Our Chiropractic Clinic Blog

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Dr. Tyler Panko

What Should I Do When a Movement or Activity is Causing Me Pain? Let the Stop Light System Be Your Guide

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PAIN GUIDELINES

First off it has to be said, if you have a NEW INJURY that is causing pain and is not getting better with any techniques you are doing at home please see a rehab specialist as soon as possible to get it assessed. 𝘎𝘳𝘪𝘯𝘥𝘪𝘯𝘨 𝘵𝘩𝘳𝘰𝘶𝘨𝘩 𝘱𝘢𝘪𝘯 𝘪𝘯 𝘸𝘰𝘳𝘬𝘰𝘶𝘵𝘴 𝘢𝘯𝘥 𝘥𝘢𝘪𝘭𝘺 𝘢𝘤𝘵𝘪𝘷𝘪𝘵𝘪𝘦𝘴 𝘪𝘴 𝘯𝘰𝘵 𝘯𝘰𝘳𝘮𝘢𝘭. 𝘈𝘭𝘴𝘰 𝘪𝘧 𝘺𝘰𝘶 𝘴𝘵𝘢𝘳𝘵 𝘵𝘰 𝘯𝘰𝘵𝘪𝘤𝘦 𝘢 𝘥𝘦𝘤𝘳𝘦𝘢𝘴𝘦 𝘪𝘯 𝘳𝘢𝘯𝘨𝘦 𝘰𝘧 𝘮𝘰𝘵𝘪𝘰𝘯 𝘪𝘯 𝘢 𝘫𝘰𝘪𝘯𝘵 𝘥𝘶𝘳𝘪𝘯𝘨 𝘢 𝘸𝘰𝘳𝘬𝘰𝘶𝘵 𝘰𝘳 𝘥𝘢𝘪𝘭𝘺 𝘢𝘤𝘵𝘪𝘷𝘪𝘵𝘺 𝘵𝘩𝘢𝘵 𝘪𝘴 𝘯𝘰𝘵 𝘨𝘦𝘵𝘵𝘪𝘯𝘨 𝘣𝘦𝘵𝘵𝘦𝘳, 𝘱𝘭𝘦𝘢𝘴𝘦 𝘵𝘢𝘬𝘦 𝘯𝘰𝘵𝘦. 𝘗𝘢𝘪𝘯 𝘪𝘴 𝘶𝘴𝘶𝘢𝘭𝘭𝘺 𝘵𝘩𝘦 𝘭𝘢𝘴𝘵 𝘵𝘩𝘪𝘯𝘨 𝘵𝘰 𝘤𝘰𝘮𝘦 𝘰𝘯. We can save a lot of aches and pains and  speed up the rehab process if these things are accessed early and not looked at until you are in unrelenting pain.
 
Now for this post we are talking the rehab process of an injury AFTER it has been accessed and serious red flags have been ruled out. Meaning we have a plan and are on our way to healing the injured tissue. So the questions become in this process: 𝘚𝘩𝘰𝘶𝘭𝘥 𝘐 𝘢𝘷𝘰𝘪𝘥 𝘢𝘭𝘭 𝘮𝘰𝘷𝘦𝘮𝘦𝘯𝘵𝘴 𝘵𝘩𝘢𝘵 𝘢𝘳𝘦 𝘱𝘢𝘪𝘯𝘧𝘶𝘭? 𝘞𝘩𝘦𝘯 𝘴𝘩𝘰𝘶𝘭𝘥 𝘐 𝘴𝘵𝘰𝘱 𝘥𝘰𝘪𝘯𝘨 𝘢𝘯 𝘢𝘤𝘵𝘪𝘷𝘪𝘵𝘺 𝘪𝘧 𝘪𝘵 𝘪𝘴 𝘱𝘢𝘪𝘯𝘧𝘶𝘭? 𝘓𝘦𝘵 𝘵𝘩𝘦 𝘴𝘵𝘰𝘱𝘭𝘪𝘨𝘩𝘵 𝘴𝘺𝘴𝘵𝘦𝘮 𝘣𝘦 𝘺𝘰𝘶𝘳 𝘨𝘶𝘪𝘥𝘦. ⁣
 

⁣STOP LIGHT SYSTEM TO PAIN 

𝐑𝐞𝐦𝐞𝐦𝐛𝐞𝐫: 𝐇𝐮𝐫𝐭 𝐝𝐨𝐞𝐬 𝐧𝐨𝐭 𝐚𝐥𝐰𝐚𝐲𝐬 𝐞𝐪𝐮𝐚𝐥 𝐡𝐚𝐫𝐦.

