Elbow Pain Part 1: Tennis Elbow

So did you know you could get Tennis Elbow even if you have never played tennis?

True story.

My mom got it from mowing the lawn (She tended to do that especially after my Dad cut off the tip of middle finger once upon a time after a bar mitzvah luncheon.  FYI, don’t stick your hand into a lawn mower if it gets clogged. Better idea, don’t mow the lawn after a couple of beers or three… it was the late 70s, ’nuff said.)

So, if you have never played tennis why the hell do you have tennis elbow?

Possible causes of tennis elbow

  • repetitive strain injuries
  • vibration
  • overuse

These can happen from all sorts of things including: overuse at work, prolonged computer or mouse work, heavy work such as construction and repetitive strain, mowing lawns, all sorts of other stuff and of course…. tennis.


Symptoms of tennis elbow

Symptoms of tennis elbow can include the following or may be just one of the following:


  • pain at the outside (lateral side) of the elbow just above or at the joint line
  • sharp pain when picking things up (even an empty cup)
  • heat or swelling at the joint (possible but not always)
  • forearm pain or tightness
  • pain can be in ‘strange’ places such as wrist or thumb ( ‘whaddaya mean its my elbow not my thumb?’)

Treatment of tennis elbow

So what can you do for this painful condition?  The best thing of course is to get it treated… Here is what I do for a patient I diagnose with tennis elbow:

  1. adjust the spine
  2. Post Isometric relaxation (PIR) technique for the elbow extensors
  3. deep muscle tissue release of the forearm
  4. kinesiotape application
  5. muscle care application
  6. Wrist adjustments
  7. exercise prescription
  8. Icing instructions for the patient


So there is a gold standard exercise for this problem is super easy but really important to do daily.  Please see the YouTube Video below for full instructions on it!

Foot pain, Fallen Arches and Tight Muscles

So I put it out there on facebook and I did get a request for this article…  Its a pretty broad topic but suffice it to say that I do treat these things. Often.

Feet are amazing things really.  We walk on them all day and pretty much forget about them until they hurt.  There are a huge number of diagnoses related to feet some of the most common being plantar fasciitis, fallen metatarsal head (fallen arches), stress fractures, tarsal tunnel syndrome, turf toe, sesmoiditis and the list goes on and on and on…

From a simple sprain to chronic pain, there are a host of different solutions for different problems.

One of the things you hear associated with foot pain is often the prescription of custom made orthotics.  These little insoles can be amazing as therapy for the right foot condition. The drawback is that they are also expensive.  Although lots of people have plans to cover some or all of the cost, some people aren’t as lucky.  While they are a useful tool for things like fallen arches (fallen metatarsal heads) they aren’t the only solution.

When a patient comes to me with foot pain, fallen arches and tight calves I always prescribe strengthening exercises for the small muscles of the feet.  – these are easy to do exercises that will help support the natural arch and help a person retrain themselves to avoid the problem in future.  These include fun things like picking up marbles with your toes, and scrunching towels with the toes as well as learning to position the foot in the proper “short foot” position. (this one is much harder than the other two and really needs to be shown in person in a hands on fashion).

Also effective are muscle techniques such as ART for the muscles of the foot and scar tissue treatment if that is deemed to be a problem in the specific patient and adjustments of the small bones of the feet. If these bones are ‘stuck’ and not moving through their normal range of motion it causes inflammatory changes surrounding the joints and irritation and inflammation in those regions – this decreases the range of motion even further and increase the pain – all super easy to solve with a small corrective adjustment in the area.

The last thing I did want to mention was that if you have a fallen arch it tends to put a bunch of strain on the calf or back of the lower leg – the mechanics of the arch falling actually pulls on the gastrocs/soleus complex- those two giant muscles at the back of your leg attached to the Achilles tendon. This makes the muscle appear tight or reflexively be tight – stretching it will really do very little as the problem is in the foot to begin with  – correcting the arch with exercise, hands on treatment and an arch support (custom or otherwise) is the first course of action – this will likely improve the tightness in the back of the lower leg – if not then we can show some stretches to remedy this at that point but in general it corrects itself if we have done the rest of the therapy.

