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What’s the first thing that comes to mind when somebody brings up chiropractic? Commonly when people think of going to the chiropractor, they most often associate that with getting “cracked” or “popped.” In todays blog we will dive into what a chiropractic adjustment actually is and how it can be helpful for treating pain.

The musculoskeletal system is made up of muscles, bones, joints, cartilage and tendons, all of which together gives us the ability to move and also plays a vital role in protecting our organs. Since the musculoskeletal system makes up the overwhelming majority of our bodies, it is no wonder that it is to blame for so many pain driven conditions. This being said, lets talk about how chiropractic adjustments can be helpful in treating pain.

A chiropractic adjustment is a therapeutic treatment that uses controlled force directed at a specific joint in the body. Within the musculoskeletal system, there are well over 300 joints, all of which play a vital role in proper function of the body. When a joint is not moving properly, it often times results in pain. When this is the case, a chiropractic adjustment can be applied to that specific joint, which helps to restore function, range of motion and decrease pain.

During a chiropractic adjustment it is not unusual to hear an audible “popping” sound. This is caused by the release of small pockets of gas trapped from within the joint, while it is being taken through a full range of motion during the adjustment. Although this does not always happen, nor does it need to happen for an adjustment to be effective, it is a phenomenon that is often times associated with the adjustment. After a adjustment is performed, the joints within the body are able to move through a greater range of motion which helps to restore natural body function.

As complex as our musculoskeletal system can be, we can greatly reduce the risk for pain when all joints are moving as they were designed to do. Benefits of getting adjusted are quite vast and include everything from improved mobility and balance to decreased pain and muscular tension. The chiropractic adjustment is a researched and proven technique that is safe and effective for restoring proper motion within a joint, helping to improve overall body function. The chiropractic adjustment plays a vital role in our success with decreasing pain and increasing function with almost all of our patients. When paired with other modalities such as acupuncture/dry needling, soft tissue therapy and dynamic rehabilitation we are able to provide a comprehensive and integrated plan to help them achieve their goals in a timely fashion. Do you feel like your body is holding you back from doing the things you love to do? If so, chiropractic care may be a great option for you. Give us a call at 317-449-2020 with any questions you may have or to set up an appointment so we can help get you back to doing the things you love.

Content provided by Dr. Milton Brinza

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Call it dry needling, call it acupuncture, whatever you want to call it – it works. Dry needling acupuncture therapy has shown to provide some of the best results in our clinic. But, what is actually happening when all those filaments are put into your body? Why is it that those teeny tiny filaments are so powerful?

Let’s begin with differentiating dry needling and traditional Chinese medicine (acupuncture). At IHS, we use the same size filaments as those used in TCM. TCM focuses on placing the filaments along the meridians or channels discovered over 3,000 years ago to be the most effective in all types of healing, not just musculoskeletal. Dr. Ma, founder of Integrative Dry Needling, states that dry needling is the evidence-informed practice of ancient Chinese medicine. Dry needling focuses on finding the trigger points aka those knots and ropes you feel in your muscles in order to restore tissue extensibility. TCM also tends to place the filaments more superficially whereas the depth of dry needling varies based on the muscle, tendon, or ligament being addressed.  Interestingly, Dr. Ronald Melzack found that more than 70% of classic meridian acupoints correspond to common trigger points. 

Now for the fun stuff. How can one little 0.25mm gauge needle be so effective? According to Dr. Ma, inserting a single filament with a depth of only 1 cm can break at least 1,000 muscle fibers. When pushed deeper, tens of thousands of muscle fibers as well as come capillaries and nerve endings are damaged by the filament. Now, multiply that by however many filaments have been inserted, and you can see how powerful this form of musculoskeletal treatment truly is.

You may be thinking at this point, why would these nice doctors be wanting to injure my tissue? This is because the brain is able to identify the trauma caused by the filament and direct your body’s natural healing processes to that area. Your cardiovascular, immune, and endocrine systems are able to target the damaged region and replace it with fresh tissue within just a few days.  Not only is short-term pathology addressed, but chronic pathology is also prevented by promoting self-healing and reducing both the mechanical and biological stress on the body. Another bonus – the filament is so thin that you barely feel it inserted – if at all!

