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Chiropractic

Chiropractic

Chiropractic

The chiropractic page at Camp4 Human Performance has a detailed discussion about the benefits of spinal manipulation. Our doctors have the skills and experience to know when this is a therapy for your complaint.

DRY NEEDLING

DRY NEEDLING

DRY NEEDLING

In order to better control pain at Camp4 Human Performance we utilize the more modern form of western medical acupuncture, also known as dry-needling. This is the most researched method of controlling muscle aches, pain, and dysfunction.

Rehabilitation

Rehabilitation

Rehabilitation

Everyone at Camp4 Human Performance gets physical rehabilitation. We understand the importance of training the nervous system to function better after we get you out of pain. Learn more about rehabilitation and its importance here.

BYU chiropractors

BYU chiropractors

BYU chiropractors

Both Dr. Tyler and Laney Nelson are the official chiropractors for the BYU athletic programs. Dr. Laney has over 20 years experience doing sports medicine with BYU and the past 8 years with the University of Missouri.

How much Water do I need per day?

dehydration1

Does dehydration cause muscle cramps? What should be my daily intake?  These are common questions athletes are concerned about.

After doing some research investigation it turns out there is no good science to support any recommendation. It is essentially an argument with no science behind it. There is one good study that was done to show that dehydration DOES NOT cause muscle cramps in endurance athletes. It was the level of intensity that was shown to cause muscle cramps in endurance athletes, not dehydration

So, it’s probably not that big of a concern for everyone else either. People who buy into the 8×8 program usually are selling bottled water. That’s not surprising, but unfortunate. I like this quote by Dr. Timothy Noakes which states“ It is time for the American College of Sports Medicine to acknowledge that humans, like all other earthly creatures, do not need to be told how much to drink during exercise.”

So, drink when you feel thirsty and play hard the rest of the time!

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Chiropractors are knowledgeable about Nutrition and Dry Needling.

BYU ChiropractorA number of factors contribute to success in sport, and diet is a key component. At Camp4 Human performance Dr. Tyler Nelson and Dr. Laney Nelson are chiropractors that understand how much an athlete’s dietary requirements depend on several aspects, including the sport, the athlete’s goals, the environment, and practical issues. The importance of individualized dietary advice has been increasingly recognized, including day-to-day dietary advice and specific advice before, during, and after training and/or competition. At BYU, athletes use a range of dietary strategies to improve performance, with maximizing glycogen stores a key strategy for many. Carbohydrate intake during exercise maintains high levels of carbohydrate oxidation, prevents hypoglycemia, and has a positive effect on the central nervous system. Recent research has focused on athletes training with low carbohydrate availability to enhance metabolic adaptations, but whether this leads to an improvement in performance is unclear. The benefits of protein intake throughout the day following exercise are now well recognized. It was recently ascertained that ingestion pre and post exercise was the gold standard. Athletes should aim to maintain adequate levels of hydration, and they should minimize fluid losses during exercise to no more than 2% of their body weight. Supplement use is widespread in athletes, with recent interest in the beneficial effects of nitrate, beta-alanine, and vitamin D on performance. However, an unregulated supplement industry and inadvertent contamination of supplements with banned substances increases the risk of a positive doping result. Although the availability of nutrition information for athletes varies, athletes will benefit from the advice of a registered dietician or nutritionist. At Camp4 Human Performance we utilize a local nutrition store as our headquarters for adding information and supplementation to our clients interested in healing tendons and muscle tissue via dry needling. In order to adequately heal tendons you must have adequate nutrition to sustain the protein(collagen) proliferation brought on by dry needling and exercise rehab. This we understand and is very important for overall tissue health.
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Shoulder pain and manipulative therapy

 

shoulder pain and manipulative therapyThis article is aimed at discussing the importance of the thoracic spine in shoulder pain and dysfunction. At camp4 Human Performance we understand the link between shoulder pain and manipulative therapy, and it is well supported in the research literature. In fact, we have observed that the upper-thoracic spine (upper back right below the neck) is the most commonly restricted area in the spine. The direct link to biomechanics in the shoulder, the upper back is a primary target for those with shoulder pain. The upper-thoracic spine is from the bottom of your neck, C7 all the way down to the 5th thoracic vertebral body. Since this is such a predominant area for patients to experience restrictions, it should be a primary target for manipulative therapy, regardless of where patients present with pain. In fact lack of proper extension, spine moving backwards, at the cervico-thoracic (neck to upper back) junction leads to a loss of your cervical curve, a jutting of your chin, and improper loading on your shoulder. 

