Articles in Category: Chiropractic

How Long will it take to Get Better?

Written by Don Williams BSc, MChiro, ICSSD. on Wednesday, 23 September 2015. Posted in Massage, General Health, Sporting Injuries, Acupuncture, Training and Performance, Chiropractic

How Long will it take to Get Better?

By Don Williams

B.Sc., M.Chiro., ICSSD., PG Dip. NMS Rehabilitation Cert DNS. Memb: FICS, CEA

 

One of the most common questions that we get asked every day in practice is, “How long will it take to get better?” Unfortunately there is no short answer to this question, however, in this article I will try to outline some of the contributing factors and delineate some guidelines and ideas which may help answer this question for you.

 

Everyone is an individual, and in that sense, how different people respond and heal from different injuries does vary somewhat, some injuries are particularly unpredictable, shoulders are particularly problematic in identifying how well or how quickly they will respond to treatment. However with most injuries, there are general time frames in which most healing will occur.

 

Most people who have ever had an injury and minor procedure which required stitches will remember that the stitches generally come out in around 7 days and this time frame is a good indication of how long a cut or trauma takes to “bond” back together, however, the general healing process generally takes around 21 days. This is the timeframe for the body to lay down a “callus” or matrix of fibres around the injury and develop new connections and bridges to stabilise the injury and repair. But this timeframe is dependent on good blood flow and environment for repair, additionally, just because the injury is stabilised, does not mean that it is fully healed and fully function. This healing process and time frame is specifically relevant for muscle and skin.

 

Areas of the body that receive poorer blood supply take longer to recover. Tendons and particularly joint cartilage and ligaments receive a lower direct blood supply and take longer to heal. We normally expect that tendon and ligament injuries will take 6 weeks to start to repair well and 3 months to be stable.

 

Bones fractures also take longer to heal. Interestingly, the ratio of cortical bone (the dense outer “shell”) to cancellous bone (the “spongey” inner core) also affects the healing rate. So when we look at bones like the tibia (the larger of the two lower leg bones) they take a particularly long time to heal (up to 4 months).

 

The other interesting thing to note is that an injury is not always something that is readily assessable via an x-ray or scan and often, the severity of the pathology on the scan can be very unrelated to the amount of pain. For example, someone with severe degenerative changes noted on an x-ray may not have any pain, and in contrast, someone with very severe pain may have really good looking x-rays.

 

It is also important to note that many people use pain as a guide to where they have a problem or not. This is a situation which has been reinforced with dodgy advertising commercials by big pharmaceutical companies suggesting that all of our aches and pains can be targeted and resolved with a little tablet.  At times pain killers can be helpful, but it is important to realise that, contrary to the advertising campaigns, and the statements of the celebrities fronting these commercials, these drugs do not “target” the source of pain. They work globally in the system to mask the pain. In fact anti-inflammatories drugs can actually slow the healing process and all of these drugs have potential for complications and side effects, some of these can be severe.

 

But pain is only the tip of the iceberg. Pain exists as an indicator that something is going wrong in our system. We have an area that is under duress or load which is unhappy or injured. Sometimes there are weaknesses or imbalances or inappropriate actions which have caused this problem to develop. Getting rid of the pain is a good start, but addressing the underlying dysfunction or causative factors is also important to reach a good long term outcome.

 

Part of our goal in assessment at Institute of Sports and Spines is to try to assess the contributing factors which caused your problem to develop in the first place and help you to eliminate or address these issues.

 

Another complicating factor as eluded to, early in the article is the individual nature of response.

Sometimes we will see muscle spasm problems which are very severe and painful, which is not related to severe pathology. At times these issues will respond very quickly to treatment and at other times they will be a little stubborn and take a little longer. Generally, the response to treatment gives a more accurate prediction of how quickly the issue will settle. Further to this, if you have had previous episodes of the same problem, the previous response rate is generally a reasonable indicator of the response rate for future episodes.

 

So as a general time line for healing rates:

  • Early tissue healing occurs in around 7 days

  • The majority of soft tissue healing takes around 21 days.

  • Early bone healing takes 6 weeks (up to 4 months so large, long bones)

  • Cartilage and Ligament issues take around 6 weeks to 3 months

  • Re-education and retraining takes a minimum of 3 months

  • Remodelling can take up to 1 year.