RED LIGHT:   

1. Major loss in range of motion or strength  (more than 50%)  after doing an activity. ⁣
2. Pain increases during activity ⁣
3. Lingering pain (not workout soreness) that last several days after doing an activity. ⁣
𝐀𝐜𝐭𝐢𝐨𝐧 𝐏𝐥𝐚𝐧: STOP THE ACTIVITY THAT CAUSED IT 𝐚𝐧𝐝 𝐬𝐞𝐞𝐤 𝐦𝐞𝐝𝐢𝐜𝐚𝐥 𝐚𝐝𝐯𝐢𝐜𝐞 𝐟𝐫𝐨𝐦 𝐲𝐨𝐮𝐫 𝐫𝐞𝐡𝐚𝐛 𝐩𝐫𝐨𝐟𝐞𝐬𝐬𝐢𝐨𝐧𝐚𝐥.
 

YELLOW LIGHT:

1. No change in range of motion, strength, and function. ⁣
2. Pain spikes during the activity. ⁣
3. Pain persists AFTER activity by 3 numbers (ex: 2/10 to 5/10) for more than couple hours or you wake up the next day and is still spiking.
 
𝐀𝐜𝐭𝐢𝐨𝐧 𝐏𝐥𝐚𝐧: 𝐑𝐞𝐦𝐞𝐦𝐛𝐞𝐫 𝐚 𝐟𝐥𝐚𝐫𝐞 𝐮𝐩 𝐢𝐧 𝐩𝐚𝐢𝐧 𝐝𝐨𝐞𝐬 𝐍𝐎𝐓 𝐞𝐪𝐮𝐚𝐥 𝐡𝐚𝐫𝐦. 𝐈𝐭 𝐢𝐬 𝐚 𝐩𝐚𝐫𝐭 𝐨𝐟 𝐭𝐡𝐞 𝐩𝐫𝐨𝐜𝐞𝐬𝐬 𝐚𝐧𝐝 𝐢𝐭 𝐣𝐮𝐬𝐭 𝐦𝐞𝐚𝐧𝐬 𝐭𝐨𝐨 𝐦𝐮𝐜𝐡 𝐭𝐨𝐨 𝐟𝐚𝐬𝐭. 𝐓𝐚𝐤𝐞 𝐧𝐨𝐭𝐞 𝐚𝐧𝐝 𝐬𝐭𝐚𝐲 𝐜𝐨𝐮𝐫𝐬𝐞 𝐰𝐢𝐭𝐡 𝐧𝐨𝐫𝐦𝐚𝐥 𝐚𝐜𝐭𝐢𝐯𝐢𝐭𝐲. 𝐀𝐯𝐨𝐢𝐝 𝐢𝐧𝐜𝐫𝐞𝐚𝐬𝐢𝐧𝐠 𝐚𝐜𝐭𝐢𝐯𝐢𝐭𝐲 (𝐬𝐩𝐞𝐞𝐝, 𝐥𝐨𝐚𝐝, 𝐯𝐨𝐥𝐮𝐦𝐞 𝐨𝐟 𝐚𝐧 𝐞𝐱𝐞𝐫𝐜𝐢𝐬𝐞) 𝐨𝐫 𝐚𝐝𝐝𝐢𝐧𝐠 𝐚𝐧𝐲 𝐧𝐞𝐰 𝐚𝐜𝐭𝐢𝐯𝐢𝐭𝐲. 𝐈𝐟 𝐬𝐚𝐦𝐞 𝐩𝐚𝐭𝐭𝐞𝐫𝐧 𝐜𝐨𝐧𝐭𝐢𝐧𝐮𝐞𝐬 𝐭𝐡𝐞 𝐧𝐞𝐱𝐭 𝐭𝐢𝐦𝐞, 𝐝𝐞𝐜𝐫𝐞𝐚𝐬𝐞 𝐚𝐜𝐭𝐢𝐯𝐢𝐭𝐲 𝐛𝐲 𝟓𝟎% (𝐥𝐨𝐚𝐝, 𝐬𝐞𝐭𝐬, 𝐫𝐞𝐩𝐬, 𝐝𝐮𝐫𝐚𝐭𝐢𝐨𝐧, 𝐬𝐩𝐞𝐞𝐝) 𝐚𝐧𝐝 𝐠𝐨 𝐛𝐚𝐜𝐤 𝐚𝐧𝐝 𝐬𝐞𝐞 𝐢𝐟 𝐩𝐞𝐫𝐬𝐢𝐬𝐭𝐢𝐧𝐠 𝐩𝐚𝐢𝐧 𝐝𝐞𝐜𝐫𝐞𝐚𝐬𝐞𝐬. 𝐈𝐟 𝐢𝐭 𝐢𝐬 𝐛𝐞𝐭𝐭𝐞𝐫 𝐭𝐡𝐞𝐧 𝐬𝐭𝐚𝐲 𝐭𝐡𝐞𝐫𝐞 𝐟𝐨𝐫 𝐜𝐨𝐮𝐩𝐥𝐞 𝐝𝐚𝐲𝐬 𝐚𝐧𝐝  𝐭𝐡𝐞𝐧 𝐢𝐧𝐜𝐫𝐞𝐚𝐬𝐞 𝐚𝐜𝐭𝐢𝐯𝐢𝐭𝐲 𝐠𝐫𝐚𝐝𝐮𝐚𝐥𝐥𝐲 𝐚𝐠𝐚𝐢𝐧. 𝐈𝐟 𝐢𝐭 𝐢𝐬 𝐧𝐨𝐭 𝐭𝐡𝐞𝐧 𝐜𝐨𝐧𝐬𝐮𝐥𝐭 𝐲𝐨𝐮𝐫 𝐫𝐞𝐡𝐚𝐛 𝐩𝐫𝐨𝐟𝐞𝐬𝐬𝐢𝐨𝐧𝐚𝐥.
 

