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Back Pain, Women and Traveling: 4 Tips for Carrying your Laptop Around

Dr. Steven Shoshany (Dr. Steven Shoshany) — Tue, 06 Dec 2011 13:30:38 PST

We see all sorts of people, from athletes to soccer moms, who suffer from chronic back pain. One group that stands out is the often traveling businesswoman. Traveling and how it can lead to pain and discomfort quite easily has been covered extensively on this blog before, but we've come to see a correlation between businesswomen who have developed chronic back pain, and their most important piece of luggage: The Laptop.

Not paying attention to posture, and awkwardly carrying around luggage, and laptop bags can lead to chronic back pain, injuries to the muscles, and intervertebral discs. These issues can lead to sciatica, bulging, or herniated discs.

Women on average have smaller frames and less muscle mass than men, and a light laptop being carried around can be an entirely different load on a woman versus a man of the same type of occupation and travel routine. Even thin and light laptops can weigh between five and seven pounds.

So think about it, better yet grab a light dumbbell, stick it in your pocket and walk around for a few hours. Sounds kind of nuts doesn't it? Well thats what its like to carry a laptop around, and most people have a separate laptop bag, which probably has a few pounds of stuff in in already aside from the computer, and most likely, a back up battery and a charger.

Pretty soon, that 5 or 6 pound laptop along with the bag and all the accessories is coming in at 10 to 12 pounds, often more. Since most people refuse to carry a backpack these days, their messenger style bags are mot built to load the spine properly. Thats also how you should think about it, your spine, not your shoulder is carrying that load and its only loading one side of the body. combine that uneven loading with ergonomically awful airplane seats, the lack of a consistent sleep cycle and the stress associated with travel, and not having back pain seems like an exception.

Here are a few tips to avoid developing pain, wether its in the lower back, upper back, neck or shoulders.

1. Flexibility

Being able to move a joint through its entire range of motion is very, very important. Not having any structural misalignments and postural deviations due to tight, or short muscles is going to go a long way in helping you avoid chronic pain and discomfort.

Take some time to stretch once a day especially if you're traveling a lot. A good warm up before stretching is also recommended.

2. Strength

Being strong is going to help you keep your body healthier and pain free longer. Make sure you are strength training properly, and find a qualified expert to help you identify and strengthen weak points. Women can benefit greatly from resistance training due to the resulting increase in bone density. The nervous system is also trained in addition to the muscles and that leads to better neuromuscular efficiency.

3. Proper Loading

If carrying a messenger style bag is casing you to have bad posture and just plain adding to your discomfort, do yourself a favor, get a backpack. Get a good backpack. This will allow you to carry the weight across both shoulders and load your spine properly.

4. Carry your computer bag in your hand

Carry the bag in your hand and make sure you switch hands often. This way you can distribute the work involved to each side and not cause overuse injuries either spinal erector and oblique.

As always, make sure you consult with a doctor before following any advice, and if you want to talk to a back pain expert, find a good chiropractor and/ or physical therapist and get consulted.

Treating Ankle Pain

Dr. Steven Shoshany (Dr. Steven Shoshany) — Thu, 17 Nov 2011 11:43:08 PST

Physical Therapy NYC
Physical Therapist NYC

Common Running Injuries as We Approach the NYC Marathon

Dr. Steven Shoshany (Dr. Steven Shoshany) — Mon, 24 Oct 2011 14:40:11 PDT

Now that the temperature is dropping, taking your morning jog in central park, the west side, or the Hudson river green-way or any other runner frequented pathways on Manhattan pavement seems like business as usual but with a few more layers for warmth. Especially now, with the New York City Marathon fast approaching, there are going to be a lot of people getting their last few days of training in. However, if every step on your outdoor run is making your shins, knees, and calves burn—even when exercising the same distance, Is running just hurting your body, and leading to injuries?

Running through Manhattan can be dangerous for your body especially if you’re used to running on a treadmill’s soft, shock-absorbing surface. Does pain shoot up through your shins with every step you take? Did you roll your ankle on an uneven surface? Maybe you find yourself limping on your run because of knee pains, or your lower back could be tight from a mechanical imbalance in your step. Whatever the source, your injury should be treated as soon as possible.

