Chiropractic in the Treatment and Prevention of Sports Injuries

The study aims to investigate whether chiropractic manual therapy intervention protocol provided in addition to the current best practice management could prevent the occurrence of and weeks missed due to hamstring and other lower-limb injuries at the semi-elite level of Australian football. The authors used two groups of male semi elite Australian Rules football athletes, matched them in several ways and randomly placed them in one of two arms of the study. All received the usual and customary management and medical care. Half also received chiropractic care which consisted of both soft tissue and high velocity spinal manipulation. The treatment plan was: 1 treatment per week for 6 weeks, 1 treatment per 2 weeks for 3 months, 1 treatment per month for the remainder of the season (3 months). The research evaluated several outcomes. When chiropractic care was added to conventional management, there was a significant reduction in lower limb strain injuries, time missed as a result of knee injuries, lower back pain, and there was improvement in health status. “In addition, although not statistically significant, there was a trend towards prevention of hamstring and primary non-contact knee injuries and there were no reported adverse outcomes from the intervention.”

Dr. David Chen
Chiropractor in Laurel, MD
Laurel Regional Chiropractic

Spinal manipulation is more effective for chronic low back pian

A randomized trial by researchers at an outpatient rehabilitation department in Italy involving 210 patients with chronic, nonspecific low back pain compared the effects of spinal manipulation, physiotherapy and back school. The participants were 210 patients (140 women and 70 men) with chronic, non-specific low back pain, average age 59. Back school and individual physiotherapy were scheduled as 15 1-hour-sessions for 3 weeks. Back school included group exercise and education/ergonomics. Individual physiotherapy included exercise, passive mobilization and soft-tissue treatment. Spinal manipulation included 4-6 20-minute sessions once-a-week.

Outcome measures were the Roland Morris Disability Questionnaire (scoring 0-24) and Pain Rating Scale (scoring 0-6), assessed at baseline, discharge, and at 3, 6, and 12months. 205 patients completed the study. At discharge, the results showed that spinal manipulation was associated with higher functional improvement and long-term pain relief than back school or individual physiotherapy, but received more further treatment at follow-ups; pain recurrences and drug intake were also reduced compared to back school or individual physiotherapy.

Reference: Cecchi F, Molino-Lova R, Chiti M, Pasquini G, Paperini A, Conti AA, Macchi C. Spinal manipulation compared with back school and with individually delivered physiotherapy for the treatment of chronic low back pain: a randomized trial with one-year follow-up. Clin Rehabil 2010; 24: 26-36.

Dr. David P. Chen
Chiropractor in Laurel, Maryland
Laurel Regional Chiropractic
www.laurelregionalchiropractic.com

Study shows little evidence of benefit for spinal fusion surgery

More Medicare patients are having complex back surgery even when there’s often an easier, less risky and less costly fix, according to a study in the Journal of the American Medical Association. The rate of complex fusion surgery for spinal stenosis, which causes lower back pain, increased 15-fold from 2002 to 2007, according to the study.
The study and an accompanying editorial suggest that aggressive marketing by implant makers, and greater physician compensation for high-tech procedures, may be influencing treatment. Meanwhile, taxpayers bear the expense, and patients face increased risks.

There are non-surgical approaches and treatments for spinal stenosis or degenerative disc disease. The symptoms can be treated with exercise, weight loss, chiropractic, and physical therapy. A study in the BMC Musculoskeletal Disorders concluded that distraction manipulation (DM) and neural mobilization (NM) are viable alternative to surgery for patients with lumbar spinal stenosis (LSS), and compares favorably with other non-surgical approaches that have been studied. The study further suggest that “As the efficacy of surgery does not appear to decrease if it is delayed in favor of a non-surgical trial, most patients with LSS should be treated non-surgically for a period of time before considering operation. DM and NM may be one non-surgical option that can be offered to patients.”

References:
Murphy, DR, Hurwitz, EL. Gregory, AA, Clary, R. A non-surgical approach to the management of lumbar spinal stenosis: A prospective observational cohort study. BMC Musculoskelet Disord. 2006; 7: 16.

Deyo, RA, Mirza, SK, Martin, BI, Kreuter, W, Goodman, DC, Jarvik, JG. Trends, Major Medical Complications, and Charges Associated With Surgery for Lumbar Spinal Stenosis in Older Adults. JAMA. 2010;303(13):1259-1265.

Dr. David Chen
Chiropractor in Laurel, MD
Laurel Regional Chiropractic

Modify your golf swing to reduce injury

Of the 25 million golfers in America, up to 62% may suffer an injury related to the game. Low back pain (LBP) is the most common injury in professional and amateur golfers; repetitive swing motion and poor swing mechanics are thought to be the primary reasons for injury.

A common belief in golfers is that the more their shoulders rotate back during the backswing portion of a golf swing, the better their swing will be; this position places the spine under a great degree of stress, however. The authors of this study hypothesized that a restricted backswing that incorporates more shoulder activity may reduce the odds for injury without harming performance levels by eliminating excessive spinal rotation.

Seven subjects who normally demonstrated a full recoil backswing (involving a shoulder turn of at least 90 degrees with a restricted hip rotation) were fitted with an electromyographic (EMG) recording device to measure muscle activity. EMG electrodes were placed on the lumbar; external oblique; latissimus dorsi; and right pectoralis major muscles. Subjects hit 10 balls consecutively for maximal distance using their typical swing, while a swing indicator measured club head speed and accuracy. Next, subjects were shown how to modify their swing to incorporate a shorter backswing; they were allowed to practice this swing for 20-30 minutes, at which time data were recorded as they hit 10 more golf balls.

Results: A backswing shortened by an average of 47 degrees did not significantly affect club speed or stroke accuracy. The target spot on the clubhead also remained the same. However, EMG activity was reduced 19% in the right oblique before impact; 12% in the left lumbar during acceleration; 21% in the right latissimus during activation; and 14% in the left lumbar during follow-through. EMG activity in the shoulder muscles increased as golfers compensated their swing.

These results are important because many golfers may not want to change their swing mechanics to reduce their odds for LBP if it might cause decreased game performance. The authors point out that although a reduced backswing may help prevent back injury, it could possibly lead to a less-debilitating shoulder injury.

Sources: Bulbulian R, Ball KA, Seaman DR. The short golf backswing: Effects on performance and spinal health implications. Journal of Manipulative and Physiological Therapeutics 2001:24(9), pp. 569-575.

http://www.naturopathydigest.com/important_research/sports_fitness/sports_injuries/11.php

Dr. David Chen
Chiropractor in Laurel, MD
Laurel Regional Chiropractic