The Achilles tendon is a rather avascular (lacking blood) thick tendon that is made up of two of your major back side calf muscles: the gastrocnemius and the soleus. The tendon attaches into a part of your heel bone, the calcaneus, and this part is called the calcaneal tubercle. We have to major bursa sacs (bursa sacs are pockets that only fill with fluid when they are inflamed), the subcutaneous calcaneal bursa and the retrocalcaneal bursa (see figure 1 right). The subcutaneous bursa seldom presents as an issue, but the retrocalcaneal bursa can be a major headache. Continue Reading →
Why Your Back Might Not Be Getting Better
There are many reasons as to why people develop back pain and luckily, conservative treatment can help most all of them. Only in the rarest of instances is surgery needed. The problem with treating back pain is that all too often the practitioner focuses so much on the pain that he/she doesn’t actually address what is causing the pain. We’ve all been guilty of this!
I could write volumes on contributing factors to back pain but this blog was written to address one common problem that we are seeing more and more: a hypermobile sacroiliac joint (SIJ). Now, the naysayer will try to suggest that this does not occur, but with over 18 years of treating sports and back injuries, I can assure you that it does, and it does with frequency. I’ve seen this problem in active kids to my professional athlete clientele base. It is usually not properly diagnosed as few practitioners know how to assess it. Continue Reading →
Why ALL Diabetics Should Be Incorporating Fasting
Okay, I’m not going to save the juicy part until the end of the blog. So, here it is: fasting not only allows for better diabetes control but it also helps to reverse diabetes. Science has now proven what many have already know for some time. Do you know a diabetic? Are they on a routine like me (Isagenix)? If they’re not, they need to be if they want optimal health.
My story: those who are familiar with me know I began a particular nutrition/lifestyle program some time ago that involves caloric restriction and intermittent fasting to not only positively affect my athletic performance and recovery, but also to better lock down tighter blood glucose control. As an insulin dependent diabetic for now over 35 years, I always want to do all I can to be as healthy as possible. Sadly, I have found in my experience (and from discussions with many other diabetics over the years) that endocrinologists do not emphasize true prevention and nutritional intervention. No, statins are not prevention…sorry. More on that soon. On the topic of nutritional intervention to help diabetic control, there is a lot of research yet very few physicians touch on its importance. This is rather unfortunate. With a bit of education and desire, it is easy to discover ways to better manage diabetes. Continue Reading →
The Truth About Plantar Fasciitis and How To Treat It
Plantar Fasciitis (PF) can be a rather debilitating condition. It doesn’t matter if you have flat feet (pes planus) or high arches (pes cavus). If there is added stress to the bottom of the foot that occurs quickly, it can result in plantar fascial pain.
What exactly is the plantar fascia? Consider the plantar fascia to be similar to a ligament. It runs from the heel (the medial calcaneal tubercle) to the heads of your metatarsals (point at about where you see the webbing of your toes). Despite what you might have been told, its function is NOT to hold the arch of the foot. Rather, the PF more-so holds the muscles under it together so that they can suspend your arch. Continue Reading →
I Have Disc Problems and I Cannot Run…Will I Be Able To Run Again?
We treat a lot of patients who suffer from disc pathologies, be they bulges or herniations. Most of these people are active and want to continue to be active. The problem they encounter is that they get pain in the low back with activity that many times goes into the gluteal region (on one side or another…or both) and sometimes goes down the leg(s) into the feet. This makes it hard for them to partake in sport. Continue Reading →
The Dreaded DCO and What It Means To You and Your Shoulder!
DCO, or Distal Clavicular Osteolysis, is a rather bad shoulder condition that all too many athletes suffer from.
DCO occurs when we have damage to our AC (acromioclavicular) joint and it goes unattended to for a period of time. More-so than that, additional damage is done with further activity and the bones that make up the joint get significant damage.
The AC joint is made up of where the distal clavicle bone meets the acromion process of the scapula (see photo below). A sprain of the AC joint tends to involve a macrotrauma (one significant injury) such as a bad fall or other form of side shoulder impact. The AC joint tends to get hypermobile (or move too much) easily as it is not a very stable joint to begin with. When the joint is injured, or sprained, care is needed to stabilize the joint and allow for it to heal. In-office treatments can significantly reduce recovery time and this is important as a healing AC joint sprain is susceptible to further injury. Continue Reading →
It’s Not Your Neck Silly, It’s Your First Rib! It’s My What?
Many people seek care from a chiropractor for neck pain. After all, it’s one of the most common conditions we treat. Sometimes, however, the reason your neck hurts is not due to the neck itself but rather something else close by: the first rib.
The first rib is just that…it’s the rib that is highest up and close to your neck. It goes from the T1 vertebra (the vertebra just below the ‘cervical’, or neck, vertebrae) to the upper portion of the sternum, on the front side. The clinical importance of the first rib (in this case) is that it has two very important muscles that attach on it. Those muscles are the anterior and middle scalenes muscles. Continue Reading →
The Biceps Tear…What You Should Know
There are two heads to the biceps brachii, the long head (that goes from the labrum to just past the elbow…the outside one in the picture) and the short head (that goes from the coracoid process to just below the elbow…the inside one in the picture). We rely on each muscle for shoulder flexion, elbow flexion, and some supination (hand rotated upward) of the forearm/wrist/hand. Of the two heads, the long head tends to tear more as it thins out as it travels into the shoulder and it is more susceptible to damage at its attachment on the shoulder labrum.
The muscle can tear due to age-related wear and tear, labral tearing, overuse and trauma. Generally, muscles tear from either the origin (where it begins proximally), or the insertion (the distal attachment). When the biceps tears from the insertion, it will tend to roll up the arm and form a ball in the middle of the biceps region. This type of tear tends to be very noticeable. Continue Reading →
The Major Reason Why Your Knee Hurts and What You Can Do About It
As a sports rehabilitation doctor, I get the benefit of seeing all types of sports injuries. One of more common injuries I see is a ‘knee tracking’ issue. I’ll go as far as saying about 75% of all people presenting with knee pain have this condition as either a primary issue or issue that is causing a more serious situation. So, what exactly is this funny sounding condition?
As humans, we are the ONLY animal to be upright and on two legs as a primary means of ambulation. Although our evolution has allowed us to do this, it is not without issues. It just so happens that the muscles on the outside of the thigh tend to get stronger/tighter than the muscles on the inside. Now, it’s a bit more complex than this but this should help give us a general idea of what is occurring. Continue Reading →
Dr. Manison is now Selective Functional Movement Assessment (SFMA) Certified
Doctors learn how to assess and treat based on their specialization. Chiropractors are taught how to diagnose neuromusculoskeletal problems and how to properly treat them. If a patient presents with a condition that a chiropractor cannot handle, then an appropriate referral should be made.
Dr. Manison has acquired skills in most of the highest level treatment approaches in his field. In fact, he now teaches part of the Certified Chiropractic Extremity Practitioner (CCEP) program nationally. This program, developed by Dr. Kevin Hearon, is regarded in the field as the highest level program on the assessment and treatment of extremity injuries. Continue Reading →
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