"The doctor of the future will give no medicine but will interest his patients in the care of the human frame, in diet and in the cause and prevention of disease."
--Thomas EdisonJune/July 1999 Newsletter
This Issue:
- Safe Sport
- The Psoas
- "Changed Life": Layne Barlow
- Psoas Case Studies
- Health Tip: Stretch Break
- New Equipment: Regainer Table
- Dr. Rick's Resource Center: "What Dr. Frankenstein Forgot"
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- Wellness Classes
- Wellness Card
- Patient Survey
- Bottom of Page
Celebrating 10 years of
helping people achieve
optimum wellness
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Safe Sport
Like many of you, I enjoy exercise and outdoor sports. Late in May, my friend Bill Newman and I (yes, it's me in the photo) had a great time cross-country skiing and hiking up the White River Canyon to the base of Mt. Hood. That same weekend a hiker was missing in the Columbia Gorge for several days and a couple fell to their death on Mt. Hood. The American Red Cross First Aid and Safety Handbook has a wealth of safety tips for outdoor enthusiasts. Try one!...Mentally walk through your entire hike as you hope it will be. Ask yourself what equipment, supplies, and skills you will need. For more safety and exercise tips, call me at 503/257-1324.
Top | BottomThe Psoas
- A Key to Relieving Pain in your low back
- Hidden Influence on Posture
"Oh, my back hurts."
While you may feel the pain in your back, the problem often arises in the front of the spine, where the large psoas (pronounced "so-as"... the "p" is silent) muscle lies hidden underneath your abdomen. Let's first examine the anatomy and function of the psoas muscle. Then let's apply our knowledge to finding solutions for the problem of low back pain caused by malfunction of the psoas.
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ANATOMY
As shown in the adjacent figure, the psoas major is a long, thick muscle that lies along the edge of the lumbar region of the spine. Psoas is a Greek word meaning the muscle of the loin. Butchers refer to the psoas muscle in animals as the tenderloin. It runs from the L1 to L5 vertebrae and associated T12 to L5 intervertebral discs down across the pelvis. It is joined by fibers of the iliacus muscle that starts from the inside surface of the pelvis. They blend together, forming the iliopsoas muscle, and insert on the thigh at the lesser trochanter of the femur. Overall, the iliopsoas, or just "psoas" for short, connects the low back with the upper leg.
FUNCTION
The psoas has two primary functions:
- When the leg is free to move, as when walking, it is a strong flexor of the thigh at the hip joint.
- When the leg is planted firmly, as when standing or sitting still, it bends the lower spine forward.
MALFUNCTION
When you sit the psoas is in a shortened position. When you sit a great deal, as many of us do, it tends to stay short, even when you stand up! The shortened psoas then pulls the lower spine forward. The paraspinal muscles of the low back then counter this pull by tightening, much as support lines on a radio tower, tent pole or mast of a sailing ship. This tug of war pulls the spine down, compressing the facet joints and intervertebral discs of the lumbar spine. The facets become irritated, causing a nagging, aching low back. The discs degenerate over time, becoming thinner and less flexible. The degeneration makes them more susceptible to bulging or tearing, especially with twisting and bending. The disc may even herniate and press on the sciatic nerve, causing unbearable pain down one or both of the legs.
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PRESENTATION
Patients typically come into my office complaining of an aching low back. Occasionally, when the psoas is extra tight on one side, they will be twisted. They may have sciatic pain down one leg, but the predominant pain is in the low back, just above the pelvis. Thomas' Test (see photo) is often positive for a short psoas. Overall, they will have reduced mobility of the low back.
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STRETCHING OF THE PSOAS
You can stretch your psoas in several ways. As explained in The Wharton's Stretch Book, to stretch the right psoas using their active isolated stretching technique, "Position yourself on your hands and knees (see figure). Reach back with you right hand and grasp your right ankle. Reaching it will require that you lift your right foot to meet your hand. Hang on tightly. Using the hamstrings and the gluteus maximus (buttocks), lift the exercising leg up until the thigh is parallel to the ground -- or aligned horizontally with your body. Be careful not to arch your back (hyperextension). You may use your hand for gentle assistance at the end of the stretch." (Please contact me at 503/257-1324 for a personal explanation of this psoas stretch.)
PROFESSIONAL TREATMENT
Once the psoas has become chronically shortened to the point where your back aches, my experience is that you require professional chiropractic help. Unfortunately, many chiropractors concentrate only on the back and ignore treating the psoas on the front. The best treatment I have found is an active myofascial and muscle release that I learned in postgraduate massage therapy classes. It is performed from the front, pressing into the abdomen. Considerable skill and care is required to release the tight psoas and the associated fascial covering while not injuring the abdominal organs, so I recommend you seek the help of an experienced professional. Don't just ask a friend to push into your belly!
Most cases respond within four to eight treatments, although I have had some cases where we have had to work for about two months to achieve the desired increase in flexibility and relief of low back pain. In such cases there is often a hindrance to progress, such as counterproductive sitting in a poorly designed chair or standing with poor posture.
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"How One Life Was Changed"
Layne Barlow came to me bent over in pain, suffering severe spasms of his low back muscles. The psoas muscle was the main culprit, twisting Layne's pelvis and back to such a degree that it prevented him from standing up normally. With a treatment plan that included release of the psoas muscle, adjustments of his low back, and natural anti-spasmodic herbs, Layne was able to walk straight again after just four days of daily treatments. Looking back at his care, he wrote to me, "Chiropractic doesn't involve surgery and gets results. I'm all for it!"
