HealthNOW Medical

Achilles Injury? What’s the biggest mistake you can make?

2012-02-22T21:53:58Z

What’s the Biggest Mistake ‘Weekend Warriors’ Make?

The bay area is filled with many recreational athletes or “weekend warriors”. The myriad of sporting activities they engage in ranges from soccer, basketball, baseball, and running, to hiking, cricket, and Frisbee golf. I’m sorry to generalize, but the issue at hand is that most of these “warriors” rarely do any stretching or focused strengthening with their bodies prior to participation in their sport of choice. The exercises they attempt to do are mostly what they remember from high school PE. I, as a physical therapist, then see them, in pain, feeling older than their years and extremely disgruntled with their body.

What have they done to themselves? They’ve pulled, strained and/or sprained muscles, tendons and ligaments. One of the most common tendon injuries by far is the Achilles heel tendon injury. The heel cord,as it is also known, is prone to all sorts of pulling, tugging and tearing forces. We use it practically every waking second of our life.

How Does the Achilles Tendon get Injured

The injury may happen in one of two ways –

Direct hit to the tendon causing it to tear
A slow build up of repeated small injuries to the tendon over a period of time due to improper training, stretching or strengthening.

The first type typically may need surgery depending on the extent of tear. If surgery is not needed, then the patient is casted or fitted with a walking boot that prevents movement of the ankle joint for a period of time until satisfactory healing occurs.

Once the boot is removed the process of physical therapy rehabilitation begins. Here at HealthNOW Physical Therapy we work extensively with manual work and exercises to regain the flexibility and strength of the tendon, as well as the related muscle. The treatment is relatively straightforward and patient compliance is high because they are fully aware of what occurred to create the injury.

The second type of injury is more resistant to treatment, unfortunately. Due to the fact that this injury occurs slowly over a period of time, the patient is often unaware of what is truly happening to his foot.

Achilles Injuries are Often Misdiagnosed

The pain may be generalized around the foot and ankle region, rather than pinpoint over the Achilles tendon. The patient may limp for a few days and then be able to walk or run normally. Most cases are erroneously diagnosed as plantar fascitis or mild ankle sprains.

Patients often try home remedies or doctors may recommend insoles, different footwear etc. As the days and months pass, the pain becomes more pronounced and it begins to affect walking as well as prolonged standing. In some patients, a small hard nodule or bulge starts appearing where the Achilles tendon joins to the ankle.

In the majority, patients are referred to me, a physical therapist, quite late into the condition. During evaluation, in addition to noting what causes pain and where it’s located, I commonly note that the calf of the affected leg is markedly reduced in size. The tightness in the heel cord too is often quite severe.

If Not Treated Correctly the Damage Can be Permanent

The tenets of Physical therapy in such conditions are slightly different from the norm. Typically we begin with pain management as our highest priority. And while there is no denying that pain management is important, as a clinician I am more concerned about the integrity of the tendon where it attaches to the heel bone.

Research has shown that cumulative trauma to the Achilles heel tendon causes the tendon cells attaching to the bone to wither away and degenerate. Once that happens, even surgical fixation will not have a 100% success rate. Therefore our priority, along with reducing pain levels, is tendon integrity.

The question is: how do we achieve this goal?

Pain reduction is achieved with a combination of manual therapy and ultrasound therapy. I have achieved my best results with using a combination of both.

What’s the Best Treatment?

The treatment program should go something like this:

1. Receive a thorough evaluation by a doctor of physical therapy

2. Severity of the damage incurred is established

3. Very specific exercises are begun that restore length and rejuvenation to the damaged tendon. These are called eccentric exercises and they literally work wonders.

4. As the patient progresses, more exercises with increasing levels of difficulty are added to the regimen.

5. Here at HealthNOW we have a special treadmill set up that allows us to put patients in a harness so that they can walk on the treadmill in all directions – forward, backward, and side to side leading with their left and right food respectively. These are called 360s and we are one of very few clinics that offer this. The 360 procedure strengthens the ankle and foot, ensuring tendon healing and pain reduction.

