Dr. Joel attends Chicago Active Release Technique (ART) seminar.

Last week I spent 21 hours learning a soft tissue technique that has become one of the leading treatments for muscle and tendon injuries.

Active Release Techniques®

ART ® is a soft tissue management system that effectively treats soft tissue problems, which frequently do not respond to other traditional treatments.

The goal of ART® is to restore optimal texture, motion, and function of the soft tissue and release entrapped nerves. This is accomplished through the removal of adhesions or fibrosis in the soft tissues via the application of specific protocols. Adhesions can occur as a result of acute injury, repetitive motion, and constant pressure or tension. ART® eliminates the pain and dysfunction associated with these adhesions.

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Some of the more common conditions are:

• Carpal tunnel and other peripheral nerve entrapments
• Spinal pain and dysfunction
• Tendonitis and other soft tissue inflammatory disorders of the hand, wrist, elbow, shoulder, hip, knee, ankle, and foot
• Sciatica, TMJ, recurrent sprains and strains

Only a credentialed ART® provider can ascertain whether ART® might prove beneficial for your condition. To become proficient in ART®, it takes approximately two years of working with patients once a provider has taken the courses and passed the required examinations. Providers must attend annual update seminars to maintain their credentialed status and keep current of any new protocols and research.

ART® is sought after by nearly every professional sports team, Olympic athletes, movie stars and insurance carriers. This technique has filled a void in the management of soft tissue conditions.

Learn more at http://www.activerelease.com/

Merry Christmas and Happy Holidays from VIMG

VIMG celebrates the holiday spirit by giving to local families in need. Merry Christmas!

Ski and Snowboard Conditioning

The ski/snowboard season is just a month away for us here in the Vail Valley. Some of you may have already taken advantage of Loveland or A-Basin and started your season early. For many individuals your summer has been filled with tackling the mountain on a bike or your good ole two feet. Kudos to you for being active, but skiing is a different animal altogether. And if you have not already started preparing for the winter season, now is the time. Prevention is the key to avoiding injury on the slopes. A well rounded conditioning program consisting of five key injury prevention workouts will help prepare you for the mountain and most importantly help to decrease your risk for injury. What are those 5 key injury prevention workouts?

1. Cardiovascular Endurance

2. Muscular Strength

3. Muscular Flexibility

4. Muscular Stability

5. Plyometric Strength

Each key prevention workout and their effect on decreasing the risk of injury are explained below:

Cardiovascular endurance is vital when lasting on the mountain run after run. The cardiovascular system delivers blood and oxygen to your working muscles. A conditioned cardiovascular system allows muscles to perform longer before fatigue occurs. Fatigue is one of the number one causes for injuries when skiing. The majority of injuries occur at the end of the ski day, when the muscles have lost their ability to use and produce energy efficiently. Start building up your cardiovascular endurance now by performing 3-5, 30-45 minute aerobic sessions per week. Some of the best choices for training the cardiovascular system are running, biking, rollerblading, stairmaster, elliptical, or arc trainer.

Muscular strength is also important when preparing for the ski season. The muscles and particularly the joints sustain a great deal of stress when skiing. Increasing strength increases the ability to endure the high stress demands of skiing. Even though skiing is a total body workout, specific major muscle groups are often used more including the quads, hamstrings, calves, low back, and core. During skiing the majority of your joints (knees, hips, ankles, and back) are kept in a flexed position, putting several muscle groups in an anti-gravity or eccentric loading position. Incorporating slow, controlled, eccentric training for the hamstrings, glutes, quads, and calves can help to improve your performance in turn decreasing your risk for injury. Some of the best ski conditioning exercises includes squats, split squats, ball hamstring curls, bridges, and calf raises.

Building strength in the legs is important for skiing, but so is building the strength of your core and low back. Remember, when skiing you are in a bent position which can place a lot of pressure on your low back. Improving your core and low back strength will help to offset low back discomfort. Core strength refers to not only strengthening the deeper, intrinsic muscles of the abdomen, but also the larger superficial muscles. The intrinsic muscles provide a “girdle” type of support between the rib cage and pelvis. The superficial muscles provide support for larger movements. Having a strong core improves your stability and decreases your risk for low back injury. Some great core exercises to incorporate into your ski conditioning program include plank, side plank, superman, birddog, and the dead bug series.

