Articles in Category: Chiropractic

Red Flags

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

Red Flags

Red Flags

By Don Williams

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


Health care practice is an interesting and ever changing profession. One of the challenges that keep us on our toes is the assessment and management of different injuries and ailments.


The first goal in assessment is (or certainly should be) to identify what the complaint is, whether it is a serious or potentially serious condition that requires urgent intervention.


Recently, we have had a number of quite serious cases which have left us a little baffled as to the management they had unfortunately NOT received.


So this month I thought I would write an article on important symptoms to watch out for so you are not feeling sore and sorry.


Red Flags; this is believe it or not, a technical term for signs and symptoms which may indicate serious underlying pathology. These flags are many and varied and their presence is merely a potential indicator of pathology. This means that just because you have a “Red Flag” doesn’t mean you have a problem.


In compiling this list, it is by no means exhaustive and is a reflection of some of the things that we see showing up in our clinic.


So regionally, what are the things you should watch out for and what can they mean?


Back Pain

If you have back pain with referral down the leg, total numbness or loss of muscle strength it may be important. Loss of bowel and bladder control is certainly something we would want to know about.


Chest Pain

Most people know that chest pain can be an indicator of a heart attack. Most people realise that this is more commonly on the left side, however, pain in the lower front of the neck, the left arm, the left upper back and the right side of the chest can also be indicators. This would be reinforced by an increase in pain with exercise and or shortness of breath.


Night pain

Pain that wakes you from sleep is a concern, additionally; if this pain is accompanied by night sweats we would be a little more concerned. Sudden loss or gain in weight for no apparent reason is also a concern.



“The worst headache I have ever had” is not a great thing to hear. If this is in conjunction with vomiting and dizziness it is more of a concern. The feeling that the head is going to explode is more of a concern. Disturbances in any of your higher senses (vision, taste, hearing or smell) can also be a concern



Unremitting pain of 6 months or more of duration may be serious. If this is high intensity pain, then it is more of a concern. If the problem is not responding to conservative treatment then it is more concerning again.


If you have had a problem which won’t go away or you have some interesting symptoms that you are just not sure about, then get them checked out. Sometimes they may mean nothing, sometimes they may be important. My thought, always, if in doubt check it out.


on Thursday, 03 March 2016. Posted in General Health, Chiropractic


By Jakob van Vlijmen

M Chiro, DC


Scoliosis is a bend in your spine. When viewed from the side your back should have a double S shape. However when viewed from behind the back should be straight. If this isn't the case it is called scoliosis. At least 4% of the world population has scoliosis, however, this figure is likely to be higher, as in many cases the deformity is so minimal that it is missed and it does not cause symptoms.


Scoliosis might be present at birth due to a structural abnormality; however, most often it is something that develops during growth. Scoliosis is most likely to become present at the age of 10. Incidentally, it can present later in life.


In 10% of cases an underlying illness is the cause of the scoliosis; usually this is an illness affecting the nerves or muscles causing a twist in the spine. However, in over 60% of the cases the cause is unknown. More research in the future will shed some light on possible causes and if family genetics play a role.


Children are often not troubled by scoliosis. They are quite flexible and their bodies are able to compensate. At a later stage in life scoliosis can be a possible contributing factor to back pain.


When you have scoliosis you might notice some of the following things:

Ø  More tension on one side of your back

Ø  One arm or leg seems longer

Ø  One shoulder blade that sticks out further

Ø  At times the tension in your back can cause headaches or back pain


The earlier scoliosis is identified, the earlier treatment can be started and the better the outcome will be. Especially with children it is good to stay vigilant as there is a greater chance for their scoliosis to worsen as they develop and grow. Luckily in most cases the severity of the scoliosis remains limited and surgery or a body cast is not needed. To determine if these measures are needed the angle of the scoliosis must be measured on an X-ray.  When the scoliosis is more than 25 degrees a cast or corset might be needed. If the scoliosis is more than 45 degrees surgical intervention may be indicated.


To help prevent the scoliosis and diminish pain there are a few different options. A Chiropractor can help decide which steps are necessary. Furthermore, a Chiropractor can treat the problems that occur as a consequence of the scoliosis such as back pain and headaches. They will also help you become more aware of your posture as this is even more important in patients with scoliosis! Certain exercises can also help. Home exercises can be sufficient; however, some patients, especially children, might need more guidance and can benefit from occupational therapy or physiotherapy. Your chiropractor can advise you on the best course of action.


Scoliosis might not be that bad, however, it is imperative to keep an eye on it, especially in children, to make sure it doesn't deteriorate. Remain vigilant and consult a Chiropractor if you have any concerns.

