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Active Release Technique

The Power of ART – Active Release Technique

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Struggling with carpal tunnel can be a debilitating experience. The inflammation around tissues and nerves in the wrist can make it difficult to perform daily tasks. The classic symptoms of carpal tunnel include numbness or pain that occurs on the thumb-side of the hand, pain that radiates up to the shoulder, and the muscles in the thumb becoming severely distorted. However, there is no need to suffer with this condition when there is ART (Active Release Technique) to help you relieve the symptoms.

One can experience the relief of the pain and numbness without invasive surgery or traditional procedures of medicine. The continuance of these symptoms is the direct result of misdiagnosis and the misinterpretation of what carpal tunnel actually is. It’s more than just the entrapment of one single nerve in the thumb; rather, it’s a more common problem that takes place further up the arm, in the muscle called the Pronator Terres. Because of this, adding a brace to the wrist can actually make the problem worse.

ART, on the other hand, is designed to eliminate the problem from the get-go, allowing patients to make a much faster recovery than with conventional methods. Instead of focusing on just one area, ART aims to restore unimpeded range of motion and function to the soft tissues of the arm and wrist.

Professionals who are trained in the technique of ART can evaluate the texture and mobility of soft tissue, and, using hand pressure, removes or breaks up the fibrous adhesions that are present in the soft tissues. This can drastically improve the recovery from this debilitating condition, and abate the symptoms for much longer periods of time between each treatment.

There are typically three levels of ART that are performed by the practitioner himself while the fourth requires the patient to be involved with the active movement of the tissue while the practitioner applies the required tension to improve the results of the treatment even more. It has been scientifically proven that patients who are actively involved with the process of their treatment are more likely to make a better recovery than those who don’t.

Understand the true source of the pain you’re experiencing, and take steps to resolving your condition before it becomes too much to handle.

Ergonomic Desk Guide

Your Guide to a Fully Ergonomic Workstation

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If you spend a lot of time sitting at your work desk, it can actually cause some serious health issues if the workstation is not set up properly. Here are some easy adjustments you can make to ensure that you will maintain a healthy posture at an ergonomic workstation.

This is your guide to a fully ergonomic workstation:

 

Chair

Ergonomic Desk Guide

  • Sit on your chair with your hips completely pushed to the back of the seat.
  • Adjust your chair height so that your feet are flat on the ground.
  • Your knees should be level to your hips or slightly lower than your hips.
  • Recline the back of the chair so that it is at a 100°-110° angle.
  • Support your lower back with a by using an inflatable cushion or a small pillow for extra support. You can also add on a lumbar support to your chair.
  • Set the arm rests at a height where your shoulders are able to relax comfortably on them. Another option is to remove the arm rests altogether.

 

Keyboard

  • Position the keyboard so that it is directly in front of you and centered with your body.
  • Sit closely to your keyboard to avoid overreaching.
  • While your shoulders are relaxed, position the keyboard so that your arms are at a 100° angle. Ensure that your wrists and hands are straight.
  • If you need to tilt your keyboard up, make sure that your chair reclines so that you are still at a 100° angle.
  • If you’d like to use a palm support, make sure that you don’t let your palms rest on it while typing, as this is not recommended. Additionally, try to keep your wrists slightly elevated when typing.
  • Keep your mouse as close as you can to the keyboard. It should also be at the same level as the keyboard.
  • If you need to adjust your seat height to accommodate the keyboard, keep a footrest under your desk for your feet to rest on. This way your feet will not be left dangling.

 

Computer Monitor

  • Adjust the monitor to keep your head in a neutral position when working.
  • The top of the monitor should be around 2 to 3 inches higher than eye-level when seated.
  • Your screen should be at least an arms length away.
  • Reduce glare and reflections on your computer screen by adjusting the monitor’s positioning.
  • If you are using a laptop, place it on an adjustable stand, and use an external keyboard and mouse.

 

Phone

  • Keep your phone as close to you as possible.
  • Wear a headset when possible to avoid holding the handset with your shoulder.

 

In addition to these guidelines, try to avoid slouching and leaning as much as possible, and don’t forget to take 1-2 minute breaks to stretch every 20-30 minutes. No matter how ergonomically correct your workstation is, sitting for prolonged period of time in a static position can significantly decrease blood circulation which can lead to other health risks. Take the time to set up your workstation the right way. By following this quick guide to a fully ergonomic workstation, you will be able to work safely and comfortably.

Ergonomic Chair Setup

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Comfortable desk work begins with proper chair setup. Follow these helpful tips to ensure a proper ergonomic chair setup.

Chair Setup

  • Push your hips as far back as they can go in the chair.
  • Adjust the seat height so your feet are flat on the floor and your knees are equal to, or slightly lower than, your hips.
  • Sometimes the desk height forces you to have the chair higher than you what will allow you to touch the ground.  If your feet don’t reach the ground put a small box under your desk to rest your feet on.
  • The back of the chair should be at a 100°-110° reclined angle which should create an angle between your body and your thighs of 90° -100°.

    Step 1 Chair.

