Extremity Injuries

Hand and Wrist complaints

Hand Pain

Having your problem checked by a Chiropractor here at our clinic in Omagh will help you understand why the hand pain has come on in the first place and what the best options are as to how to manage it. Chiropractors are most well known for their treatment of the spine, what is less well known is that they also have extensive training in the diagnosis and treatment of extremity muscle, joint and nerve injuries including most of the common causes of hand pain.

Hand pain symptoms

• Swelling
• Redness
• Popping, clunking, clicking, stiffness
• Pain at the joints of the fingers
• Weak and Tired Muscles
• Arm and shoulder Pain
• Tingling, Pins and Needles
• Wrist Pain
• Neck Pain and Stiffness

What to do if you have hand pain

Apply an Ice pack to the region regularly. The Chiropractor at the OmaghChiropractic Clinic will be able to diagnose, treat and advise you on your hand pain. Their aim is to get your hands functioning as best possible as soon as possible using manipulation, soft tissue techniques and a variety of progressed home and in clinic exercises and rehab plans. If the problem is not deemed treatable by a Chiropractor (such as with some systemic conditions), then we will refer you to another appropriate specialist

Wrist Pain

Wrist pain is something that can occur for multiple reasons, a few of which are sports (e.g wrist sprain), overuse (e.g Repetitive strain injury, RSI), systemic conditions (e.g Rheumatoid Arthritis) and trauma. The Chiropractor at our clinic here in Omagh will be able to determine the cause of wrist pain. A Chiropractor’s knowledge of the body is very extensivee, they have in depth training in the causes of many problems that affect the muscles, bones and nerves of the whole body, not just the spine.

If the Chiropractor finds that they cannot treat the cause of your wrist pain, they will refer you as appropriate to another local recommended specialist. When a wrist pain problem is treatable, the Chiropractor will explain the reason for the pain, what they can do to help, provide a home treatment and exercise plan, and also and ergonomic advice as necessary.

Common symptoms experienced with wrist pain:

• Stiff wrists and finger joints
• Hand pain
• Weak and tired muscles
• Arm and shoulder pain
• Temperature changes
• Numbness, tingling and pins and needles in the hand
• Neck pain and stiffness
• Swelling
• Redness

What to do if you Have Wrist pain

If you know what the cause of wrist pain is, then try applying an ice pack to the region regularly . If you do not know the cause and an ice pack has not worked, we would recommend seeing a Chiropractor at our clinic here in Omagh to see exactly what is going on at your wrist and to discuss what the best options are for you to get better.

The Chiropractor at the OmaghChiropractic Clinic will be able to diagnose, treat and advise you on your problem. Their aim is to get your wrist functioning as best possible as soon as possible using manipulation, soft tissue techniques and a variety of progressed home and in clinic exercises, home advice and rehab plans.

Carpal tunnel syndrome

Carpal tunnel syndrome (CTS) is a common entrapment neuropathy-meaning a common condition where a nerve is trapped somewhere along its course. It is characterized by pain, numbness and/or tingling felt in the wrist and hand (specifically the palm side of the hand into the thumb and fingers-but not the little finger) or radiating pain up into the arm. The pain may become increased when the wrist is flexed or bent. The cause of this discomfort is irritation or damage to the median nerve. Along its course to the hand, the median nerve passes through a narrow and rigid tunnel (called the carpal tunnel) made of bone and ligament. Overuse of the wrist (as in sewing, playing piano, or repetitive activity) or injury to this tunnel may result in damage or irritation to the median nerve producing carpal tunnel syndrome. Carpal tunnel is also common in pregnancy due to fluid retention and hormonal changes. The median nerve may be compressed or entrapped anywhere along its path; you may be interested to know that there are 7 locations (in addition to the carpal tunnel) where the median nerve could be compressed. For this reason, it is important to establish the location of entrapment before treatment (especially if you are considering surgery).

How is Carpal tunnel syndrome Diagnosed?

In order to prevent permanent damage to the median nerve early diagnosis is essential.

The first (and perhaps most important) step is a thorough history and physical exam of the neck, shoulder, forearm, wrist and hand. Your chiropractors will also perform specific orthopedic and neurological tests that are effective in establishing a diagnosis. In order to confirm the diagnosis of CTS, a nerve conduction study may be performed. Other tests may include diagnostic your chiropractor might order include ultrasound and MRI.

