What our chiropractors in Scarborough Maine can treat

Disclaimer:

This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific medical and/or orthopaedic advice should consult with his or her primary care physician. The information is copyrighted from AAOS.

Snapping Hip Syndrome

Snapping hip is most often the result of tightness in the muscles and tendons surrounding the hip. People who are involved in sports and activities that require repeated bending at the hip are more likely to experience snapping hip. Dancers are especially vulnerable. Young athletes are also more likely to have snapping hip. This is because tightness in the muscle structures of the hip is common during adolescent growth spurts.

Snapping hip is a condition in which you feel a snapping sensation or hear a popping sound in your hip when you walk, get up from a chair, or swing your leg around. The snapping sensation occurs when a muscle or tendon (the strong tissue that connects muscle to bone) moves over a bony protrusion in your hip.

Although snapping hip is usually painless and harmless, the sensation can be annoying. In some cases, snapping hip leads to bursitis, a painful swelling of the fluid-filled sacs that cushion the hip joint.
Hip Bursitis

Bursitis is inflammation of the bursa. There are two major bursae in the hip that typically become irritated and inflamed. One bursa covers the bony point of the hip bone called the greater trochanter. Inflammation of this bursa is called trochanteric bursitis.

Another bursa — the iliopsoas bursa — is located on the inside (groin side) of the hip. When this bursa becomes inflamed, the condition is also sometimes referred to as hip bursitis, but the pain is located in the groin area. This condition is not as common as trochanteric bursitis, but is treated in a similar manner.

The main symptom of trochanteric bursitis is pain at the point of the hip. The pain usually extends to the outside of the thigh area. In the early stages, the pain is usually described as sharp and intense. Later, the pain may become more of an ache and spread across a larger area of the hip.

Typically, the pain is worse at night, when lying on the affected hip, and when getting up from a chair after being seated for a while. It also may get worse with prolonged walking, stair climbing, or squatting
Sciatica/Piriformis Syndrome

The piriformis is a muscle that is behind the hip joint in the buttocks. The piriformis muscle is small compared to other muscles around the hip and thigh, and it aids in external rotation (turning out) of the hip joint. The piriformis muscle and its tendon have an close relationship to the sciatic nerve--the largest nerve in the body--which supplies the lower extremities with motor and sensory function. The piriformis tendon and sciatic nerve cross each other behind the hip joint, in the deep buttock. Both structures are about one centimeter in diameter.

When people are diagnosed with piriformis syndrome, it is thought that the piriformis tendon may be tethering the sciatic nerve, and causing an irritation to the nerve. While it has not be proven, the theory supported by many physicians is that when the piriformis muscle and its tendon are too tight, the sciatic nerve is pinched. This may decrease the blood flow to the nerve and irritate the nerve because of pressure.

Sciatica

If you suddenly start feeling pain in your lower back or hip that radiates to the back of your thigh and into your leg, you may have a protruding (herniated) disk in your spinal column that is pressing on the nerve roots in the lumbar spine. This condition is known as sciatica.

Common signs and symptoms experienced by people who have been diagnosed with piriformis syndrome include:

Pain behind the hip in the buttocks
Electric shock pains traveling down the back of the lower extremity
Numbness in the lower extremity
Tenderness with pressure on the piriformis muscle (often causing pain with sitting on hard chairs)

Sciatica may feel like a bad leg cramp, with pain that is sharp ("knife-like"), or electrical. The cramp can last for weeks before it goes away. You may have pain, especially when you move, sneeze, or cough. You may also have weakness, "pins and needles" numbness, or a burning or tingling sensation down your leg.

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IT Band Syndrome
The iliotibial band is a band of fibrous tissue that runs down the outside of the thigh. It provides stability to the knee and hip and helps prevent dislocation of those joints. The band may overdevelop, tighten, and rub across the hipbone or the outer part of the knee. Each time the knee is bent or the hip flexed, the band rubs against bone. This is particularly common in runners, cyclists, and people who participate in other aerobic activities.

Symptoms of iliotibial band syndrome include:
- Pain on the outside of the knee or hip.
- Snapping hip pain as the iliotibial band snaps back and forth over the point of the hip (greater trochanter).
- Pain that generally disappears as the band is stretched out and becomes more flexible.
- Pain that improves with rest.
Iliotibial band syndrome is treated with rest, medicines to relieve swelling and pain, and stretching exercises as instructed by a physical therapist or sports medicine doctor. Steroid injections at the most tender spot are sometimes helpful.
Patellofemoral Pain Syndrome(Tendonitis, Runners/Jumpers Knee)

Patellofemoral pain syndrome is a broad term used to describe pain in the front of the knee and around the patella, or kneecap. It is sometimes called "runner's knee" or "jumper's knee" because it is common in people who participate in sports—particularly females and young adults—but patellofemoral pain syndrome can occur in nonathletes, as well. The pain and stiffness it causes can make it difficult to climb stairs, kneel down, and perform other everyday activities.

Many things may contribute to the development of patellofemoral pain syndrome. Problems with the alignment of the kneecap and overuse from vigorous athletics or training are often significant factors.

Symptoms are often relieved with conservative treatment, such as changes in activity levels or a therapeutic exercise program.

