Low Back Pain: Releasing the Iliopsoas for Relief

Having low back pain? Look to the front! Specifically the anterior thigh and the hip flexor muscles.

The Psoas major and Iliacus muscles, together called Iliopsoas, is a large muscle that is involved in the action of hip flexion. With muscle fibers originating from the lateral aspect of the twelfth thoracic vertebrae, all lumbar vertebrae and their corresponding discs, and the iliac fossa, and then attaching to the lesser trochanter of the femur, which is high up on the interior thigh, this large muscle is also involved in lateral rotation and adduction of the hip, and flexion of the torso.

The psoas initiates walking while the iliacus is active throughout walking. Iliopsoas plays a significant role in postural stabilization, contributing to the natural curve of the lumbar spine by controlling the pelvic tilt.

Although these two muscles, psoas major and iliacus, are often viewed as one muscle and as a singular discrete unit of movement, it’s important that anyone doing manual therapy can also differentiate the muscle fibers of psoas and iliacus individually in order to fully assess and treat.

In a recent seminar entitled Releasing the Iliopsoas presented by Peggy Lamb MA, LMT, NCTMB Ms. Lamb discussed the manual therapy technique she developed and named Muscle Swimming used to work this muscle. The core components of Muscle Swimming are:

1) Warming the tissue and freeing the fascia before any deep tissue work using Swedish massage strokes.

2) Pin and rock which, after passively shortening the muscle, combines pinning the muscle with a broad, dispersed pressure while using a slow rhythmic rocking of the joint. Rocking stimulates a parasympathetic response and allows the patient to relax and thus the tissue can soften and now be worked deeper.

3) Pin and move where the patient is now an active part of the technique. The muscle is first placed into a shortened state and then stretched to just the first barrier and pinned. The patient performs, in a slow controlled motion, the actions of the muscle. This is repeated 4-5 times then check-in with the patient for any noted change. If none or little change, then the therapist can either add resistance to the movement or try a different movement pattern.

4) Work the muscle from different positions. Ms. Lamb also detailed specific protocols using her Muscle Swimming for working/releasing iliopsoas and the secondary thigh flexors. When working the iliopsoas muscles it is always a good idea to first begin work with the secondary hip flexors: rectus femoris, adductors longus, brevis and magnus, Sartorius, TFL as these muscles can also be involved when the iliopsoas is problematic.

Address Low Back Pain and Other Symptoms

So, what are some indications that you need to have the iliopsoas worked on? Low back pain, pain in the anterior thigh, pain the in the lateral thigh due to active trigger points, and difficulty rising from a seated position are just a few that a Portland chiropractor can address by working on the iliopsoas.

Acute Injury Care in Athletics

University of Western States
Fall Symposium 2015

Acute Injury Care In Athletics
Third in a series of articles from the UWS Symposium
by Pam Worthington

