What does a chiropractor know about Diabetes?

What does a chiropractor know about diabetes?

During a new patient history after dealing with the main complaint that brought the patient to the office, I will ask some general health questions assessing for things like diabetes.
What does a chiropractor know about diabetes, aren’t they just for backs? A chiropractor’s scope of practice is limited to neuromusculoskeletal conditions, or conditions related to nerves, muscles and bones, however as primary contact health care providers we just as importantly need to know about conditions that we don’t manage.

Getting back to our question, what does a chiropractor know about diabetes? While diabetes is an increasingly common problem, especially Type 2 diabetes that has its onset in middle age, it is often an undiagnosed condition. Research suggests that 3-5% of the adult population are undiagnosed diabetics or prediabetics.

Thus as a chiropractor we need to be aware of the signs and symptoms of diabetes so patients can get the care and education they need. Some of these signs and symptoms relate to the neuromusculoskeletal system, such as muscle cramps, numbness and tingling in the hands or feet, weakness, stiff and painful joints, contractures of the hands, back and neck pain. I will assess the vibration sense of the feet as this sense is often lost early in diabetes, leading to problems with balance, falls and possibly injuries to the feet and toes which can heal poorly.

Secondly, as chiropractors we can help treat some of the neuromusculoskeletal conditions associated with the condition. Encouraging activity and exercise is an early treatment for diabetes, this can be hard to do if it hurts to move.

  • Conditions that are commonly associated with diabetes that can be helped by chiropractic care are:
  • Peripheral neuropathy
  • Stiff Hands Syndrome
  • Carpal tunnel syndrome
  • Adhesive capsulitis of the shoulder
  • Tenosynovitis
  • Back pain
  • Neck pain
  • Joint pain
  • Dupuytren’s contracture

So hopefully that helps to answer the question, what does a chiropractor know about diabetes?

So if you have diabetes or know someone with diabetes, add me to your healthcare team
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Why do I need orthotics?

Why do I need orthotics? What are orthotics used for anyway? Why would a chiropractor recommend orthotics?
There are a number of questions, let’s start with what orthotics are and what they’re used for.

Orthotics are custom made insoles for your shoes, designed to correct imbalances in your foot structures, muscles of the lower leg, protect against the forces of hard flooring on your feet.

Symptoms one might experience if orthotics are necessary aren’t limited to the feet, but include; foot, arch or heel pain, leg or knee pain, leg length inequality, hip or back pain even neck pain.

Foot orthotics work similar to braces for the teeth, or glasses for your eyes, they slowly and consistently place your foot structures in the correct position. We use orthotics in all kinds of footwear, even skates and ski boots!

I think I need orthotics what’s next?
During an orthotic examination I perform a static ( not moving) postural assessment, both weight bearing and non-weight bearing, to see how your foot reacts to supporting your body. I assess any mobility issues in the ankle or foot, check to see wear the forces stress the foot as shown in any calluses you may have. Next I have you walk several times in bare feet to assess your dynamic posture, do the toes point in or out, does the ankle roll in with walking?

Next I make a mold of your foot in special foam with you sitting, having your foot kept in the optimal position. The mold is then sent to the orthotic lab and analyzed. The orthotics are then ready in about a week or two.

I have my orthotics now what?
Initially you wear the orthotics an hour or two each day slowly increasing the time you wear them.

Wear them as much as you can , the more consistently you wear them, the better the benefit will be. Often we need to make 2 pair of orthotics to accommodate different kinds of foot wear, i.e. dress shoes vs. running shoes.

How does this fit with chiropractic?
Why as a chiropractor would I recommend orthotics?

Typically the answer is to either be reactive or proactive. If you are already having pain and there are structural or muscular imbalances that are contributing to your pain, orthotics may be part of the recovery process. If during our assessment process I discover some issues that may not be contributing to a pain process but have the potential to, I may suggest the orthotics as a preventative measure.

For more information go to https://yourpickeringchiropractors.cablog/
Or http://www.theorthoticgroup.com/PatientSite/Home.aspx

Why does my chiropractor care about my feet?

Why does my chiropractor care about my feet?

Why does my chiropractor care about my feet? Isn’t that what a podiatrist or chiropodist is for?
Another good question, why should a chiropractor care about feet?
There are several good reasons why as a chiropractor I am interested in feet. Most obviously, feet are the first thing that make contact with the ground and as such have a bearing on what occurs above them I.e, your ankles, your knees, hips and even your back and neck, areas you might expect me to be more interested in.

Why does my chiropractor care about my feet: Posture
If we take someone with flatter feet, meaning the arch on the inside of the foot is lower or absent altogether, this can cause the ankle to roll in when walking or running, causing more forces to be applied to the inside of the knee, tight muscles at the hip and weak glutes. This can lead to increased or imbalanced stresses at the lower back and other compensatory changes in the upper back and neck.