Overuse
In many cases, patellofemoral pain syndrome is caused by vigorous physical activities that put repeated stress on the knee —such as jogging, squatting, and climbing stairs. It can also be caused by a sudden change in physical activity. This change can be in the frequency of activity—such as increasing the number of days you exercise each week. It can also be in the duration or intensity of activity—such as running longer distances.

Other factors that may contribute to patellofemoral pain include: Use of improper sports training techniques or equipment, Changes in footwear or playing surface. Muscular imbalances or weaknesses, especially in the quadriceps muscles at the front of the thigh. When the knee bends and straightens, the quadriceps muscles and quadriceps tendon help to keep the kneecap within the trochlear groove. Weak or imbalanced quadriceps can cause poor tracking of the kneecap within the groove.

Symptoms
The most common symptom of patellofemoral pain syndrome is a dull, aching pain in the front of the knee. This pain—which usually begins gradually and is frequently activity-related—may be present in one or both knees. Other common symptoms include:

Pain during exercise and activities that repeatedly bend the knee, such as climbing stairs, running, jumping, or squatting.
Pain after sitting for a long period of time with your knees bent, such as one does in a movie theater or when riding on an airplane.
Pain related to a change in activity level or intensity, playing surface, or equipment.
Popping or crackling sounds in your knee when climbing stairs or when standing up after prolonged sitting.
Pes Anserine Bursitis

Pes Anserine (Knee Tendon) Bursitis
Bursae are small, jelly-like sacs that are located throughout the body, including around the shoulder, elbow, hip, knee, and heel. They contain a small amount of fluid, and are positioned between bones and soft tissues, acting as cushions to help reduce friction.

Pes anserine bursitis is an inflammation of the bursa located between the shinbone (tibia) and three tendons of the hamstring muscle at the inside of the knee. It occurs when the bursa becomes irritated and produces too much fluid, which causes it to swell and put pressure on the adjacent parts of the knee.

Pain and tenderness on the inside of your knee, approximately 2 to 3 inches below the joint, are common symptoms of pes anserine bursitis of the knee. Pain from pes anserine bursitis is located on the inside of the knee, just below the joint.

Cause
Bursitis usually develops as the result of overuse or constant friction and stress on the bursa. Pes anserine bursitis is common in athletes, particularly runners. People with osteoarthritis of the knee are also susceptible.

Several factors can contribute to the development of pes anserine bursitis, including:

Incorrect training techniques, such as neglecting to stretch, doing excessive hill running, and sudden increases in mileage
Tight hamstring muscles
Obesity
An out-turning of the knee or lower leg
Osteoarthritis in the knee
Medial meniscus tear

Symptoms
The symptoms of pes anserine bursitis include:

Pain slowly developing on the inside of your knee and/or in the center of the shinbone, approximately 2 to 3 inches below the knee joint. Pain increasing with exercise or climbing stairs
Shin Splints

Shin splints (medial tibial stress syndrome) is an inflammation of the muscles, tendons, and bone tissue around your tibia. Pain typically occurs along the inner border of the tibia, where muscles attach to the bone. Shin splints are a common exercise-related problem. The term "shin splints" refers to pain along the inner edge of the shinbone (tibia).

Shin splints typically develop after physical activity. They are often associated with running. Any vigorous sports activity can bring on shin splints, especially if you are just starting a fitness program.

Simple measures can relieve the pain of shin splints. Rest, ice, and stretching often help. Taking care not to overdo your exercise routine will help prevent shin splints from coming back.

Cause
In general, shin splints develop when the muscle and bone tissue (periosteum) in the leg become overworked by repetitive activity.

Shin splints often occur after sudden changes in physical activity. These can be changes in frequency, such as increasing the number of days you exercise each week. Changes in duration and intensity, such as running longer distances or on hills, can also cause shin splints.

Other factors that contribute to shin splints include:

Having flat feet or abnormally rigid arches
Exercising with improper or worn-out footwear
Runners are at highest risk for developing shin splints. Dancers and military recruits are two other groups frequently diagnosed with the condition.

Stress Fracture
If your shin splints are not responsive to treatment, your doctor may want to make sure you do not have a stress fracture. A stress fracture is a small crack(s) in the tibia caused by stress and overuse. Imaging tests that create pictures of anatomy help to diagnose conditions. A bone scan and magnetic resonance imaging (MRI) study will often show stress fractures in the tibia.

Prevention
There are things you can do to prevent shin splints.

Wear a proper fitting athletic shoe. To get the right fit, determine the shape of your foot using the "wet test." Step out of the shower onto a surface that will show your footprint, like a brown paper bag. If you have a flat foot, you will see an impression of your whole foot on the paper. If you have a high arch, you will only see the ball and heel of your foot. When shopping, look for athletic shoes that match your particular foot pattern.

In addition, make sure you wear shoes designed for your sport. Running long distances in court-type sneakers can contribute to shin splints.

Slowly build your fitness level. Increase the duration, intensity, and frequency of your exercise regimen gradually.

Cross train. Alternate jogging with lower impact sports like swimming or cycling.

