Dr. Andrew Rackovan

Just attended a weekend of dry needling with Midwest Rehabilitation Institute and can’t wait to incorporate the benefits of dry needling into clinical practice!

Midwest Rehabilitation Institute Rehabilitation & sports medicine education for advanced clinical knowledge in physical medicine.

Great night tonight for Rockwood Summit Football. 32-0 win over Fox. We were busy tonight triaging athletic injuries but, man do I love high school sports…

Harvard Medical School agrees: chiropractic should be the first line of defense against back pain. You don't need to schedule with a orthopedic surgeon at the first sign of back pain! Chiropractic is cheaper and more effective in the long run. Only if conservative care doesn't work should you look at more invasive options.

HOT TOPIC!!!

Surgery vs. Conservative Care for Rotator Cuff

Journal of Shoulder and Elbow Surgery:

"We found no significant differences in clinical outcomes between (rotator) cuff repair and nonoperative treatment at 12-month follow-up."

"[surgery] may provide little or no clinically important benefits with respect to pain, function, overall quality of life or participant-rated global assessment of treatment success when compared with non-operative treatment."

Ranebo MC, Hallgren HC, Holmgren T, Adolfsson LE. Surgery and physiotherapy were both successful in the treatment of small, acute, traumatic rotator cuff tears: a prospective randomized trial. Journal of shoulder and elbow surgery. 2020 Mar 1;29(3):459-70.

Karjalainen TV, Jain NB, Heikkinen J, Johnston RV, Page CM, Buchbinder R. Surgery for rotator cuff tears. Cochrane Database of Systematic Reviews. 2019(12).

So this is neat... put in the work and avoid surgery.... sounds like a win to me.

97% OF LUMBAR DISC HERNIATIONS MANAGED SUCCESSFULLY WITHOUT SURGERY, SAYS STUDY. Results of a retrospective cohort study [1] including almost 280,000 subjects have concluded that pr*****ed lumbar intervertebral discs may be successfully managed without the need for surgery in 97% of cases.

The study examined the records of adults presenting 2007 to 2017 selected from a large insurance database. Only 3% failed non-operative therapy and underwent microdiscectomy.

Of the patients requiring surgery, the majority were male and an association was found with a history of lumbar spinal epidural injection or perioperative opioid use, leading the study to conclude that male gender and a history of prior opioid use were independent predictors of non-operative treatment failure.

The study provides yet more evidence supporting treatment and management interventions for lumbar disc herniation commonly provided by chiropractors, including manual therapy, education, exercise prescription and self-management strategies.

References: [1] Lilly DT, Eldridge CM, Singh R, Montgomery EY, Bagley C, Adogwa O. An assessment of non-operative management strategies in a herniated lumbar disc population: successes versus failure. Global Spine J. 2020 Jul 7;2192568220936217. doi: 10.1177/2192568220936217.

Image courtesy of Dynamic Disc Designs (https://dynamicdiscdesigns.com/)

Dynamic Disc Models for Human Spine Education - Dynamic Disc Designs Realistic dynamic spine models with dynamic disc anatomy for effective patient education of spine related conditions. Improve your outcomes with ddd models.

Top Tendinopathy Treatment

Scandinavian Journal of Medicine & Science in Sports:

"Eccentric exercises were the most common and consistently effective treatment for tendinopathy across systematic reviews. Low-level laser therapy and extracorporeal shockwave therapy demonstrated moderate effectiveness, while platelet-rich plasma injections demonstrated inconclusive evidence on their ability to decrease tendinopathy related pain and improve function. Corticosteroids also showed some effectiveness for short-term pain, but for the long-term use deemed ineffective and at times contraindicated. Regarding surgical options, minimally invasive procedures were more effective compared to open surgical interventions.

When treating tendinopathy regardless of location, eccentric exercises were the best treatment option to improve tendinopathy related pain and improve self-reported function."

Irby A, Gutierrez J, Chamberlin C, Thomas SJ, Rosen AB. Clinical Management of Tendinopathy: A Systematic Review of Systematic Reviews Evaluating the Effectiveness of Tendinopathy Treatments. Scandinavian Journal of Medicine & Science in Sports. 2020 Jun 2.

What does my neck have to do with any of this?🤔

Patients with elbow, shoulder and TMJ issues ask me this all the time during the initial evaluation when I suggest an evaluation targeted to the cervical spine.

👇Here is why. 👇

Cureus Literature Review Supports Cervical Manipulation

"The results of the research show that HVLA techniques, on subjects with musculoskeletal disorders, are able to influence pain modulation, mobility and strength both in the treated area and at a distance. Cervical manipulations are effective in management of cervicalgia, epicondylalgia, temporomandibular joint disorders and shoulder pain."

📖: Giacalone A, Febbi M, Magnifica F, Ruberti E. The Effect of High Velocity Low Amplitude Cervical Manipulations on the Musculoskeletal System: Literature Review. Cureus. 2020 Apr;12(4).

Concerned about low back pain, but not sure where to turn while social distancing?

Take a look at this infographic to dispel myths and learn the facts about low back pain.

For more information on the treatment we offer for low back pain, visit our website or call our office! 👇

📱: 636-717-0600

💻: www.bodybalancechiropractic.com

🚨Spinal Manipulation Affects Muscle Function🚨

"Joint mobilization immediately decreases the activation of superficial muscles during low load conditions in symptomatic individuals. For asymptomatic individuals, there is a low level of evidence that passive joint mobilization improves maximum muscle strength. Current best evidence suggests that passive joint mobilization has the ability to immediately alter muscle function."

🤔What does this mean? Getting adjusted in the right area at the right time can decrease musculoskeletal pain and improve function!

📖: Pfluegler G, Kasper J, Luedtke K. The immediate effects of passive joint mobilization on local muscle function. A systematic review of the literature. Musculoskeletal Science and Practice. 2019 Dec 26:102106.