Joint Replacements

Before I start with my intended article on joint replacements I need to share an announcement....

                       We have finally released our new website...www.ConwayClinic.com.

It's been completly overhauled with complete explanations of our treatment and services that are provided to both the athlete and non-athlete alike. Lot's of people think that we only treat athletes. Although the majority of the cases that we see, we continue to offer the same quality of services to patients in auto accidents, on-the-job injury, slip and falls and many other chronic type of symptoms. Okay, enough of that...let's get on with the article.

Joint Replacements
One area that I want to address is the issue of joint replacements. Patients that have been dealing with long standing pain in their knees, hips, shoulders or ankles have been told that they have degenerative changes. Most doctors are telling their patients that they have arthritis. Put them on some type of medication and send them on their way. Billions of dollars are spent every year on degenerative arthritis for the most part just to patch it up temporarily. There are many cases that can be fixed and fixed for years on end of pain free living.

If the patient continues on the pain medication over riding the pain the problem continues to produce problems to the joint causing increase degeneration. And what happens it leads to a visit to the surgeons office at the other end of a diagnosis of joint replacement.

It seems to me that there has been a rash of orthorpedic diagnosis given to a lot of my patients telling them that their problem is "bone-on-bone."   The doctor tells them that due to the knee pain they are going to need a replacement because they have "bone-on-bone" when I put up the x-ray to read there is plenty of room between the bones.

It is my judgement after seeing patients for over 27 years that when a patient has a joint pain that is bone-on-bone they can hardly walk 10 yards without having to stop for assistance. Patients continue to come into my office telling me that they are scheduled for surgery when they can walk normal to the average eye. Yes, they have some pain but nowhere near the pain of a patient who truly has "bone-on-bone" pain. That type of pain is severe and disabling.

Joint pain in many, if not all patients, not related to a pathological disease, is directly due to the supporting muscles not doing their job. The muscles gets its electrical supply from the nerve. If  the muscle didn't get a nerve supply then in reality all you have is a filet mignon. Once the nerve supply feeds the muscle the energy it turns the muscle from a steak to a moveable muscle.

The muscle is designed to turn on (contract) and turn off (relax). When it turns on (contracts) its designed to absorb force. Just like the shock absorber of your car the muscle is designed to absorb the same force before it gets into the joint. The joint isn't designed to absorb force and the bones of the joint begin to bang together in a round about way. This leads to inflammation that leads to pain and eventually to degeneration...also known as arthritis. Now if the degeneration goes too far then in fact you may need to have surgery to replace the joint. But please, please listen to me...most of these joints don't need to be replaced.

If the muscles are properly turned on they will contract in the manner they were designed and properly  absorb force. If the force is taken up by the muscle(s) that force can't get to the joint and the joint will remain healthy.

At my office the first thing done is a functional exam to see where the breakdowns are coming from. Muscles are an outward expression of the nervous system. So I can test the nervous system through testing the muscles. I can track down what muscles aren't properly turned on not absorbing force. Then with a specialized machine that I have I can locate the exact area to where this "short circuit" is located. From there, I can then design a protocol to remove that short circuit turning on the neuromuscular response allowing for the proper healing to take place.

We have been able to help lots of patients get rid of they chronic pain and save them from surgery. I can even help patient who already had joint surgery. We are able to  to accelerate the healing process in many cases as much as 60 to 80%. That can take months off of your rehabilitation time. One of our patients who had complete reconstructive ACL (knee ligament) surgery was scheduled by his doctor to be in rehab for 6 to 8 months. Using out innovate treatment protocols we were able to get him back to his football team workouts in six weeks.

If you have questions about any of this feel free to drop me a line via email at drc@conwayclinic.com. I'll be happy to answer any of your questions and hopefully keep you away from surgery.

