Plantar Fasciitis Explained

Written by: William Walsh, D.C.

We’ve all heard of plantar fasciitis, after all, 3 million people suffer every year from the condition, but what the heck is it?

Simply put, “plantar fasciitis,” is inflammation of the “plantar fascia.”

The plantar fascia is a ligament that starts at the heel, runs through the arch of your foot, and attaches at the base of your toes. When this ligament becomes inflamed, it causes pain at the heel where it originates.

Senior man relaxing his feet with a massage

The plantar fascia can become inflamed if it is stretched out or too much pressure has been placed upon it over a long period of time. Certain things can contribute to plantar fasciitis, including:

***Being over weight – this puts extra stress on MANY parts of the body, including your plantar fascia.

***Non-supportive footwear – I know flip-flops are great in the summer, but footwear like this provide no arch support. This leaves your
plantar fascia vulnerable to additional stress.

***Biomechanical Imbalances – Your hips not being balanced can cause more than low back pain, as we should know, the whole body is connected. An imbalance of your hips will put more stress on one leg/foot. The average American takes about 6,000 steps per day. That is A LOT of additional stress on one of your plantar fascia!

***Occupations that keep you on your feet – Teachers, hairdressers, mail carriers, retail employees… being on your feet for hours obviously puts stress on your plantar fascia.

***Tight muscles – Your achilles tendon attaches to the back of the heel. If this is tight, it may rotate the heel just enough to put additional stress on the plantar fascia which attaches at the front of the heel.

So what can you do?

The first step is to have supportive footwear. The amount you wear flats and flip-flops should be limited. Next, stretch the muscles of your lower legs, specifically the calf muscle. Finally, getting regular adjustments will help eliminate mechanical imbalances.

If you suspect you have plantar fasciitis, don’t hesitate to call Monmouth Pain and Rehab for a professional evaluation. Our practitioners are trained in understanding the cause of your symptoms and making the proper corrections at the source of the problem. To request a free consultation ($245 value) fill out the form on this page or call 732-345-1377.

Athletics as you Age

Written by: Michael Sabatino, DPT

You’re not 20 anymore, or 30 for that matter…

Working out and staying limber gets tough as we age. Once our bodies hit 35, science has shown that the good hormones necessary for working out and recovery take a serious nose dive. Moreover, we fail to appropriately adapt our lifestyles and training regimens as we get older. When we are younger, we can afford to make more mistakes in lifestyle and training without significant consequences on performance. As our bodies age, there is far less margin for error. Staying lean and building muscle, while not impossible, becomes much more challenging to achieve. Life happens; kids, work related stress and adult responsibilities take a toll on our bodies and serve as serious roadblocks to maintaining optimal health.
Let’s address a few notable areas to help improve general health and well-being.

Greater focus needs to be placed on consistency of exercise and recovery from your workouts.
One simple item is going to bed early enough for your body to recover. Getting adequate amounts of regular sleep allows your body to cope with accumulating physical stresses. Another important factor is varying the intensity and volume of workouts. I tell patients all the time that frequency, duration and intensity are the three key elements we look to change during the rehabilitation process. During training, these three elements are also the only ones that can be manipulated. As we age, intensity needs to increase while duration needs to be conversely less. This change typically results in shorter sessions with higher intensity. This stimulates muscle growth while shortening your recovery time; allowing you to receive the maximum benefit from your workout.

Track what you eat – modifications to your diet are critical.
Proper nutrition is a close second in effective recovery techniques. During the recovery period, getting adequate amounts of protein and carbohydrates is essential for optimal recuperation immediately following a high stress workout. Meals should be based on wholesome carbohydrates, protein rich foods and healthful fats such as fish oils. The bottom line is eat clean, drink plenty of water and exercise regularly. Our needs don’t change all that much from when we are younger, we are just able to overcome the shortcomings much easier at a younger age.

It may appear that you are fighting an uphill battle; however, as you age making key modifications will help you to continue an active lifestyle. Failing to accept the aging process will only result in abuse to your body and joints; resulting in time away from activities you enjoy. I’ll leave you with a famous quote from Mickey Mantle, “If I’d known I was going to live this long, I would have taken better care of myself…”

Michael Sabatino, DPT is the Director of Physical Therapy at Monmouth Pain and Rehabilitation. Monmouth Pain is a group of Physicians, Physical Therapists, Chiropractors, and Acupuncturists working together to offer patients the most comprehensive, well-rounded, and successful plans of pain management imaginable. Call 732-345-1377 or fill out the form on this page to request a consultation at the Shrewsbury or Wall Township location.