What are the options for treating Carpal tunnel syndrome?

Carpal tunnel syndrome is commonly treated at Omagh Chiropractic. Our chiropractor offers treatment strategies that consist of manual therapy, therapeutic (stretching/strengthening) exercise, chiropractic manipulation and ergonomic assessment/advice. While at home, RICE (rest, ice, compression, elevation) is helpful. Also, your chiropractor may recommend a wrist brace to wear at night. Other conservative methods that are not provided at Omagh Chiropractic (but may be worth trying) are acupuncture and yoga.  The most invasive, last resort for pain resulting from carpal tunnel syndrome is surgery. Even when surgery goes well (it is estimated that about 60% of surgeries result in full recovery), symptoms may return within two years. Complications from surgery include scarring, infection, pain, stiffness, loss of motion, and nerve damage. That being said, if you are suffering from CTS, explore conservative options first. So many patients have experienced the lasting benefits of the treatments provided at Omagh Chiropractic. We want you to join them-It’s your turn to experience relief!!

References

1. Bilecenoglu B, Uz A, Karalezli N. Possible anatomic structures causing entrapment neuropathies of the median nerve: an anatomic study. Acta Orthop Belg. 2005 Apr;71(2):169-76. Review.
2. Burke J, Buchberger DJ, Carey-Loghmani MT, Dougherty PE, Greco DS, Dishman JD. A pilot study comparing two manual therapy interventions for carpal tunnel syndrome. J Manipulative Physiol Ther. 2007 Jan;30(1):50-61.
3. Brininger TL, Rogers JC, Holm MB, Baker NA, Li ZM, Goitz RJ. Efficacy of a fabricated customized splint and tendon and nerve gliding exercises for the treatment of carpal tunnel syndrome: a randomized controlled trial. Arch Phys Med Rehabil. 2007 Nov;88(11):1429-35.
4. Piazzini DB, Aprile I, Ferrara PE, Bertolini C, Tonali P, Maggi L, Rabini A, Piantelli S, Padua L. A systematic review of conservative treatment of carpal tunnel syndrome. Clin Rehabil. 2007 Apr;21(4):299-314. Review.
5. Napadow V, Liu J, Li M, Kettner N, Ryan A, Kwong KK, Hui KK, Audette JF. Somatosensory cortical plasticity in carpal tunnel syndrome treated by acupuncture. Hum Brain Mapp. 2007 Mar;28(3):159-71.
Shoulder and Elbow pain

Shoulder pain

Shoulder pain is a very common problem, the cause of which is usually due to poor movement throughout various positions. If the arm and shoulder blade are not moving perfectly, then with repetitive motions over time, pain and discomfort can occur.

The shoulder is prone to injuries as it is a very loose joint and is only connected to the spine by one small true joint (The Streno-clavicular joint), the rest of the shoulder is held in position by musculature. This means that an imbalance in the musculature can lead to a variety of different types of injury at this complex joint. The neck is often a cause of discomfort in this region and is one of the key parts of treating a shoulder injury as a lot of the muscles holding it in place originate at the neck. a group of muscles commonly associated to this complex region of the body is known as the ‘rotator cuff’, these four muscles are crucial in the rehabilitation of a shoulder injury and the Chiropractor in our clinic in Omagh will explain the role of these muscles, and the neck, in relation to the rest of the muscles and joints that make up this very complex, but brilliant, joint.

Symptoms associated with shoulder pain

• Neck Pain and Stiffness
• Headaches
• Arm Pain
• Weak and Tired Muscles
• Clicking
• Tingling and Pins and Needles
• Popping
• Grinding
• Fatigue and Tiredness

What to do if you have shoulder pain

Shoulder pain can be helped with the use of ice. Of all the joints in the body this joint is the most reliant on correct function as slight imbalances can lead to long term problems. The treatment of this region is often very complex and the Chiropractor at our Omagh clinic has all the tools to be able to diagnose, treat and rehabilitate your injury back to function. Our Chiropractor is always up to date with the latest techniques and literature as they are focused on their own continued professional development.

