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Cycling Knee pain San Diego Treatment

Cycling Knee Pain Treatment

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Most cyclists at one point or another experience knee pain when riding their bike. There are many types of cycling knee pain and many different causes. In majority of cases, knee pain from cycling is due to overuse of the muscles/tendons around the knee joint. The complicating factor is the bike itself and how you are fit on that bike. A dialed in bike fit will allow your body to absorb the forces that hard cycling produces. If your knee joint, is working in a strained position, the muscles and tendons will eventually fail once a certain volume and/or intensity is reached during training. Forced time off will occur, the cyclist will train pain free until that tissue threshold is hit, and then knee pain occurs again. Frustrating! Below you will find the most common causes of knee pain in cycling.

Knee Pain Running Doctor

Anterior knee pain

  • Patellar tendonitis most common
  • Chondromalacia
  • Fat pad impingement
  • Bike fit suggestion: increase saddle height
    • Advanced with evaluation of foot: shoe insert, cleat wedges

Medial knee pain

  • Pes anserine bursitis
  • MCL/knee capsule irritation
  • Bike fit suggestion: move cleats outward
    • Advanced with evaluation of foot: shoe insert, cleat wedges

Lateral knee pain

  • Iliotibial band syndrome it band syndrome
  • Hamstring strain (biceps femoris)
  • Bike fit suggestion: lower saddle height, move clears inward (toward bike)

Posterior knee pain

  • Hamstring tendonitis
  • Hamstring train
  • Calf strain
  • Bike fit suggestion: Lower saddle height

Evaluation of Cycling Knee Pain

Evaluation begins with a thorough history, including details on your personal history of cycling, and bike fit. Our sports chiropractor will take you through various range of motion, orthopedic, functional movement, and strength/endurance testing. After the evaluation, a working diagnosis is developed and treatment begins.

Treatment for Cycling Knee Pain

Most cases of knee pain from cycling improve with a combination of manual therapies including Active Release Technique, Graston Technique, and joint mobilization. A individual exercise routine will be prescribed as well to strengthen/stretch the affected tissues to reduce pain and dysfunction quickly. Our cycling doctor will help construct a cycling training plan to get back to riding pain free; some bike fit suggestions may be necessary.

Schedule today to get your knee pain properly diagnosed at our Mission Valley, San Diego office. Both Dr. Travis Rose, DC CCSP and Dr. Kevin Rose, DC DACBSP are trained to treat cycling injuries and are both avid cyclists and triathletes themselves. Dr. Travis Rose, DC CCSP has additional training in Bike Fit analysis for health care providers.

Knee pain san diego treatment

Patellar Tendonitis and Knee Pain

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The patellar tendon runs from the bottom point of the patella (knee cap) and runs down to the top of the tibia (shin bone). It acts as a pulley to lift the leg upward into extension when the quadricep muscles contract. Leg extension is important in many sports and day to day activities; squatting, walking up and down stairs, getting in and out of cars, etc.
When the quadriceps become overused, excessive amount of load occurs at the patellar tendon and patellar tendonitis begins to develop.

What are the Symptoms of Patellar Tendonitis?

Patellar tendonitis is characterized by pain and possibly inflammation along the patellar tendon. Early stages of patellar tendinitis tends to cause pain after exercise/aggravating activity, and then goes away hours after the activity; it may also be felt at the start exercise but feels better as exercise continues. As the condition progresses, pain may be felt before, during, and then is worse after exercise. If it gets ignored and an athlete tries to push through the pain, the tendon will actually start to deteriorate resulting in patellar tendinosis.

Patellar Tendonitis Treatment San Diego

Who are at risk?

Athletes who perform repetitive jumping and leg bending are at risk to develop patellar tendonitis. Basketball players, CrossFit athletes, volleyball players, runners, cyclists, backpackers/hikers, triathletes, are all at a higher risk due to the potential overuse of the quadricep muscles. Specifically for running and hiking, performing lots of down hill routes will increase the likelihood of developing patellar tendonitis.

Evaluation

In most cases, patellar tendinitis can be diagnosed with a thorough history of the injury and brief physical exam. In some cases, imaging such as a X-ray or MRI may be necessary to rule out other conditions such as meniscus injury, patella alta, chondromalacia, arthritis, etc. Check out our blog here for other causes of anterior knee pain.