Tendinopathy - What Is It?

on Thursday, 15 October 2015. Posted in General Health, Chiropractic

Tendinopathy - What Is It?

As we are all aware pain can be a debilitating thing to live with and manage. In past months I typed some overviews on understanding discal pain, shin splints and neck pain. Today we'll be covering something a little trickier to manage, Tendon irritation and pain, often known as either tendinopathy, tendonitis, or tendinosis (these terms differentiate the pathophysiological mechanism of the injury – we won't go into that today).


Tendons are the tough fibres that connect muscle to bone. For example, the achilles tendon connects the calf muscle (gastrocnemius and Soleus) to the heel bone. Most tendon injuries occur near joints, such as the shoulder, elbow, knee, and ankle, although the can also occur in the buttocks (gluts and hamstring insertions) and other areas.


Most tendon injuries are the result of gradual wear and tear to the tendon from overuse or aging. Anyone can have a tendon injury. But people who make the same motions over and over in their jobs, sports, or daily activities are more likely to damage a tendon. A tendon injury can happen suddenly or little by little. You are more likely to have a sudden injury if the tendon has been weakened over time – this may be related to previous traumas, injuries, or surgeries (which may have not been managed as well as they should/could have in the past -we all have those little gremlins in the closet unfortunately – me included!).


Symptoms of tendinopathy can include:

  • Pain, tenderness, redness, warmth, and/or swelling near the injured tendon. Pain may increase with activity. Insertional tendon pain may affect the local area where the injured tendon is, or can radiate out from the joint area along the associated muscle's distribution.

  • Crepitus, or a crunchy sound or feeling when the tendon is used. This can be uncomfortable or painful.

  • Pain and stiffness that may be worse at the night or when getting up in the morning.

  • Stiffness in the joint near the affected area.


Movement or mild exercise of the joint usually reduces the stiffness. But a tendon injury typically gets worse if the affected tendon is not allowed to rest and heal. Too much movement may make existing symptoms worse or bring the pain and stiffness back.

As mentioned above, The joint areas most commonly affected by tendinopathy are the shoulders (rotator cuff), elbow (and forearm/wrist), hips (gluteal), knees (knee cap), and ankles (achillies).


More chronic tendinopathies can be caused by inflammation around calcium crystals in or around the tendon (calcific tendinitis). The cause of the deposits often isn't known. These crystal deposits can be very painful, and a little more difficult to manage.

Tendinopathy pain may be similar to those of inflammation of the bursa (bursitis) and are often diagnosed concurrently because of the proximity and function/role of both structures


Diagnosis, Treatment and Management Considerations

Early diagnosis and treatment of a tendinopathy is important for recovery times as the turnaround for an acute tendinopathy to progress to a more degenerative chronic tendon injury can be as rapid as 6 weeks. Often orthopaedic assessment and provocation testing is necessary to identify the problem. Though if the injury is more complicated (obviously depending on the location and mode of injury) further assessment may need to be made, or if the problem is not responding to conservative treatment. Often xrays, ultrasounds and occasionally MRI is the most commonly used imaging tools for assessment and diagnosis.


Initially the focus on an acute tendinopathy is primarily based on reducing load on the tendon, stabilising the pain and protecting the area. Often topical applications of ice/heat and taping methods can be utilised, as well as the use of anti-inflammatory medications. In more severe cases the administration of a guided cortisone injection may also need to be considered. This can only be referred by your GP and performed by a specialist medical practitioner.


Understanding the mechanism of injury can go a long way towards recovery from a tendon injury. The tendon is the primary structure that deals with the load and force to move a joint (via muscle contraction) the primary focus of exercises for tendinopathies has to be based on reintroducing load onto a tendon gradually – thereby strengthening the tendon to adapt with load. Studies support the use of isometric exercise initially. (Isometric being defined as a contraction of any muscle without a change in the length of the muscle – thus performing isometric contraction of a muscle over a progressively increasing period of time allows the tendon to strengthen over time.)


Other more dynamic loading of the tendon can occur once clinical markers have been reached during treatment. These include less pain, improved strength and functional capabilities in more everyday tasks depending on the location of the tendon injury.


Do you have unusual pain in the shoulder, knee, hips ankles that seem to worsen with trivial tasks then assessment and diagnosis is always the first step. Problems such as these can lead to more sinister and traumatic problems which we would hope to avoid. These could be anything from chronic disability, tendon ruptures, and Adhesive Capsulitis (frozen shoulder) which can take anywhere from months to years to improve. Please contact the team at IOSAS and we'll help you find a plan forward for problems such as these.