Importance of Posture as It Relates to Injury

How a person physically presents themself in an upright standing position is considered the base from which an individual moves and reflects the alignment of the body. Posture provides the foundation from which the arms and legs function. As with any structure, a weak foundation leads to secondary problems elsewhere in the system. For example, if the foundation of your house has shifted it will not become noticeable until cracks appear in the walls or problems occur at the roof.

One of the functional methods utilized by the doctors at Life in Motion Chiropractic and Wellness is a postural assessment which helps to identify muscle imbalances. Postural assessment is an excellent evaluation tool that can help to clarify a person’s musculoskeletal complaint(s) and assists with the development of a treatment plan that will address the causative factors of the complaint  rather than simply treating the symptoms.

As with the house example mentioned earlier, it is easy to add a bit more plaster to a crack in the wall, sand it out, and paint over it. However, if the weakened and shifted foundation of the house is left as is, the visible cracks in the wall will return, or perhaps become larger and be accompanied by problems with the ceiling. Eventually simply patching the structure will no longer work and will lead to an overall renovation or quite possibly reconstruction. The same is true within the body.

Treating musculoskeletal symptoms with over the counter or prescription medications, modification of activities, or simply pushing through the pain, all lead to further dysfunction and cumulative layers of structural and neuromuscular adaptations. By identifying the causative factors of the inflammation, discomfort, or poor performance, our chiropractors can implement the most effective intervention to assist you in alleviating the dysfunction and provide the pain-free functional outcomes you are trying to achieve.

To learn more about how our Doctors of Chiropractic can assist you, visit us at www.LifeInMotionChiro.com.

Joint Dysfunction - #ThinkChiropractic

Over time the human body can and will experience static malalignments that alter the optimal resting length and tension of the muscles within the musculoskeletal system. Common static malalignments include joint fixation and myofascial adhesions that lead to or can be caused by poor posture.

Joint dysfunction (a.k.a. hypomobility) is one of the most common causes of pain in the human body.[1] [2] Once a joint has lost its normal range of motion, the muscles around that joint may tighten to minimize the stress at the involved segment (altering the length-tension relationship) or become overactive to prevent movement and further injury (altering the force-couple relationships).[1] [2] This process initiates the cumulative injury cycle which subsequently alters normal movement patterns and leads to structural and functional inefficiency.[3] [4] [5]

Joint Dysfunction

The doctors at Life in Motion Chiropractic & Wellness have been specifically trained to assess and treat joint dysfunction, myofascial adhesions, as well as a variety of other musculoskeletal disorders. The goal of treatment at Life in Motion Chiropractic and Wellness is to restore balance, flexibility, and control which instills self-efficacy and helps to keep your body moving naturally, feeling good, and aging well.

To learn more visit us at LifeInMotionChiro.com

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[1] Janda V. Muscles and Motor Control in Cervicogenic Disorders. In: Grant G, ed. Physical Therapy of the Cervical and Thoracic Spine . New York, NY: Churchill Livingstone; 2002:182-199.

[2] Lewit K. Muscular and articular factors in movement restriction. Man Med . 1985;1:83-85.

[3] Sahrmann SA. Diagnosis and Treatment of Movement Impairment Syndromes . St. Louis, MO: Mosby; 2002.

[4] Chaitow L. Muscle Energy Techniques . New York, NY: Churchill Livingstone; 1997.

[5] Sahrmann SA. Does postural assessment contribute to patient care? J Orthop Sports Phys Th er . 2002;32:376-379.

Spinal Maintenance Care

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Keeping You Moving Well so that You Can Age Well

Your body’s motion is controlled by the neuro-musculo-skeletal system. This motion system is broken down into three groups based upon the function of the various tissues within your body. The first group is known as the Active Subsystem which consists of the muscles that create motion. The second group is known as the Passive Subsystem which consists of the skeleton, ligaments, tendons, fascia, and other connective tissue that hold your body together. The third group is the Control Subsystem which consists of the brain, spinal cord, nerves, and mechanoreceptors that control the motion of your body.

These three subsystems must work together for normal, healthy motion. Even if you have strong healthy muscles you cannot maintain overall wellness if your Passive and Control subsystems are not as equally strong. Therefore if you are trying to lift something without integration of these subsystems you will unable to move any more weight than your muscles, joints, or nerves will allow.  Balanced and full motion allows joints and muscles to move smoothly and keep you moving well as you age.

