Are Toe Crunches just as important as Stomach Crunches??

Intrinsic Marbles

 

I have struggled over the years as to the importance of including toe flexor strengthening as part of a program for plantar fasciitis. Many researches agree that the potential causes of plantar fasciitis are just too numerous and multi-factorial. The evidence in the literature has not been conclusive and I have let many of my patient’s comments that “this is silly” when picking up marbles dictate my decision-making. I have slowly but surely, and I believe wrongly, eliminated this important exercise from my treatment approach. I have recently read several articles that have rekindled my enthusiasm for toe flexor strengthening. So why the change in heart??

I am always looking for ways to get our patients better…faster. I have written a book on plantar fasciitis called the Plantar Fasciitis Treatment Manual and it identifies ankle muscle weakness as a result of plantar fasciitis but not include the presence of toe flexor weakness. That is my oversight and I will correct that in the book. Yes, the literature does identify weakness of the ankle muscles and the toes flexor muscles with the plantar fasciits population, yet the research does NOT confirm any causative factor of this weakness on the development of plantar fasciitis.(1,3,4) It is the chicken or the egg conundrum. Unfortunately, there are theoretical assertions that the “flexor digitorum brevis muscle (the muscle directly underneath the plantar fascia) plays an important role in distributing pressure away from the plantar fascia” that are simply not supported by research. (2) Does this mean that we should not perform strengthening exercises? Let me provide some more evidence.

As we get older, we get weaker. We all lose muscle mass, we lose muscle fibers and, as a consequence, we see decreases in strength between the ages of 30 and 80 within a range of 20-40%.(5) Several articles have also shown that “older people” exhibit 24-40% less strength in the muscles of the foot and ankle(5,6,7,8). As a consequence of foot and ankle weakness, older adults are more susceptible to loss of balance, the development of foot and toe deformities and can be susceptible to overuse syndromes such as plantar fasciitis. (5,6,7,8) The biggest question that has not been answered when it comes to strengthening exercises for older adults is WHICH exercises are the most effective?

As a result, we have to rely on some common sense. If the muscles in our ankles and feet get weaker as we get older (proven!), then we should strengthen them to avoid plantar fasciitis. Right? Not necessarily. There is not a direct correlation between weakness and the development of plantar fasciitis but, then again, many people don’t believe that there is a direct correlation between human activity and climate change. My point is why should we wait to change our approach until it is conclusive – whether it be climate change or your plantar fasciitis?

 

  1. http://www.ncbi.nlm.nih.gov/pubmed/12968860
  2. http://running.competitor.com/2014/06/photos/new-techniques-treating-plantar-fasciitis_96398
  3. http://www.jospt.org/doi/pdfplus/10.2519/jospt.2003.33.8.468
  4. http://www.ncbi.nlm.nih.gov/pubmed/1672577
  5. https://www.karger.com/Article/FullText/368357
  6. http://biomedgerontology.oxfordjournals.org/content/61/8/866.full
  7. http://www.jfootankleres.com/content/7/1/32
  8. http://www.jfootankleres.com/content/7/1/28

Do Pain Creams Really Work?

Pain Cream

Do pain creams really work??

There are a lot “pain creams” on the market that tout their effectiveness. Do they really work? Do they just take your mind off of the pain temporarily?

A topical counterirritant is a cream that essentially takes your mind off of the pain. Creams such as BenGay and IcyHot simply activate nerve ending in your skin that “fool” your brain temporarily. These products do not cross the skin barrier to get to the root of the problem. What if I told you that we recommend a product at OrthoWell that is:

*Safe

*Natural

*95% absorbed thru the skin

*Fast acting

*Research proven

We use a cream from two different companies that contains esterified fatty acids. One of the companies is EFAC at Hope Science and the other one is 1-TDC at Elite Science The inventor of the EFAC-brand formula researched the effects of esterified fatty acids and came up with a combination that beats the effects of chondroitin and glucosamine…hands down! You can read the results and more about the evidence behind EFAC HERE.The proprietary formula for esterified fatty acids is the same in both products but the 1-TDC product uses a paraben-free cream. So how does it work?

It has been shown that EFAC reduces joint and muscular discomfort within 30 minutes of topical application and within 14 days of oral consumption. The effects of the esterified fatty acids include:

*Pain reduction

*Tissue regeneration

*Improved function and range of motion

*Reduction of inflammation

*Lubrication of your joints and tissues.

