soft tissue

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Chiropractic Done Differently #3 – Why Rehab Matters in your Plan of Care

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Part 1 – Quality of Movement ~ Quality of Life

Humans have been blessed with cognizance of our ability to move in different patterns, speeds, intensities, and with varying intentions. To ignore your body’s movement potential is to ignore one of the biggest gifts of life.

If we are going to move, why not practice efficient, fluid, and controlled motion? We can prevent many acute injuries and chronic pains by simply increasing quality of our movement. An example;

  • Patient describes an ache in their low back while performing daily activities (brushing their teeth, doing laundry, picking up their child).
  • A movement analysis shows the patient lacks awareness of how to utilize their hips while bending forward, resulting in increased loading of their low back.
  • Through several sessions, their rehab specialist teaches hinging concepts, increases available range of motion at involved joints, and strengthens corresponding muscles.
  • Patient leaves treatment with the tools necessary to reduce future stress on their low back, ultimately leading to a decreased reliance on medical providers, pain medications, or other palliative measures.

We love our patients, but your presence in clinic likely means something is not going well. Often, learning to move your body efficiently is THE BEST means of avoiding pain and injury. 

Some words of wisdom from a master of movement, Ido Portal;

  • “Your existence is within a body”
  • “You are in a body, you must move”
  • “You better learn how to move well, because it’s such a big part of your life”
  • The Power of Movement – The School of Greatness Podcast with Lewis Howes

Part 2 – What can affect the way you move?

  • Lack of exposure/knowledge
  • Lack of practice (effort?)
  • Strength
  • Injury or Chronic Pain
  • Lack of motion/mobility
  • Lack of coordination (motor control)

 

Example – Progression of Parkinson’s with Exercise Prescription

https://movementdisorders.onlinelibrary.wiley.com/doi/full/10.1002/mds.21922

 

Written by
Derek Knotts, MS ATC, Mercer Island Thomas Howes, Senior Rehab Specialist

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Chiropractic Done Differently – Instrument Assisted Soft-Tissue Mobilization

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In this series we’re aiming to highlight the treatment modalities Helix offers BEYOND traditional chiropractic adjustments. Today we dive into the how and why of IASTM!

Instrument Assisted Soft Tissue Mobilization or IASTM is performed by sliding or “scraping” a tool on the skin in selected directions with varying degrees of pressure. This can be done to tissue that is stationary, moving, or even to a tissue that is under load/resistance.

IASTM can:

-Increase ROM by facilitating the movement of tissues

-Decrease swelling at a site of inflammation

-Reduce pain by decreasing sensitivity in an area of the skin

When would a Helix chiropractor utilize IASTM?

Let’s say your favorite method of exercise requires you to repeatedly reach your arm overhead, but in doing so you feel a pinch or sharp pain. During evaluation, your Helix chiropractor may identify a soft-tissue restriction limiting your ability to move into an overhead position, IASTM can subsequently be utilized to increase range of motion through the shoulder girdle.

Whether you are a climber, swimmer, or Olympic lifter, IASTM, along with corrective exercises, can prove beneficial in giving the athlete the shoulder mobility needed to functionally raise their hand over head and return to your favorite activity!

5-Minute Guide: Exactly How Does Laser Therapy Work?

Written by

Logan Trachuk D.C., Ballard
Thomas Howes, Senior Rehabilitation Specialist
Helix Sport + Spine Ballard

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Chiropractic Done Differently – Incorporating Laser Therapy into your Plan of Care

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If you train on a consistent basis, chances are you’ve encountered some sort of tendon/ligament strain, sprain, or tear. Whether you’re a runner who struggles with Achilles pain, or a powerlifter dealing with tricep tendinopathy, connective tissue injuries can be frustrating, confusing, and challenging to rehab. 

Outside of traditional soft-tissue therapy, rehabilitative exercise, and nutritional approaches, what else can we utilize to speed the body’s healing capabilities?

