The psoas muscle starts in the lower back at which point the paired psoas muscles act as anchors on either side of the spine. These muscles wrap around the pelvic area attaching at the knobby part of the hip with several strong tendons. The psoas muscles are considered to be crucial among the hip flexor muscles. Hip flexors allow people to bend their bodies into their hips and to pull their hips into their bodies. Low back or hip pain can come from contracted psoas muscles which fail to provide support. They can gently stretch to elongate their muscles and make them more flexible, as well as seeking medical attention if the pain continues, grows worse, or changes. Engaging in a regular physical fitness routine which includes stretching such as Pilates or Yoga will help to keep the psoas muscle aligned, strong, and flexible, along with other vital muscles of the body.
A gentle psoas stretch, involves lying on your back on the floor. Make sure that your pelvic position is neutral, your shoulder blades are flush with the floor, with your spine and head aligned, forming a straight, smooth line. Gently bring one knee up to your chest while extending the other leg along the floor, breathing deeply and evenly. Hold the position for 10 breaths before switching sides, and repeat 3 times. You should feel a gentle stretching action but not pain
For a deeper psoas stretch, adopt a lunging position with one knee forward, forming a 90 degree angle, if possible, between the hip and the calf. Extend the other leg behind you, kneeling slightly, and lower yourself slowly into the stretch, which you will feel in the front of the hip. Make sure you don’t increase the curve in your back as you come forward (the Psoas connects the back with the front of the hip). Sometimes it helps to tighten the stomach muscles as you come
forward. This will prevent too much arching of the back. Keep your spine perfectly straight while performing this stretch, and do not allow the knee of your forward leg to overhang your toes.Hold for 30-60 seconds and perform twice a day or when you have back pain
Please Consult Your medical professional before stretching the psoas, In some cases psoas stretches can be counterproductive
Richard Don Tigney referenced below states, “Stretching the psoas is usually counter productive as a dysfunction of the SIJ will cause the psoas to become tight while correction of the dysfunction will loosen it. If you stretch the psoas you will increase the dysfunction in anterior rotation of the psoas.
Similarly the SIJ dysfunction will cause a vertical shear on the piriformis at the S3 segment. Correction of the dysfunction corrects and relieves the vertical shear. The piriformis, the G. max and the iliacus all have origins on both the sacrum and the ilia. The shear is the cause of the piriformis syndrome. Similarly the sacral origin of the G. Max will tend to separate from its ilial origin and the ilial origin of the iliacus m will tend to separate from a small slip on the sacrum.(1)
Periarticular injections are superior to intra-articular injections for diagnosis of SIJ dysfunction.(2)Murakami
Fukushima (3) found that many times cervical strain will not release until the SIJ is corrected.”
References:
1. DonTigny, RL: A detailed and critical biomechanical analysis of the sacroiliac joints and relevant kinesiology: the implications for lumbopelvic function and dysfunction. In Vleeming A, Mooney V, Stoeckart R: Movement, Stability& Lumbopelvic Pain: Integration of Research and Therapy. 2nd edition. Edinburgh, Churchill Livingstone, 2007, Chapter 18, pp 265-278
2. Murakami E, Tanaka Y, Aizawa T, Ishizuka M, Kokubun S: Effect of periarticular and intraarticular lidocaine injections for sacroiliac joint pain: Prospective comparative study.J of Ortho Science 12(3):274-280, May 2007
3. Fukushima M: Radiographic findings before and after manual therapy for acute neck pain. International Musculoskeletal Medicine, 30(1): 1-19, 2008
The ligaments act like duct tape to hold our bones and joints together. When ligaments lose their elasticity the bones and joints move too much and irritate the structures around them. Ligaments provide boundaries for movement. For example when we bend our fingers backwards the ligaments will stop us from pushing them too far back and breaking the bones. It is this way with most of the joints in our bodies. The ligaments cause them to work within a safe range of motion. When one of the ligaments is torn or stretched, the excess movement will cause pain and swelling. In an injured joint and you may notice more popping, cracking or even a grinding feeling. The joint may have become unstable.
In the neck and spine, ligaments are crucial for holding vertebrae together. Spinal ligaments are especially vulnerable to overstretching or tears in a car wreck. If you experience these symptoms after a wreck you may want to be examined for a ligament injury:
• popping, cracking, or grinding in the neck with movement
• pain or spasms that get much worse with activity
• Numbness or tingling into the hand(s) or feet that gets worse with activity or accompanied by popping, cracking, or grinding.
