Chiroblog

With the rise of elite athletes competing in high-intensity and sometimes contact sports, it raises the question of what is truly safe for pregnant women? The American College of Obstetrics and Gynecology currently recommend a minimum of 150 minutes of moderate intensity exercise per week during pregnancy. This should include both aerobic and resistance training. Exercise during pregnancy has been shown to demonstrate significant positive effects for the mother including but not limited to reducing weight gain and its subsequent effects, alleviating and preventing musculoskeletal pain, shortening labor and delivery, and reducing the risk of an emergency c-section. While exercise does not seem to have a direct effect on the fetus, it has been shown to potentially reduce fetal distress during labor. More importantly, exercise has not been shown to have any negative effects on a fetus during a low-risk pregnancy.^1-2 It is also important to note that the upper limits of how much exercise intensity a pregnant mother and fetus can tolerate safely is currently undetermined. However, special concern should be given to competing in high fall-risk or impact activities, high heat and humidity, and exercise at elevation >6000ft.³ In short, if your obstetrician has given you the clearance to exercise during your pregnancy, most exercise and athletic activities will be well-tolerated by both mother and baby, especially in well-trained adults going into pregnancy. Remember, chiropractic is your best bet to achieve healthy maximum performance!  But, if you are concerned about a specific activity or any symptoms you are experiencing while exercising, always consult your healthcare team immediately.^1-3

References:

1. Perales M, Santos-Lozano A, Ruiz JR, Lucia A, Barakat R. Benefits of aerobic or resistance training during pregnancy on maternal health and perinatal outcomes: A systematic review. Early Human Development. 2016;94:43-48. doi:https://doi.org/10.1016/j.earlhumdev.2016.01.004

2. Albright E. Exercise During Pregnancy. Current Sports Medicine Reports. 2016;15(4):226-227. doi:https://doi.org/10.1249/JSR.0000000000000277

3. Cooper DB, Yang L. Pregnancy And Exercise. PubMed. Published April 17, 2023. https://www.ncbi.nlm.nih.gov/books/NBK430821/

With the entire world watching the 2024 Olympic Games play out in real time, one major talking point has become women competing in the Games during their pregnancies. In fact, Egyptian fencer Nada Hafez and Azerbaijani archer Yaylagul Ramazanova both competed while seven and six-and-a-half months pregnant, respectively. In addition, marathon runner Maegen Krifchin competed at the 2024 US Olympic Trials at 7 months pregnant and heptathlete Lindsay Flach competed in the 2021 US Olympic trials at 18 weeks pregnant. While novel in the second and third trimester, women have been competing in the first trimester for many years. For example, US volleyball player Kerri Walsh Jennings competed in the 2012 Olympic Games while 5 weeks pregnant and tennis superstar Serena Williams won the 2017 Australian Open while 8 weeks pregnant with her first daughter.

So, how can chiropractic care help? Chiropractic care during pregnancy has been shown to demonstrate decreased low back and pelvic girdle pain (in an average of 4.5 days), reducing neck and shoulder pain associated with postural changes from pregnancy, and decreasing overall musculoskeletal pain.^4-6  Chiropractors are uniquely capable of helping pregnant patients move better overall and with less pain. Discomfort during pregnancy is one of the main reasons women cite for not completing an exercise regimen,^7-8so in summary, chiropractic care keeps you moving throughout your pregnancy!

References:

4. Stuber KJ, Smith DL. Chiropractic Treatment of Pregnancy-Related Low Back Pain: A Systematic Review of the Evidence. Journal of Manipulative and Physiological Therapeutics. 2008;31(6):447-454. doi:https://doi.org/10.1016/j.jmpt.2008.06.009

5. CONNER SN, TRUDELL AS, CONNER CA. Chiropractic Care for the Pregnant Body. Clinical Obstetrics & Gynecology. 2021;64(3). doi:https://doi.org/10.1097/grf.0000000000000621

6. Weis CA, Pohlman K, Draper C, daSilva-Oolup S, Stuber K, Hawk C. Chiropractic Care for Adults With Pregnancy-Related Low Back, Pelvic Girdle Pain, or Combination Pain: A Systematic Review. Journal of Manipulative and Physiological Therapeutics. 2020;43(7). doi:https://doi.org/10.1016/j.jmpt.2020.05.005

7. Skjold I, Benvenuti MB, Haakstad LA. Why do so many pregnant women give up exercise? An Italian cross-sectional study. Women’s Health. 2022;18:174550572211179. doi:https://doi.org/10.1177/17455057221117967