The sharp pain and soreness from running could be among numerous injuries, including:

- Medial tibial stress syndrome, compartment syndrome, and stress fractures (shin splints)

- Patellofemoral syndrome (runner’s knee)

- Iliotibial band syndrome (a thigh injury causing knee pain)

- Strained calves

- Ankle sprains

- Snapping hip syndrome

- Pulled hamstring

- Dislocating kneecap

- Plica syndrome (irritation and/or inflammation of the knee)

- Achilles tendonitis

This list might seem daunting, but with proper treatment, your days of outside running don’t have to end. Located in the heart of Soho, Living Well Medical provides patients treatments in massage therapy, physiotherapy, and chiropractic—all under the same roof.

Quick tips for injury prevention:

First, take preventative measures. Wear appropriate running shoes that can absorb shock from your feet hitting the pavement. Proper running shoes will prevent this impact making its way up to your shins. Over time, wearing improper shoes can add stress to your lower back.

If you sprain your ankle on a run, keep as much pressure off of the injured ankle as possible. Keep the ankle elevated while resting and icing in 1- -15-minute increments to decrease muscle inflammation. Rest and icing goes for other injuries, as well. Avoid putting strain on the muscle, and make an appointment to be treated by a professional at Living Well Medical.

Types of treatment for injuries:

Living Well Medical will assess your injury to give you the best treatment possible. By using our in-house x-ray machine, along with ultrasound, cold laser and early mobilization techniques the recovery time can be greatly reduced. Depending on the level and degree of your injury, the experts will use massage therapy and gentle manipulation to treat your ankle or knee injury and get you back to training, with a reduced chance for re-injury.

Living Well Medical also offers the Graston Technique, which is very effective for running-related injuries. As a Instrument Assisted treatment, the technique is useful for diagnosing and repairing skeletal and connective tissue, just like the injuries that you may develop by running outdoors. This technique can help reduce adhesions and scar tissue build up from years of training and help the body repair and rebuild itself.

Chronic Back Pain: Herniated Disc

Dr. Steven Shoshany (Dr. Steven Shoshany) — Thu, 20 Oct 2011 14:16:58 PDT

If you have been suffering with chronic back pain and/or leg pain or if you are experiencing tingling, weakness, or numbness down the leg, you may be suffering from a  herniated or bulging disc in your spine. A herniated disc can be very painful depending on a few factors like age, the condition  of the disc, and the severity of the injury.

For people that have severe, unrelenting pain in their back, leg, or shooting pains, it can turn every day chores and routine tasks in to a major obstacle.

You can find fast, non-invasive pain relief from visiting a Chiropractor in NYC. Manhattan is, in fact, a hub of chiropractic practitioners, but you want fast relief, and unparalleled results you want to go to the best most reputable chiropractors in New York. Dr. Steven Shoshany has been helping people get out of pain for well over 10 years, and his spinal decompression center uses the latest technology, proven to get results and relieve pain.

By decompressing the spine and letting the intervertebral disc heal naturally, you can naturally, safely start back on the road to recovery, without pain pills. For those  people in sever pain who can not undergo chiropractic treatment of physical therapy, he also offers interventional pain management solutions like epidurals or facet bloc injections, at his integrated practice on Broadway, in Manhattan.

Usually bones in the spine (the vertebrae) have sufficient cushioning from intervertebral discs, these spinal discs are rubbery and contain a gel like fluid that acts as a shock absorber, and cushion between each vertebrae. Sometimes, as a result of acute trauma, or chronic postural issues, deconditioning, or general wear and tear, these discs can herniate or bulge, and impinge the nerves housed in the spine. This can result in an excruciating amount of pain, depending on the severity of the herniation. Some people who have herniated discs will show no symptoms at all because the herniation may not be severe enough to interfere with nerve activity.

If you are currently experiencing back and leg pain, or may be concerned about your back health. You can schedule a free consultation and get all the answers that you are looking for. You don't have to suffer through pain for long periods of time or be pumped full of medication (often with awful side effects) just to function every day. Contacting a chiropractor or your doctor as soon as possible is very important so that if you already have a herniated disc, its not made worse by just waiting.

Take action today, you don't have to be in pain, there are qualified healthcare professionals that specialize in getting people out of pain, and they help people with herniated discs every day.

