Sciatic Nerve: A Real Pinch

Sciatica: it’s a word that sounds like the name of a heavy metal band, but there’s nothing positive to say about sciatica (whether there is anything positive about heavy metal is up for debate as well, I guess). Chances are if you’ve ever had a run-in with it, sciatica has made sure that you never wanted to feel that pain again. It can get you in the back, butt, legs and even extend into your feet. It’s not just pain either - it’s numbness, pins & needles, and, in the worst case, muscle weakness/wasting. There’s a world of agony and suffering that comes with problems related to the sciatic nerve.

Even though people in general throw around the word sciatica as if it were a disease/condition itself, it’s actually just a grouping of symptoms. It doesn’t actually refer to one specific cause or diagnosis. However, it does describe the nature of the problem in that it is neuropathic (or related to nerve irregularities, compression or inflammation).

The sciatic nerve (also called the ischiatic nerve) exits the spinal canal in lower back and passes down through the buttocks into the legs. Nerve compression can happen at any point along that path but is very common in the lower back and rear end. Compression leads to inflammation which causes pain and worse depending on the severity.

You’ve probably heard someone complain of a pinched nerve. Sciatica is an example of a type of pinched nerve.

So now what? You’ve got the quick and dirty version of what it means to have sciatica - what should you do, right? That’s where opinions start to differ.

Many medical doctors will often subscribe pain medications or injections for nerve compressions, but in addition to the risk of dependency (among others) carried by some of the more powerful narcotics, who wants to put chemicals in their down if there’s another way?

Living Well Medical in SoHo/NoHo NYC is a practice that integrates non-invasive methods like spinal decompression therapy and Active Release Technique with other approaches. We firmly believe that the non-invasive should be the first line of defense for pain; meds and injections shouldn’t be the starting point in a treatment that might be successful without it. Physical therapy and manual therapies can be just as effective for some patients. Chiropractic and the Cox Flexion technique also have their place in treating problems like herniated or bulging discs.

If you have back pain from sciatica in NYC or for any reason, give our office a call today at (212) 645-8151. We help people like you every day.

- NYC Chiropractor, Dr. Shoshany

Radiating Nerve Pain and Spinal Decompression

Nerve pain of any sort can be a real killer. If you’ve ever known someone that suffered from sciatica (or a similar nerve condition) or suffer with it yourself, you’ve seen how badly it can work its way into every nook and cranny of your life. You can’t move without pain. You can’t sleep properly because of pain. You sit down, pain. Stand up, pain. Everywhere you look, it’s just pain. What the heck are you supposed to do?

At Living Well Medical, my practice (it's a pain relief center in NYC), we see patients with nerve problems all the time. It’s not uncommon under certain circumstances. Trauma like in traffic accidents can cause spinal discs to tear and herniate. A herniated disc is just one way that people find themselves suffering from sciatica. Age and level of activity play a role in spinal health too, of course, but injuries will often catalyze the actual pain. Nerve pain of this sort can be described as a burning sensation that may radiate to other areas of the body like the legs and buttocks; the lower back isn’t going to be the only part that hurts necessarily.

Once we’ve determined that the source of pain is indeed related to a nerve problem like impingement or sciatica (technology like EMG and NCV is used for this purpose as well as MRI’s and x-rays), we put together a plan to get you back on track. Your personalized plan often includes elements like spinal decompression therapy as a portion of multidisciplinary rehabilitation. Spinal decompression therapy is a potent therapeutic technology that works to relieve pain associated with disc-related nerve pain like sciatica. In concert with other non-surgical treatments, we have seen patients make massive improvements in range of motion, quality of life and, really, overall wellness. Combining spinal decompression with important measures like physical therapy and postural training to try and prevent re-injury is also commonly part of a plan. This varies, of course, from patient to patient as needs will differ greatly.

Nerve pain is a major issue, but with the right help, lots of people can get better without surgery and without pain medication, and that’s a big deal. If you are hurting, give my office a call today at (212) 645-8151 and make an appointment to come in and see us.

- Dr. Shoshany, NYC Chiropractor

Leg Pain and the Spinal Nerves

When you think of pain in your legs, you might not think of your spine. In fact, I would wager that unless you knew a bit about anatomy, it’s likely that you wouldn’t have associated the two at all. Unfortunately, leg pain has many potential sources, such as muscular or neurological - neurological is the kind they we’ll be concerned with here, and it can be a miserable experience, especially here in NYC where life never stops moving and people are ALWAYS in a hurry! That’s why we’re here at Living Well Medical in SoHo - to get you up and running full speed ahead again..

So how can our backs affect our legs? What does a spine have to do with leg pain? As you likely know, the spine is the protector of the spinal cord, the mass of nerves that send and receive information from throughout the body. Near the base of the spine, radicular nerves exit the spine and provide sensation and motor skill to the lower body, such as the legs.

When the lower back is injured, this nerve can become compressed and then irritated, leading to severe pain and disability. In extreme cases, loss of sensation and muscular weakness and wasting can occur. It’s a very serious situation to be in. The symptoms that go along with a problem like this are collectively referred to as sciatica.

Thankfully, unlike in years passed, there are a number of non-surgical solutions to leg pain from sciatic nerve compression/impingement. At Living Well Medical in NYC, my practice, we use the latest in conservative treatments like non-surgical spinal decompression and physical therapy to rehabilitate without the invasiveness of surgery or the risks of painkiller regimens.

If you need help and want to have surgery as the last resort, call 212-645-8151 and schedule a consultation. We’re here to help.

- Dr. Shoshany, NYC chiropractor

(Check out my colleague, Dr. Eben Davis, a San Francisco chiropractor, for more on non-surgical treatment.)