Flexion-extension x-rays, or digital motion x-rays can be a good way to help diagnose ligament instability. A good physician will want to test the spine segment by segment to test for stability and this is an essential step for enabling accurate treatment. The diagram above shows some of the ways ligament pain is referred in the neck area. For referred pain in other body areas look at our dermatome pages
Treatment usually proceeds as follows:
• Specially trained medical practitioners such as Chiropractors or Osteopaths can mobilize any stiff segments that may be overloading the unstable segment
• Posture Training can improve stability, injury can increase tightening of muscle structures which can cause guarding of the painful area. This throws posture off balance and can aggravate instability.
• Strengthen any weak, deep supporting muscles (like multifidus) that may be allowing too much movement. Core strength exercise like modified Pilates with the guidance of a trained physiotherapist can be helpful
• Don’t be talked into mobilizing or manipulating an unstable segment as this can bring a temporary improvement but over time can make things worse. Sometimes bracing is used and while this may seem like a good solution to reduce pain initially prolonged bracing can cause further weakening of the surrounding muscles and later slow recovery.
• Prolotherapy may prove helpful, adult stem cell therapy using your own cells has been reasonably successful in initial trials.
• Surgical stabilization is sometimes used when no other treatment brings improvement.
Memory Can Be Disrupted By Trauma Get tested for free!
Sparks of Genius Brain Optimization Center to Hold Free Memory Screenings
National Event Stresses the Importance of Proper Detection and Treatment
Boca Raton, FL— Consumers who want a status check on their memory can take advantage of free, confidential screenings on November 17 as part of National Memory Screening Day, an annual initiative of the Alzheimer’s Foundation of America (AFA) designed to promote proper detection of memory problems and strategies for successful aging.
Memory screenings are a significant first step toward finding out if a person may have a memory problem. Memory problems could be caused by Alzheimer’s disease or other medical conditions.
Now in its seventh year, AFA’s National Memory Screening Day coincides with National Alzheimer’s Disease Awareness Month, which takes place during November.
On November 17, Sparks of Genius Brain Optimization Center will hold memory screenings at 7777 Glades Road, Boca Raton, from 10 am – 3 pm. Please call 561-859-4060 for more information or to make an appointment. You are also welcome to stop by. Refreshments will be provided.
At Sparks of Genius we offer cognitive training program which can slow down the progression of memory loss or delay it’s onset.
AFA suggests memory screenings for adults concerned about memory loss or experiencing warning signs of dementia; whose family and friends have noticed changes in them; or who believe they are at risk due to a family history of Alzheimer’s disease or a related illness. Screenings also are appropriate for those who do not have a concern right now, but who want to see how their memory is now and for future comparisons.
The event features a face-to-face screening, which takes only about five to ten minutes, and consists of a series of questions and tasks. Screenings will be conducted by Dr. Rohn Kessler, Dr. Amy Price and Ninah Kessler, LCSW. The results do not represent a diagnosis, and AFA advises those individuals with below-normal scores or those who have normal scores but are still concerned to follow up with a qualified healthcare professional.
Eric J. Hall, AFA’s president and CEO, is urging consumers “to be proactive about brain health.”
”We pay so much attention to the health of our bodies, but we should be equally concerned about the health of our brains,” he said. “National Memory Screening Day offers the opportunity to find out how your memory is now and to learn how to protect it in the future.”
Radio Frequency Ablation (Denver Pain Management ,2009)
Radiofrequency (RF) and pulsed radiofrequency (PRF) neurolysis are techniques used to treat chronic pain that is transmitted through the sensory nerves. RF neurolysis utilizes heat to destroy selected nerve fibers, which block pain transmission through the neural pathway. These techniques are used when intermittent anesthetic injections no longer provide extended pain relief.
Chronic cervical, lumbar and sacral pain can come from your facet joints. These pain signals can be interrupted by blocking the nerve to the facet joint with an anesthetic injection this is very temporary (facet block), For longer lasting relief the nerve can be heated using a radiofrequency wave (radiofrequency ablation) . This can often prevent the neural transmission of pain. The nerve to the facet joint is sometimes referred to as the “medial branch” and therefore a facet nerve block is also referred to as “medial branch” block. These blocks are performed as a part of a diagnostic workup for back or neck pain. Relief following a precise injection of local anesthetic confirms the facet joint as the source of pain.