Has injury care gone Paleo? We are all very familiar with the acronym R.I.C.E. (Rest, Ice, Compression, Elevation). The R.I.C.E. protocol was first proposed by Dr. Gabe Mirkin in his 1978 bestseller “Sportsmedicine Book”. Coaches, physicians, and lay people alike have followed his advice for decades. It has been accepted wisdom for years that Rest provided the body opportunity to heal. Ice was excellent at reducing inflammation and pain, and Compression and Elevation reduced swelling by expediting venous blood return to the heart.
But, times are changing. The R.I.C.E. protocol is being challenged. R.I.C.E was developed to control inflammation. The new thinking is that anything that reduces inflammation also delays healing. Healing requires inflammation.
For example, Rest has been shown to delay soft tissue healing, because immobilization decreases blood flow. As a result, ligaments, tendons and muscles lose mass and become weaker, fibroblasts don’t synthesize as much collagen, and joints lose range of motion. The use of Ice causes blood vessels near the injured tissue to constrict. This shuts off the flow of blood that brings healing cells, such as macrophages, to the injured area. Compression and Elevation also slow the recovery process by reducing blood flow to injured tissues.
M.E.A.T. to the rescue! M.E.A.T. is quickly becoming the new protocol. The acronym stands for: Movement, Exercise, Analgesics, Therapy. The theory is that encouraging blood flow to injured tissues, rather than restricting it, speeds healing. Passive movement can be used to start the healing process right away. Injured athletes can start with passive range of motion (MOVEMENT) and move to active range of motion/tissue loading (EXERCISE), as pain subsides and the acute injury stage has passed. Movement and Exercise increase blood flow, decrease adhesions and joint stiffness, increase collagen synthesis, encourage proper collagen alignment, and increase strength and proprioception.
ANALGESICS are good for controlling pain. However, NSAIDs (non-steroidal anti-inflammatory drugs) such as aspirin and ibuprofen, are not recommended. They have been shown to have a detrimental effect on healing, because they reduce inflammation. In fact, ice and NSAIDs used together are capable of completely shutting down the inflammatory process. Natural Analgesics and tylenol are recommended in the place of NSAIDS. Topical Analgesics with menthol are good choices for natural analgesics. Cryoderm, Biofreeze and Rock Sauce are some favorites.
THERAPY can include a variety of treatments: kinesiology taping, Spidertaping, manual lymph drainage, contrast therapy (alternating hot/cold), acupuncture and relieving trigger points in adjacent muscles.
So, which should you use? R.I.C.E. or M.E.A.T.? The broad thinking, in favor of M.E.A.T., is that increasing blood flow promotes healing. However, there is some argument as to whether M.E.A.T. should be applied to muscles, tendons and ligaments or just tissues that lack a good blood supply, like tendons and ligaments. For example, there can be a strong case made for the use of ice in the treatment of some conditions such as anterior compartment syndrome (injury to the anterior tibialis muscle of the lower leg). And, how does Dr. Mirkin weigh in on the latest findings? Dr. Mirkin states that ice remains very effective for reducing pain, but suggests using it sparingly, not more than 6 hours after acute injury and not for more than 10 minutes at a time.

In need of athletic injury care in Portand?
Call Kelsall Chiropractic Clinic at (503) 223-8719
or request an appointment here.

Snapping Hip Syndrome

Snapping hip syndrome is characterized by a recurrent snapping/clicking of the hip that can be heard during activity. It can be heard during running, walking, stretching, or non­-weight bearing movements as well. It is more commonly seen in female athletes of all ages. There are four types, the most common types are from the iliotibial band catching on the greater trochanter, followed by the iliopsoas rolling over bony bumps (prominences). The second major cause is inflammation of the iliopsoas tendon where it attaches to the hip, similarly, the iliopsoas tendon may catch over a bony bump (iliopectineal eminence). The last two, rare causes include the biceps femoris tendon catching on the ischial tuberosity or due to a labral tear, loose body or sources within the joint. The iliotibial band that travels from the pelvis to the knee can snap over the greater trochanter, causing irritation/inflammation of the bursa (a bursa that reduces friction between the iliotibial band and the greater trochanter).

Risk factors predisposing an athlete may include muscular imbalances of the hips and/or pelvis, limited hip/pelvis movement, scar tissue overtraining or improper training. An inflamed snapping can be painful, limiting exercise and bringing activity to a halt, though it is not uncommon to have painless, recurrent snapping after the condition has resolved. It is best to address the condition immediately, preventing an inflammatory cycle which may lead to more scar tissue and prolonged healing times. Chiropractic and massage therapy are interventions commonly used for snapping hip. The chiropractors at Kelsall Chiropractic can diagnose, then treat this condition using chiropractic manipulation/adjustments, myofascial release, Graston treatment, cold laser, ultrasound, and manual therapies. Treatment will include a home exercise plan to correct muscular imbalance, stretching tight muscles, strengthening weak muscles, and correcting any functional concerns.

Call (503) 223-8719 for more information or to schedule an appointment, or request an appointment online here.

Cupping Therapy & IASTM Techniques

This year three of Kelsall Chiropractic Clinic’s licensed massage therapists selected to attend the University of Western States 2015 Homecoming and NW Symposium as part of their continued professional development:

Kari Asher
Amy Homsi, and
Pam Worthington

One of the subjects covered in this 2 day seminar was “Cupping and Instrument Assisted Fascial Release”.  The presenter for this class was Molly Verschingel, an LMT in Portland, OR for more than 20 years.