So, if you are suffering with foot pain please don’t wait any longer! Call us to find out how we can help you.

Carpal Tunnel Syndrome – She of the tingly fingers

So many people come in to see me complaining of Carpal Tunnel Syndrome.  Some actually have it and some technically don’t.  Either way we can help you treat it or find relief.

Carpal tunnel syndrome is caused when the Meidan nerve gets entrapped (or squished) at the wrist – at a place called the carpal tunnel.  It is literally a little tunnel formed of bone (the 9 carpal bones that make up the wrist) an the tough layer of tissue that makes its roof.  9 tendons and a big nerve and a bunch of blood vessels run through this tunnel so if anything annoying, say a little bit of inflammation, causes anything to get a teeny weeny bit bigger in this area everything goes SQUISH!

Nerves hate squish.  They HATE squish a lot.

When nerves get squished they do things like cause the nerve host (aka person) to feel a tingly sensation or maybe pain, pins and needles, burning, hot or cold.  In general, don’t piss off a nerve. They don’t like it and they will make you regret it.

Ok so what do you do?  The medical community sends you for testing and possibly to a hand surgeon for surgery.  Sometimes the surgery is successful and sometimes it isn’t.  In the surgery they release the tough roof of the carpal tunnel so that the stuff inside has more room – More room = less squish so why do some of the surgeries not work?

In my chiropractic opinion it is because some carpal tunnel syndrome isn’t carpal tunnel syndrome at all – or at least it isn’t ONLY carpal tunnel syndrome.  Sometimes patients have symptoms and go for testing (nerve conduction) and the test says they are fine. So what gives?  They aren’t likely making up the tingling sensation…. what would they gain from that?  Some of these cases are a problem with what I and some of the chiropractic community like to call ‘triple crush’ syndrome.  The nerve is getting squished a little bit at the carpal tunnel but not enough to mess up nerve conduction.  BUT it is also getting a little bit squished at the elbow and in the upper back near the ribs or the shoulder.  All of these little bits add up to enough hateful SQUISH to piss off the nerve.

What we can do about it – Generally I like to do muscle treatment, adjustments, exercise and anything else I can think of to take pressure off the nerve at all of these locations.  The end result is often symptom relief and I have even had a few patients be able to avoid surgery indefinitely because of this. If you have any more questions, please do not hesitate to contact us and ask!

I am superhuman – crap I hurt my back…

And so, I got the above picture from a patient via text this week with the following words attached: “I didn’t want to make two trips and now my lower back hurts… have anything this week at your home (office)?”

Yep, we’ve all done it. Sometimes we get away with it unscathed with no problems but most of the time we tweak something in to hurting… that picture above is 9 grocery bags from the car to condo by the way.

So, lesson one – make two trips

lesson 2- text me for an appointment because there is no way you will actually make two trips

This is a good one because she did. I did see her and her problem is minor and relatively easy to treat at this stage… leave it  a week or two or three and if it is unresolved the longer it has been around the longer it takes to get rid of as a general rule.  Even if it seems to go away you really shouldn’t ignore what your body is telling you hurts – these aches and pains that come and disappear unfortunately accumulate over time and build until one day you do something innocent seeming, like bending over at the sink to spit out your toothpaste, and you can’t get back up.  (Seriously I have heard this story I don’t know how many times over the years and when they told us that at school I thought they were joking).

Patients always ask me – Doc how did I get this? what can I avoid so this doesn’t happen again I mean I was only bending over the sink?!?!

Well the bending over the sink didn’t do all of it – it was the straw that broke the camels back (pun intended).  Life happens. We all do stuff we shouldn’t do like not make two trips, sit too long in front of the TV or computer, stand too long at work, lift things that are too heavy, engage in weekend warrior antics, play one sided sports like golf or hockey, carry kids in one arm primarily … I could go on forever and I haven’t even mentioned slips and falls and minor injuries.  Scar tissue and injury accumulate over the years.  Chiropractic care can make sure that you aren’t headed for that last straw by making sure that the minor things that are there already are taken care of before that happens.   Love living life to the fullest myself and I don’t have time for setbacks…. Chiropractic wellness care is just for that. And if you do hurt yourself, don’t wait, make the call and get it fixed sooner than later.