Laser therapy is an effective supplemental treatment to add to your plan of care. Utilizing light waves, research has demonstrated laser therapy can;

  • Stimulate ATP production – Increased energy supply within a cell to support healing of tissue
  • Increased circulation through vasodilation – Enhances delivery of oxygen and immune cells to healing tissue
  • Improve cellular maintenance by stimulating several “clean-up” and healing processes;
    • Phagocytosis – Ingestion of pathogens, bacteria, cellular debris
    • Collagen synthesis/Fibroblast proliferation – Connective tissue formation
    • Angiogenesis – Formation of new blood vessels
    • Keratinocytes – Skin repair

In layman’s terms, research shows that laser therapy can act to support and enhance the body’s natural healing processes, leading to shorter periods of recovery from injury or chronic pain. Ask your Helix provider whether laser therapy might be appropriate for you!

References 

The Smart Chiropractor

How Does Laser Therapy Work?

Written by Thomas Howes, Steven Kaiser D.C.
Helix Sport + Spine Ballard

Electrolyte 101

Electrolytes 101

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The word ‘electrolyte’ is thrown around liberally in the world of sports performance and nutritional supplementation, but what in fact are electrolytes and how do they affect our ability to move, compete, and enjoy the great outdoors?

Electrolytes are minerals that in solution form have the capability to conduct electricity. Their presence in the human body, via consumption of food and drink, facilitates the contraction and relaxation of muscle fibers through the nervous system. Athletes that excessively sweat due to prolonged physical activity (over 90 minutes) are suggested to supplement with electrolytes. Other circumstances necessitating supplementation may include multiple games/events within a short time span (tournaments), excessively hot/humid, or fluid loss due to fever, vomiting, or diarrhea. 

The most common electrolytes found in sports nutritional supplementation are Sodium, Potassium, Magnesium and Calcium, ensuring these four minerals are balanced is a great starting point for increasing performance in the gym, pool, or on the field! 

  • Magnesium – Can help to promote muscle relaxation and reduce cramping. 
    • Sources: green leafy vegetables, nuts, beans, whole-grain cereals. 
    • Deficiency (hypomagnesemia): lethargy, weakness, cramping, tetany (spasms)
  • Potassium – Essential in the delivery of nerve signals to muscles fibers.
    • Sources: avocados, spinach, sweet potatoes, salmon, grapefruit.
    • Deficiency (hypokalemia): constipation, fatigue, rhabdomyolysis, weakness/muscle spasms
  • Calcium – Plays an integral role in muscle contraction. 
    • Sources: seeds (poppy, sesame, chia), cheese, yogurt, sardines, beans, and lentils.
    • Deficiency (hypocalcemia): muscle cramps, confusion, fatigue, muscle weakness/spasms, pins/needles
  • Sodium – Integral in nerve conduction, delivering nutrients to cells and removing metabolic waste.
    • Sources: spinach, carrots, celery, meat, seaweed, cantaloupe 
    • Deficiency (hyponatremia): nausea, headache, confusion and fatigue

Sports drinks are marketed as a source of electrolytes, but generally come with a staggeringly high level of sugar (one 32 oz Gatorade contains ~53 grams of sugar!). Try this homemade sports drink for an electrolyte boost without the sugar crash!

Home Sports Drink Recipe

  • ¼ tsp. salt
  • ¼ cup lemon juice
  • ¼ cup honey
  • 1 ½ cups unsweetened coconut water
  • 2 cups cold water
  • Option: Powdered magnesium or calcium (based on bloodwork and recommendation from a medical doctor)
  • 16-24 ounces per pound of bodyweight lost due to fluid loss


Thomas Howes

 

 

Thomas Howes
Athletic Development Coach & Senior Rehabilitation Specialist

Helix Sport + Spine Ballard

Isolation to Integration: 3 Drills to Help your Golf Swing

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Do you consistently experience low back pain after a round of golf or session on the driving range? Utilize these three strategies to;

·         Improve mobility through the hips and thoracic spine

·         Gain neuromuscular control of your improved range of motion

·         Enhance your ability to produce force through the “foot to floor” concept

The golf swing is a complex and integrated skill that requires extensive coordination through the entire body. When we see a breakdown in motion/strength through specific regions, we tend to sacrifice the overall quality of the swing and increase our risk of pain and injury. Today we will focus on improving isolated motion through the hips and thoracic spine and learn to integrate these skills in a full-body exercise.