6. Finally, the patient is educated on good stretching and strengthening habits in order to prevent future injury.

Is a Gluten-free Diet a Healthy One

2012-02-21T21:46:37Z

Is a gluten-free diet healthy? Learn from a doctor what you need to eat.

www.youtube.com/watch?v=6MXZEytywVU

Dairy Products in Kids Triple Risk of Colorectal Cancer as Adults

2012-02-14T19:37:51Z

Dairy products are cancer causing. Children consuming dairy products show a 3x increased risk of colorectal cancer as adults. Learn more from a doctor and author.

www.youtube.com/watch?v=n7pbGfu1Esg

Clinical Nutrition Report: Kids Fed Dairy 3X Cancer Risk

2012-02-16T22:51:09Z

Here at HealthNOW’s Clinical Nutrition department we have found many of our patients to be intolerant to dairy products. More research is discovering the negative effects associated with dairy ingestion and today we’ll be discussing children, dairy and colorectal cancer.

The reaction that we see is not an ‘allergy’ in the true sense of the word, but a sensitivity or intolerance.

What’s the Difference Between ‘Allergy’ and ‘Intolerance’

• Allergy – a reaction that occurs within an hour of consuming a food and the symptoms tend to be quite dramatic. E.g. Vomiting, hives, diarrhea, trouble breathing, etc.

• Sensitivity or Intolerance – a reaction that occurs within several hours or days of consuming a food and the symptoms can be intense, mild or silent (meaning that you cannot ‘feel’ them but they are still damaging the body) and covers anything from digestive problems to non-digestive to degenerative changes that can lead to disease.

Individuals who have a true allergy tend to know it because the reason behind their symptoms is easy to track. If every time you drank milk you had diarrhea within an hour, for instance, it probably wouldn’t be long before you figured out the connection for yourself.

Sensitivities are trickier to spot due to the intervening time frame that can occur between ingestion and symptom development. Imagine you at a bagel for breakfast Sunday morning and Tuesday afternoon you got a headache and were quite exhausted. Would you think to ‘blame’ Sunday morning’s bagel? Unlikely, yet for many people that’s exactly the kind of scenario that occurs.

In this post I am referring to dairy sensitivities, not allergies.

As a clinical nutrition patient so aptly put it to me this morning, dairy foods and gluten foods are ‘well marketed’ and ‘positioned’ in our society. Whole wheat bread just ‘sounds’ healthy. Dairy products that are promised to ‘build strong bones’ and campaigns such as: ‘Milk- it does a body good’ are well ingrained into our society.

What If… a lot of what we’ve been told about dairy products is untrue?

What if the calcium in dairy didn’t build strong bones and what if, in fact, societies that ingested the largest amount of dairy products actually had the highest incidence of osteoporosis – meaning weakened bones?

What if the high phosphorous, protein and calcium in dairy products actually tended to prevent Vitamin D from being activated and therefore prevented the cancer prevention aspects of Vitamin D from manifesting themselves?

What if dairy products actually increased a substance in the blood called insulin-like growth factor, a known cancer causing agent?

All the above ‘what ifs’ have been documented in research studies.

Study Reveals Tripled Risk of Cancer

Getting back to children and their consumption of dairy products, a study published in the American Journal of Clinical Nutrition titled “Childhood dairy intake and adult cancer risk: 65-year follow-up of the Boyd Orr cohort” (December 2007), found that children consuming high quantities of dairy products tripled their risk of developing colorectal cancer as adults.

This was an incredibly robust study done in Scotland and England with 4,999 children. Beginning in 1937, participants were followed for two full years, and the study ended in 2005, sixty-eight years later. The almost 5,000 children were tracked based on their family’s food consumption 7 days per week. These children were then followed into adulthood up until their ultimate passing. Of the 5,000 children, 770 deaths due to cancer were recorded. The correlation of high dairy consumption and a tripled incidence of colorectal cancer was discovered.

High dairy consumption was defined as 2 plus glasses of milk per day or the equivalent in a different form of dairy.

Low dairy consumption was defined as ½ glass of milk or less per day or the equivalent in a different form such as cheese.