10 Things You Didn’t Know Chiropractic Can Treat!  

Written by: Dr. Nicole Yarbenet, D.C.

Pregnancy Pain   

During pregnancy, there are several physiological and hormonal changes that occur in preparation for creating the environment for the developing baby. Chiropractic care can help in maintaining a healthier pregnancy, reducing the time of labor and delivery, relieving back, neck or joint pain, and preventing a potential cesarean delivery.


People suffering from anxiety have an overly active sympathetic nervous system which controls our fight or flight mechanism. The thoracic vertebrae are highly innervated by the sympathetic nervous system, therefore, any irritation of that area will cause symptoms of anxiety. Adjusting the thoracic spine will calm down this response and relieve anxiety.


Headaches are a common problem. A majority of headaches originate in the neck. When you have a headache it is important to see your chiropractor. Your chiropractor can perform a spinal adjustment to improve spinal function and alleviate the stress on your system. They can also provide nutritional advice, recommending a change in diet and perhaps the addition of B complex vitamins. Your chiropractic can also offer advice on posture, ergonomics (work postures), exercises and relaxation techniques. This advice should help to relieve the recurring joint irritation and tension in the muscles of the neck and upper back.

Attention-deficit/hyperactivity disorder (ADHD) 

Chiropractic cannot necessarily treat ADHD but it can help decrease the symptomatology. ADHD is a central nervous system disorder that causes tension on the nervous system. A chiropractic adjustment can help calm down the nervous system by releasing nerve tension.


Comfortless crying and periodic fussiness can be very upsetting to a new parent and even more upsetting for baby. This condition can last for hours or days. Colic is characterized by a loud piercing cry, tensed abdominal muscles, flexed legs, and clenched fingers.  Any type of vertebral subluxation can adversely affect the child’s nervous system resulting in colic symptoms. A chiropractic adjustment helps to restore normal function in a child’s nervous system, bringing it back to full normal potential. The result is a happy and content baby.

Gastrointestinal Issues  

The nervous system controls the digestive system in many ways. The vagus nerve which comes from the brain and travels around the first cervical bone innervates all the major organs of digestion and functions to stimulate the digestive process. Other major areas controlling digestion include the sympathetic nerves coming out of the thoracic and lumbar regions of the spine. Spinal misalignment in any of these regions can lead to neurological compromise and altered digestive function. Regular chiropractic adjustments can help alleviate digestive problems.

Sinus Infections

Your sinuses consist hollow spaces in the bones of the forehead, cheeks and temples. Healthy, open sinuses are lined with sticky mucus to ensure that air going into the lungs is moist, warm and free from dust, dirt, and pollutants. Your Chiropractor is specially trained to help properly drain the sinuses with specific cranial and upper cervical adjustments. Chiropractic care is also proven to help boost the immune system. There is a direct relationship between the immune system and the central nervous system.  If we support the nervous system through proper spinal function and alignment, then we will ultimately support and strengthen the immune system.

Bed-wetting (Enuresis)

Bed-wetting (enuresis) is another of the many reasons why parents bring their children to see the chiropractor. Emptying of the urinary bladder is controlled by the detrusor and trigone muscles. The nerve supply to these muscles is via the sacral parasympathetic nerves from S2 to S4. Adjustment of the sacral segments in children will relieve any nerve interference that contributes to bed-wetting.

Difficulty breast feeding 

It is very frustrating when a newborn has a difficult time latching on to breastfeed. This can be upsetting for mom and baby. The birth process is very traumatic to an infant’s upper cervical spine, by correcting the misalignment with a gentle adjustment will help the baby latch on without difficulty.


Chiropractic care can help manage your stress levels.  When you experience stress, your body releases stress hormones into your bloodstream, including cortisol and adrenaline.  These stress hormones cause a whole series of physiological changes in your body, such as increasing your heart rate and blood pressure, shutting down your digestive system, and altering your immune system. One of the effects of chronic stress is muscle tension and contraction, which can lead to uneven pressure on the spine, which in turn leads to subluxations. Adjustments help ease muscle tension, which will diminish the stress on certain parts of the skeleton leading to stress reduction.

