Posts Tagged ‘Chiropractic’

USTA Sport Science High Performance Profile

Thursday, August 5th, 2010

by Casey Chan, DC, QME

The United States Tennis Association is encouraging tennis players to improve their game through the Sports Science Department’s  High Performance Profile.  The profile includes tests that are outside of those typical of fitness assessments.  When performed by a qualified and capable healthcare provider (orthopedist, physical therapist, athletic trainer, or chiropractor), a player’s “profile” may be assessed to identify areas of improvement in biomechanics, strength, flexibility, coordination and balance.  Your healthcare provider should follow up the profile results with recommended exercises and/or treatment.  It is suggested by the USTA that the profile test be performed every 3 to 4 months so that the athlete and healthcare provider may monitor his/her progress.

The High Performance Profile is composed of 10 different tests:

1.  Scapular Stabilization Test – Shoulder movement is assessed for proper biomechanics while lifting light weights.

2. External Rotation Strength Test – Strength of the rotator cuff muscles is assessed while resisting the doctor’s external force.  The rotator cuff muscles are very important for the stability of the shoulder.  Being small in size, the rotator cuff muscles are easily injured especially during the over head service motion.

Hand Grip Dynamometer

3. Grip Strength Test – Forearm, wrist and hand grip strength is tested using a Hand Grip Dynamometer.  The subject squeezes the device to measure the amount of pressure elicited.  Good grip strength is necessary to hold the racket firmly to strike the ball well.

4. Shoulder Internal/External Rotation Test in Active Range of Motion – Using a goniometer (a tool used to accurately measure the degree of motion), the shoulder’s flexibility in internal and external rotation is assessed.

5. Hip and Leg Strength (One-leg Stability Test) – One legged squats are performed to assess core and lower body strength, coordination and balance.

6. Hip External Rotation (Patrick Fabere’s Test) – Flexibility of the hip in external rotation is measured.

7. Hip Flexor Flexibility – Flexibility of the hip is measured.  The hip’s movement may be limited due to the hip’s bony structure, damaged cartilage,  ligaments, and hip flexor and quadriceps muscles.

8. Hamstring Flexibility (Straight Leg Raise) – The hamstring muscles’ flexibility is measured by a goniometer.

9. Quadriceps Flexibility – The quadriceps muscle’s flexibility is measured by a goniometer.

10. Core Stabilization Strength  (Blood Pressure Cuff Test) – The core ‘s strength, primarily the abdominal muscles and low back muscles, is assessed.

When weaknesses are identified through the High Performance Profile, specific exercises and treatment may be prescribed to reduce and remove these weaknesses.  At Chan Chiropractic these may include specific strength exercises for the shoulder, shoulder blade, core muscles and legs; stretching; balance exercises; plyometric exercises; fitness training; and various forms of chiropractic treatment.

While the tests of the High Performance Profile don’t evaluate every fitness or performance component needed to play optimally, the selected tests are unique to tennis, helping tennis players improve their performance.

Dr. Casey Chan helps tennis athletes using the USTA High Performance Profile in her Rancho Penasquitos and Kearny Mesa clinics in San Diego.  Dr. Casey is an experienced practitioner treating tennis athletes in all age groups from the recreational to competitive player.  She has served as the medical staff at local USTA Tennis Tournaments.  She also has experience coaching and teaching children tennis through the Strawberry Canyon Youth Sports Program at the University of California, Berkeley.   Please email her office for more information.  care@chanchiropractic.com

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Chiropractic for the Elderly with Arthritis

Tuesday, July 6th, 2010

by Casey Chan, DC, QME

Today my patient asked me whether it becomes harmful or dangerous to use chiropractic as she gets older. She was particularly concerned about the arthritis she had in her spine.  Like all forms of healthcare, there are benefits, risks and contraindications to chiropractic manipulation with patients with arthritis.  If necessary there are treatment options that I can use to help her with the pain and stiffness she feels from daily stresses.

Benefits

You may have heard the saying that exercise is important for arthritis. This is because movement is important for the health and nutrition of joints. Chiropractic manipulation does the same for the health and nutrition of joints.  A chiropractic manipulation is a low-amplitude high-velocity thrust into a specific, restricted, misaligned or stiff joint to induce movement into the joint. Stimulation of joint and muscle receptors through chiropractic manipulation also helps to reduce pain and muscle spasm/tension.

Risks

The caveat to both exercise and chiropractic manipulation, however, is that they both pose some risks.  It is possible to sprain you hip while jogging or while overstretching.   An improperly performed chiropractic manipulation may also cause a strain to your back muscles.

There are other risks to chiropractic manipulation to the arthritic and elderly patient.  In the case of moderate to severe arthritis, it is possible that a forceful manipulation can fracture bone spurs. Elderly with osteoporosis are also at risk of fracture with manipulation. If disc herniation is associated with the arthritis, chiropractic may be helpful or harmful depending on the severity of the herniation.  Moderate and severe disc herniations often require gentler forms of treatment.

Treatment Options

Every patient must be assessed individually to properly apply appropriate treatments that will be most beneficial while reducing the risks related to that treatment.

There are alternatives to chiropractic manipulation for the care of arthritis. This includes drop-table forms of chiropractic manipulation, joint mobilization (a gentle stretching movement to the joint), therapeutic massage, electrical stimulation (to reduce muscle tension, spasm and pain), rehabilitative exercise, and the use of an Activator instrument to stimulate joint receptors.

In contrast to the manually performed chiropractic manipulation, the drop table form of manipulation uses the design of the table to minimize the force applied to the patient.  The speed of the manipulation tends to increase when the table underneath the patient drops.

An Activator instrument is a triggered device that is used to tap at specific joints to stimulate joints.  Joint receptors are stimulated, causing the joint to loosen up and decreased pain. Because of the low-force of the Activator, there is low risk of injury to patients with conditions such as severe arthritis or osteoporosis.

Conclusion

I have many elderly patients, several of them older than 80 years old!  A few of them are female and of petite build. I have to care for them individually using different treatment techniques depending on their condition. Many patients are helped with skillfully applied chiropractic manipulation, causing no pain. For those who have contraindications to chiropractic manipulation, there are options that I use within our clinic.   Activator or drop table forms of manipulation may be used as may joint mobilization, therapeutic massage, rehabilitative exercise,  electrical stimulation.  The ultimate goal in caring for elderly patients is to maximize benefits and minimize risks to help our patients live a long, happy and healthy life.

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