Frozen Shoulder (Adhesive capsulitis)

“Our hands-on treatment methods can remove adhesions associated with frozen shoulder.”

-Dermot Gillan (Chiropractor)

What is Frozen Shoulder?

Frozen Shoulder occurs when adhesions develop in the joint capsule of the shoulder; the medical term used to describe frozen shoulder is adhesive capsulitis. The condition is characterized by three stages: pain stage, frozen/stiff stage, and the thawing stage. Pain may develop as a result of a surgery, trauma or illness, or it may appear without cause; if you are suffering from this condition, you may notice pain that is often described as an ache in the shoulder joint which becomes worse at night. Over time, stiffness develops; you may be unable to lift your arm to the side or overhead. Activities that demand unrestricted shoulder motion may become increasingly difficult. Over time and with the appropriate management, the pain and stiffness associated with frozen shoulder should begin to thaw. Although researchers are unable to determine the exact cause of the condition, certain individuals (women, over the age of 40, injury to the arm that requires immobilization of the shoulder, diabetes, autoimmune diseases, and thyroid problems) are more prone to developing it. Although it is generally only seen in one shoulder, in certain cases, both shoulders area affected. If early interventions are instituted, you may be able to reduce the duration and severity of the condition; if you suspect that you have frozen shoulder, contact your chiropractor.

How is frozen shoulder diagnosed?

Frozen shoulder is generally diagnosed by detailed history and physical exam. Your chiropractor will ask you questions like what makes it worse, what makes it better, how/when it began, and what it feels like. Next, an exam will be performed; your chiropractor will palpate (examine by touch) the anatomical structures of the shoulder. He/she will then assess the shoulder’s motion and perform specific orthopedic tests. Occasionally imaging will be ordered to rule out other conditions; however, frozen shoulder cannot be seen on an x-ray or MRI.

What are the options for treating frozen shoulder?

Frozen shoulder is commonly evaluated and successfully treated at Omagh Chiropractic. In many cases, conservative management is successful and most people who suffer from frozen shoulder will not require invasive treatments like surgery. The chiropractor at Omagh Chiropractic will develop a treatment plan that will work for you. Joint manipulation and manual, therapeutic strengthening/stretching exercises. Looking for a drug, injection and surgery-free way to thaw that frozen shoulder?  The chiropractor Omagh Chiropractic may be the alternative you have been looking for.

References

1. Diagnosis and management of adhesive capsulitis. Manske RC, Prohaska D.Curr Rev Musculoskelet Med. 2008 Dec;1(3-4):180-9. A rational management of tennis elbow. Kamien M. Sports Med. 1990 Mar;9(3):173-91. Review.
2. Comparison of the early response to two methods of rehabilitation in adhesive capsulitis. Guler-Uysal F, Kozanoglu E. Swiss Med Wkly. 2004 Jun 12;134(23-24):353-8.

Elbow pain

Elbow pain can arise for a variety of reasons, whether from traumatic events during sporting activity or following a fall or from overuse such as with Tennis Elbow, Golfers elbow or Repetitive Strain Injuries (RSI).

The Elbow appears like it is a very simple hinge joint, though as with most things in the body it is important to understand that there is more to this joint then what it seems. Without the special joints within your elbow, not only would you not be able to bend your arm, you would not be able to twist your wrist as much as you do. The elbow is a very clever joint in the way that is constructed to allow both flexion, extension and rotation as well as being able to transmit great forces into the upper extremity when fully straightened out and under force.

Common Causes of elbow pain

Tennis elbow is considered one of the more common elbow conditions .This condition occurs as a result of repeated flexion and extension activities, most commonly associated, but not limited to, sports. Hence the name ‘Tennis Elbow’ as it is very common in tennis players as they tend to flex and extend their wrists to apply an element of spin and therefore control to their shots. Another condition on the other side of the elbow joint is known as Golfer’s Elbow, this condition again is due to repeated flexion and extension except that it affects the flexor compartment of muscles whereas Tennis elbow affects the extensor compartment. Both these conditions are as a result of micro tears occurring where the muscles are originating, this leads to a low level of inflammation being present at this region which becomes irritating and persistent. Our Chiropractor in Omagh has all the treatment techniques required to deal with this condition and can even advise you with some self help tips and exercises for at home. Our aim is to get you back to work or playing sport as soon as possible.