The doctors at Life in Motion Chiropractic and Wellness approach treatment with three principles in mind. The first is motion; problems with this affect all three of the body’s subsystems. To effectively help a motion problem treatment solutions must address the mechanical and neurological issues involved and our doctor’s approach to this threefold:

- Chiropractic manipulative therapy unlocks, restores, and maintains joint motion. Joint mobilization reduces restrictions and other posture and motion distortions. In fact, freeing a compressed nerve or restoring motion can affect other parts of the body via the Control Subsystem.

- Myofascial therapy lengthens tight muscles and breaks up ligamentous and fascial adhesions. Other benefits of this form of therapy can be pain relief, which also affects the Control Subsystem, improved circulation, and general stress reduction.

- Therapeutic exercise, during which we teach you how to properly stretch tight/facilitated muscles and strengthen weak/inhibited muscles.

Secondly, we look for compensatory movement patterns in the body’s chain of motion. Your body type, injuries, and lifestyle habits train you, over time, to involuntarily and without thinking move your body in a unique pattern of motion using your stronger muscles. Your joints and ligaments stretch in the direction they are used and subsequently adhesions form along unused paths of motion. Therefore, you begin to move along the path of least resistance, just as a piece of paper bends along a crease the tissues of the body literally groove and fold in the way they are being used. As these mechanically inefficient patterns of poor posture and unbalanced motion progress, a “pain cycle” is created, the result of which is a continuous loop of increased body stress, joint degeneration, chronic pain, and recurring injury.

The solution, which is the third principle of treatment at Life in Motion Chiropractic and Wellness, is the implementation of “the motion cycle” through the use of postural retraining which helps to form new “life habits” and trains the body to move with conscious, full range of motion. Free, balanced motion reduces joint stress, relieves pain, and restores flexibility subsequently breaking the “pain cycle”.

The goal of treatment at Life in Motion Chiropractic and Wellness is to restore balance, flexibility, and control which instills self-efficacy and helps to keep your body moving naturally, feeling good, and aging well.

Optimal Wellness Through Massage - VIDEO

Healthcare Fee Schedules

Our office continues to receive shocked and, on occasion, agitated feedback from prospective patients who call our office that are either under-insured or have a policy with a company we don’t participate with when we inform them of our cash rate fee schedule. These folks feel that our rate(s) for care are high or, on occasion, exorbitant and state that they will seek care elsewhere. The fact is that our fee schedule is simply something we have no control over.

For ANY healthcare provider that participates with insurance company reimbursement for services rendered they are required by federal law (i.e. Health Insurance Portability and Accountability Act) to adopt a cash rate fee schedule that is comparable to the reimbursement rates of the insurers they participate with. To do so otherwise (i.e. discount their fees for cash paying patients) is known as a “dual fee schedule”. This unfortunately is illegal and to do so would open any healthcare provider up to litigation from the insurance company(s) for insurance fraud.

The doctors at Life in Motion Chiropractic and Wellness are also everyday consumers and we would relish the opportunity to provide those individuals who are under-insured or possess policies we don’t participate with a discounted rate(s) for care but due to federal statutes our hands are tied. The only way we would legally be able to provide any discount is to simply stop our participation with health insurance companies and we entertained this idea at the end of 2016. The feedback we received from most of our current insured patients was not favorable and therefore we decided to maintain our involvement with third-party payers (i.e. BC/BS, UHC, UPMC).

In closing, we encourage everyone to petition their local government representatives with your thoughts about the healthcare conundrum in the United States and request that they begin to allow healthcare providers more latitude with their billing practices so that we can truly make healthcare affordable for everyone!

Here is the LINK to our current fee schedule.

NOTE: The one service that we do offer in our office that is not covered by health insurance and therefore allows us to set our own fee is myofascial therapy (i.e. massage). If you feel that your particular problem is related to muscular tension/pain our rates for strictly myofascial therapy is $1/minute with a 15 minute minimum however you can schedule appointments for up to one hour.

Here is the LINK for more information on this service.

