Dr. Timothy Allen Swank, D.C.

Most of us think of being cured of a disease or malady means it's completely gone and isn't coming back. From this perspective, a herniated disc cannot be cured. However, another way to ask is, Will a herniated disc heal & will my symptoms go away? To that question, the answer is yes! Studies have shown that between 18 39% of people have herniated/bulging discs & are completely symptom free! The question as to whether a disc herniation fully heals is harder to answer. Spinal discs can heal, and they can also become asymptomatic without fully healing. You may consider yourself healed if you're out of pain with restored movement. But the absence of pain doesn't always equal healing. The bottom line is this; more than 90% of herniated discs will get better with conservative treatment. In my opinion, with treatment, most people will be able to resume normal, pain free activities.

Rather than passively observing worsening scoliosis, chiropractic treatment offers a proactive & rational strategy for limiting or reversing spinal curve progression. This is achieved through the application of spinal adjustments, along with physiotherapy & exercise methods such as Schroth. For patients already utilizing braces, our approach involves co-management, as we can enhance the effectiveness of traditional bracing, alleviate discomfort associated with bracing & reduce the likelihood of surgery.

Technically, “frozen shoulder” is adhesive capsulitis, which is a painful condition that limits the movement of the shoulder. We aren't really sure why adhesive capsulitis occurs. We do know that it's more likely to occur in people who have diabetes or those who recently had to immobilize their shoulder for an extended period, such as after surgery or an arm fracture & people who are over 40, particularly women.

Frozen shoulder may be divided into 3 stages, where each stage can last weeks or months.

1.*Freezing stage*: where the shoulder becomes stiff & is painful to move. The pain may slowly increase or come on fairly rapidly. It may worsen at night. Inability to move the shoulder increases.

2. *Frozen stage*: pain often decreases, but the shoulder stiffness remains. This makes it more difficult to complete daily tasks & activities.

3. *Thawing stage*: pain decreases & shoulder movement slowly improves. In most cases, full or nearly full recovery occurs as normal strength & motion return.

In general, prompt treatment will speed recovery. At our Sports Medicine office, we utilize manipulation, phonophoresis (which combines ultrasound & topical anti-inflammatories. Ultrasound waves help the skin absorb the medication into the underlying tissues), muscle stimulation & dry needling. We ask patients to help at home with heat/ice applications (as appropriate) & range of motion exercises. Many patients will also use NSAIDs to help decrease swelling & pain.

If no progress is made; a steroid injection may be helpful. As a last resort, surgery may be used to cut the tissues in the shoulder to release the tightness. During surgery, swollen or damaged tissue may
also be removed.

Knee buckling is the perception that the knee is giving out. We call
this knee instability.

The reasons for instability are many:meniscus & cartilage tears,
ligament injuries (torn ACL/ PCL or MCL), articular loose bodies &
patellar instability, as well as muscular & neurologic issues.

Although some instability may resolve on its own, I recommend a thorough
evaluation. If indicated, this may include MRI to evaluate internal knee
structures. You didn’t mention your chosen sport. Although knee injury
may occur in any athletic activity, significant knee injuries are
extremely common in girls’ soccer, making evaluation more important.

The short answer is yes. Foot pain is a common complaint we see in Chiropractic Sports Medicine. As with any condition, we determine the cause of the pain with a thorough history and examination. Conditions range from functional issues due to flat feet to stress reactions to
stress fractures to radiculopathy from a lumbar pinched nerve to diabetes. In any event, we’ll diagnose and treat conservatively or refer as appropriate.

Bruised ribs are typically caused by direct trauma. A sports injury, a fall, or an accident are commonly reported. Less commonly; a severe coughing episode may cause a rib bruise. Unfortunately, bruised ribs have to heal on their own & may take a month or more. We really don’t wrap/brace bruised ribs or even fractures anymore. NSAID’s & ice at home are helpful for pain. We use Interferential therapy at our facility to reduce pain/swelling & to speed healing. We may refer to a Physiatrist for pain-reducing injections in cases of moderate to severe pain. You didn’t mention how your condition began. Please keep in mind other conditions may appear to be bruised ribs. Shingles come to mind first. Also, pulmonary issues, etc should be ruled out. If your pain isn’t slowly improving (or is getting worse) or you feel short of breath, get an evaluation.

