Andrea Buccino, DC

Knuckle Cracking

docboo — Wed, 03 Oct 2012 16:35:16 +0000

In a recent article published by the BBC, researchers have concluded that there is no absolute conclusion to the myth of arthritis and knuckle cracking!
http://www.bbc.com/future/story/20120917-is-it-bad-to-crack-your-knuckles
The physiologic explanation is what I have been explaining to patients for years. Gas escapes the joint capsule, and it makes a funny noise…like a fart. A “joint fart” to be more professional.
If patients insist on “cracking themselves” and their knuckles especially, I ask that they pull their finger, as if to elongate the digit. This is a distraction of the joint, and leads to less hypermobility (too much movement). Flexing your fingers (so your fingertips touch your wrist) or extending your fingers (so your nails reach back towards your forearm) hyperflexes or hyperextends the joint respectively, causing stress on the joint.

If you have Legs, You Probably Have Tight Hamstrings

docboo — Wed, 03 Oct 2012 16:32:26 +0000

As ESPN highlights the few injuries keeping several competitors from performing at their best, we as amateur athletes and weekend warriors can identify with their injuries. Most of us have never felt the pain and frustration from withdrawing from the race of our life, but anyone who kicked a ball a little too hard, or landed unevenly can attest to the searing pain of a muscle injury.

Hamstrings, the major muscle group in the back of our thighs, are commonly injured. The hamstrings are made up of the biceps femoris, semitendinosus, and semimembranosus muscles. These muscles start at the bottom of our pelvic bone, called the ischium. (When seated on a hard chair or the floor, you can often feel these bony prominences). The muscles attach at the back of the shin bone, behind the knee. The hamstrings collectively extend our thigh and flex our knee. Because it crosses two joints, it is more prone to injury. It is also one of the major muscle groups of the body, which means it is used for more movements than you might realize.

In sports, the most commonly injured structures are the muscles, tendons and ligaments. Tendons attach muscle to bone. Ligaments attach bone to bone. A muscle strain occurs when minor tears develop in the fibers from overexertion. Strains can range from mild (just a few fibers affected) to severe (a tear through the full thickness of the tissue). Most injures heal within a few days to a week, more severe injuries can cause symptoms up to a month.

After injury, RICE (Rest, Ice, Compression, Elevation) is the first choice of treatment. The best choice for prevention, however, is conditioning the muscle from the start.

To stretch your hamstrings, put the heel of one leg on a step. Your standing leg should be straight. Your hips should be centered and squared. Lean forward from the hip, not the waist. You should feel a gentle tug in the back of your thigh. Hold the stretch for 20 seconds. Downward Dog, a very common yoga pose, is also great to lengthen your hamstrings.

A great yoga pose to stretch out those hammies!

To strengthen your hamstrings, air squats are beneficial for a warm up. Start from a standing position, squat while striving to achieve 90 degrees of knee flexion, and return to standing. No weight is necessary. A great rehab exercise is single leg lifts for the hamstring. The exercise builds the muscle in an eccentric motion. This means the benefit comes from lengthening the muscle. Start in the standing position. Keep a weight in one hand (start with a 5 pound dumbbell, more advanced can try a small kettlebell). Keep one leg planted. Lean forward at the hip, lifting the opposite leg straight behind you. Goal is to have your legs make a 90 degree angle. Return to starting position. Start with a set of 10. Switch sides. Walking lunges are fantastic too. Start with 10 down, and 10 back. More advanced can carry dumbells or kettlebells in either hand.

If any of the exercises hurt, stop immediately and consult your doctor. An experienced doctor with a sports background will be able to correct any of the factors that may dispose a person to injury.

Not So Fantastic Gymnastics

docboo — Fri, 02 Mar 2012 18:58:25 +0000

Gymnastics became more popular in the United States after the 1972 Olympics. Though few athletes make it to the elite level of international competition, high schools and colleges do have upper level competitors on their gymnastic teams.

There is the potential for overuse injuries due to the amount of practice time, and attempt to perfect certain series of skills and tricks. Due to the physical demands placed on the body during landings, there is a high risk for injury (despite the copious amounts of mats and foam padding). According to the NCAA Injury Surveillance Survey for the 1997-98 Women’s Gymnastics Season, 87% of all injuries were during practice. Sprains and strains were the most common, but 7% of the injuries were head and neck trauma. During an event, such as a meet, the Floor Exercise held the highest amount of injuries. Most of these injuries were sustained during a manuever without the use of a spotter.

Very common in gymnastics is the prevalence of hyperlordosis. Our lumbar spine (the lower segment of our spine) has a natural curve called a “lordosis” this develops approximately 10-18 months after birth as the infant begins to walk upright. When this curve is strongly accentuated, it is termed “hyperlordosis.” This is very common due to the nature of the hyper-extension positions of the athlete. These poses may lead to microtrauma to the spine, which could further lead to an increase in spondylolysis, a fracture of the pars interarticularis, a small portion of the vertebra.