Barefoot running. In recent years, barefoot running has gained in popularity. Many people claim it has helped to resolve shin splints. Some research indicates that barefoot running spreads out impact stresses among muscles, so that no area is overloaded. However, there is no clear evidence that barefoot running reduces the risk for any injury.

Like any significant change in your fitness regimen, a barefoot running program should be started very gradually. Begin with short distances to give your muscles and your feet time to adjust. Pushing too far, too fast can put you at risk for stress injuries. In addition, barefoot runners are at increased risk for cuts and bruises on their feet. Several brands of minimalist shoes with "toes" are available and these also require a slow working in period as your body adjusts to this different activity.

If your shin splints do not improve after rest and other methods described above, be sure to see a doctor to determine whether something else is causing your leg pain.

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Disclaimer: This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific medical and/or orthopaedic advice should consult with his or her primary care physician. The information is copyrighted from AAOS.

Shoulder Impingement/ Rotator Cuff Tendinitis

One of the most common physical complaints is shoulder pain. Your shoulder is made up of several joints combined with tendons and muscles that allow a great range of motion in your arm. Because so many different structures make up the shoulder, it is vulnerable to many different problems. The rotator cuff is a frequent source of pain in the shoulder.

The rotator cuff is a common source of pain in the shoulder. Pain can be the result of:

Tendinitis. The rotator cuff tendons can be irritated or damaged.
Bursitis. The bursa can become inflamed and swell with more fluid causing pain.
Impingement. When you raise your arm to shoulder height, the space between the acromion and rotator cuff narrows. The acromion can rub against (or "impinge" on) the tendon and the bursa, causing irritation and pain.

Cause
Rotator cuff pain is common in both young athletes and middle-aged people. Young athletes who use their arms overhead for swimming, baseball, and tennis are particularly vulnerable. Those who do repetitive lifting or overhead activities using the arm, such as paper hanging, construction, or painting are also susceptible.

Pain may also develop as the result of a minor injury. Sometimes, it occurs with no apparent cause.

Symptoms
Rotator cuff pain commonly causes local swelling and tenderness in the front of the shoulder. You may have pain and stiffness when you lift your arm. There may also be pain when the arm is lowered from an elevated position.

Beginning symptoms may be mild. Patients frequently do not seek treatment at an early stage. These symptoms may include:

Minor pain that is present both with activity and at rest
Pain radiating from the front of the shoulder to the side of the arm
Sudden pain with lifting and reaching movements
Athletes in overhead sports may have pain when throwing or serving a tennis ball

As the problem progresses, the symptoms increase:

Pain at night
Loss of strength and motion
Difficulty doing activities that place the arm behind the back, such as buttoning or zippering
If the pain comes on suddenly, the shoulder may be severely tender. All movement may be limited and painful.
Adhesive Capsulitis (Frozen Shoulder)

Frozen shoulder, also called adhesive capsulitis, causes pain and stiffness in the shoulder. Over time, the shoulder becomes very hard to move.

Frozen shoulder occurs in about 2% of the general population. It most commonly affects people between the ages of 40 and 60, and occurs in women more often than men.

Description
In frozen shoulder, the shoulder capsule thickens and becomes tight. Stiff bands of tissue — called adhesions — develop. In many cases, there is less synovial fluid in the joint.

The hallmark sign of this condition is being unable to move your shoulder - either on your own or with the help of someone else. It develops in three stages:

Freezing
In the"freezing" stage, you slowly have more and more pain. As the pain worsens, your shoulder loses range of motion. Freezing typically lasts from 6 weeks to 9 months.

Frozen
Painful symptoms may actually improve during this stage, but the stiffness remains. During the 4 to 6 months of the "frozen" stage, daily activities may be very difficult.

Thawing
Shoulder motion slowly improves during the "thawing" stage. Complete return to normal or close to normal strength and motion typically takes from 6 months to 2 years.

Cause
The causes of frozen shoulder are not fully understood. There is no clear connection to arm dominance or occupation. A few factors may put you more at risk for developing frozen shoulder.

Diabetes. Frozen shoulder occurs much more often in people with diabetes, affecting 10% to 20% of these individuals. The reason for this is not known.

Other diseases. Some additional medical problems associated with frozen shoulder include hypothyroidism, hyperthyroidism, Parkinson's disease, and cardiac disease.

Immobilization. Frozen shoulder can develop after a shoulder has been immobilized for a period of time due to surgery, a fracture, or other injury. Having patients move their shoulders soon after injury or surgery is one measure prescribed to prevent frozen shoulder.

Symptoms
In frozen shoulder, the smooth tissues of the shoulder capsule become thick, stiff, and inflamed. Pain from frozen shoulder is usually dull or aching. It is typically worse early in the course of the disease and when you move your arm. The pain is usually located over the outer shoulder area and sometimes the upper arm.
Thoracic Outlet Syndrome

The thoracic outlet is the space between your collarbone (clavicle) and your first rib. This narrow passageway is crowded with blood vessels, muscles, and nerves. If the shoulder muscles in your chest are not strong enough to hold the collarbone in place, it can slip down and forward, putting pressure on the nerves and blood vessels that lie under it. This causes a variety of symptoms which together are known as thoracic outlet syndrome.