Muscular flexibility is another key factor when preparing for the upcoming ski season. Muscles need to be pliable when skiing. Tight muscles increase your risk for muscular sprains/strains or even more serious injuries including ACL tears, or avulsions. Since skiing is a predominately fixed, flexed sport attention needs to be given to hamstrings, hip flexors, calves, low back, and chest. Some light stretching of these areas should be performed before hitting the slopes and then more time spent stretching these areas again after skiing. Beneficial flexibility effects occur when the stretch is held for 30 seconds or greater. Try and stretch each muscle group 2-3 times.

When skiing, the terrain is always changing; therefore you must have excellent balance and full body stability. Increased balance and stability decreases your risk for falling due to enhanced proprioception along with an increased reactive ability to self-correct changes in your balance. Balance training can easily be added to you ski conditioning program by using equipment such as dyna discs, BOSU’s, and stability balls. Try those same exercises suggested earlier in the muscular strength section, but on a BOSU.

Plyometrics can be incorporated with stability training. Plyometrics are explosive movements such as jumping, power squats, and split lunges. Plyometrics are very stressful on the body and should only be performed after you have built a strong cardiovascular, strength, flexibility, and stability base. Adding plyometrics to your ski training regimen will help you prepare for the rigors of landing after bumps, jumps, and moguls, by training you how to absorb impact with a less rigid frame decreasing your risk for injury.

Preparation is prevention. This winter you’ll want to spend your time on the mountain not on the couch with an injury. You now have 5 key injury prevention type workouts to help prepare you for this season…..so get to work!

Casey Charlebois MS, MPT is a physical therapist and personal trainer with VIMG. If you have questions, you can reach her by email at casey@vailhealth.com. If you wish to jumpstart you ski conditioning program and get you season started right, call 926-4600 to schedule an appointment.

USA Taekwondo Rocky Mountain Open

Dr. Joel Dekanich assisted with medical coverage for the USA Taekwondo Rocky Mountain Open at the US Olympic Training Center in Colorado Springs, CO November 7-8.

Chiropractic and Easing Back Pain For Soldiers

Fox news Interview with Brigadier General Becky Halstead -Chiropractic and Easing Back Pain For Soldiers - http://bit.ly/2Hm22s

Evening with Phil Jackson

The evening with Phil Jackson was a memorable one. A great night for a great cause gave us an opportunity to hear some life lessons from the “Zen Master.”






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Graston Technique for Olympians

When at the Olympic Training Center last summer I was introduced to a technique that has great results for soft tissue injuries like tendonopathies, strains and myofascial adhesions. I set out to learn this technique and since implementing this technique into our practice this year, we have seen excellent results. Unlike massage, Graston® Technique Graston® Technique uses stainless steel instruments to break down fascia and help re-align the muscle fibers.

The Graston® Technique, originally developed by athletes, is changing the way clinicians view treatment of acute and chronic soft tissue injuries.

Graston® Technique is an innovative, patented form of instrument-assisted soft tissue mobilization that enables clinicians to effectively break down scar tissue and fascial restrictions. This technique utilizes specially designed stainless steel instruments to specifically detect and effectively treat areas exhibiting soft tissue fibrosis or chronic inflammation.

The curvilinear edge of the patented Graston® Technique Instruments combined with their concave/convex shapes molds nicely to the various contours of the body. This design allows for ease of treatment, minimal stress to the clinician's hands and maximum tissue penetration.

The Graston® Technique protocol induces micro trauma to the area, which increases the amount of cells that are associated with wound healing. The damaged tissue is replaced with new tissue. Ice is then applied to reduce the pain and exercise is implemented to increase function and range of motion.


Dr. Joel Dekanich is Clinic Director at VIMG and practices out of the Edwards Location. You can contact the Edwards office at 970-926-4600

For more information on Graston® Technique research click here.
For frequently asked questions about Graston® Technique click here.

Dr. Mark's Applied Physiology article is now available in free full text version

The Journal of Applied Physiology Nutrition and Metabolism has made the article "Reliability of electromyographic and force measures during prone isometric back extension in subjects with and without low back pain" available in a free full text format. Check it out here!