Chiropractic NYC-Chiropractic adjustments for Low Back pain

Dr. Steven Shoshany (Dr. Steven Shoshany) — Wed, 14 Sep 2011 09:36:27 PDT

Chiropractor NYC, NY

A Recent study from the American Chiropractic Association

Chiropractic therapy for low back pain.

A review of 270 studies found that spinal manipulation works just as well as pain medication for reducing the intensity of low back pain. Practitioners apply a controlled force to a joint of the spine, pushing it beyond its normal range of motion to improve physical functioning.
Besides chiropractors, physical therapists, osteopaths and some conventional medical doctors practice spinal manipulation as well.
Chiropractor have always know that Chiropractic works, but its nice to see more and more studies validating Chiropractic.
If you are looking for a Chiropractor in NYC follow the link below.
We combine Chiropractic care, with Physical therapy and Osteopathy.

632 Broadway suite 303
NY,NY 10012
Call (212) 645-8151

Low back pain doesn't stand a chance in Manhattan

Chiropractor NYC

Treatment for a Bulging Disc

Dr. Steven Shoshany (Dr. Steven Shoshany) — Thu, 14 Jul 2011 15:09:57 PDT

As far as problems with the back and neck go, pain related to the intervertebral discs is among the worst. It might feel like a fire running through your body, or like electricity shooting up and down your extremities. It more than likely is debilitating and causing you to live your life differently and without much enjoyment. Chronic and severe pain has a way of sapping the joy out of even the greatest moments.

Among the causes of major pain related to discs is the bulging disc; while in most instances, a bulging disc is not something to worry about, even occurring without a person knowing it, there are times when it can be a source of agony. Obviously, that’s when it’s time to seek treatment.

Treatment for a bulging disc can take several forms, and they vary from the completely non-invasive to surgical intervention in the most severe cases. As it related to my practice, Living Well Medical in NYC, there are a number of options available that can resolve pain to restore quality of life. Here I’ll be discussing a few of our approaches that we use in our office for treatment of conditions like bulging spinal discs.

Being a chiropractor, chiropractic techniques are one of the most common treatments performed at my office. In particular, when it comes to bulging discs, we use what is called the Cox Flexion Distraction Technique. Using this technique, a specialized table helps a chiropractor perform several precision adjustments while the patient keeps a comfortable position. Cox Flexion Distraction can also be used to treat herniated discs, sciatica and other back and neck issues.

Physical therapy is also an important part of treatment for a bulging disc because it helps patients to avoid relapse after treatment is complete and pain is relieved. Educating the muscles that support the back and neck can prevent re-injury by supporting the spine properly. We have a physical therapist on staff who sees to our PT patients.

Spinal disc decompression is a non-surgical technology that we incorporate that aims specifically at helping patients who suffer with disc problems. In a spinal decompression session, a patient is placed on a therapeutic table with a harness around their lower body (if used for lower back pain). A precise stretch is applied which creates more space between the targeted vertebrae in the spine. Over time, this can allow the bulging or herniated disc material to return to its original position which in turn reduces or eliminates pain. Although not for everyone and in no way a magic solution, spinal decompression can be extremely helpful to patients suffering with discogenic pains.

As you can see, we have a number of therapies available that are effective treatments for pain related to a bulging disc. If you need help, don’t hesitate to call Living Well Medical in NYC at 212-645-8151 and make your appointment today.

- Dr. Shoshany, NYC Chiropractor

NYC Chiropractor: Spinal Decompression Testimonial

Dr. Steven Shoshany (Dr. Steven Shoshany) — Tue, 21 Jun 2011 12:43:52 PDT

What is Spinal Stenosis?

Dr. Steven Shoshany (Dr. Steven Shoshany) — Tue, 31 May 2011 10:51:45 PDT

There are a world of conditions that can be the cause of back or neck pain. You hear a lot about pinched nerves, slipped discs, disc bulges, herniated discs, but there are a number of other serious conditions that can be the cause of back and neck pain. The main thing they all have in common is nerve compression and major pain. Today I’m going to go over a condition that is perhaps less well known than the others: spinal stenosis.