Symptoms of elbow pain

• Arm, Hand or Shoulder Pain
• Neck Pain
• Weak and Tired Muscles
• Clicking
• Creaking
• Tightness and Stiffness
• Tingling and Pins and Needles
• Popping
• Grinding
• Fatigue and Tiredness

What to do if you have elbow pain

Applying an ice pack regularly and making sure your keep the joint moving are just a few simple basic strategies to help with very simple elbow problems. There are many other conditions that can affect the elbow joint and our Chiropractor is well trained in the diagnosis and treatment of this area. If you have any questions at all or would like to make a booking to consult our Chiropractor please call 028 8225 9181

What are the options for treating Tennis elbow pain?

Tennis elbow is commonly evaluated and successfully treated at Omagh Chiropractic. In most cases, conservative management is successful and most people who suffer from tennis elbow will not require invasive treatments like surgery. The chiropractor at Omagh Chiropractic will develop a treatment plan that will work for you. Joint manipulation and manual therapy, bracing, ice massage, therapeutic strengthening/stretching exercises, and rest are often included in that plan.

References

1. Manipulation of the wrist for management of lateral epicondylitis: a randomized pilot study. Struijs PA, Damen PJ, Bakker EW, Blankevoort L, Assendelft WJ, van Dijk CN. Phys Ther. 2003 Jul;83(7):608-16..
2. A rational management of tennis elbow. Kamien M. Sports Med. 1990 Mar;9(3):173-91. Review.

Hip & Knee Pain

Hip Pain

Hip Pain is a common problem that the Chiropractor sees here in our Omagh clinic.  There are various causes of hip pain, some of which you may find surprising.  Age is a big guide when deciding the cause of hip pain and various conditions can occur at each age, The Chiropractor in our clinic will be able to explain your diagnosis and why you hip pain has occurred in the first place.  Hip pain is usually quite a straight forward problem to treat as the hip is a very stable joint (unlike the shoulder). Different sports and/or work activities can lead to different causes of hip pain

Hip Pain Symptoms

Symptoms you may experience are often sharp or dull pain in the hip region and/or the groin region or radiating to or from the hip and/or groin. Associated symptoms may include an inability to bear weight on the hip, loss of movement in one or more directions, clicking, clunking or snapping with or without associated pain, swelling, tingling, numbness, and pins and needles. The hip can often refer pain to the knee, causing knee pain like symptoms and is more common than you would think. The lower back can also refer pain to the hip.  Problems such as disc bulges and trigger points in the lower back are just two problems that may be causing your hip pain.

What to do if you have Hip Pain

Applying an Ice pack to the hip and groin region regularly, making sure you keep the joint moving, and applying weight to the leg when possible are just a few simple basic strategies to help with most hip pain. However, we recommend that you get your hip pain checked out by a Chiropractor at our clinic here in Omaghto treat the problem and prevent the likelihood of the hip pain returning.

Our aim is to get your hip functioning as best possible as soon as possible using manipulation, soft tissue techniques, and a variety of progressed home and in clinic exercises and rehab plans.

Iliotibial Band Syndrome

What is Iliotibial Band Syndrome?

The Iliotibial band (aka I.T. Band) is layer of strong and fibrous connective tissue (fascia) that runs from the hip-down the outside of the thigh-to a point just below the knee. The band functions in coordination with the quadriceps to stabilize the knee. With overuse or injury, the connective tissue becomes inflamed and painful resulting in Iliotibial band friction syndrome (ITBFS). Runners, dancers, cyclists and other athletes who engage in repetitive exercise are prone to developing this syndrome. The pain can be located anywhere along the lateral aspect (outside) of the thigh. Generally, the pain increases with increasing activity and is worse when running down hill or traveling down stairs. In some people the pain is constant, but typically the pain is felt with movement.

Runners, dancers, cyclists and other athletes who engage in repetitive exercise are prone to developing this syndrome.
How is Iliotibial Band Syndrome diagnosed?