When discussing shoulder mechanics at Camp4 Human Performance, we will educate you as to the importance of this extension motion on clavicular rotation, subacromial space widening, and improved overhead motion as to eliminate classic shoulder problems such as rotator cuff tears, bursitis, frozen shoulder, and thoracic outlet syndrome to name a few. Also, having a stiff upper-thoracic spine also decreases our ability to activate the deep neck flexors and the abdominal muscles. There has been demonstrated a significant association between decreased mobility of the thoracic spine and the presence of patient reported complaints associated with neck pain as well. When motion is restricted in this key transitional area, we force rotation into segments that are not designed for this task which leads to breakdown. 

What happens is that we develop more movement in segments of the lower cervical spine when faced with upper-thoracic spine restrictions. The movement has to happen somewhere for us to keep our eyes level with the horizon. This is why shoulder pain and manipulative therapy go hand-in-hand, and patients respond so well. Patients who present with lack of thoracic extension also have tight latissimus dorsi, tight pectoralis major and minor, and poor postural stabilization of the diaphragm.

 the shoulder jointAt Camp4 Human Performance, we believe that shoulder pain and manipulative therapy are tightly linked and recognize this as a primary focus of our clinical practice. Remember, The true source of musculoskeletal strain in the cervical or lumbar spine or shoulder girdle is upper-thoracic spine stiffness. 

 

 

References

  1. Faye L Motion Palpation and Chiropractic Technic, 2nd Edition. Huntington Beach: The Motion Palpation Institute, 1990.
  2. Lewit K. Manipulative Therapy in Rehabilitation of the Locomotor System, 3rd Edition. Boston: Butterworth-Heineman, 1999.
  3. Kolar P. Facilitation of Agonist-Antagonist Co-activation by Reflex Stimulation Methods. In: Liebenson C. Rehabilitation of the Spine, 2nd Edition. Baltimore: Lippincott/Williams and Wilkins, 2007.
  4. Boyles RE, Ritland BM, Miracle BM, et al. Man Ther, 2009;14:375-380.
  5. Cleland JA, Childs JD, McRae M, Palmer JA, Stowell T. Immediate effects of thoracic manipulation in

    patients with neck pain: a randomized clinical trial. Man Ther, 2005;10:127-135.

  6. Cleland JA, Childs JD, Fritz JM, Whitman JM, Eberhart SL. Development of a clinical prediction rule

    for guiding treatment of a subgroup of patients with neck pain: use of thoracic spine manipulation,

    exercise, and patient education. Phys Ther, 2007;87:9-23.

  7. Norlander S, Nordgren B. Clinical symp- toms related to musculoskeletal neck- shoulder pain and

    mobility in the cervico- thoracic spine. Scand J Rehabil Med, 1998;30:243-251.

  8. Bang MD, Deyle GD. Comparison of supervised exercise with and without manual physical therapy

    for patients with shoulder impingement syndrome. Journal of Orthopaedic and Sports Physical Therapy, 2000;30:126-37.

9. Bergman GJ, Winters JC, Groenier KH, Pool JJ, Meyboom-de Jong B, Postema K, et al. Manipulative therapy in addition to usual medical care for patients with shoulder dysfunction and pain: a randomized, controlled trial. Annals of Internal Medicine, 2004;141:432-

  1. Liebenson CS. Treatment of mid-thoracic dysfunction: a key link in the body axis. Part 1: overview and assessment. Journal of Bodywork and Movement Therapies, 2001;5(2):90-98.
  2. Cook G. Movement: Functional Movement Systems. On Target Publications, Santa Cruz, CA: 2010.
  3. Janda V, Frank C, Liebenson C. Evaluation of Muscle Imbalance. In: Liebenson C. Rehabilitation of

    the Spine, 2nd Edition. Baltimore: Lippincott/Williams and Wilkins, 2007. 

 

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Spinal anatomy at Camp4 Human Performance

The basics of spinal anatomy at Camp4 Human Performance

This blog post is designed to educate patients about spinal anatomy at Camp4 Human Performance. In future posts I will discuss biomechanics and the loading patterns of each segment of the spinal column. Those posts will make much more sense with an initial exposure to basic spinal anatomy. At Camp4, we are all about educating our patients so they can make informed decisions why chiropractic and functional movement rehabilitation is a good choice to stay healthy.  For additional questions about our therapies or clinic hours call the clinic or simply ask a question online.

To get started, lets breakdown all the bones of the human skeleton, in order to narrow down which ones belong to the vertebral column. The vertebral column (aka spinal column) are synonymous, and in this post I will use them interchangeably. Out of 206 bones in your body, only 80 of those compose the spinal column.