Read what Robin said about it:

“After only 3 days I noticed a huge improvement in my feet. I also applied the EFAC to my knuckles and thumb joint, when arthritis is bad! Pain gone after application! I want to take a bath in this cream!” Robin Graves. January 31, 2017.

The esterified fatty acids are carried in the membranes of our white blood cells. Because white blood cells are the first responders after injury or in the presence of inflammation, the fatty acids are delivered directly to the affected site and play a role in mediating the inflammatory process. You can read more about the pharmacology HERE. These products have shown dramatic effects in the treatment of gum disease and positive results have been demonstrated in humans as well as animals. Don’t forget about your dog!

Both companies offer a cream as well as capsules. The cream contains a 7% concentration of the esterified fatty acids where as the capsules contain a 70% concentration. You can maximize your benefits by taking the supplement orally as well as topically. There are no side effects and no maximum allowable dosage. You can essentially take as much as you want. However, the manufactures suggest 3-6 capsules per day. We recommend that you apply the cream at least twice daily or as needed depending on your pain level. In some cases, we suggest piercing the capsules and applying the contents of the capsule on smaller areas for maximum effect. There is a small amount of menthol in the cream for the topical analgesic effect. Research has been done that compared the effects of the cream with versus without the menthol and the results were the SAME

You can purchase these products online or in our office. Let us know if you want to give them a try! You wont be disappointed.

CUPPING THERAPY

Cupping Therapy

We offer another specialized service at OrthoWell called Cupping Therapy. Cupping has been used in traditional Chinese medicine (TCM) for thousands of years. It is used in TCM to stimulate specific points on the skin which correspond to acupuncture points that lie on energy meridians, or pathways. Through manipulation of the points on the skin, the TCM practitioner can influence or change a specific organ’s blood or energy called Qi (chi).

In our clinic, we use cupping in a different way. We are not TCM practitioners. We are western practitioners with a great respect for eastern treatment philosophy. There are many types of cupping methods. We use Dynamic Cupping in our clinic. I can personally say that I have had incredible results with dynamic cupping. One day I asked myself “if I have such great results, why not use cupping on my patients?”

Our method for using dynamic cupping is to lightly lubricate the skin. We place gel, polymer cups onto a region that we are treating by squeezing the cups and placing them directly onto the skin. When we release the”squeeze”, it creates a negative pressure within the cup which “sucks” the skin up into the cup. The intensity of the negative pressure depends on the tolerance of the patient. Our goal is to pre-stretch the skin and underlying fascia and then to have you slowly move through controlled range of motion exercises in order to increase the effectiveness of the stretch. This is the “dynamic” part of our cupping method. Cupping therapy should NOT be painful! You should experience a warm, pulling sensation during the treatment which lasts around 5-6 minutes. Cupping therapy can improve blood flow and lymphatic drainage. TCM practitioners talk about the release of energy “stagnation” via cupping therapy.

Yes, you will have cupping marks on your skin for several days after a treatment. The color and response to the cupping is dependent on the extent of stiffness or the extent of “stagnation” at the treatment site as well as the amount of time that the cups are in place. TCM practitioners believe that the skin is a mirror of our health. All skinmarks that appear as a result of cupping therapy are usually not painful. The discoloration is a result in a change of blood flow through the area. It is not traumatic “bruising”.  There is no external or internal damage inflicted to the skin and the capillaries do not leak as a result of injury due to trauma. The “bruised” areas will turn yellow green before totally fading away.

So, we typically perform cupping therapy after we have completed other manual techniques such as pump massage, Active Release Technique and Graston Technique. It is a good way to mobilize the tissue after the other manual therapy techniques. It is just another treatment technique that we offer at OrthoWell to get you better…faster! Check out the video below for a demonstration.

 

Trigger Point Dry Needling -Video – FREE trial!

For those of you who don’t know, we are offering another specialized service at OrthoWell PT. It is called Trigger Point Dry Needling. Our new PT, Katie Moulison,DPT, is certified in dry needling and she has been performing this technique for 2 years as well the past several months in our clinic. I have created a comprehensive web page devoted to trigger point dry needling. CLICK HERE. It is another one of those techniques that not everyone knows about. It is a technique that can have a profound effect on the chronic pain associated with trigger points and myo-fascial restrictions.

