How Can Musicians Injure themselves?

Musicians must practice long hours and often times develop what is called a repetitive strain injury (RSI).  This can be anywhere in the body from the jaw, arm, leg, hand, fingers, low back, shoulder.  This can greatly effect their jobs and keep them out of work for long periods of time because the discomfort is too hard to deal with while working.   Unfortunately, a lot of musicians and people in general think that discomfort will go away on its own.  If you are experiencing discomfort in your body, it means there is a problem.  Your body is trying to tell you something and is trying to protect itself from further damage by giving you pain or some kind of discomfort so you don’t make your injury worse.

Most times, I see people who have pushed it so far that they now can’t play and can’t work and they want fast results.  Unfortunately, what has happened is an injury and injuries take time and dedication to heal, not to mention stay incident free.

So, how do RSIs happen?

Lets begin by letting you know that the brain and spinal cord (Nervous System) control everything in your body.  That means your organs (heart/lungs), glands (release hormones/substances), tissues, immune system.  As you know, your brain is involved in everything so this should make sense.

Stress interferes with your body, especially your nervous system.  When your body can not get rid of stress it stores in the body and presents itself as a symptom.  There are 3 different stress:

1. Physical: Stressful lifestyle choices like sitting slouched (posture), falls or accidents etc.

2. Chemical: Bad food, pesticides, toxic chemicals in the body (smoking/junk food)

3. Emotional: Stress from Family, work, relationship, death of a loved one or animal

Continued stress from these different areas will cause the body to tighten up and effect your posture, spine and muscles.  Then the nervous system will be effected and then will effect all the areas that the nervous system sends signals to.  This is called a subluxation.  Subluxations untreated will lead to diseases, sickness and discomfort in the body.

What is fairly common is for me to hear people say they felt great before and had no problems and then the symptom suddenly appeared.  Problems arise when the stress keeps happening and nothing is done about it to release it from the system.  Playing an instrument for 8 or more hours per day is stressful to the body.  Eating foods that aren’t good for you causes more stress, then if you are worried about anything else will effect the body as well.  Everything starts building up and the body will give you some signals.  It may be tight or you may feel a tweak or shock for a second and then it goes away.  This is a warning sign of things to come.  Don’t ignore this or next time it will be a harsher signal.  The problem is that people feel these signs and they ignore them until there is so much discomfort that they can’t deal with it anymore.  This is a great example of how built up stress will effect everything and lead to sickness and discomfort.

We can help by getting rid of such stress in the body.  We not only do any physical tests we need to do, but we have a diagnostic machine that tracks stress in the body.  It is non-invasive and will let us know where this stress is storing in the nervous system.  Pretty cool huh?   Give us a call today to make an appointment and see how we can help release stored stress in your body and keep you playing and feeling great at the same time!

YIPS Makes Putting Hard To Do

Yips are involuntary wrist spasms that occur most commonly when golfers are trying to putt. However, the yips can also affect people who play other sports — such as cricket, darts and baseball.

It was once thought that the yips were always associated with performance anxiety. However, it now appears that some people have yips that are caused by a focal dystonia, which is a neurological dysfunction affecting specific muscles.

Some people have found relief from the yips by changing the way they perform the affected task. For example, a right-handed golfer might try putting left-handed.

The involuntary movement associated with the yips may:

  • Occur at the beginning or middle of your stroke
  • Come and go
  • Worsen during high-pressure situtations
  • The yips may result from neurological factors, psychological factors or a combination of both.

Neurological factors
In some people, the yips are a type of focal dystonia, a condition that causes involuntary muscle contractions during a specific task. It’s most likely related to overuse of a certain set of muscles, similar to writer’s cramp. Anxiety worsens the effect.

Psychological factors
In a pressure situation, some athletes become so anxious and self-focused — over-thinking to the point of distraction — that their ability to execute a skill, like putting, is impaired. Choking is an extreme form of performance anxiety that may compromise a golfer’s game.

A combination of factors
For some people who have a mild degree of focal dystonia, stress, anxiety or high-pressure situations can worsen the condition.

Neurological yips are associated with:

  • Older age
  • More experience playing golf
  • Lower handicap

Psychological yips can be a problem at any age and experience level. When you start to have episodes of the yips, you lose confidence, worry about recurrence and feel anxious whenever you have to putt. These reactions can perpetuate the cycle — your increased yips-related anxiety makes your symptoms worse.

