The PRICES acronym for treating common sports injuries

As we enjoy this sunny week in Portland, a review of how to properly treat acute sports injuries seems appropriate. 

First, it’s important to remember that swelling is your body's normal response to injured tissue (muscle, tendon, ligaments). Excessive swelling, though, can cause pain, reduced range of motion and may interfere with healing. You can limit swelling and inflammation leading to faster and more efficient healing by using the PRICES principle:

P — protect from further injury

Take time off from aggravating activities. While healing, your body is more susceptible to re-injury.

R — rest

Get plenty of sleep, this is when your body can focus its efforts on healing.

I — apply ice

Apply ice immediately after a common sports injury. Use ice for 20 minutes every one to two hours for the first 72 hours after the injury. Don't use heat during this time — it encourages swelling and inflammation.

C — apply compression

Compression with an elastic bandage will help reduce swelling.

E — elevate the injured area

Elevating the injured area above the heart will also reduce swelling.

S — see a chiropractor

At Hosmer Chiropractic Health, our doctors are certified in Active Release Technique, a great treatment for soft tissue injuries. We will also teach you specific stretches and exercises that can help your heal better and faster.

If you suspect a serious injury or if you have any of these signs, please see a doctor:

• Deformities in the joint or bone — it looks twisted or moves abnormally

• You cannot bear weight or can't use the limb without it “giving way”

• Excessive swelling or extreme pain

• Changes in skin color beyond mild bruising

• It's not getting any better after a few days of PRICE therapy

Although neck and/or shoulder pain is the most common symptom associated with whiplash injury, other symptoms may include headaches, neck swelling, muscle spasms, numbness or tingling into your arms, nausea, difficulty swallowing, dizziness, and blurred vision. Symptoms may be present immediately after an accident or they may slowly begin to develop over hours or even days.

2) Injury may occur at speeds less than 5mph

It's hard to believe that at such slow speeds your body may become injured, but researchers recently conducted low speed rear impact tests and concluded that 29% of people developed symptoms related to whiplash at speeds of just 2.5mph. Furthermore, it has been shown that a 10mph rear end collision can produce up to 9 G's of force in your neck! Keep in mind, the speed of the collision does not correlate to the degree of injury your body may sustain.

3) During impact your neck is forced into an unnatural S curve

The 7 vertebrae of the neck normally combine to form a 35-45 degree curve called the cervical lordosis. Biomechanical studies have shown that during a rear-end collision the torso is forced back into the seat and at the same time moves upward causing the lower cervical vertebrae to move into hyperextension while the upper cervical vertebrae flex forward. It is believed that it is during this time that injury occurs in the neck as the muscles, tendons, and ligaments are being strained to hold the vertebrae against opposing forces.

4) X-rays are usually negative for fracture

Advancements in seat and headrest design have helped to diminish the number of serious head and neck injuries resulting from rear-end collisions. Although x-rays are usually negative for fractures of the cervical spine, a common finding associated with whiplash injuries is a straightening of the cervical curve. This can be due to persistent muscle spasm and is usually associated with pain. Have a trained medical professional exam you after an accident and decide if X-rays are indicated.

On the right is an X-ray of a normal cervical lordosis, whereas the X-ray on the left shows a decreased lordosis or straightening of the curve.

5) Chiropractic treatment can help

Chiropractors are trained to diagnosis and treat many of the injuries that are typically associated with whiplash. Your chiropractor will perform a thorough history and physical examination, may request x-rays or other imaging if necessary, will provide treatment to the soft tissues and joints as necessary, and will teach you proper home care for your injuries. Treatment can last anywhere from a few weeks to a few months depending on the severity of injury, and in the State of Oregon your PIP coverage will cover medical expenses, including chiropractic and certain types of massage, up to $15,000.

More than 1 million people suffer whiplash injuries each year and about 10% of those end up with chronic pain that affects their daily activities. If you or someone you know is suffering from pain related to an auto accident, get it checked out by a professional, you don't deserve to be in chronic pain.