Treatment for Patellar Tendonitis in San Diego

For acute pain relief, Active Release Technique, Graston Technique, stretching, foam rolling, and training modification are essential. As the patient improves, eccentric exercises are prescribed to repair the patellar tendon. This helps strengthen tendon fibers to resist future load from activity. Eccentric loading for patellar tendinosis is even more important as this restarts the inflammatory process at the tendon so the tendon can heal.

Stop dealing with patellar tendinitis on your own. Schedule today to get evaluated by our sports chiropractors located in Mission Valley, San Diego. We have helped countless athletes overcome knee pain with our targeted approach.

Outer hip pain running clinic San Diego

Outer Hip Pain in Runners

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Outer hip pain is a very common complaint we see with out runners at our Mission Valley office. The outer hip musculature is designed to provide hip, and lower back stabilization during running. When there is pain or tightness at the outer hip, the stability at the hip and lower back is compromised. This in turn can create abnormal stress into the hip, outer hip muscles, lower back, the knee, and even the lower leg/foot. The following conditions cause outer hip pain and dysfunction:

Causes of Outer Hip Pain

  • Glute Medius Muscle Strain
  • Tensor Fascia Latae Strain
  • Gluteus Medius Tendinopathy
  • Trochanteric Bursitis
  • Iliotibial Tract Syndrome (IT Band Syndrome)
  • Sciatic Nerve Entrapment

As mentioned above, the out hip plays a role in lower back and hip stability. If the outer hip is painful or dysfunctional the following conditions may also be present:

  • Low Back Pain
  • Facet Joint (Lower Back Joint) Irritation
  • Hip Impingement
  • Knee Tracking Issues
  • Outer Knee Pain (IT Band Syndrome)
  • Shin Splints
  • Plantar Fasciitis

Evaluation

It is important to be evaluated by a running doctor and sports chiropractor. We will help diagnose your outer hip pain and any potential compensatory injuries that may be occurring simultaneously.  A combination of range of motion, orthopedic, functional movements, and strength/endurance tests will be used to pinpoint the exact cause of your pain.

Gait Analysis

We currently offer at home gait analysis for current patients. After being evaluated in our office, if it is deemed necessary, we have our patients video tape themselves running on a treadmill and send it back to us for evaluation. For outer hip pain, many runners with outer hip pain run with what is known as a cross over gait. Check out our previous blog posts here on what a cross-over gait consists of.

Hip pain Running San Diego

Potential sites for injury with cross over gait

Treatment for Outer Hip Pain

Active Release Technique is an excellent tool for helping runners with outer hip pain get out of pain quickly. A targeted home rehab approach is then prescribed b our running doctor as a way to prevent the injury from coming back again. Schedule with us today at our Mission Valley, San Diego running injury clinic today!

The Running Clinic Certification

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Congratulations to Dr. Travis Rose, DC CCSP for successfully completing the course in “New Trends in the Prevention of Running Injuries”! This course, taught by The Running Clinic, teaches health care providers about the latest methods to treat and manage running injuries. Dr. Rose is currently the only healthcare provider with this certification in Mission Valley, San Diego.

Running Clinic Running Doctor San Diego

The following is a quick Q and A with Doctor Rose regarding running injuries.

Q: Having taken this latest course, put on by The Running Clinic, what were the main takeaways to prevent running injuries?

Dr. Rose: The main takeaways for injury prevention and increasing running efficiency were the following: 1. Run with a cadence between 170-180 steps per minute, 2. Limit the up and down motion while running (decrease vertical loading associated with injury), and 3) Use as little of a shoe as possible as this allows you to run more naturally.

Q:  Was there information that surprised you or went against conventional running information?

Dr. Rose: The biggest “eye opener” was the fact that there is zero research to support prescription of specific shoes for specific types of feet. Many people put their trust in companies to tell them which shoe to buy based on treadmill analysis. Unfortunately there is research that shows that shoes don’t limit pronation like they claim to do. So why give somebody a big bulky shoe when it doesn’t do what it is designed to do? Instead, work on the items listed above and become a better runner!

Q: What is the biggest cause of injury in runners?

Dr. Rose: It is when a runner changes something. For example, a runner runs 25 miles per week, same distances for each run. But then decides to run an extra 10 miles one week. That change in volume is what will likely cause an injury to pop up. Another example is always running on concrete or hard trails, then deciding to run 10 miles on soft sand. The body was not ready to support a long soft sand run and an injury occurs.