When fascia becomes thickened and has adhesions it affects our proprioception, reduces strength and mobility. Fascia can become stiffer/denser when it has received damage but also along lines of stress.  Both Cupping and Instrument Assisted Fascial Release are great additions for a massage therapist’s practice for a different, yet effective therapy for their clients.  It is effective in releasing restrictive fascia, connective tissue, and muscular tension.

Cupping Therapy

Traditional Cupping Therapy, a part of Chinese Medicine, has been practiced for thousands of years.  Cupping technique involves creating a vacuum, or suction, on the skin to gently draw the tissue upward into the cup, to mobilize blood flow in an order to promote healing. Cupping is believed by some to treat pain, decrease deep scar tissue in muscles and connective tissue, reduce swelling, stimulate activation of the lymphatic system, and can aide in detoxification. The cups can be left on for 5 to 15 minutes, or even dragged across the skin while suctioned in order to break down muscle fiber and adhesions. 

Usually treatments are not painful; however a red ring or sometimes dark circles may appear post-treatment. These marks are not dangerous and usually disappear within a few days. Plastic and glass cups are the most common materials used today, replacing the horn, pottery, bronze and bamboo cups used in earlier times.

When glass cups are used the suction in the cup is created by lighting a cotton ball soaked in 70% alcohol, quickly placing it inside cup and pulling out to remove the oxygen inside the cup.

Silicone cups are also now being used by some practitioners. These cups create suction with a simple push top and can be easier to use, more malleable for use over non-flat surfaces of the body and allow for a more exact amount of suction, thus it is believed creating less of the “bruising” markings.  Cupping can be a great complement to other techniques and modalities of bodywork.

Instrument Assisted Soft Tissue Manipulation (IASTM)

In IASTM techniques, an instrument is initially used to detect scar tissue and adhesions by rubbing or scraping over the skin. Scar tissue limits range of motion and can cause pain, preventing patient from functioning as they did preinjury. After an area of restriction has been identified, the tool is then used to apply friction to the tissues, breaking down scar tissue, and creating a local inflammatory response. This inflammatory response increases blood flow in and around the area thus helping promote the healing process in the affected fascia and soft tissues.

Here are three specific types of IASTM technique, each with their own unique tool(s).

  • Gua Sha is a part of traditional Chinese Medicine that uses small, hand-held tools made of stone, jade or animal horn. Some practitioners use plastic or ceramic tools.  The tool is used to scrape the skin producing a light bruising. It is believed that Gua Sha releases unhealthy, or toxic, elements from injured areas and the scraping stimulates blood flow and healing.
  • Graston Technique is a registered technique, requiring certification to perform under this name, which uses stainless steel tools formed in six sizes and shapes that allow the practitioner to rub across the client’s fascia and muscular tissue to identify injury areas and provide treatment.
  • Fascial Abrasion Technique (FAT) uses a specially designed instrument known as the Fascial Abrasion Technique tool which has a contoured shape used to break down scar tissue and fascial restrictions.

IASTM tools can be used to treat painful conditions resulting from injury or overuse disorders such as carpal tunnel syndrome, plantar fasciitis, cervical and lumbar strain, iliotibial band syndrome, rotator cuff tendinosis, and tennis and golfers elbow.

Dr. Weber and Dr. Kelsall are both Certified Graston Practitioners, both having great success over the years offering this modality/technique to their patients. Request an appointment online or call (503) 223-8719.

Oregon Chiropractic Health and Wellness Month

October has been proclaimed “Oregon Chiropractic Health and Wellness Month”, perfect timing as we approach the winter months. It is officially fall, the weather is changing and it is time to bolster your immunity/health for the upcoming months. Make it your goal this season to begin or continue exercising, eating healthy, enjoy better sleep and relaxation, and enter the New Year without any resolutions. Chiropractic care and massage therapy are a crucial piece to helping in attaining wellness-excellence or getting you back on your feet in the event of any neck or back pain, and sports or auto injury.

Oregon Chiropractic Health and Wellness Month October 2015

The Advantages of Cold Laser Treatments

Suffering from back, neck and other types of pain can be excruciating.
A chiropractor in Tempe recently blogged about a study that found roughly 75 to 85 percent of people have experienced back pain. Unfortunately for many, finding non-invasive treatment options is difficult.

