Workers Compensation Doctors

One of the most rewarding parts of being a chiropractor is helping patients get back to work after an injury. Recently in my ambler office, I had a patient that was injured at work. While standing at his work bench someone ran him over with a golf cart. Ouch. This patient entered my ambler, pa office with low back and hip pain. Together the patient and I have worked with both passive and active rehabilitation to enable him to keep his activities of daily living at a normal level. Workers compensation has also paid the bills for his physical therapy. This patient let’s call him bob had no out of pocket expense for his work injury except for the gas it took to get to my office . My chiropractic office click here

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Workers Compensation Doctors

One of the most rewarding parts of being a chiropractor is helping patients get back to work after an injury. Recently in my ambler office, I had a patient that was injured at work. While standing at his work bench someone ran him over with a golf cart. Ouch. This patient entered my ambler, pa office with low back and hip pain. Together the patient and I have worked with both passive and active rehabilitation to enable him to keep his activities of daily living at a normal level. Workers compensation has also paid the bills for his physical therapy. This patient let’s call him bob had no out of pocket expense for his work injury except for the gas it took to get to my office . My chiropractic office click here

Dr. Richard Schwartz /215-283-2844/ Ambler Chiropractic / Can Poor Posture Predict Mortality?

Dr. Richard Schwartz / 215-283-2844/ Ambler Chiropractic

Can poor posture

predict mortality?

Maybe so according to a recent study and that ain’t all! Turns out that posture (in this case thoracic HYPER kyphosis) is getting some attention in the literature and appears related to a wide range of ailments, of which increased risk of death is only one. Only problem is that chiropractors aren’t doing the research. OH NOOO!!!

Because while half of our profession has relegated spinal structure to the dustbin of chiropractic history in pursuit of more “sophisticated” theories, our MD and PT colleagues are more than happy to lay the scientific ground work relating spinal structure to a wide range of ailments. End Of Rant…promise.

First off…thanks to Dr. Roger Coleman at ScienceInBrief.com for making me aware of this research. For those of you who aren’t familiar with the ScienceInBrief.com
project, we review scientific articles on a wide range of subject which are of interest to chiropractors. Unlike this newsletter, very little of what we do at SIB is directly related to posture based chiropractic. But occasionally, I run across articles which are relevant for readers here at Postural Rehab. Here’s a recap of the article along with some thoughts on managing thoracic HYPERkyphosis.

Hyperkyphotic Posture Predicts Mortality in Older

Community-Dwelling Men and Women: a prospective study 1

The Facts:

a. The authors studied the association between thoracic hyperkyphosis and mortality in over 1300 individuals with a mean age of 73.

b. If the individual laid on their back and was unable to rest the head on the table without putting the neck into hyperextension they were considered to have thoracic hyperkyphosis.

c. Patients were followed for an average of 4.2 years.

d. Those “with hyperkyphotic posture had greater mortality rates. Increased severity of “kyphotic posture” appeared to be associated with a higher risk of mortality.

Discussion: Obviously, the inability to bring the head back to neutral resting position COULD be also caused by factors other than thoracic hyperkyphosis, but what’s important here is that POSTURE appears to be associated with early mortality. Interestingly, thoracic kyphosis was found to be twice as common in men (44%) as women(22%) in this study, which seems to be at odds with conventional thought that thoracic hyperkyphosis is commonly caused by osteoporosis, a condition much more common in women.

The “NORMAL” Thoracic Kyphosis

Obviously, a radiographic evaluation of the T spine gives us a much more accurate idea of the sagittal curvature.

Harrison defined the thoracic kyphosis as ELLIPTICAL in shape, having a Jackson’s (Cobb) angle of 44.2 degrees from T1-T-12. Realizing the difficulty of visualizing both T1 and T12 on the radiograph, Harrison recalculated the model to reflect a thoracic kyphosis of 33.3 degrees between T 3 and T10. 2

Vaz et al, define the average thoracic kyphosis as 47 degrees in healthy young adults. 3

Boseker et al, defined a range of “normalcy” between 20-50 degrees in healthy children. 4

So you can see that opinions vary as to what is actually normal. I encourage interested readers to come to do some reading and establish in their mind what they consider to be the appropriate upper limits of thoracic kyphosis. Personally, I generally tend to view curves in excess of 40 degrees (as measured from T3-T10) as suspect. That’s just my opinion based on my reading of the literature, but 40 degrees is an upper limit you will find frequently cited. Regardless of which value you consider appropriate, it is important to have some sort of firm upper limit, above which you will start considering clinical intervention.

Clinical Management:

A number of tools have been looked at for treating thoracic hyperkyphosis but definitive research is still sorely lacking. Some options you may want to consider are exercise, bracing, and spinal remodeling. Here are two simple, inexpensive tools I have found to be helpful.



Thoracic Rolls

One method of actively addressing the thoracic kyphosis is to simply place the patient over a large foam roll ( our Multipurpose Rolls in the 10-13″ range work well for this), have them raise their hips up, and then “roll” themselves up and down over the roll by alternately flexing and extending the knees. This does two things. First, it introduces a fulcrum effect into the mid T spine to help reduce the kyphosis. Secondly the rolling motion helps mobilize the spine and costovertebral articulations to promote a reduction of kyphosis.