Iliotibial band syndrome is generally diagnosed by history and physical exam. Your chiropractor will ask you questions like what makes it worse, what makes it better, how/when it began, and what it feels like. An exam will be performed that will consist of orthopedic tests designed to provoke the pain. The chiropractor will use his/her hands to palpate for abnormalities along the outside of your thigh. Your chiropractor may also provide a biomechanical assessment (watching you in action) to establish if there are any abnormalities of gait and movement. Rarely, further testing such as an x-ray or MRI will be ordered.

What Are the Options for Treating Iliotibial Band Syndrome?

Iliotibial band syndrome is commonly treated at Omagh Chiropractic. You may experience relief with the conservative treatments rendered by our chiropractor. For this condition, treatments such as Spinal/Pelvic and extremity manipulations, myofascial release, strengthening exercises, and stretching are safe and effective. Our chiropractors may also recommend RICE (rest, ice, elevation, compression), reduced training, and changes in footwear. Don’t let pain prevent you from the activities you enjoy. Contact Omagh Chiropractic to schedule your first appointment and get on the road to recovery.

References

1. Iliotibial band friction syndrome–a systematic review. Ellis R, Hing W, Reid D. Man Ther. 2007 Aug;12(3):200-8. Epub 2007 Jan 8. Review. Treatment of an individual with piriformis syndrome focusing on hip muscle strengthening and movement reeducation: a case report. Tonley JC, Yun SM, Kochevar RJ, Dye JA, Farrokhi S, Powers CM. J Orthop Sports Phys Ther. 2010 Feb;40(2):1.
2. Practical management of iliotibial band friction syndrome in runners. Fredericson M, Weir A. Clin J Sport Med. 2006 May;16(3):261-8.
3. Relief of internal snapping hip syndrome in a marathon runner after chiropractic treatment. Konczak CR, Ames R. J Manipulative Physiol Ther. 2005 Jan;28(1):e1-7.

Piriformis Syndrome

What is Piriformis Syndrome?

A small muscle located deep in the buttock, the piriformis is prone to spasm with overuse or injury. The sciatic nerve runs closely to the piriformis and in some cases, actually pierces the muscle. When the muscle is overused or injured it may cause compression or irritation of the sciatic nerve resulting in pain or tingling that radiates down the leg. This is often referred to as sciatica. Not every person with piriformis syndrome experiences sciatica; sometimes the only symptom is pain in the buttock. There are a few different causes of piriformis syndrome. Muscle imbalance, falling on the buttocks, sitting for long periods (especially with a wallet in the back pocket), and activities that result in overuse of the muscle such as running are all established causes of the syndrome. Piriformis syndrome is commonly treated by the chiropractors at Omagh Chiropractic.

How is Piriformis Syndrome diagnosed?

Piriformis Syndrome is generally diagnosed by history and physical exam. Your chiropractor will ask you questions like what makes it worse, what makes it better, how/when it began, and what it feels like. An exam will be performed that will consist of orthopedic and neurologic tests to determine the cause of the pain. If your pain is related to activity, your chiropractor may also provide a biomechanical assessment (watching you in action) to establish if there are any abnormalities of gait and movement. In some cases, further testing such as an x-ray or MRI will be ordered. Although piriformis syndrome cannot be seen on an x-ray or MRI, these types of tests may be helpful in ruling out other conditions.

What Are the Options for Treating Piriformis Syndrome?

Piriformis syndrome is commonly treated at Omagh Chiropractic. You may experience relief with the conservative treatments rendered by our chiropractor. For this condition, treatments such as Spinal/Pelvic and extremity manipulations, myofascial release , strengthening exercise, muscle energy techniques, stretching and application of heat and or Ice are safe and effective.

References

1. Piriformis syndrome, diagnosis and treatment. Kirschner JS, Foye PM, Cole JL. Muscle Nerve. 2009 Jul;40(1):10-8. Review.
2. Treatment of an individual with piriformis syndrome focusing on hip muscle strengthening and movement reeducation: a case report. Tonley JC, Yun SM, Kochevar RJ, Dye JA, Farrokhi S, Powers CM. J Orthop Sports Phys Ther. 2010 Feb;40(2):1.
3. Diagnosis and management of posttraumatic piriformis syndrome: a case study. Mayrand N, Fortin J, Descarreaux M, Normand MC.

Hamstring Strain

What is a Hamstring Strain?