Symptoms

Symptoms may vary, depending on which nerves or blood vessels are compressed. Symptoms from nerve compression are much more common than symptoms from blood vessel compression.

Pressure on the nerves (brachial plexus) may cause a vague, aching pain in the neck, shoulder, arm, or hand. It may also cause pain, numbness, or tingling on the inside of the forearm and the fourth and fifth fingers of the hand. Weakness may make your hand clumsy. Pressure on the blood vessels can reduce the flow of blood out of your arm, resulting in swelling and redness of your arm. Less commonly, pressure can reduce the blood flow into your arm and hand, making them feel cool and easily fatigued. Overhead activities are particularly difficult because they worsen both types of compression. There may be a depression in your shoulder, or swelling or discoloration in your arm. Your range of motion may be limited.

If you have symptoms of thoracic outlet syndrome, avoid carrying heavy bags over your shoulder because this depresses the collarbone and increases pressure on the important structures in the thoracic outlet.

You should also do some simple exercises to keep your shoulder muscles strong. Here are four that you can try—10 repetitions of each exercise should be done twice daily:

Corner Stretch - Stand in a corner (about 1 foot from the corner) with your hands at shoulder height, one on each wall. Lean into the corner until you feel a gentle stretch across your chest. Hold for 5 seconds.

Neck Stretch - Put your left hand on your head, and your right hand behind your back. Pull your head toward your left shoulder until you feel a gentle stretch on the right side of your neck. Hold for 5 seconds. Switch hand positions and repeat the exercise in the opposite direction.

Shoulder Rolls - Shrug your shoulders up, back, and then down in a circular motion.

Neck Retraction - Pull your head straight back, keeping your jaw level. Hold for 5 seconds.

As with all exercise programs, if any of these movements cause pain, stop immediately.

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Disc Herniation

Sometimes called a slipped or ruptured disk, a herniated disk most often occurs in your lower back. It is one of the most common causes of low back pain, as well as leg pain (sciatica).

Between 60% and 80% of people will experience low back pain at some point in their lives. A high percentage of people will have low back and leg pain caused by a herniated disk.

Although a herniated disk can sometimes be very painful, most people feel much better with just a few weeks or months of nonsurgical treatment.

Intervertebral disks. In between your vertebrae are flexible intervertebral disks. They act as shock absorbers when your walk or run.

Intervertebral disks are flat and round, and about a half inch thick. They are made up of two components:

1. Annulus fibrosus. This is the tough, flexible outer ring of the disk.
2. Nucleus pulposus. This is the soft, jelly-like center of the disk.

A disk begins to herniate when its jelly-like nucleus pushes against its outer ring due to wear and tear or a sudden injury. This pressure against the outer ring may cause lower back pain. Once the nucleus breaks — or herniates — through the outer ring, pain in the lower back may improve. Sciatic leg pain, however, increases. This is because the jelly-like material inflames the spinal nerves. It may also put pressure on these sensitive spinal nerves, causing pain, numbness, or weakness in one or both legs.

In many cases, a herniated disk is related to the natural aging of your spine.

In children and young adults, disks have a high water content. As we get older, our disks begin to dry out and weaken. The disks begin to shrink and the spaces between the vertebrae get narrower. This normal aging process is called disk degeneration.

Risk Factors
In addition to the gradual wear and tear that comes with aging, other factors can increase the likelihood of a herniated disk. Knowing what puts you at risk for a herniated disk can help you prevent further problems.

Gender. Men between the ages of 30 and 50 are most likely to have a herniated disk.

Improper lifting. Using your back muscles to lift heavy objects, instead of your legs, can cause a herniated disk. Twisting while you lift can also make your back vulnerable. Lifting with your legs, not your back, may protect your spine.

Weight. Being overweight puts added stress on the disks in your lower back.

Repetitive activities that strain your spine. Many jobs are physically demanding. Some require constant lifting, pulling, bending, or twisting. Using safe lifting and movement techniques can help protect your back.

Frequent driving. Staying seated for long periods, plus the vibration from the car engine, can put pressure on your spine and disks.

Sedentary lifestyle. Regular exercise is important in preventing many medical conditions, including a herniated disk.

Smoking. It is believed that smoking lessens oxygen supply to the disk and causes more rapid degeneration.
Cervical Neck Sprain/Strain (Whiplash)

Neck Sprain

The seven bones of the spinal column in your neck (cervical vertebrae) are connected to each other by ligaments and muscles--strong bands of tissue that act like thick rubber bands. A sprain (stretch) or tear can occur in one or more of these soft tissues when a sudden movement, such as a motor vehicle collision or a hard fall, causes the neck to bend to an extreme position.

Symptoms
A person with a neck sprain may experience a wide range of possible symptoms:

Pain, especially in the back of the neck, that worsens with movement
Pain that peaks a day or so after the injury, instead of immediately
Muscle spasms and pain in the upper shoulder
Headache in the back of the head
Sore throat
Increased irritability, fatigue, difficulty sleeping, and difficulty concentrating
Numbness in the arm or hand
Neck stiffness or decreased range of motion (side to side, up and down, circular)
Tingling or weakness in the arms

Doctor Examination
To diagnose a neck sprain, your doctor will perform a comprehensive physical examination. During the physical examination, your doctor will ask you how the injury occurred, measure the range of motion of your neck, and check for any point tenderness.