Q: There is a lot of information for exercises online to help improve running technique, can a runner do home exercises and fix their running flaws?

Dr. Rose: Unfortunately no. I used to be under that assumption when I was an injured runner. I would get frustrated when I would do a ton of strength exercises and core work to then run 2 miles and have that all too familiar pain come back. Running gait needs to be corrected to take strain off the injured area. Using myself as an example, I suffered from repeated shin splints due to cross over gait. It did not matter how much glute or calf strengthening I did because once I ran incorrectly again, the tendon would get overloaded and I would be back to square one. Once I learned to run with a wider step width and have a faster turn over (faster cadence), my injury went away almost immediately and I was able to slowly build back up.

Q: Any other advice on running injuries that you learned?

Dr. Rose: When in doubt, get it checked out. Running should be fun and injury free. I hear too many stories from patients about how tight and sore they are after every run. Or that pain is something “you deal with as a runner”. Not true! Get evaluated by a running doctor who can get your gait back on track. If there is not a running doctor in your area, there are a few pieces of wearable technology that can help. One being Lumo Run which gives feedback on cadence, vertical bounce, hip drop, hip rotation, and braking force. If you already run with a running watch, usually they have features that you can use (like cadence) to start really emphasizing proper technique.

Dr. Travis Rose DC CCSP and Dr. Kevin Rose DC DACBSP are Chiropractors trained to treat a wide variety of sport related injuries. Schedule a visit at our Mission Valley, San Diego office!

Hip pain running doctor San Diego

Types of Hip Pain and Running

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The hips play an important role during running. Running is essentially a single legged sport once you break down the movement.  The hip not only helps propel the body forward but also is a stabilizer of the lower back and the leg during the gait cycle. Due to the demands placed on the hip, it is susceptible to overuse, and acute running injuries. A running doctor can help by diagnosing the problem correctly and developing a treatment plan to get you back to running pain free.

Common types of hip injuries found in runners

There are many types of running injuries that can occur at the hip. Pain may be felt in the front, outside,inside, or back of the hip. Certain cases runner’s will describe the pain as deep in the hip joint. We will categorize the most common types of injuries we see based on location of the injury:

Front hip pain in runners

  • Hip flexor strain
  • Rectus Femoris/quadricep strain
  • Iliopsoas bursitis
  • Iliopsoas tendinitis/tendinosis
  • Rectus femoris tendinitis/tendinosis
  • Hip impingement
  • Hip labral tear
  • Stress reaction/stress fracture
  • Hernia

Outside hip pain in runners

  • Gluteus Medius tendinopathy
  • Iliotibial band syndrome
  • TFL strain
  • Trochanteric bursitis

Inside hip pain in runners

  • Adductor strain
  • Adductor tendinopathy
  • Iliopsoas tendinopathy
  • Hip impingement
  • Hernia

Back hip pain in runners

  • Hip osteoarthritis
  • Hip labral tear
  • Gluteal muscle strain
  • High Hamstring injury
  • Piriformis syndrome
  • Low back pain referral
  • Sciatica

To complicate the injury spectrum, there are cases where runners feel pain in the hip but is a referral from joint/nerve impingement from the lower back. Also if the hip is weak and injured, other injuries to the lower back, knee, shin, and foot may become prominent. Receiving a diagnosis from a running doctor trained in diagnosing and treating runners is very important.

Hip pain treatment

Our sports chiropractors at our Mission Valley office are trained to treat a wide variety of running injuries. We specialize in Active Release Technique, Graston technique, running form analysis, and rehabilitative/performance exercise. Schedule today to get evaluated by a running doctor who knows how to get your training back on track!

Knee Pain Running Doctor

Anterior Knee Pain and Running

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Pain in front of the knee is a common complaint that runners seek advice for from a running doctor. There are many conditions that can cause anterior knee pain including:

  • Patellar tendinitis/tendinosis
  • chondromalacia
  • Patella tracking issues
  • Quadriceps strain
  • Hip flexor strain
  • Capusular ligament sprain
  • Meniscus injury
  • Fat pad syndrome
  • Osgood Schlatter’s disease

It is important to seek treatment from a sports physician and running doctor to get a correct diagnosis, and begin correct treatment immediately.

