Rehabilitation

Cervical Spine Trauma

By Frank M. Painter|May 15, 2012|Cervical Spine, Chiropractic Care, Evaluation & Management, Rehabilitation|

Cervical Spine Trauma

Clinical Monograph 18

By R. C. Schafer, DC, PhD, FICC

As with most parts of the body, traumatic effects in the forearm or wrist may occur abruptly (eg, fracture, strain, sprain) or be the result of long-term microtrauma (eg, tunnel syndromes, arthritis, entrapment by scar tissue).

The cervical spine provides structural stability and support for the cranium, and a flexible and protective column for movement and balance adaptation, along with housing of the spinal cord and vertebral arteries. It also allows for directional orientation of the eyes and ears. Nowhere in the spine is the relationship between the osseous structures and the surrounding neurologic and vascular beds as intimate or subject to disturbance as it is in the cervical region.

BACKGROUND

Whether induced by trauma or not, cervical subluxation syndromes may be reflected in total body habitus. IVF insults, and the effects of articular fixations can manifest throughout the motor, sensory, and autonomic nervous systems. Many peripheral nerve symptoms in the shoulder, arm, and hand will find their origin in the cervical spine, as may numerous brainstem disorders.

Common Injuries and Disorders of the Cervical Spine

Cervical spine injuries can be classified as

(1) mild (eg, contusions, strains);

(2) moderate (eg, subluxations, sprains, occult fractures, nerve contusions, neurapraxias);

(3) severe (eg, axonotmesis, dislocation, stable fracture without neurologic deficit); and

(4) dangerous (eg, unstable fracture-dislocation, spinal cord or nerve root injury).

Spasm of the sternocleidomastoideus and trapezius can be due to strain or irritation of the sensory fibers of the spinal accessory nerves as they exit with the C2–C4 spinal nerves. The C1 and C2 nerves are especially vulnerable because they do not have the protection of an IVF. Radicular symptoms are rarely evident unless an IVD protrusion or rupture is present.

Prevalence

Because of its great mobility, relatively small structures, and weight-bearing role, the cervical spine is a frequent site of severe spinal nerve injury and subluxation/fixations. A large variety of cervical contusions, Grade 1–3 strains and sprains, subluxations, disc syndromes, dislocations, and fractures will be seen as the result of trauma.

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Soft-Tissue Neck Trauma

By Frank M. Painter|May 12, 2012|Chiropractic Care, Evaluation & Management, Rehabilitation, Spinal Manipulation|

Soft-Tissue Neck Trauma

The Chiro.Org Blog

Clinical Monograph 15

By R. C. Schafer, DC, PhD, FICC

The mechanical relationship between the head and neck has been crudely compared to a brick attached to a flexible rod. As the structural mass of the head is so much greater than that of the neck, it is no wonder that injuries of the neck are so prevalent. Even the person with a short neck and well-developed neck muscles and ligaments is not free of potential injury.

BACKGROUND

The viscera of the neck serve as a channel for vital vessels and nerves, the trachea, esophagus, and spinal cord, and as a site for lymph and endocrine glands. When the head is in balance, a line drawn through the nasal spine and the superior border of the external auditory meatus will be perpendicular to the ground.

Anterior injuries are more common to the head and chest as they project further forward, but a blunt blow from the front on the head or chest may cause an indirect extension or flexion injury of the cervical spine and soft tissues of the neck. In any neck injury, the injury may not be the product of a single force. For example, while extension, flexion, and lateral flexion injuries are often described separately, rotational, compressive, tensile, and shearing forces are invariably part of the picture.

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Chronic Neck Pain and Chiropractic Page

The anterior and lateral aspects of the neck contain a variety of vital structures that have no bony protection. Partial protection is provided by the cervical muscles, the mandible, and the shoulder girdle.

After neck injury, a careful neurologic evaluation must be conducted, and every examination should begin with a thorough case history. See Table 1. Note any signs of impaired consciousness, inequality of pupils, or nystagmus. Do outstretched arms drift unilaterally when the eyes are closed? Standard coordination tests such as finger-to-nose, heel-to-toe, heel-to-knee, and for Romberg s sign should be conducted, along with superficial and tendon reflex tests.

Table 1 Typical Questions Asked During the Investigation of Joint Pain

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The Foundation of Biomechanical Evaluation Following Injury

By Frank M. Painter|May 11, 2012|Chiropractic Care, Clinical Pearl, Evaluation & Management, Rehabilitation|

The Foundation of Biomechanical Evaluation Following Injury

The Chiro.Org Blog

Clinical Monograph 9

By R. C. Schafer, DC, PhD, FICC

INTRODUCTION

The study of human biomechanics includes the mechanical principles involved, the physiologic considerations of muscle length-tension relations, and an understanding of the controlling neuromotor mechanisms and the sensory feedback apparatus, reflecting both locomotor activity and cerebral function. Applied biomechanics is the application of the practical principles of mechanics (the study of forces and their effects) to the body in movement and at rest.