The correlation was independent of meat, fruit and vegetable consumption, as well as socioeconomic status.

What Should You Do?

In my family we have eliminated dairy consumption from any mammal including cow, goat and sheep. I have become convinced that milk from a mammal, other than your own mother when you’re an infant, is not beneficial for humans. If you compound the fact that we’re not really ‘designed’ to digest the milk of another mammal with the fact that the dairy products sold in this country are typically full of synthetic hormones, antibiotics and other toxic elements, you begin to see the problem.

I know that I will receive questions regarding the benefits of organic milk and unpasteurized milk. Granted, milk that doesn’t contain hormones and drugs would be better than the alternative, but you are still left with the milk of another mammal and I am convinced that is not beneficial in the long-run for optimal human health.

During the past several years we have gotten increasingly strict with our clinical nutrition patients in this regard and it has only confirmed that the above is factual. Additionally, patients who are gluten intolerant show a high preponderance of dairy sensitivities and this too is being confirmed in research findings.

I hope you find this helpful and I will continue to provide more information on this important topic as it becomes available. Unfortunately the dairy lobbies are quite powerful and such research is not happening in the numbers it needs to.

Please write to me with any questions you may have.

If your health is not at the level you desire, consider contacting us for a free health analysis – call 408-733-0400. Our destination clinic treats patients from across the country and internationally – we are here to help!

p.s. I wrote an earlier post on milk alternatives that we recommend, so feel free to read that one here.

To your good health,

Dr Vikki Petersen, DC, CCN
Founder of HealthNOW Medical Center
Co-author of “The Gluten Effect”
Author of the eBook: “Gluten Intolerance – What you don’t know may be killing you!”

Permission is granted to re-post this article in its entirety with credit to Dr Vikki Petersen & HealthNOW Medical Center and a clickable link back to this page. Dr Vikki Petersen, DC, CCN is founder of HealthNOW Medical Center and the author of “The Gluten Effect” and eBook: “Gluten Intolerance – What you don’t know may be killing you”. She has been featured in national magazines, international medical journals and is a frequent headlined speaker.

Reference: American Journal of Clinical Nutrition. 2007 Dec;86(6):1722-9. “Childhood dairy intake and adult cancer risk: 65-y follow-up of the Boyd Orr cohort.” van der Pols JC, Bain C, Gunnell D, Smith GD, Frobisher C, Martin RM.

Clinical Nutrition Report: Dairy Products Increase Cancer Risk in Men

2012-02-11T01:56:15Z

Dairy products are found to increased incidence of prostate cancer. Learn more from a doctor and author.

www.youtube.com/watch?v=g-iylH0aPZE

Do You Slouch? Physical Therapy Can Help!

2012-02-03T19:12:10Z

Slouching is Common, but…

The other day, my patient who is being treated for mid-back pain came in with her 3 children. The children sat in our Physical Therapy gym with their respective “toys” while mom was being treated by the therapist. Mom explained that the kids off from school and she did not want them to be alone at home.

At our clinic, we love children and encourage parents to bring them whenever possible. These particular children ranged in age from 6 to 13 years and were very well behaved while enjoying their ipad, iphone and books.

As a physical therapist, I am trained to observe and what I saw was that all of the children slouched so much that their heads were almost at the level of their chest. This can indicate certain underlying problems, so as an experiment I asked them gently to sit up a little straighter. Interestingly, the younger ones were able to maintain the posture for 10 minutes while the older one complained of mid-back pain immediately upon sitting up straight.

I believe, in this day of computers and video games, slouching has become pretty much an epidemic. As a matter of fact, most people are slouched whether they are sitting, standing or walking. I see the “question mark” posture on a daily basis everywhere I look. And most individuals are completely unaware of it or don’t realize that it’s a problem.

Slouching is Not Normal and It Creates Long Term Damage

Here is the truth about slouching:

1. It is a direct correlation to how strong or weak, the spinal or core muscles are. It also indicates whether these muscles are capable of holding the spine in proper alignment. When I say ‘spinal muscles’ it means the muscles lining the spine in the front, back, to the sides and also in-between. These are major postural stabilizers.