GREEN LIGHT: ⁣

⁣1. No change in range of motion, strength, and function. ⁣
2. Pain spikes during the activity. ⁣
3. Pain is no worse after activity and back to baseline after few minutes.
 
𝐀𝐜𝐭𝐢𝐨𝐧 𝐏𝐥𝐚𝐧: 𝐒𝐭𝐚𝐲 𝐭𝐡𝐞 𝐜𝐨𝐮𝐫𝐬𝐞. 𝐁𝐞 𝐜𝐨𝐧𝐟𝐢𝐝𝐞𝐧𝐭 𝐚𝐧𝐝 𝐠𝐫𝐚𝐝𝐮𝐚𝐥𝐥𝐲 𝐥𝐨𝐚𝐝 𝐚𝐧𝐝 𝐜𝐡𝐚𝐥𝐥𝐞𝐧𝐠𝐞 𝐭𝐡𝐞 𝐭𝐢𝐬𝐬𝐮𝐞 𝐦𝐨𝐫𝐞 𝐚𝐧𝐝 𝐦𝐨𝐫𝐞 𝐨𝐯𝐞𝐫 𝐭𝐢𝐦𝐞. ⁣
 

HOW ICT MUSCLE & JOINT CAN HELP YOUR PAIN

 𝘏𝘦𝘳𝘦 𝘢𝘵 𝘐𝘊𝘛 𝘔𝘶𝘴𝘤𝘭𝘦 & 𝘑𝘰𝘪𝘯𝘵 in Wichita 𝘸𝘦 𝘩𝘢𝘷𝘦 𝘵𝘦𝘤𝘩𝘯𝘪𝘲𝘶𝘦𝘴 𝘭𝘪𝘬𝘦 𝘤𝘩𝘪𝘳𝘰𝘱𝘳𝘢𝘤𝘵𝘪𝘤 𝘢𝘥𝘫𝘶𝘴𝘵𝘪𝘯𝘨,  𝘥𝘳𝘺 𝘯𝘦𝘦𝘥𝘭𝘪𝘯𝘨, 𝘐𝘈𝘚𝘛𝘔, 𝘢𝘯𝘥 𝘤𝘶𝘱𝘱𝘪𝘯𝘨 𝘵𝘰 𝘩𝘦𝘭𝘱 𝘳𝘦𝘭𝘪𝘦𝘷𝘦 𝘱𝘢𝘪𝘯 𝘢 𝘭𝘪𝘵𝘵𝘭𝘦 𝘣𝘪𝘵, 𝘣𝘶𝘵 𝘢𝘭𝘭 𝘵𝘩𝘢𝘵 𝘪𝘴 𝘢 𝘮𝘦𝘢𝘯𝘴 𝘵𝘰 𝘨𝘦𝘵 𝘺𝘰𝘶 𝘮𝘰𝘷𝘪𝘯𝘨 𝘢𝘯𝘥 𝘨𝘦𝘵 𝘺𝘰𝘶 𝘴𝘵𝘳𝘰𝘯𝘨 𝘢𝘨𝘢𝘪𝘯. We use this stop light system to help guide you to being more resilient and come out of any injury being more educated and stronger than before. ⁣