Concept 1: Unlock your Hips (Supine Banded Hip IR/ER)

·         Lie on back, band pulling laterally across body and looped around outside knee

·         Brace core, drive outside knee down/out slowly. Focus on contracting through the backside of the hip.

·         Maintain stable pelvis and aim for 3 second concentric, 3 second isometric hold, and 3 second eccentric. Perform reps to light fatigue, our goal is to maintain control rather than absolute fatigue.

·         Repeat on inside leg into internal rotation, driving the knee inward while maintaining a level pelvis.

Concept 2: Maximize Spinal Rotation and Control (Split Stance Trunk Rotation)

·         Standing in a spit stance, hinge forward while maintaining spinal position (minimize flexion or extension)

·         Slowly rotate your spine towards lead, don’t allow pelvis to rotate. Aim for the 3:3:3 tempo we utilized in drill #1.

·         Repeat into opposite direction, minimize collapse of knee or rotation of pelvis.

·         If you experience “sticky” points in your range, slow tempo down and work to develop control in this phase of motion.

Concept 3: Develop Force from your Feet (Med Ball Lateral Hop to Iso)

·         Stand on right food, 6-10 lb. medicine ball held in front of torso.

·         LOADING: Slowly chop the ball across your body as you load weight onto right leg. Notice the position of your right foot as you move deeper into the right hip.

·         ACCELERATION: Driving right foot down/out, push through right hip and jump to your left leg. Focus on landing softly with “quiet feet”, aiming to control your landing and hold 1-2 seconds.

·         Build speed on control! We prefer to see solid loading and landing mechanics before attempting fast or large reps.

·         This drill incorporates the hip and trunk rotation we previously isolated in drills 1 & 2, think about how each individual concept integrates into this last skill.

These drills, performed with control and intention, will help you begin to understand how individual joints affect the overall golf swing. With time, we are aiming to increase your active range of motion capabilities through improvements in motor control and strength. Ultimately, improvements should decrease stress on the lumbar spine, increase club speed, and create greater overall kinesthetic awareness. Happy swinging! 

 

Thomas Howes

 

 

Thomas Howes
Athletic Development Coach & Senior Rehabilitation Specialist

Helix Sport + Spine Ballard

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A Beginner’s Guide to Youth Resistance Training: Part One

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Through a decade of coaching in the health/wellness industry, one question seems to be constant. 

Is my child too young to participate in a weightlifting program? 

In short, there are ways to appropriately challenge physical fitness AT ANY AGE, but the challenge MUST be specific and appropriate to the individual. Parents often worry about likelihood of injury, specifically to the epiphyseal growth plate of maturing bones. A 2009 research review (Faigenbaum et. al.) found that a majority of youth training injuries were a result of improper technique, hasty progression of load, and/or lack of qualified coaching supervision.

 

This checklist will help you;

  • Identify what type of training is appropriate for your child and their needs
  • Identify their ideal training setting/facility
  • Begin the process of finding the right coach

