(801) 829-9500

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.

Addressing Chronic Pain

Chiropractor Taylorsville UT

There is a recent (past decade) change in the rehabilitation of chronic musculoskeletal disorders all patients should be educated about, preferably on his/her first visit. In fact, it’s the single most important factor of patient education. That is why we have an hour long appointment for our new patients.  

The structural paradigm (short leg, disc bulge, subluxation, etc) is hopefully leaving soon as a primary accused source of chronic pain and is being replaced with an understanding to the neuroplastic changes that occur in the long term.  

A key topic to address is ‘Central Sensitization’ which is a condition of the nervous system that is associated with the development and maintenance of chronic pain.  If your therapist isn’t discussing ‘central sensitization’ with you, and you have a chronic pain complaint, ask them about it. If they act confused by your question, or have no response, that’s a good clue you need a new therapist.

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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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Can Dry Needling help patients with Knee Arthritis?

BYU chiropractor

If you are someone who suffers from knee osteoarthritis the doctors at Camp4 Human Performance are here to help. Being the BYU team chiropractors, Dr. Nelson understands the biomechanics leading up to arthritis of the knee, and more importantly how to treat it with conservative therapies. It turns out that dry needling, discussed elsewhere on the website, is recommended by quite a few well established journals as a first exposure treatment for arthritis of the knee.

Dry needling can help stimulate blood flow to the knee which brings with it nutrients and hormones while reducing the leftover products that produce pain and further dysfunction. Alongside your dry needling therapy, nutritional supplementation is important for cartilage health, exercise prescription to control knee alignment, and an overall weight loss exercise substantially improve conservative outcomes. The great thing at Camp4 Human Performance is our relationship with other physicians around the valley, especially in Taylorsville UT, in case we need to co-manage your case with another one of our physicians.

In Taylorsville UT it is hard to find somewhere to go for honest advice regarding pain in the knee however the doctors at Camp4 Human Performance are sure they can get you the right information quickly so as to save you money and time. This clinic is all about getting patients what they need, when they need it. Call today to have our doctors look at your knees. 801-829-9500

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Knee osteoarthritis: sports rehabilitation Taylorsville UT

Knee osteoarthritis (a sports rehabilitation approach)

At Camp4 Human Performance’s sports rehabilitation Taylorsville UT, we understand the importance of rehabilitating our middle aged patients with Knee osteoarthritis. Commonly abbreviated as OA, it is steadily becoming the most common cause of disability for the middle aged population and has become the most common cause of disability for those over the age of 65. The desire to remain physically active for an aging population has led to an increasing need to prevent and rehabilitate the patient with degenerative joint disease. A common location for osteoarthritis in active patients is the hips and knees. This blog post discusses the rehabilitation of patients with knee osteoarthritis.Common in all OA conditions is an overload of a focal area of joint cartilage which leads to failure of the load-bearing capacity of the cartilage and bone below.

Did you know that forces of 3 to 8 times the body weight act on the knee with weight bearing activities, and muscular imbalances can lead to focal joint overload over time and predispose the joint to osteoarthritic changes.

The goal of rehabiliation: ‘‘building a better shock absorber’’

The goals of sports rehabilitation Taylorsville UT at Camp4 Human Performance is to improve function, minimize discomfort, and limit further injury. This is a multifactorial process consisting of patient education, pain control, optimizing range of motion of the entire kinetic chain, functional strengthening of the involved extremity, aerobic exercise, and the potential use of assistive devices and orthoses.

It has been noted in the literature that this rehabilitation process is more of a marathon than a sprint. 

An important piece of patient education is that osteoarthritis is at times unpredictable, and having patients take an active role in their rehabilitation process both enhances compliance, and helps reduce pain. Due to the fact that OA is often asymptomatic in its initial stages and only later becomes symptomatic as the disease process progresses means that many are not seen until they have significant wear on their knees. This is dangerous because once the knee becomes symptomatic, the degeneration as occurred and the prognosis is much worse.

At Camp4 Human Performance’s sports injury clinic we understand the common signs and symptoms of advanced OA: severe pain, loss of motion and movement of the involved joint and limb, deformity, joint swelling, abnormal gait, changes in activities of daily living, and muscle recruitment compensations.