Knee pain running doctor San Diego

What to expect at your appointment

At our Mission Valley office, our running doctor will take a thorough history of the running injury. After the history is completed an exam will occur which will include some or all of the following: range of motion, orthopedic, neurologic, functional movement, and strength/endurance tests.

Gait analysis is another important aspect for certain running conditions. We currently offer remote gait analysis where current patients can take a treadmill video of themselves running, then email it to our running doctor for evaluation. General recommendations for running technique can be found on our blog here: Increase your Cadence, and Improve Running Posture

Treatment for anterior knee pain

A combination of Active Release Technique, Graston Technique, and a home exercise program resolves many cases of anterior knee pain. We see significant results within 4-8 visits. Our goal is to our runners back to running pain free as soon as possible and have exercises to do to prevent the injury from reoccurring.

If you have been dealing with anterior knee pain during your training, please call our Mission valley office to schedule today. Our running doctors are certified to treat running injuries and get you back to running pain free fast!

Dr. Travis Rose DC is a certified health professional through The Running Clinic. Both Dr. Kevin Rose DC DACBSP and Dr. Travis Rose DC CCSP have treated hundreds of runners including Boston marathon qualifiers, and Olympic trial marathon runners.

Running Doctor Running Injuries San Diego

Running Injuries Treated in Mission Valley, San Diego

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Your training plan was going well and then out of nowhere, pain and discomfort pops up. At first you think, “Well it’s pretty minor, probably just a little sore from the weekend workouts.” So running continues as normal. Each run becomes more and more painful until the injury now hurts before, during, and after runs. This is when patients begin to search for a running doctor in San Diego to help recover from the injury. Our doctors of chiropractic are certified to treat sports and running injuries at our Mission Valley clinic.

What to expect for your running injury evaluation

Our running doctor will go through a thorough history of the injury first and then perform an exam which includes: range of motion, orthopedic, neurologic, functional movement and strength/endurance testing. If special tests are needed (x-ray, MRI), they will be ordered to help with a proper diagnosis.

Running injuries we treat

Runners seek treatment from a running doctor to specifically treat their injury. We treat the following conditions at our Mission Valley running injury clinic:

  • Runners knee
  • Quadriceps tendinitis
  • Hip bursitis
  • IT band syndrome
  • Hip impingement
  • Chondromalacia
  • Shin splints
  • Plantar fasciitis
  • Heel pain
  • Metatarsalgia
  • Morton’s Neuroma
  • Hallux limitus/rigidus
  • Posterior tibialis tendinopathy
  • Peroneal tendinopathy
  • Low back pain
  • Sciatica
  • Hamstring tendinopathy
  • Muscle strains

San Diego Sports Chiropratic

Treatment

Majority of running injuries are a result of overuse, with not enough rest which results in eventual injury (muscle strain, tendinitis, periostitis). Specific interventions to the affected area will help speed up the recovery process. These treatments may include:

Seeking the help from a running doctor specifically, will help get you back to running pain free faster. Schedule with one of our sports chiropractors today at our clinic in Mission Valley San Diego!

Shin Splints treatment San Diego

Shin Splints and Running

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Shin splints can be a frustrating condition to deal with. There are two types: anterior and posterior shin splints. Anterior shin splints are more common in beginner runners and doing “too much too soon” when starting a running training plan.  Posterior shin splints are more common in over trained runners; too much load over time, and/or too much intensity without proper recovery. Running form and technique can play a HUGE roll in recurring shin pain. We will mainly focus on discussing posterior shin splints as this is the most common condition we treat at our San Diego running injury clinic.

Do You have Shin Splints?

Shin splints are characterized by pain along the inner shin bone. In minor cases it may only hurt before and after runs. In more chronic or severe cases, it may hurt before, get worse during, and then be quite debilitating afterward. It is important to get evaluated by a sports chiropractor to rule out more serious conditions such as: chronic exertional compartment syndrome, stress fracture, and calf tear.

Why does the shin hurt with shin splints

The lower leg muscles attach to the tibia (shin bone) and run down to the heel and bottom of the foot. They act as shock absorbers during walking, running, jumping, etc. When these muscles contract, they pull on their bony attachments. If the muscles are not strong enough to absorb the shock well, the pulling at the attachments sites increase. Add in inadequate recovery after workouts, the tissues will not regenerate and will begin to fail. This will lead to soreness, pain, and inflammation along the inner shin where the muscles attach.