Radiofrequency neurolysis is a procedure in which sensory afferent nerve fibers are selectively destroyed with heat produced by radio waves delivered through an electrode. Treatment objectives are to eliminate pain, reduce the likelihood of recurrence and prolong the time to recurrence by selectively destroying pain fibers without inducing excessive sensory loss, motor dysfunction, or other complications. Radiofrequency (RF) neurolysis carries the potential risk of neuritis (nerve inflammation). Histological studies have revealed indiscriminate destruction of both small and large fibers following RF treatment.
Pulsed radiofrequency is thought to be a less destructive alternative to standard RF in that it applies RF energy with a pulsed time cycle that delivers short bursts of RF current instead of a continuous RF flow. By pulsing the electrical current, the needle remains relatively cool (up to 42 degrees celsius compared to temperatures of 60-69 degrees celsius with continuous RF) so that the tissue cools slightly between each burst, reducing the risk of destroying nearby tissue and preventing any long-term damage to the nerve. The reasoning behind this is transmission of impulses across small unmyelinated fibers is disrupted while larger fibers remain protected by the myelin sheath.
Some researchers show short term success with pulsed radio frequency in comparison to radio frequency lesioning. However others are reporting success rate of over nineteen months. It would seem that results could be altered by the skill of the spine care practitioner it is crucial to choose carefully.
You have been sent to a specialist…what next? First of all sort out what you expect to happen as a result of this visit. What are your goals? Make sure they are realistic. If this was easy your primary care doctor could probably fix it.
Before your visit explain what records you have and ask which of these they would like you to copy and pre-send. Usually you can get copies of MRIs or other diagnostic tests on CD. They are easier to carry with you or send than bulky films. If you choose to send your diagnostic results and films call and confirm they arrived. Get a cost for a cash price unless you have medical insurance which will cover your visit so that you will know your costs and if you can absorb them.
If you are making a distance appointment insist on a phone consultation so you will know if your expectations are viable. If the staff you speak with don’t have information about a certain area make arrangements to call back when it is available. This way all the preliminary material is out of the way and your appt can focus on what is most important. Explain you are travelling from out of town and are in pain and request the best time of day to be seen promptly. Emergencies or office back ups can still happen but this step minimizes the possibility.
Write down what you consider to be the most important things you want covered in your visit. You may want to refer to a dermatome map The reason you may want to do this is because chronic pain and injury can cause us to be sidetracked by emotion. You may get a compassionate response but it may eat away at the time available.
This is the place to get your MRI and other diagnostic tests explained. The doctor that ordered the test is the one who needs to explain it. Get an advance copy of the report and ask about what you don’t understand. We get emails every day from people who want us to translate the MRI or other diagnostics. We cannot do this because the MRI is only part of the equipment needed for a diagnosis. It is your job to make sure you understand your diagnosis before you leave the doctor’s office. Here are more practical tips on making the most out of the doctor’s appointment
It is helpful to plan a nice dinner out or a treat for yourself for afterwards and if you can, take someone with you who will remember what the Doctor says. The reason for this is it will be difficult for you to reconcile yourself to a 40 minute appt when the injury has taken over your life 24/7. Even though your appointment time may be quite generous, logic and rational thought cannot always be counted on, when you just want it fixed.
Now relax and trust the specialist you have chosen!
DIGITAL MOTION X-RAY® is a diagnostic test that records real time, full motion x-ray imaging of any body joint in motion. DMX® can often unlock the mystery of spinal pain. It is common knowledge among spinal care professionals including surgeons that damage to ligaments, tendons and underlying support structures can not be corrected with surgery or physiotherapy alone. Until now it has been difficult to diagnose these injuries objectively. Serious ligamentous and facet joint injuries are well documented at autopsy however this is not a working solution for live patients in need of care! Should you ask your doctor to order a DMX® exam for you?…. To find out ask yourself these questions:
• Do I have pain in one or more of my joints that increases with motion?
• Did I injure myself with a sudden jolt to one or more of my joints, as a whiplash injury, slip and fall or blow from a sporting activity?
• Do I have joint pain, the cause of which has not been determined by conventional x-ray, MRI or other diagnostic tests?