    From UCLA Ergonomics

  • Make sure your upper and lower back are supported. Use extra cushions at the small of your back if your chair does not have adequate support.
  • Adjust the armrests so that your shoulders are down and relaxed.
  • If your armrests prevent your shoulders from being in a relaxed position, remove them.
  • Keep your body straight with the head and neck upright and looking forward, not to the side. Do not hunch over or slouch.

OTHER TIPS

  • Don’t cross your legs while sitting. This can cut off circulation and/or lead to hip problems.
  • Make sure your chair seat has a soft, downward curved edge so that it does not dig into the back of your thighs. This can also cut off circulation.
  • When purchasing a chair the best feature is its ability to adjust each component separately.
  • If sitting is too painful, consider a standing workstation.

 

Next post “Ergonomic Keyboard and Mouse Setup”

Best Chiropractor in Mission Valley

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Congratulations to Dr. Rose, DC on being voted 2012 Best Chiropractor in Mission Valley by Mission Valley News.

Click Here for the entire release.

Mission Valley News offers community news and information on Mission Valley, Old Town, Linda Vista and surrounding areas.

Sciatic Nerve Glide

Piriformis Syndrome Part III- Treatment

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Piriformis Syndrome Treatment

The two main goals of treatment are 1) to relief irritation to the sciatic nerve and 2) address any functional problems that may be contributing.
If the sciatic nerve is inflamed the first step is to decrease aggravation from compression. Things to avoid are leg crossing, sitting on your wallet, and sitting on hard surfaces.  Things you should begin doing are applying ice to the piriformis, stretching of the piriformi, and taking oral anti-inflammatories (as directed).  Stretching every 2-3 hours (while awake) is a key to the success of non-operative treatment. Prolonged stretching of the piriformis muscle is accomplished in while lying on your back with the hip flexed and passively adducted/internally rotated (see picture).  Another exercise that can be helpful to decrease irritation between the piriformis and sciatic nerve is a nerve gliding exercise.  This exercise tensions the sciatic nerve and allows it to move relative to the piriformis. It is sometimes called nerve flossing to better describe how the nerve moves through other structures.  Two types of nerve gliding exercises are pictured below. (Pictures from http://www.dynamicchiropractic.com/mpacms/dc/article.php?id=53203)
 Sciatic Nerve GlideSciatic Nerve Tensioner
Manual therapy can be extremely helpful in releasing tension on the sciatic nerve and addressing functional deficits.  Soft tissue therapies, including myofascial release and Graston®, aimed at releasing tension and muscular adhesions within the piriformis can be beneficial.  Chiropractic spinal adjustments can help address functional contributions from the spine such as sacroiliac joint hypomobility and low back dysfunction.  Hyperpronation of the foot can be addressed through orthotics in the short term and foot strengthening in the long term.  Pronation is a normal foot motion however overpronation may lead to increased external rotation of the hip with walking putting tension on the piriformis and sciatic nerve.
Treatment may take several months of consistent work and it is important not to get discouraged. As long as there is no progression of neurological symptoms conservative treatment is the best option. Your symptoms should be monitored by a healthcare practitioner to ensure there is no progression.
-Dr. Kevin Rose, DC
Q Angle

Piriformis Syndrome Part II- Evaluation

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Clinical Diagnosis

Piriformis syndrome occurs most frequently between ages 40-60 and is more common in women than men.  Some reports suggest a 6:1 female-to-male ratio for piriformis syndrome; , possibly because of biomechanics associated with the wider quadriceps femoris muscle angle (ie, “Q angle”) in the pelvis of women. Reported incidence rates for piriformis syndrome among patients with low back pain vary widely, from 5% to 36%.

Q-Angle

The most common  symptom of patients with piriformis syndrome is increasing pain after sitting for longer than 15 to 20 minutes. Many patients complain of pain over the piriformis muscle (ie, in the buttocks), especially over the muscle’s attachments at the sacrum and medial greater trochanter. Symptoms, which may be of sudden or gradual onset, are usually associated with spasm of the piriformis muscle or compression of the sciatic nerve; these symptoms include radiating/shooting pain or tingling or numbness in the back of the thigh, leg, or foot.  These symptoms must be evaluated by a healthcare provider to differentiate the possible causes.  Patients may also complain of difficulty walking and of pain with internal rotation of the involved leg, such as occurs during cross-legged sitting or walking. X-rays or an MRI offer little help in directly diagnosing piriformis syndrome but may be used to rule out other causes of sciatica such as a herniated disc in the lumbar spine.

Functional Evaluation

There are many functional abnormalities that may have either caused or resulted from this condition.  Once the diagnosis has been made, these underlying, perpetuating biomechanical factors must be addressed.

Functional biomechanical deficits associated with piriformis syndrome may include the following:

  • Tight hip external rotators including pirifromis
  • Tight adductors (groin)
  • Hip abductor weakness
  • Lower lumbar spine dysfunction
  • Sacroiliac joint hypomobility
  • Hyperpronation of the foot and prolonged toe-off

Functional adaptations to these deficits include the following:

  • Ambulation with the thigh in external rotation
  • Functional limb length shortening
  • Shortened stride length

Next post will discuss treatment options for piriformis syndrome