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The SpineForce equipment is available Tuesdays and Thursdays from 9-4 and Wednesdays 9-11. Using the list below, find an open day for the SpineForce equipment and click on DETAILS to reveal what appointments are available to choose from. You can conveniently book multiple days and times by selecting ADD TO CART for each day you want to book and when done, select VIEW CART to select the times for each day. Call (716) 626-6301 or email us here to ask us about discounts for 10 and 50 session purchases.

Due to machine maintenance, Spine Force appointment scheduling will resume on November 16, 2015. Sorry for any inconvenience.
[EVENT_CUSTOM_VIEW event_category_id="spineforce-1433123791"]
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Low Back & Sacroiliac

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Knee

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Featured Articles

Prolotherapy for cartilege growth in severe knee osteoarthritis December 4, 2016 - Chondrogenic Effect of Intra-articular Hypertonic-Dextrose (Prolotherapy) in Severe Knee Osteoarthritis Gasto´n Andre´s Topol, MD, Leandro Ariel Podesta, MD, Kenneth Dean Reeves, MD, FAAPM&R, Marcia Mallma Giraldo, MD, Lanny L. Johnson, MD, AAOS, Raul Grasso, MD, Alexis Jamı´n, MD, Tom Clark, DC, RVT, RMSK, David Rabago, MD Abstract Background: Dextrose injection is reported to improve knee…
The Dormant Butt Syndrome June 6, 2016 - http://www.cbsnews.com/news/dormant-butt-syndrome-a-cause-of-common-aches-and-pains/ Multiple news sources last week have reported on a physical phenomenon labeled as a “dormant butt syndrome”. This is a condition where postural muscles become deconditioned from too much siting and cause problems in the lower back, knees and hips. Although it sounds like it is something that has been newly discovered, medical, sports…
Soft Tissue – Why Is It Important April 28, 2015 - The soft connective tissue, located just under the skin, is a white membrane that wraps and connects the muscles, bones and blood vessels of the body. Soft tissue is also called fascia. This of it like the white fuzz inside an orange peel, connecting the "skin" and the "meat" of the orange. Learn More
Spring Clean the Diet April 22, 2015 - Spring is a time of regrowth and renewal. As the sun begins to shine and the temperature rises, we begin to open windows or clean the yard in order to prepare for a new season. Tis’ also the perfect time to “spring clean” your diet, transitioning from common comfort foods of winter to nutrient dense…
Physical Therapy Outdoor Walking Season April 13, 2015 - Spring marks the opening of “outdoor walking season” in western New York. Like any other activity, walking has its own specific injury profile often involving the foot and ankle. Learn More
Prolotherapy Prolotherapy Stimulates Tissue Repair March 23, 2015 - Prolotherapy is injection of any substance that promotes growth of normal cells, tissues, or organs. Studies have shown that it stimulates tissue repair.
Lumbar Spinal Stenosis: Understand it and Beat it! February 23, 2015 - The typical lumbar spinal stenosis patient has difficulty with walking, standing and occasionally reaching overhead. You are not doomed to a life of leg pain and weakness. We can guide you through a progression of non-surgical options.
What exactly is the practice of Yoga? February 23, 2015 - The practice of yoga is for keeping in shape, but it creates fitness in more then just the physical sense. Learn more about what the practice of yoga is.
Hypoglycemic Index helps determine what kind of foods are good for you! February 13, 2015 - The Glycemic Index is a way to categorize carbohydrate rich foods and classifies foods from 0 to 100, based on how quickly glucose is absorbed after foods are consumed. Learn more...
PRP Platelet Rich Plasma (PRP) Treatment for Knee Osteoarthritis: Study shows significant pain reduction and improvement in function December 14, 2014 - The purpose of this study was to investigate whether platelet-rich plasma therapy for early knee osteoarthritis is associated with good clinical outcomes and a change in magnetic resonance imaging (MRI) structural appearances.