Spondylolysis is painful. Treatment protocols have been debated, but the agreed upon goal is to restore pain-free range of motion and normal function. Bracing may be suggested to assist in healing. Return to the sport is allowed after the athlete is pain-free, asymptomatic, and has done a series of rehabilitative exercises to restore function.

Like any sport, there is an increase for injury when the athlete is not properly trained or performing through injury or fatigue. It is important for the athlete to know their own limit, and for coaches and parents to pay close attention to changes in physical behavior.

NFL Cares about Head Injuries

docboo — Fri, 02 Mar 2012 18:54:08 +0000

According to the New York Times, the NFL is making progress in their attempt to decrease the number of hits to the head and neck of players during the season.
Last year the league cracked down on hits by threatening suspensions for repeated violators. This change is starting to show progress. Concussions in preseason and regular-season games dropped 12.5 percent from 2010 to 2011, from 218 concussions reported in 321 games last season to 190 concussions in 320 games this season.
The NFL is attempting to combat the image that players and coaches have deliberately hidden concussion symptoms so that players can continue playing. This may lead to more serious injuries (something called Second Impact Syndrome) and chronic debillitation.
The last commercial in the 3rd quarter will show the improved safety in the league from its inception.
For more, read: http://www.nytimes.com/2012/01/31/sports/football/nfl-to-address-head-injuries-in-commercial.html?_r=2&pagewanted=all

Warning Signs for the Female Athlete

docboo — Fri, 02 Mar 2012 18:51:29 +0000

According to a study conducted in St. Louis and to be presented at the American Academy of Orthopedic Surgeons in San Francisco, female soccer players are at an increased risk for the Female Athlete Triad. This triad includes: irregular periods, eating disorders, and osteoporosis.
The study found that one in five elite soccer players had irregular periods, and 14% had stress fractures. Stress fractures is when the body’s physical demand is too much for the body’s supply of bone-building calcium to repair at an adequate rate. Stress fractures are overuse injuries. Rest is typically prescribed for this diagnosis.

Sports chiropractors can help identify patient-athletes at risk, and help modify training so that the cycle of damage can be stopped.
Warning signs include, missing periods, having irregular periods (especially during training), pain in the shins, feet or ankles after intense activity, and an unusual picky diet.

Austrailian Footballers Know Best

docboo — Fri, 02 Mar 2012 18:47:40 +0000

According to a study published by the BMC Musculoskeletal Disorders in 2010, Australian professional football players missed less games than their injured counterparts AND had fewer number of leg injuries. The trial included adding chiropractic care to standard medical and physical therapy treatment. Sports chiropractic manual therapy had a positive effect to back pain, hamstring, and lower leg injuries. Good news, mate!

For more, read: http://www.biomedcentral.com/bmcmusculoskeletdisord/

Get Off the Couch and Out of Bed

admin — Wed, 12 Jan 2011 01:59:53 +0000

Why Bed Rest Doesn’t Do a Body Good

A recent study reported in Spine demonstrated that extended bed rest can actually injure the low back – including the joints, muscles and discs.

Nine healthy male subjects endured 60 days of enforced immobility. In addition to soft tissue findings, researchers reported that at the end of the study, 5 of the 9 men reported low back pain the first week after re-ambulation.

The researchers found that extended bed rest affects the natural curve in the low back (lordosis). The lordosis is established by 18 months of age, around the time a child stands. The lordosis should measure between 40 and 60 degrees in an adult. Bed rest decreases the degree of the curve which puts can put additional pressure on the disc. This pressure can reduce the natural ability of the disc to absorb shock.

The study also showed that bed rest increases disc height and muscle atrophy. These changes could easily increase biomechanical stress on the spine. A group of muscles mentioned by name in this study were the multifidi (deep muscles in the low back)which have the task of spinal stability. If the foundation is weakened, the multifidi muscles would need to work harder in order to pick up the slack of malfunctioning joints to stabilize the spine.

This study as a whole may help explain why some back pain patients report more low back symptoms when rising from bed after a night of immobile rest. Bed rest is not a good idea when nursing a low back injury in most cases. Movement, as simple as proper stretching and walking, promotes aerobic activity which brings fresh bloodflow to the stabilization muscles. Keep it moving!

GET HEALTHY in 2011

admin — Wed, 05 Jan 2011 07:18:54 +0000

New Year…New You! Get out of pain, and break the cycle of dysfunction!

Your perception of pain is increased after a lack of sleep or rest. This is a cycle that many people in pain would love to break out of. Think about it…you are in pain, so you cannot get comfortable. You toss and turn (in pain), you get out of bed, you find a chair, you still cannot sleep. You go back to bed. Argue with your pillow, and eventually find some rest just in time for the alarm to go off. On a scale of zero to ten, your pain is probably pretty high, and most of us have a stressful and jam-packed schedule that doesn’t leave much room for pain.