In order to look closely at the bones in your neck, your doctor may request x-rays. This evaluation will help your doctor rule out or identify other sources of neck pain, such as spinal fractures, dislocations, arthritis, and other serious conditions.

Treatment
All sprains or strains, no matter where they are located in the body, are treated in a similar manner. Neck sprains, like other sprains, will usually heal gradually, given time and appropriate treatment. You may have to wear a soft collar around your neck to help support the head and relieve pressure on the ligaments so they have time to heal.

Pain relievers such as aspirin or ibuprofen can help reduce the pain and any swelling. Muscle relaxants can help ease spasms. You can apply an ice pack for 15 to 30 minutes at a time, several times a day for the first 2 or 3 days after the injury. This will help reduce inflammation and discomfort. Although heat, particularly moist heat, can help loosen cramped muscles, it should not be applied too quickly.

Other treatment options include:

Massaging the tender area
Ultrasound
Cervical (neck) traction
Aerobic and isometric exercise
Most symptoms of neck sprain will go away in 4 to 6 weeks. However, severe injuries, may take longer to heal completely.
Spinal Stenosis

Lumbar Spinal Stenosis

A common cause of low back and leg pain is lumbar spinal stenosis.

As we age, our spines change. These normal wear-and-tear effects of aging can lead to narrowing of the spinal canal. This condition is called spinal stenosis.

Degenerative changes of the spine are seen in up to 95% of people by the age of 50. Spinal stenosis most often occurs in adults over 60 years old. Pressure on the nerve roots is equally common in men and women.

A small number of people are born with back problems that develop into lumbar spinal stenosis. This is known as congenital spinal stenosis. It occurs most often in men. People usually first notice symptoms between the ages of 30 and 50.

Spinal stenosis occurs when the space around the spinal cord narrows. This puts pressure on the spinal cord and the spinal nerve roots, and may cause pain, numbness, or weakness in the legs.

Treatment

Nonsurgical Treatment
Nonsurgical treatment options focus on restoring function and relieving pain. Although nonsurgical methods do not improve the narrowing of the spinal canal, many people report that these treatments do help relieve symptoms.

Physical therapy. Stretching exercises, massage, and lumbar and abdominal strengthening often help manage symptoms.

Lumbar traction. Although it may be helpful in some patients, traction has very limited results. There is no scientific evidence of its effectiveness.

Anti-inflammatory medications. Because stenosis pain is caused by pressure on a spinal nerve, reducing inflammation (swelling) around the nerve may relieve pain. Non-steroidal anti-inflammatory drugs (NSAIDs) initially provide pain relief. When used over the course of 5-10 days, they can also have an anti-inflammatory effect.

Most people are familiar with nonprescription NSAIDs, such as aspirin and ibuprofen. Whether over-the-counter or prescription strength, these medicines must be used carefully. They can lead to gastritis or stomach ulcers. If you develop acid reflux or stomach pains while taking an anti-inflammatory, be sure to talk with your doctor.

Steroid injections. Cortisone is a powerful anti-inflammatory drug. Cortisone injections around the nerves or in the "epidural space" can decrease swelling, as well as pain. They also reduce numbness, but not weakness, in the legs. Patients should receive no more than three injections a year.

Acupuncture. Acupuncture can be helpful in treating some of the pain for less severe cases of lumbar stenosis. Although it can be very safe, long-term success with this treatment has not been proven scientifically.

Chiropractic manipulation. Chiropractic manipulation is generally safe and can help with some of the pain from lumbar stenosis. Care should be taken if a patient has osteoporosis or disk herniation. Manipulation of the spine in these cases can worsen symptoms or cause other injuries.

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Lateral Epicondylitis (Tennis Elbow)

Tennis elbow, or lateral epicondylitis, is a painful condition of the elbow caused by overuse. Tennis elbow is an inflammation of the tendons that join the forearm muscles on the outside of the elbow. The forearm muscles and tendons become damaged from overuse repeating the same motions again and again. This leads to pain and tenderness on the outside of the elbow.

Lateral epicondylitis, or tennis elbow, involves the muscles and tendons of your forearm. Your forearm muscles extend your wrist and fingers. Your forearm tendons — often called extensors — attach the muscles to bone. They attach on the lateral epicondyle. The tendon usually involved in tennis elbow is called the Extensor Carpi Radialis Brevis (ECRB).

The symptoms of tennis elbow develop gradually. In most cases, the pain begins as mild and slowly worsens over weeks and months. There is usually no specific injury associated with the start of symptoms. Common signs and symptoms of tennis elbow include: Pain or burning on the outer part of your elbow or weak grip strength.

The symptoms are often worsened with forearm activity, such as holding a racquet, turning a wrench, or shaking hands. Your dominant arm is most often affected; however both arms can be affected.
Medial Epicondylitis (Golfers/ Little Leaguers Elbow)

Medial epicondylitis, or "golfer's elbow," is similar to the more common lateral epicondylitis ("tennis elbow") in many respects. Both conditions are overuse tendinopathies that can be associated with racquet sports. Other activities with which medial epicondylitis are associated include golfing and throwing sports. Medial epicondylitis has also been reported in bowlers, archers, and weight lifters.