Part 1: The Basics

  1. Identify your Child’s Goals
  • Your child’s goals should play a major role in deciding the coach, style of training, and facility you decide upon. Is your athlete looking to increase speed, maximize strength, assist with mental wellness, aiming for weight-loss? 
  • Is your child aiming to improve athletic performance? If so, what are the demands of their sport? Does the athlete have performance testing parameters they need to meet, if so, are you aware of which tests will be employed? Does your facility have the ability to create this sort of training environment?
  • What is the timeline prior to their start of their practice schedule and competitive season? How much time does the coach have to prep your athlete for their season? Ideally, a coach has AT LEAST 3 months for competitive preparation.
  1. Physical Preparedness of your Child
  • Sedentary vs. Active Lifestyle: Programs should be modified to meet the individual. Throwing a sedentary child into a high-intensity training program is a great way to get your child hurt OR destroy their relationship with physical activity for the foreseeable future. 
  • Experience: Similarly, placing a highly-skilled athlete into a novice training setting will hinder development of skill, strength, speed, and mindset.
  1. Communication Style and Social Tendencies
  • Introvert vs. Extrovert: Your child’s success may be contingent on their preferred communication style and innate personality. Yes, placing your shy and introverted child into a group setting MAY help them “break out of their shell”, it may also backfire and end up pushing the individual away from fitness and health due to negative self-talk, feelings of ineptitude, or feeling aloof from the group.
  • Behavioral Challenges: I had an athlete in a group setting who continuously talked back, would not follow directions, and combatively isolated himself. Two weeks into our program, I was ready to kick the athlete out, as he was presenting a safety hazard to himself and others. At this point, I was informed that he had Asperger’s and social scenarios posed a significant challenge. His mother didn’t want to divulge this information in fear of her son being treated differently due to his diagnosis. While I understand (and support) her point of view, this information could have proved useful in my preparation for each session in regard to feedback tools and physical/environmental factors (location of athlete in relation to coach, what athletes are placed near the individual, volume of music, etc).
  1. Hx of Injury 
  • Does the individual have any injuries that need to be addressed with the coach prior to initiation of the program?
    • Some injuries may rule-out specific styles of training. Example, it would be highly inappropriate to program Olympic lifting or high volume of overhead lifting for athletes recovering from back injuries.
    • Coach may need to address stability/range of motion in reference to this injury
    • Coach may need to modify program to match the individual’s capabilities
    • Coach can use this information to decide what level of force or type of exercise is appropriate for the athlete. 
  1. Facility, Coaching, & Expectations
  • Setting: Would your child be more likely to succeed in a 1:1 or group setting? Does loud music and a high intensity environment affect their ability to concentrate? Does your child have friends that have similar goals and would be appropriate to pair with? Does your child have friends they should not be paired with due to inability to focus?
  • Coaching: Any coach can give you a “head in the trash can/can’t walk the next day” workout. Is your coach/trainer taking your goals into consideration when designing your child’s workout or simply trying to push you as hard as possible? 
    • Educational Background: Credentials are not everything, I have met plenty of coaches with numerous “qualifications” that don’t take their job or their clients seriously. That being said, certifications indicate that an individual is invested in their trade and has exposed themselves to a multitude of approaches to training. 
    • Specificity: A pilates instructor will not likely help your athlete increase their 40 time, likewise I haven’t met a plethora of bodybuilding coaches who understand the importance of joint mobility. Does your coach have a background in your sport or desired goals?
  • What are the Facilities Rules/Expectations?: I employ a “2-strike” rule for my athletes in group training settings. Once we have gone over the basics of each lift, I communicate that I trust all athletes to respect the principles of progressive loading (don’t go too heavy too quickly). If I dictate that an athlete is excessively loading their exercises on two or more occasions within a session, they will be asked to leave. I am aiming to instill trust and autonomy to my athletes, but will not accept unnecessary injuries as a result of poor judgment.

Your local Helix team is well connected in the Puget Sound fitness community and can likely provide you with referrals to gyms/coaches that match your needs. Stay tuned for Part Two, identifying specific safety guidelines and how to make sure training volume matches your child’s short and long-term goals!

 

Thomas Howes

 

 

Thomas Howes
Athletic Development Coach & Senior Rehabilitation Specialist

Helix Sport + Spine Ballard

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4 Components of the Perfect Golf Warm Up

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Doesn’t it feel like no matter how many years of effort you put into improving your golf game, you still somehow end up as an amature ?

Golf lessons and annoying playing partners who critique your swing aside, you could probably work on your golf game more than any other sport, and still come out behind. Almost no other sport can someone do so regularly, and still make little to no progress. 

Have you ever met a mountain climber that just never could figure out how to get uphill? An outfield player who never got better at catching fly balls even though they tried every day? With most sports, as long as you put a little effort and energy into it, you can at least eventually claim the title of “not being terrible”. But not golf, because golf is hard.

And for those of us who care, and put unintentional practice in, we tend to groove bad habits more than good ones. We keep trying to fix things mid-swing with those bad habits, poor flexibility, and no way of really determining the actual needs of the swing.

So, what’s the point here?

The point is, that we should be focusing on the start of our golf game. The warm up. The beginning. The set up. The address before the address. 
Whatever your weakness is, this should be the first thing we are attacking if we want to improve. See a therapist if you’re injured or looking to improve hip motion, but incorporating the following four components into your warm up paired with the exercises we’ve listed alongside them, you’ll be on the right track to improving your golf game.