 

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Dr. Tyler Panko

Bad Posture: Does it Lead to Pain?

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In today's technology age, most people spend a lot of time sitting at desk looking at a computer, or looking down at their phone. There is nothing wrong with this posture. I'll say it again, THERE IS NOTHING WRONG WITH THIS POSTURE. I wrote this while sitting in that position. However, because of this position and how gravity works, our postural muscles work as our anti-gravity muscles. Without them, we would technically face-plant on our computers and phones ????‍♂️. 

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Dr. Keith Sparks

What Causes Pain to the Body: Understanding Pain Handout

What Causes Pain to the Body: Understanding Pain Handout

WHAT CAUSES PAIN TO THE BODY?

There are two, main mechanical (movement-based) pain causes: inflammation and tight soft tissue(s). The medical term for tight soft tissue is ischemia. Soft tissue is everything besides bone (ie hard tissue). The third category, highlighted in our overall overview of pain, is directed to the nerves – specifically the peripheral nerves. These are the nerves outside of your spine.

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Dr. Keith Sparks

Understanding Pain Handout: An Overview

Understanding Pain Handout: An Overview
Pain Grap 1

Pain is not always simple. It is easy to understand if we roll an ankle or break a bone what is causing the pain. However, pain is not always a cause and effect event. Pain can come from many different sources and may be simultaneously with other sources at the same time (as shown below). Individuals with multiple sources of pain are often dragged through the healthcare system with little results or given complicated diagnoses such as Fibromyalgia or Chronic Regional Pain Syndrome.

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Dr. Keith Sparks

Pain's Traffic Light Handout

Pain's Traffic Light Handout

Navigating through pain can be frustrating. This traffic light handout’s goal is to help you understand WHEN to perform your exercises based on your pain symptoms.

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Dr. Keith Sparks

Relaxation: Diaphragm Breathing Handout

Relaxation: Diaphragm Breathing Handout

BREATHING AND PAIN

When we have pain or become stressed we can develop a rapid or shallow breathing pattern. This breathing pattern can increase tension in the neck, chest, and shoulders. Overtime, this increased tension can lead to trigger point formations which can produce specific pain patterns.

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Dr. Keith Sparks

Nerve Pain Handout

Nerve Pain Handout

WHAT IS NERVE PAIN?

Nerve pain is typically thought of as radiating pain down the arms or legs with diagnosis such as Sciatica. This pain occurs via the peripheral nerves. Your peripheral nerves connect your brain and spinal cord to the rest of your body. These nerves connect your brain and body to express danger. Anywhere along the path of these nerves a negative stimulus can cause symptoms.

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Dr. Keith Sparks

Stages of Healing Handout

Stages of Healing Handout

There are three stages of healing following an injury: inflammatory, proliferative, and remodel. Each phase of healing may take different amounts of time depending on the extent of the injury and tissue(s) injured. Recognizing which phase of healing you may be in is important for a speedy recovery. Be sure to ask your chiropractor about which phase of healing you are in during your journey to recovery.

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Dr. Keith Sparks

Inflammatory Pain Handout

Inflammatory Pain Handout

WHAT IS INFLAMMATION?

After an injury, or flare-up of an existing issue, the body produces inflammation. Symptoms of inflammation may include: pain, swelling, redness, increased temperature, and loss of movement. When inflammation sets in, it usually is felt as an increase in 3 points on a 10-point scale, which lasts longer than a day. Once inflammation sets in, the body starts to heal. Pain is your body’s response to inflammation. Pain bring awareness to an area of the body to decrease the odds of re-injury during the early phase of healing.

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Dr. Keith Sparks

How to Program Stretches at Home: Part 2

How to Program Stretches at Home: Part 2

The whole moto of this approach is “too much of a good thing can be bad.” With each example, in Part 1, the person started to experience a decline in feeling better when performing more reps or more amount of time spent in a specific stretch. Let’s explain why.