Pinched nerve in the neck causing shooting stabbing arm pain NYC

Pinched nerve in the neck causing shooting stabbing arm pain-NYC

Pinched nerve treatment nyc
I wanted to post a brief discussion about a “pinched nerves” and “slipped discs”.
The last several weeks I have seen an influx of patients that can hardly move their neck comfortably in any range of motion and describe their arm pain as stabbing and or shooting.
If the symptoms are in the left arm the patient is concerned that it could be a sign of a heart condition and usually get it checked out by their medical doctor, once it is confirmed that it is not the heart almost always it points to a cervical disc (neck)involvement.
What that means is the disc in the neck is misplaced and can causes pressure or irritation to the very delicate nerves that innervate the hand and arms.
Hence the term” slipped discs”. So the disc themselves don’t necessarily slip they can and do move out of their normal position and the proper medical terminology for a “slipped disc” is either a bulging or herniated disc. To better understand the disc I wanted to go a bit into the disc biomechanics.
Cervical Herniated disc treatment discussion
In people between the ages of 30 and 40 years, their nucleus has a water content of 80% which decreases with age. The average person is 1% shorter in height at the end of the day than on first arising in the morning. This difference is attributed to decreasing water content in the disc, which occurs with advancing age.

The nucleus pulposus, which occupies about half the disc surface area, bears the vertical load, whereas the annulus or outer bands bear the tangential load.
Two terms are used to describe disc degenerative change allowing nuclear herniation. “contained disc” and “noncontained disc” They refer to the state of the annulus fibrosus, that is whether it is intact and restraining the nucleus pulposus ( a contained disc) or whether it has completely radially torn to allow the nuclear material to sequester or free-fragment into the vertebral canal.



Once you start to understand the anatomy of the region it starts to really make sense that the most effective way to not only reduce the pain but correct the problem is to Unload or decompress the area.

In our NYC Physical therapy clinic we utilize a multi pronged approach.
Our first treatment involves the Cox cervical flexion distraction technique.
This is a very gentle movement that allows the doctor to guide the patient’s neck into freeing restricted movement and reducing pressure on discs and spinal nerves.
We also use cervical spinal decompression to reduce intradiscal pressure and help to return disc material back. Cervical spinal decompression is fantastic for patients suffering with cervical herniated disc and arm pain.
The Graston technique is tremendously effective in dealing with “soft tissue” fascia and tight muscles that usually accompany a cervical disc herniation.
Putting together the most effective non-surgical methods to deal with pinched nerves and herniated discs allows us to get our NYC patients back to doing the things enjoy without pain.
Give us a call today if you are suffering with a pinched nerve or have a slipped disc in NYC @ (212)645-8151

A Pain in the Neck

Chances are that at some point, you've had a stiff neck when you woke up in the morning. We say things like, "I think I just slept wrong," and for a little stiffness that might be true. But when it persists, something more serious is at work. Long-term pain or joint stiffness of any sort isn't something that should be ignored; if for no other reason, we shouldn't ignore it just so it doesn't get worse.

There are a ton of causes for a stiff neck or neck pain (in the event that the problem escalates) that we regularly encounter at Living Well Medical in NYC.

One of the most common injuries that can lead to chronic neck stiffness is a whiplash injury. We've all heard of it - you get into an accident, your head gets jerked back and forth brusquely and you feel it right away. It's a recipe for neck pain and stiffness that's all too familiar to people in New York. We regularly treat whiplash patients using the latest in non-surgical technologies.

Another common cause is arthritis; this broad group of degenerative disorders has a way of making us feel "creaky" in our joints, stiff and achy, particularly during shifts in the weather. As structures within the joints break down, a neck that was just stiff can become chronically painful. Although there is no cure for arthritis, it can be effectively managed with physical therapy and exercise, among other treatments.

Of course, disc problems are also something we encounter with neck pain in NYC. A herniated disc can press against spinal nerves leading to serious pain.

One of the factors that often gets overlooked as a contributor to neck stiffness is sleep posture. Just like the way you sit at your desk can cause problems if not balanced, if you sleep in a mechanically incorrect position, the strain on joints begins to add up and pain and loss of range of motion can result. It can have a big effect on daily living.

At Living Well Medical in NYC, we use a variety of non-surgical therapies to stop neck problems - chiropractic, Active Release Technique and Spinal Disc Decompression just to name a few. If a stiff or painful neck won't go away, give us a call at 212-645-8151, and let us help you feel like yourself again.

-Dr. Steven Shoshany, NYC Chiropractor

Pinched nerve in the cervical spine/ herniated disc cervical spine and shoulder/arm treatment

Pinched nerve in the cervical spine due to a herniated disc.
Cervical spine and shoulder/arm treatment NYC.

Just last night we had a patient come in with extreme neck/shoulder arm pain.
He had just had a MRI that confirmed presence of a C5/C6 disc herniation that was putting pressure on his C5/C6 nerve root and facet joint inflammation (similar to tiger woods recent injury.)
We started him out on some moist heat and electro stimulation,followed by Cox cervical flexion distaction and a gentle Chiropractic adjustment.
We followed that by cervical spinal decompression and then he was worked on by our Massage therapist.
He did a complete 360 in one visit, he left with the biggest smile and almost 75% better in one visit.
Awesome stuff!

www.livingwellnewyork.com
Call (212) 627-8149 for pinched nerve treatment in NYC

Low Back & Radiating Leg Pain treatment NYC

Low Back & Radiating Leg Pain treatment NYC

Suffering with Low back pain and radiating leg pain (Sciatica) NYC?
Call the experts at 212-627-8149 or visit us online at herniated disc treatment NYC


Why do I have Low back pain and radiating leg pain?
It is necessary to differentiate between pain in the lower back and pain, which radiates down the leg. It is common for the layperson to combine them into one category, but to a physician or surgeon, they represent different problems.