Little leaguer's elbow is sometimes considered a variant of medial epicondylitis, but this condition is technically a traction apophysitis of the medial epicondyle, which requires a different treatment course.

Symptoms

Pain and tenderness on the inner side of your elbow. Sometimes the pain extends along the inner side of your forearm. Pain typically worsens with certain movements. Stiffness. Your elbow may feel stiff, and it may hurt to make a fist. Weakness. You may have weakness in your hands and wrists. Numbness or tingling. These sensations might radiate into one or more fingers — usually the ring and little fingers. The pain of golfer's elbow can come on suddenly or gradually.

Causes

Training errors: These errors may increase the risk of developing medial epicondylitis. Athletes usually have a history of increased intensity or duration of activity, and they may not warm up adequately.

Improper technique: This is one of the major causes of medial epicondylitis. Tennis players with excessive top spin, poor serves and forehand strokes are at greater risk of developing medial epicondylitis.

Equipment: The use of an incorrectly sized tennis racquet grip, overly tightened racquet strings, older tennis balls, and wet tennis balls may increase elbow stress. The use of graphite racquets and larger headed racquets can decrease elbow stress.

Functional risk factors: Weakness, poor endurance, and poor flexibility of the forearm may increase the risk of developing medial epicondylitis.
Cubital Tunnel Syndrome

Ulnar nerve entrapment occurs when the ulnar nerve in the arm becomes compressed or irritated.

The ulnar nerve is one of the three main nerves in your arm. It travels from your neck down into your hand, and can be constricted in several places along the way, such as beneath the collarbone or at the wrist. The most common place for compression of the nerve is behind the inside part of the elbow. Ulnar nerve compression at the elbow is called "cubital tunnel syndrome."

Numbness and tingling in the hand and fingers are common symptoms of cubital tunnel syndrome. In most cases, symptoms can be managed with conservative treatments like changes in activities and bracing. If conservative methods do not improve your symptoms, or if the nerve compression is causing muscle weakness or damage in your hand, your doctor may recommend surgery.

Cause
In many cases of cubital tunnel syndrome, the exact cause is not known. The ulnar nerve is especially vulnerable to compression at the elbow because it must travel through a narrow space with very little soft tissue to protect it.

Common Causes of Compression
There are several things that can cause pressure on the nerve at the elbow:

When your bend your elbow, the ulnar nerve must stretch around the boney ridge of the medial epicondyle. Because this stretching can irritate the nerve, keeping your elbow bent for long periods or repeatedly bending your elbow can cause painful symptoms. For example, many people sleep with their elbows bent. This can aggravate symptoms of ulnar nerve compression and cause you to wake up at night with your fingers asleep.

In some people, the nerve slides out from behind the medial epicondyle when the elbow is bent. Over time, this sliding back and forth may irritate the nerve. Leaning on your elbow for long periods of time can put pressure on the nerve.
Fluid buildup in the elbow can cause swelling that may compress the nerve. A direct blow to the inside of the elbow can cause pain, electric shock sensation, and numbness in the little and ring fingers. This is commonly called "hitting your funny bone."

Symptoms
Cubital tunnel syndrome can cause an aching pain on the inside of the elbow. Most of the symptoms, however, occur in your hand.

Numbness and tingling in the ring finger and little finger are common symptoms of ulnar nerve entrapment. Often, these symptoms come and go. They happen more often when the elbow is bent, such as when driving or holding the phone. Some people wake up at night because their fingers are numb. The feeling of "falling asleep" in the ring finger and little finger, especially when your elbow is bent. In some cases, it may be harder to move your fingers in and out, or to manipulate objects. Weakening of the grip and difficulty with finger coordination (such as typing or playing an instrument) may occur.

These symptoms are usually seen in more severe cases of nerve compression. If the nerve is very compressed or has been compressed for a long time, muscle wasting in the hand can occur. Once this happens, muscle wasting cannot be reversed. For this reason, it is important to see your doctor if symptoms are severe or if they are less severe but have been present for more than 6 weeks.
Pronator Teres Syndrome

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Achilles Tendinitis
Achilles tendinitis is a common condition that causes pain along the back of the leg near the heel.

Description

Simply defined, tendinitis is inflammation of a tendon. Inflammation is the body's natural response to injury or disease, and often causes swelling, pain, or irritation. There are two types of Achilles tendinitis, based upon which part of the tendon is inflamed.
- Noninsertional Achilles tendinitis
- Noninsertional Achilles Tendinitis
- In noninsertional Achilles tendinitis, fibers in the middle portion of the tendon have begun to break down with tiny tears (degenerate), swell, and thicken.
Tendinitis of the middle portion of the tendon more commonly affects younger, active people. Insertional Achilles tendinitis involves the lower portion of the heel, where the tendon attaches (inserts) to the heel bone. In both noninsertional and insertional Achilles tendinitis, damaged tendon fibers may also calcify (harden). Bone spurs (extra bone growth) often form with insertional Achilles tendinitis.