Pain can also be higher or more widespread with those with even mild cases of depression. Depression can affect certain neurotransmitters (serotonin and norepinephrine) which also is influenced by estrogen. Estrogen levels become altered around menopause and peri-menopause which can increase certain symptoms.
The link here, is that many factors can influence the perception of pain. Stress, sleep, depression, and aging may manifest in your body as pain. In order to combat nature (because pain is inevitable, but suffering is optional), you can fight back naturally.
Eat a well balanced diet: A balance of whole grain carbohydrates, lean proteins, and a good mix of fruits and vegetables as snacks throughout the day can keep your body nourished. Real foods (not processed foods) make for real people.

Don’t be thirsty: Drinking water is key, it helps keep your muscles hydrated. If you are thirsty, you are already dehydrated.
Exercise: not only does cardio (like walking a few times a week) bring fresh blood to the deep muscles of the low back preventing injury, but lifting weights can help keep osteoporosis away. In addition, exercise helps ward off weight gain, putting less pressure on the joints. Exercise also increases serotonin and endorphins, naturally letting someone feel better about themselves, and improve their mood.

Supplementation: No matter how healthy you eat, you still may be missing key ingredients from your diet. I recommend a multi-vitamin to all of my patients, especially one that includes a Vitamin B complex (which is healthy for nerves and cells). Vitamin C is not only great to help keep the immune system functioning properly, but the vitamin is also very important in ligament and tendon repair. Calcium and Magnesium are also key for muscle functioning, and Fish Oils supplement Omega 3s which make for a happy cardiovascular system.

Chiropractic: Muscle tightness is a side effect of stress. Most men carry their stress in their low back and most women, up near their neck and shoulders. Loosening these muscles my stretching or myofascial release can decrease the muscle spasm, allowing the joints in your spine to move properly. Adjustments increase your range of motion and decrease your pain. Make an appointment and start feeling better!

Hip Hip Hooray

admin — Tue, 16 Nov 2010 11:14:54 +0000

With recent alarm about replacing hip replacements, the United States will start gathering data to uncover implant problems more quickly. The registry’s goal is to include 90% of 5000 American hospitals that do hip replacement procedures. Keeping Tabs on Implants (Kamp) The Wall Street Journal (10/13/10) This potential collection of raw information can serve as an early warning system for devices that may fail and lead to further patient complications. Hip replacement devices are approved by the Food and Drug Administration, however, currently, there is no long-term monitoring on the devices. Manufacturers would join voluntarily, thereby avoiding mandated rules down the road.

In its early inception, it is still being debated whether or not hospitals or insurance companies will cover the cost. The information they collect now may be able to improve and influence devices made for the future. At the end of August, the Wall Street Journal reported that as many as 93,000 hip replacement devices made by Johnson and Johnson were recalled, with very few still left out on the market. The original device cost approx $6000, and repair of the joint after a malfunction may have cost as much as $20,000. The implant was made of metal, not the traditional ceramic, which was originally thought to increase the longevity of the product, however, caused debris to collect in the hip joint as it wore down. This new registry hopes to track patients who need additional surgery due to worn out joints, implant loosening, or joint dislocation, thereby catching cases where some of the devices have an early demise. Hip replacement is a bigger issue now due to the increase in the “baby boomer” population that is suffering from more osteoarthritis (wear and tear of the bones and joints) and osteoporosis (widespread thinning of the bones).

Patients starting off with hip problems may ultimately suffer from knee pain, ankle sprains, and low back issues. The reasoning is simple, your torso splits its weight into two at your pelvis, evenly distributing into your hip joints and legs. When one hip is diseased or dysfunctioning, that causes your gait (the way you walk) to be altered, putting more pressure on one knee, and sometimes twisting your back as you hike your hip up to walk. Pressure is put on the joints in the low back, which now have to work harder and inappropriately from how they were designed, and may cause spasming in your low back muscles. It is very common for a patient with a hip issue to have tight hamstrings on one leg, tight hip flexors on the opposite side, and muscle spasming in their low back.

Chiropractors cannot determine whether hip replacement is right for you, but we can help keep your hip joint healthy. With proper stretching, muscle release, adjustments and rehab exercises, we may be able to keep a small problem small. Likewise, it is beneficial for patients to seek chiropractic care after surgery to keep joints moving correctly, and preventing the formation of scar tissue. Visit our office if you have a hip or other joint issue. Dr. Buccino would be happy to assess if your low back and hips are working the way they were designed.

Interesting Back Pain and Treatment Statistics

admin — Wed, 20 Oct 2010 18:25:26 +0000

In 2007, 27 million US adults (18 and over) reported having back problems. Over 19.1 million received treatment. 10.9 million women and 8.2 million men.
The back accounted for 20% of all musculoskeletal consultations, and the lower back 14% out of 100,000 people presenting for primary care(BMC Musculoskeletal Disorders, 2010; 11:144) Not many of them tried chiropractic first…but you should.

Chiropractic care treats chronic pain…without dangerous risks…A 2009 report found that deaths related to opioid overdose in the US more than tripled from 1999 to 2008 from 4000 to 13,800 fatalities. Most of these were attributable to opioid misuse and abuse. Centers for Disease Control and Prevention estimated a 111% increase in ER visits between ’04 and ’08 for non medical use of opioid meds.