Because the yips may be related to overuse of specific muscles, a change of technique or equipment may help. Possible strategies include:

  • Change your grip. This technique works for many golfers, because it changes the muscles you use to make your putting stroke. However, if you have the type of yips related to performance anxiety, changing your grip likely won’t make much difference.
  • Use a different putter. A longer putter allows you to use more of your arms and shoulders and less of your hands and wrists while putting. Other putters are designed with a special grip to help stabilize the hands and wrists.
  • Mental skills training. Techniques such as relaxation, visualization or positive thinking can help reduce anxiety, increase concentration and ease fear of the yips.

What is Chronic Exertional Compartment Syndrome?

Chronic exertional compartment syndrome is an uncommon, exercise-induced neuromuscular condition that causes pain, swelling and sometimes even disability in affected muscles of your legs or arms.

Anyone can develop chronic exertional compartment syndrome, but it’s more common in athletes who participate in sports that involve repetitive movements, such as running, fast walking, biking and swimming. Chronic exertional compartment syndrome is sometimes called chronic compartment syndrome or exercise-induced compartment syndrome.

Symptoms:

The pain and other symptoms associated with chronic exertional compartment syndrome may be characterized by:

1. Aching, burning or cramping pain in the affected limb — usually the lower leg, but sometimes the thigh, upper arm, forearm or hand

2. Tightness in the affected limb

3. Numbness or tingling in the affected limb

4. Weakness of the affected limb

5. Foot drop, in severe cases, if nerves in your legs are affected

6. Occasionally, swelling or bulging as a result of a muscle hernia

Pain typically happens soon after you start exercising the affected limb, gets progressively worse for as long as you exercise, stops 15 to 30 minutes after the affected limb comes to rest and over time, may begin to persist longer after exercise, possibly lingering for a day or two.

Taking a complete break from exercise may relieve your symptoms, but usually once you take up running again, your symptoms usually come back unless you continue to stretch and do keep up to date with your rehabilitative exercises.

If you experience unusual pain, swelling, weakness, loss of sensation, or soreness related to exercise or sports activities, talk to your doctor because these symptoms may be associated with conditions that require emergency medical treatment. Don’t try to exercise through the pain, as that may lead to permanent muscle or nerve damage — and jeopardize continued participation in your favorite sports.

Sometimes chronic exertional compartment syndrome is mistaken for shin splints. If you think you have shin splints but they don’t get better with self-care, talk to your doctor.

What are the causes?

Your arms and legs have several groupings, or compartments, of muscles, blood vessels and nerves. Each of these compartments is encased by a thick layer of connective tissue called fascia (FASH-ee-uh), which supports the compartments and holds the tissues within each compartment in place. The fascia is inelastic, which means it has little ability to stretch.

In chronic exertional compartment syndrome, exercise or even repetitive muscle contraction causes the tissue pressure within a compartment to increase to an abnormally high level. But because the fascia can’t stretch, the tissues in that compartment aren’t able to expand sufficiently under the increased pressure. Imagine shaking up a soda bottle but leaving the cap on — an enormous amount of pressure builds up.

As the pressure builds up within one of your muscle compartments, with no outlet for release, nerves and blood vessels are compressed. Blood flow may then decrease, causing tissues to get inadequate amounts of oxygen-rich blood, a condition known as ischemia (is-KE-me-uh). Nerves and muscles may sustain damage.

Experts aren’t sure why exercise or muscle contraction creates this excessive pressure in some people, leading to chronic exertional compartment syndrome. Some experts suggest that biomechanics — how you move, such as landing styles when you jog — may have a role. Other causes may include having enlarged muscles, an especially thick or inelastic fascia, or high pressure within your veins (venous hypertension).

In chronic exertional compartment syndrome, exercise or even repetitive muscle contraction causes the tissue pressure within a compartment to increase to an abnormally high level. But because the fascia can’t stretch, the tissues in that compartment aren’t able to expand sufficiently under the increased pressure. Imagine shaking up a soda bottle but leaving the cap on — an enormous amount of pressure builds up.

As the pressure builds up within one of your muscle compartments, with no outlet for release, nerves and blood vessels are compressed. Blood flow may then decrease, causing tissues to get inadequate amounts of oxygen-rich blood, a condition known as ischemia (is-KE-me-uh). Nerves and muscles may sustain damage.