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Prolotherapy for cartilege growth in severe knee osteoarthritis

Chondrogenic Effect of Intra-articular Hypertonic-Dextrose (Prolotherapy) in Severe Knee Osteoarthritis

Gasto´n Andre´s Topol, MD, Leandro Ariel Podesta, MD, Kenneth Dean Reeves, MD, FAAPM&R, Marcia Mallma Giraldo, MD, Lanny L. Johnson, MD, AAOS, Raul Grasso, MD, Alexis Jamı´n, MD, Tom Clark, DC, RVT, RMSK, David Rabago, MD

symptomatic-knee-oa-on-the-rise-feature-image-1080x663Abstract Background: Dextrose injection is reported to improve knee osteoarthritis (KOA)related clinical outcomes, but its effect on articular cartilage is unknown. A chondrogenic effect of dextrose injection has been proposed.

Objective: To assess biological and clinical effects of intra-articular hypertonic dextrose injections (prolotherapy) in painful KOA.

Design: Case series with blinded arthroscopic evaluation before and after treatment. Setting: Physical medicine and day surgery practice.

Participants: Symptomatic KOA for at least 6 months, arthroscopy-confirmed medial compartment exposed subchondral bone, and temporary pain relief with intra-articular lidocaine injection. Intervention: Four to 6 monthly 10-mL intra-articular injections with 12.5% dextrose.

Main Outcome Measures: Visual cartilage growth assessment of 9 standardized medial condyle zones in each of 6 participants by 3 arthroscopy readers masked to pre-/postinjection status (total 54 zones evaluated per reader); biopsy of a cartilage growth area posttreatment, evaluated using hematoxylin and eosin and Safranin-O stains, quantitative polarized light microscopy, and immunohistologic cartilage typing; self-reported knee specific quality of life using the Western Ontario McMaster University Osteoarthritis Index (WOMAC, 0-100 points).

Results: Six participants (1 female and 5 male) with median age of 71 years, WOMAC composite score of 57.5 points, and a 9-year pain duration received a median of 6 dextrose injections and follow-up arthroscopy at 7.75 months (range 4.5-9.5 months). In 19 of 54 zone comparisons, all 3 readers agreed that the posttreatment zone showed cartilage growth compared with the pretreatment zone. Biopsy specimens showed metabolically active cartilage with variable cellular organization, fiber parallelism, and cartilage typing patterns consistent with fibro- and hyaline-like cartilage. Compared with baseline status, the median WOMAC score improved 13 points (P ¼ .013). Self-limited soreness after methylene blue instillation was noted.

Conclusions: Positive clinical and chondrogenic effects were seen after prolotherapy with hypertonic dextrose injection in participants with symptomatic grade IV KOA, suggesting disease-modifying effects and the need for confirmation in controlled studies. Minimally invasive arthroscopy (single-compartment, single-portal) enabled collection of robust intra-articular data.

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The Dormant Butt Syndrome

http://www.cbsnews.com/news/dormant-butt-syndrome-a-cause-of-common-aches-and-pains/
Multiple news sources last week have reported on a physical phenomenon labeled as a “dormant butt syndrome”. This is a condition where postural muscles become deconditioned from too much siting and cause problems in the lower back, knees and hips.

Although it sounds like it is something that has been newly discovered, medical, sports fitness and rehabilitation professionals have recognized this problem over a decade ago and have been addressing it through a variety of strength building exercises. In the course of my medical career, I became aware of this issue 13 years ago when I started to study and understand the consequence of sitting on the body. Based on this experience I would like to offer this description of the syndrome and provide some practical solutions to prevent it.