If you or anyone is suffering from any of these conditions, do not hesitate- Contact Monmouth Pain & Rehabilitation for a FREE consultation ($245 value).  To schedule a consultation fill out the form on this page or give us a call at 732-345-1377.

Is your young athlete at risk? Concussion Prevention Tips

Written by: Marci D’Argenio, PT, DPT

Concussions caused by contact sports are a quickly growing epidemic among young athletes.  The Center for Disease Control reports show that the amount of reported concussions has doubled in the last 10 years.  Sports-related concussions account for more than half of all emergency room visits by children aged 8 through 13, according to the National Athletic Trainers’ Association.  High school football accounts for 47 percent of all reported sports concussions, with 33 percent of concussions occurring during practice. After football, ice hockey and soccer pose the most significant head health risk.   A child who suffers a concussion is one and a half times more likely to experience another, and those who have had two concussions have a threefold greater risk of a concussion happening again.

  1. Make sure your child wears the appropriate equipment for your sport and wear it properly.Close the chin strap if their sport requires a helmet, even during practices.
  2. Enforce the importance of playing by the rules. Teach young athletes to respect the rules of their sport.
  3. Examine the playing field prior to and during games for uneven areas or holes.
  4. Make sure that end posts are adequately padded.
  5. Teach proper technique for their sport.Some organizations minimize risk of concussion by limiting the number of contact practices allowed during the season.
  6. Reiterate good sportsmanship.Teaching good sportsmanship minimizes unnecessary aggression on the field.

A Vital ‘Serving’ of Tennis Elbow Tips

Written by: Amy Ramos, PTA

Tennis Elbow (also called lateral epicondylitis) is an overuse injury that occurs where the muscles of the forearm attach to the elbow.  Although it is named “Tennis Elbow” because of its frequent occurrence among tennis players, it can affect other athletes as well as those who participate in leisure or work activities that require repetitive arm, elbow, wrist, and hand movement, especially while tightly gripping something.  Tennis Elbow is typically diagnosed by a medical doctor from a description of symptoms and a few simple muscle tests.   Symptoms of Tennis Elbow include:  pain/tenderness on the outer part of the elbow, pain from gripping, with or without movements of the wrist and lifting movements, and pain from activities that involve extending the wrist (e.g. pouring a container of liquid, lifting with the palm down and sweeping – especially when wrist movement is required).

Initially, it is recommended that one avoid activities that exacerbate the symptoms of tennis elbow as well as use ice to alleviate the pain and reduce inflammation.  Once the initial symptoms have subsided, Tennis Elbow is usually successfully treated with conservative interventions such as physical therapy and chiropractic care to decrease pain and restore mobility and strength to the affected arm.  In addition, acupuncture treatments and massage therapy have been shown to be quite effective in treating tennis elbow.

Monmouth Pain & Rehabilitation is a multidisciplinary facility offering chiropractic, massage, acupuncture, physical therapy and weight loss to help you get you back to what you enjoy doing!  Call (732) 345-1377 or fill out the form on this page to request a free consultation ($245 value). We have offices conveniently located in Shrewsbury and Wall Township.

Cupping: Have you ‘Spotted’ this recent Trend?

Written by: Nicole Heuschkel, L.Ac

The iconic purplish circular marks, made popular by athletes and celebs like Michael Phelps, Gwenyth Paltrow and Jennifer Aniston, are blazing an eastern path in a western minded world. While the marks may look intimidating, they are indeed beneficial and can even be relaxing. These marks are the result of a procedure called Cupping.

Cupping is a form of alternative therapy, in which cups are placed on the skin to create suction. The goal is to increase circulation, help relieve pain, remove “heat” and pull out toxins that linger in your body’s tissues. Cupping can help treat pain and inflammation and can even act as a deep tissue massage. It stimulates the flow of fresh blood, lymph and qi to the affected area. “Traditionally, the process involves a glass that is heated inside using a flame and then placed on top of the skin, where it creates a vacuum and sucks the skin up into the cup. The aim is to release the tension in sore muscles, Perlman said. Some use pottery or bamboo cups, or a more modern device that relies on a hand pump to produce the suction.” (1) You will usually feel a tight sensation around the area of the cup, but most people experience is to be soothing. Your practitioner can alter the intensity of suction based on your preference.