A hamstring strain (otherwise known as “pulled hamstring”) is an injury to the one or more of the muscles that are collectively known as the hamstrings. The semitendinosus, semimembranosus, and biceps femoris (long and short heads) are located at the back of the thigh. These muscles work together to flex the knee and extend the hip. The muscles are commonly strained, stretched or torn while running (especially sprinting) and jumping. Certain athletic endeavors that involve bursts of activity such as football, basketball, dance, track, soccer, field hockey, and baseball are more likely to result in this type of injury. Injuries may be acute (sudden onset), or they may be chronic (especially seen in distance runner who consistently stress the area). This type of injury may result in mild pain and limited disability or may cause severe pain and debilitation. Unfortunately, these types of injuries heal slowly and athletes are prone to re-injury without the appropriate treatment. Proper warm-up, stretching and conditioning of the muscles may prevent the injury. The chiropractor at Omagh Chiropractic provides strategies for optimum athletic performance that will speed recovery and prevent recurrence.

How is Hamstring Strain diagnosed?

Hamstring strains are classified by a grading system. A grade of 1 means there are micro-tears that have occurred within the muscle which cause pain and tightness in the back of the thigh. Generally there is little visual evidence of the injury (swelling, bruising, or redness).  Grade 2 injuries are characterized by a loss of muscle strength against resistance due to a partial tear. Swelling, stiffness, decreased range of motion, and bruising are often present. With a grade 3 injury, there is a complete tear of muscle fibers which causes a great deal of pain and complete weakness. Inability to walk, discoloration, bruising and a bulge of muscle (where the tear occurred) are characteristic of grade 3.
Generally, hamstring strains are diagnosed by history and physical examination. The chiropractor Omagh will ask you questions about the mechanism of your injury and perform orthopedic tests to evaluate the condition. In certain cases an MRI or other tests will be ordered to determine the extent of the injury.

What Are the Options for Treating Hamstring Strain?

Hamstring strains are commonly treated at Omagh Chiropractic. Depending on the extent of the injury, you will be provided with a treatment plan that will include Spinal/Pelvic and extremity manipulations, myofascial release and therapeutic exercise. Many active patients have reaped the benefits of chiropractic care. Schedule your appointment with one of our chiropractors and ride, run, dance, skate or ski your way to the top.

References

1. Hamstring strain injuries: recommendations for diagnosis, rehabilitation, and injury prevention. Heiderscheit BC, Sherry MA, Silder A, Chumanov ES, Thelen DG.J Orthop Sports Phys Ther. 2010 Feb;40(2):67-81.
2. Mangialardi R, Mastorillo G, Minoia L, Garofalo R, et al. Lumbar disc hernation and cauda equina syndrome. Considerations on a pathology with different clinical manifestation. Chir Organi Mov. 2002 Jan-Mar; 87 (1):35-42.
3. The effects of active release technique on hamstring flexibility: a pilot study. George JW, Tunstall AC, Tepe RE, Skaggs CD. J Manipulative Physiol Ther. 2006 Mar-Apr;29(3):224-7.

Knee Pain

The Knee Joint

The knee is a complex joint that relies heavily on ligaments and muscles for stability. The knee is a major weight bearing joint and is composed of:

• the tibio-femoral joint (between the thigh and lower leg)
• the patello-femoral joint (between the knee cap and the thigh),
• muscles and ligaments, which gives active and passive stability to the knee.
• two ring shaped cartilage discs in the knee, called the menisci (one meniscus).

Knee pain can occur for many reasons and many factors play a role in what may be felt as knee pain and what may be the cause.  Injuries can develop as a result of a one off incident, or may be a result of a problem that has been building up for a long time. Problems that have built up over time usually take longer to correct as there are usually many factors involved. Different sports and activities can cause different types of knee pain.

Knee Symptoms

Symptoms you may be experiencing with knee pain are pain in or around the knee joint, or pain radiating toward or from the knee joint. Associated symptoms may be popping, clicking, locking, giving way, swelling, inflammation and stiffness.
Knee pain may also be coming from a different region – the lower back, hip and pelvis can all refer pain to this region. The Chiropractor in our clinic here in Omagh will be able to determine the cause with regard your knee pain.