Lower back pain is not due to the pressure on a nerve root, as lower extremity pain is. Most low back pain is muscular or mechanical in nature, caused by overexertion, overuse, strain or sprain of the ligaments and tendons of the low back. It may also be attributed to degeneration of the disk space and facet joints, which hold the spine together. It may be caused additionally by arthritis or stenosis or referred symptoms from organ involvement ( bladder, gall bladder, kidney, prostate) One must also rule out organic causes as any form of cancer, especially prostate cancer.




Lower extremity (leg) pain is often seen to radiate, termed “radicular pain.” This refers to pain which shoots down the leg (sciatica), from the low back or buttock. It usually results from pressure on a nerve, which produces a “pinching” of the nerve, which appears to radiate down the leg in the distribution of the nerve pattern. When the “pinching” of the nerve is mild, one may experience numbness or tingling. As it progresses and becomes more severe, pain may develop. Further progression may present actual damage to the nerve and weakness may also result.




Each nerve in the lumbar spine has a specific pathway. The nerves also carry three distinct characteristic properties. They carry all three of these properties to specific parts of the leg and foot.




One characteristic is known as the sensory distribution property. What this means is that a nerve will supply the sensory (sensations) property to a certain part of the leg. For example, the S1 root, which is the first sacral root, supplies sensation to the lateral aspect of the foot (little toe).
One characteristic is known as the motor function property. What this means is that each nerve also supplies a characteristic muscle. The S1 root supplies the calf muscles (gastrocnemius), which allows each of us to stand on our toes.
One characteristic is known as the reflex pattern property. Several of the nerves in the lumbar spine have a reflex associated with them. The S1 root has the achilles reflex, which is elicited by tapping on the tendon of the heel.



Leg Pain Brought On By Walking: Neurogenic claudication refers to pain in the lower extremities brought upon by walking. This is often caused by pressure upon the spinal nerves within the spinal canal, usually the result of the disc bulging into the nerves when standing.




Vascular or intermittent claudication is a type of pain, which must be distinguished from the leg, and lower extremity pain from above. Vascular claudication is due to insufficient blood supply to the legs (arterial insufficiency), and is also brought upon by walking. The difference between the two is that merely standing (without walking can cause neurogenic claudication but vascular claudication can only be brought on by walking.




It is extremely important to match the symptoms a patient experiences, with all the pertinent history of patient and family, and match it to the symptoms one would expect based on the:




General Physical Examination
Orthopedic Examination
Postural Evaluation
Palpation Evaluation
Range of Motion Evaluation
Muscle Strength Testing
X-rays, Labs, Diagnostics
All of which are available at Low back and radiating leg pain treatment NYC


With decompression therapy,close to 80% of patients with herniated discs had relief of pain with recovery. Decompression is truly the most effective procedure for severe and chronic cases of bulging, herniated discs, degeneration, arthritis, stenosis and pressure on nerves.




Decompression is non-surgical, drug free and the safest method of the treatment of severe low back available. It also offers the highest percentage of recovery, with most patients well or better.

NYC Disc decompression specialists visit www.nycdisc.com

Back Pain NYC: Suffering with Low Back Pain in Manhattan, New York, NYC?

Back Pain NYC: Suffering with Low Back Pain in Manhattan, New York, NYC? Call today for an immediate appointment
at (212) 645-8151

So you have been diagnosed with a herniated disc, Now what?
In our Manhattan,NYC Back pain clinic we focus on one thing.
That is to get you out of pain as quickly as possible with the latest and most technologically advanced methods in NYC.
We have helped hundreds of New Yorkers overcome the pain associated with Herniated discs, Sciatica and Chronic Low back pain. We utilize a multi-disciplinary approach to not only eliminate your Back pain pain but correct the root cause of your back pain NYC.
We have been providing Non-surgical spinal decompression with the DRX 9000 system for close to 8 years and remain the only facility in New York City to hold a Patent on our protocols.
We offer an initial complimentary consult to discuss treatment options and review MRI findings.
Utilizing a combined non-surgical approach integrating Chiropractic care, Physical therapy, Spinal decompression, Acupuncture, Medical Massage, Three dimensional rehab on the SpineForce, Cold laser therapy and experience of a Medical doctor that specializes in Pain Management we effectively help you return to a life without back pain.

Chiropractic in the Treatment and Prevention of Sports Injuries

Chiropractic in the Treatment and Prevention of Sports Injuries


The article was written by the combined efforts of the ChiroACCESS editorial staff.
ChiroACCESS

Low back pain-NYC-Manhattan Low back pain treatment-
Sports injuries treatment in NYC
Back pain treatment NYC-visit.www.backpaintreatmentnyc.com
Same day appointment for back pain treatment in NYC call (212) 627-8149

Chiropractors have a longstanding history of treating musculoskeletal sports injuries. There have been few research studies that document the value of chiropractic treatment for sports injuries and nearly no research that has looked at providing evidence that chiropractic care can play a role in preventing those injuries. The void and need for research supporting the role of chiropractic in sports injury prevention makes a randomized clinical trial (RCT) published last week (8 April, 2010) an important contribution to the literature. Hoskins and Pollard used two groups of male semi elite Australian Rules football athletes, matched them in several ways and randomly placed them in one of two arms of the study. All received the usual and customary management and medical care. Half also received chiropractic care which consisted of both soft tissue and high velocity spinal manipulation. There research evaluated several outcomes. When chiropractic care was added to conventional management, there was a significant reduction in lower limb strain injuries, time missed as a result of knee injuries, lower low back pain, and there was improvement in health status. “In addition, although not statistically significant, there was a trend towards prevention of hamstring and primary non-contact knee injuries and there were no reported adverse outcomes from the intervention.” The authors do acknowledge the several limitations to their work including the small sample size. The work is nonetheless an important piece and one of the few where the focus is prevention. Free full text here.