The word stenosis comes from the Greek for “narrowing.” As such, spinal stenosis is related to the narrowing of the spinal canal, the space in the center of vertebrae through which the dense bundle of nerves in the spinal cord travel as it provides information, sensation and motion to all parts of the body. As the space in the canal is decreases due to this narrowing, compression of the spinal nerves can lead to symptoms that are often very similar to that of a herniated disc like pain, numbness, muscular atrophy, paresthesia (pins & needles) and tingling.

Spinal stenosis can be caused by several factors, some of them genetic and some of them happening over time. In many cases, stenosis is related to aging and degeneration of the intervertebral discs which lose their capacity to retain fluid over time. This is completely normal but can contribute to the pain of spinal stenosis. In cases where disc problems are in any way responsible for stenosis, we generally recommend a multidisciplinary program that may include physical therapy, spinal decompression therapy (specifically aimed at restoring disc health), chiropractic and other non-surgical techniques like massage, acupuncture and manual therapies.

Other contributing factors that can cause spinal stenosis are displacement of a vertebra in relation to its neighboring vertebra. This in effect narrows the spinal canal at the “pinch point.” This is known as spondylolisthesis. Therapeutic exercises and manual therapies are often an effective treatment for this type of stenosis, but of course, each case is different and requires an individualized analysis.

If you are experiencing back or neck pain, come in to Living Well Medical in NYC today. Our experts are here to help eliminate pain like that of spinal stenosis. Call today - 212-645-8151.

- Dr. Shoshany, NYC Chiropractor

What Should I Do About My Back Pain?

Dr. Steven Shoshany (Dr. Steven Shoshany) — Tue, 03 May 2011 08:34:52 PDT

Back pain is maybe the most common problem that keeps people out of work in the US; whether it’s caused by an injury, an accident, or a consequence of age, it can shut you down in an instant. Now, having said that, it’s certainly true that not all back pain is created equal. A muscle strain is a completely different animal than, say, a herniated disc. That’s what makes knowing what to do (and what not to do, for that matter) about certain kinds of back pain a bit confusing. Not to worry - I’m here to help! In general, the to-do’s (and to-don’t’s... ?) are pretty straight-forward, but for the sake of making sure, it never hurts to put it down in writing.

1. Rest!
It’s sad, but so many people aggravate their condition by continuing the strenuous activity that caused the back pain in the first place! Give yourself some time to recover and you’ll be thankful for it.

2. Eat well!
Nutrition can play a big role in healing and overall health. Try and eat balanced meals, and do like your parents told you and eat your fruits and veggies, kids.

3. Drink up!
And we’re not talking soda or beer, folks. Make sure you get your eight glasses of water every single day! Water is about as vital as it gets for maintenance and good health. keep your whistle wet, and you’ll be thankful for it.

4. See a doctor!
Is the pain persisting after a week or more of the above? A doctor should probably be consulted. As frustrating as it is, there are some things that you simply can’t fix on your own. Talk to an expert and find out what’s going on. Knowledge really is power (hokey but true!).

These are just the simple rules. A doctor will likely have more like specific activities to avoid and specific foods to eat more/less of. If you need advice, call my office, Living Well Medical, in NYC at 212-645-8151. We’re here to help!

- Dr. Shoshany, NYC Chiropractor

The Importance of Staying Pain Free

Dr. Steven Shoshany (Dr. Steven Shoshany) — Mon, 25 Apr 2011 13:14:46 PDT

People suffer from pain all the time, sleeping the wrong way, or in an awkward position can cause neck pain all day (a stiff neck), sitting for two long can cause back pain, etc. On the other hand if you like to run, or exercise a lot to avoid problems like back pain, be ready for knee or ankle pain, or shin splints. You want to just keep going and "run through" it, be ready for the shin splints to degrade in to stress fractures.

Living in New York City is great but it also takes a toll on your health - not even going to start about the usual "unhealthy air" and "overcrowded subways" bit, that's going to have to wait for a different time. The physical demand on top of a hectic lifestyle that requires you to keep a break neck pace, combined with long bouts of inactivity, which in turn leads to exhaustion and further disdain for energy requiring activity, i.e: exercise can just pound on the stress. Feel like managing your physical health is a losing battle yet?