Although cupping has been in the recent spotlight with the Olympics, you don’t have to be an athlete (or an Olympian!) to reap the benefits of it. Cupping therapy is great to treat tight muscles, aid in detoxing the body, and may even help with the flu, cough/ congestion, poor circulation, anxiety, fevers and a variety of other ailments. People who commute long hours for work or those that are hunched over their computers non-stop can just as easily benefit from cupping. Neck pain and back pain may be top contenders for reasons to seek treatment, but it can be performed almost anywhere (fleshy sections tend to work best) on the body to help aches, pains and joint issues. Dr. Michael Smith explains the procedure and benefits of cupping as, “The suction pulls the tight muscles and stretches the fascia, the connective tissue around the muscles, and in effect, allows blood vessels to expand. The theory is that the increased blood flow speeds healing.”

“Cupping causes the skin to temporarily turn red, blue or purple, especially if there is an injury or energetic blockage under the area that was cupped. The skin discoloration can last anywhere from a few days to a couple of weeks, but is rarely painful. Once the marks have cleared, the procedure can be repeated until the condition or ailment is resolved.” (2) If you can get past the odd looks you may get from others, you may find that cupping is that extra something you have been searching for. As always, it is important to go to a licensed professional. Call Monmouth Pain & Rehabilitation at 732-345-1377 or submit the form on this page to learn more about cupping or to schedule an appointment.



Hips Don’t Lie…

Written by: Eric Chludzinski, DC

3d rendered, medically accurate 3d illustration of the painful hHip pain happens as a result of various conditions of the lower back or hip. Some of the more common reasons are arthritis, injury to the soft tissues or infection. In all of these situations, the origin can be the hip joint itself or spine. Pain arises due to inflammation and swelling of these structures.  Inflammation in the joints will stretch the capsule and cause pain and stiffness.

The hip joint is lined with cartilage. This cartilage gives us the ability to move our leg in all directions as well facilitate gliding of the joint without friction. The femoral head and the acetabulum are lined with articular cartilage that allows the bones to move within the joint with less friction. With overuse or increased loading on it, the hip joint can wear away and restrict mobility and function of the leg. Joint stability is maintained by a group of soft tissues that encapsulate the hip joint.

There are a great deal of muscles and tendons that surround the hip joint. Various soft tissue structures cross the hip joint and allow movement of the leg in virtually every direction. These structures are also involved in hip joint stability. Additionally, there are sacs filled with fluid known as bursa. These bursas allow the soft tissues to move smoothly over the bone structures of the hip and leg. Through chronic overuse and irritation these bursa can become inflamed and act as a source of pain in the hip.

Another frequent area of irritation is one of the many nerves that stem down from the lumbar spine and supply the muscles of the legs with innervation. These nerves can become compressed by a spinal disc or inflamed muscle, tendon or ligament. These areas of impingement can create a pain referral across the hip, groin and leg.

Whether the pain is affecting your ability to play with your kids on the floor, swing your golf club or is affecting your workouts at the gym do not ignore what your body is telling you. Your body (specifically your hips in this case) doesn’t lie! It’s warning you that there is a problem…listen to your body.

The practitioners of Monmouth Pain & Rehabilitation are highly trained at arriving at the correct diagnosis of the origination of hip pain. With the proper diagnosis, treatment will be determined and carried out with correct pain relief and rehabilitative measures.

When considering a remedy for hip pain, Monmouth Pain & Rehabilitation should be your first stop. Our practice comes highly recommended by numerous physicians throughout Monmouth and Ocean County. Feel free to contact us for FREE consultation & evaluation by filling out the form on our website. If you are looking for faster service, give us a call at 732-345-1377. Just tell them that you read this blog and you will receive our complimentary in-office evaluation (a $245 value). 