Here is a video that we made in-house about trigger point dry needling. It includes an explanation of trigger points as well as a demonstration of the actual trigger point dry needling technique. It will give you a much better understanding of the technique and may even encourage you to come in for a FREE session to try it out. Just give us a buzz and we will get you in the schedule. The video will be available on our trigger point dry needling web page as well as a comprehensive Q&A section. Don’t forget to share with your friends!!

CANCER – I FOUND A CURE!!

Cancer Cure

CANCER- I FOUND A CURE!!

My subject line is no joke. I really did find a cure for cancer!!

The realization will come as quite a shock to many of you.

I spend a lot of time reading and talking about health and fitness. I thoroughly research each and every blog post before I share it with you. Patient education is a top priority at OrthoWell and it is an integral part of our mission statement. We really DO care about you and your health. For this reason, I feel obligated to share the following information.

I was introduced to a book by one of my patients that may change or even SAVE your life! The title of the book is Outsmart Your Cancer by Tanya Harter Pierce. I have had the unfortunate experience of getting a phone call by my father that he has bladder cancer. The realization, of course, was more unfortunate for him. This came up in the conversation with my patient as we broached the cancer subject. She shared her experiences regarding her own cancer history and then she began to open my eyes, my mind, and my anger to the realization that our medical establishment is intentionally misinforming the public about cancer. Some of you may be saying “yeah, right, why wouldn’t my doctor tell me if there was a cure for cancer?” or, like my father said, “yes, I have heard these things before” but then he dispels the “myth” and decides to go through with his radiation and chemo. Don’t get caught up in the “disbelief factor”. I am telling you, from the bottom of my heart, not to be naïve and not to stay ignorant to this realization. You NEED to read this book as my words alone will not do it justice.

Outsmart Your Cancer is not a promotional vehicle for a new cancer pill or a new cancer prevention diet. As a matter of fact, the author does not promote any one single approach to curing cancer. Her objective is to share with us all that has been hidden from us. Yes, there are MANY alternative treatment options to both prevent and to cure yourself of cancer. Her introduction to cancer was the same as mine. The realization that a loved one may die from cancer! I would like to share some excerpts form the book regarding the misinformation campaign that has been waged on the public.

In the author’s words:

I have also discovered that for many of these cancer approaches, the way they work has been proven by rigorous scientific research performed by highly respected physicians, brilliant biochemists, and Nobel prize-winning scientists. Effective alternative approaches to cancer ARE obtainable today, and they are not bogus methods developed by quacks and kooks as the public has been led to believe.’

“During my research, I spoke to over 100 people who had recovered from their cancers using the alternative treatments presented in this book.”

 “The suppression (of information) has been carried out in many different ways by many different organizations and is simply the result of business economics and common unethical tactics that tend to occur when large money interests are involved in any field.’

 ‘Surgery, chemotherapy, and radiation involve billions of dollars of profits for the industries that supply them… the cost of developing and bringing a new cancer drug to market is close to $1 billion… A treatment made up of natural ingredients is not patentable… A natural form of treating cancer will never be pursued by a drug company… alternative treatments will always be considered an economic threat to the multibillion-dollar cancer establishment.”

 If you want to watch a YouTube video to convince yourself of the misinformation campaign that has been waged by the FDA and American Medical Association, then watch this video on Dr Burzynski’s treatment for cancer. CLICK HERE.

So when should you start an alternative treatment approach if you’ve been diagnosed with cancer?

 As soon as possible! Unfortunately, most people start with conventional treatment before they try alternative approaches. It is the fear and shock factor associated with “I have Cancer” that makes people decide prematurely regarding the BEST treatment option. They usually start with the big three…chemotherapy, radiation therapy, and surgery. Don’t become a statistic. Get educated!

 So how do you make an educated decision on what treatment path to follow after you’ve been diagnosed with cancer?

Outsmart Your Cancer spells it out in simple terms and in black-and-white. There ARE options…successful options that have cured thousands of patients with cancer. All you need to do is read and/or listen (a DVD of patient testimonials comes with the book).

So when do you start a cancer prevention program?

 NOW!! Outsmart Your Cancer will empower you to start a prevention program today. Scrutinize what you put into your body. Yes, you ARE what you eat. Don’t forget to read my post on Vitamins-To Take or Not To Take for more information.

Because I WANT to be your advocate for health and wellness and because I WANT you to stay cancer-free, I am stocking Outsmart Your Cancer in my clinic. I feel that strongly about the information in this book! I have purchased them in bulk so the wholesale cost is only $20 per book. Don’t delay! Get the facts!