Keep in mind that according to Janet Travell, after an injury, tissues heal, but muscles learn, they readily develop habits of guarding that outlast the injury. You do not always have to be in pain to benefit from acupuncture/dry needling. Myofascial pain involves tissue inflammation, tissue contracture, swelling, degeneration, tissue adhesion, scarring, and biomechanical muscle imbalance. All of these changes outlast the pain itself, which you may not notice until one day your shoulder starts to hurt, or your back is a little tense.  

In short, even without pain, there still may be trigger points and imbalances causing repetitive dysfunction throughout the body.  One of the purposes of dry needling acupuncture therapy is to lower the stress in muscles so that they can absorb more force during sporting activity and thereby prevent or reduce stress-related injuries to the musculoskeletal system. If the muscles are tight, they will pull on the tendons, causing the tendons to be tight, and so on and so forth. 

Here at Integrated Health Solutions, we have seem amazing results with dry needling acupuncture therapy. What were thought to be cases of frozen shoulder were actually just some dysfunctional tissues that were able to be relieved by dry needling and rehab after just 8 visits.  Presumed hip labral issues were overactive hip flexors that were able to be released via dry needling and some exercises to get the patient back to all activities of daily living. The cases could go on and on. Give it a try for yourself!

Content provided by Jennifer Brenneisen

Reference: Ma, Y.-tao. (2011). Biomedical acupuncture for sports and trauma rehabilitation: dry needling techniques. St. Louis, MO: Churchill Livingstone/Elsevier.

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Do you suffer from a chronic shoulder pain? Were you told it was a rotator cuff injury? What is a rotator cuff?

Let me begin by answering the latter question: the rotator cuff is comprised of four muscles that surround the shoulder joint: Supraspinatus, Infraspinatus, Teres Minor and Subscapularis (SITS). The origins of these muscles are found primarily along the scapula (your shoulder blade), along with 9 other muscles! The scapula is what keeps your arm attached to your body and allows fluid motion of your arms away from your body during movements like swinging a golf club, lifting weights and throwing a ball.   Together these structures provide support from your arms to your core.  Without proper stabilization and joint centration, the shoulder becomes more susceptible to pain and injury.

Simply put, imbalances in the muscles actually change the axis of motion in the shoulder, decreasing range of motion and function and increasing the likelihood of injury.  Terms like “frozen shoulder”, “scapula winging” and “impingement syndrome” are the results of instability around the shoulder joint.  Overuse syndromes or a “tendinosis” can occur when imbalances cause certain muscles to be overworked while others are left over-utilized.  This causes an inability to incorporate proper sensory input to the muscles, which in turn further reduces the range of motion.

Now lets address the issue of chronic shoulder pain. It is important to understand that shoulder issues don’t necessarily have to occur from one particular instance.  In fact, most people with shoulder complaints report no history of trauma or even diagnosis from a doctor.  In my experience, patients have convinced themselves that the shoulder “has given out” or “is all screwed up” from age and or activity.  Some patients just give up; others seek help but aren’t being supervised properly. Even those under professional care may be missing the underlying cause of symptoms.

If you have been doing months of rotator cuff strengthening exercises with rubber tubing and you still have shoulder pain, you may need to readdress your treatment protocols.  Without a strong base of support to work from, the rotator cuff will never be able to fully recover. The shoulder and arm can only get as strong as the muscles that hold the shoulder blade onto your body.

At Integrated Health Solutions, we work with athletes at all levels to assess, diagnosis and treat the kinetic dysfunction in the body, not just the symptoms.  In regards to shoulder complaints, techniques such as stretching the posterior shoulder capsule, strengthening the muscles that hold your scapula in place (SITS muscles) and stretching/relaxing the tight/overused muscles that pull the scapula into a different position have had excellent results.  Chiropractic manipulations and soft tissue techniques such as myofascial release, Graston, and kinesiology taping are designed to address these issues on functional, anatomical, and neurological levels. Medical dry needling has proven to be an extremely valuable tool for pain – “Adding trigger point dry needling to an exercise program for patients with chronic shoulder pain may be more cost-effective than exercise alone, according to a recent clinical trial. The combined intervention led to improved quality of life and lower…costs than exercise alone,” write authors in Pain Medicine.