Experts aren’t sure why exercise or muscle contraction creates this excessive pressure in some people, leading to chronic exertional compartment syndrome. Some experts suggest that biomechanics — how you move, such as landing styles when you jog — may have a role. Other causes may include having enlarged muscles, an especially thick or inelastic fascia, or high presse within your veins (venous hypertension).

What are the risk factors?

The condition is most common in athletes under 40, although people of any age can develop chronic exertional compartment syndrome.

People most at risk of developing chronic exertional compartment syndrome are those who engage in exercise that involves repetitive motions or activity. Young female athletes may be at particular risk, for reasons unknown.

Risk factors include engaging in such sports, exercises and activities as:

  • Running
  • Football
  • Soccer
  • Biking
  • Tennis
  • Gymnastics

Overuse of your muscles or overtraining — that is, working out too intensely or too frequently — also can raise your risk of chronic exertional compartment syndrome.

Chronic exertional compartment syndrome isn’t a life-threatening condition and usually doesn’t cause any lasting or permanent damage if you seek appropriate treatment. However, if you continue to exercise despite pain, the repeated increases in compartment pressure can lead to muscle, nerve and blood vessel damage. As a result, you may develop permanent numbness or weakness in affected muscles.

Perhaps the biggest complication of untreated chronic exertional compartment syndrome is its impact on participation in your favorite sports — the pain may prevent you from being active.


Don’t try to exercise through your pain. Limit your physical activities to those that don’t cause pain. For example, if running bothers your legs, you may be able to swim. Use ice or take omega 3s until you can see your doctor and make sure this is NOT an emergency.

The following basic sports and fitness guidelines can help protect your health and safety during exercise:

  • Warm up before starting exercise.
  • Cool down when you’re done exercising.
  • Stop if you’re in pain.
  • Check with your doctor before starting a new exercise program if you have any health issues.
  • Eat a healthy, balanced diet.
  • Stay hydrated.
  • Engage in a variety of physical activities.

Sections of this article are published on http://www.mayoclinic.com/health/chronic-exertional-compartment-syndrome/DS00789

Erb’s Palsy In New Born Babies

Erb’s palsy occurs when there is an injury to the cervical nerve roots, C5 and C6 (Brachial Plexus).  It commonly occurs due birth injury in a baby during difficult labor. Tugging and pulling on the infant’s head during birth pulls on the nerves and can severely damage the nerves coming from the neck going down to the hand.  It can also occur in adults due to bike accidents or fall when the shoulder is pulled downward and the head is tilted.

Erbs palsy involves the deltoid muscle, which helps in lifting the arm upwards and other shoulder muscles that help with rotating the arms.  It is also known as “waiters tip deformity” because the arm is straight down the side of the body with the palm of the hand pointing up as if a waiter is asking a bribe or tip from someone.

Surgery is sometimes performed but in many cases, new borns can get a slight  adjustment to the neck by a Chiropractor to help lessen the stretching of the nerves.  When these nerves start to relax they can regenerate and normal movement can be restored.

How To Prevent Tommy John Surgery

Tommy John surgery has become something that most big league pitchers and players have to consider when having elbow pain.  Throwing, especially at high speeds puts a lot of stress on the elbow.  Repetitive throwing can lead to swelling and tearing of the Ulnar Collateral Ligament in the arm. This ligament keeps the Humerus, Radius and Ulna in place and provides mobility of the elbow.

Compared to the larger muscles and ligaments in the body, this ligament is not as strong as knee ligaments (Anterior Cruciate Ligament).   Our body also wasn’t designed to perform high velocity throwing for years.  In time, if enough pressure is applied to the elbow, it will tear apart causing pain and effecting the velocity of throwing.

It is common for major league pitchers to have Tommy John Surgery.  Surgeons take some of the tendon of the players “good” forearm or hamstring and put it into the “bad” elbow.

They also drill holes in the ulna and humerus bones to sew it in.  Sounds easy huh?  Well, there are some concerns with this surgery.  In order to move the ulnar nerve away, surgeons have to cut or detach major muscles.  This can lead to infection, fractures, nerve irritation, numbness and inability for the muscle to function properly.  It is also pricey.  This surgery can run between $10,000 and $20,000.

Proper stretching, weight lifting can help pitchers stay away from this painful and expensive surgery.  Exercises with elbow pronation, supination and flexion are key to keeping the elbow in proper condition and ready to take the added stress of throwing a ball 100mph.