Truth is, its not all that complicated to take care of your body. Its not always "sound mind, sound body", in recent years and especially in cities like Manhattan its really become clear that its often the other way around. Being in a physical state of well being, peace, and pain free has a great carry over to the mental state, in a big part because you aren't constantly reminded, via physical stimulus (pain) that something is wrong.

Step back and take a look at whole picture.
When you're hungry, you eat
When you're exhausted, you fall asleep (sometimes at work)
When you're bored, you seek out fun and companionship
So how is it that when you're in pain you simply ignore it in favor of "more important" matters, even if its just sitting back to watch TV or play Xbox.

Exercise can create an environment for some serous stress relief as well as help strengthen muscles. That said, an injury can be compounded by just trying to train it away. People have a tendency of addressing their common biological needs and processes, but often when it comes to pain we ignore it, take a few pills and hope for the best.

So what happens when you ignore chronic pain?
Letting chronic pain, even when its minimal, can lead to degenerative conditions like:
Radiculopahty, which causes symptoms like Sciatica.
Bulging Discs, when the Annular swells and bulges out interfering with spinal nerves
Herniated Discs, when the internal disc material leaks out past the annulus.

Furthermore, untreated problems of the spine can lead to the discs becoming dessicated and the longer you wait to get treated, usually, the longer it may take to correct the problem. However some patients at Living Well Medical have felt relief almost immediately and a remission of symptoms after only a handful of treatments. Getting rid of pain can relieve a lot of mental stress as well. Knowing that you're physically capable of anything, can help you feel mentally more capable and happier as well.

A Safe Alternative to Back Surgery

Dr. Steven Shoshany (Dr. Steven Shoshany) — Mon, 18 Apr 2011 11:25:04 PDT

So you have had chronic back pain and its only gotten worst...

Over the past 50 years, our natural movement patterns and have deviated from what we are actually built to do. We have evolved to walk upright, perform physical work, stand, and lie down to sleep. We aren't necessarily built to sit for long periods of time. Sitting loads the lumbar spine directly instead of the big bones and muscles carrying most of the weight through to the ground, it is instead loaded directly on to the lumbar spine, which is further deviated form its natural position by rounding and over arching.

Loading the spine properly involvers standing with feet apart, chest up head up, and allowing the natural curve in your back to curve normally. Sitting not only makes it easier slouch, or round, it makes it desirable to do so. This not only impacts your posture, it also makes you fatigue faster because the body is in a state of rest and anticipates sleep, which is why we are a huge coffee drinking culture.

Along with consuming vast quantities of natural, and now, ever increasingly, synthetic stimulants with harmful concentration of certain acids and sugars, we also are becoming de-conditioned faster, and for longer. Being "out" of shape doesn't only contribute to back problems, it accelerates them, making them an eventuality. You don't have to be out of shape to experience back problems, you can even be a well trained, and well conditioned athlete, and still experience chronic pain.

Exercise Exercise Exercise
Doctors have been saying it for years - that a steady exercise regimen that elevates your heart rate and challenges you physically is essential to maintaining a healthy weight and a healthy cardiovascular system. Recently many studies have shown that weight training has a range of benefits from increasing cardiovascular health and efficency, to increasing bone density, fighting osteoporosis. There is no substitute or pill for good old fashioned exercise.

Getting the right type of treatment

Making sure that you have the proper people working for your benefit is essential to getting back on the path to healing, and getting back to doing what you love. An integrated approach combining multiple disciplines under the same roof, like medical care, chiropractic, physical therapy, acupuncture, massage, and other soft tissue treatment methods, can produce fast and effective treatment protocol that can speed up the healing process and eliminate the need for surgical intervention.
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Free Herniated Disc and Sciatica Seminar in NYC

Dr. Steven Shoshany (Dr. Steven Shoshany) — Tue, 05 Apr 2011 10:42:59 PDT

Free Herniated Disc and Sciatica Seminar in NYC

At the end of April, there is a very informative and useful, free, seminar on back pain, including herniated discs and sciatica treatment, focusing on non surgical spinal decompression. If you live in or around NYC and are suffering from chronic back pain, or even looking for a second opinion or non surgical pain treatment option, check out the seminar.

Do I Have Sciatica?