What causes shin splints?

Many times we see shin splints due to a recent change in training; change in volume, intensity, terrain, shoes, etc. For example, going from running 30 miles a week to then running 50 miles the next week. The interesting part is that many runners will not recognize this and state, “My training is great! I’ve had no issues until I ran 6 miles yesterday and had pain during and after the run.” It was not the 6 mile run that led to the shin splints, it was the 20 mile jump in volume the week before!

Many runners are susceptible to developing shin splints due to past injury to the lower leg muscles, poor running form, weak core muscles, weak lower leg muscles. When screening an athlete with shin splints, our running doctor will look at all of these potential causes  of shin splints.

But you said most cases are due to training error?

Correct, but if you have deficiencies mentioned above, your body will not be able to handle the forces involved in running as well, and failure will occur at a certain point. We see this a lot when patients have recurring shin pain season after season, or they develop pain only if they do speed work, or only if they run more than 25 miles per week. Their bodies are simply not strong enough to support the increased demands they ask of it. Or their running style puts more strain on the lower leg muscles; see our post on cross-over gait.

Treatment

Short term relief of shin splints involves: potential rest, Active Release Technique, Graston Technique, and home exercises. We see excellent results when we treat shin splints with Active Release technique to break down tight sore muscles that are irritating the bone. A rehab schedule will be advised so patients know when and how far to run. We typically see significant reduction in symptoms within 4-8 visits.

ART shin splints

Long term relief involves: correcting running form, correcting muscle imbalances in the lower leg, strengthening the core, and following a well periodized training plan every season.

We have worked with countless runners dealing with shin pain at our sports injury clinic in Mission Valley. It is important to have a running doctor correctly diagnosis your injury so a custom treatment plan can get you out of pain fast!

 

Dr. Travis Rose, DC CCSP and Dr. Kevin Rose, DC CCSP are Sports Chiropractors who practice in Mission Valley, San Diego.

 

San Diego Sports Chiropratic

Benefits of Sports Chiropractic

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Sports Chiropractic Mission Valley San Diego

Sports Chiropractic Benefits

In general, chiropractic care is excellent for treating many different muskuloskeletal conditions. Many people also seek sports chiropractic care to recover from sport related injury, improve sport performance and avoid potential re-injury through regular maintenance visits. Unfortunately, not all chiropractors are trained to specifically diagnose and treat sport related injuries. If you are seeking care for a sports injury, it is important to know how to find a chiropractor who specializes in treating sport injuries.

Sports Chiropractic Board CertificationDACBSP Certfified

There are two main sport chiropractic certification courses that chiropractors can take after graduating chiropractic college. Both certifications are governed by the American Chiropractic Board of Sports Physicians (ACBSP). The first certification is a Certified Chiropractic Sports Physician® (CCSP®) which is a 100 hour post graduate program designed to educate chiropractors in the most common sports injuries and best practices to treat them.  Successful completion of the program requires a passing score of 250 question multiple-choice questions. The second certification is a Diplomate American Chiropractic Board Sports Physicians® (DACBSP®) is a continuation of the CCSP® program with an additional 100 hours of field training with a research project, and requires successful completion of both a written and practical examination. A sports chiropractor will have either the CCSP® or DACBSP designation behind their name.

Treatment Types

A sports chiropractor is trained in many manual and passive therapies to help an athlete recover from injury and prevent future injury. Our Sports Chiropractors at our office in Mission Valley offer the following therapies and modalities:

  1. Joint manipulation/mobilization– Restores proper range of motion and function to an injured joint.
  2. Muscle Stimulation– Electricity is transmitted via pads to the muscles surrounding the injured area. This helps loosen muscles, and increase blood flow to the area.
  3. Active Release Technique– Active Release technique is the “gold standard” in soft tissue treatment. It helps break down scar tissue that developed from acute trauma or chronic micro trauma to a structure.
  4. Graston Technique– Graston utilizes a set of stainless steel instruments to break down scar tissue in the muscles and the fascia that surrounds the muscles.
  5. Therapeutic taping– RockTape is used in our office to promote body awareness in a dysfunctional area and to support injured tissues during athletic competition
  6. Therapeutic exercise– Flexibility, mobility, strength, endurance, etc. exercises are given to each patient for specific goals in the treatment.
  7. Training advice– A progressive return of the athlete to their sport is vital for the full recovery from injury.