Pain control is an early goal. Medication, acupuncture dry-needling, laser therapy, ice, heat, and foot orthoses all assist in minimizing discomfort. Furthermore, the use of intra-articular injections, acetaminophen, anti-inflammatories, and glucosamine all have been shown to reduce pain.

The coordination of these therapies for pain conjoined with activity and exercise rehabilitation offers a far more productive therapy.

Patient education also contributes in this area as reviewing the fact that exercise increases circulating endorphins which allows patients to understand that exercise can reduce the discomfort rather than increase pain. These therapies that block pain allow for the initiation of a therapeutic program as the next step.

 

To decrease the risk of further joint injury and degeneration to the knee, several interventions should be implemented.

  1. Sporting or recreational activities and exercise programs should be low impact and not include significant rotation loading to the knee.

            (recreational swimming, stationary cycling, low-impact aerobics, golf, walking)

It has also been suggested that the activities be alternated in a manner that decreases repetition of the same movement patterns and joint loads.

2. Exercises should be implemented to improve muscle strength, normalize joint range of motion, stability, and endurance to the trunk and lower extremities to help the muscle’s own ability to absorb impact and loads to the involved joint.

Patients need a range of motion program that emphasizes a three-times-a-day program of stretching for seven sets of 15 to 20 seconds that includes the hips, knees, foot, and ankle. Range of motion is necessary for subsequent strengthening program.

  3. General conditioning should be performed to help maintain the patients desired weight, which decreases the risk of joint injury due to fatigue.

This last point is very important. It has been demonstrated that patients with knee OA who participated in a weight loss program while performing a rehabilitation program had significant pain reduction, weight reduction, and improved walking speed.

It is generally accepted that weight loss can occur with sustained aerobic activities lasting more that 20 minutes at a target heart rate in the range of 50% to 85% of maximal heart rate at least 3x per week. Also, improved range of motion has been shown to improve discomfort and result in an increase in function. At Camp4 Human Performance, as a chiropractic sports medicine clinic, we take very seriously the benefits of increased exercise, and have all the tools necessary to educate, as well as rehabilitate patients with knee osteoarthritis. Call now to schedule your appointment and see how we can decrease your pain and improve your function. 

Camp4 Human Performance

1951 West 4700 South

Tayorsville, UT 84129

801-878-7356 

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Hyperkyphosis, chiropractor Taylorsville UT

Age related hyperkyphosis, chiropractor Taylorsville UT, and conservative therapy

 dowager's humpThis post is important for everyone however, it is especially important for our elderly patients. If you remember from the spinal anatomy blog post, the thoracic spine has a curvature which is concave to the front, called a kyphosis. It is important to understand that this curvature is natural due to the shape of the vertebral bodies as well as the intervertebral discs in the thoracic spine. The vertebral bodies as wells as the discs are taller in the back than the front creating a stacking shape that develops a curve.  A complication that is common as we age is the exaggeration of this curvature which can develop into a condition called hyperkyphosis, chiropractor Taylorsville UT, sometimes also referred to as a dowager’s hump, or gibbous deformity. In childhood and through the third decade of life the angle of kyphosis averages from 20° to 29°. After 40 years of age the kyphosis angle begins to increase, and more rapidly in women than men. There is reported to be a mean of 43° in women aged 55 to 60 years to a mean of 52° in women 76 to 80 years of age. The same reports of prevalence and incidence of this condition in older adults varies from approximately 20% to 40% among both men and women. thoracic curve

ico_infoIt has been demonstrated that as this kyphosis angle increases, physical performance and quality of life decline,  making early intervention a priority. Lets discuss in more detail  what the literature says about the negative consequences that have been associated with hyperkyphosis on physical performance.

Women with hyperkyphosis have demonstrated

  • difficulty rising from a chair repeatedly without using their arms
  • having significantly poorer balance and slower gait velocity
  • having a wider base of support with stance and gait
  • difficulty reaching and performing heavy housework
  • decreased stair climbing speed.