Dr. Steven Shoshany (Dr. Steven Shoshany) — Thu, 31 Mar 2011 08:39:06 PDT

When it comes to lower back pain, there a couple of “buzz words” that you often hear in connection (I hesitate to use the expression “buzz words” because it sounds sort of dismissive). Sciatica is definitely one of those words. It feels like one of those words you might hear in a movie like Grumpy Old Men - “I got a pinched sciatica that’d make your lumbago look like eye strain,” says Jack Lemon to Walter Matthau. It’s a great line, but guess what? it’s not very medically accurate. I know, surprise, surprise, Hollywood gets it wrong, but in this case it’s important to make it clear what exactly sciatica is so you can figure out what’s causing your back, leg or hip pain.

So back to the quote, let’s take it apart a little. First, you can’t pinch your sciatica. Sciatica isn’t a thing - it’s a set of symptoms. Basically, that means that you can’t “have” sciatica, but you can display sciatica symptoms. Sciatica is really a word used to describe a set of symptoms such as:

lower back pain

leg pain

burning sensation

loss of sensation

tingling

numbness

muscle weakness

The quote also mentions “lumbago” which is another broad term that essentially just means lower back pain, so in fact, that “pinched sciatica” could also have had lumbago as one of its symptoms!

Now that we know what sciatica really is, we can move on. If you experience some of the symptoms that fall under sciatica, it’s commonly associated with spinal disc related problems like herniation (also called prolapse) or bulges. The spinal discs that separate the vertebrae in the lower back tend to weaken with age and, when out of place, can press on the nerve roots as they exit the spinal canal. This compression leads to inflammation, irritation and potentially significant pain. In severe cases, loss of sensation and muscle wasting can occur. Basically, sciatica is pretty serious and requires a long term approach because discs have very little blood supply with which to heal.

For problems like sciatica, Living Well Medical in NYC focuses on the non-surgical side of care; spinal decompression, chiropractic adjustment, acupuncture, massage therapy, Active Release Technique and a number of other treatments are available at our office, and by combining them, getting the right kind of help for chronic back pain is within reach. We can help you stop the pain if you need help - call today at 212-645-8151.

- Dr. Shoshany, NYC Chiropractor

Can Cervical Stenosis Occour Alongside Lumbar Stenosis

Dr. Steven Shoshany (Dr. Steven Shoshany) — Sat, 12 Mar 2011 22:19:04 PST

Stenosis simply means "narrowing of", specifically "Spinal Stenosis" is the narrowing of the middle spinal column, which runs vertically, holding the central nervous system inside it, providing protection to this vital sensory system. "Foreaminal Spinal Stenosis" is the narrowing of the horizontal openings in the spine, through which the peripheral nervous system branches out. In either case, spinal stenosis is the narrowing of the spinal columns, which puts pressure on the nervous system and causes interference, which often results in pain.

Patients who suffer from cervical spondylititic myelopathy, complain of neck pain, unsteadiness on their feet, difficulty walking, numbness paresthesias, and a loss of dexterity in the upper extremities are common. Radicular symptoms can also be caused by coexisting compression of nerve roots in the cervical spine. Bladder control can also be an issue, but it is less prominent.

It can be common to have lumbar stenosis along with cervical spondylitic myleopathy, so there should be a careful evaluation of the patient to rule out the coexistence of both conditions.

At Living Well Medical, we have treated many cases of spinal stenosis, it is very important for long term quality of life for the patient that coexisting conditions be ruled out and an integrated, individualized treatment plan be implemented to speed recovery and cause minimal disruption to the patient's lifestyle and hobbies.

“I Have Back Pain...What Should I Do?”

Dr. Steven Shoshany (Dr. Steven Shoshany) — Wed, 02 Feb 2011 14:18:05 PST

When something is wrong with us, we tend to panic a little - it’s a very natural reaction, especially when the problem or pain is severe. Back pain is one of those issues that, again and again, leaves people searching, clamoring really, for an answer and a solution. And it’s no wonder. People who suffer with back pain go through a lot just to feel like themselves, to get a little shred of normal back. All of those feelings get summed up in the question, “what should I do?” It’s one of the more common questions I hear, and at Living Well Medical, back pain and other serious issues like it are a big part of our daily work. So then, let’s start by trying to get some basic answers.