Sources:

Harvard Health Publications, Whiplash, 9/1/2009

Spine Research Institute of San Diego, www.srisd.com

Clinical Biomechanics, Cervical Spine Curvature During Simulated Whiplash, Volume 19, Issue 1, January 2004

American Journal of Medicine, Whiplash: A Review of a commonly Misunderstood Injury, June 1 2001

What makes a good doctor?  Is it education?  Experience?  Good listening skills?  The Institute for Family Centered Care asked this very question, and arrived at a "Top 10" list of things that are important to patients:

1. Listens to all symptoms before making a diagnosis.
2. Is knowledgable about the patient's condition – past and current status.
3. Is very knowledgeable about diagnosis and current treatments, staying up to date on current evidence and recent research.
4. Encourages patients and family members to ask questions and participate in the care experience.
5. Gives opinions for solving problems and suggests ways in which patient and family members can participate in care.
6. Collaborates with patient and family members in seeking additional solutions.
7. Volunteers information about agencies that provide additional services and knows how to access those services.
8. Uses familiar terminology or carefully defines new terms; checks to ensure that the patient and family members understand.  
9. Takes time and does not seem rushed.
10. Follows through on care and outcomes

I might add a few things to the list as well:

1. Works with the patient to understand their insurance coverage and payment options.
2. Provides a well-rounded approach to both treatment and preventative measures.
3. Gives the patient tools that they can use to improve their health.

Seeing this list validates our approach to healthcare here at Hosmer Chiropractic Health.  Whether we are treating a sports injury, car accident injuries, or garden variety neck and back pain – the same principles apply.  We are here to help and do our best to guide you back to health.

How are your adjusting skills?  Are you confident that you are providing the right treatment to restore function?  These seminars will teach you to evaluate biomechanics of joints and soft tissues to accurately determine which joint needs to be adjusted, and what specific adjustment will help the patient.

How do you feel at the end of a busy day or busy week?  Are you wearing out your shoulders, hands and spine?  These seminars will teach you to provide an adjustment that is safe for your body, and comfortable for the patient.

From Dr. Seth Hosmer:

"I have taken both the Spine and Extremity Seminars on 5 previous occasions, and find that each immediately improve my ability to effectively diagnose and treat musculoskeletal conditions of all types.  Specific things that have helped me with my patients include:

• Knowing which joints need to be adjusted and in which direction – it is not enough to simply make something "pop" where it hurts, or do watever adjustment that you are good at. The patient needs a specific adjustment, and I am confident knowing I can provide that.
• Easy Adjustments – comfortable for me, comfortable and effective for the patient.
• Head-To-Toe proficiency – if there are areas of the body you are not able to fully examine or treat, there are going to be patients that you cannot help.
• More Fun in Practice – Treating patients is more rewarding for the Doctor when you are confident in your ability and technique; you'll have more fun as you treat your patients."

Seminar Instructor

Dr. Kenneth Stillwell is a second-generation Chiropractor, and has been practicing Chiropractic with his father since 1978.  His enthusiasm and experience as an instructor and practitioner fosters a seminar experience that will educate and inspire.  He has been teaching Chiropractic technique since 1983, originally with the Motion Palpation Institute.  He maintains a busy private practice in Tacoma, Washington and is eager to help Chiropractors improve their diagnosis and treatment.

Dates:

Spine Seminar: July 21-22, 2012

Extremities Seminar: September 22-23, 2012

Both Seminars run from 10:00 AM to 5:00 PM on Saturday and from 8:00 AM to 12:00 PM on Sunday

Location:

Both Seminars are held at:

Hosmer Chiropractic Health

1102 NW 10th Ave, Portland OR  97209

www.HosmerChiropractic.com

Registration:

Please call Hosmer Chiropractic Health at 503-227-2279 to register.  Class is limited to 20 participants.  We expect a full house, register early to reserve your spot.

Cost:

Regular Registration is $250.  Early registration is discounted to $225 if registered by July 1st for the Spine Seminar, or September 1st for the Extremity Seminar. Student registration for either seminar is $150.

