If you’re like many Chicagoans, one of your goals is to run AND complete the Chicago Marathon. Every year nearly 30,000 people line up at the start line to compete in the marathon. The real question is how many were unable to start because the rigors of training were too much for their bodies to handle? Marathon training is a progressive endeavor, each week building upon the last until the final weeks where multiple long runs prepare your body for the “real thing.” After the long runs, there are a couple weeks to taper and recover and you’re off to do the real thing.
Time and time again, our office sees countless people who have had to stop their training due to back or knee pain. The number of steps required to complete a marathon is around 22,968 steps, give or take a few if you happen to be taller or shorter. The most common cause of injury for marathon trainers is repetitive stress. If your body happens to be perfectly symmetrical and balanced, you are much less likely to be injured. By the same token, imbalances or asymmetry in your body will increase your chances of getting injured astronomically. Many of the common injuries associated with marathon training CAN be reduced or even eliminated. Investing your time and effort to train is no small commitment, getting derailed and throwing it all away because of a simple, undetected problem is unnecessary.
As many athletes who have visited our office can attest, Align Joint & Spine has a gift for being able to help athletes achieve higher and higher levels of performance. We have the tools and technology to get runners and athletes back to training and can make certain you don’t miss the chance to compete and complete your race! Dr. Jacobazzi is extremely familiar with injuries due to increased training volumes. As a collegiate athlete, he saw a repeating pattern during his years on the Auburn University Track and Field team. Early in the season, he was relatively injury and pain-free, at least as much as is possible with high level training similar to the marathon training you have undertaken. Mid-season, the aches and pains started to come more frequently and at a higher level. By the end of the season, he was starting to break down, had to miss meets and sit out to recover. It was this experience of missing out on the chance to do his best that inspired him to pursue a career in physical medicine.
Physical medicine is exactly what it sounds like, using physical treatments to restore a body to health and wellness. Even at a young age, Dr. Jacobazzi realized that pills and medications were only a temporary solution and would actually lead to more serious problems down the road because he had experienced the effects first hand. He realized using Advil, Aleve or stronger drugs would allow him to train longer but the underlying injuries would eventually catch up to him and require even more attention and effort to resolve. All athletes, not just marathoners, need to be certain their entire musculoskeletal system is in balance. Your joints, muscles, ligaments and bones must work in balance to most effectively propel you forward and avoid injury.
By balancing both physical therapy and chiropractic protocols, Dr. Jacobazzi is able to restore functional stability by balancing the function of all these areas in your musculoskeletal system. As the only healthcare professional in Illinois to be licensed as both a physical therapist and a chiropractor, Dr. Jacobazzi has a unique understanding of what it takes to get your body back from the edge of DNR (Did Not Race) and towards being a FINISHER. His personal experience as an athlete for over 20 years and professional experience as a physical medicine specialist for just as long play a key role in helping his patients find their way back to health.
Getting rid of pain is easy; keeping it away is the hard part. It becomes even harder when you throw marathon training into the mix. Any successful treatment program must have three basic components: restoration of normal movement, neuromuscular (NMR) reprogramming and specific strengthening. Any program failing to address all three areas won’t give you the results you need. Restoration of normal movement is necessary because of the scar tissue and adhesions caused by abnormal movement. These adhesions and scar tissue limit your motion, reduce your flexibility and actually slow you down. These same injuries also INCREASE the chances you will be re-injured. If you skip this important first step, you are only delaying your time to total breakdown not preventing it. Neuromuscular programming can only occur AFTER normal movement has been restored to your body. If you begin NMR reprogramming before normal movement has been restored, your body will learn compensated motor movement. Compensated motor movements MAY be sustainable for a short period of time but, your body will only tolerate them for so long before NEW problems occur and your inevitable breakdown occurs. Follow the proper order of treatment progression, not only do you decrease pain, restore movement and improve the success of the NMR programming, you prepare your body to exit treatment at a higher level of performance than you enter.