 

In a perfect world things can progress more quickly. The addition of complicating factors can drag these times frames out.  The better that problems are managed and treated increases the probability of a good resolution and good long term outcome.

 

Later in this newsletter and over the next few additions we will outline more specifically injuries of the neck, back, knee, hip, shoulder and tendonopathies.

 

If you have any further questions then talk to the team and we will help you out with more specific advice.

 

Fracture Healing -

 

Fracture Healing

 


Wound Healing -

 

Wound Healing

 

 

 

 

 

How To Correct Lower Back Pain

on Wednesday, 13 February 2013. Posted in Ergonomics, Chiropractic

Lower back pain is one of the leading financial burdens on the Australian public health purse. Costing the government and consumer billions of dollars per year.
This problem creates a massive negative impact on  peoples quality of life and their ability to participate in their normal daily routine.
According to one of the leading journals, 79.2% of Australians Suffer Lower Back Pain at some point in their life. (J manipulative Physiol Ther. 2004 May;27(4):238-44.)
We also know that

Hyperlordosis - Are you Over Arching?

on Friday, 26 May 2017. Posted in Newsletters, General Health, Ergonomics, Chiropractic

Hyperlordosis - Are you Over Arching?

Hyperlordosis - Are you Over Arching?

Hyper Lordosis – Are you Over Arching? 

 

Tight Psoas 

Anterior pelvic tilt is the postural position where your butt sticks out more, accentuating the arch on your lower back. So say if you are overarching the lower back doing a back squat or a plank, the odds are high you are over tilting your pelvis forward.

 

Overtime, this issue can contribute to a disc bulge/slipped disc due to the overloading and pressure on the back part of the disc during overextension of the spine and let's not forget the probability of a hip impingement as well from the jamming of the pelvic and femur together in hip flexion and internal rotation.

Facet Joints in Motion

We tend to see this problem a lot more often now as we do spend long hours sitting at a desk or in the car which over activates the hip flexors and lengthens the hip extensors; causing a forward pull of the pelvis.

 

Some of the signs and symptoms of anterior pelvic tilt are:

1.back pain/stiffness especially standing for long periods and/or lying flat on back

2.tight hamstrings

3.gut (protruding belly)

4.gluteal muscles (butt muscles)

5.curve in the lower spine

 

In order to correct this dysfunction, we have to solve the muscle imbalances around the pelvic area. APT is more a stability issue than a mobility one. That being said though, the mobility side of things still need to be addressed.

 

 

Important tight muscles to be stretched to tackle the mobility issues are:

Hip Flexors - https://youtu.be/ut4mGaPvbZk

Hip Flexor 1 Hip Flexor 2

 

Erector Spinae - https://youtu.be/P_4yDo-hiHw  

Erector Spinae 

 

Rectus Femoris (The Quad muscles) - https://youtu.be/ei9Gh6RogDg

Rectus Femoris 

Do these stretches 10-15 times, hold 10-15 seconds post workout and throughout the day. 

 

As mentioned above, the root of APT is from the lack of muscle stability to hold your spine in a neutral position. Without these muscle controls, the body then tries to lock the joints together for stability instead (therefore the overextension of the lower back in squats when further loaded with a barbell/weights).  

 

When addressing stability, start off by reactivating these few muscles: 

Transverse Abdominis (Core stability) – https://youtu.be/T6CaTUBTtUA

Transverse Abdominis 1 Transverse Abdominis 2

Glutes - https://youtu.be/depTc0ME7wk

Glutes 1 Glutes 2

 

Pelvic mobility - https://youtu.be/CU7w8zjrzIc

Pelvic Mobility 1 Pelvic Mobility 2

 

Start with 10-15 reps throughout the day increasing to 30 reps as you progress and have better control.

 

I highly recommend these reactivation exercises to be done in the mornings to ease off any tension built during sleep the night before and before bedtime to de-load the body after a long stressful day at work.

 

You may not feel much progress on the first day, but persist for a week or more; a difference in pain intensity and stiffness will definitely be noticeable!

 

By Iris Tan

B.App.Sc (Chiropractic) M.Clin.Chiropractic. 

Memb: CA, Gonstead (Australia)

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