This RCT was published only a few months after a Cochrane Systematic Review (please see second abstract below) that found insufficient evidence that manual procedures prevent hamstring injuries.


The effect of a sports chiropractic manual therapy intervention on the prevention of back pain, hamstring and lower limb injuries in semi-elite Australian Rules footballers: a randomized controlled trial.

BMC Musculoskelet Disord. 2010 Apr 8;11(1):64. [Epub ahead of print]

Hoskins W, Pollard H.

BACKGROUND: Hamstring injuries are the most common injury in Australian Rules football. It was the aims to investigate whether a sports chiropractic manual therapy intervention protocol provided in addition to the current best practice management could prevent the occurrence of and weeks missed due to hamstring and other lower-limb injuries at the semi-elite level of Australian football.

METHODS: Sixty male subjects were assessed for eligibility with 59 meeting entry requirements and randomly allocated to an intervention (n=29) or control group (n=30), being matched for age and hamstring injury history. Twenty-eight intervention and 29 control group participants completed the trial. Both groups received the current best practice medical and sports science management, which acted as the control. Additionally, the intervention group received a sports chiropractic intervention. Treatment for the intervention group was individually determined and could involve manipulation/mobilization and/or soft tissue therapies to the spine and extremity. Minimum scheduling was: 1 treatment per week for 6 weeks, 1 treatment per fortnight for 3 months, 1 treatment per month for the remainder of the season (3 months). The main outcome measure was an injury surveillance with a missed match injury definition.

RESULTS: After 24 matches there was no statistical significant difference between the groups for the incidence of hamstring injury (OR:0.116, 95% CI:0.013-1.019, p=0.051) and primary non-contact knee injury (OR:0.116, 95% CI:0.013-1.019, p=0.051). The difference for primary lower-limb muscle strains was significant (OR:0.097, 95%CI:0.011-0.839, p=0.025). There was no significant difference for weeks missed due to hamstring injury (4 v14, chi2:1.12, p=0.29) and lower-limb muscle strains (4 v 21, chi2:2.66, p=0.10). A significant difference in weeks missed due to non-contact knee injury was noted (1 v 24, chi2:6.70, p=0.01).

CONCLUSIONS: This study demonstrated a trend towards lower limb injury prevention with a significant reduction in primary lower limb muscle strains and weeks missed due to non-contact knee injuries through the addition of a sports chiropractic intervention to the current best practice management. Trial registration The study was registered with the Australian and New Zealand Clinical Trials Registry (ACTRN12608000533392).


Interventions for preventing hamstring injuries.

Cochrane Database Syst Rev. 2010 Jan 20;(1):CD006782.

Goldman EF, Jones DE.
Synergy Healthcare, 1-4 Stokers Buildings, Front Street East, Bedlington, Northumberland, UK, NE22 5DS.

BACKGROUND: Some sports, such as football, have a high incidence of hamstring injuries. Various interventions targeting the prevention of such injuries are in common use.

OBJECTIVES: To assess the effects (primarily, on the incidence of hamstring injuries) of interventions used for preventing hamstring injuries in physically active individuals. SEARCH STRATEGY: We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register (to December 2008), the Cochrane Central Register of Controlled Trials (The Cochrane Library, 2008, Issue 4), MEDLINE and other databases (to December 2008), reference lists and clinical trials registers.

SELECTION CRITERIA: Randomised or quasi-randomised trials of interventions for preventing hamstring injuries were included; as were trials testing interventions for the prevention of lower-limb injuries, provided that hamstring injuries were reported. Secondary outcomes included compliance, severity and the occurrence of other leg injuries.

DATA COLLECTION AND ANALYSIS: Two authors independently screened search results, assessed methodological quality and extracted data. Risk ratios (RR) and 95% confidence intervals (95% CI) were calculated for dichotomous variables and are reported for individual and pooled data.

MAIN RESULTS: Seven randomised controlled trials involving 1919 participants were included. All trials involved people, predominantly young adults, participating in regular sporting activities. Some trials were compromised by poor methodology, including lack of blinding and incomplete outcome data.Four trials, including 287 participants, examined interventions directly targeted at preventing hamstring injuries. Three of these trials, which tested hamstring strengthening protocols, had contradictory findings, with one small trial showing benefit (although the control rate of mainly minor hamstring injury was unusually high). The other two trials found no benefit, with a greater incidence of hamstring injury in the intervention group. One unpublished and underpowered trial provided some evidence that manual therapy may prevent lower-limb muscle strain (RR 0.13, 95% CI 0.02 to 0.97), although the finding for hamstring injury did not reach statistical significance (RR 0.21, 95% CI 0.03 to 1.66).Three trials testing interventions for preventing lower limb injuries for which data for hamstring injury were available found no statistically significant effect for hamstring injury for either proprioceptive protocols (two cluster randomised trials) or a warm up/cool down and stretching protocol (one trial).

AUTHORS' CONCLUSIONS: There is insufficient evidence from randomised controlled trials to draw conclusions on the effectiveness of interventions used to prevent hamstring injuries in people participating in football or other high risk activities for these injuries. The findings for manual therapy need confirmation.


Strength imbalances and prevention of hamstring injury in professional soccer players: a prospective study.