Component 1: Club head speed

Exercises: Medicine ball slams and kettlebell swings (this can be tricky on the course, consider carrying a tennis ball or deflated soccer ball with you).

Purpose: These dynamic moves will help to prime your body for the explosion of the golf swing. 

Component 2: Flexibility

Exercises: Reverse lunge with thoracic rotations and box jumps into a squat

Purpose: More range of motion results in higher club head speed, fewer injuries, and a more diverse golf game

Component 3: Control

Exercises: Side jumps, med ball passes, and RDL’s

Purpose: Balancing the body is critical. You can’t shoot a cannon out of a canoe, so having a balanced base and power through all ranges of motion will really help develop consistency

Component 4: Stability

Exercises: Utilize a variety of plank or deadbug positions

Purpose:  Learning how to brace the core will help with range of motion in the arms and the hips. It’s easier than stretching and you will connect your body in ways you didn’t know you could.

The good news is, the game of golf is more about muscle memory and mental preparedness than it is about athletic ability. Working on these four components can help make your game consistent, and reproducible. 

Once you’ve gotten the beginning down, it’s always a good idea to seek out a coach or trainer so that they can help you with next level training or injury prevention. 

If you want to take it to the next step and are looking for more specifics on how you can improve your golf swing, you can head over to our Instagram to check out the “Improve Your Golf Swing” series one of our rehab specialists created for our patients who love to golf.

Joanna IASTM Soft Tissue Injury

Tool Assisted Soft Tissue: What You Need to Know

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At Helix, our doctors utilize a variety of techniques to help our patients get out of pain and return to the activities that bring them joy in life. One of the techniques we rely upon to treat patients is known as “Instrument Assisted Soft Tissue Mobilization” or IASTM for short. This technique is also commonly known as “Graston”, but for the sake of simplicity we’ll refer to it as IASTM.

So what exactly is IASTM? 

IASTM is a treatment technique that effectively helps to break down scar tissue while improving range of motion and decreasing pain. IASTM can be used to treat all types of injuries ranging from muscle strains, ligament sprains, and can even help treat post-surgical scars. IASTM is popular for all types of athletes including CrossFitters, golfers, tennis players, baseball players, runners, cyclists, and more! IASTM tools come in various shapes and sizes to accommodate different areas of the body. Some of these tools are shown in the image below.

 

How is it performed?

The doctor will use the tool to gently scrape the skin in the area of the injured soft tissue utilizing the appropriate pressure and angle of application. The doctor will utilize an emollient (lotion) of some kind to help the instrument glide across the skin. The treatment shouldn’t be painful, as the goal is to tailor treatment to your tolerance level.

How does it work?

When we experience an injury to our soft tissue (muscles, tendons, ligaments and fascia) the body responds by laying down fibrotic scar tissue as a protective barrier over the injured area. While this is a natural response to injury we will occasionally run into an issue where pain seems to linger or we lose the ability to move through a particular range of motion without it feeling stuck or restricted as a result of this scar tissue. 

IASTM is applied to the injured area of soft tissue to intentionally create microtrauma. This may seem counterintuitive, but the presence of microtrauma begins a cascade of events that starts with blood being brought to the area followed by a natural process that reabsorbs the excessive fibrotic tissue formed after the injury and allows for new healthy tissue to be laid down in a more organized fashion. When we combine IASTM with a custom rehabilitative exercise program we can effectively help to remodel soft tissue to become stronger and more resilient, which means you’ll have less pain when you return to activity!

Got a problem? We can help!

If you or someone you know has experienced a recent soft-tissue injury, if you feel restricted in certain ranges of motion, or if you had an old injury that never seemed to heal properly IASTM might be the solution for you! All of our doctors at Helix are trained in this technique and can utilize this treatment as part of a custom program to help you get out of pain and get back to doing the things you enjoy. 

 

SOURCES:

https://pubmed.ncbi.nlm.nih.gov/31322903/

https://www.physio-pedia.com/Instrument_Assisted_Soft_Tissue_Mobilization