8. Coll CVN, Domingues MR, Gonçalves H, Bertoldi AD. Perceived barriers to leisure-time physical activity during pregnancy: A literature review of quantitative and qualitative evidence. Journal of Science and Medicine in Sport. 2017;20(1):17-25. doi:https://doi.org/10.1016/j.jsams.2016.06.007

Chiropractic care has shown promising positive benefits for children with autism, providing a complementary approach to traditional treatments. One of the key advantages is the improvement in the neurologic function. Chiropractic adjustments focus on correcting spinal misalignments. These misalignments or subluxations can decrease the nervous system’s ability to communicate effectively. For children with autism, brain-based chiropractic care can result in better sensory processing and improved motor skills. Studies have demonstrated that chiropractic care, combined with exercises to extinguish primitive reflexes, can lead to significant gains in coordination, communication, and overall behavior. These improvements can profoundly impact a child’s ability to engage with their environment and participate in social interactions, contributing to a higher quality of life. 

One article that discusses the positive effects of chiropractic care plus extinguishing primitive reflex exercises is Dr. Rubin’s article, “Combining Chiropractic Care with Extinguishing of Primitive Reflexes: A Case Series of 8 Children.” This study detailed eight children with various neurodevelopmental issues who received a combination of chiropractic care and exercises aimed at extinguishing primitive reflexes. Four of these cases were handled in a chiropractic university clinic, while the other four were treated in private practices. Each child had previously been diagnosed with neurodevelopmental conditions, and gentle, brain-based chiropractic care was given to ‘reconnect the disconnections’, while exercises were recommended to reduce retained primitive reflexes. The results were overwhelmingly positive, with seven of the eight children showing significant improvements. These improvements included enhanced coordination, better social interactions, increased independence, and improved academic performance. The study concludes that integrating chiropractic care with primitive reflex exercises could be highly beneficial for children with neurodevelopmental issues. You can find this article here, http://bit.ly/2RyUGnf or visit https://www.theadjustment.com/page/dr-rubins-published-articles.html for more information. 

In this blog post, we present a case study of a 10-year-old football player with bilateral plantar fasciitis who experienced significant improvement following a multimodal conservative approach involving chiropractic treatment. Plantar fasciitis is a common condition characterized by pain and inflammation of the plantar fascia, a thick band of tissue that runs along the bottom of the foot. It typically presents as heel pain, particularly with the first steps in the morning or after periods of rest. While plantar fasciitis can affect individuals of all ages and activity levels, it is particularly prevalent among athletes, including young athletes engaged in high-impact sports like football. The case highlights the potential benefits of chiropractic care in managing plantar fasciitis, particularly in young athletes, and underscores the importance of a comprehensive approach to achieve optimal outcomes.

A 10-year-old football player presented with bilateral plantar fasciitis characterized by three weeks of heel pain. Over a six-week period spanning six visits, a multimodal conservative approach involving chiropractic care and home rehabilitation exercises was implemented. Specific attention was given to the origin of the plantar fascia and the triceps surae bilaterally, with high-velocity, low-amplitude extremity adjustments targeting the restricted ankle joint. Following the six sessions, the patient reported bilateral foot pain resolution and enhanced daily functioning. Subsequent follow-up three months later indicated sustained improvement and the absence of pain. This case underscores the efficacy of a comprehensive chiropractic intervention coupled with exercise may effectively manage bilateral plantar fasciitis in young athletes.

Dr. Rubin is a board-certified pediatric chiropractor as well as a certified sports chiropractor, so we see athletes of all ages.  Success is seen across the board, ranging from pre-teens, teens involved in high level competitive sports (some of whom have gone on to play at the Division 1 college level), college students who play on Division level or are just playing intramural sports, and many adults who just want to improve their tennis and golf games or rank higher in their Cross-Fit gyms!

Reference: Daniels CJ, Morrell AP. Chiropractic management of pediatric plantar fasciitis: a case report. J Chiropr Med. 2012 Mar;11(1):58-63. doi: 10.1016/j.jcm.2011.06.009. PMID: 22942843; PMCID: PMC3315855.

The challenges posed by abnormal muscle tone in children are multifaceted and can significantly impact motor development and overall well-being. Whether hypertonic or hypotonic, these conditions can range from mild to severe. Hypertonicity is characterized by increased muscle tension and limited flexibility. It can stem from various factors, including intrauterine injuries or neurologic conditions affecting the motor pathways such as cerebral palsy. In a chiropractic case study, a four-month-old infant presented with hypertonicity in the arms and legs.