Croisier, J.L.; Ganteaume, S.; Binet, J.; Genty, M.; Ferret, J.M.;

American Journal of Sports Medicine 2008 AUG Vol. 36(8) pp. 1469 - 75

BACKGROUND: The relationship between muscle injury and strength disorders remains a matter of controversy. PURPOSE: Professional soccer players performed a preseason isokinetic testing aimed at determining whether (1) strength variables could be predictors of subsequent hamstring strain and (2) normalization of strength imbalances could reduce the incidence of hamstring injury. STUDY DESIGN: Cohort study (prognosis); Level of evidence, 1. METHODS: A standardized concentric and eccentric isokinetic assessment was used to identify soccer players with strength imbalances. Subjects were classified among 4 subsets according to the imbalance management content. Recording subsequent hamstring injuries allowed us to define injury frequencies and relative risks between groups. RESULTS: Of 687 players isokinetically tested in preseason, a complete follow-up was obtained in 462 players, for whom 35 hamstring injuries were recorded. The rate of muscle injury was significantly increased in subjects with untreated strength imbalances in comparison with players showing no imbalance in preseason (relative risk = 4.66; 95% confidence interval: 2.01-10.8). The risk of injury remained significantly higher in players with strength imbalances who had subsequent compensating training but no final isokinetic control test than in players without imbalances (relative risk = 2.89; 95% confidence interval: 1.00-8.32). Conversely, normalizing the isokinetic parameters reduced the risk factor for injury to that observed in players without imbalances (relative risk = 1.43; 95% confidence interval: 0.44-4.71). CONCLUSION: The outcomes showed that isokinetic intervention gives rise to the preseason detection of strength imbalances, a factor that increases the risk of hamstring injury. Restoring a normal strength profile decreases the muscle injury incidence.


Predictors of hamstring injury at the elite level of Australian football.

Gabbe, B.J.; Bennell, K.L.; Finch, C.F.; Wajswelner, H.; Orchard, J.W.;

Scandinavian Journal of Medicine & Science in Sports 2006 FEB Vol. 16(1) pp. 7 - 13

BACKGROUND: Hamstring injuries are the most common injury sustained by elite Australian football players and result in substantial costs because of missed training time, unavailability for matches and lost player payments. Evidence to support proposed risk factors for hamstring injury is generally lacking, limiting the development of appropriate prevention strategies. AIM: To identify intrinsic risk factors for hamstring injury at the elite level of Australian football. METHODS: A prospective cohort of 222 players underwent baseline measurement in the form of a self-report questionnaire and a musculo-skeletal screen during the pre-season period of the 2002 Australian football season. Injury surveillance and exposure data were collected for the full season. Logistic regression analyses were used to identify independent predictors of hamstring injury in this group of players. RESULTS: Thirty-one players sustained a hamstring injury. A past history (previous 12 months) of hamstring injury and increasing age were found to be independent predictors of hamstring injury. CONCLUSIONS: Older players and those with a previous history of hamstring injury are target groups for further research and implementation of injury prevention strategies. Restricted ankle dorsiflexion range of movement warrants consideration in the development of prevention programs for hamstring injury.


Recurrent posterior thigh symptoms detrimental to performance in rugby union: predisposing factors.

Devlin, L.;

Sports Medicine 2000 APR Vol. 29(4) pp. 273 - 87

Recurrent hamstring injury is a very common problem in rugby union, but has been largely ignored in the literature. It is concluded that a multifactorial aetiology may be present, and that these symptoms may be part of a continuum of symptoms that may lead to more serious injuries. Effective management needs to focus not just locally, but include proximal issues such as lumbo-pelvic stability and correcting lumbar spine dysfunction. The factors addressed in a prevention programme are likely to contribute to performance gains.


Factors associated with hamstring injuries. An approach to treatment and preventative measures.

Worrell, T.W.;

Sports Medicine 1994 MAY Vol. 17(5) pp. 338 - 45

Following hamstring strain, rehabilitation is often prolonged and frustrating for the athlete and for the sports medicine clinician. Though the initial treatment of rest, ice, compression and elevation is accepted for muscle strains, no consensus exists for rehabilitation of hamstring muscle strains. This lack of agreement concerning rehabilitation of hamstring injury represents our lack of understanding of the mechanism of injury and the factors that contribute to hamstring strain. A hamstring rehabilitation model is proposed that is based on our current understanding of the aetiological factors that contribute to hamstring muscle strain. The influence and interaction of hamstring strength, flexibility, warm-up and fatigue are aetiological factors that should be addressed in the rehabilitation and prevention of hamstring strains. The rehabilitation model is, however, not without limitations and speculations. Further research is needed to clarify the etiological factors of hamstring strain and the efficacy of different rehabilitation protocols.
Are you suffering with Low back pain? Sciatica NYC? or a herniated disc NYC?
Then visit your NYC Back pain specialist

Herniated disc NYC-Chiropractor NYC

Herniated disc NYC Back pain NYC The Disc Its long name is the intervertebral disc. It is the structure that seperates each of the vertebral bodies. The disc is analogous to the white cream between the two chocolate wafers in a Oreo cookie, where the wafers are the vertrbrae. It's a critical part of the spine. The disc looks solid, but it isn't. It's contructed s lot likea jelly donut. It has a firm outer shell (called the annulus fibrosis) and a soft inner core (called the nucleus pulposus). The job of the nucleus (the jelly) is to absorb shock. Just as the hydraulic fluid in a cars shock absorbers prevent us from feeling every bump in the road, the doft inner core of your disc provides the give that prevents your vertebraw from rattling against each other with every step you take. The job of the annulus (the bready part of the donut) is to keep the nucleus from leaking out, and to attach to the end plates of the vertebral bodies above and below. The annulus plays a role in back pain because there are nerves in it. If you have Back pain or a herniated disc in NYC visit www.nycdisc.com or www.herniateddiscnyc.com Dr. Steven Shoshany-NYC Herniated disc specialist www.drshoshany.com

Back pain NYC-Best back pain treatment

Back pain treatment in NYC-Call 1212-645-1495
or visit Herniated disc NYC
In our office we utilize multiple disciplines to alleviate your Back pain and return you back to the things that you enjoy.

