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Pain Underfoot: Metatarsalgia
Foot pain can interfere significantly with normal activities and severely limit participation in sports. Metatarsalgia is foot pain involving the metatarsal bones in the forefoot – the complaint of pain on the bottom of the ball of the foot.
MPA Media Wins 7 Publishing Awards
MPA Media, publisher of Dynamic Chiropractic and DC Practice Insights, among other titles, has been recognized for editorial and design excellence with an unprecedented seven publishing awards by the American Society of Business Publication Editors (ASBPE), the nation's largest organization for business-to-business publications.
9 Common Causes of Thyroid Imbalance and How You Can Help
How you sleep, how easily you wake up, and how much energy and stamina you have during the day are directly related to levels of the thyroid hormones.
Building From the Bottom Up
I caught up with my dear friend Honora Wolfe, in her Colorado painting studio where, if she is not praying in Bhutan or doing charitable work in a Nepali free clinic, she spends most of her time now.
Peer Points: Always Seeking To Grow
Ellen "Kiki" Geary has spent the last decade honing her craft. As a specialist in integrative holistic care, she went straight from completing her master's degree in acupuncture and chinese herbal medicine from Bastyr University to building a successful and thriving practice in the small community of Anacortes, Washington.
A Vibrating Capsule for Constipation? Relevance to Your Chiropractic Practice
The relationship between gastrointestinal (GI) complaints and back pain is not typically written about or discussed.
New Medical Technologies You Need to Know
We're all familiar with how fast computers become obsolete, as well as the rapid pace of development in the field of cell phone technology. The latest smart phones are far more powerful than desktop computers were only a few years ago.
Finders Keepers: The Secret to Relationship-Based Marketing
Becoming a successful practitioner has less to do with what you learned in school, and more to do with your ability to find new patients and keep them!
Why Young People Need Chiropractic Now More Than Ever
According to a recent study published in BMC Musculoskeletal Disorders, "It is now widely acknowledged that neck pain (NP), mid back pain (MBP), and low back pain (LBP) (spinal pain) start early in life and that the lifetime prevalence increases rapidly during adolescence to reach adult levels at the age of 18."
News in Brief
National Chiropractic Health Month: Be Proactive; Collegiate Roundup: Academic Appointments at Parker, Logan.
Chiropractic Research in Review
Chiropractic Treatment of Lateral Epicondylitis; Cost / Benefit Analysis: Different Doses of SMT for Low Back Pain; Imaging for Occult Rib and Costal Cartilage Fractures; Treating Neck Pain: Thoracic Thrust Manipulation vs. Non-Thrust Mobilization.
Don't Turn a 2 Into a 10
The Wong-Baker FACES Pain Rating Scale1 is so useful because it can be used by almost anyone. Patients can use the numbers associated with the faces depicted on the scale or select the face that demonstrates their current level of pain from 0-10.
A History Worth Telling
The popularity and the use of acupuncture for the treatment of animals in the United States is at its peak.
Waking Up the Gluteus Maximus
In previous articles in this series, we expounded on the importance of the gluteus maximus (GM) in athletic performance and protecting the knee from injury. We also know there is a link between iliotibial band syndrome and GM weakness.
A Chinese Medicine Story: An Interview with Mazin Al-Khafaji
Mazin Al-Khafaji's work has interested me for years. In February 2014, we invited him for the second time to speak at the Southwest Symposium in Austin, Texas.
Medical Qigong for the Heart: Part III
Part 1 and Part II of this series focused on the physical aspect of the Heart and mental emotional aspects of the Heart respectively. Now, I would like to focus on the spiritual aspect of the Heart.
A Guide for Talking to Doctors about Acupuncture and Brain Chemistry
Before I begin any discussion of how to talk about the effects of acupuncture on brain chemistry, nervous and endocrine function, it is essential to understand just what physicians most need help with.