Optimal Wellness Through Massage

An extensive amount of research has been conducted on the effects of massage therapy. Research data has shown that massage produces measurable biological effects and may have an effect on the immune system.[1] While some of this scientific evidence is preliminary it has shown that massage can also help with back pain, neck pain, headaches, extremity pain and may improve quality of life for people with depression, cancer, HIV/AIDS and when utilized appropriately and provided by a trained professional, massage therapy appears to have few risks.[2]

Massage therapy focuses on the muscle and other superficial soft tissues of the body to help alleviate tension, inflammation, and pain via the application of manual hands-on techniques. The goal of massage is to establish and maintain good physical condition and health by normalizing and improving muscle tone, promoting relaxation, stimulating circulation, and producing therapeutic effects on the respiratory and nervous systems.[3]

So what is massage therapy?

Swedish massage utilizes long strokes, kneading, deep circular movements, vibration, and tapping.

Deep tissue massage focuses on certain painful, stiff "trouble spots" in your body and utilizes slow, deliberate strokes that focus pressure the muscles, tendons, or other tissues deep under your skin and provides relief from chronic patterns of tension and injuries such as back sprain.[4]

Structural massage, also known as myofascial release, manipulates the soft tissues within the body using different angles and degrees of physical pressure to stretch and guide fascia to a place of easier movement.[5] Research has shown that this style of massage produces positive effects on pain, anxiety, depression, fatigue, and stiffness in those suffering with fibromyalgia.[6]

Myofascial trigger point therapy is most effectively utilized in the treatment of chronic and acute pain. Postural holding patterns, emotional stresses and work-related muscular usage all contribute to areas of contracted muscle that develop firm nodules or taut bands know as trigger points which most of the time we aren’t even aware of. When pressed, trigger points are painful and are associated with pain elsewhere in the body and without direct intervention to eliminate them will not go away on their own.[7]

So what exactly does medical research say about massage?

Since 2008, the National Center for Complementary and Integrative Health (NCCIH) a division of the U.S. Department of Health & Human Services has taken an active role in not only reviewing the available literature but has also funded clinical trials on massage therapy. This is what they have discovered:

- Massage therapy helped reduce pain, improve function, and decrease the use of anti-inflammatory medication more effectively than usual medical care[8] in people with chronic low-back pain.[9]

- Massage therapy led to statistically significant improvements in neck pain severity, pain-related disability and function, and in one study participants reported a 14% decrease in the use of pain medication.[10] [11]

- A 2012 study found that a 60 minute massage once per week exhibited significant improvements in pain, function, and global response compared with those receiving usual care medical care for osteoarthritis of the knee.[12]

Aside from the research conducted by the NCCIH there have been other studies that have found myofascial therapy to also be an effective form of treatment for conditions such as tension type headache [13] [14] [15] [16], temporomandibular joint (a.k.a. TMJ) pain[17], and chronic shoulder pain.[18]

Chronic muscular restriction can inhibit essential physiologic processes such as blood flow, lymphatic drainage, nerve conduction, and cellular metabolism which can, over time, affect our overall health. The primary reason for the therapeutic effects of massage therapy is that it increases blood flow in small vessels that has been impeded due to muscle tension and that leads to better and faster recovery around the muscle tissue which in turn improves the range of motion, reduces swelling, and has pain-reducing properties.[19] [20]

Dr.Sean Konrad at Life in Motion Chiropractic and Wellness applies a collection of skills when performing therapeutic myofascial treatment, however the type of therapy performed will depend on your needs and physical condition.

Dr. Konrad provides treatment via chair massage, during which myofascial therapy is performed over the clothing in a forward seated position as seen here,

Chair Massage

or on a flexion-distraction therapy table for cases in which a more deep tissue approach is warranted. 

Aside from this he can also apply a range of modalities to supplement this hands-on therapy which include:

Heat or Ice Application

Muscle Stimulation

Hot Stone Massage

Instrument Assisted Soft Tissue Manipulation

Kinesio Tape Application

Here a short summary of Dr. Konrad’s formal training in myofascial techniques:

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[1] Rapaport MH, Schettler P, Bresee C. A preliminary study of the effects of a single session of Swedish massage on hypothalamic-pituitary-adrenal and immune function in normal individuals. (http://www.ncbi.nlm.nih.gov/pubmed/20809811) The Journal of Alternative and Complementary Medicine. 2010; 16(10):1–10.