If you have answered yes to any of the above, consider a DMX® examination.
Stretched and torn ligaments can result in a condition called “kinesiopathology” or abnormal motion of the bones that make up the joint. This abnormal motion results in ongoing rubbing and grinding of the bone surfaces during motion, preventing normal healing, and leading to premature onset of degenerative joint disease, a wear and tear type of arthritis. DMX® can fully evaluate internal joint motion, and properly screen for kinesiopathology
What Makes DMX® unique?
Good question! Auto accident injuries occur in milliseconds, too quick for the human nervous system to react and protect. This leaves only bones and ligaments to protect the body. Since cervical bones are rarely broken, the connective tissues are most commonly injured.
The Hidden Culprit – Ligaments
Ligaments are connective tissue that attach bone to bone. The purpose of ligaments is to keep bones in proper position, and work similar to hinges on a door. It has been suspected that ligaments are damaged easily, but until now, it has been difficult to diagnose ligamentous injuries. DMX® can demonstrate these injuries in as little as 15 minutes.
DMX® visually demonstrates aberrant movement of bones, allowing the radiologist to specifically determine which ligaments are injured. Treatment can then be tailored to the patient’s need and progress can be assessed with the help of DMX®. Promising solutions for tissue regeneration are currently in development at the Spinal Injury Foundation.
With the help of DMX® these injuries can be seen from the inside out
A perfect egg sample
Common sense will tell you that one cannot determine the injury an accident victim has suffered by merely looking at the outer shell of the car. When we buy eggs, how often do we open the carton to check if the eggs on the inside are broken? Every time!
Experience teaches that we cannot determine the condition of the egg by looking at the container. The same holds true for a person’s body – the evidence is in the person’s body, not the car.
Although high TESLA MRIs can pick up ligament damage they are sometimes less available that DMX. For information on MRIs see this link
Cervical spine showing nerve compression from Wikipedia 2009
Anterior cervical diskectomy is an operation performed on the upper spine (neck) to relieve pressure on one or more nerve roots, or on the spinal cord. The procedure is explained by the words anterior (front), cervical (neck), and diskectomy (cutting out the disc).
ACD is a surgery used as neck and arm pain, among other symptoms, may occur when an intervertebral disc herniates. This happens, either suddenly with injury or slowly over time, when some of the disc’s jelly-like center (the nucleus pulposus) bulges or ruptures through its tough, fibrous outer ring (the annulus fibrosus) and presses on a nerve. When a disc ruptures in the cervical spine, it puts pressure on one or more nerve roots (often called nerve root compression) or on the spinal cord. This pressure causes symptoms in the neck, arms, and even legs. Further pressure may be caused by rough edges of bone, called bone spurs, that naturally build up around some herniated discs. If at all possible it is best to not have this done unless it is pressing on a nerve or the spinal cord, if it is a surgeon will often advise the surgery to avoid further damage to the nerve or spinal cord.
In this operation, the cervical spine is reached through a small incision in the front of your neck. After the soft tissues of the neck are separated, the intervertebral disc and bone spurs are removed. The space left between the vertebrae may be left open or filled with a small piece of bone. In time the vertebrae may fuse, or join together.
If used, the pre-formed bone graft may be obtained from a bone bank. It will not be rejected by your body, because it is avascular (contains no blood cells) or artificial bone protien can be used. In some circumstances, or if your surgeon prefers, the bone graft might instead be removed from your own hip through a second incision.
Anterior cervical diskectomy is not the only solution. A minimally invasive surgery can be done which leaves almost no scar. This link will lead to where you can see a four minute movie of the procedureThe results are best with single level sugery. There are also procedures which are used to patch tears. Autologous stem cell therapy (using your own stem cells) and platelet rich plasma or PRP can be used to fix tears which can be a major source of pain because of the leakage of fluid which irritates the surrounding tissue.