Achilles tendinitis is typically not related to a specific injury. The problem results from repetitive stress to the tendon. This often happens when we push our bodies to do too much, too soon, but other factors can make it more likely to develop tendinitis, including:
- A bone spur that has developed where the tendon attaches to the heel bone.
- Sudden increase in the amount or intensity of exercise activity—for example, increasing the distance you run every day by a few miles without giving your body a chance to adjust to the new distance
- Tight calf muscles—Having tight calf muscles and suddenly starting an aggressive exercise program can put extra stress on the Achilles tendon
- Bone spur—Extra bone growth where the Achilles tendon attaches to the heel bone can rub against the tendon and cause pain
If you have experienced a sudden "pop" in the back of your calf or heel, you may have ruptured (torn) your Achilles tendon. See your doctor immediately if you think you may have torn your tendon.
Plantar Fasciitis
Plantar fasciitis (fashee-EYE-tiss) is the most common cause of pain on the bottom of the heel. Approximately 2 million patients are treated for this condition every year. Plantar fasciitis occurs when the strong band of tissue that supports the arch of your foot becomes irritated and inflamed.

The plantar fascia is designed to absorb the high stresses and strains we place on our feet. But, sometimes, too much pressure damages or tears the tissues. The body's natural response to injury is inflammation, which results in the heel pain and stiffness of plantar fasciitis.

The most common symptoms of plantar fasciitis include:
- Pain on the bottom of the foot near the heel
- Pain with the first few steps after getting out of bed in the morning, or after a long period of rest, such as after a long car ride. The pain subsides after a few minutes of walking
- Greater pain after (not during) exercise or activity
Metatarsalgia/ Mortons Neuroma

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Carpal Tunnel Syndrome

The carpal tunnel is a narrow, tunnel-like structure in the wrist. The bottom and sides of this tunnel are formed by wrist (carpal) bones. The top of the tunnel is covered by a strong band of connective tissue called the transverse carpal ligament.

The median nerve travels from the forearm into the hand through this tunnel in the wrist. The median nerve controls feeling in the palm side of the thumb, index finger, and long fingers. The nerve also controls the muscles around the base of the thumb. The tendons that bend the fingers and thumb also travel through the carpal tunnel. These tendons are called flexor tendons. The carpal tunnel protects the median nerve and flexor tendons that bend the fingers and thumb.

Cause
Carpal tunnel syndrome occurs when the tissues surrounding the flexor tendons in the wrist swell and put pressure on the median nerve. These tissues are called the synovium. The synovium lubricates the tendons and makes it easier to move the fingers. This swelling of the synovium narrows the confined space of the carpal tunnel, and over time, crowds the nerve.

Carpal tunnel syndrome is caused by pressure on the median nerve traveling through the carpal tunnel.
Many things contribute to the development of carpal tunnel syndrome:

Heredity is the most important factor - carpal tunnels are smaller in some people, and this trait can run in families.
Hand use over time can play a role.
Hormonal changes related to pregnancy can play a role.
Age — the disease occurs more frequently in older people.
Medical conditions, including diabetes, rheumatoid arthritis, and thyroid gland imbalance can play a role.

Symptoms
The most common symptoms of carpal tunnel syndrome include:

Numbness, tingling, and pain in the hand
An electric shock-like feeling mostly in the thumb, index, and long fingers
Strange sensations and pain traveling up the arm toward the shoulder
Symptoms usually begin gradually, without a specific injury. In most people, symptoms are more severe on the thumb side of the hand.

Symptoms may occur at any time. Because many people sleep with their wrists curled, symptoms at night are common and may awaken you from sleep. During the day, symptoms frequently occur when holding something, like a phone, or when reading or driving. Moving or shaking the hands often helps decrease symptoms.

Symptoms initially come and go, but over time they may become constant. A feeling of clumsiness or weakness can make delicate motions, like buttoning your shirt, difficult. These feelings may cause you to drop things. If the condition is very severe, muscles at the base of the thumb may become visibly wasted.
De Quervain's tendinosis

De Quervain's tendinosis occurs when the tendons around the base of the thumb are irritated or constricted. The word "tendinosis" refers to a swelling of the tendons. Swelling of the tendons, and the tendon sheath, can cause pain and tenderness along the thumb side of the wrist. This is particularly noticeable when forming a fist, grasping or gripping something, or when turning the wrist.

Causes
De Quervain's tendinosis may be caused by overuse. It also is associated with pregnancy and rheumatoid disease. It is most common in middle-aged women.

Symptoms
Signs of De Quervain's tendinosis:

Pain may be felt over the thumb side of the wrist. This is the main symptom. The pain may appear either gradually or suddenly. Pain is felt in the wrist and can travel up the forearm. The pain is usually worse when the hand and thumb are in use. This is especially true when forcefully grasping objects or twisting the wrist.
Swelling may be seen over the thumb side of the wrist. This swelling may accompany a fluid-filled cyst in this region.
A "catching" or "snapping" sensation may be felt when moving the thumb.
Pain and swelling may make it difficult to move the thumb and wrist.

To determine whether or not you have De Quervain's tendinosis, your physician may ask you to perform the Finkelstein test by placing your thumb against your hand, making a fist with your fingers closed over your thumb, and then bending your wrist toward your little finger. If you have De Quervain's tendinosis, this test is quite painful, causing tendon pain on the thumb side of the wrist.
Ganglion Cyst

Ganglion cysts are the most common mass or lump in the hand. They are not cancerous and, in most cases, are harmless. They occur in various locations, but most frequently develop on the back of the wrist.