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Dr. Keith Sparks

The 7 Most Important Things to Know for Self-Treating Movement Pain

The 7 Most Important Things to Know for Self-Treating Movement Pain

When it comes to self-treatment, there is a plethora of information on the internet. How do you navigate it accordingly? Stretch this, activate that, feel here and not there – you can quickly be standing on your head feeling more lost then when you started. We have put together a “cheat sheet” on what we find are the most important CONCEPTS when trying to self-treat at home. By focusing your efforts on concepts or principles, it will help weed out 95% of unneeded information on the web.

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Dr. Keith Sparks

Foam Rolling Friday: Glute Medius & Minimus

Foam Rolling Friday: Glute Medius & Minimus

Glute Medius Minimus Referral Pattern

Improper hip motion is oftentimes a culprit to low back pain and knee pain. Interestingly, the area where we experience pain is regularly not the source of pain. When the glute medius and glute minimus become problematic they can refer pain down the leg (mimicking a disc herniation), and to the SI joint. These muscles become dysfunctional due to lack of use. Stating this, you would think working on activating these muscles alone would be sufficient, but recent research indicates that combining soft tissue therapy with rehab/exercise training, adds greater benefit then either alone.¹

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Dr. Keith Sparks

Foam Rolling Friday: The Calves

Foam Rolling Friday: The Calves

Stop whatever you’re doing right now and take a second to feel your calves. Sit in a chair and cross one leg over the other. To do this correctly your calf muscles have to be on slack. Take your fingers and roll across your calf toward your shin. I can almost guarantee every single one of you will feel tension in the inside or outside of the calf, if performed correctly. If you throw your leg on a foam roller and try to foam roll your calf with the shin facing the ceiling, you will feel almost nothing and dismiss the idea that foam rolling your calves can be beneficial for you. You need to foam roll where the tension is present. If you skip this step I politely, and with all my love and sincerity, tell you that you're most likely missing out on huge benefits. End rant. Yes, I know that was a pointless rant but I do feel better getting it off my chest.  
 
The Functional Anatomy  
 
When talking about the function of the calf muscles, it helps to separate them into two categories: Calf muscles that cross the knee and calf muscles that don’t cross the knee. Both categories will cross the ankle so don’t worry about that. Also, we could get fancy and name every single muscle at play here, but this is a short blog, not a textbook.  
 
There are two main calf muscles that people think of when discussing the calves: the big meaty cannon, called the gastrocnemius (aka gastroc) and the wider, deeper, soleus muscle.  The gastroc crosses the knee, while the deeper soleus muscle does not. However, both join together to form the achilles tendon. Whenever you experience achilles tendonitis, there is a disturbance in how these muscles are firing and holding tension compared to one another. A third sensory muscle lays in between these muscles called the Plantaris. It's main role is to perform as a relay sensor to help control how the soleus and gastroc fire in relation to each other. 
 
The gastroc’s and soleus’s main roles are to create and maintain relative isometric tension in the muscles so the achilles tendon can lengthen throughout the gait cycle. Isometric tension means the muscles fire only to maintain position, they will not shorten and they will not lengthen. There are calf muscles that activate by pushing the foot and toes into the ground, however, these 2 muscles primarily hold position and length to allow the achilles tendon to stretch and return energy back into the gait cycle. 
 
   
The Why  
 
The why is roughly always the same: To get out of pain and improve performance. Keep it simple. Foam rolling the calves can have huge benefits in relieving foot pain, calf pain, achilles tendinitis, knee pain, and even low back pain. This area of the body tends to hold a lot of tension and is often ignored in regards to tissue health. When trigger points and fascial adhesions are present, performance can hinder everyone from desk jockeys, runners, Crossfit athletes, figure skaters, to the weekend warrior.  
 
For me, my why is to not become a couch potato looking back in 5 years asking myself how I got here. The deeper, and harder questions are: What do you want out of your life and what are you going to do to achieve that life? Foam rolling might be an answer, it might not be. That's for you to decide and you alone, not me, or anyone else. Being honest with yourself in who you are and what you want out of life are always the hardest things to truly identify. I believe you can do this. Find what you want and execute.  
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Do you have a question about chiropractic care, fitness or nutrition?  We would love to hear from you, and we might even turn your question into our next blog post!

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