Thoracic Arch

Another method is to simply allow the patient to passively rest over a foam roll or fulcrum for 20-30 minutes. This time frame allows for stretching of the paraspinal tissues to occur and for the spine to “remodel” into a reduced kyphosis. I use our Thoracic Archfor this purpose and we now have lots of doctors using these arches on a regular basis to remodel the T spine.

I generally start with the patient over the arch with the fulcrum at the apex of the kyphosis as shown above. Once they can comfortably relax for the full 20-30 minutes without any problems or soreness, I place a 1″ spacer beneath the arch to raise it up and increase the leverage effect into the mid thoracics. Occasionally, I may end up placing an additional spacer or two as needed to effectively introduce extension into the thoracics.

References:

1.Kado DM, Huang MH, Karlamangla AS, Barett-Connor E, Greeendale GA. Hyperkyphotic posture predicts mortality in older community-dwelling men and women: a prospective study. JAGS 2004;52:1662-7

2. Harrison DE, Janik TJ, Harrison DD, Cailliet R, Harmon SF. Can the thoracic kyphosis be modeled with a simple geometric shape? The results of circular and elliptical modeling in 80 asymptomatic patients. J. Spiinal Disord Tech. 2002 Jun;15(3):213-20.

3. Vaz G, Roussouly P, Berthonnaud E, Dimnet J. Sagittal morphology and equilibrium of pelvis and spine.Eur Spine J. 2002 Feb;11(1):80-7.

4. Boseker EH, Moe JH, Winter RB, Koop SE. Determination of “normal” thoracic kyphosis: a roentgenographic study of 121 “normal” children. J Pediatr Orthop. 2000 Nov-Dec;20(6):796-8.

Horsham, Pa Chiropractic, Horsham, Pa / Horsham Chiropractor / Glenside, PA

Chiropractors warn ‘text neck’ incidences on the rise+

 

Society can add another ailment to the growing list of problems associated with using text messaging. Chiropractors are warning of a condition on the rise that they are calling “text neck”.

Text neck is caused by keeping the neck flexed for long periods of time, which often occurs when texting obsessively throughout the day. The positioning people use when sending text messages is generally a down gaze with the neck flexed to make the head look down. It’s not just texting either, sufferers who generally get this ailment may be spending too much times on other gadgets, such as iPads.


 

MSNBC’s Today Health reports, “This is a global epidemic,” says Richard Schwartz, a chiropractor who practices at the Advanced Chiropractic and Wellness Center in Ambler, Pa., Horsham, Pa Glenside, Pa.

Schwartz said,

“It’s starting younger and younger. There are more than six billion phones connected, and that’s not counting the Kindles, iPads, tablets and all these devices we rely on daily,” adding, “Go outside, to a restaurant, the supermarket, a gym, the airport and notice the posture of almost everyone around you. You will see this everywhere, and now multiply that by every city in the world.”

Schwartz noted 45 percent of his patients have the same complaint and all are connected to the positioning used when looking down at various forms of screens or gadgets.

The Telegraph reports, Rachael Lancaster, of Freedom Back Clinics in Leeds, said,

“Sufferers are increasing as the use of smart phones and tablet computers become more popular.”

Lancaster relates this to joints and tissues in the neck not “built” to handle being flexed for extended periods of time. Lancaster stated, “Imagine sitting on your ankle sideways for 10 minutes. It would feel stiff and sore when you returned it to its natural position,” adding, “That is exactly what people are doing with their necks. If people continue to put their necks in these positions, the body will gradually adapt to the stresses.” Another concern is the natural curvature of the neck reversing. Chiropractors are warning this can lead to other health issues such as headaches and other body pains in shoulders, arms and wrists. Over the long term experts are warning this could lead to permanent arthritic damage. Health experts are indicating that “text neck” can be mitigated by taking breaks and allowing the neck to sit in its natural positioning, and also repositioning the phone to be higher can help too. Additionally getting enough regular exercise might also help reduce the risks associated with text neck. Over the years since computers have become a part of daily life for a couple of decades now, ailments such as carpal tunnel syndrome, have been associated with heavy use. Being texting is relatively new in the scale of technology; there is perhaps not enough data to provide a rounded scenario of the long-term effects; however doctors appear to be reporting increased incidences of body pains related to technology. Now “text neck” can be added to the list. The medical community has long been concerned about the ill-health effects often linked to texting.

Dr. Richard Schwartz DC talks about Trigger Point Massage

Trigger Point Massage

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Car Accident and Work Injury Chiropractic Treatment For Montgomery County

Car Accident and Work Injury Chiropractic Treatment For Montgomery County

Specializing in physical rehabilitation, we are committed to helping our patients restore their normal lives after a car accident or work-related injury. Using the latest knowledge and technology in chiropractic care, we apply a multidisciplinary approach to diagnosing and treating your condition.

If you’ve ever been involved in a car accident or work-related injury, it often isn’t until days – or even weeks – later those physical problems arise, stemming from the accident.

When your livelihood, and more importantly, your health are at risk, you want to be sure your care is entrusted to experienced and qualified medical professionals. At Burch Chiropractic Center, we specialize in and frequently treat a wide variety of chiropractic conditions, including:

  • Back pain
  • Headaches
  • Neck pain
  • Muscle spasms
  • Stiffness
  • Insomnia
  • Located at 701 Limekiln Pike, Ambler, Pa

Your health should be your top priority after a car accident or work-related injury. To schedule a free exam, call or contact us online today!

215-283-2844