“Dormant butt syndrome” refers to weakening of the buttock muscles that occurs during sitting. The issue at it’s most basic is that our bodies were never built for the amount of sitting that our modern environment demands. The human body developed through evolution to be an efficient hunting and gathering machine. We are built for walking and running for miles with a purpose of foraging for plant food, chasing down pray, or running away from predators. The muscles that support us rely on motion for maintenance of strength and conditioning of the leg and core muscles and the process starts when the foot comes in contact with the ground. This force of the weight of the body is transmitted through the feet, and ground responds in kind, transmitting an equal force back through the feet to the bigger muscles of legs, pelvis and back. The force that is transmitted from the ground up is called a ground reaction force. An overwhelming presence of electronics in the home and work place has placed us in sedentary positions where this communication with the ground does not happen. The feet loose their essential role in stimulating the legs and core to support the body weight. As a result our bodies slump. The weight of the upper body can now bear down, and the pressure builds in the discs and joints of the spine. This creates wear and tear of the spine that can lead to disc injuries and spine joint osteoarthritis.

Without the ground reaction force to keep our muscles active, core muscles, buttock muscles, and muscles of the legs become deconditioned and weak. These weakened muscles cannot provide enough support to the joints of the back, hips and knees. This lack of support leads to overuse of the joints and ultimately to stiffness and pain.

The good news is that we can prevent the problems of the “dormant butt syndrome”.

The solution consists of two parts, postural alignment and exercise.

In regards to proper posture, it is crucial that the feet are touching the ground and are actively pressing into it to create the stimulus to the muscles of the legs and core that typically happens during standing. The back needs to be supported by the back of the chair or a lumbar support to prevent the slump that otherwise occurs as muscles fatigue. Even with these adjustments, the body still needs to be given a break from sitting. Frequent alternating between sitting and standing with the help of a hi-lo desk or a hi-lo desktop computer station has been shown to be the best way to avoid the weakening of the muscles and the build up of pressure in the spine. Exercise is also a critical part of the solution and can reverse much of the issues that sitting creates. The catch is that it must be done correctly and frequently. Seated back and leg machines should be avoided because they place even more pressure on the back and confuse the muscles of the legs. The exercises that use body resistance, focus on total body movements and are either done standing or prone (face down), are the most effective. Early morning exercise should not include bending, twisting or heavy weight lifting as the spine discs contain the highest amount of pressure then and are most susceptible to injury. In conclusion, even though the demands of our modern lives glue our butts to our seats, we don’t have to take it sitting down! A few simple postural adjustments and a solid, well thought out exercise routine can spare us the dreaded dormant butt. Osteopathi Wellness Medicine’s specialized yoga and fitness classes provide guided training to prevent posture related issues and maintain optimal fitness.

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Soft Tissue – Why Is It Important

Treating Soft TissueThe soft connective tissue, located just under the skin, is a white membrane that wraps and connects the muscles, bones and blood vessels of the body.  Soft tissue is also called fascia.  This of it like the white fuzz inside an orange peel, connecting the “skin” and the “meat” of the orange.

At times, the muscles and fascia are not stretched enough and they become stuck or tear, which results in soft tissue injuries or adhesions.  The outcome?  You’ll have restricted muscle movement, pain, soreness and reduced flexibility.

We can detect these adhesions and restrictions.  Our Graston Technique instruments have been clinically proven to achieve quicker and better outcomes in treating acute and chronic conditions, including:

  • Neck Pain – 82% success rate
  • Shoulder Pain – 92% success rate
  • Golfer’s Elbow – 60% success rate
  • Tennis Elbow – 90% success rate
  • Back Pain – 87% success rate
  • Wrist Pain – 86% success rate
  • Knee Pain – 71% success rate
  • Foot Pain – 70% success rate
  • Ankle Pain – 92% success rate

As well as helping other treatable conditions such as Fibromyalgia, Hip Pain, Wrist Tendinitis, ITB Tendinitis and more.

The Success Rate relates to a set of predetermined patient/clinician goals established at the onset of care and based on the average number of treatments using Graston Technique (GT).  Click here for more information on the GT Outcome Data and how the results were calculated.

Treating Soft Tissue

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Spring Clean the Diet

Jessica NyropSpring is a time of regrowth and renewal. As the sun begins to shine and the temperature rises, we begin to open windows or clean the yard in order to prepare for a new season. Tis’ also the perfect time to “spring clean” your diet, transitioning from common comfort foods of winter to nutrient dense foods of spring.