Shoulder Pain – What the Rotator Cuff?

I recently had someone ask me if I treat shoulders.  The treatment that chiropractors are best known for is back pain and neck pain.  This is great but for me really falls short of describing what I do every day.  One of the things I love most about my job is the variety of problems I see daily and my ability to problem solve for them and help patients get the care and treatment they need to heal.

I had a patient recently who came to me after having care for a shoulder injury for three months somewhere else.  He told me that he was no better at all and still had trouble sleeping despite the care he received.  We did an examination and I diagnosed him with a rotator cuff problem – specifically a possible small tear in the supraspinatus muscle (one of four muscles the rotator cuff).  He had been given exercise, ultrasound and some massage already but hadn’t seen improvement.

What I do differently is examine the whole spine as well as the shoulder and add treatment that also involves much more hands on therapy and support for the spine – the shoulder doesn’t float around in space it is attached to the skeleton by muscles – muscles that get tight, angry and irritate all of the joints surrounding them.  Irritated joints tend to cause inflammation.  More inflammation causes more tightness in the muscles – a vicious cycle that we need to break.

Pain from rotator cuff problems can refer down the arm, into the hand, into the upper back and neck and can even cause headaches.  This can cause decreased range of motion of the shoulder and weakness in the arm.  I love treating shoulders because the results can be super dramatic.

Within 2 weeks of seeing the patient I was talking about he told me he felt 80% better and his range of motion was amazing and almost 100% better.  He told me he could sleep again at night and started bringing me lunch because he loved to cook and was able to do that again.

Please don’t live with shoulder pain – it usually gets worse and sometimes turns into a frozen shoulder which is often much harder to treat and takes much longer to heal.  I would love to help you.

Falling on your tailbone – A pain in the ass (literally)

Have you ever fallen smack on your butt and felt like you broke your tailbone?  They may or may not even X-ray it at the hospital because if it is broken frankly there is nothing you can do about it.  Most of the time really it isn’t broken but you walk around, or rather sit around, very carefully for about 2-4 weeks because it hurts so much.  If you really smacked it good it hurts longer.  If you are really unlucky it can hurt for years or indefinitely and you just live with it.

What would you say if I told you there IS actually something you can do about it?  Would it be worth a couple treatments with me to make it go away, usually permanently?

Ok, so we will get to that….So what made me think of this? It’s October, there is no ice on the ground (though its coming – even though its been warm….it’s coming). My almost-grandmother*** fell a couple weeks ago and fell right on her tailbone.  She is 90 and ended up at the hospital for other reasons but they didn’t bother X-raying her (see above) and the pain she had (in her butt) was one of her biggest problems upon her return home (she is doing well btw -thanks!)

***Sidebar – what in the what is an ‘almost-grandmother’?  Ok so we aren’t related by blood.  She has no children or grandchildren and all of my biological grandparents and my mom are gone.  Rita has been part of my life since I was 12 as she worked for my Dad as his bookkeeper.  She and her husband Jake spent every holiday I can remember at our house and after my Mom died I continued that tradition.  She is one of my closest family members, I love her.  I’ve adopted her and she has adopted me. So there you have it ‘almost-grandmother’ Oma Rita.

Ok back to the pain in the ass that is tailbone pain.  I went to her house a few days in a row to help her out and now there is no pain anymore.  With a fall onto the tailbone, often the pain comes from irritation and inflammation to the ligaments that attach the tailbone (or coccyx) to the bottom of the spine (the sacrum).  Fixing this problem is as easy as doing some soft tissue treatment (gently) to the area to settle the inflammation.  Yes this means I may have to touch your butt –  I promise to ask first and not catch you by surprise.

All joking aside, its simple, it works, it takes very little time and its worth it.

Next time you fall on your ass – think of me.