It is very common for our patients to tolerate training at higher levels and intensities after completing their treatment program because their body “knows” how to move correctly, moves more easily and has more stability. Stability occurs in the last phase of treatment, the specific strengthening phase (SS phase). The SS phase develops the core muscles responsible for controlling the lower kinetic chain: lumbar spine, hips, knees, feet and ankles. Using exercises specifically tailored to the imbalances found during your initial evaluation, your body will be forced to adapt and improve. Sometimes this process is easy and sometimes it’s hard. But, the end result is always the same, our patient athletes tell us the long runs seem easier and their movement seems less taxing as we near the end of their treatment program. It is not uncommon for patients to reduce their training volume during the initial phases of treatment and it’s VERY common for these same patients to let us know their PRs drop within a few weeks after being back to training full time. Dr. Jacobazzi’s favorite words are “I can’t believe how easy it feels for me now” and it’s something he gets to hear quite often. Recently, a half Ironman triathlete who had been completely OFF running due to severe knee pain from mid-December to mid-March PRd in a 10K training run 3 days after completing his treatment program, this level of result is common. Can Dr. Jacobazzi turn you into a world-class athlete? Probably not BUT, he can turn you into the best athlete you can possibly be. The only thing worse than not being able to compete is not being able to give your best effort because of an injury. It’s admirable to power through your race even if you’re hurt, it’s even better to give your best effort and have fun doing it without having to worry about permanently damaging your body.
Using his unique kinetic chain evaluation, Dr. Jacobazzi will examine both the soft tissue (muscles, tendons and ligaments) and hard tissue (bones and joints) to find the structural imbalances which your body to work harder than necessary and increase your risk of injury now and in the future. The injuries sustained by marathoners are musculoskeletal in origin. The kinetic chain evaluation looks at both sides of the equation.
A standard physical therapist can only address the soft tissue problems occurring in your body and a chiropractor is only able to address the skeletal (joint component). Dr. Jacobazzi has a unique perspective due to his professional training and will be able to tell you exactly what’s wrong and, most importantly, exactly what you need to correct it. Half the solution will only yield half the result, at best.
If you are experiencing aches and pains now, don’t wait. If you AREN’T experiencing aches and pain, don’t wait until you are! Don’t wait until it’s too late and you’ve missed your chance. Get the best possible solution for your body and make certain you don’t miss out on your chance to give your best effort on race day. A call to Align Joint & Spine will be the best investment you can make in your marathon training program. Call us today and find out what’s been missing.
Are Invasive Procedures the Only Hope for Managing Neck Pain?
In a recent article published in a journal for neurosurgeons reported “successful” treatment of neck pain was only obtained after utilizing an “MBB.” MBB, meaning medial branch block, is a procedure where medication is injected into the spine next to branches of spinal nerves to deaden them. Interestingly enough, the procedure is only temporary and was used after a typical regime of medications of varying combinations, which included: Tylenol, tramadol (muscle relaxer) and codeine. If various combinations of the drug were unsuccessful, the patients were subjected to the more invasive nerve block procedure.
The authors of the study made “discovery” after taking x-rays. There was a relationship between loss of cervical curve and severity of pain.
“Dysfunctional cervical intervertebral discs, cervical facet joints, atlanto-axial and atlanto-occipital joints, ligaments, fascia, muscles, and nerve root dura have been shown to induce pain in the cervical spine with the resulting sequelae of neck pain, upper extremity pain, and head- ache.”
It is EXACTLY this analysis which we have been using at our office for the past 15 years to not only determine the cause of neck pain, headaches and radiating arm pain but also to create a solution. The methods used in the study cited above can only manage symptoms. Our process of spinal remodeling solves these problems. Loss of normal cervical curvature and alignment will cause problems if present; it’s only a matter of time. Only consistent, perpetual use of these drugs will diminish symptoms and make you feel better. Unfortunately, the use of pharmacological interventions will stop pain AND allow the degenerative processes, which are causing the pain and symptoms to continue. The long-term effect is people will think their problem has been solved instead of realizing it has only been “managed.” They will no longer look for a solution because they think once the pain has gone; their problem has been solved. It’s actually the exact opposite. The abnormal position of your spine, which has lead to your symptoms, continues to create accelerated degenerative changes. You can think of the opportunity to solve your neck pain as one with an expiration date. The longer you wait to actually solve the problem, the harder it will be to achieve a successful outcome.