As chiropractors, we help keep prevent this surgery by keeping the joint in its proper position,  allowing the muscles and ligament to remain strong and work out any tissue damage that may have occurred.  We are a great option.

Complex Regional Pain Syndrome

Complex regional pain syndrome “CRPS” occurs when a you have severe pain typically affecting one arm or leg. Often this problem begins after an extreme injury.

Symptoms include strong, burning pain in your extremity (leg, foot, arm or hand). You may also experience swelling, stiffness and damage to the area involved. Decreased movement, muscle loss, weakness or spasms may also become frequent. Skin temperature changes from hot to cold, alterations of color from white to red and blue with tender, thin and shiny skin are also common with this type of problem.  This pain, if untreated will get worse.

This syndrome happens after experiencing a Shrapnel blast, gunshot wound, surgery, heart attack, fractures or infections. Your nerves can be highly affected by this type of trauma to your body.

If you are experiencing this problem, please give us a call we can help!

What Is Nursemaid’s Elbow? 5 Ways kids can have elbow pain

Nursemaid’s elbow, also known as “pulled elbow” usually happens in kids from ages 1 to 3 years old, but Infants and older kids can experience it, too.

So, what is Nursemaid’s Elbow?

Your elbow joint consists of three bones. The Humerus (upper arm bone which rounds at the shoulder), Radius and Ulna (lower arm bones in the forearm). Ligaments surround these bones and keep them tight and stable.  If there is force on the joint, a ligament may slip over the bone. This is normally the radius but can be other ligaments as well.   This pulls the bone out of place.  Pain will occur and your child may start grabbing his/her elbow, hold their arm in a abnormal position or experience pain when moving their arm. This can happen a lot easier than you think with minimal force so it is not recommended to grab kids by the arm and yank them up for any reason.

Here are some common reasons why Nursemaid’s elbow may occur:

1. Jerking a child’s arm.

    • Pulling a toddler along while walking or quickly grabbing his or her hand can jerk the arm, causing the radial head to slip. Remember to be gentle when taking a child by the hand.

2. Pulling a child up by the hands. Pulling on hands or forearms can put stress on the elbows. Never pick up a toddler or infant by the hands or wrists. Lifting under the armpits is the safest way to lift a child.

3. Swinging a toddler by the arms. Any type of swinging by holding the hands or wrists can put stress on the elbow joint and should be avoided.

4. Breaking a fall with the arm. The natural response to falling is outstretching an arm for protection. The elbow can overextend during this action, resulting in a slip of the radial head.

5. Rolling over in an awkward way. Sometimes rolling over in a crib, bed, or on the floor can cause nursemaid’s elbow in infants and very young children.

The injury happens in younger kids because their ligaments (the elastic-like bands that hold bones together) are loose and bones are not yet fully formed. This makes it easier for some of the bones to slip in and out of place. As kids get older, however, their ligaments tighten, bones enlarge and harden, and the risk of nursemaid’s elbow decreases.

While a child with nursemaid’s elbow has some initial pain in the arm, the injury does not cause any long-term damage. We can gently put the bone back into place, causing symptoms to go away quickly.

If your child is experiencing elbow pain, give our Redwood City office a call.  We can help.

 

Rotator Cuff Injuries Can Creep Up On You

Your rotator cuff consists of muscles and tendons on the upper part of your shoulder.  These muscles are responsible for rotating your arm outward (Teres Minor and Infraspinatus), rotating it inward (Subscapularis) and moving it away from your body (Supraspinatus).  Since we use our arms a lot, irritation or damage to the rotator cuff is fairly common.

Injuries to the area can result from falling on the shoulder, lifting and repetitive arm movements.  The most common cause of a rotator cuff injury occurs when you lift our arm over your head to throw a baseball or to open shelves that are above the shoulders.  Athletes and chefs commonly have problems with the shoulder.

Here are some common symptoms of a rotator cuff injury:

Pain and tenderness in your shoulder, especially when reaching overhead, reaching behind your back, lifting, pulling or sleeping on your side
Weakness
Limited movement in the shoulder
avoidance of lifting your arm over your head for fear of pain.

What causes a rotator cuff problem?