Rotator Cuff Injuries are Common but NOT Normal

Written by: Marcia D’Argenio PT, DPT

a man suffering from an aching shoulder

Almost every week we have a patient come into the office explaining how they injured their rotator cuff. Some do it lifting weights overhead, for others it’s an old baseball or tennis injury. Whatever the difference in the origin of the injury, one thing is common, it’s something that usually lingers for a long time if not initially treated properly and it is NOT normal.
The rotator cuff is made up of several muscles that help support and guide range of motion for the shoulder joint. Pain arises when someone injures or overuses the surrounding muscles, tendons, ligaments and joint surfaces.

The rotator cuff is a large tendon comprised of four muscles which combine to form a “cuff” which attaches to the head of the humerus. The muscles that comprise the rotator cuff are:

• Supraspinatus
• Infraspinatus
• Subscapularis
• Teres Minor

These muscles originate from the “wing bone” aka the scapula and together form a single tendon unit that attaches to the humerus. Rotator cuff injuries occur when tendons are impinged by the acromion (part of the anterior scapula).This mechanism is believed to be a major cause of cuff tears in individuals older than 40 years. Rotator cuff injuries also happen after a fall or may be caused by chronic wear and tear leading to degeneration of the tendon.
The shoulder is considered a ball-socket joint. It allows the arm to move in many directions. It is made up of the humeral head (a ball at the end of the bone of the upper arm) fitting into the glenoid fossa of the scapula (the socket). The humeral head is kept in place by the thick bands of cartilage and the joint capsule. The joint itself contains a synovial membrane. It is the inner membrane of tissue that lines a joint. The synovial membrane secretes synovial fluid that lubricates the joint. The rotator cuff muscles are the dynamic stabilizers and movers of the shoulder joint and adjust the position of the humeral head and scapula during shoulder movement.
Symptoms of rotator cuff injuries are pain in the front of your shoulder that may radiate down the side of your arm. Overhead activities such as lifting or reaching usually hurt and sleeping on the affected side may hurt. The arm may be weak and can cause difficulty with even routine activities such as combing your hair or reaching behind your back. When the rotator cuff is damaged it can produce pain, spasm, inflammation and swelling. All of those ailments restrict movement and mobility. Non-surgical options include anti-inflammatory medication, steroid injections, acupuncture, laser therapy and/or physical therapy.

The aim of physical therapy is to keep the shoulder joint stable by strengthening the muscles of the rotator cuff and to restore full range of motion. Typically rotator cuff rehabilitation takes 4-6 weeks but varies depending on the type of injury and the patient. Some examples of exercises that comprise a rotator cuff program are active assisted range of motion exercises with a wand or stick and strengthening exercises with a theraband to support the shoulder joint. After recovery, these exercises should be continued as a maintenance program 2-3 days per week for lifelong protection of your shoulders.

When a patient comes to our office with a rotator cuff injury, our approach is to first and foremost decrease the pain, swelling and inflammation.Our goal is to assist healing without painful or invasive procedures. If after our evaluation and examination we have the opinion that a condition requires medical intervention beyond the procedures available our office, the patient will be referred to other professionals who offer more invasive procedures such as injections and surgery (But only if absolutely needed!).

In most instances rotator cuff injuries can be remedied rather quickly by the painless, non-invasive procedures available at Monmouth Pain & Rehabilitation. Because of our excellent track record in taking care of these injuries, we receive a great deal of referrals from various physicians in our community.

So while it is true that many rotator cuff injuries evolve into chronic issues, it is usually because from the start they are not treated or allowed to heal properly. At our office we have great success in recognizing and treating the injury properly. With the attention, patience and techniques available in our office it is an infrequent occurrence for this type of injury to cause discomfort beyond the normal time of healing.

When considering a remedy for your rotator cuff injury, Monmouth Pain & Rehabilitation should be your first stop. Give us a call at 732-345-1377. Mention that you read this blog and you will receive a complimentary in-office evaluation (a $245 value).

The Single Most Important Test to Consider If You Are Experiencing Pain, Numbness, Tingling or Weakness…

Written by: William Walsh, DC

Have you or someone you know experienced pain that shoots down the back of their leg or down their arm and into their foot or hand?  Many times patients come to our office saying they have “hand or foot pain”, underwent weeks of therapy, and finished with no results.  They want to know how we are different and if we can help them.  Many patients are surprised when they are informed that the injury may not be at the point of pain and that we’ll have to do further testing to determine if the nerves are involved.