The more biomechanics are understood, the better musculoskeletal disorders in sports and the workplace can be appreciated. The same can be said of physical work and recreational activities. The athlete is constantly attempting to improve performance by applying biomechanical principles to specific movements. The same is true for ergonomics in the workplace. From the viewpoint of the doctor, knowledge of the mechanisms involved in an injury is necessary to evaluate an injury accurately.

PERTINENT BIOMECHANICS

From a pure musculoskeletal standpoint, the human body is a mechanical device. All mechanical devices are subject to wear during use that reflects their history of destructive forces. Unique to living tissue is its ability to heal, adapt, and strengthen, which provides a dialogue between catabolic and anabolic forces. While machines convert thermal or chemical energy into mechanical energy, muscle tissue transforms nutrients directly into mechanical energy without a thermal intermediary. Body energy enables it to overcome resistance to motion, to produce a physical effect, and to accomplish work.

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Chiropractic Rehabilitation

Practical Concepts

The body’s kinetic energy is reflected in its velocity, and its potential energy is reflected in its position. Work is the result of a force acting through a distance. Power relates to the time element and the work accomplished. There is a close association in the same unit of time between the work accomplished by a weight lifter and that of a sprinter. (more…)

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Outcomes For Adult Scoliosis Patients Receiving Chiropractic Rehabilitation: A 24-month Retrospective Analysis

By Frank M. Painter|September 5, 2011|Rehabilitation, Scoliosis, Spinal Manipulation|

Outcomes For Adult Scoliosis Patients Receiving Chiropractic Rehabilitation: A 24-month Retrospective Analysis

The Chiro.Org Blog

SOURCE: J Chiropractic Medicine 2011 (Sep); 10 (3): 179–184

By Mark Morningstar DC, FACSP, FRCCM, FAAIM

Objectives: The purpose of this study was to retrospectively report the results of patients who completed an exercise-based chiropractic program and its potential to alter the natural progression of adult scoliosis at 24 months after the clinic portion of treatment was concluded.

Methods: A retrospective chart review was conducted at 2 spine clinics in Michigan, USA. Each clinic uses the same chiropractic rehabilitation program to treat patients with adult scoliosis. Multidimensional patient outcomes included radiographic, respiratory, disability, and pain parameters. Outcomes were measured at baseline, at end of active treatment, and at long-term follow-up.

Results: (more…)

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Applied Physiotherapy: Rehabilitation Methodology

By Frank M. Painter|July 27, 2010|Diagnosis, Education, Rehabilitation|

Applied Physiotherapy: Rehabilitation Methodology

The Chiro.Org Blog

We would all like to thank Dr. Richard C. Schafer, DC, PhD, FICC for his lifetime commitment to the profession. In the future we will continue to add materials from RC’s copyrighted books for your use.

This is Chapter 13 from RC’s best-selling book:

“Applied Physiotherapy in Chiropractic”

These materials are provided as a service to our profession. There is no charge for individuals to copy and file these materials. However, they cannot be sold or used in any group or commercial venture without written permission from ACAPress.

Chapter 13: Rehabilitation Methodology

The topics of this chapter have been adapted from Volume 1, Chiropractic Rehabilitation, by K. D. Christensen, DC, © 1990, and used here with permission.

INTRODUCTION

Strengthening exercises for the muscular system play an essential role in the chiropractic management of various neuromusculoskeletal disorders. Knowledge of various training methods and exercise techniques are thus among the most important requirements for effective treatment. [1] Properly conducted individual exercise programs help prevent many injuries and serve to shorten the recovery period necessary to restore the patient back to health. [2] Exercise programs can be designed to increase strength, aid weight loss, increase cardiorespiratory efficiency, or simply improve overall musculoskeletal performance.

All exercise programs should have specific goals in mind. The cornerstone of exercise is Davis’ Law, or the (SAID) principle that states that the body makes specific adaptation to imposed demands. [3] The more specific the exercise, the more specific the adaptation. Exercise, therefore, should be as specific as possible to the individual’s goals and needs. (more…)

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Proprioceptive Neuromuscular Training Reduces Sports Injuries

By Frank M. Painter|March 19, 2010|Chiropractic Technique, Rehabilitation, Sports|

Proprioceptive Neuromuscular Training Reduces Sports Injuries

The Chiro.Org Blog

Thanks to ChiroAccess for this information!

A March 2010 systematic review conducted in Germany underscores the value of neuromuscular training in preventing sports injuries. [1] They concluded that “On the basis of the results of seven high-quality studies, this review showed evidence for the effectiveness of proprioceptive/ neuromuscular training in reducing the incidence of certain types of sports injuries among adolescent and young adult athletes during pivoting sports.”

The pivoting sports included basketball, hockey, handball, volleyball, soccer and floorball. Multiple high quality studies now support the use of training programs to improve proprioception and the research further supports that this proprioceptive improvement translates to reduced risk of sports associated injuries. [2–4] The benefit is even greater for those with a previous history of sports injury. (more…)

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