Other things that could change your life that are discussed in the book include:

ACIDIC vs ALKALINE

Did you know that it has been scientifically proven that cancer cells cannot survive if the environment is alkaline enough? Did you know that the QUALITY of what you consume determines whether your body becomes acidic or alkaline? Many people, either with cancer or attempting to prevent cancer, strive to maintain their body pH at an optimal alkaline range between 7.0 and 7.5. Your body pH can be evaluated by a simple saliva test using pH strips in the privacy of your own home. So how do you do this? I’ll give you the answer even though you need to read more about it…CALCIUM. One of the most important roles of calcium is to help our bodies maintain proper pH levels. In addition, the absorption of calcium into the body is completely dependent on the levels of vitamin D in the intestinal tract.

WOMEN -THE PILL – HORMONE REPLACEMENT THERAPY

Do you really understand the effect of synthetic hormone replacement therapy? Outsmart Your Cancer discusses what every woman NEEDS to know about the effects of The Pill and hormone replacement therapy. You need to really be aware of the things that your doctor is NOT telling you. Long-term clinical studies have proven the cancer-causing effects of synthetic hormone replacement therapy. Get the facts!

MEN-TESTOSTERONE & PROSTATE CANCER

As for the men, did you realize how controversial conventional treatments are for prostate cancer? There are studies in the medical literature which contradict the current use of testosterone inhibiting drugs to lower your PSA level. It has been shown that testosterone actively INHIBITS cancer growth and that elevated PSA is actually a man’s defensive strategy for fighting prostate cancer. So then, why does the medical establishment advocate the exact opposite approach?

DENTAL FILLINGS & MERCURY

Did you know that the main component of silver fillings is mercury and that mercury is one of the most deadly substances on earth if ingested? Did you know that your dentist is not required to tell you that your filling contains mercury? Did you know that several European countries have band silver-mercury amalgam feelings for decades but they continue to be used in the United States? The toxic nature of amalgam feelings has been down-played by the American Dental Association for a century in spite of warnings to dentists to “never touch the amalgam with your fingers” and “it must be disposed of under strict toxic waste protocols.” Dentists who have been outspoken against amalgam fillings have lost their licenses to practice. Outsmart Your Cancer references a book written by one such dentist who describes the alleviation of multiple sclerosis and Parkinson symptoms as well as cancer via the removal of amalgam feelings. Once again, get the facts.

There is SO MUCH more in Outsmart Your Cancer. The rest is up to you!!

LASER – The New Gold Standard?

 

DEEP TISSUE LASER THERAPY IS HERE!!!

For those of you who haven’t been in to see us recently, we have been using a demo class IV laser device from Litecure since the beginning of June and have been getting some amazing results. We were so impressed with the results that we “bit the bullet” and purchased our own laser. A very worthwhile investment for OrthoWell and for the health of all of our patients.

I have added a page on our website that provides a comprehensive explanation and videos of the benefits and effects that a class IV deep tissue therapy device provides. In a nutshell, the laser uses photon energy to stimulate chemical reactions at the cellular level. Research has demonstrated an increase in metabolism, a decrease in inflammation, a decrease in pain, and an acceleration of healing at the treatment site. In other words, the application of laser in combination with our manual therapy and exercise techniques is getting our patient better even FASTER! It has also been extremely beneficial to conditions that have NOT been responsive to our traditional physical therapy interventions.

If you are interested in trying laser or if you feel that your symptoms have plateaued, then laser may be the answer that you are looking for.

***SPECIAL OFFER***

We want you to experience the benefits of deep tissue laser therapy so we are announcing a special offer. Call us now to schedule a FREE laser treatment. We will  introduce you to laser therapy and provide a laser treatment FREE of charge. Let us know what works for you!

Laser Dog

 

 

 

Cross Fit – Is It Killing You??

Cross Fit Box jump
(Courtesy of Freedigitalphotos.net)

 

CROSS FIT 101

First of all, you need to understand the difference between aerobic and anaerobic exercise. Aerobic exercise requires oxygen, is low powered and lasts for greater than 15-20 minutes. Anaerobic exercise, like Cross Fit, does not require oxygen, is high powered and each exercise lasts less than 2 minutes.