Content provided by Dr. Drew Hunt

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TMJ, or temporomandibular joint, is the joint that connects your jaws to your skull. Temporomandibular joint disorder, otherwise known as TMJD, is a disorder of the joint that may create discomfort and pain not only in the joint itself, but the pain may also be sensed around the ear, in the neck area and in the head, often resulting in headaches.

Many of our patients come into our affordable chiropractic clinic, unaware that their symptoms are caused by their TMJD. They often express that their pain is in their neck, around their ear, and up into their head. In addition, many of them describe a sensation of clinching and grinding their teeth, and a feeling of tightness around their jaw. After a thorough exam, we are able to link their symptoms to TMJD.

There is no direct causality of why TMJD occurs, however in most cases it is contributed by tension in the temporal musculature, otherwise known as the temporalis and the masseter muscle, which are the chewing muscles located in your cheek. This tension, that develops, often in forms of trigger points within the muscle fibers, restricts the muscles and joint from their proper function, making the joint problematic and symptomatic.

What can you do to help reduce your TMJD symptoms?

TMJD can be considered a biopsychosocial matter. At our Indianapolis chiropractic clinic, we begin by encouraging and educating our patients on the importance of eliminating external factors and stressors, whether emotional or environmental; many are able to do so through meditation, breathing exercises, and journaling.

In addition, maintaining proper mouth posture will help eliminate undue stress on affected muscles. A proper mouth posture is maintained by keeping lips sealed, teeth slightly separated, with your tongue resting just behind your upper teeth. It is important to be aware of your body posture, as well, when driving, eating, and sitting at a desk. We also recommend refraining from chewing gum, and when possible, chew your food equally on both sides.  We do encourage our patients to consult with their dentist, to make sure there is no dental work that needs to be addressed.

An integrated approach to address the TMJD is the most appropriate treatment plan. At our Indianapolis chiropractic clinic, we address these symptoms and disorder by administering different soft tissue therapies, and when necessary, we incorporate acupuncture and dry needling into the treatment plan. This approach diffuses the trigger points and the tension that has formed along the jaws and the temporal areas, which will also help reduce anxiety and tension.

If you are suffering from tension in your jaw or neck, are suffering from frequent headaches, or have found yourself clinching and grinding your teeth, call our affordable chiropractic clinic, today at 317.449.2020 to see how we can help.

About Integrated Health Solutions

Dr. Charbel Harb is a licensed chiropractic physician and the Medical Director of Integrated Health Solutions. Our core belief is that each patient who walks through the doors is a person, not just a medical record or chart. Our greatest pleasure is bringing joy to our patients and helping them to fully embrace life, allowing them to enjoy each day: active, healthy and pain free.

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I am often asked what dry needling is, and how it works. Dry needling, in a sense, is very similar to acupuncture, when it comes down to the tools that we use. We use very thin filaments, which are inserted into the tissues, such as muscles, tendons, and ligaments that are dysfunctional and deranged. However, with dry needling, our main focus is on musculoskeletal pain, reduction of pain, and enhancement of soft tissue function.

In a simple form, dry needling normalizes and resets the muscles and tissue to its original homeostatic function. For instance, if a muscle is too tight, tense, and has trigger points and adhesion, dry needling resets it back to a normal density with no spasms or tension. On the other hand, if the muscle is inhibited and is not functioning, as it should, dry needling will reset the mechanism in that muscle, helping to reawaken it.

There are several theories about how dry needling works. One of the predominate theories was proven by observing the brain in a functional MRI, while a patient was treated with metal needles that were not conductive to magnetic fields. This study showed, that the brain sensors responsible for pain reduction became more active, and in turn secreted pain reduction chemicals, such as endorphins.