Dr. Malcolm Conway
Conway Clinic for Sports Injury
www.ConwayClinic.com

Health Update

Weekly Health Update Week of: Monday, October 31st, 2011 Courtesy of: Malcolm Conway, D.C. (570) 287-7070 "Security is mostly a superstition. It doesn't exist in nature." ~ Helen Keller
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Mental Attitude: Friendships & Anxiety. Anxious, solitary kids are more emotionally sensitive and more likely to be excluded and victimized by their peers. They're also less likely to have friends, and when they do, to have fewer than their peers and to lose friendships over time.  Child Development, Sept 2011 Health Alert: Obesity Costs!  States spend up to $15 billion a year in medical expenses related to obesity. Estimates in dollars range from $203 million in Wyoming to $15.2 billion in California. National costs of obesity are $147 billion.   Agency for Healthcare Research and Quality, Sept 2011 Diet: Wine & Dementia Risk. Moderate wine drinkers are 23% less likely to develop dementia and/or Alzheimer's disease. Resveratrol, found in fairly high levels in wine, is a naturally occurring antioxidant that decreases the stickiness of blood platelets and helps blood vessels remain open and flexible. It also inhibits enzymes that can stimulate cancer cell growth and suppress immune response. Alzheimer's Disease Research Center Exercise: Good Reasons.  Exercise decreases the rate of joint degeneration in people with osteoarthritis, lowers your resting heart rate, helps to boost creativity and reduces circulating levels of triglycerides. Surgeon General's Report on Physical Activity and Health, 1996                  Chiropractic: What Does Double Crush Mean?  If there is irritation of a nerve root at the vertebra of the neck, or at the triangle formed between the scalene muscles and the first rib, the nerve itself becomes "sick." As that nerve passes into the arm, it passes through several muscles before it enters the hand, beneath the transverse carpal ligament. If the nerve is already "sick," the "secondary stress" of compression within the arm muscles, or at the wrist, may cause regional symptoms at that location. We call that second insult to the nerve a "double crush" phenomenon.  Wellness/Prevention: Four Ways To Live Longer.  Those who practice all 4 are 66% less likely to die early from cancer, 65% less likely to die early from a major cardiovascular disease, and 57% less likely to die early from other causes. 1) Avoid Tobacco. 2) Limit Alcohol: Men should have no more than two drinks a day, women no more than one. 3) Improve Your Diet: Eat more fruits, eat more vegetables, eat more whole grains, switch to fat-free and low-fat dairy and eat more seafood. Cut down on salt and foods high in sodium, saturated fats, trans fats, cholesterol, added sugar, and refined grains. 4) Exercise at least 150 minutes of moderate exercise spread over at least 5 days a week - or - do a total of 75 minutes of vigorous exercise 3 days a week or more.  American Journal of Public Health, August 2011
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Conway Clinic for Sports Injury

How One Vitamin Can Save Your Life...

I've written about this before and I have to come back to it once again becasue of its importance...Vitamin D(3). Please read and if you have questions feel free to contact me. I'll be happy to show you more evidence on how truly important this cheap readily available vitamin can help you boost your immune system.

I don't want to sound like a broken record but here is one of the cheapest forms of medicine that can do more for your health than you can imagine. For years vitamin d has been known for bone health when used with calcium. Well please, please read  and understand that vitamin d can not only help with your bones but with many more conditions.  The research is overwhelming to the efficacy of building your immune system. Research over the past two decades is now gone way beyond the norms of showing how powerful this one small supplement can improve your life. In many cases can it can save your life.

                    Females: Correct levels of Vitamin D can reduce breast cancer by 50%.

You may or may not know but I've been preaching about vitamin d for years once I learned about how powerful it  really was. But I needed facts so I began taking vitamin d for myself taking 5,000 iu per day. After three months I had my blood tested and found out that I was still deficient and below the normal values of vitamin d. So I began taking 10,000 iu per day and found that was the trick and my values normalized.
 
Vitamin D deficiency is at epidemic proportions in the United States and many other regions around the world today, largely because people do not spend enough time in the sun to facilitate this important process of vitamin D production.

The best way to get your primary dose of vitamin d is to get exposed to the sun. You need to sun at least 40% of your body in direct sun light for period of time conducent to your skin type. If you are fair skin you will only need 15 to 20 min and you can continue to add time the darker complected you are. Even African-Americans need direct sun light because of the fact that all humans are designed to receive UVB spectrum of light. It's the UVB that is important to the production of vitamin d to your body.

So what happens if you live in an area like me that doesn't allow to absorb that type of light? There are two ways that can help you get the appropriate amount of sun light. If you live in the upper portion of the U.S. you won't be able to get UVB sun light that will provide the needed vitamin d. You have two alternatives:
        1. Tanning Bed or Salon
        2. Oral Supplementation

Yes, you heard that right a tanning bed that uses UVB bulbs is completely safe AS LONG AS YOU DON'T BURN! The key is that you get enough that your skin turns LIGHTLY pink.  You can do this two to three times per week which will give you the vitamin d needed to boost your health.