First - Take a day or two of rest. If the issue is related to the muscles, it should start to feel better after a little rest. If the problem persists, start looking at options for clinics and doctors to see. Chiropractors and physical therapists are often excellent first choices.

Second - Understand that if you do nothing, there is no way of knowing what the result will be. Many people “work through the pain” and end up all the worse in the end. Do yourself a favor and take action. At the very least, you can learn what you are up against and make a plan. In the best case scenario, doctors and therapists can get you back on track. The main thing is to take action.

Third - After you choose a place for treatment, listen to your doctor. It sounds simple, but so often, patients who need back rehabilitation to prevent future injury don’t follow through and end up re-injuring themselves or even worsening the problem. Do yourself a favor by taking your treatment seriously, even after pain has been reduced.

If you are in serious pain, make sure to call a doctor. The best way to deal with pain quickly and effectively is to consult an expert. Call us today for a consultation at 212-645-8151.

- Dr. Shoshany, NYC Chiropractor

Ringing in the New Year...without Neck Pain

Dr. Steven Shoshany (Dr. Steven Shoshany) — Mon, 03 Jan 2011 09:50:14 PST

It’s the New Year, and we’ve probably all made our resolutions for things we want to change in our lives. It might be a habit you want to stop. It might be a goal you want to achieve. But for some, the resolution might reflect more of a hope for the future, and if you are someone who suffers with severe pain, you probably know what I mean. You’d give anything to feel like yourself again. At Living Well Medical in NYC, that’s our job - helping people live better lives and find relief - and every one of us works hard at it.

Among the worst types of chronic and severe pain is neck pain. Whiplash injuries, herniated discs, and pinched nerves can be nightmarish when they don’t get resolved; it’s common to find patients who have had pain for years, some off and on, some always on. The major effect it can have on how you live your life is unreal - a complete halt to physical activities is sometimes warranted. At the very least, sufferers aren’t able to do the things they used to enjoy. Even sitting, standing, and lying down can be a problem. And so for the new year, a sort of prayer for relief is understandable.

To relieve neck pain, Living Well Medical in the SoHo/NoHo area of New York City has a wide variety of treatments available. All of them focus on non-surgical pain relief and the vast majority are also completely non-invasive. Chiropractic adjustment using the Cox Flexion technique has been known to help reduce the pain of herniated discs and shorten recovery times. Spinal decompression therapy is another potent treatment option that works particularly with discogenic (originating in the spinal disc) pain. Manual therapies like Active Release Technique and the Graston Technique can be effective for chronic myofascial problems like tendonitis or muscle strain. In cases of acute pain, management techniques like injections and medications can provide near-immediate relief. Our NYC office is outfitted to be able to help a wide spectrum of aches and pains.

So why start off the New Year on a bad note? If neck pain is wearing you down and changing the way you live your life, take action. Give us a call at 212-645-8151 and learn more about what Living Well in New York can do for you. Happy New Year to all!

- Dr. Shoshany, NYC Chiropractor

Sciatic Nerve: A Real Pinch

Dr. Steven Shoshany (Dr. Steven Shoshany) — Tue, 14 Dec 2010 13:38:14 PST

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

Dr. Steven Shoshany (Dr. Steven Shoshany) — Tue, 19 Oct 2010 09:17:13 PDT

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

Dr. Steven Shoshany (Dr. Steven Shoshany) — Tue, 24 Aug 2010 16:12:46 PDT

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

Dr. Steven Shoshany (Dr. Steven Shoshany) — Fri, 30 Jul 2010 06:47:13 PDT

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

Dr. Steven Shoshany (Dr. Steven Shoshany) — Mon, 21 Jun 2010 06:52:32 PDT

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

Dr. Steven Shoshany (Dr. Steven Shoshany) — Thu, 13 May 2010 12:13:02 PDT

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

Dr. Steven Shoshany (Dr. Steven Shoshany) — Mon, 10 May 2010 12:58:05 PDT

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?

Dr. Steven Shoshany (Dr. Steven Shoshany) — Sat, 24 Apr 2010 10:06:21 PDT

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

Dr. Steven Shoshany (Dr. Steven Shoshany) — Thu, 22 Apr 2010 09:43:19 PDT

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