The Positives: Recent studies have shown that anaerobic exercise is a vastly superior protocol for fat burning than it’s less intense aerobic counterpart. There is evidence that shows that anaerobic exercise is evenly matched to aerobic exercise with regard to cardiovascular benefits.  Check out the evidence in an article in the Journal of Strength and Conditioning. More evidence that comparable calorie burning effects can be achieved in half the time with anaerobic exercise.

The Negatives: Potential for INJURY! The article in the Journal of Strength and Conditioning also states that 16% of the participants dropped out due to “injury or overuse”. In addition, in 2011, the U.S. military, in conjunction with the American College of Sorts Medicine, advised soldiers to avoid CrossFit, citing “disproportionate musculo-skeletal injury risk.” You can read it HERE. In 2009, the US Military was encouraging training programs such as CrossFit. You can read it HERE. So what happened?

CrossFit goes out of its way to warn people that if they can’t maintain proper technique, they should back off. After all, the CrossFit mantra is “Mechanics, Consistency, Intensity”. Backing off , however, is a hard sell for many participants because workouts are viewed as a competition. The 2009 US Military study states that “Properly trained coaches are fundamentally important in both establishing an effective training program and developing proper movement mechanics in athletes.” It sounds like something, or someone, went wrong between 2009 and 2011.

So I guess the biggest question that you should ask (before joining a local Cross Fit gym) is WHO is running the classes and HOW they are trained. Make sure they at least have Level I or Level II Cross Fit training. A power lifting background is very helpful as power lifters are obsessive about proper form. Make sure you observe a class or two to witness how or if the instructor is scrutinizing and ensuring proper form. The proof is in the puddin’.

So BEWARE!!

Foot Orthotic Videos – What do YOU need?

I have created several videos to demonstrate HOW and WHY we make custom foot orthotics at WalkWell Foot Orthotics to treat various foot pain conditions. You can share the links to these videos with friends or family members who may be suffering from foot pain and who are looking for answers. The conditions I cover are:

1. Plantar Fasciitis

2. Metatarsalgia ( ball of foot pain )

3. Supinated or High Arch Foot

4. Specialized Foot Orthotics

5. Sesamoidits ( pain under big toe )

6. Posterior Tibialis Dysfunction ( pain on inside of ankle )

7. Hallux rigidus / Hallux Limitus ( Big Toe Pain )

How do we treat thrower’s elbow?

In my last post, I highlighted elbow injuries in the throwing athlete. Lets review!

“For many pitchers, the first sign of impending trouble with the UCL(ulnar collateral ligament on inside of the elbow) is pain or stiffness in the flexors of the forearm. The flexors and pronators of the forearm are the active restraints and the UCL is the primary passive restraint to the extreme valgus forces that occur at the elbow during terminal cocking phase and early acceleration. Did you know that when the UCL is tested in isolation during cadaver studies that it only takes 32 newton/meters of force to rupture it? Guess how much valgus stress is on the inside part of the elbow during terminal cocking phase….64 newton/meters!! It has been shown that the UCL takes on 35 newton/meters of that force. Yikes!! So why doesn’t it rupture? It doesn’t rupture because the rest of that stress is controlled by the active restraints…your muscles in the forearm. You can probably guess what happens when you ignore your forearm muscles?”

It is my job as physical therapist to not only emphasize prevention of  an injury but to provide the most effective treatment of an injury. This video demonstrates the use of Active Release Technique, Graston Technique, and a compression flossing technique to treat elbow pain. Check it out!!

 

Get Rid of “Cold” Inflammation.

We reviewed an ARTICLE in Precision Nutrition about the effects of chronic inflammation and how to combat it with exercise. Researchers are using the term “cold inflammation” to describe chronic inflammation because it doesn’t have the typical hallmarks of acute inflammation such as fever, heat, or swelling. Cold inflammation is an inflammatory process caused by every day exposure things such as pollution, nutritional deficits, and chronic stress (what’s that?). An uninterrupted cycle of cold inflammation has been linked to obesity, diabetes, and heart disease.

This article presents a study published in the Medical Science of Sports and Exercise Journal. The study looked at two groups of healthy, yet obese, post menopausal women. The control group was given patient education and sedentary activity. The other group was given a moderate general resistance training routine to be done 3 times a week for 12 weeks. The results included a reduction of specific inflammation cells between 18% – 33% and an increase in an anti-inflammation markers by 20%!

By working with a health care professional or personal trainer to develop a safe resistance program, you can significantly improve your health and reduce your risk of disease.