Continuing Education Credits are available.

1) Front to Back Leg Swing - hamstrings, glutes, quads

Begin by supporting yourself with one arm while swinging your opposite leg forward then backward. Keep your leg straight as it moves forward and stretches the hamstrings then as it comes back try to kick yourself in the butt to stretch the quads. With each swing you should take the stretch a bit further. Try 20 reps on each leg. 

2) Sideways Leg Swing – abductors, adductors

While facing a wall place both hands against it for support. Swing one leg at a time from side to side in front of your other leg. Try not to let your toro rotate as you do this stretch. Stretch both legs 20 reps each.

3) Handwalks- shoulders, core, hamstrings

Start by standing up straight with your feet together. Slowly bend forward until your hands reach the ground, walk your hands forward until your body is almost parallel with the ground and then slowly walk you feet back up to your hands. Repeat 6 times.

4) Lunge with Rotation – glutes, hip flexors, calves

Lunge forward with either foot, keeping your knee over your toes, and rotate your body toward the forward leg. Stand back up and repeat with the other leg. 10 reps each side. 

5) Scorpion – low back, hip flexors

Lie on your stomach with your arms stretched out. Kick your right foot towards your left arm and then your left foot towards your right arm. Use slow controlled movements with this stretch and repeat 10 times.

6) Arm Swings – chest, shoulders

Just like you remember from gym class. Swing your arms back and forth across the body as you stretch your chest and shoulders. Spend about 30 seconds to a minute on this stretch.

7) Power Skip – preparing for explosive movements

Skip across the field using powerful explosive motions. Try to emphasize height instead of distance while using big arms swings and high knee lifts. Try 20 skips on each side.

A study published in the Annals of Internal Medicine suggests that chiropractic care and home exercises are more effective than medication for the treatment of neck pain. Participants in the study were assigned to one of three groups: chiropractic treatment, home exercises, or medication. Participants in both the chiropractic and exercise groups saw improvements in pain and function which were still seen 1 year after the study while participants int he medication group fared worse and reported increased use of medication during and after the trial. The New York Times summarized the research in this article.

Recent research suggests that regular exercise is not only beneficial for your cardiovascular and musculoskeletal systems but that your brain benefits as well. By participating in regular exercise researchers have discovered that your brain will store increased amounts of glycogen, the storage form of glucose, that it uses for energy when needs are increased. The interesting part of their research is that the parts of the brain that store the most glycogen are those responsible for the mechanic of movings, these same brain regions are also responsible for thinking and memory. The researchers hypothesize that with increased glycogen storage in these areas of the brain, cognitive function may be improved. Just one more reason to maintain regular exercise as part of a healthy lifestyle. A link to the New York Times article can be found here

A study published in The Journal of Physiology concluded that "high-intensity interval training is a time-eficient strategy to increase skeletal muscle oxidative capacity and induce specific metabolic adaptations during exercise that are comparable to traditional endurance training". The study followed 2 groups over 6 weeks, one group was assigned sprint interval training 3 days per week, the other endurance training 5 days per week. Weekly time commitments were 1.5 and 4.5 hours respectively. Researchers found that both groups displayed similar biological changes related to skeletal muscle carbohydrate and lipid metabolism despite that difference in training volume. Here is a link to the study.

The New York Times posted an article today titled "How 1-Minute Intervals Can Improve Your Health" . The article reviews research from McMaster University in Hamilton, Ontario which studied non-athletes participating in interval only training. The results were astonishing, sedentary individuals and those diagnosed with cardiovascular disease saw significant improvements in their health, fitness, and the functioning of their blood vessels and heart. The study participants also noted that they enjoyed the interval sessions more than traditional longer, moderate intensity exercise. The researchers also noted that the training "improved volunteers' insulin sensitivity and blood sugar regulation, lowering their risk of developing Type 2 diabetes".

For those of us with busy schedules and time constraints, interval training provides similar results as endurance training with far less time commitment.

Call today 503-227-227 and start your weekend off right!