2. Slouching is also related to stiffness and misalignment of the bones of the spine.

3. Inactivity or poor function of a part of the body can also lead to slouching. This is more prevalent in individuals who work in sitting professions e.g. computer professionals, students etc.

4. In some cases, young girls or boys learn to slouch early on with the advent of puberty because they are embarrassed by their height or development.

Nevertheless, slouching is detrimental. The mid-back learns very quickly to adapt to the bent posture and the muscles in that region shorten. Once this occurs, the bones and joints in that region tend to get rigid in the bent position resisting any attempt to move or straighten them.

In fact, people feel soreness and pain on trying to sit straight. Chronic slouching leads to poor breathing capacity because the rib cage has a lesser area to expand. It is very rare for people who slouch to sustain well on long hikes or endurance based activities. And as one gets older the mid-back spinal bones tend to start collapsing on top of each other, leading to potential nerve damage and arthritis.

What’s the Solution?

Now, how do we stop this and start inculcating a good habit of sitting straight? It actually needs to be started right at infancy. Young infants should be encouraged to play on their tummy for long periods. Crawling, not only within small distances, but also down long hallways should be encouraged for infants.

As they grow older, pull ups, bar hangs, single leg hopping, and jump rope activities should be emphasized. Good study habits with a proper table and chair are very important. Too often children do their homework or studying sitting at the kitchen counter, coffee table, couch, or bed because it is comfortable. That is not ideal and should be discouraged for long term health.

If slouching persists through adulthood, simple changes as mentioned above may not be enough to treat the problem. One must consult a physical therapist to get a comprehensive evaluation and understanding of all the possible physical impairments associated with adulthood slouching.

X-rays and bone density testing may be requested by the physician to rule out any bone damage. In some patients, traditional physical therapy management with manual therapy and focused exercises may be all that is needed to treat the problem.

Other patients might require a more advanced approach with extensive core training, biofeedback training and traction, in addition to manual work in order to achieve success.

At our physical therapy clinic at HealthNOW, we employ the pneuback chair which works wonders with slouching and other postural dysfunction. We plot the patient’s spinal curve on a graph and use the coordinates to customize an exercise session for the patient. It’s painless and highly effective.

Slouching has practically become an epidemic but we can cause a change with education and good physical therapy treatment. It goes far beyond appearance, slouching actually creates physical problems.

It you or someone you know slouches, feel free to contact me for a free health analysis. We’ll let you know what we can do to assist you.

In health,

Dr Rupa Chakravarty, DPT, OCS
Director of HealthNOW Physical Therapy

Permission is granted to repost this article in its entirety with credit to Dr Rupa Chakravarty & HealthNOW Medical Center and a clickable link back to this page.

Irritable Bowel Syndrome Handled!

2012-02-03T02:26:22Z

Listen to a woman who had life-long digestive pain (diagnosed as Irritable Bowel Syndrome- IBS) and how she resolved it with the help of doctors at HealthNOW.

Hiatal Hernia? Chiropractic Can Help

2012-01-28T01:51:41Z

Do You Need Antacids or a Chiropractic Adjustment?

You might not think about going to your chiropractor to get relief from abdominal discomfort, but think again…

Here at HealthNOW Medical Center, we see many patients who have been dealing with digestive related distress – some for a very long time. The stomach is a major organ along the digestive pathway, and a big player in a condition known as a hiatal hernia – which basically means that the stomach spams and pushes up on your diaphragm leading to symptoms such as:

• heartburn

• pain in the upper abdomen

• chest pain

• difficulty breathing

• anxiety

• panic attack symptoms

How the Stomach Can Create So Many Problems

The condition of ‘heartburn’ is also known as GERD (gastroesophageal reflux disease) wherein some of the acidic contents of the stomach escapes through the the top of the stomach and projects upwards into the esophagus causing a painful burning sensation in the chest.

The esophagus (that tube running from the mouth to the stomach) penetrates through a large muscle called the diaphragm in its journey from the mouth to the stomach. The opening in the diaphragm through which the esophagus passes is called a hiatus (which simply means ‘hole’).