[2] Field, Tiffany, PhD, Andrea Furlan, MD, Karen Sherman, PhD, Partap Khalsa, DC, and John Killen, MD. "Massage Therapy for Health Purposes." National Center for Complementary and Integrative Health. U.S. National Library of Medicine, 06 Sept. 2016. Web. 21 Sept. 2016.

[3] Fritz, Sandy. "Chapter 2." Mosby's Fundamentals of Therapeutic Massage. 4th ed. St. Louis, MO: Mosby/Elsevier, 2009. 30-33. Print.

[4] Keifer, David, MD. "Massage Therapy Styles and Health Benefits." WebMD. WebMD, 01 Aug. 2016. Web. 21 Sept. 2016.

[5] Konopelky, Karin. "Structural Integration." Massage Therapy 101. Tsavo Media Canada Inc., n.d. Web. 22 Sept. 2016.

[6] Yuan SL, Matsutani LA, Marques, AP. Effectiveness of different styles of massage therapy in fibromyalgia: a systematic review and meta-analysis. Man Ther. 2015;(2):257-264

[7] Finando, Donna. "What Is the Difference Between an Acupoint and a Trigger Point? Part 1." MASSAGE Magazine. Massage Magazine, 08 Dec. 2008. Web. 01 Mar. 2017.

[8] Usual care for low-back pain may include medication, other forms of physical therapy, back exercises, and education.

[9] Cherkin DC, Sherman KJ, Kahn J, et al. A comparison of the effects of 2 types of massage and usual care on chronic low-back pain: a randomized, controlled trial. (http://www.annals.org/content/155/1/1.abstract?aimhp) Annals of Internal Medicine. 2011;

155(1):1–9.

[10] Sherman KJ, Cherkin DC, Hawkes RJ, et al. Randomized trial of therapeutic massage for chronic neck pain. Clinical Journal of Pain. 2009; 25(3):233–238.

[11] Sherman KJ, Cook AJ, Wellman RD, et al. Five-week outcomes from a dosing trial of therapeutic massage for chronic neck pain. (http://www.ncbi.nlm.nih.gov/pubmed/24615306) Annals of Family Medicine. 2014;12(2):112–120.

[12] Perlman AI, Ali A, Njike VY, et al. Massage therapy for osteoarthritis of the knee: a randomized dose finding trial. PLoS One. 2012; 7(2):e30248.

[13] Doraisamy, Magesh Anand, Charles Prem Kumar & Anshul, and Chandran Gnanamuthu. "Chronic Tension Type Headache and the Impact of Myofascial Trigger Point Release in the Short Term Relief of Headache." GJHS Global Journal of Health Science 2.2 (2010): 239-44. Web.

[14] Fernández-De-Las-Peñas, César, and Carol A. Courtney. "Clinical Reasoning for Manual Therapy Management of Tension Type and Cervicogenic Headache." Journal of Manual & Manipulative Therapy 22.1 (2013): 45-51. Web.

[15] Quinn, Christopher, Clint Chandler, and Albert Moraska. "Massage Therapy and Frequency of Chronic Tension Headaches." American Journal of Public Health 92.10 (2002): 1657-661. Print.

[16] Ferna´ndez-de-las-Pen˜ as, Cesar, Maria L. Cuadrado, and Juan A. Pareja. "Myofascial Trigger Points, Neck Mobility, and Forward Head Posture in Episodic Tension-Type Headache." Headache 47 (2007): 662-72. Print.

[17] Miernik, Marta, Mieszko Więckiewicz, Anna Paradowska, and Włodzimierz Więckiewicz. "Massage Therapy in Myofascial TMD Pain Management." Advances in Clinical and Experimental Medicine 21.5 (2012): 681-85. Print.

[18] Bron, Carel, Arthur De Gast, Jan Dommerholt, Boudewijn Stegenga, Michel Wensing, and Rob Oostendorp. "Treatment of Myofascial Trigger Points in Patients with Chronic Shoulder Pain: A Randomized, Controlled Trial." BMC Medicine. BioMed Central Ltd., 24 Jan. 2011. Web. 30 Jan. 2017.

[19] Goats GC: Massage – the scientific basis of an ancient art: part 2. Physiological and therapeutic effects. Br J Sp Med 1994, 28(3), 153–156.

[20] Smith AR Jr.: Manual Therapy: The Historical, Current, and Future Role in the Treatment of Pain. Sci World J 2007, 7, 109–120.