Back pain can interfere with everyday activity like putting on your shoes,going to the bathroom and many more activities that depend on you ability to move properly.

When you visit our NYC Back pain office we will evaluate the source of back pain we do this with a comprehensive exam and if necessary we offer On-site diagnostics like Digital radiographs or x-rays and Diagnostic ultrasound that can see exactly where it hurts and what is going on.We are open late during the week and offer Saturday appointments.

Once we diagnosis the problem, we offer a multiple prong approach to end your pain as quickly as possible and start your recovery. Dr. Arnold Blank MD is our on site pain management specialist. He can prescribe the appropriate pain medication and determine what is the most appropriate course of treatment either Chiropractic care,Physical therapy, Medical Massage, Acupuncture or a combination methods.

Most major medical insurance covers most of the services we provide, we offer a initial complimentary consultation to determine if we can help you.
Call us @ 347-562-2144 and we can verify your insurance coverage.

Does your Back pain come from

Herniated disc-leaking of disc material into the spinal canal
Spinal Stenosis-narrowing of the spinal canal
Spondylolishtesis- an out-of-line vertebra
Facet joint syndrome- degeneration of the joints holding the vertebrae together
Scoliosis- abnormal lateral curvature of the spine
Sacroiliac joint problems- degeneration of the joint that connects the sacrum to the pelvic bone
or discogenic low back pain
There are allot of different types of back pain and our team of experts work together to identify and effectively correct these problems with a combination of non-invasive and non surgical cutting edge technology's like
Spinal decompression on the DRX 9000
Cold laser therapy with the Erchonia laser
Power Plate Whole body vibration
Kinesio taping and the Graston Technique.
Physical therapy and the Mackenzie technique
Digital gait scan analysis and Custom orthotic fabrication.
Prolotherapy injections
If you live or work in Manhattan and suffer with Back pain, look no further then livingwellnewyork.com
Back pain treatment NYC-Back pain and Sciatica-

Chiropractic care for headaches

More Evidence Supporting the Effectiveness of Chiropractic Spinal Manipulation for Cervicogenic Headache

A study published in the February 2010 issue of The Spine Journal added additional evidence supporting the effectiveness of chiropractic spinal manipulation (SMT) for cervicogenic headache (CGH). Dr. Mitch Haas and his team at Western States Chiropractic College investigated the differences in dose (8 versus 16 treatments) and between high velocity low amplitude spinal manipulation versus light massage in the treatment of cervicogenic headache. Both interventions were provided by experienced chiropractors. There were multiple outcomes assessed and the SMT group had clinically significant improvement over the light massage control. However, there was only a small dose effect difference between the groups receiving eight versus sixteen treatment sessions.

In that same issue of the journal, Drs. Haldeman and Dagenais provide commentary on this research. They conclude by stating that, despite some weaknesses in the research, “this study represents a step forward for stakeholders considering SMT )spinal manipulation therapy) for CGH. For clinicians who establish a working diagnosis of CGH that conforms to accepted diagnostic criteria, it appears reasonable, based upon currently available evidence, to consider a trial of SMT.”

Treatment of cervicogenic headache is one of the areas were the evidence is strongest for SMT and chiropractic. As the number of studies increases and improve, using different patient demographics, different techniques, different doses, etc., the stronger the position of the chiropractic profession becomes in the care of this condition.

Dose response and efficacy of spinal manipulation for chronic cervicogenic headache: a pilot randomized controlled trial.

Spine J. 2010 Feb;10(2):117-28.

Haas M, Spegman A, Peterson D, Aickin M, Vavrek D.
Center for Outcomes Studies, Western States Chiropractic College, 2900 NE 132nd Ave., Portland, OR 97230, USA. mhaas@wschiro.edu

BACKGROUND CONTEXT: Systematic reviews of randomized controlled trials suggest that spinal manipulative therapy (SMT) is efficacious for care of cervicogenic headache (CGH). The effect of SMT dose on outcomes has not been studied.

PURPOSE: To compare the efficacy of two doses of SMT and two doses of light massage (LM) for CGH.

PATIENT SAMPLE: Eighty patients with chronic CGH.

MAIN OUTCOME MEASURES: Modified Von Korff pain and disability scales for CGH and neck pain (minimum clinically important difference=10 on 100-point scale), number of headaches in the last 4 weeks, and medication use. Data were collected every 4 weeks for 24 weeks. The primary outcome was the CGH pain scale.

METHODS: Participants were randomized to either 8 or 16 treatment sessions with either SMT or a minimal LM control. Patients were treated once or twice per week for 8 weeks. Adjusted mean differences (AMD) between groups were computed using generalized estimating equations for the longitudinal outcomes over all follow-up time points (profile) and using regression modeling for individual time points with baseline characteristics as covariates and with imputed missing data.

RESULTS: For the CGH pain scale, comparisons of 8 and 16 treatment sessions yielded small dose effects: AMD. There was an advantage for SMT over the control: AMD=-8.1 (95% confidence interval=-13.3 to -2.8) for the profile, -10.3 (-18.5 to -2.1) at 12 weeks, and -9.8 (-18.7 to -1.0) at 24 weeks. For the higher dose patients, the advantage was greater: AMD=-11.9 (-19.3 to -4.6) for the profile, -14.2 (-25.8 to -2.6) at 12 weeks, and -14.4 (-26.9 to -2.0) at 24 weeks. Patients receiving SMT were also more likely to achieve a 50% improvement in pain scale: adjusted odds ratio=3.6 (1.6 to 8.1) for the profile, 3.1 (0.9 to 9.8) at 12 weeks, and 3.1 (0.9 to 10.3) at 24 weeks. Secondary outcomes showed similar trends favoring SMT. For SMT patients, the mean number of CGH was reduced by half.

