Author: Tim Bertelsman, DC, DACO

Biceps Tendinopathy

Biceps tendinopathy describes a painful inflammation or degeneration of the tendon of the long head of the biceps. (1,2) The term “tendinopathy” may suggest either an inflammatory or degenerative origin. (3) In the case of a recent acute insult, inflammation (tendinitis) may be a valid explanation. However, current evidence suggests that many cases of tendinopathy occur without inflammation and are the result of chronic overload, which leads to microscopic tearing, failed healing and subsequent degenerative changes within the tendon. (3) Injuries that have been present over three months consistently demonstrate fibrosis and degeneration with very little inflammation. (3)

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High Ankle Sprain

Fall and winter collision sports like football, hockey, and even soccer, pose unique threats to the bodies of its participants. The foot and ankle are common sites of injury. This article will focus on the current evidence-based assessment and management of one of the more troublesome ankle injuries.

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Lumbar Disc Lesions

This month we will review the existing best practice literature regarding the etiology and management of lumbar disc lesions. Check out this related video to see what a real disc nucleus actually looks like. Then register for the Orthopedic Diplomate Class 1: Best Practice Management of LBP at the ICS fall convention [link needed for completion] to learn more about the most common conditions that cause LBP, the functional problems that perpetuate those conditions, and how to dramatically improve your clinical outcomes by using a highly-effective “classification” system.

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Plantar Fasciitis

The plantar fascia is a dense, fibrous band serving as a biomechanical stabilizer, as well as a protector to the vulnerable neurovascular structures on the plantar aspect of the foot. The diagnosis “plantar fasciitis” encompasses disorders ranging from acute inflammation to chronic fibrotic degeneration, usually involving the calcaneal attachment. (1,2) Plantar fasciitis most commonly affects the medial portion of the band. (2)

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Lateral Epicondylopathy

“Lateral epicondylopathy,” formerly “lateral epicondylitis, is a painful irritation of the common origin of the wrist extensor muscles. Lateral epicondylopathy (LE) is the most common cause of elbow pain. (1) The condition is related to repetitive wrist extension and is commonly referred to as “tennis elbow,” although the majority of those affected do not play tennis. (2)

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JAMA Endorses Spinal Manipulation

For the second time in as many months, a prominent medical journal has endorsed spinal manipulation for the management of low back pain. (1) On April 11th, 2017, JAMA published a systematic review of 26 randomized clinical trials in order to evaluate the safety and effectiveness of spinal manipulation for low back pain.

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Chiropractic Management of Pregnancy-Related Low Back Pain

Researchers estimate that between 45-75% of pregnant women will experience low back pain at some stage of their pregnancy. (1-5) Up to 33% rate their pain as severe. (6) Pregnancy-related low back pain (P-LBP) leads to lower quality of life, restricted activity, and disability, with almost 25% of pregnant women taking sick leave for LBP. (2,7-11) The recurrence rate for pregnancy-related low back pain is 85-90%. (11-14) Consequently, almost 1 in 5 women who report P-LBP during an initial pregnancy will avoid future pregnancies due to fear of returning symptoms (15)

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