Begin with your food supply. Open the freezer and fridge and throw away any foods that may have freezer burn and expired items. Some foods do not have an expiration date; the USDA provides an extensive list of foods and estimated expiration dates:

(http://www.fsis.usda.gov/wps/portal/fsis/topics/food-safety-education/get-answers/food-safety-fact-sheets/safe-food-handling/kitchen-companion-your-safe-food-handbook/CT_Index).

The next place to inspect is the pantry. Following the same method as above, remove all expired food items. Check the shelf life of the following items: flour is good for 1 year; opened cereal is good up to 3-4 months; rice should be replaced after 6 month; canned soups will last up to 12-18 months.

Once you have cleaned out the food supply, you can now replace Nutrition winter-based “comfort foods” with nutrient dense, functional foods found in spring. Nutrient density is the amount of nutrients per calorie in food. Winter foods such as casseroles or hot chocolate tend to be high in calories and limited in nutrients. If we compare a cookie to cut vegetables such as carrots, the cookie provides more calories than the carrot, however the carrot provides more vitamins and minerals compared to the cookie.

Switching from caloric dense foods to nutrient dense foods can be simplified during spring due to the abundance of new fresh produce. Try several of these examples in order to “spring clean” your diet: Stews can be replaced with fresh soup such as gazpacho. Instead of bread try quinoa or brown rice and replace chips/crackers with kale chips. Substitute cookies with fresh cut vegetables stored in individual plastic bags, ready to snack on with your favorite hummus. Casseroles and caloric dense dishes can be replaced with a kale or spinach salad dressed with asparagus, peas and your favorite type of seafood. Lastly, replace hot chocolate and high calorie drinks with sparkling water infused with cucumber and mint, strawberries, cherries, blackberries or grapefruit with mint.

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Outdoor Walking Season

Physical TherapySpring marks the opening of “outdoor walking season” in western New York. Like any other activity, walking has its own specific injury profile often involving the foot and ankle. If you haven’t been consistent with a walking routine and have experienced a long layoff, how you reengage in walking is very important for avoiding injury and improving your fitness.   So, let’s get ready for a walk by not taking our feet and ankles for granted and doing some specific things for them.   Problems such as plantar fasciitis and Achilles tendonitis can be avoided with a few simple exercises and routines incorporated before and during your walk.

To improve the mobility and strength of the foot and ankle try the following:

  1. Condition the plantar fascia for the impact of walking: roll a small ball along the foot’s long arch from the ball to the heel. This can be done seated or standing for a few minutes.
  2. Walking backwards emphasizing landing on the forefoot then slowly bringing the heel to the ground stretches the Achilles tendon and plantar fascia. Be mindful about keeping your feet straight as if walking on parallel lines and stand tall which will add an additional load onto the front of the hip as long as the feet are parallel.   Add this periodically into your walk and it will get the neighborhood talking.
  3. Prior to and after your walk roll back and forth on the inner and outer borders of each foot.( pictures 1, 2,3)
    Also, stretch the topside of the foot by positioning the foot behind you and the bottom by rising up on the toes. (pictures 4,5)
  4. Foot stomp: Sumo wrestlers stomp the feet to jump-start their leg muscles before training and competition. Follow their lead and do a 5-6 moderately intense foot stomps before your walk to activate the muscles of your hips and thighs which control how well you control your bodyweight with each stride. Your feet will thank you for taking the time to stomp.
  5. The “short foot” exercise. This exercise will strengthen the muscles of your foot. It takes some concentration but it will help your foot act as an active shock absorber when walking. It’s done by lifting the long arch of the foot by drawing the ball of the foot toward the heel. ( Picture 6) Try a few minutes of this particularly if you have fallen arches and pain in the sole of the foot. When walking with a short foot the knees will naturally lock straight. Try a few minutes of this daily.

Feel free to contact the PT desk at Osteopathic Wellness Medicine of WNY if you have any questions about this routine.