Oral supplementation is good however not as effective as the upper two suggestions. But it still works pretty well if the other ways are out of the question. You need to take 8,000 iu per day and in about three to four months you need to have your vitamin d levels tested.

Occasional sunlight exposure to your face and hands is not sufficient for vitamin D nutrition for most people. To optimize your levels, you need to expose large portions of your skin to the sun, and you may need to do it for more than a few minutes. Ultraviolet light from the sun comes in two main wavelengths -- UVA and UVB. It's important for you to understand the difference between them, and your risk factors from each.

First there is UVB, the healthy wavelengths that help your skin produce vitamin D. Then there is UVA, which is generally considered the unhealthy wavelengths because they penetrate your skin more deeply and cause more free radical damage. Not only that, but UVA rays are quite constant during ALL hours of daylight, throughout the entire year -- unlike UVB, which are low in morning and evening, and high at midday.
So to use the sun to maximize your vitamin D production and minimize your risk of skin damage, the middle of the day (roughly between 10:00 a.m. and 2:00 p.m.) is the best and safest time. During this UVB-intense period you will need the shortest sun exposure time to produce the most vitamin D.

Based on recent research published by Grassroots Health from the D*Action study, the average adult needs to take 8,000 IU's of vitamin D per day in order to elevate his or her levels above 40 ng/ml -- the bare minimum requirement necessary for disease prevention. Ideally, you'll want your levels to be between 50-70 ng/ml.

As Carole Baggerly, director and founder of Grassrootshealth.com, noted:

"We just published our very first paper. We have about 10 people in this study now that are taking 50,000 IU a day and they're not reaching a potential toxicity level of 200 ng/ml.  It should be noted, however, that this is not a recommended intake level. The study reported data on about over 3,500 people.
… One very significant thing shown by this research was that even with taking the supplement, the curve for the increase in the vitamin D level is not linear. It is curvilinear and it flattens, which is why it's even hard to get toxic with a supplement."

This means that even if you do not regularly monitor your vitamin D levels, your risk of overdosing is going to be fairly slim -- even if you take as much as 8,000 IU's a day. As an aside, there is evidence that the safety of vitamin D is dependent on vitamin K, and that vitamin D toxicity (although very rare with the D3 form) is actually aggravated by vitamin K2 deficiency.

My hope for you that you heed this advice and begin to get your Vit D in any form that is comfortable for you. The scientific evidence is overwhelming now to help you boost your immune system.

Dr. Malcolm Conway
www.conwayclinic.com
www.raisingeliteathletes.com

Lower Back Pain

By: Dr. Malcolm Conway
www.conwayclinic.com

Most lower back pain is caused by overuse to the muscles.  This then puts a strain on the ligaments which ends up not stabilizing the bones in the back.  This can cause pinched nerves, disc problems that can lead to severe back and leg pain. Most of us who treat backs for a living believe that with repetitive weakness of your lower back can lead to structural degeneration of the spine.

Once a person injures their lower back they tend to move away from the pain. They begin to walk differently to protect themselves against the pain using muscles that were not intended for that particular movement. We call this compensation pattern. This compensation pattern causes the muscles that weren’t designed in the first place to do this type of work to fatigue putting more stress on other muscles in the area.  As time goes on the muscles begin to shut down functionally which leads to other complications.

It’s very rare for anyone to wake up with severe back pain unless they were in some type of traumatic situation.  Someone with severe lower back pain developed that pain over time. If you see someone with severe lower back pain walking bent over or walking in an extremely guarded position think to yourself somewhere along the line something happened to cause this condition – a strained muscle, over use from prolong bending, lifting something that was too heavy for them or even prolonged poor posture.

So let’s imagine that we can trace back each day of that person’s life to see what they did to start the snowball growing downhill.  We look at each individual day, day by day, until we find the day that started it all. It may take months or even years until we find that day that started.  But if we look back at each successive day from the day the pain began to become severe we would observe many different scenarios.  Each day going backwards would be different - one day we would see the patient walking different to protect the pain, one day we would see the patient taking aspirin to dull the pain, one day we would notice the patient shifting their weight from one side to another in order to protect them from increasing the pain.  As we begin to add up the days, we  notice that weeks, months or even years add up to this severe outcome of lower back pain.

Could this have been prevented? Heck yea, but people have to realize that posture, strengthening exercises, and other fitness protocols are important in maintaining normal mechanics of your body.

We can all sit around and say I told you so but that isn’t going to get us anywhere. The more important question is that can this be reversed. The answer is that in just about all cases….absolutely yes!

