinichi Demura.  The study was published in the Journal of Physiological Anthropology and Applied Human Science.  The name of this study is Percentage of Total Body Fat as Estimated by Three Automatic Bioelectrical Impedance Analyzers. Continue Reading →

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Introducing The InBody 570 Body Composition Analyzer Part 1

Introducing The InBody 570 Body Composition Analyzer Part 1

We are excited to be introducing our patients to the FDA approved  InBody 570 Body Composition Analyzer.

So, what does this incredible machine do?  Well, it does a LOT.  Simply put, it provides information about what you are made up of…do you have enough muscle, too much fat, are you more likely to have serious health issues due to too much visceral fat, too much systemic inflammation, etc…?  Did I mention this unit has cleared FDA testing?

It is now considered to be one of the gold standards for body composition assessment.  This might seem like an odd piece of equipment for a sports medicine chiropractic office, but in reality, all sports chiropractors should all have one.  It is vital to have a quality body composition analyzer as so many patients need to improve their muscle:fat ratio as an imbalance in this plays a direct role in a patient’s ability to recover.   In addition, we can determine the intracellular water weight vs. the extracellular water weight in the body.  This helps us in a unique and validated fashion to determine whether a patient has systemic inflammation. This is very important to be able to assess.  On the topic of visceral fat, the major contributor to vascular health and an indicator that most have probably never had checked, yes, the 570 has you covered (it’s validity has been compared to abdominal CT scans). Continue Reading →

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Teaching An Old Dog New Tricks: My Personal Experience With Caloric Restriction and Intermittent Fasting

Teaching An Old Dog New Tricks: My Personal Experience With Caloric Restriction and Intermittent Fasting

INTRODUCTION

I’ve been in the health and fitness business for close to 20 years.  I’ve worked with many supplement and nutrition companies but none could fully deliver what I needed for both my patients and me. I’ve always considered myself to be ‘in great shape’, but there is never a time that more cannot be done for a diabetic, like me.  I’ve always looked for products or systems that could lower my oxidative stress (high free radical levels) so that there would not be cumulative damage to my body by such stressors. There are options, but they are all allopathic in nature…meaning, they treat an existent problem yet do nothing to reduce/eliminate what is causing the problem.  With diabetes and most other health issues, this is too late.  I needed to find a system that could get to the cause of the oxidative stress.

My evolution led me to a program that I have now discovered is unmatched by any other in the industry for my health, and for yours.  Period. Continue Reading →

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Sarcopenia is a Killer and You Should Know About It

Sarcopenia is a Killer and You Should Know About It

Sarcopenia is a condition that we are ALL at risk of getting and it’s really quite scary.  It is defined as a process of reduction in skeletal muscle mass and muscular function that begins after the third decade of life (yeah, by age 40) and progresses as we age.  If we look at the body as having hundreds of thousands of different proteins/enzymes, and each muscle is made up of primarily protein, this problem begins to look really bad.  It’s one thing to have loss of skeletal muscle and be able to see yourself getting softer and weaker as you age, it’s another to not be able to see the decay in our heart and other organs.  Think about it…you are not just losing muscle mass and health on the outside, it’s occurring on the inside as well.   The problem is that this will not be identified usually until you have a significant health problem…and who wants that?  Sarcopenia is a condition of malnutrition yet almost nobody in the US does anything about it until it causes serious health issues.

Healthcare costs in the year 2000 were 18.5 billion dollars for the treatment of Sarcopenia and its related disease processes and that number is far greater now (this amount constituted 1.5% of the total health care cost of the nation in 2000).  Sarcopenia is well studied in the literature and all physicians should be discussing this topic with their adult patients (before they become geriatric patients). Sarcopenia has a direct link to COPD (Chronic Obstructive Pulmonary Disease), contributes to osteoporosis and related fractures, increases hip fracture riskcontributes to mental disorders, increases the risk of postoperative complications, and more.