Another theory suggests that the very thin filaments that are inserted into the tissue, even though they are quite thin and unnoticeable in almost all instances, create damage to thousands of cells. The brain perceives this damage, and initiates a healing effect and rejuvenation of the tissue.

In another study, it was shown that the biochemical changes that occur around the needle are favorable in reducing inflammation and pain.  A final theory of how dry needling works is a study that suggests that a properly placed needle in a triggered point of a muscle or tendon, will send a signal to the nervous system in a reflex form, which will reset the muscle and tissue fibers.

Dry needling differs from acupuncture, in a sense that it does not follow the meridian channels, and focuses primarily on musculoskeletal pain. At our Indianapolis chiropractic clinic, we utilize dry needling for a variety of symptoms, such as runner knee pain, TMJ, and headaches.

If you have been suffering with pain and are looking for an alternative treatment, contact Integrated Health Solutions, an affordable Indianapolis chiropractic clinic, today at 317.449.2020.

About Integrated Health Solutions

Dr. Charbel Harb is a licensed chiropractic physician and the Medical Director of Integrated Health Solutions. Our core belief is that each patient who walks through the doors is a person, not just a medical record or chart. Our greatest pleasure is bringing joy to our patients and helping them to fully embrace life, allowing them to enjoy each day: active, healthy and pain free.

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What is Tennis Elbow?

Tennis elbow, also known as lateral epicondilitis, is a medical condition in which the outer part of the elbow becomes inflamed and painful. This injury is directly related to a repetitive micro trauma, in which muscles of the forearm (the extensor muscles) become overused, leading to adhesion, tension, and tightness in the musculature. This in turn creates a pull and a tug on the bone (epicondyle) where the pain is felt.

Can Anyone Get Tennis Elbow?

Even though this condition is predominately present in tennis and racquetball players, it is is not an exclusive condition to the athletic population. In our clinic, we have seen this condition present in patients who use their arms at work repetitively on a daily basis, such as hair designers, office workers and chefs.

What Causes Tennis Elbow?

This condition is primarily correlated with overused and over activate muscles of the forearm, known as extensors muscles. These muscles become inflamed, hypertonic, adhesed and tender, in turn creating a tugging and pulling sensation on the insertion, which is a tiny bone of the forearm located at the elbow, which is most commonly where people with this condition feel their pain.

These tense, triggered, and adhesed muscles eventually form nodules within the muscle fibers, known as trigger points. The trigger points will contribute to a viscous cycle of additional pain in the area of the forearm and tension in the muscles, that again augment the pain at the side of the elbow and along the forearm muscles.

Can Tennis Elbow be Treated?

At Integrated Health Solutions, we have formulated a treatment plan that has been proven to be exceptionally successful. Dr. Charbel conducts a comprehensive exam, that not only includes the elbow, but also the shoulder and cervical area. We have found that in many of our patients there is a high correlation of elbow injuries and poor shoulder and upper back mechanics. These poor mechanics create additional and unnecessary demand on the elbow. This thorough exam allows us to have a greater success in the treatment of this condition. Most of our patients experience 80 to 90 percent relief from their symptoms within as few as eight visits.

The treatment plan typically includes soft tissue treatment, physical rehab, and exercises and stretches to the effected area, and to any other areas our exam indicates needs treatment. One proven therapy that we add to our treatment plan that is a key factor, is dry needling.

What is Trigger Point Dry Needling?

Trigger point dry needling is one of the most evidence based, clinically proven therapies that help us expedite the healing process, especially when it is used in conjunction with our other modalities. Trigger point dry needling, also known as medical acupuncture, is very similar to acupuncture, however, during this technique, Dr. Charbel addresses the affected area in addition to points throughout the spine, shoulders, and arms. This will help expedite the healing, and allow better nerve flow and help balance the musculature and eliminate the cause of the pain.

Trigger point dry needling has consistently proven in our clinical setting to have almost a hundred percent success rate in releasing tension, adhesion, and resolving trigger point formations within the muscle fibers and decreasing pain. Once these soft tissue muscles relax, the pulling and tugging on that little bone on your elbow (epicondyle) diminishes, which relieves the inflammation and the pain that you are dealing with.