Let’s start with a quick anatomy lesson to better understand the nervous system.  The “Central Nervous System” consists of the brain and spinal cord. From the spinal cord, between each vertebrae comes a “spinal nerve”. This is the start of the “peripheral nervous system”.  The peripheral nerves that originate from the neck run down through the arms and into the hands.  The same is true for the peripheral nerves that originate from the low back; they run through the legs down to the feet.Neuropathy, Nerve Damage

Peripheral nerves can become irritated at many points and by many irritants along their path from the spinal cord to the terminal end in the hands or feet.  A tight muscle, tight ligament, poor bio-mechanics, compromised tissue or inflammation can cause nerve irritation which results in pain, tingling, numbness or burning sensations anywhere along that peripheral nerve distribution.

The doctors at Monmouth Pain are trained in identifying nerve irritation and damage as board certified practitioners in electro-diagnostic testing, also referred to as Nerve Conduction Velocity testing (NCV).  An NCV can tell if there is nerve damage, a nerve disorder or if the nerve is firing improperly.  All 3 of these findings are important in determining the correct diagnosis.

Nerve conduction velocity testing assesses the “speed” of each nerve.  Each nerve in the body carries a signal at a particular “speed”.  During an NCV test the practitioner puts a receiver on the terminal end of the nerve (hand or foot).  Utilizing an impulse tool, a current is sent as an impulse into the nerve. That signal goes along the nerve and is recorded by the receiver.  The practitioner then moves the impulse tool up the arm or leg and repeats at several points.  If the nerve velocity or “speed” is slower in a particular region of the nerve this would indicate nerve irritation or damage.

Electro-diagnostic testing is both a highly sensitive and specific assessment tool. An NVC quickly leads to a reliable diagnosis when utilized in conjunction with clinical testing.  A reliable diagnosis leads to a more effective treatment which results in less visits to your doctor. This means more time doing what you love.

So if you or a loved one are suffering with pain, tingling, numbness or a burning sensation that has gotten out of control give us a call to schedule a free consultation to determine if we can help.

What Everyone Needs to Know about Pregnancy

Written By: Angie Mohamed, PTA

Hip pain is a common ailment that many women feel during pregnancy. There are many different causes to hip pain and more so, treatments that our office can use to help address and relieve your symptoms, including chiropractic care, physical therapy and acupuncture.

During pregnancy, your body releases a hormone called relaxin that allows connective tissues, the tough bands of tissues that connect joints, to relax and soften. As a result of nature’s way of preparing you for labor and delivery, the joints and ligaments in your pelvis will loosen and quite possibly move unevenly. This ligament softening, along with changes in posture and a heavier uterus all may contribute to the pain you may feel in your hip and groin.

Increased pressure on the sciatic nerve is another possible cause of hip pain. These two nerves branch from either side of your low back down to your feet. When there is increased pressure on the nerves, you may feel pain, numbness and/or tingling in the buttocks, hips, or thighs.

Round ligament pain is another common issue that may contribute to hip pain during pregnancy. Sharp pains in the abdomen, hip and groin area are characteristic of round ligament pain.

With any of these conditions you may feel pain in the following areas:

  • in your lower back
  • in your symphysis pubis joint
  • in your sacroiliac joints
  • in your groin
  • at the front and the back of your thigh
  • at the back of your lower leg
  • around your hips
  • in your pelvic floor

How we can help you in our offices:

Our physical therapists can help address what condition you may be suffering from and help guide you with exercises that will help you strengthen your abdominal muscles and low back, teach you proper ways to transfer from different positions, posture and body mechanics training and soft tissue mobilizations. Along with our physical therapists, our chiropractors can help manipulate joints that may be stiff or not moving properly in your back, hip and pelvis. Lastly, our licensed acupuncturist can provide treatment to help alleviate pain and discomfort that is safe for pregnancy.

Parenthood is hard enough without being uncomfortable during your pregnancy. Monmouth Pain and Rehabilitation is conveniently located in Shrewsbury and Wall Township, NJ and is proud to serve the wellness needs of women before, during and after pregnancy. If you are experiencing pain or discomfort fill out the form on this page or call us at 732-345-1377 – mention this blog to receive a FREE consultation ($245 value).

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