These impairments have been demonstrated to impair mobility to the point where they increase the incidence and risk for falls and fractures in the elderly population. Also, it has been documented that an increase in mortality is the result of these patients having a reduced vital capacity, which is predictive of increased incidence of pulmonary death.  It has been suggested that hyperkyphosis development is predominately from muscle weakness and subsequent degenerative disc disease which leads to vertebral fractures and worsening of the condition. This however is not as conclusive as it might sound, for there is no real proof to identify which of these factors happen first and it is most likely that the muscle weakness and disc disease happen simultaneously. It has also been documented that individuals can generate this condition of the same magnitude from different processes.

Regardless of the cause, it has been suggested repeatedly in the literature that the significant negative consequences of hyperkyphosis indicate early conservative intervention.   The gold standard orthopaedic technique for assessing the kyphosis angle is a standing lateral xray of the thoracic spine. The measurement of choice is called the cobb angle, which is the same measure used to detect scoliosis. There is also a more conservative measure called the debrunner kyphometer measurement which has been shown to be relatively accurate as well.

Some of the consequences to your musculoskeletal system from this accentuated curve are pain and risk of dysfunction in the shoulder, pelvic girdle, and  spine. The forward head posture, scapula protraction, reduced lumbar lordosis, and decreased standing height which is common in postural decompensation syndromes has a negative domino effect on your body. This type of deformity increases the flexion bias of the hips and shoulders which both promote further exacerbation of the problem.

Older women with hyperkyphosis have a 70% increased risk of future fracture, independent of age or prior fracture, and the risk for fracture increases as hyperkyphosis progresses.

Risk factors that have been associated with hyperkyphosis are vertebral fractures (wedging of the anterior vertebral body), muscle weakness, degenerative disc disease, sensory deficits, and decreased mobility.

Lets discuss each of these in a bit more detail. It is important to note however that compression fractures, although a risk factor, are not as common as it would appear without the data.

studies of older adults report only approximately 40% of men and women with the most severe hyperkyphosis have vertebral compression or wedge fractures.

A common radiographic finding associated with hyperkyphosis among older adults is degenerative disc disease. As the anterior disc height is decreased the angle of kyphosis is increased. The majority of older adults 50 to 96 years of age with hyperkyphosis had degenerative disc disease and no evidence of vertebral fractures or osteoporosis, suggesting that hyperkyphosis does not predict fractures or osteoporosis.

Several studies do confirm that hyperkyphosis, chiropractor Taylorsville UT, is associated with spinal extensor muscle weakness. There is also an inverse relationship between grip and ankle strength and kyphosis, suggesting that age related hyperkyphosis may be part of a larger geriatric syndrome associated with adverse health outcomes. Decreased spinal extension mobility occurs with aging, interfering with the ability to stand erect and maintain normal postural alignment. Furthermore, shorter pectoral and hip flexor muscles are linked to severe hyperkyphosis, Age-related deficits in the sensory, visual, and balance systems likely contribute to the loss of upright postural control.

With a loss of proprioceptive and vibratory input from the joints in the lower extremities in elderly adults compared with young adults, the perception of erect vertical alignment becomes impaired. This problem is further increased among older adults wearing bifocals during stair descent.

There is a lack of efficacious medical interventions for hyperkyphosis and exercise rehabilitation should be a first-line approach, particularly because many of the causes of hyperkyphosis are of musculoskeletal origin.

Lets discuss the current treatments for hyperkyphosis. While osteoporosis treatments help to prevent incidence of spinal fractures, no medications have been shown to improve hyperkyphosis, Chiropractor Taylorsville UT. Vertebroplasty and kyphoplasty are surgical procedures primarily used to treat refractory pain following vertebral fractures and they have been shown to reduce kyphosis angle in select patient populations only. The current evidence suggests that physical disability and pain relief may be improved after vertebroplasty and kyphoplasty compared to medical management but only within the first 3 months after the intervention.

flexion:extension imageResearch suggests that forces applied to the spine during exercise can alter the occurrence of subsequent vertebral compression fractures in women with prior fractures. In one study, 68% of the women who performed flexion (bending the trunk forward) exercises developed a subsequent fracture within the following 6 months, compared with only 16% of those who performed extension exercises, suggesting that flexion exercises increase fracture risk. It is important to train individuals with age-related hyperkyphosis to avoid flexion stresses on the spine during exercise and activities of daily living, regardless of whether they have had a prior fracture. Trunk stabilization should avoid curl-up exercises to reduce flexion bias on the spine.

