Achilles Tendinopathy

Why You Should Avoid Refined Sugars: A Wellness-Based Perspective

Osteoarthritis is the most common form of arthritis, affecting millions of people worldwide. It occurs when the protective cartilage that cushions the ends of the bones wears down over time. Studies now show that this may be prevented or even reversed with weight loss! It is estimated that a force of three to six times one’s body weight is exerted across the knee while walking. This means that a person who is only 10lbs overweight can increase the force across their knee joint by 30-60lbs with each step! 1 In fact, in one study it was found that obese women had 4 times the risk of knee osteoarthritis compared with non-obese women. For obese men the risk was nearly 5 times greater! 2 It makes sense that the more pressure you put on a joint the more likely that joint is going to develop arthritis, but the story goes deeper. Being overweight has also been associated with higher rates of hand osteoarthritis suggesting a second factor in overweight individuals as well. 3 Studies show that engorged fat cells increase the release of pro-inflammatory chemicals which may cause increased inflammation arthritis in joints all over the body, not just those that are weight bearing. People who are overweight experience more joint pain than those with a normal weight. But there is hope. If obesity increases the development and progression of systemic joint osteoarthritis can losing does weight reverse the effects? One study noted that in “overweight” women (BMI greater than or equal to 25) there was a significantly lower risk of osteoarthritis when these women lost weight. 4 They concluded that for every 11lbs of weight loss, the risk of knee osteoarthritis decreased by over 50%! Weight loss substantially reduced reports of overall pain as well. You may not have to live the rest of your life with knee and joint pain. A safe and effective weight loss program will help you to stop the progression or even eliminate your joint pain all together. 1 Felson DT: Weight and osteoarthritis. J.Rheumatol. 1995;43:7-9. 2 Anderson J, Felson DT: Factors associated with osteoarthritis of the knee in the First National Health and Nutrition Examination (HANES I). 3 Carman WJ, Sowers M, Hawthorne VM, Weissfeld LA: Obesity as a risk factor for osteoarthritis of the hand and wrist: a prospective study. 4 Felson DT, Zhang Y, Hannan MT, et al: Risk factors for incident radiographic

How Chronic Neck Pain Affects Balance, Reaction Time & Strength

Are you an athlete, fitness enthusiast, or someone struggling with chronic pain or mobility issues? In Atlantic County, NJ, sports chiropractic care is revolutionizing how individuals recover from injuries and enhance their performance.

Written by Charlie Annunziata, DC Low back pain (LBP) is the second most common symptom-related reason for clinician visits in the United States (skin disorders was number one) and is THE most common indication for Chiropractic care. In fact, up to 84% of the US population has been found to report LBP symptoms at some point during their lifetime. However, the etiology of LBP is not well understood considering the evidence that people without LBP have structural changes and many LBP patients have no structural changes on imaging studies of the lumbar spine. Long and colleagues performed a standardized mechanical assessment on 312 patients with LBP, with and without sciatica. They were able to successfully subgroup 230 (74%) of these patients, however 26% of the patients did not fit into a subgroup (Long A, 2004). So, the question remains: how do health care providers best assess people with LBP in order to develop a specific and successful treatment recommendation? Might we look beyond the spinal column for the source of, or contributor to, pain and loss of function? Research now shows that limited hip internal rotation can significantly contribute to low back pain. This may be caused by hip joint variants but more commonly by trauma causing adhesion of the hip joint capsule or even prolonged sitting which over activates the hip flexors and abductors and under activates the hip extensors and adductors. This article explores the relationship between hip mobility and lower back health, highlighting how restricted hip internal rotation can lead to various issues in the lumbar spine. Biomechanics Hip internal rotation plays a crucial role in normal gait, balance, and functional movement. When this range of motion becomes restricted, it forces compensation in other parts of the body, particularly the lumbar spine (Sadhegisani, 2015). This compensation can lead to several problems: Lumbar Over-rotation: Reduced hip mobility causes the lumbar spine to over-rotate during everyday movements, increasing pressure on intervertebral discs, muscles, and ligaments. Pelvic Dysfunction: Limited internal rotation, especially when asymmetrical, can cause pelvic imbalances that pull the lower spine into abnormal positions. Altered Biomechanics: The lack of hip internal rotation changes overall movement patterns, altering the natural biomechanics of the spine and pelvis. What Does the Research Say? The correlation between limited hip internal rotation and low back pain is elucidated in many recent studies. Sadhegisani reported that asymmetrical and limited hip internal rotation ROM were common findings in patients with LBP. Reduced and asymmetrical total hip rotation was also observed in patients with LBP. However, none of the studies explicitly reported limited hip external rotation ROM. Proving that not all hip rotation ROM affects low back pain, just internal rotation. Ellison et al. reported that deficits in hip internal rotation are related to both LBP and sacroiliac joint pain (JB, 1990). Another study found that patients with low back pain and positive hip findings such as a positive anterior hip impingement test, FABER test, and/or log-roll test, have more pain and worse function compared to those without positive hip findings. Research has also demonstrated that a loss of hip internal rotation can prevent the pelvis from rotating properly over the stance limb during gait, affecting the coupling mechanics of the sacrum and lumbar spine (Yoon, 2024). What Causes Hip-related Low Back Pain? The development of low back pain due to limited hip internal rotation can occur through several mechanisms such as compensatory spinal motion, pelvic and lumbar muscle imbalances, and repetitive stress syndrome (Sadhegisani, 2015). When hip rotation is limited, the spine may compensate by rotating, extending, or flexing more than it should. Restricted hip mobility can lead to muscle imbalances through overactivity and tightness related muscles such as the piriformis, potentially compressing the sciatic nerve. Repetitive stress injuries also come into play. Even small amounts of repeated rotation in the spine, compensating for lack of hip mobility, can produce microscopic injuries to spinal structures over time. How to Make the Diagnosis Limitations in hip internal rotation can be diagnosed through several assessments such as: Seated Test: The patient sits on the edge of a treatment table with feet dangling, knees and hips flexed to 90 degrees. They are asked to keep their knees together while moving their ankles apart. The Chiropractor may apply overpressure to add a passive component. Prone Test: With knees together and flexed to 90 degrees, the ankles are allowed to fall apart. Overpressure can be applied for a passive component. Gait Observation: While assessing gait you may notice movement compensations such as overpronation of feet, knee valgus, reduced step length, external rotation of the foot during stance phase, increased lumbar and knee extension.