The infant's case history revealed a complex birth involving interventions such as forceps and suction which potentially contributed to the muscular tension. Through a chiropractic care plan involving spinal and cranial adjustments, along with home care exercises, significant improvements were noted over a six-month period. The infant showed gradual resolution of hypertonicity symptoms, with improved milestones, limb flexibility and primitive reflexes. This case underscores the potential of chiropractic care in addressing muscle hypertonicity in pediatric patients and highlights the need for further research in this area to better understand its efficacy and applicability.

Beyond addressing physical symptoms, chiropractic care may play a crucial role in supporting motor development associated developmental delays or disabilities. As such, continued exploration and documentation of chiropractic approaches for pediatric musculoskeletal disorders are essential for optimizing care and promoting the well-being of young patients facing these challenges.

Reference: Kylie Read, BChiro. Resolution of Hypertonicity in a Pediatric Patient Undergoing Chiropractic Care: A Case Report. Volume 12, No. 1, June 2011 Journal of Clinical Chiropractic Pediatrics.

Visual disturbances, ranging from double vision to narrowed visual fields, have been reported to improve following chiropractic manipulation. This intriguing case outlines the resolution of intermittent double vision and over-convergence in a 13-year-old boy after chiropractic care. The patient's symptoms, which had persisted for a year and worsened with schoolwork, were attributed to accommodative/convergence insufficiency, a condition affecting eye alignment and focus.

Upon referral from an optometrist, chiropractic evaluation revealed vertebral dysfunction in the cervical and lumbopelvic spine. Treatment involved spinal adjustments and manipulation to correct the identified dysfunctions. Remarkably, the patient reported full symptom resolution after just one visit, with sustained improvement noted over subsequent appointments.

The case underscores the potential role of chiropractic care in addressing visual disturbances associated with mechanical neck and back issues. While the exact mechanisms behind these improvements remain under investigation, theories suggest that chiropractic adjustments may enhance neural integrity and cerebral blood flow, aiding in the restoration of visual function. Further research is needed to quantify the efficacy of chiropractic interventions in cases of sensory system impairments, highlighting the importance of interdisciplinary collaboration in optimizing patient outcomes.

This is why Dr. Rubin makes sure to check eye functioning of all children, because the eyes are the 'windows into the brain!'

Reference: Gabrielle Tymms, BAppSc(ClinSc)/BChiroSc. Visual Recovery from Diplopia in a 13–Year-Old Following Chiropractic Intervention. Journal of Clinical Chiropractic Pediatrics Volume 12, No. 1, June 2011.

Birth-related injuries can present complex challenges, particularly in pediatric patients. One example is in a case report from 2011 that sheds light on a rare occurrence: a neonate with combined brachial plexus and facial nerve palsy seeking care at a chiropractic clinic. The patient, delivered via forceps-assisted vaginal birth after Caesarean, exhibited facial asymmetry and upper limb postural issues from birth, stemming from shoulder dystocia during delivery.

Upon examination, the patient displayed signs of both brachial plexus and facial nerve involvement, indicating a unique obstetric trauma. Chiropractic management, focusing on craniosacral techniques and soft tissue therapy, yielded impressive results. Gradual improvement in facial symmetry and upper limb posture was observed over several months, with no reported adverse effects.

This case underscores the importance of considering conservative therapies, such as chiropractic care, as one alternative to managing birth-related injuries. While severe cases may necessitate surgical or other intervention, mild to moderate presentations can often be effectively addressed through specialized pediatric chiropractic care and neurological exercises. Close monitoring and individualized care are paramount in optimizing outcomes for pediatric patients with birth-related injuries.

Reference: Sharon Gordon, BAppSc(Chiro). Chiropractic Management of a Combined Neonatal Brachial Plexus and Facial Nerve Palsy: A Case Report. Volume 12, No. 1, June 2011 Journal of Clinical Chiropractic Pediatrics

Recent epidemiologic studies have estimated that the lifetime prevalence of low back pain in children is approximately 50%, with almost 15% of children experiencing frequent or continual pain. A pediatric chiropractor can help alleviate low back pain in children through gentle spinal adjustments and exercises to strengthen supporting muscles and prevent future episodes. By employing safe and effective chiropractic care, pediatric chiropractors aim to reduce pain, improve function, and enhance the overall well-being of young patients experiencing low back discomfort.

A low back pain research study involving 54 pediatric patients with an average age of 13 years old highlights the potential of chiropractic care in alleviating low back pain in children. Most of the patients were diagnosed with lumbar dysfunction or subluxation. Treatment outcome was measured with a subjective rating scale and a self-report pediatric visual analogue scale. Patients responded well to adjustments, with 87% of patients experiencing "important" improvement within a 6-week treatment course. There were no reported complications and significant improvements were observed, however, the need for further investigations is needed.