There are 80 bones in the axial skeleton (which comprises the  skull and spinal column)spinal anatomy at Camp4 Human Performance

28 in the skull

26 in vertebral column including the sarum (tailbone) and coccyx

24 (1 on each side) ribs attached to the middle, or thoracic, section of the spinal column

1 sternum which holds the ribs in place on the front side

1 hyoid bone near your throat

126 bones in the appendicular skeleton (arms, legs, fingers & toes)

60 in the upper extremity

2 clavicles (collar bones)

2 scapulae (shoulder blades)

60 in the lower extremity

2 in the pelvic girdle

There are 6 primary functions of the spinal column:

  • To protect and control transmission of the spinal cord and nerves.
  • Stabilization, by serving as an attachment point for muscles and ligaments.
  • As a support and weight bearing structure for the head and body.
  • To create shape and position of the body.
  • To control movement and flexibility throughout all 6 ranges of motion.
  •  As a primary shock absorbing structure.

Of the 26 vertebral bodies, 24 are considered true and 2 are considered false. True segments consist of those that are freely moveable in an adult, and false vertebrae are those which are not freely moveable. An example of this is the sacrum and coccyx, which are not fused in children.

There are three regions of the spinal column which are True.

spinal anatomy at Camp4 Human Performance7 Cervical vertebrae (neck region) that creates a curve which is concave to the back and convex to the front, also known as a                                               lordosis.

12 Thoracic vertebrae (upper and mid back) that creates an opposite curve which is concave to the front and convex to the back,                                              known as a kyphosis.

5 Lumbar vertebrae (low back) with a curve similar to the cervical region.

There are an additional two fused regions in the lower most portion of the spine which are considered false.

1 fused sacrum made up of 5 segments

1 fused coccyx made up of 4 segments

Both of these segments create a joint, the sacrococcygeal joint with a concavity towards the front of your body similar to that in the thoracic spine.

In sum, the adult spine is composed of 26 segments (24 true + 2 false) and a child’s spine is composed of 33 (24 + 5 + 4). Complete bone fusion doesn’t happen until between we are between 18-25 years of age.

 Between each of the vertebral bodies you have a wedge shaped structure called the intervertebral (between) spinal anatomy at Camp4 Human Performancedisc, which is designed to transmit and restrict forces in each part of your spine. This creates a joint classified as a syndesmosis, which  means it is a joint composed primarily of fibrocartilage, and is not a synovial joint. The exact structure and shape of each disc varies depending on the segment of your spine. This will be covered in greater depth in later posts given the important role they play in spinal biomechanics.

 Both above and below, each vertebral body has two joints (articulations) with its adjacent vertebrae. The 2 superior (above) articulate with the inferior processes of the vertebrae above, and 2 inferior (below) which do the opposite.  Including the intervertebral disc joint, each spinal vertebrae has 5 joints that control its motion. Exceptions to this are at the very top of your neck, the first two vertebrae, and in the mid back where the ribs create additional joints.

Each vertebral body has two processes, which project off the backside called pedicles. Pedicles are the connection point between the body of the vertebrae and the posterior, or neural arch. The neural arch consists of lamina, transverse processes, and a spinous process. The details of these names are less important than the understanding that this space houses the spinal cord. Since the discs create space, the arch-like structure of the pedicle above and below, creates a space between vertebral bodies called the intervertebral foramen. This is where the spinal nerves (peripheral spinal nerves) exit and enter the spinal cord for communication with the peripheral tissues.

 You have a total of 33 peripheral nerves that exit your spinal cord, and each segment (cervical, thoracic, lumbar, etc.) of your spinal cord has these branches.  The peripheral nerves in the cervical region exit the spinal canal above the vertebral body of the same number and once you reach the first thoracic vertebrae they exit below the vertebral body of the same number. The other peripheral nerves come from the cranial nerves and the splanchnic nerves which are part of your autonomic nervous system which also will be covered in a later post.

 Other important structures in regards to spinal anatomy at Camp4 Human Performance are the 9 cardinal ligaments of the vertebral column. There is one that runs on the front and back of the vertebral column called the anterior and posterior longitudinal ligament. Others which go between each spinous process connecting them all called the interspinous and supraspinous ligament. Similarly, there are ligaments that connect each transverse process and also lamina together called the intertransverse and ligamentum flavum. These ligaments are designed to serve as muscle attachments, restrict and control motion, share spinal loading mechanics, and facilitate cell-to-cell communication.

“The spinal column itself makes up approximately 40% of your total body weight”

 Now lets talk about the histogenesis and properties of bone.