The spine is a complex system of joints, ligaments, tendons, muscles and nerves. All of these units work in together to create our neutral and active postures. Our posture is just an external expression of what’s happening internally. The reason posture is one of the many tools our office uses to develop treatment plans for patients is because it allows us a quick and easy method to establish a baseline prior to treatment. We tend to think that posture and movement are separate entities when, actually, they are tied together on a spectrum of active movement versus static balance. The spine forms the structure to which the muscles are attached. If the underlying structure is out of position, our muscles will have to work harder to control movement. Static balance is a very active process, the brain is using your nervous system to detect slight movements and activate your muscles to keep your body balanced. Muscles that have to work harder due to poor internal structure (and poor posture) fatigue more quickly, have a harder time maintaining balance (equilibrium) and lead to increase loading on the joints. The increased loading (force) on your joints will inevitably lead to breakdown and degeneration of both the hard and soft tissues in your body.
Good posture isn’t as simple as just “sitting or standing up straight.” Your body and the ligaments responsible for posture have remodeled and changed shape over time.
Your muscles aren’t strong enough to last against ligaments. Ligaments act exactly like gigantic rubber bands and are responsible for helping create your posture in conjunction with the action of your muscles. These rubber bands can deform over time, looking down at cellphones, laptops or working at a desk, can all create changes in the shape of your ligaments. Car accidents, falls off a bike or a slip on ice can create immediate changes to the shape of your ligaments. The soreness your feel after a car accident or a fall are a sign your muscle and ligaments have been damaged. Even though the pain may go away, the damage remains and will lead to progressive degenerative changes over time. It’s not a question of “if” your spine will degenerate when it has lost its normal position; it’s a question of “when” and “how bad.”
In “The cell biology of intervertebral disc aging and degeneration” written by Zhao, et al and published in the journal, “Ageing Research Reviews” is very clear that abnormal position is responsible for accelerate aging and breakdown of our bodies:
“Intervertebral disc degeneration, which mimics disc aging but occurs at an accelerated rate, is considered to be related to neck or low back pain and disc herniation.”
The relationship of pain to the presence of accelerated degenerative changes is clear. The only remaining factor is answering the question: does abnormal position cause increased loading and stress? You can probably guess since I’m asking the question, someone has already found the answer. In an article titled, “Straightened cervical lordosis causes stress concentration: a finite element model study,” the authors used a very sophisticated system of analysis to compare spinal position and loading within the spine. In this instance, spinal position and posture can be considered to mean the same thing. “The result demonstrated that the active movement range of straightened cervical spine decreased by 24–33 %, but the stress increased by 5–95 %.”
The short version? Abnormal position leads to LESS MOTION and MORE STRESS. The same article tells us these results may be useful in the treatment of cervical spondylosis (arthritic changes). The obvious statement they missed is that abnormal position CAUSES these changes. In the absence of abnormal spinal position (posture), the presence of degeneration is very rare.
Our office chooses to correct the CAUSE of these problems. Using the most advanced spinal analysis software available, your spine is compared to a normal spine and used to build a prescription for corrective care which will help your body remodel the spine into a more normal position. Our goal is NOT to manage your pain, it’s to SOLVE your problem! If you have persistent back or neck pain, it’s a safe bet abnormal spinal position is the cause because true muscular complaints resolve within 4-6 weeks. We help people get a new perspective on their pain and help them eradicate symptoms and get back to doing what they enjoy with whom they enjoy doing it.
BY: Abbey Hudetz
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