Trigger point dry needling, when incorporated in our treatment plan allows us to address the cause of the pain and not just mask the symptoms. At Integrated Health Solutions, our approach to treating injuries is comprehensive, and addresses the cause. This is why when a patient complains of lateral epicondilitis, Dr. Charbel examines the entire upper body’s functionality and alignment, which will ensure better usage and faster healing.

Along with dry needling and the other therapies in our treatment plans, Dr. Charbel also reviews the mechanics that the patient utilizes. By enhancing the biomechanics of the different joints involved, stress is reduced on a daily basis. Patients are educated on different exercises and stretches, which will expedite the healing process, and eventually allow the patient to become self-reliant and manage their conditions on their own, and also prevent the injury from reoccurring.

For more inquiries on trigger point dry needling and tennis elbow, please do not hesitate contacting Integrated Health Solutions at 317-449-2020.

About Integrated Health Solutions

Dr. Charbel Harb is a licensed chiropractic physician and the Medical Director of Integrated Health Solutions. Our core belief is that each patient who walks through the doors is a person, not just a medical record or chart. Our greatest pleasure is bringing joy to our patients and helping them to fully embrace life, allowing them to enjoy each day: active, healthy and pain free.

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Working with an active population and athletes on a daily basis, I am constantly searching for cutting edge techniques that reduce recovery time by relaxing the body and healing it. For that, I am an advocate of utilizing dry needling.

Dry needling is a form of acupuncture, otherwise known as medical acupuncture, for treating patients with soft tissue pain and sports injuries.

Using dry needling and acupuncture at our affordable chiropractic office has never ceased to amaze me with the quality of the outcome and speed of the recovery from a variety dysfunctions, contusions, strains, among other sports and soft tissue injuries

What is Dry Needling?

“Dry,” as opposed to “wet”, needling is the gentle application and insertion of very thin filaments in the soft tissue, without injection of any liquid substance or medicine, to treat human tissue dysfunction and pain.

In lieu of just covering up symptoms, dry needling acupuncture focuses more on healing the tissue and addressing the cause of the symptoms. It’s more of a holistic approach instead of just focusing on symptoms alone.

Dry needling is a non-pharmaceutical or chemical therapy that promotes healing by decreasing mechanical stress of the body.

Why Sports Injuries?

Most sports injuries are related to soft tissue dysfunction, or tissue extensibility dysfunction, also referred to as TED.  Even when surgery is unavoidable, recovery from both the injury and the surgery always depends on restoring the physiologic function of soft tissue.

Increased workout frequency and repetitive workout sessions leads to different TED disorders, such as tension, adhesion, trigger points, decreased tissue mobility, scar formation, among others. All of which, will impact performance and training frequency. Its reach goes beyond just the physical stress, and begins affecting athletes on a psychological level, because they are unable to perform without a dysfunctional pattern or without pain. The psychological stress, that is caused by TED begins to affect the athletes emotional level, which in turn results in affecting other systems in the body, such as the immune, cardiovascular, and respiratory systems, the performance continues to decrease from that point. As you can see, TED reaches far beyond just a tissue disorder, especially when it results in increased pain and injuries that are beyond just the tissue itself. However, TED is easily fixed with proper therapy.

Dry needling is one of my favorite therapies in resolving TED and reducing trigger points with a technique known as trigger point dry needling. This method of dry needling aids in treating movement dysfunctions and enhancing athletic performance.

Dry needling is a great therapy for maintenance that helps improve recovery and rejuvenation from the micro-trauma caused by training and competing, allowing for faster recovery and continuous training with better performance.

Don’t hesitate in contacting Dr. Charbel, a licensed Chiropractor in Indianapolis, who is also licensed in acupuncture and dry needing, to start your recovery.

About Integrated Health Solutions

Dr. Charbel Harb is a licensed chiropractic physician and the Medical Director of Integrated Health Solutions. Our core belief is that each patient who walks through the doors is a person, not just a medical record or chart. Our greatest pleasure is bringing joy to our patients and helping them to fully embrace life, allowing them to enjoy each day: active, healthy and pain free.

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