Chiropractic care for headaches in NYC visit www.drshoshany.com

Chiropractic care in the Olympics

Chiropractic Care Included in 2010 Olympic Vancouver Winter Games at On-Site

Polyclinic – A First for Olympic Athletes

Source Southern California University of Health Sciences

For the first time in the history of the Olympic Games, the 2010 Winter Games in Vancouver, Canada, include chiropractic care inside the Olympic Village Polyclinic, a multi-disciplinary facility offering comprehensive healthcare and medical services.

While DCs (Doctors of Chiropractic) have historically been included on the Olympic medical staff, this year’s events mark the first time that DCs from the host country will be treating athletes and officials from around the world directly inside the Polyclinic.

“This is an historic event not only for the chiropractic profession, but also the athletes who will now have access to the care that will help them prepare their bodies for competition,” states Michael Reed, DC, MS, DACBSP, and team USA’s medical director (USOC). “These athletes train hard and endure significant physical demands. Sports-focused DCs, along with other members of the sports medicine team, are specially skilled to assist them in reaching peak performance.”

Chiropractic care has experienced several major moments in Olympic history, dating back to Leroy Perry, DC, who provided chiropractic care to athletes representing Antigua during the 1976 Games in Montreal, Canada. During the 1980 Winter Olympic Games in Lake Placid, NY, George Goodheart, DC, became the first official chiropractor appointed to the U.S. team.
With each subsequent Olympic Games and Pan American Games, the U.S. teams — along with a growing number of other national teams — have included at least one doctor of chiropractic on their medical staff.

“Inclusion inside the Polyclinic is another major milestone for the chiropractic profession, and we are grateful to the host city of Vancouver, the head of medical services at the Polyclinic, Jack Taunton, MD, and to Robert Armitage, DC, who helped make this possible,” says USOC Director of Sports Medicine Clinics, Bill Moreau, DC, DACBSP.

World class athletes utilize Chiropractic care to keep them aligned and free of nervous system interference for that competitive edge.
Learn more about how Chiropractic care can help you at www.drshoshany.com
Chiropractic care in New York City visit www.livingwellnewyork.com

Posture's newest Ally

In our Chiropractic practice we work on improving patients posture through a combination of Chiropractic care,Core Strengthing using the SpineForce and kinesiolgy tape. One specific application that all of our patients love is the
Postural Spider.


Posture's Newest Ally

Dr. Kevin D. Jardine



The scapula is frequently involved, yet seldom symptomatically, in the majority of shoulder girdle conditions. With the shoulder relying on soft tissue control and coordination to provide stability, any deficiency in the required muscles performing their functions can alter the function of the shoulder. Proper coordinated co-activation of the shoulder musculature along with proper scapular positioning is necessary in order to minimize the mechanical stresses imposed on the articular and myofascial structures around the shoulder.

Dysfunction in the normal scapulothoracic rhythm is associated with many common shoulder
injuries. Common alterations in the positioning of the scapula can include:

Excessive protraction of the scapula during arm movements leading to anterior positioning of the head of the humerus.
Superior displacement of the humerus within the joint leading to pinching of the space between the acromion and the humerus.
The shoulder blade sitting too high on the back leading to the acromion being tilted anteriorly therefore increasing the likely hood of impingement.
The classical case of impingement syndrome includes a patient with a primary complaint of pain over the tip of the shoulder radiating over the upper lateral arm with movements involving horizontal abduction of the arm. With visual observation we can see that the patient has anteriorly rounded shoulders and protracted scapulae bilaterally. In providing training for this client to strengthen and rehabilitate the rotator cuff we must address the scapular positioning issue in order to reduce the mechanical strain imposed on the joints and muscles affected. If left unaltered, the poor positioning of the scapulae will continue to stress the adjacent structures in the kinetic chain which have had to compensate. This can result in accelerated wear and tear and eventually structural breakdown.

To address the issue of scapular positioning, we will apply a Postural Spider™ to the mid back of the patient. The Postural Spider™ is a kinesiology taping application which is pre-designed and ready to apply belonging to the comprehensive line of SpiderTech™ applications. The application may be worn continuously for up to five days in which the client can exercise and shower. SpiderTech™ is an innovative functional medicine approach to modulate pain and myofascial dysfunction through the use of specialized pre-cut elastic tape applications. There are 3 possible variations for application, depending on the therapeutic objectives and the client’s condition, including Microcirculatory applications, neurosensory applications, and the one we will be demonstrating here, Structural applications.

Structural applications are designed to dynamically support better static and dynamic postural positions; provide relative immobility in order to prevent harmful ranges of motion without a hard end feel; and reduce strain on affected muscles and joints.

Structural applications involve applying the tape while it is stretched to the desired level of tension while the body part is held in a neutral position. This allows for the muscle and joint to move with more natural barriers to faulty postures and ranges of motion which may be harmful. SpiderTech’s™ Postural Spider application can address a concern most therapist have when addressing proper shoulder girdle posture, the ability to maintain proper positioning even when the client is not consciously aware of maintaining the ideal postures.

The improvement in posture and scapular stabilization allows for overhead arm elevations without the risk of impingement. Once the scapula is stabilized, the client can then condition the appropriate musculature to develop the proper strength and length/tension relationship of the muscles involved. Current evidence has shown that rehabilitation protocols that emphasize restoring normal functional stability and movement, along with proper biomechanics, have higher rates of successful outcomes.