Examination of the Knee Joint

When pain is perceived as coming from the knee, all the anatomical components need to be examined and in addition to the knee joint, the low back, pelvis, hip, ankle and foot need to be examined due to the direct influence they have on the knee, and vice versa.

As chiropractors we take a comprehensive medical history and perform a thorough physical and biomechanical examination in order to make an accurate diagnosis – without an accurate diagnosis, the treatment will not be successful.
Our approach of assessing and treating the knee includes the evaluation of the other joints and muscles relating to the knee.

This is for several reasons:

• Firstly, pain can be referred from other structures in the low back, pelvis and hip into the knee, in certain conditions.
• Secondly, if other joints in the lower limb are not working correctly they can put increased stress on the knee joint, resulting in injury over time. Therefore to resolve the knee pain chiropractors may also treat other areas, to maximise long-term improvement.

Chiropractic treatment of knee pain

We have outlined the process of our treatment below to give you an idea of our approach. We would normally modify the treatment to suit each patient and their specific conditions. So the type of treatment that is most appropriate for one person is not necessarily right for another

Stage 1: Reduce joint inflammation and reduce pain.

• Avoidance of aggravating factors, use of a support
• Ice to reduce inflammation, muscle spasm and pain
• Postural assessment

Stage 2: Normalise joint function

• Specific chiropractic manipulation and mobilisation techniques to areas of restricted movement in the knee and surrounding joints, to increase movement, improve the function and reduce pain
• Deep soft tissue massage, trigger-point therapy and cross-friction.

Stage 3: Rehabilitation exercise programme.

• When appropriate we introduce exercises to improve strength, endurance and stability. We also work on improving your balance and your sense of joint position (proprioception). This will help you to return to normal and also prevent new injuries.

Shin Splints (Medial Tibial Stress Syndrome)

What are Shin Splints?

“Shin Splints” is commonly used as a general term to describe pain in the lower leg. That being said, there are several causes of shin pain (stress fractures, compartment syndrome) that may not be related to shin splints. Otherwise known as Medial Tibial Stress Syndrome (MTSS), shin splints are caused when the connective tissue that attaches the muscle to bone (tibia) is overused or used incorrectly. The area becomes inflamed which contributes to pain, tenderness and in some cases swelling that is located on the inner part of the front of your leg (shin). In some cases the symptoms are only present with exercise or activity; in others, pain is constant. Runners are especially prone to this condition. Exercising on hard surfaces, improper foot wear, uphill/downhill running, and over-training often contribute to the onset. In some cases the way you run may also increase your chances of getting shin splints.

How are shin splints diagnosed?

Shin splints are generally diagnosed by history and physical exam. Your chiropractor will ask you questions like what makes it worse, what makes it better, how/when it began, and what it feels like. An exam will be performed that will consist of orthopedic and in some cases neurologic tests to determine the cause of the pain. Your chiropractor may also provide a biomechanical assessment (watching you in action)  to establish if there are any abnormalities of gait and movement. In some cases, further testing such as an X-ray, bone scan or MRI will be ordered.

What Are the Options for Treating Shin Splints?

Shin splints are commonly evaluated and successfully treated at Omagh Chiropractic. Some cases will require only minimal intervention and may be treated at home with ice massage, changes in foot wear, arch support, rest, elevation. Other cases require rehabilitative treatment. The chiropractor at Omagh Chiropractic is trained to provide high quality and individualized treatment that will get you out of pain and improve your performance. Many active patients have reaped the benefits of chiropractic care. Schedule your appointment with one of our chiropractors and ride, run, dance, skate or ski your way to the top.

References

1. Tibial stress injuries: decisive diagnosis and treatment of ‘shin splints’. Couture CJ, Karlson KA.Phys Sportsmed. 2002 Jun;30(6):29-36.
2. Medial tibial stress syndrome: conservative treatment options. Galbraith RM, Lavallee ME. Curr Rev Musculoskelet Med. 2009 Oct 7. The effects of active release technique on hamstring flexibility: a pilot study. George JW, Tunstall AC, Tepe RE, Skaggs CD. J Manipulative Physiol Ther. 2006 Mar-Apr;29(3):224-7.