One of the bigger concerns with Sarcopenia is that it has a link to mitochondrial damage.  This is a big deal as mitochondrial damage is linked to almost all disease processes in the human body. So, listen up…if you are near 40, at 40, or over 40, you need to pay attention if you want to be healthy and maximize your life!  This is nothing to laugh about.  As a society, we are getting softer and weaker as we age and yes, we can do something about it.

For those out there who still think we get enough protein, the easy way to prove this point wrong is by looking at our population as a whole and recognizing that Sarcopenia affects a large amount of our adult population.  Simply put, we are wasting away…yikes!  We have to concede that very little is being done to address this serious problem. The great thing is that with some basic lifestyle improvements, we can get healthier…yes, it’s that simple!

We have to keep in mind that the out of date notion that ‘don’t eat too much protein as it leads to positive nitrogen balance or kidney damage’ is simply that: out of date.  This blog falls on the heels of my last blog that discussed what caloric restricted resistance training athletes need for protein needs.  To many, this amount of protein would seem high, but the research, for some time, has been showing that we are not consuming enough high quality protein.  It’s time for healthcare professionals to update their knowledge on protein and make proper recommendations.  More protein isn’t needed just for those who are lean and active, it’s needed for everyone!

Treatment for sarcopenia involves being active/exercising and eating more protein to offset the age-related loss.  A 2015 double blind randomized study in the American Journal of Clinical Nutrition determined that a Vitamin D and leucine enriched whey (protein) ‘nutritional supplement’ improved muscle mass and lowered the risk of Sarcopenia.  Another study from 2015, this one a review study, suggests at least 25-30gm of ‘high quality’ protein at each meal to prevent Sarcopenia.  Beasley et. al authored a great study in 2013 in Nutrition in Clinical Practice that discussed how whey protein works better than other proteins at muscle protein synthesis (MPS) and his study makes recommendations to consider protein supplementation for those who are Sarcopenic and are not getting in enough protein (this basically means all of them).   

In the next few blogs, I’ll be writing about the best ways to extend your life/reduce diseases as per the literature.  In regards to Sarcopenia, we need to get in more high quality protein.  So this begs the question: what is the best protein to ingest, how do I compare protein sources,  and where do I get the best stuff?  To whet your appetite, I’ll mention that the literature shows that whey is the best protein.  As to where to get it, ask me now or wait until I write about it.

More on its way…stay tuned!

 

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‘Leaner and Meaner’:  How Much Protein Do You Need?

‘Leaner and Meaner’: How Much Protein Do You Need?

There has always been a debate about how much protein an athlete needs.  ‘You need one gram per kilogram of weight’ or you need ‘one gram per pound of weight’ and some other somewhat random numbers are usually used to determine how much protein resistance training athletes need.  As a healthcare provider who works with athletes, I need to make sure my athletes have enough protein to ensure healthy soft tissue function and reduce the likelihood of injury. Without proper protein consumption, an athlete will not achieve his/her fitness goals, and if there’s an injury, the athlete will certainly need extra protein during the recovery phase to get better.  I won’t discuss the subject of sarcopenia in this blog but this topic too is a major crisis in our country.  So, how do we know where to really start?

A literature review study from 2014 in the International Journal of Sports Nutrition and Exercise Metabolism gives us a good formula for determining the range of protein needed for caloric restricted, resistance trained athletes. Before we go any further, we should define who these athletes are…. they are…you and me.  If you work out, want to look good, and want a high level of lean muscle mass (highly desirable for good health), then this formula applies to you.  In fact, if you just work out and wish to have healthy muscle, this formula will help you achieve your goals.  The bottom line is that athletes tend to ingest less protein than they need and this is a major concern.  Not only that, but they also are unlikely getting the best quality protein they can. Oh, this study also mentions that total fat consumption should not go below 20% of total calorie intake.  So what are we looking at?  A sensible caloric restricted diet with adequate micronutrient ingestion and the proper ratio of macronutrients.  So, you want to be ‘lean and mean’?…here’s how to achieve it… Continue Reading →