Picture 1, Ball rolling stretch

IMG_1055

 

Picture 2     Foot outer border stretch            Picture 3   Foot inner border stretch

 

 

 

IMG_1053 IMG_1052

Picture 4       Top of the foot stretch                Picture 5    Ball of the foot stretch

IMG_1050 IMG_1051

 

Picture 6    “Short foot” walk

IMG_1046

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Prolotherapy Stimulates Tissue Repair

ProlotherapyProlotherapy is injection of any substance that promotes growth of normal cells, tissues, or organs. Prolotherapy is performed in all major hospitals but not by the name prolotherapy. An example is injection of red blood cell growth stimulator (erythropoietin) in patients with anemia.

The three types of prolotherapy are:

1. Growth factor injection prolotherapy:  Injection of a growth factor (a complex protein) that specifically begins growth of a certain cell line (erythropoietin example). This type of prolotherapy is in early stages of study for arthritis (growing cartilage cells) and sprain and strain (growing fibroblasts) and will advance substantially in years ahead. It will be a more expensive option however than the latter two types.

2. Growth factor stimulation prolotherapy:  Injection of something that causes the body to produce growth factors. Non inflammatory (10% or less) dextrose is an example of this. Two double blind studies have now shown that simple 10% dextrose injection is effective in arthritis.(1,2) (Large and small joint) Humans cells exposed to as little as 0.3% dextrose produce growth factors such as platelet-derived growth factor (PDGF), transforming growth factor-beta (TGFB), epidermal growth factor (EGF), basic fibroblast growth factor (bFGF), and connective tissue growth factor (CTGF).

3. Inflammatory prolotherapy:  Injection of something that causes activation of the inflammatory cascade to produce growth factors. These solutions often include dextrose for a growth factor stimulation effect, but the inflammatory signals that result causes a more vigorous growth response. Examples of solutions in current use are 12.5%-25% dextrose, phenol-containing-solutions, and sodium-morrhuate-containing solutions. Double blind studies done thus far have been treatment comparison studies rather than placebo controlled studies(3-5) as the control groups received injection with multiple bone contacts which itself will stimulate growth factor release. Despite this, the inflammatory proliferant groups did better except for one study in which the technique used was questionable.(5) Inflammatory prolotherapy will likely be the most cost effective form of prolotherapy in the future as it is an inexpensive medical technique for stimulation of the natural wound healing cascade.
Since the primary pathology in chronic sprain/strain is best described as connective tissue insufficiency, connective tissue laxity and/or weakness (the term connective tissue insufficiency has been utilized), it will be imperative to correct the primary pathology. The primary pathology in arthritis however, is a combination of too little growth factors and too much disrepair factors, and how to limit disrepair factors is currently under investigation.(6)

1. Reeves, K.D., and K. Hassanein. Randomized prospective double-blind placebo-controlled study of dextrose prolotherapy for knee osteoarthritis with or without ACL laxity. Alt Ther Hlth Med, 2000; 6(2): 37- 46
2. Reeves, K.D. and K. Hassanein. Randomized prospective placebo controlled double blind study of dextrose prolotherapy for osteoarthritic thumbs and finger (DIP, PIP and Trapeziometacarpal) joints: Evidence of clinical efficacy. Jnl Alt Compl Med, 2000; 6(4): 311-320
3. Ongley, M.J., et al. A new approach to the treatment of chronic low back pain. Lancet, 1987; 2: 143 – 146.
4. Klein, R.G., et al. A randomized, double blind trial of dextrose-glycerine-phenol injections for chronic low back pain. Journal of Spinal Disorders, 1993; 6: 23- 33.
5. Dechow, E., et al. A randomized, double blind, placebo-controlled trial of sclerosing injections in patients with chronic low back pain. Rheumatology, 1999; 38:1255- 9.
6. Reeves, K.D., Prolotherapy: Basic science, clinical studies, and technique. In Lennard TA (Ed). Pain procedures in clinical practice (2nd Ed.). Philadelphia; Hanley and Belfus; 2000:172-190.

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