CCE Finally Takes a "Baby Step" Toward Reform
During a 16-month period from October 2010 to February 2012, I devoted four separate columns to the heavy-handed attempt by the Council on Chiropractic Education to radically change the chiropractic profession through the accreditation process.
December, 2005, Vol. 05, Issue 12
Shin Splints or Compartment Syndrome?
By Whitney Lowe, LMT
One of the most common overuse injuries affecting the lower extremity is the condition known as shin splints. While the term shin splints routinely is used, especially among the athletic population, it does not represent a specific clinical pathology.Instead, it describes chronic shin pain resulting from overuse. It occurs in two regions of the leg. When it occurs in the proximal anterior lateral region of the leg, it's called anterior shin splints. It's also seen regularly in the distal medial region of the leg, where it's called posterior shin splints or medial tibial stress syndrome (MTSS). This discussion focuses on anterior shin splints, which routinely is confused with another overuse condition of the lower leg called anterior compartment syndrome.
Anterior shin splints are attributed to overuse of the dorsiflexor muscles, such as the tibialis anterior, extensor digitorum longus and extensor hallucis longus. Overuse results from excessive eccentric loading on the dorsiflexors. An example is walking or running downhill. With anterior shin splints, the client reports a history of repetitive activity performed on a regular basis or a sudden increase in activity levels. Pain is felt in the anterior lateral region of the leg near the proximal tibialis anterior attachment. The client with shin splints routinely reports pain at the beginning of an activity that gradually subsides with use, only to return after activity has ceased. The pain is like delayed onset muscle soreness by coming on hours later, even at rest.1
Anterior compartment syndrome sometimes occurs as an acute injury from a direct blow to the lower leg. However, it's more commonly a chronic condition resulting from overuse, such as running on a hard surface or suddenly changing the intensity of training. The condition often is referred to as exertional compartment syndrome (ECS) if it results from changes in training intensity.
Muscles of the extremities performing similar functions are enclosed within fascial compartments separating them from other muscles. Repetitive overuse of these muscles causes these tissues to swell, increasing compartmental pressure. Subsequently, the deep peroneal nerve and tibial artery or vein are squeezed within the compartment. Ceasing the offending activity allows symptoms to subside immediately. Anterior compartment syndrome and shin splints frequently are confused because symptoms are felt in the same region of the lower leg.2
Clients with exertional compartment syndrome will describe a repetitive activity performed on a regular basis. The client also might report a sudden increase in activity levels preceding the onset of symptoms. For example, chronic compartment syndromes often develop in military recruits when they begin basic training and their activity levels are drastically increased.3 Symptoms might include aching lower leg pain, paresthesia, coldness in the feet, color changes in the distal lower extremity, or motor impairment to the dorsiflexor muscles, in more extreme cases. The more pressure within the compartment, the worse the symptoms will be.
With a compartment syndrome, symptoms increase as the client engages in the aggravating activity. Once the activity is ceased, symptoms generally subside within about 30 minutes as compartmental pressure returns to normal. The reduction of symptoms when activity is ceased is one way to distinguish compartment syndrome from shin splints. Although there might be some initial soreness, shin splint pain characteristically increases after the activity with delayed onset soreness.
Compartment syndromes usually produce pain with palpation only if the compartmental pressure is elevated, such as right after the activity, while shin splints likely are to be tender to palpation long after activity has ceased. Shin splints produce pain with stretching and manual resistance (resisted dorsiflexion). Compartment syndrome is not as likely to be painful with either manual resistance or stretching because neither of these maneuvers increases the intracompartmental pressure. If paresthesia is present, compartment syndrome should be suspected because this is a symptom of nerve involvement and there is no nerve pathology in shin splints.
Both conditions affect the same region of the body and result from similar patterns of overuse. However, it's crucial to make a distinction between the conditions because treatment strategies for each differ. The only way to accurately identify the crucial differences between these similar conditions is with a comprehensive and thorough examination process.
Click here for more information about Whitney Lowe, LMT.
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