Some people have artificial disks inserted , rather than a diskectomy or fusion. A great place to get information on this option is the ADR support community
People who have sustained head or serious neck injuries can also damage the thyroid as well. Sometimes people who are diagnosed with whiplash later develop thyroid issues. Many of the symptoms of hypothyroid are the same as those as those for people who have dealt with a brain injury so they tend to be ignored. This is tragic because low thyroid levels can eventually lead to cognitive damage and even dementia. The thyroid can be damaged even if you are thin. It is not always true that people gain massive amounts of weight with this kind of condition just as it is not true that people with a past brain injury need to be constantly exhausted or depressed. The video above will tell you about symptoms and what you can do about this disorder
Your thyroid gland weighs less than an ounce and is located in the front of your neck just below the Adam’s apple. The thyroid acts as a feedback mechanism for your metabolism so when it is too slow or too fast this can upset a lot of body functions The thyroid gland takes iodine and converts it into thyroid hormones. Thyroid cells are the only cells in the body which can absorb iodine. These cells combine iodine and the amino acid tyrosine to make T3 and T4. T3 and T4 are then released into the blood stream and are transported throughout the body where they control metabolism (conversion of oxygen and calories to energy). Every cell in the body depends upon thyroid hormones for regulation of their metabolism.
Get this checked by your doctor. It takes a simple blood test and oral medication. This disorder can show up years after an injury so be aware.
Symptoms of a slow thryroid include
•Fatigue, Depression
•Weight gain or increased difficulty losing weight, or loss of appetite
•Coarse, dry hair, thinning hair or outer portion of eybrows thinning out
•Dry, rough pale skin,
•Cold and heat intolerance (you can’t tolerate cold temperatures like those around you)
•Muscle cramps and frequent muscle aches, weakness
•Constipation
•Depression, Irritability
•Memory loss, lack of focus, reduced coordination
•Abnormal menstrual cycles, decreased interest in sex
There have been multiple articles featuring brain and serious neck injury stating how people have overcome cognitive obstacles despite adversity. I celebrate these articles as I know from personal experience the tolls that this road takes and the cost to family members and supporters. One mother was explaining how one minute her brain injured son could do complex algebra and the next he could not tell a red diamond from a black spade in a deck of cards. I too remember those days.
The cognitive inconsistencies are joined by emotional areas. Sometimes the brain will forget what we want it to remember and play over and over like a broken tape those areas we only want to put behind us. The other day I found some practical help in the way of videos and research on how to navigate the initial trauma. These outline what to expect in the emergency room, how to protect yourself in the event of a crash and ways you can help yourself get the best medical care. I thought I would share them here. If you go to the web site you can download the material as MP3 or as PDF files. This is a brilliant solution as watching a video makes it tough to pick up the references which are the key to deeper study…Enjoy!
In the next few posts there will be strategies for overcoming brain fog and getting the sharp mental edge back
When Volvo first introduced their WHIPS anti-whiplash seat, few auto manufacturers showed much interest in following suit. After all, air bags were just becoming standard in most cars, was this taking this protection thing a bit far?
A news report published today tells us that this attitude is no longer acceptable in the automotive industry. A Hyundai with an anti-whiplash seat? Now that Volvo, Toyota, GM, Saab, BMW, and Mercedes have them, why not? The Insurance Institute for Highway Safety has confirmed that most of these new seat designs do reduce neck injury rates. In addition, they have begun testing seats with a newer dynamic technique and reporting the results of the tests.
This may be what has motivated Hyundai and others to invest in this important technology. It is no longer enough to have only good frontal and side impact rating; in the future seat design may be a deciding factor in consumer auto purchases.How do these seats work? Whiplash is not a whip or a lash, but rather an injury caused by the seat back being pushed forward while the head lags behind (at least in rear impact collisions, the most frequent cause of injury in crashes). This mechanism causes shear, compression, and other potentially damaging forces on the neck joints and ligaments. In addition, this unique movement momentarily increases the pressure in the fluid around the spinal cord. This new breed of anti whiplash seats all do the same thing, more or less; they reduce (not eliminate) the potentially damaging forces between the head and the torso. Some of the seats do this by allowing the torso to recline slightly at the same time as the head, so that the two stay in better alignment during a rear impact.
Other systems deploy a head restraint forward so that the head cannot move backwards relative to the torso. Neither system is perfect; injury frequency is typically reduced but not eliminated.So, could there be an anti-whiplash seat in every garage in the future? This is a distinct possibility, particularly if government auto manufacturing safety regulations change to include a seat safety standard. It is nice to see that car manufacturers (spurred on by our friends at the Insurance Institute for Highway Safety) are realizing that the best way to reduce whiplash injuries is to prevent them from happening.Christopher J. Centeno, M.D.Michael D Freeman PhD DC MPH