With cold laser treatment, there is a way for some pain sufferers to receive the pain reduction and relief that they’re searching for. This therapy option is growing in popularity because:

– It is a non-invasive procedure
– It does not require medications
– It allows for faster recovery
– Studies have shown it does not produce any serious side effects when performed properly

Unfortunately, cold laser treatment isn’t for everyone — it is ideal for those with certain types of pain.

There are other treatment options used for pain relief or pain reduction, but many patients choose cold laser therapy because it doesn’t require surgery or medications. The procedure can be performed as a standalone treatment or it can be used in combination with other types of therapies.

A Cutting-Edge Solution

In the medical community, cold laser is seen as a cutting-edge option for those who would like non-invasive treatment without sacrificing optimal results. To learn whether your condition can be successfully treated with this procedure, you’ll need to consult with a properly trained chiropractor.

At Kelsall Chiropractic Clinic, you will find a highly trained Portland chiropractor capable of using cold laser therapy to treat your pain. Schedule an appointment today to find out which treatment options are ideal for you.

Governor’s Park Chiropractic, a Denver chiropractor, offers cold laser treatments to Colorado patients.

Contact a local chiropractor trained in cold laser therapy today for a new pain reduction and relief option!

Introducing: Wally Walsh, LMT

Introducing a new addition to the clinic team, Wally Walsh, LMT and Guild Certified Feldenkrais® Practitioner

Wally WalshWe are pleased to introduce Wally Walsh as part of our team at Kelsall Chiropractic. Wally has now been a bodywork professional more than 17 years, with over 12,000 hours of hands-on experience. He has worked successfully with a diverse population of people, including professional athletes, expecting mothers, ‘weekend warriors’, stressed out office workers, actors, musicians, and children. In June of 2014, he completed a four year training to program to become a Certified Feldenkrais® Practitioner, which has greatly expanded his capacity to help clients move better and feel better. “For many years, I have been fascinated by how bodies move, feel and function​.​ ​On a daily basis, I get the pleasure of witnessing human potential in action as I see clients change, adapt, and expand their ability to thrive.​ I’m truly fortunate to have a career that profoundly affects people in such a positive way”.

Read Wally Walsh’s bio here. To schedule an appointment with Wally, contact us today at (503)-223-8719.

How Strength Training and Chiropractic Work Together

If you’re looking to create a stronger, more flexible, healthier body in the new year, consider a combination of strength training and chiropractic care that addresses every aspect of your musculoskeletal system. Many individuals who are training for strength also enlist the help of a trained chiropractic professional. These two approaches can go hand-in-hand to reinforce whole-body wellness and lessen the risk of traumatic injury.

While it’s important to develop muscle during strength training, you can’t forget to take care of your nervous system too. This is where chiropractic care comes in: working on the nerves that cause muscle contractions will allow your body to make optimal use of its workout.

In addition to helping these nerves reach their maximum potential, chiropractic treatment also helps bones and muscles align in the best possible way to increase their function. Straining to lift weights with improperly-aligned vertebrate or joints is a sure path to serious injury. Not only is this a painful risk, it’s also a counterproductive one. Muscles do not contract and tense properly over misaligned joints, which leads to an inefficient workout and overall loss of strength in the area. It’s better to stop the problem before it starts by making sure that your friendly neighborhood chiropractor has given you a clean bill of health before you hit the weight room.

According to Marc Holt, a representative of Eden Prairie, MN chiropractor Premier Sports and Spine, there’s one often-overlooked benefit to chiropractic treatment in conjunction with strength training: consistency. “As any gym goer knows, the next-day soreness after a hard workout is one of the greatest deterrents to making everyday workouts a habit. No matter how hard the regimen, it’s not going to have any effect if it’s not practiced consistently.” A chiropractor can help you work out the kinks and relieve the stress of a workout, letting you get back to it the next day and beyond.

Anyone interested in finding a Portland Chiropractor to aid in them in strength training should consider Kelsall Chiropractic. In Centennial CO, chiropractic services available from Heritage Health can help you boost your strength training, overcome pain, and much more.