Sports Chiropractic at Peak Form Health Center Mission Valley

Our sports chiropractors at our Mission Valley office are board certified to treat sport related injuries. We treat athletes of all abilities, from the weekend warrior to the professional athlete. We are also athletes ourselves, and understand the importance of feeling your best for optimal performance. Our office is conveniently located off the Texas Street exit in Mission Valley. Please schedule today to get your training back on track and perform at your highest level!

Sports Chiropractor Ironman

Sports Chiropractic Baseball

Dr. Travis Rose, DC CCSP (Left) is an accomplished Ironman Triathlete. Dr. Rose successfuly completed the Ironman World Championship in Kona Hawaii 2017.

Dr. Kevin Rose, DC DACBSP (Right) is a former professional baseball player. Dr. Rose pitched for the Philadelphia Phillies organization.

 

 

 

What is Chiropractic Care?

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What is Chiropractic Care?

Chiropractors are trained to evaluate, diagnose and treat neuromuscular and musckuloskeletal conditions. It is a common misconception that chiropractors only treat spinal conditions with spinal manipulative therapy, or adjusting techniques. In fact, chiropractors treat a wide array of muskuloskeletal conditions which include neck pain, back pain, and headaches but also tendon disorders, muscle strains, and ligament sprains which commonly affect our upper/lower extremities. In our Mission Valley, San Diego office, we commonly treat soft tissue injuries with a combination of joint manipulation, Active Release Technique, Graston Technique, and rehabilitative exercise.

What to Expect for your First Visit?

History

There are a few forms to be filled out that answer questions regarding your current injury (or reason seeking care) and past health issues. One of our chiropractors will then go over this information with you and ask a series of questions regarding your current and past injuries; this helps give us information that leads to a working diagnosis.

Exam

Pain Fighting Exercises

After the history is complete, a physical exam is performed. This normally includes: active/passive range of motion, orthopedic testing, neurological testing, and functional tests such as squats/lunges. All these tests give us further information to accurately diagnose the condition that you are presenting with. This in turn will develop an appropriate treatment plan moving forward. In some cases, the history and exam may reveal a condition that is in need of further testing (X-ray, MRI) before treatment can begin. In rare cases, a referral to a specialized health care provider is warranted.

Many of our patients at our Mission Valley office seek out our care for sport performance and are not currently injured. In these cases, we focus on evaluating musculoskeletal imbalances that may be limiting sport performance.

Treatment

As mentioned above we utilize the latest therapies and treatment protocols for each injury we see in our office. Treatment may include some or all of the following:

                                          Active Release Technique Mission Valley

  1. Joint manipulation/mobilization- If it is determined that there is loss in range of motion at a joint, joint manipulation or mobilization can be performed to restore proper range of motion and joint function   
  2. Active Release Technique– Active Release Technique or (A.R.T) is considered the “Gold Standard” for treating soft tissue injury. The practitioner identifies the injured structure, applies pressure, and has the patient perform active movements. This helps break down scar tissue and restore proper function to the soft tissue. Treatments usually last 5-15 minutes and can be painful in areas where the injury is.
  3. Graston Technique– Graston is another technique we use in our Mission Valley office that helps break down scar tissue in the superficial layers of muscle and fascia in our body. Graston is also excellent for treating chronic injuries due to its ability to increase blood flow to the injured area. After treatment, you may notice red marks and feel warm in the area due to this increase in blood flow.
  4. Rehabilitative Exercise– An individual exercise plan is prescribed for each patient. Exercises may include flexibility, mobility, strength, stability, etc.depending on your injury and or goals with care. Our goal is to always keep the exercises progressive to avoid plateaus in care.

 graston technique in san diego Active Release Technique Mission Valley

 

Our goal is return patients to their sport, activity, job as quickly as possible, pain free. We often see significant results between 4-8 visits, depending on the severity of the condition. Once a patient has reached maximal improvement for the condition we recommend periodic check ups to re-evaluate the area. This allows us the opportunity to offer further advice, change exercises, etc. to avoid future re-injury. 

Please do not hesitate to contact our Mission Valley office at 619-818-4306 if you have any questions. You may call our office or visit our website to schedule today! We accept most major insurances, offer affordable cash rates, and offer a military discount for treatments.