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If you're unsure which therapy is best for your specific condition, don’t hesitate to reach out to our office. We’re here to help guide you toward the most effective treatment for your pain.

The Snowball Effect of a Weak Hip Abductor Muscle Written by Charlie Annunziata , DC What is your hip abductor and why is it so important when you have pain or dysfunction in your lower back and legs? Think of your hip abductor as a side butt muscle. When it's weak, it can cause a domino effect of problems, such as pain in the low back, knee, hip and even as far down as the foot because of how crucial this muscle is in stabilizing the pelvis and controlling leg movement. Recent research has shown that about 70% of low back pain patients have hip abductor weakness. How It Impacts Different Body Parts Wobbly Hips : This muscle helps keep your hips stable. When it's weak, your hips can become wobbly, especially when you're standing on one leg (like when you walk). This wobbliness can stress your lower back. Low Back Pain: A weak hip abductor can result in increased arch in your lower back and subsequent intervertebral disc compression. It may also cause the body to compensate by relying on other muscles to work overtime. When your side butt muscle is slacking, other muscles must pick up the slack. One muscle in your lower back (called the QL) often works extra hard, which can make your back stiff and painful. Knee Pain: A weak hip abductor muscle can cause the knee to rotate inward, causing the patella to rub against the femur which is known as patellofemoral pain syndrome or runner's knee. This inward rotation creates an imbalance during walking or running, potentially causing lateral meniscus problems and patellar tracking issues. Hip Pain: The most prominent symptoms of a weak hip abductor are hip pain and stiffness. This will cause a muscle on the front of the hip called the TFL to work too hard leading to a forward tilt of the pelvis and pain on the side of your thigh called iliotibial (IT) band syndrome. Foot Pain: As discussed previously, weakness in the hip abductor causes the leg to rotate inward, placing abnormal strain on the foot and causes the arch in the foot to drop. This can lead to pain in the bottom of the foot that does not seem to go away, a condition known as plantar fasciitis. Additional Consequences: A weak hip abductor can also decrease stability and balance which can lead to falls, and abnormal walking patterns which can increase the risk of hip, knee, and foot injuries.  How do we fix this? It is important to understand that strengthening these abductor muscles will prevent or alleviate most of these conditions, improve overall lower body function and reduce pain. First, we diagnose if your pain is caused by a weak hip abductor muscle through specific tests and then determine what is causing the muscle weakness. We then use treatments such as Active Release Technique, pelvic balancing and targeted exercises and stretches designed for you as a unique patient to get the abductor muscle nice and strong. So, let’s say you have been shoveling snow. Every time you lift the snow-weighted shovel and rotate your lower body you are contracting your hip abductor muscle. If that muscle is weak, your body will compensate and cause a “snowball” (pun intended) effect of your hip raising up causing compression and pain in your lower back, your knee rotating inward putting pressure on the inside of your knee as well as causing your knee cap to rub against your femur bone, and the arch in your foot to collapse causing plantar fascia pain. Don't let muscle weakness hold you back from living your best life. Our experienced team of physicians use advanced diagnostic techniques to pinpoint the root cause of your discomfort, providing personalized treatment plans tailored to your unique needs. Whether you're an athlete, active professional, or simply seeking improved mobility, we are committed to getting you back to feeling strong and confident.

Lumbar Spine Facet Joints Karishma Patel, DC Facet Joints are one of many sources of lower back pain. If you have localized lower back pain with the pain starting from 30degrees to 60degrees of lumbar flexion, it may be due to facet joints. What are facet joints? Facet joints link the top and bottom vertebra together. They also allow you to bend forward, extend backward, and assist you in side-to-side movement. Patients who constantly bending over with a weighted load in front of them usually have facet joint hypertrophy, degeneration, and arthritis. For example: Gardeners, Police Officers, Construction Workers, Cyclists, Weight Lifters, etc. Why does this happen? Even though your facet joints help your spine move, they are not supposed to do majority of the work. Your core stabilizing muscles, including your glutes and diaphragm (yes, this also means breathing techniques) are supposed to assist you in movement. If these muscles are inactive, your facet joints are over worked causing a lot of localized, across the back, lower back pain. Get your movement assessed to see which muscle groups are inactive causing you to have a deeper issue. Call to make an appointment today!