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).

Don’t Let Pain keep you from making Par

Written by: Nicole Yarbenet, DC

Do you notice pain in your elbow while swinging a golf club? Does this pain prevent you from driving the golf ball as far as the pro’s do? If so, you may be suffering from Golfer’s elbow, otherwise known as Medial Epicondylitis. This frustrating and treatable condition is common among golfers.

Golfer’s elbow is an irritation on the inside of the elbow. It is often associated with an overhand throw, a golf swing, or use of a hammer. Sometimes this condition begins with an acute sprain or strain from the forearm muscles being overworked. Symptoms include pain on the inside of the elbow when lifting the wrist or hand, pain when twisting the forearm, or when making a fist. The area may be slightly swollen or tender to the touch. If the problem is chronic, additional symptoms can include stiffness in the elbow or weakness in the hands or wrist.

Golfer’s elbow can be slow to heal, but don’t get discouraged; conservative treatment can give excellent results! During the initial presentation, it’s important to rest until the pain subsides. You can always place an ice pack over the painful area for 15-20 minutes several times a day. Make sure your skin has completely warmed up before using ice again. Early chiropractic adjustments and physical therapy are highly recommended to restore motion in the wrist, elbow, and shoulder to speed up recovery. Massage therapy of the forearm which includes myofascial release, trigger point therapy and friction massage will assist in relaxing the forearm musculature and breaking up scar tissue that has formed. Ultrasound therapy and laser therapy are other forms of treatment that can be beneficial in reducing pain and inflammation.

When it’s time for you to return to play, it’s important to stretch your forearm muscles to prevent re-injury! Simple stretches such as wrist flexion and extension will help loosen the muscles. Your chiropractor or physical therapist can always recommend an elbow brace or kinesiology tape to wear while playing golf. Just remember, golfers elbow will not heal if it’s not allowed to rest!

If you are suffering from a gym or other sports injury and are looking to find relief, don’t hesitate – Call Monmouth Pain & Rehabilitation for a consultation and exam.  Feel free to fill out a form on our website. If you are looking for faster service, give us a call at 732-345-1377.

Below are some simple exercises to help strengthen and stretch those muscles.

Gentle wrist flexion and wrist extension, start with 1lb and increase the weight when it becomes easy!

Hold 10 seconds then release! Repeat 3 times.

**You can use a soup can at home!



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The Truth About Whiplash

Written by: Nichole Chaviano, PT, DPT

Driver Suffering From Whiplash After Traffic Collision

Over a million people are diagnosed with whiplash each year in the USA alone. Whiplash is caused by a quick jerking motion of the head and symptoms can include an achy neck and shoulder muscles, stiffness through your joints, headaches and even numbness and tingling down the arms. When your body is hit either through the contact with another body such as in a sporting event or with the seat in a car crash your torso gets thrown forward as your neck gets thrown backwards then forward very quickly. In severe cases spinal nerves and joints can be damaged but most likely the injury occurs to the ligaments, muscles and tendons. In some cases, concussion also known as mild traumatic brain injury can occur. When not treated properly symptoms and chronic pain can persist with up to 50% of whiplash victims never making a full recovery.
When the accident appears severe immediate medical attention is usually provided, but in other cases symptoms can take days to weeks to manifest which is when you should seek medical care. X-rays should always be taken to rule out fractures or dislocations of the vertebrae or facet joints. With more severe cases an MRI or CT scan of the neck and head may be needed to better diagnose potentially torn ligaments, spinal cord damage or herniated discs and rule out fatal instability.
When medically cleared it is important to start treatment with Physical Therapy or Chiropractic care to improve symptoms as quickly as possible. A patient’s prognosis significantly improves when they are able to safely keep their necks moving through stretching and mobilization. With an individualized plan of care patients work through strengthening exercises to reduce risk of re-injury. A passive treatment that may be incorporated is infrared light therapy; known to decrease pain and speed up the healing of injuries by improving circulation.
Associated treatments are available including Massage Therapy which works to reduce muscle spasm, combat inflammation and promote relaxation; and Acupuncture, working to reduce pain and inflammation by inserting very thin needles into specific energy points to stimulate healing by releasing endorphins and serotonin.
If you have experienced a whip lash injury the practitioners at Monmouth Pain and Rehabilitation can help. Our facility has on staff Medical Doctors, Chiropractors, Physical Therapists, Acupuncturists and Massage Therapists. Our team works collaboratively to create a customized treatment plan for each patient designed to help you recover from your injury. Fill out the form on this page or call 732-345-1377 and mention this blog to receive a FREE consultation ($245 value).

What to Do If You Feel Pain During Your Workout at The Gym

Written by: Eric Chludzinski, DC

Gym injuries happen.

They can be sudden, happen un-expectantly and quickly.  In the middle of your dead lift workout you reach down to pick up that barbell and pain in your back stops you in your tracks instead.

They can develop over time. You have been training for a marathon and now there is a pain in the arch of your foot with each step, running or walking.

Does this mean you stop lifting weights or give up on that dream of running a marathon?  No, of course not.  But it does mean that it’s time to treat your injuries and bring your body back to a healthy state.  It can also be time to start a regular routine of care that could help you avoid future injuries.

Consulting a doctor for treatment in regards to your gym injury is a great option.  Our doctors are experts at treating the spine, of course, but they are also highly trained in many other musculoskeletal problems. They are skilled at treating both an injury to get the body back to a healthy state, as well as, focusing on the body’s overall structure and balance.

We use safe and effective methods that promote they body’s own natural healing process.  Treatments include rehabilitation of the spine.  However, they can also include rehabilitation of the extremities and joints increasing range of motion and promoting healing at the site of injuries.

Some examples of gym injuries include:

  • Tennis Elbow
  • Golfer’s Elbow
  • Tendonitis
  • Rotator Cuff Injury
  • Strains
  • Sprains
  • Shin Splints
  • Shoulder Injury
  • Neck Injury
  • Back / Disc Injury
  • Plantar Fascitis

If you feel pain, you should seek treatment for any injury as soon as possible.  Getting the proper diagnosis and treatment from the earliest onset of the injury has been known to increase the healing process, getting you back to the gym to train.

At Monmouth Pain & Rehabilitation our highly trained providers will use a consultation and exam for the diagnosis process.  Depending on the type of injury and severity, additional tests may be needed.  For example, an MRI or x-rays may be used to confirm a diagnosis for proper treatment.

Once a diagnosis is confirmed a treatment plan is created. It may include chiropractic care, physical therapy, deep-tissue massage, acupuncture, laser treatment or interventional pain management.

The goal is always the same.  Getting you out of pain and healthy enough to get back to the gym.  We want you enjoying your workout routine, whatever it is.

If you are suffering from a gym or other sports injury and are looking to find relief, don’t hesitate – Call Monmouth Pain & Rehabilitation for a consultation and exam.  Feel free to fill out a form submission 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 article and you will receive our complimentary in-office evaluation (a $145 value). 

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