PGA Tour

This past June I had the opportunity to work my first PGA Tour event in Milwaukee, WI. Formerly known as the GMO (Greater Milwaukee Open), the US Bank Championships have been a Tour stop for many years and just so happened to coincide with the British Open where Tom Watson had his ‘almost’ amazing finish. Many people want to know what the medical staff does at the PGA Tour and here is a quick answer. At each PGA event there are two double wide trailers available for players to have treatment, rehabilitation and therapy before and after a player’s round. Many players use the staff to get stretched out before a round and/or get an adjustment or therapy if needed on a particular issue they might be having. Some is based solely on prevention while others have true injuries that need attention. The staff is comprised of two excellent physical therapists and one chiropractor as each event and they work in concert to what the players needs may be. These ‘moving clinics and gym’ have all state of the art equipment for treatment and therapy. What is probably most unique is that players have such a wide range of athleticism, fitness and body types yet are all the best golfers in the world!

A typical day is from as early as 5:30 am to about 7:00 pm and about half the field (80 players) was treated for various needs and conditions throughout the week. All in all it was a great week (in my home state) and I look forward to working more events in the future with such talented staff and players.

Joel

Control Over Pain

Pain is created and transmitted in the body. It is an unpleasant sensation, a signal to the body that it has been damaged. Pain is influenced by our beliefs, culture, stress level, and genetics. Pain may cause change in heart rate, blood pressure, breathing rate, emotions and behavior. When pain becomes chronic (lasting longer than 3-6 months) some people will stop doing things they once enjoyed. They may limit social activities, stop doing hobbies or sports because of the possible pain those activities may cause.

People in pain may loose a sense of control over their bodies, mind and spirit, becoming a hostage to their pain. There are many alternative ways of managing pain such as meditation and breathing techniques. These various techniques teach patients how to develop a locus or center of control over their pain. A gentle exercise or movement therapy that is used is QiGong. QiGong is one part of a multi-faceted system of Traditional Chinese Medicine. Most hospitals in China include QiGong as part of their health care program. It is one method of cultivating chi, a term used to describe the body’s vital energy system that promotes all activity of the human body. QiGong is included in physical therapy rehab programs at VIMG for patients suffering from headaches, stress related injuries, balance dysfunction and chronic pain management. It is part of the NorthBay Pain Management Essentials program which she co-founded in Fairfield, California and she uses it here at VIMG. Instruction is based on the DVD from the National Qigong Association. It gives patients an introduction to Qigong and Miki provides community resources if patients are interested in persuing their practice further.

The Healing Wave Project is sponsored by the National Qigong Association and an effort to expose all people to the benefits of Qigong. Their website www.nqa.org has information on how you can receive the Qigong DVD and more information about practioners in your area

Miki Blanchard is a physical therapist based out of our Eagle Office. She can be contacted at 970-328-1200
Click here to read more about Miki.

Eagle Boot Days

On May 16th, VIMG sponsored a tent and ‘jumpy house’ for the Boot Days festival in Eagle. More than 1,500 participants took part in Eagle’s fun and sun along with the 10K Bone yard Boogie. Physical therapists’ Miki and Dave Blanchard along with Dr. Stanzel provided free injury assessments and consultations throughout the day. Most of these came from mid air collisions in the jumpy house!

And Miki rubbed her forearms and fingers raw while doing 5 (yes 5!) hours of free chair massage...which was as popular as the jumpy house...just older crowd!

Annual Chiropractic Sports Sciences Symposium

Last weekend I attended the ACBSP (American Chiropractic Board of Sports Physicians) annual sports medicine symposium in San Diego. Besides leaving four feet of newly falling snow into warm, sunny ‘beach’ weather, the seminar was packed with great speakers and relevant sports science updates. Of interest to me were the medical directors of the USOC (United States Olympic Committee) Mike Reed, DC, DACBSP and John Reasoner, MD discussing the new model of sports care at the USOC and primary care issues during international competition at the Olympic level. Having recently returned from Beijing, several sports chiropractors also gave presentations regarding specific cases from last summer’s Olympic Games. Having been at the USOC training facility in Colorado Springs the two weeks before Beijing, it brought back great memories of that environment. Drs. Tim Brown and Doug Anderson also gave their consistent great lectures. The annual conference is also a great time to hook up with great friends and colleagues of mine from around the country.

