Login to view Shoulder & Elbow Pain videosDry Needling Carpal Tunnel Syndrome
September 30, 2010
I've just had my second visit with a patient with 20+ years of carpal tunnel syndrome for which we are trying dry needling (an anatomically based approach to using acupuncture needles). I must say, I've run into an issue in which the needles are either meeting with resistance or the patient is hypersensitive to the needle. This was unexpected as his hands have been numb for at least the last 20 years and he has even burned his hands a couple times due to an inability to feel heat.
Nevertheless we continued with his second treatment today and found him less sensitive to the needles. We were, therefore, able to go deeper into the key forearm and hand muscles I believe may be contributing to his carpal tunnel syndrome. We've stayed away from his neck area thus far but I intend to work my way up there once the forearm area is desensitized.
In addition to the dry needles I am also using vacuum cup therapy on his forearm muscles. This uses bell-shaped cups to create a vacuum within and draw the skin and fascia away from the bone according to Dr. Yun-Tao Ma, my instructor in dry needling and vacuum therapy. I'm using an electric motor to generate the vacuum. This is apparently 4x the strength of traditional cup therapy which uses a flame to create the vacuum. My goal here is to loosen fascia around the muscles to help allow the needles to penetrate.
Finally I stretched his deep forearm rotator muscles into pronation and supination according to my book, Fixing You: Shoulder & Elbow Pain. I believe tightness in these muscles creates stress to the finger and wrist extensors and flexors causing tennis elbow, golfers' elbow, and perhaps my patient's carpal tunnel syndrome.
My hope is that by combining corrective exercises for his functional deficits with dry needling and vacuum therapy, we can obtain a better result. This is because I treated him a few years ago using my approach and generated some very positive results which then plateaued. Although we were able to obtain some feeling in the tips of his thumb, first, and third fingers, we could progress no further in our results. I'm hoping that combining these three treatment modalities, we can achieve broader and deeper changes.
After his first treatment, the sharp electric shocks in his hand have dramatically reduced in frequency and intensity. I'm heartened by this and am remaining cautiously optimistic. We will continue with treatment for a few weeks to see where this takes us.
Bunions, Biomechanics, and Dry Needling?
September 16, 2010
I've been experimenting with the effects of reduced heel strike and increased mid- or forefoot strike patterns on issues such as plantar fasciitis, heel spurs, bunions, and other foot maladies for my sixth book in the Fixing You series. It's been very interesting and I believe this should be an integral part of treating these conditions. But in many people, something more is needed, either because they are not being vigilant enough in changing their foot strike patterns or their issue is complicated by years of adaptations in the foot musculature and ligaments. I've begun addressing more specific soft tissue issues and my results are now even better.
In every person I've seen with bunions, however, I believe this extra attention to the soft tissues should apply specifically to the abductor hallucis and medial head of the flexor hallucis brevis muscles in addition to the transverse and oblique heads of the adductor hallucis muscle. I won't get too technical here but I believe these muscles, as well as ligament changes, must adapt over time to hold the bunion deformation in place. So even if the mechanics of the foot are restored, these muscles may not "release" the bones to return where they need to go.
I've just taken a dry needling course and will take the advanced course in the next couple of days to become certified in Colorado. Dry needling, among other things, is meant to relax needled muscles and promote healing. Regarding bunions, I wonder if I needled the muscles mentioned above, together with changing the foot strike mechanics, whether this would reduce the size and pain of bunions. It's just a thought but I'll be experimenting with this over the next few months to test my ideas. We'll see how it goes!
Marathon Training & Foot Strike Pattern
September 3, 2010
I've been training for my 3rd marathon testing my theories about foot mechanics by running in Chuck Taylors (Converse) shoes. And no, I'm not sponsored by Converse! I'm up to my 20-mile runs and am feeling very good about my foot strike mechanics (although wish I was a faster runner!). I've had no, foot, knee, hip, or back pain since switching. Previously, I would always have to correct a pelvic rotation which contributed to back and hip pain but no longer. I'm feeling very good about my new theories regarding our walking (running) patterns.
Yesterday saw a woman with bunion problems and we were able to temporarily reduce the size of her bunions by changing how she stood. Now the trick will be to get her to walk better, thereby correcting the mechanical issues, I believe to be behind her foot, hip, and back pain issues. I'm really enjoying experimenting with this as I believe our anatomy supports my theory. Of course, I have a lot to learn, however, to tweak it and make it applicable to everyone.
Holistic Success and Back Pain
August 14, 2010
Earlier this summer I flew out to California to be interviewed about back pain on The Holistic Success Show. I had a wonderful time meeting Dr. Puff, Elizabeth, and the crew. They really made me feel at home. Feel free to check out Episode 38 if you'd like to hear me speak about back pain. Feel free to contact me with your thoughts!
Plantar Fasciitis, Bunions, and Foot Mechanics
May 24, 2010
I've been experimenting with my theories about walking mechanics and chronic pain conditions such as plantar fasciitis, bunions, heel spurs, hammer toes etc. Although it has been simple to remove the pain of bunions through improved gait training, I haven't yet been able to reduce the size of the bunions--until now (I think). The problem is I took pictures of my client's bunions but mistakenly sent them to my trash. She believes (as well as I) they are reduced--dramatically. But I have no proof without those pictures!
The plantar fasciitis has been more difficult to treat. I can make the pain go away with my simple taping technique but getting people to actually alter their gait pattern consistently has been the problem. I'm now also experimenting with a simple knee taping technique to help change their gait mechanics even if they're not thinking about it. This is an interesting mental leap for me as I generally haven't considered the knee affecting the foot. Instead I've always thought of the foot affecting the knee. I think this should help though. We'll see! I'm also understanding that, for those with chronic plantar fasciitis, the foot mechanics are in a "deep hole" of poor function and so taping right off the bat is the right way to go instead of just altering gait patterns.
Ultimately my theory is that we should not need foot orthoses to fix our foot mechanics given the proper guidance. This, in light of the fact that I cast for foot orthoses, would be a major revelation in the industry. What I am learning, however, is that changing foot strike patterns on a regular basis is more difficult than I expected. For those unable (or unwilling) to change their patterns, foot orthoses are a good choice--assuming they are casted correctly (which many are not).
Anyway, my experiments continue and I am heartened by my results!
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