When the muscles of the body do not absorb force properly, one of the places that force often goes is the spinal column. This force can cause damage, which causes the muscles in the low back to stay chronically tight in order to protect the area. As the force increases in the spinal column an unnatural movement occurs which can lead to inflammation which will lead to pain and sometimes disability.

Now, keep in mind that the pain that the person is feeling in the lower back “is where the damage ended, not where the damage began.” 

When you can locate the origin of the damage and properly correct it then you can drastically reduce the worry of the pain returning. How many people do you know tell you about their chronic back pain. It never seems to go away…why?  I hurt my shoulder or knee I have it fixed and it goes away. But lower back pain for many means a life time of misery.

A new treatment called the ARPwave has been shown to first locate the original site of damage. Once this is corrected the stress from that damaged site is relived immediately reducing the pain. This machine has been shown not only to locate the source of damage but to help rehabilitate the area to a strong supportive state lessening the change greatly of reoccurrence.

This bio-electric form of healing is years ahead of its time. Using a unique patented wave form it has shown to reduce the healing period up to 85% faster than conventional treatments. With every injury to the body, cell membranes are damaged, and the natural electrical polarity of the body is disrupted. The result is a negative charge buildup within the injured tissue. This is good at first; it is the negative charge that initiates the healing process by attracting white blood cells and promoting the growth of scar tissue. However, if the negative charge buildup does not dissipate, it becomes a liability, causing the scar tissue to adhere to the muscle tissue. This embedded scar tissue within the muscle fibers makes it impossible for the muscles to elongate fully and hence to contract maximally, thereby weakening them. ARPwave direct current breaks up this scar tissue in an efficient manner.

Simply put, the experienced doctor using this machine can locate the original area of damage, begin to eliminate the inflammation that is the underlying cause of the ongoing pain and then develop a protocol to begin to strengthen this area to prevent the pain and damage from returning.

Predicting Joint Injury in Athletes

How many times have you heard ‘AFTER THE FACT’ when the athletes says it just came on but I did feel some discomfort on and off for a while. Well I can tell you that discomfort the patient was feeling for a while was slight warning sign that was not paid attention to.

This past summer I witnessed and treated an increase in shoulder and elbow injuries in baseball players. Here’s the bad part…many of them where in Little League.

Pitching and throwing places an extreme combination of force, velocity, and stress to the shoulder while throwing overhand. You probably didn’t notice but there is almost no injury to shoulders and elbows to female softball players. That is mainly because of the throwing motion is underhand and is more natural movement for humans.

Male baseball players experience high velocity range of motion during overhand throwing that pushes the shoulder and elbow joints to their limits.  It’s not surprising then that shoulder and elbow injuries are so common in baseball.

 

Clinical studies have shown that there doesn’t have to be this high incident of injury. In my office we do a careful study of the passive range of motion of the patient prior to the season. Studies have found that the players who had a decrease of 25 degrees of internal rotation in their dominant arm were 4 times more likely to suffer an injury, and a 10-20 degree loss of total range of motion doubled the risk of injury. (American Journal of Sports Medicine)

This study shows that a decrease in the range of motion of the player’s dominant arm, mainly internal rotation, is a strong predictor of possible shoulder or elbow injury.

So if you notice that your young baseball or softball player has a little restriction in their shoulder or elbow and/or complains of stiffness or restriction in either their shoulder or elbow it’s best that you take time to get them checked out. Don’t wait until it’s too late when a full blown injury takes place.

Proper training of the muscles of the upper quarter including the upper back, shoulder, neck and upper extremity can not only prevent injury but allow for your athletes to increase their performance in their sport.

We have developed a unique way of finding the exact area to where the muscles broke down or weakened to begin with. You see, the pain in the joint is where the damage 'ended' NOT where it began. The muscles that are responsible to aborb the force were not doing the job and that force continued to travel into the joint where increase friction and compression began to cause inflammation...which caused the pain.

A Sports Makeover

Sports Makeovers

Athletes are no different from everyone else when it comes to attitude. Change your attitude for the better and watch your performance improve. Most people get bombarded with negative encounters all day long. Whether its from the newspaper, television or your next door neighbor, you have to guard your brain against negative inupt. If your neighbor came over every day to dump their garbage on your front lawn I'm assuming you would take a stand to stop that behavior. So why would you let all of the other negative interactions be allowed to be processed in your mind.  Guard your mind like you would guard money...it's just as valuable or more.