Normal wear and tear. Increasingly after age 40, normal wear and tear on your rotator cuff can cause a breakdown of fibrous protein (collagen) in the cuff’s tendons and muscles. This makes them more prone to degeneration and injury. With age, you may also develop calcium deposits within the cuff or arthritic bone spurs that can pinch or irritate your rotator cuff.
Poor posture. When you slouch your neck and shoulders forward, the space where the rotator cuff muscles reside can become smaller. This can allow a muscle or tendon to become pinched under your shoulder bones (including your collarbone), especially during overhead activities, such as throwing.
Falling. Using your arm to break a fall or falling on your arm can bruise or tear a rotator cuff tendon or muscle.
Lifting or pulling. Lifting an object that’s too heavy or doing so improperly — especially overhead — can strain or tear your tendons or muscles. Likewise, pulling something, such as a high-poundage archery bow, may cause an injury.
Repetitive stress. Repetitive overhead movement of your arms can stress your rotator cuff muscles and tendons, causing inflammation and eventually tearing. This occurs often in athletes, especially baseball pitchers, swimmers and tennis players. It’s also common among people in the building trades, such as painters and carpenters.
Being an athlete. Athletes who regularly use repetitive motions, such as baseball pitchers, archers and tennis players, have a greater risk of having a rotator cuff injury.
Working in the construction trades. Carpenters and painters, who also use repetitive motions, have an increased risk of injury.
Having weak shoulder muscles. This risk factor can be decreased or eliminated with shoulder-strengthening exercises, especially for the less commonly strengthened muscles on the back of the shoulder and around the shoulder blades.

Problems in your shoulder can be a long term problem.  When tissues are damaged it can take 8-12 weeks to heal.  Even after reconditioning the area you must keep up with it especially if you have a job that calls for repetitive shoulder movement.  I have had great success with S.A.S.T.M. to recondition the tissue along with proper alignment of the shoulder.  Incorporating exercises to strengthen the area really helps!  You don’t have to live with shoulder pain and limitation.  Give us a call and we will guide you to health.

Spinal And Extremity Care

Chiropractors are masters of the spine and nervous system.  We track and follow symptomatic patterns in the body and relieve stressors in these areas which allow the body to function at its highest level.  Did you know that we can affect any joint in the body?  Yes! Its true!  Some chiropractors believe that the whole body including your hands, feet, shoulders etc. are all involved in symptomatic problems in the body and here is why….

Everyone has heard about the kinetic chain we have on our bodies.  Remember the song…hand bones connected to the wrist bone, the wrist bones connected to the elbow bone?  Well, chiropractors certified in chiropractic extremities by the Council of Extremity Adjusting believes this to be true.

Everything is connected so after we adjust the spine, we make sure the other areas of the body are addressed to make sure they don’t affect the movement and function of your body.

I am the only chiropractor in the San Mateo County area that is certified by the CEA to adjust ribs, arms, legs, shoulders, feet and address TMJ problems.  If you have any problem in your body, we can help!

Tips for Adhesive Capsulitis (Frozen Shoulder)

Causes:

The bones, ligaments and tendons around your shoulder joint are encased in a capsule of connective tissue. Frozen shoulder occurs when this capsule swells and thickens tightening the shoulder joint, restricting its movement and causes pain.

Frozen shoulder is often initially ignored when symptoms first occur because the pain subsides within a few days so people think it is just a short term problem.  It will come back and when it does it is more painful and lasts longer.  Scar tissue and inflammation re-occur and continue to restrict the shoulder from moving properly.

This problem takes a long time to see full results but it can be alleviated.

Frozen shoulder has three stages:

  • Stage one: The “freezing” or painful stage, which may last from six weeks to nine months, and in which the patient has a slow onset of pain. As the pain worsens, the shoulder loses motion.
  • Stage two: The “frozen” or adhesive stage is marked by a slow improvement in pain but the stiffness remains. This stage generally lasts four months to nine months.
  • Stage three: The “thawing” or recovery, when shoulder motion slowly returns toward normal. This generally lasts five months to 26 months.

Risk Factors:

  1. Age: People 40 or older are at risk
  2. Repetitive jobs especially jobs which require raising the arms over the head
  3. Injuries to the shoulder which causes improper movement of the shoulder adding to inflammation.

Treatment:

Inflammation must be decreased before exercises can really be beneficial.   Scar tissue must be broken and new healthy tissue must take its place.  Sound Assisted Soft Tissue Mobilization can decrease scar tissue and increase mobility.  We can also train your shoulder to move properly to prevent further injury.