Columbia Advanced Chiropractic, LLC

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The Dreaded DCO and What It Means To You and Your Shoulder!

The Dreaded DCO and What It Means To You and Your Shoulder!

DCO, or Distal Clavicular Osteolysis, is a rather bad shoulder condition that all too many athletes suffer from.

DCO occurs when we have damage to our AC (acromioclavicular) joint and it goes unattended to for a period of time.  More-so than that, additional damage is done with further activity and the bones that make up the joint get significant damage.

The AC joint is made up of where the distal clavicle bone meets the acromion process of the scapula (see photo below).  A sprain of the AC joint tends to involve a macrotrauma (one significant injury) such as a bad fall or other form of side shoulder impact.  The AC joint tends to get hypermobile (or move too much) easily as it is not a very stable joint to begin with.  When the joint is injured, or sprained, care is needed to stabilize the joint and allow for it to heal.  In-office treatments can significantly reduce recovery time and this is important as a healing AC joint sprain is susceptible to further injury.   Continue Reading →

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It’s Not Your Neck Silly, It’s Your First Rib!  It’s My What?

It’s Not Your Neck Silly, It’s Your First Rib! It’s My What?

Many people seek care from a chiropractor for neck pain.  After all, it’s one of the most common conditions we treat.  Sometimes, however, the reason your neck hurts is not due to the neck itself but rather something else close by: the first rib.

The first rib is just that…it’s the rib that is highest up and close to your neck.  It goes from the T1 vertebra (the vertebra just below the ‘cervical’, or neck, vertebrae) to the upper portion of the sternum, on the front side.  The clinical importance of the first rib (in this case) is that it has two very important muscles that attach on it.  Those muscles are the anterior and middle scalenes muscles. Continue Reading →

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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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Dr. Manison now TPI (Titleist Performance Institute) Medical Level 3 Certified Provider

Dr. Manison now TPI (Titleist Performance Institute) Medical Level 3 Certified Provider

Golf is a sport that many consider to be an addiction: players will go through great lengths to improve their swings, ball distance, fitness, conditioning, etc… all in the name of lowering that handicap.  Along with the need to have a good teaching golf professional to work with, players at all levels need a proper assessment to see if their bodies are even capable of doing what they are asking it to do and proper personnel to help them ‘move’ as they should.  Fixing a golf swing is not as easy as simply saying ‘you need to rotate more.’  The body is quite complex and the golf swing relies on so many joints and muscles that even a slight bio-mechanical issue can cost the golfer many strokes! 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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Slouching Population Part 2 of 3: Good Posture and Children

Slouching Population Part 2 of 3: Good Posture and Children

Have you recently witnessed a child sitting hunched over with their head down staring at a smartphone, ipad, or tablet on a table or on their lap? I would venture to guess that you see this picture multiple times per day if you have, or are around, children.  I would also go as far as to assume that most, if not all, children have been told multiple times to “sit up straight” by teachers, parents, and/or grandparents. However, even with the constant reminders, it seems that kids have been slumping more and more with the passing of each decade. One of the worst postures I have seen to date is a preteen who developed a point in his mid-back where there should be a smooth curve.

What is causing our youth to have worsening poor posture? Are they having an undeclared slouching contest with the previous generation, are they trying to be cool, or are they just a product of their environment with the vast surge in the use of technology? I get it. Even we adults need to be told to sit-up properly, especially when we are working at a computer, texting, or using a tablet. And you know what? Children hate being corrected as much as we do. With that said, it is hard enough to get adults to follow instructions, so how do we get children to change their habits, and understand the lifelong repercussions of sitting and standing in bad posture? Continue Reading →

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Dry Needling Support Models (4 of 4): Central Model and Studies That Prove the Efficacy of Dry Needling

Dry Needling Support Models (4 of 4): Central Model and Studies That Prove the Efficacy of Dry Needling

We have covered a lot of information about Dry Needling in our last 3 blogs.  We discussed the Radiculopathy Model, the Trigger Point Model, and the Spinal Segemental Sensitization and Pentad Model.  Already, we can clearly see how Dry Needling can help to break down myofascial trigger points (MTrPs) and reduce pain.  The fourth model will discuss another reason as to why Dry Needling can help you.

Central Model

Our final model, the Central Model, covers information about how Dry Needling and other physical interventions (including manipulation, massage, mobilization, etc…)  affect the spinal cord and brain.  This is a rather basic but powerful model.  The premise is that input stimuli will affect tracks in the spinal cord that will carry that information up to the brain.  The deeper the treatment, the more information that will be conveyed.  The hypothalamus will then take the stimuli and  communicate with the pituitary gland and affect other endocrine functions.

In regards to the hypothalamus, it has three primary functions:  1.  It supplies input to the brainstem, thus affecting autonomic regulation, 2.  It controls endocrine function, and 3.  It exerts influence on posture and locomotion.

With the Central Model, MTrPs along the spine will likely cause more autonomic issues (please click to read more about autonomic issues on the Trigger Point Blog).   Dry Needling causes an anti-inflammatory response that emanates from the hypothalamic-pituitary-adrenal axis.  This is deep stuff!

If we assume that the hypothalamus is directly or indirectly adversely affected by MTrPs, then we can conclude that such MTrPs create autonomic and endocrine problems in addition to postural and movement issues (this means it affects the way you work inside and outside).  Certainly, we would want to rid our bodies of such noxious stimuli, and since Dry Needling can eliminate such MTrPs, then this makes it a great option for restoring proper function of not only the musculoskeletal system, but also the autonomic and endocrine functions that are affected by an improperly functioning musculoskeletal system.

Any way you slice it, Dry Needling can help you to function better.  From simple pain and dysfunction to autonomic concomitants, Dry Needling offers a viable option for the treatment of trigger points and pain due to musculoskeletal causes.

Let’s take a look at some studies supporting the application of Dry Needling…there are a few here but many more in print:

We will start with the grand-daddy of them all…the landmark study performed by Karl Lewit, MD published in 1979.  This study broke down the effects of trigger point injections to determine if the analgesic/steroid that was the agent that helped the patient, or was it the needle alone that contained all the magic!  Please read study, and if you would like the full study (versus just the abstract), please let us know.

The Needle Effect In The Relief of Myofascial Pain

And the other studies…

Dry Needling Having Anti-Nociceptive (anti-pain) Effects

Probable Mechanisms of Needling Therapies for Myofascial Pain Control

The Influence of Dry Needling of The Trapezius Muscle on Muscle Blood Flow and Oxygenation

Dry Needling at Myofascial Trigger Spots of Rabbit Skeletal Muscles Modulates the Biochemicals Associated with Pain, Inflammation, and Hypoxia

The Effect of Dry Needling in the Treatment of Myofascial Pain Syndrome: A Randomized, Double-Blinded Placebo-controlled Trial

Dry Needling and Exercise for Chronic Whiplash – A Randomized Controlled Trial

Management of Shoulder Injuries Using Dry Needling in Elite Volleyball Players