 One important thing for people to understand is that the cellular constituents and chemical reactions necessary for bone formation are the same for all bones in the body, and they are continuously changing throughout your life. Bone is always formed by replacing some pre-existing material, more specifically cartilage, in a few different ways.

 There are two primary means by which this happens, termed histogenesis. One of the ways in which vertebral spinal anatomy at Camp4 Human Performancebodies are formed is termed enchondral ossification. In this bone formation model, cartilage is present and causes growth and formation at the ends of bone by the continuous cell division of cells called chondrocytes. This cell division is also accompanied by secretion of an extracellular matrix, which can thicken, forming chondroblasts that cause an apposition of the matrix to make bones thicker and longer. Bone is a dense form of connective tissue which means there is a high proportion of extracellular material in relation to cells.

 “Enchondral ossification is also responsible for the healing process of bone fractures”.

 One very important thing to note is that bone is a living and growing organ, it is not dead inanimate tissue.

–       highly dynamic and metabolically active

–       hard, yet light weight and resilient to tension and compression

–       constantly remodeling (understress = atrophy, overstress = hypertrophy)

–       highly vascular

–       innervated by nerve fibers that run with nutrient arteries

Primary functions 

–       protect and support muscles

–       perform hemopoiesis (production of blood cells and platelets)

–       store salts (Ca+, P) in its matrix

–       mechanical basis for movement

 Bone composition

–       fibers – highly organized collagen fibers (mostly) and elastic fibers (minimal) which give bone strength and resiliency

–       Organic salts – hydroxyapatite crystals (primarily calcium phosphate and calcium bicarbonate) and ground substance ( glycosaminoglycans, chondroitin sulfate, deratan sulfate, and hyaluronic acid)

Bone has three primary layers

  • an outer cortical layer which is 80% of the skeletal mass and serves as a protective outer shellspinal anatomy at Camp4 Human Performance
  • an inner trabecular layer which is the other 20% of the skeletal mass but 80% of the bone surface making. The trabecular layer is less dense and more elastic and rigid and makes up most of the bone tissue in the spine.
  • An outermost periosteal layer which is specialized connective tissue which surrounds the compact bone layer except at the articulating (joint) surfaces. This layer has a rich nervous and vascular supply and provides the interface for tendon and ligament attachments.

 Three types of bone cells

 spinal anatomy at Camp4 Human Performance–       Osteoblasts which are bone forming cells that synthesize bones by making osteoids and producing alkaline phosphatase which is an enzyme that helps mineralize Ca+ and P precipitate from blood. They also manufacture matrix collagen.

–       Osteoclasts, derived from marrow are bone remodeling cells. These cells resorb bone by digesting the old mineral matrix. They secrete enzymes (acid phosphatase) responsible for this process. These cells also contain estrogen, vitamin D and calcitonin receptors, which inhibit resorption.

–       Osteocytes are the mature bone cells and the most numerous of the three. Osteocytes are really osteoblast cells trapped in the bony matrix and are responsible for maintaining the regulation of activity. They contain mechanoreceptors which are responsible for reulating the bons response to stress.

Wolff’s law (1892)

–       Bone will transform to stressors and is constantly remodeling and growing! Since bone is a living structure, it adapts itself to its surroundings and demands placed on it. Stressed bone remodels and becomes stronger to resist the stress. Removal of stress leads to resorption where it is not needed. As an example, the weight bearing bones of the lower limb are stronger due to them being under more stress. Bones under stress become larger, heavier, and more dense.

** peak bone mass varies between individuals and density peaks at approximately 25 years of age**

 In the vertebrae of the spine, the trabecular pattern inside the cortex looks like a scaffolding with the vertical collagen fibers being more predominate. The horizontal struts simply support the vertical beams which carry the primary load. A prolonged increase in axial load results in an increase in trabeculae (mostly vertical).

 Factors which affect the shape and strength of bones

–       Genetic factors – gender and genetics

–       Hormonal status

–       Poor nutrition – vitamins & minerals, too much alcohol or drug use, cigarettes and tobacco, carbonated beverages, too much grains or salt

–       Lack of mechanical constraints – weightless environment, disuse and lack of compressive forces, sedentary lifestyles, and paralysis

–       Metabolic factors – calcium, phosphorous, vitamins a, c, and d, and hormones from the pituitary.

Important clinical notes about bones:

–       Bones can heal and remodel

–       Bones can be painful

–       Bones bleed when they fracture

–       Change with age

Now you understand spinal anatomy at Camp4 Human Performance, call today to schedule an appointment and see how we can improve your function (801) 878-7356

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