Joel Dekanich, DC, DACBSP, EMT, CSCS
Diplomate American Chiropractic Board of Sports Physicians

Arnold Palmer Invitational at Bay Hill

March 25, 2009

I had an opportunity to spend a morning with Scott Fonda, DC, DACBO in the medical trailer at this recent PGA Tour event. Scott has been on the staff for the PGA for the past 3 years. Days working as the staff chiropractor are long (5:30 am to as late as 7:00 pm) but he says that working with the PGA players is extremely rewarding. Many of the players are very interested in a higher level of fitness and health that focus on strength, agility and endurance. Golf (and travel) is very demanding on the spine so many players get worked on daily when at an event. The ‘team’ is comprised of two physical therapists, a chiropractor and the medical director.

Joel

Chiropractic Board of Sports Physicians in Vail

In February, several DC's from around the country met at the Arabelle in Vail for the practical committee with the American Chiropractic Board of Sports Physicians. Pictured (left to right) are Jeff Hebert, DC, DACBSP, PhD (c), Park City Utah, Josh Sandell, DC, ATC, DACBSP, Minneapolis, myself, Darren Hancock, DC, CCSP, Chicago and Tim Schardein, DC, DACBSP, Denver.

We are responsible for scenarios and relevant current content for the diplomate practical examination for the ACSBP. It is always great to 'hang with my crew' and these guys are some of the best minds and clinicians in the country.

Dr. Joel

Pilot study finds chiropractic care and physical therapy may reduce costs and need for surgery

After only one year, a pilot program designed to measure patient quality of care shows significant clinical outcomes and health care cost reductions. The Wellmark Blue Cross and Blue Shield 2008 pilot was a quality improvement program for Iowa and South Dakota physical medicine providers. A total of 238 chiropractors, physical therapists, and occupational therapists participated in the pilot, submitting information on the care provided to 5,500 Wellmark members with musculoskeletal disorders.

"...89 percent of the Wellmark members treated in the pilot reported a greater than 30 percent improvement in 30 days. . . . The comparison showed that those who received chiropractic or physical therapy care were less likely to have surgery and experienced lower total health care costs."

Data from participating clinicians show that 89 percent of the Wellmark members treated in the pilot reported a greater than 30 percent improvement in 30 days.

In addition, Wellmark claims data for members who received care from chiropractors or physical therapists was compared with data for a member population with similar demographics (including health) who did not receive such services. The comparison showed that those who received chiropractic or physical therapy care were less likely to have surgery and experienced lower total health care costs.

Commenting on the value of the program's data collection and reporting, Dr. Shayan Sheybani, clinics operations administrator at Palmer College of Chiropractic, said the following: "The faculty, staff, and interns of the Palmer Clinics were able to objectively and consistently gather valuable information for services provided for our Wellmark patients that support the College's commitment to providing quality patient care. Overall, we have a positive impression of this program, and we are planning to continue our participation during the 2009 fiscal year. Continued participation in Wellmark's pilot satisfies our desire to contribute to new knowledge, continual improvements, and the development of quality-focused patient care."

Pamela A. Duffy, PT, PhD, OCS, Wellmark's physical medicine director, believes the results are reflective of the participants' commitment and dedication to providing quality care. "Participants in our first pilot on quality are dedicated to pursuing professional development, improving quality health care, and helping their patients live the most productive and pain-free lives possible. Wellmark is very pleased with the clinical outcomes demonstrated by these practitioners, and will continue working with providers to design programs that help evaluate the value of physical medicine services for members."

Triad Healthcare will continue to administer the 2009 program for Wellmark, which is open to participating Wellmark medical and osteopathic physicians, podiatrists, chiropractors, physical therapists, and occupational therapists in Iowa and South Dakota. To obtain additional information about the 2009 Physical Medicine Pilot on Quality, contact Wellmark at 800-799-0199, option 1.

Wellmark, Inc., does business as Wellmark Blue Cross and Blue Shield of Iowa. Wellmark and its subsidiaries and affiliated companies, including Wellmark Blue Cross and Blue Shield of South Dakota and Wellmark Health Plan of Iowa, Inc., insure or pay health benefit claims for more than 2 million members in Iowa and South Dakota. Wellmark Blue Cross and Blue Shield of Iowa, Wellmark Blue Cross and Blue Shield of South Dakota, and Wellmark Health Plan of Iowa, Inc. are independent licensees of the Blue Cross and Blue Shield Association.

Source: Wellmark