Why does my chiropractor care about my feet: Musculoskeletal conditions
A couple of common conditions we also see in the feet are plantar fasciitis and fat pad syndrome, these typically present as heel pain, either first step of the day or after rest( plantar fasciitis) or with prolonged activity (fat pad). These are conditions that as chiropractors we can easily manage and help educate the patient to manage at home. This might involve exercises for the muscles of the feet or lower legs, custom or off the shelf orthotics shoe inserts, heat or ice.

Why does my chiropractor care about my feet: Neurological conditions
Have you ever wondered why I may check sensation in your feet? I usually check 3 ways, with a very light touch using a tissue, with a sharp object ( paper clip or pinwheel) and lastly checking vibration sense with a tuning fork. Why do I do this? Checking three types of sensation checks three different pathways of the nervous system from the foot to the brain, a problem feeling these sensations tells me something about where the problem may be. Most often with someone with back pain it might mean that a disc is putting pressure on the nerves going to and coming from the feet. It might also be a sign that someone who is diabetic is having a worsening of their condition and are at greater risk of injury be it from lack of balance because they can’t feel the ground under their feet or from cuts to the feet or toes that may not heal well and cause ulceration.

I hope that briefly explains why a chiropractor might care about your feet.
If you have further questions, please don’t hesitate to ask, or show me your feet.
For other blogs go to https://yourpickeringchiropractors.cablog/
https://yourpickeringchiropractors.ca

Ankle Sprains

This blog comes about due to the recent slippery conditions, resulting ankle sprains. Ankle sprains are one of the most common joint injuries, most people have experienced at least one during their life. Some people have had repeated ankle sprains whether due to sport or as some people will tell me they have “ weak ankles”, more on that comment later.

The ankle joint is formed by the two lower leg bones, the tibia (shin bone) and the fibula (the smaller bone on the outside of your leg) and the bones beneath that are part of the ankle and the heel.

So you’ve just twisted or rolled your ankle, what now? Ankle sprains or any injury to the ligaments ( tough connective tissues that connect bone to other bones) are graded from 1-3.

Grade 1 being the least severe, only some stretching of the ligaments, there may be some swelling and obvious at the end range of movements but no real damage to the ligament. You will be able to stand on your toes and may have a limp for a couple of days. Recovery takes 1-2 weeks.

Grade 2, is more common and involves some partial tearing of the ligaments, here there will be obvious swelling plus some bruising will also appear around the ankle and then into the bottom of one side of the foot. You will limp for up to 2 weeks, you will be unable to hop, run or stand on your toes, there will be pain with most movements. Recovery takes 1-2 months.

Grade 3 is more severe, complete tearing of the ligament, there will be bruising on both sides of the foot, weight bearing is impossible and nearly all movements will be painful and severely reduced. This may require surgery and months of treatment/rehab.

Ok, so when do I need an x-ray, should I go to the hospital? To determine need for an x-ray we follow the Ottawa Ankle Rules. These rules developed by the Ottawa Hospital Research Institute are designed to reduce unnecessary x-rays and reduce unnecessary hospital trips. In short the rules recommend x-ray if there is pain on touching the bones of the ankles and foot or there is an inability to bear weight and take 4 steps ( 2 with each foot) both right after the injury and at presentation to the health care provider’s office.

So what now, Grades 1-2 will respond well to conservative care including chiropractic care. Grade 3 will require a specialist consult, but if no surgery is necessary a conservative route can be taken but will require more time.

Initial home care will be for inflammation control (icing 10minutes/hour), rest ( including crutches), protection /compression of the joint ( some form of tensor bandage or brace) and elevation. Regaining mobility early is important, so moving the foot as much as possible in a non-weight bearing position, i.e. spelling the alphabet with your toes.

In the office we can use electrotherapy, ultrasound and hands on mobilizations to improve range of motion and decrease swelling.

As mobility improves and swelling decreases we will begin with strengthening exercises, initially non-weight bearing and then weight bearing.

Lastly, if you recall at the beginning of the blog, some people will say they have weak ankles or sprain them frequently. The reason for this is they have not retrained the ankle’s proprioceptive ability, or simply the ankle and the brain are not communicating properly and your balance is affected. To train for balance we need to stress the affected ankle alone, with one legged standing, hopping and balancing on an unstable surface.

I hope that this gives you a better understanding of ankle sprains and what to do about them. As always if you have any questions give me a call, send me an email, tweet or find me on Facebook.

 

https://yourpickeringchiropractors.ca     info@drkevinfinnca @drkevinfinn 905-831-3939