Now lets discuss the importance of thoracic spinal extension.  A large randomized trial of prone trunk extension exercises in 60 healthy postmenopausal women, the angle of kyphosis and back extension strength improved among women with the most severe kyphosis and significant weakness of the spinal extensor muscles at base- line, suggesting that hyperkyphosis may be modified by spinal extensor muscle strengthening exercises.

Patients treated with 10 repetitions of prone trunk extension exercises 5 times a week for 1 year while wearing a weighted backpack, at 10- year follow-up showed a significant decrease in the number of compression fractures in the intervention group compared with controls, regardless of kyphosis or strength.

Kyphosis as well as forward head posture were significantly reduced among the compliant exercise groups compared with the noncompliant group in another study that employed respiratory muscle exercises combined with back extensor muscle strengthening and aerobic exercises in a study of 14 women with osteoporosis. They found that respiratory pressures improved 12% to 23%, exercise tolerance increased 13%, and thoracic curvature was reduced 5%

Additional therapies such as myofascial, spinal, and scapular mobilization techniques improve postural alignment in patients with hyperkyphosis. Some active therapeutic movement techniques such as self-mobilization lying on your back on a foam roller has been used successfully in a multidimensional exercise program that reduced kyphosis among hyperkyphotic women.

What does the research say about stretching the kyphosis away? A randomized controlled trial among 118 men and women 60 years and older with kyphosis greater or equal to 40°, participation in modified classical yoga 3 days a week for 24 weeks resulted in a 5% improvement in kyphosis index and a 4.4% improvement in kyphosis angle measured from the flexicurve device. This intervention did not result in statistically significant improvement in kyphometer angle, measured physical performance, or self-assessed health- related quality of life.

Other common treatments are the use of spinal orthosis. The research done on orthosis consisted of a wearing of  2 hours a day for 6 months which did result in an 11% decrease in kyphosis angle, improved standing height, increased spinal extensor strength, and decreased postural sway. Although the orthosis appeared to be beneficial, passive bracing does not provide the beneficial effects of exercise on bone. While not yet studied, bracing used in combination with therapeutic exercises may provide additional beneficial effects. Therapeutic taping may also reduce kyphosis angle according to preliminary research in 15 women with osteoporotic vertebral fractures; those with the greatest initial kyphosis had the greatest reduction in kyphosis with taping evidence supports the use of exercise, bracing, and taping interventions to reduce hyperkyphosis, improves quality of life, and reduce risk for future fractures for men and women. Relatively simple, available, and inexpensive conservative interventions may have a beneficial effect.

Here is a helpful list of Do’s and Don’t’s of postural alignment during exercise and activities of daily living.

Lets start with the Do’s.

  • Maintain good postural alignment during exercise.
  • Strengthen core stabilizer muscles, such as transversus abdominis, obliques, and multifidus
  • When bending or lifting objects, keep the lumbar spine (low back) neutral and bend with your hips and knees while keeping the load close to your body.
  • When getting out of bed, roll onto the side before sitting up (log roll)
  • When coughing or sneezing, stabilize the trun in neutral by hugging a pillow, or placing both hnds on your knees while hip hinging, or place hand in small of back to help keep neutral.
  • Maintain natural curves in your neck and back while sitting and standing. Imagine that you are lengthening the crown of your head.
  • If you use a walker, adjust the height to stand up straight and stay within the confines as you walk.

Dont’s

  • Avoid seated rowing machines or upper body ergometers
  • Avoid crunches, curl-ups, or flexed position (traditional sit-ups)
  • Don’t twist or bend your spine when lifting objects
  • Don’ sit straight up from a horizontal position
  • Avoid forceful trunk flexion while coughing or sneezing
  • Avoid leaning over towards your work, or standing in pelvic tilt, bending to reach or push walker

At Camp4, we specialize in functional movement assessment and treatment with manual therapy as well as exercise rehabilitation. If you are a patient who are concerned about this particular condition call the clinic for your appointment.

Primary reference

Wendy B. Man, PT, DPT. Linda Wanek PT, PhD. John A. Shepherd PhD. Deborah E. Sellmeyer MD. Age-Related Hyperkyphosis: Its Causes, Consequences, and Management Journal of orthopaedic & sports physical therapy. June 2010 vol 40(6)

 

 

 

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