Foot & Ankle Problems

The foot and ankle is actually a very complex structure containing no less than 26 separate bones and many more individual muscles and tendons. It is responsible for absorbing ground impact, stabilising the lower limb, actively controlling motion and providing feedback for balance, all whilst under the full load of the body. A fine compromise has to be achieved between support, shock absorption, balance and mobility, making it particularly vulnerable to injury. Problems with the foot can therefore create issues all the way up the lower limb and even to the lower back or further.

Ankle Pain

If the ankle pain has been present for some time and use of the ankle has been avoided, the muscles supporting the ankle can be prone to wasting. This can lead to a decrease in the body’s ability to stabilise the joint and the ankle pain recurring. Different sports and activities can lead to different causes of ankle pain. Symptoms often experienced are pain locally to one or more of the joints in the ankle, or sharp or dull aching pain in or around the joint. Associated symptoms are swelling, clicking, clunking, tingling, numbness and pins and needles. Pain coming down the leg and around the ankle may also be as a result of Sciatica, associated symptoms of this are tingling, numbness and weakness of the muscles around the ankle.

Foot Pain

Foot pain is an often debilitating problem and can occur for a variety of reasons, the foot is an incredibly important and dynamic aspect of force distribution throughout the body and is often associated with lower back pain. Our Chiropractor is well trained in dealing with foot pain and can diagnose the cause of foot pain using a variety of skills. Assessing the feet in a sporting individual is particularly important and is a crucial aspect of any treatment whether it is for foot pain, knee pain, hip pain or lower back pain. This is because the body is all inter related and the feet are like the base of a very finely balanced cake. Slight changes in the mechanics of the feet or a history of foot pain can lead to a cascade of problems up throughout the lower limbs and in to the body.

Foot pain or symptoms in the feet may be related to another area of the body, a common problem that often refers pain down the leg and in to the foot is Sciatica. This may be associated with tingling, numbness, pins and needles or muscle weakness of the foot.

Over pronation, hyper pronation, pes planus and flat feet are common foot problems often associated with foot pain and lower limb pain. The reasons why this problem occurs are very complicated and a Chiropractor at our Gloucester based clinic will be able to tell you why it has occurred in your case, and whether or not it needs to be addressed.

Conditions seen in the clinic:

Tendonitis – Literally means inflammation of the tendon. This occurs secondary to damage which may occur for a number of reasons including repetitive movements, direct trauma or poor movement function. Pain is the most notable symptom.
Achilles Tendonitis – The Achilles tendon is the large tendon that attaches the calf muscle to the heel bone. It produces heel pain and calf tightness.

Sprain/strain – Overuse or sudden twisting can result in ankle sprains. Tearing of the muscles and ligaments which support the ankle will cause local swelling and tenderness. The most common is an inversion sprain where the foot twists inwards.

Plantar fasciitis – a painful condition affecting the sole of the foot and into the heel. Usually related to poor foot mechanics, so as well as directly treating the area of pain, it is essential to correct the foot’s mechanics for full and continued resolution.

Tarsal tunnel syndrome – compression of a nerve on the inside of the ankle, this condition causes tingling and numbness across the bottom of the foot under the big toe.

Symptoms experienced:

Pain – When sharp indicates inflammation. This may be in a tendon, bursa or ligament,
Ache – Most commonly associated with muscular problems including tightness or overuse.
Restriction – When the joints of the foot or ankle fail to move, additional strain is placed on the rest of the lower limb so restoring function is important for the whole leg.
Weakness – This can occur secondary to pain, trauma or nerve damage. It is often a more involved symptom, and needs really to be examined to determine the cause.
Swelling – This will often occur after a trauma, commonly after an inversion sprain of the ankle.

What to do if you have foot and/or Ankle Pain

Applying an ice pack to the region regularly, making sure your keep the joint moving and applying weight to the joint when possible are just a few simple basic strategies to help with most foot and ankle problems. We recommend that you consult The Chiropractor at our clinic to treat the problem and to reduce the chance of the ankle pain coming back.
The Chiropractor will be able to diagnose, treat and advise you on your foot /ankle pain.  Our aim is to get your ankle functioning as best possible as soon as possible using manipulation, soft tissue techniques, and a variety of progressed home and in clinic exercises and rehab plans.