Top | BottomRESULTS...TWO CASE STUDIES
The best way to explain the difference release of the psoas muscle can make is to give you two case studies. Let two of my grateful patients explain in their own words:
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Michelle Uttke referred Chad Bartmess, her dance student, so that I might help Chad with chronic low back pain that hindered his competitive dancing. I focused treatment on the psoas, performing myofascial release and stretching. Summarizing his experience, Chad told me, "After years of pain and discomfort from low back and neck injuries, continuing therapy and repeated attempts to get me to undergo surgery, I gave up! No sign of relief in sight until I heard Dr. Rick talk on posture at Michelle Uttke's dance studio. Michelle recommended that I see Dr. Rick for help, as she had done. After two months of treatments I feel great. I can move, turn, bend and dance like I have not been able to do for years! Thanks, Dr. Rick."
Judy Rush is an office worker here in Portland. Approximately three years ago she developed low back pain following a cross-country airline flight. She was examined and treated by several medical doctors, who ruled out serious pathology and sent her to physical therapy for exercises. She had several sets of x-rays and a magnetic resonance image (MRI) of the low back that did not reveal the problem. Nothing seemed to help. The pain in her low back persisted for three years until I performed myofascial release and stretching on her psoas muscles. To help her long-term, I had her employer's ergonomic specialist evaluate and correct her desk and chair to fit her properly. Judy explains just what a difference treatment has made: "Since Dr. Rick has been treating my psoas muscles, I have started to enjoy life again. I have suffered the last three years from chronic low back pain. Through weekly massage and chiropractic adjustments, in additional to stretching at work and home to keep the psoas muscles stretched out, my chronic low back pain is almost non-existent. It's amazing how these muscles affected my quality of life for the worse. I feel better now than I have for the last three years!!!"
Top | BottomHealth Tip
Take a brief stretch break every 15 minutes while at the computer. Get your eyes off the tube, roll your shoulders, bend left and right, shake out your arms and hands, stand up, leaning back to stretch the psoas. You'll feel better and be more productive.
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"The person who cannot find time for exercise must find time for illness."
Top | BottomNEW EQUIPMENT...for you?
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Recently I made a substantial investment in Chiropractic Biophysics equipment. This new Regainer Table is being used by Matthew Miller to regain proper posture.
It has already eliminated Matthew's daily severe headaches. For a further explanation of Chiropractic Biophysics and how the equipment might help you, please call me.
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Don't Forget Dr. Rick's Resource Center
Contact Dr. Rick for What Dr. Frankenstein Forgot, a fearless 7-minute cassette tape, available free to current, new, and prospective patients. For your benefit Dr. Rick has a large collection of health, chiropractic, and nutrition books and tapes in his lending library.
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New! Dr. Rick's Chiropractic Wellness Classes
In response to the overwhelming requests for additional health and wellness information, I will be giving regular, monthly presentations for exisitng, new and prospective patients. The first will be a 1-hour multi-media presentation Monday June 28, from 7:30 to 8:30 p.m. at my clinic, "Getting Rid of Common Office Complaints: Headaches, Low Back Pain and Carpal Tunnel Syndrome."
The second talk will be Tuesday, July 27 at the same time and location, topic to be announced. Each talk will incorporate practical chiropractic tips for lifelong wellness. Call Dr. Rick at 503/257-1324 to reserve your spot!
Check out current month's wellness class
Wellness Care Options:
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Choose your care, or we can decide together what is best for you now.
- COMPLETE CARE $45
- Chiropractic adjustment
Massage
Nutritional, exercise suggestions
Up to 45 minutes- WELLNESS TUNE-UP $35
- Chiropractic adjustment
Brief massage
Brief self-care suggestions
Up to 30 minutes- BRIEF ADJUSTMENT $25
- Chiropractic adjustment
Up to 20 minutesWhat to Expect on Your First Visit
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Wellness Card Program
Ask Judy Rush about wellness. She's a believer! Her story is above. Or ask any of my wellness patients whether wellness makes a difference. It does. The wellness options above provide affordable options for you to maintain optimum health. Dr. Rick's Wellness Card allows you to save $25 on your 5th wellness visit for your first round of sessions. Please call me to discuss the value of wellness for you or to make an appointment.
Conveniently located in Portland, Oregon, at 221 NE 78th Ave (between Glisan and Burnside, near I-84 & I-205)
Top | BottomWhat Happened to the Patient Survey?
Thanks so much for the overwhelmingly positive response to my patient survey. Over 75 people responded, 95% of whom rated my overall service "outstanding" or "excellent." Of many helpful suggestions offered, I'm implementing two immediately: 1) improve my newsletter; 2) start a wellness class. That newsletter is before you. The first class is June 28. Details above. MORE IMPROVEMENTS TO COME!
Dr. Allen lectures about wellness and other health-related topics. To attend a talk, or have him talk to your group, please call 503/257-1324. To learn more about anything in this newsletter, or any upcoming newsletter, please contact Dr. Allen.Dr. Rick Allen is a chiropractor, massage therapist and dance student in Portland, Oregon. Dr. Rick welcomes your questions and suggestions for future articles. However, he cannot make specific diagnoses or treatment recommendations unless you visit him in person. He can be reached by phone: 503-257-1324, mail: 221 NE 78th Avenue, Portland, OR 97213, e-mail or World Wide Web: www.CascadeWellnessClinic.com
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