Taking an integrative and comprehensive approach to shoulder conditions will provide enhanced training and therapeutic outcomes with the scapula playing a crucial role.

Dr. Kevin D. Jardine is a chiropractor and CEO of a Toronto based multidisciplinary sports therapy clinic called The Urban Athlete and co-inventor and designer of SpiderTech™.
SpiderTech is available in NYC at www.livingwellnewyork.com

Can you guarantee spinal decompression works?

I often have patients ask me if I can guarantee that Spinal decompression works,and the response is that I cannot- because although this treatment is highly effective for 86% of patient population some do not respond favorably.
On a side note there are no guarantees with surgery, especially that you will even wake up,Just look what happened to Charlie Wilson.


I posted below several misconceptions about spinal decompression below:

Every year millions of Americans suffer from back pain. For many, back pain leads to non-surgical spinal decompression treatments. Even though this treatment has been around for years, there are still misconceptions about what it is and how it is used. Here we will go over some of those common misconceptions and set the record straight.
Misconception #1: Spinal Decompression is Painful - Besides being untrue, this is actually the exact opposite of the truth. Most patients find the procedure relaxing. Some even fall asleep during treatments. Patients lie down on a table and watch TV or listen to their Ipod as the machine works.

Misconception #2: Spinal Decompression is Expensive - This all depends on how you look at it. Sometimes it is covered by insurance, making it very affordable. Even when it is not covered by your insurance, if you compare it to the cost of surgery, spinal decompression is cheaper. This does not even include the money you would lose from time lost recovering from surgery. There is no down time from spinal decompression.

Misconception #3: Spinal Decompression Works for Everyone - Another big misconception is that if you have a slipped disc or herniated disc then spinal decompression will work for you. As much as chiropractors would like this to be true, it is not. There is no guarantee that any treatment will work. Not everyone qualifies for spinal decompression. You will have to be evaluated to see if your condition meets the requirements.

Misconception #4: Inversion Tables do the Same Thing - Frankly, I am not sure how this rumor got started. Inversion tables are not the same thing. Spinal decompression requires special FDA approved equipment run by a licensed chiropractor. There is no way you can get the same results and the same treatment at home. Inversion tables are completely different and will not give you the same results.

Misconception #5: Spinal Decompression and Spinal Surgery Have the Same Results - Thankfully, this is not true either. Spinal surgery has a shockingly low rate of success. In fact, the majority of patients will experience pain even after having surgery. Spinal decompression, on the other hand, has an exceedingly high success rate. In addition, patients do not lose time from missing work and there is no pain experienced with the procedure.

Misconception #6: All Chiropractors Give the Same Spinal Decompression Treatment - Again, this is a myth that needs to be stopped. Not all chiropractors are the same. Different chiropractors will offer different services. When choosing a chiropractor for your spinal decompression treatments, you will want to base the decision on a variety of factors. First, does the chiropractor work with a team? You will want to make sure you can get physical therapy, massage therapy and chiropractic services all in the same office. Second, does the chiropractor work well with you? No sense going to a chiropractor that doesn't listen to you. You want to find a chiropractor that will work with you to develop a plan of recovery that may or may not include spinal decompression. Finally, you need a chiropractor and staff you can trust. Do they greet you with a friendly smile? Do they guarantee you will get the same day appointment? You need someone who is willing to see you when you need to be seen. You need someone you can trust to be there for you.
Also not all spinal decompression are the same, be sure to insist on the highest possible quality medical equipment like the DRX 9000 spinal decompression machine.
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Spinal decompression in NYC with Herniated disc specialist-Dr.Steven Shoshany

What Is Making My Neck Hurt?

The other day I woke up with a little pain in my neck, so it occurred to me to write a little bit about neck pain.

Right next to back problems, neck pain is one of the biggest problems for Americans every year. It's true that little pains are likely to creep into our lives little by little as we get older; unfortunately, it's often a part of the normal aging process. However, that isn't always the way it goes. Acute pain that shoots right through you and chronic pain that hangs around for long periods of time are both indications of a dysfunction. Pain is the physical signal that tells us to stop our activity because of potential physical damage we have experienced. On the other hand, as complicated as our bodies are, sometimes the pain we feel isn't actually related to the place where damage has occurred.

Let's cover a few of the more common reasons for neck pain, all of which we routinely treat at Living Well Medical in NYC.

Neck Muscle Strain: Overusing the muscles that support the head and neck can result in muscle pain. Poor posture, whiplash injuries, and poor ergonomics often contribute to muscle strains in the neck. For less serious strains, deep tissue massage can be beneficial, especially when coupled with physical therapy to strengthen those muscles and prevent future problems. Your treatment might be different depending on the type of muscle strain.

Facet Joint Syndrome: Each of the bones in the spine contain four facet joints, and when they work properly, they are responsible for a lot of movement and flexibility of the spine. Trauma, deterioration of intervertebral discs, and poor posture are among the more common causes of pain related to the facet joints. Physical therapy and non-surgical spinal decompression can be effective in treating facet joint syndrome, but individual needs will vary

Cervical Disc Herniation: The spongy structures between the spinal bones can sometimes bulge out and herniate, compressing the nearby nerves in the spinal canal. The pain can range from irritating to completely debilitating, and some patients opt for spinal surgery as a result. Our treatment programs incorporates a number of different therapies (determined by the initial evaluation), often including spinal disc decompression and physical rehabilitation.

This only scratches the surface of the reasons we experience pain in the neck. If the pain is bad enough that it's affecting the way that you live each day, give us a call at Living Well Medical in NYC at (212) 645-8151.