Hold Your Head High: Knowing Your Neck

The neck is a delicate structure. Neglecting its well-being can lead to big trouble. Read on to learn about the neck’s complex nerves and bones, and how they interact to keep you going.

The nervous structure of the neck begins at the top of the spinal cord, which extends downward from your brainstem. The powerful nerves contained inside control every process of your body, from regulating your breathing to coordinating arms and legs to keeping your stomach digesting its food. They also enable you to move the surrounding muscles to nod your head or turn to look to the side. Naturally, this makes protecting these nerves crucial — which is the job of the bone structure.

The neck is made up of seven bones known as the “cervical spine.” Its curve begins developing when you are a baby and can just hold your head up to look around things. A properly-developed cervical curve ensures that your spinal cord is in alignment to promote normal function in the rest of your body.

Because the neck requires so much flexibility, its structure is delicate and prone to injury. Falls, car wrecks, sports accidents or other harmful injuries to the area can cause persistent long-term pain, as well as impaired nerve function or even paralysis.

If you’re noticing pain in your neck area, it’s important to get to a qualified chiropractor or other medical professional right away. While the inflammation and discomfort caused by an injury may initially seem minor and subside with over-the-counter medications, untreated problems can grow into major health risks.

An injury to the neck or back can cause pain to spread to other areas of the body. According to Shehee and Callahan Family Orthodontics, an orthodonist in Pensacola, the link between the neck and the jaw is very real: “there’s a strong relationship between neck health and development and jaw health. Because of the connection between the two, combining orthodontic treatment with chiropractic treatment after an accident or injury can produce better outcomes for many patients.”

Don’t want until there’s a problem — regular maintenance of your neck area is always a good investment. Qualified professionals can help you adjust your curvature and alignment to increase its functionality and enhance your quality of life.

For those in the Portland area, contact Kelsall Chiropractic for neck pain treatments and care. If you are seeking a Fort Worth chiropractor, consider the help of ChiroPlus Clinics for specialized treatments, and Jenkins Chiropractic can help you if you are looking for a Cedar Rapids chiropractor.

How to Treat Back Pain Affected by Winter Weather

Many people report that their back pain can get even more severe during seasonal changes, especially at the onset of winter. After years of dealing with the discomfort and recognizing the first warning signs, some back pain sufferers can predict early winter weather developments more accurately than the local meteorologist.

It’s clear that seasonal changes can affect chronic conditions, but the question remains: what treatment options do you have when cold temperatures are affecting you? Here are some tips on how to treat back pain that is inflamed by winter weather.

When to Visit a Chiropractor

Even mild pain can be reason enough to schedule a visit with a back pain doctor. Just because your pain is seasonal and may diminish in time doesn’t mean you should avoid treatment. Don’t tough it out. Look for solutions!

If it’s your first visit, they will want to know about any history related to your pain. Be ready to tell them when it began, how long flare ups (if any) generally last, and common times for it to get better or worse. Definitely let them know if your back ever caused you to visit an orthopedic surgeon or an emergency room.

Treating Seasonal Back Pain

There are a few tips that can help you cope with severe discomfort during a temperature drop.

  1. Bundle Up

When being cold is causing you pain, it’s extra important to dress appropriately for the weather. Add an extra layer when you feel a cold snap coming on. Also, make sure you have all the warm accessories — hat, gloves, long underwear, etc.

  1. Stretch

Keeping your back loose and limber may reduce the chances of a flare up. It all depends on the specifics of your condition. Some people may experience negative effects from stretching. Make sure you consult with a doctor before starting a regular routine.

  1. Keep Heat on Your Back

Body trimming belts, available at fitness stores, are effective at delivering heat to the back. They are intended as waste slimmers, but the extra heat might be just what you need for pain prevention in the winter. Otherwise, consider using heat packs or similar products.

Schedule a Solution

The best solution of all is to seek professional back pain treatment from a chiropractor. There, you will find treatment options that get results during the worst stretches winter and throughout all the major seasonal changes of the year. Schedule an appointment with our Portland chiropractor today to make sure you aren’t slowed down by colder temperatures. If you are in the Denver Area, connect with Heritage Health for Centennial chiropractic care, including back pain support.