Reference: Hayden JA, Mior SA, Verhoef MJ. Evaluation of chiropractic management of pediatric patients with low back pain: a prospective cohort study. J Manipulative Physiol Ther. 2003 Jan;26(1):1-8. doi: 10.1067/mmt.2003.11. PMID: 12532132.

Pediatric athletes that are involved in high velocity sports, frequently encounter ankle problems and sprains. This blog post will examine two case studies to illustrate the potential effectiveness of chiropractic treatment in addressing these issues. Traditional care methods, including rest, ice, compression, elevation, and rehabilitation exercises, often fall short in resolving persistent symptoms such as pain, weakness, and instability. Chiropractic management utilizes manual techniques to realign the ankle joint, reduce inflammation, and restore proper ranges of motion. The articles highlight chiropractic interventions in addressing persistent post-sprain concerns and facilitating young athletes' return to sports activities.

One of the studies presented A 15-year-old male patient that presented with persistent ankle pain and limited ranges of motion due to an inversion sprain while playing soccer. The incident happened approximately 8.5 months prior. The athlete sought chiropractic care and the management included adjustments and education on home exercises and stretching to improve ankle dorsiflexion. After 4 visits, the athlete showed significant symptom relief and returned to full athletic participation. There was a follow-up evaluation at 5 months which revealed no pain or functional complaints.

The second article discusses the case of a 16-year-old female soccer player experiencing ankle pain for 3 weeks which was exacerbated by running. From a young age she had gait difficulties and foot flare which were still present upon examination. Detailed history-taking and examination revealed multiple contributing factors, including biomechanical abnormalities, and muscular imbalances. Treatment involved chiropractic adjustments of both the spine and extremities, and some functional rehabilitation. Over seven weeks, the patient showed significant improvement in pain levels, had a 10 degree decrease in foot flare and was able to return to play without discomfort.

Chiropractic works for athletes young and old, weekend warriors or Super Bowl level professionals!  Make sure you find a chiropractor that is sports certified!

References:

Hewitt RL, Brocker JL. Chiropractic Management of Chronic Ankle Pain and Limited Mobility in a Pediatric Athlete: A Case Report. J Chiropr Med. 2023 Mar;22(1):85-88. doi: 10.1016/j.jcm.2022.10.001. Epub 2022 Dec 13. PMID: 36844988; PMCID: PMC9947970.

Anderson, M., & Barber, M. (2011). Kinetic Chain Dysfunction in a 16-Year-Old Soccer Player with Ankle Pain. Journal of Clinical Chiropractic Pediatrics, 12(1), 862-863. Retrieved from https://www.chiroindex.org/?search_page=articles&action=&articleId=21953&search1=sport%20injuries

Pediatric injuries in soccer are a significant concern as the popularity of the sport continues to rise among children and adolescents worldwide. Soccer, known for its fast pace, agility demands, and physical contact, poses various risks to young players. While the sport offers numerous health benefits, including cardiovascular fitness and teamwork skills, the potential for injuries cannot be overlooked. Understanding the nature and prevalence of these injuries is crucial for developing effective prevention strategies and promoting safe participation in soccer among children.

In recent years, there has been a growing interest in alternative healthcare modalities for children, particularly chiropractic care. Chiropractic interventions can be beneficial for children suffering from injuries, whether acute or chronic. The gentle and non-invasive nature of chiropractic adjustments makes it suitable for children of all ages. Chiropractic care focuses on restoring proper alignment and function of the musculoskeletal system. This approach not only helps alleviate pain and discomfort but also promotes natural healing processes within the body, which is particularly advantageous for pediatric patients who may be more sensitive to pharmaceutical interventions.
 

In order to prevent long-term complications and promote optimal development, it is important to practice early intervention. Chiropractic care offers a holistic approach to pediatric healthcare, addressing not only the immediate symptoms but also underlying biomechanical issues that may contribute to recurrent injuries or musculoskeletal imbalances. By incorporating chiropractic adjustments, soft tissue therapies, and rehabilitative exercises, healthcare practitioners can effectively manage pediatric injuries and support the overall well-being of children.

Reference: Corso M. Developmental changes in the youth athlete: implications for movement, skills acquisition, performance and injuries. J Can Chiropr Assoc. 2018 Dec;62(3):150-160. PMID: 30662070; PMCID: PMC6319435.