These fluid-filled cysts can quickly appear, disappear, and change size. Many ganglion cysts do not require treatment. However, if the cyst is painful, interferes with function, or has an unacceptable appearance, there are several treatment options available.

A ganglion rises out of a joint, like a balloon on a stalk. It grows out of the tissues surrounding a joint, such as ligaments, tendon sheaths, and joint linings. Inside the balloon is a thick, slippery fluid, similar to the fluid that lubricates your joints.

Ganglion cysts can develop in several of the joints in the hand and wrist, including both the top and underside of the wrist, as well as the end joint of a finger, and at the base of a finger. They vary in size, and in many cases, grow larger with increased wrist activity. With rest, the lump typically becomes smaller.

Most ganglions form a visible lump, however, smaller ganglions can remain hidden under the skin (occult ganglions). Although many ganglions produce no other symptoms, if a cyst puts pressure on the nerves that pass through the joint, it can cause pain, tingling, and muscle weakness. Large cysts, even if they are not painful, can cause concerns about appearance.

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Headache/ Migraines
Concussion

Sports Concussion
According to the U.S. Centers for Disease Control and Prevention, about 200,000 people in the United States suffer concussions while playing sports every year. Concussions occur in a wide range of sports and affect all athletes, from professional players to little leaguers.

Concussions are mild traumatic brain injuries, and sports concussion has become a significant problem. It has recently made headlines with reports about the consequences of returning to play too soon, as well as research findings into the long-term effects of the injury.

Recognizing concussion and providing proper treatment is especially important for younger athletes because it typically takes them longer than adults to fully recover.

In addition, coaches, parents, and school administrators must be aware that concussion causes a wide range of symptoms and can interfere not only with sports participation, but with school and social relationships. Most athletes will fully recover from concussion, and understanding the varied symptoms can help with the healing process.

Cause
Derived from the Latin word concusses, concussion means to shake violently. A concussion happens when a force causes the brain to rapidly move back and forth inside the skull. This may be caused by either a direct blow or by a blow to the body that forces the head to quickly rotate.

Although some sports have higher instances of concussion — such as football, ice hockey, and soccer — concussions can happen in any sport or recreational activity.

Because of the potential long-term consequences of sports concussion, it is important that athletes, coaches, and parents know as much as possible about how to recognize them.

Symptoms are not always obvious. Although it is commonly assumed that concussions cause loss of consciousness, many people with concussions have not been "knocked out."

Concussion causes a variety of symptoms. These may appear right away, or may be delayed for several days after the injury. Some symptoms are physical, such as drowsiness. Others are cognitive, like memory loss. In many cases, people with concussions are more emotional than usual.

The most common symptoms of concussion include:

Drowsiness
Headache
Loss of consciousness
Memory loss
Irritability
Confusion
Balance problems, dizziness
Difficulty speaking and communicating
Depression
Nausea and vomiting
Changes in sleep patterns

Treatment
The key to healing from a concussion is complete rest. This includes not just physical rest, but mental rest, as well. Reading, computer work, video games — even television — should be limited until all symptoms have resolved. This typically takes 7 to 10 days, although some people have symptoms for weeks or months after the injury.

Once you are free of symptoms, you can gradually return to physical and mental activity. It is important to slowly return to daily activities because being symptom-free does not mean the brain injury has fully healed. Your doctor may recommend a step-by-step program: first add an activity, then monitor your symptoms. If your symptoms do not return, you can continue increasing the challenges.

This slow, steady approach typically reduces the time spent away from school, work, and athletics because it provides enough time for the injury to heal. Diving back into activities as soon as your symptoms have resolved can bring them back on and require a return to complete rest.

Getting back into the game too soon puts you at risk for another concussion.

If you suffer a repeat concussion before your first concussion has healed, it may take much longer for your symptoms to resolve and you may have long-term problems, such as learning difficulties or chronic headaches. Although it rarely happens, repeat concussion can cause permanent brain damage and even death.

New Recommendations
In 2010, the American Academy of Pediatrics recommended that young athletes with concussions be evaluated and cleared by a doctor before returning to sports. The American Academy of Neurology issued a similar statement, and stressed that doctors who clear athletes for return to sports should be trained in managing and assessing sports concussions.

Baseline Evaluations
Because it is difficult to determine when a concussion has fully healed, baseline neurocognitive evaluation is an important tool for assessing whether it is safe for an athlete to return to play. Before the sports season starts, each athlete takes a computerized test that measures brain functions, such as memory and reaction time. If an athlete later has a concussion, post-injury tests can be compared to the baseline evaluation to measure the severity of the concussion and help doctors monitor healing.

In addition, pre-season evaluations can help identify athletes who have had previous, unrecognized concussions and who are at risk for repeat concussions. For example, past injuries to the face or neck may have been accompanied by an unrecognized concussion.

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Dr Tracey St John DC & Dr Victor St John DC

Chiropractic | Massage | Sports Therapy

Neck Sprain

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