Sleeping on your back is the best position. The mattress most directly supports your spine & is the most neutral posture. Sleeping on your back helps evenly distribute your weight & decreases the formation of uncomfortable or unnatural curves in your spine. Some people find they’re more comfortable in this position with the help of a small pillow under their knees. And, of course, using a proper supportive pillow for your head & neck. Many people prefer to sleep on their side in the fetal position. In general, this leaves the frame improperly supported. With shoulder issues (and the most likely cause of your pain), sleeping on the side may cause pressure on the shoulder, aggravating the condition. It’s a good idea to uncover the cause of your shoulder pain & sleep on your back. If you’re having trouble getting comfortable, apply ice for 20 min to your shoulder before lying down. Or use a topical analgesic such as Biofreeze or Salonpas.

The goal of Chiropractic treatment is the restoration (insofar as possible) of normal musculoskeletal function. This would mean full range of motion without pain. Doctors of Chiropractic utilize Chiropractic adjustments (spinal manipulation), physiotherapy, stretching, etc., to attempt to reach this goal. Everyone is different; however, each treatment (Chiropractic adjustment) should incrementally move a patient towards the goal of full, unrestricted, pain free movement. The Chiropractor should perform objective, periodic re-evaluations to document progress. Patients should notice progression in terms of decreased symptoms and increased range of motion. It is important to note; some patients progress more quickly than others, some may temporarily regress, and some treatment sessions are more effective than others. However, overall, there should be progress. If not, the Chiropractor should change the treatment or refer to another specialist.

The goal of a chiropractic adjustment is to restore normal (insofar as possible) joint movement & physiology. This is accomplished by a precise, quick movement that is faster than muscles can respond. The short, quick adjustment enables Chiropractic Physicians to restore motion without the encumbrance of muscle guarding or tension. This is different from mobilization or stretching.

Either over time or acutely due to injury, joints lose their ability to move properly. Normal joint motion is important not only for needed support of our frame, but also for the health of the joint itself. In a nutshell, joints need to move to stay healthy & handle the mechanical loads placed upon them.There is some times a harmless sound called cavitation that is heard during an adjustment. This is not a necessary component to successful treatment.

Tingling and/or numbness in the fingers are a common condition treated by Chiropractic Physicians. Obviously, the first goal is to determine the cause. Patients receive a thorough evaluation, including case history, exam & any appropriate diagnostic testing & imaging. Once we have a working diagnosis, we treat or refer as appropriate. Carpal Tunnel Syndrome is a very common cause of finger tingling. Your Doctor of Chiropractic can provide effective conservative care for this condition. Other causes, such as a “pinched nerve” are routinely treated in Chiropractic offices. However, there are medical conditions, such as diabetic neuropathy, systemic diseases, infections, etc., that are better addressed by your medical doctor.

The adjustment of the knee (or any joint in the body) takes a less than a second. This is by design. The specific directive force is ideally faster than the body can respond, restoring motion into the otherwise restricted/malpositioned joint. (Think of a magician quickly removing a linen tablecloth from a table without disturbing the china plates & crystal glasses). This is in contrast to manipulation or mobilization typically performed by a PT. This is a slow, stretching type procedure.

In addition to adjusting the knee, most Sports Chiropractors will also address concurrent conditions that affect the knee; over-pronation, muscle imbalances in surrounding musculature, weight bearing issues, rotated hips, etc.

Inflammation of tendons (tendonitis) is generally the result of acute or repetitive stress. This stress is often amplified by either the overtight muscles attached to the tendon, poor joint movement or both. In Sports Chiropractic, the goal is to restore normal muscle tonus and joint function, thereby taking the stress off the tendon. We reduce inflammation in the tendon using physiotherapy modalities and/or support/bracing. We have great success with this approach.

Incidentally, the medical approach is to use medications to accomplish the same result. In my opinion, Chiropractic is generally superior, as addressing all aspects of the condition decreases the chances of reoccurrence.

When you have arthritis, movement can decrease your pain and stiffness, improve your range of motion, strengthen your muscles, and increase your endurance. There was a time that osteoarthritis was considered to be the result of too much use of a joint. It was the inevitable result of years of abuse, friction, and wear and tear. However, movement actually keeps the joints healthier longer. And part of this has to do with how movement helps the flow of synovial fluid through the joint, keeping cartilage pumped up. Without movement, synovial fluid slowly drains out of the cartilage, causing the cartilage to flatten and become more susceptible to damage. The goal goal of chiropractic treatment is to restore normal movement to joints (insofar as possible). Therefore, in most cases, chiropractic will help arthritic joints.