Here are a few "Attitude Makeover Strategies"...

1. Accept that what IS....IS - STOP complaining about it. STOP wishing it was different, STOP blaming yourself or others about it.
2. Focus on what you have and not what you don't have.
3. Focus on what you want and not on what you don't want.
4. Focus on solutions.
5. Say "Yes," "Please" and "Thank You" more.
6. If something doesn't go your way, just say, "Next!"
7. Create a "No Drama" life.

You create your reality. Assume that if things aren't going your way, then your attitude, thoughts, actions or lacks are the cause.

...Or, maybe they are going your way and you just don't know it yet! With a bad attitude you will find a way to screw it up. STOP…turn it around and your career will turn around.

Knee Pain

Knee Pain

For people over the age of 30 knee pain slowly becomes an issue of day to day live. There are many different types of knee pain that affect people. Over use, direct trauma, degeneration, past injury and believe it or not lack of exercise.

For the majority the reason why so many people experience knee pain is due to the lack of support of the VMO or Vastus medalis obliqus muscle. The vmo is the ‘tear drop’ muscle that runs down your thigh and attaches to the medial or inside portion of your knee. When this muscle weakens it loses its ability to absorb force. Once that happens slowly over a period of time the day to day force that you produce will begin to end up in the knee itself. The knee with its tendons, ligaments and cartridges are not designed to absorb force and the tissue begins to fray. The fraying first begins at a microscopic level then at a greater level that will produce inflammation that. Inflammation will then produce pain.

What most people do is to take some type of over the counter medication for it which will help with the pain. However, in the long run you’re not getting to the cause of the pain you are only dealing with the symptoms. This leads to further damage and eventual degeneration of the internals aspects of the knee joint. In extreme cases some surgeons advise a complete knee replacement.

As people age they tend to develop ‘arthritis’ which is no more than what I explained above. These people suffering with this type of daily pain don’t know enough but to take pills to ease the pain. But I’m here to tell you that most knee pain can be stopped if the proper measures are taken to build up the proper support for the knee joint itself.

I’ve taken care of tons of patients who have been told that they have bone-on-bone and that they need a knee replacement. Please let me tell you in some cases this may be true however I can tell you with direct sincerity that many of these patients can avoid needless surgery.

New Technology

Several years ago I along with two colleagues came across scientific literature that was buried in the archives of treatment. The theory was that fascia that is a thin connective tissue within the entire body has a tremendous factor in joint, muscle and organ protection. Once strained or disrupted the tissue becomes one of the leading pain generators of the damaged area. Over time it can develop in loss of motion, swelling and pain. If not corrected it can continue to linger causing the patient to compensate which leads to further disability.

So let me tell you a quick story on how I started using this method. As I said we found many of this information scattered in different areas of research. We took the time to connect the dots and developed a theory that could relieve pain faster that what is being offered today.

Out of the blue a young college girl was referred to me for a chronic sprained ankle. She entered wearing an air cast and using crutches. She was desperate to drive to New Jersey to see her sick mother and she was unable to drive due to the severe pain in the ankle. I told her that I have a new technique that I’ve never done before but I think it will help you. She reported that she didn’t care – she really wanted to get back to see her mother. I agreed to try it on her.

Well, I started treating her and after about 5 minutes of treatment I had her get up and stand on it. Honestly, to my amazement she reported that she had no pain. After 15 minutes of treatment she walked down the hall without the crutches and the air cast reported a tremendous reduction of pain. Even my staff came to me asking me what I did because they saw her come in and now she had here cast and crutches up on the counter signing out.

Well that was the birth of MFDT in my office.

What I found out was that when you straighten out this tissue in just a few minutes the pain begins to go away along with the swelling and the range of motion begins to return…literally minutes after starting treatment. We continued to develop this treatment which we call the MyoFascial Disruption Technique (MFDT). I have been using on athletes and non-athletes alike for year with amazing success.

Another treatment that we offer is called the ARPwave. An extremely unique machine that provides an electrical current that will actually find where the damage originated from.  What makes this so unusual is that where you feel the pain is not where the damage began…it’s where the damage ended up. By locating the source of the damage we can instantly begin to correct the situation and help strengthen it so that it doesn’t return.

The combination of these two treatments has helped people with chronic pain for years begin to live normal lives. It has also has helped hundreds of athletes return to the field of competition much faster than other conventional treatments.

Don’t let nagging pain keep you down…give us a call to see how we can help you. You will probably be surprised how fast we can have you feeling better.