Normally, when we swallow and food goes into the stomach, the hole at the top of the stomach closes, keeping food and the acidic digestive juices within the confines of the stomach. Under certain circumstances, the upper portion of the stomach actually pushes up through the hole (hiatus) in the diaphragm causing a ‘hiatal hernia.’ This can result in pain in the stomach area, chest pain and the more commonly known heartburn sensation.

As with most conditions, there is a range of severity for hiatal hernias from mild to moderate to severe. Severe conditions may need require more serious medical interventions such as surgery.

A Manual ‘Adjustment’ May Be All You Need

For mild and moderate conditions, however, a manual procedure to physically pull the stomach down below the diaphragm can be very helpful. Along with dietary changes that reveal why the stomach is spasming and possible nutritional supplements to reduce stomach acidity, this manual procedure can bring immediate relief or produce gradual improvement over repeated manipulations.

The stomach pull-down procedure (Hiatal Hernia Technique) is performed here at HealthNOW Medical Center by a doctor of chiropractic who is trained in the technique. The patient can either stand against a wall or lie on a treatment table to receive the technique. While there may be some mild discomfort associated with the technique, it’s worth it considering there is often immediate relief. The patient can take a deeper breath and the pressure and pain subsides. The procedure may need to be repeated multiple times for lasting results.

In addition to the above, our department of physical therapy can perform a manipulation called a ‘diaphragmatic release’ that can reduce the tension of the diaphragm as well as related muscles in the area of the rib cage.

Lastly, chiropractic adjustments performed in the neck and mid-back can positively affect nerves that go to the diaphragm itself.

If you or anyone you know suffers from acid reflux, heartburn, chest pain or panic attacks, please consider getting evaluated for a hiatal hernia. A simple, natural and drug-free therapy may be all that’s needed to eradicate your discomfort.

Feel free to contact us for a complimentary health analysis – we’re here to help! Call 408-733-0400

In health,

Dr Koen Kallop, DC
Director of Chiropractic Services
HealthNOW Medical Center

Permission is granted to repost this article in its entirety with credit to Dr Koen Kallop & HealthNOW Medical Center and a clickable link back to this page.

Celiacs at Risk for Increased Bone Fractures

2012-01-27T17:48:28Z

Celiacs before diagnosis or those not following their diet will likely be at increased risk for bone fractures at a younger age. Learn more from a doctor and author.

www.youtube.com/watch?v=pQ9Yx9nfZV0

Celiac Disease Report: An Emergency C-section is Healthier than a Planned One

2012-01-24T20:37:53Z

Elective C-sections proven to increase risk of celiac disease in infants. Why? Learn more from a doctor and author.

HealthNOW Medical

Achilles Injury? What’s the biggest mistake you can make?

What’s the Biggest Mistake ‘Weekend Warriors’ Make?

How Does the Achilles Tendon get Injured

Achilles Injuries are Often Misdiagnosed

If Not Treated Correctly the Damage Can be Permanent

What’s the Best Treatment?

We’re Here to Help

Is a Gluten-free Diet a Healthy One

Dairy Products in Kids Triple Risk of Colorectal Cancer as Adults

Clinical Nutrition Report: Kids Fed Dairy 3X Cancer Risk

What’s the Difference Between ‘Allergy’ and ‘Intolerance’

What If… a lot of what we’ve been told about dairy products is untrue?

Study Reveals Tripled Risk of Cancer

What Should You Do?

Clinical Nutrition Report: Dairy Products Increase Cancer Risk in Men

Do You Slouch? Physical Therapy Can Help!

Slouching is Common, but…

Slouching is Not Normal and It Creates Long Term Damage

What’s the Solution?

Irritable Bowel Syndrome Handled!

Hiatal Hernia? Chiropractic Can Help

Do You Need Antacids or a Chiropractic Adjustment?

How the Stomach Can Create So Many Problems

A Manual ‘Adjustment’ May Be All You Need

Celiacs at Risk for Increased Bone Fractures

Celiac Disease Report: An Emergency C-section is Healthier than a Planned One