Take Control of Your Pain with the McKenzie Method

When pain becomes so severe that it impedes or obstructs your life – and the quality thereof – it is time to take decisive action. For some of us, our backs hurt so much that it is virtually impossible to get out of bed. Others might experience a burning, stabbing pain in the legs from sciatica, which – aside from being deeply unpleasant – can severely reduce mobility. Still some people are affected by a throbbing, aching pain in elbow and knee joints, which often results in losing practical limb function for stretches of time. Indeed, if we are unable to simply get out of bed, walk from one place to another or achieve simple movements with our arms and legs, we are in a situation in which pain is utterly controlling, dominating and possibly even ruining our lives. Wouldn’t it be nice if there were a way to take back control of our pain – and therefore our lives – with an innovative and credible therapy that has a remarkable track record of success? 

Thankfully this isn’t a pipe dream – it’s called the McKenzie Method of Mechanical Diagnosis and Therapy. It takes its name from its inventor, New Zealand Physiotherapist Robin McKenzie and it has been successfully used as an interactive way to treat, neck, spinal and extremity pain for more than 30 years throughout the world. Our McKenzie Method therapists at the Mount Sinai Department of Rehabilitation Medicine are trained to assess and diagnose our patients musculoskeletal systems to locate and subsequently treat any pain issues in or around joints and/or muscles.

Prospective patients who believe that the McKenzie Method might be a viable option to help them mitigate and hopefully eliminate their pain symptoms will begin with an initial assessment with one of our therapists. No expensive and potentially intimidating tests like an MRI are generally required. All we’ll want to do is conduct a safe and reliable screening of your musculoskeletal system by testing the mechanics of your body and seeing its responses to various positions and movements.

If our McKenzie Method clinicians believe this treatment is for you, you will be classified into one of three syndromes:

·     Posture Syndrome – When normal soft tissue becomes painful due to prolonged postural stress.

·     Dysfunction Syndrome – When pain is caused by mechanical deformation of structurally impaired soft tissue, usually from scarring or adaptively shortened tissue.

·     Derangement Syndrome – The most common classification and refers to pain caused by a disturbance in the normal resting position of joint surfaces. 

Based on your classification, Mount Sinai’s McKenzie Method therapists will tailor a treatment plans specifically for you that will involve a range of safe and effective exercises to do with your therapist at one of our Mount Sinai locations and some others for you to do on your own at home that will quickly set you on your way to a life of which you are in control, with less pain and greater bodily mobility and function. 

If you suffer from sciatica, arthritis or shooting pain in your shoulders, upper arms, hips or buttocks, intermittent pins and needles or numbness in your feet or hands, aching elbows or knees or you have difficulty bending down as a result of a stiff and painful lower back, the McKenzie Method might just be the treatment you have been looking for.

If you any of the pains or symptoms mentioned in this blog are similar to the ones you are experiencing, get in touch with us at (212) 241-6321 to see if the McKenzie Method is right for you.

What Is An EMG/NCS And How Can It Change Your Life?

At Mount Sinai’s Department of Rehabilitative Medicine, we will sometimes refer patients to complete an Electrodiagnostic test when an underlying muscle issue is unobvious. These tests are helpful in evaluating weakness, numbness, and pain; and there are two main components in the examination – the electromyographic examination (EMG) and the nerve conduction study (NCS). 

While the EMG and NCS are different tests, they’re often used together as the information from each test synergises with the other, giving a more complete analysis.

The tests will inform our physicians on unexplained muscle weakness, twitching, paralysis, and find the cause of numbness and pain the patient may be experiencing. Most importantly, it informs your physician on whether there is a muscle disorder in the muscle itself, or within a nearby nerve.

The EMG and NCS are considered non-invasive imaging tests, although there will be a needle involved. Your physician will insert a very fine needle, which acts as an electrode through the skin and into the problematic muscle. You will be asked to begin contracting the muscle by moving the area local to your symptoms. For example, the needle will be placed into the tricep, and the patient will slowly extend the arm, contracting the tricep with increased force as the electrical activity is recorded. Activity within the localized area will be visualized and available to watch on an oscilloscope and played audially through a speaker. These results can inform our physicians on the muscles ability to respond to nerve stimulation.

Nerve stimulation is often reported to causes a tingling sensation however there are no long-term effects. The EMG and NCS usually require an hour to complete and there are no restrictions in activities or meals before or after the test. Patients however do frequently feel some minor discomfort, similar to an injection, when the needle is inserted – with examined muscles feeling sore for a few days. There may also be light bruising in the affected area.

The results will also be able to help us diagnose neuromuscular diseases, and motor control disorders such as carpal tunnel syndrome or muscular dystrophy. From this point, there is no general direction as results will vary, and diagnosis will simply point you toward the optimal rehabilitation.

If you are suffering from an undiagnosed muscle issue and think you could benefit from a EMG/NCS diagnosis please contact our switch on (212) 241-6321) to see if our physicians can further help.

When Should You See A Doctor?

This week we are going to give you our advice on an often dreaded question:

When Should A Niggle Become Visit to The Doctor?

Knowing exactly when to see a doctor when being affected by a minor sports injury is like asking “how long is piece of string?” Obviously, it depends on the string. It is a common question asked in our field as many players have niggling pains and aches but notice that often they go away on their own. When should you go and see someone?

 There is a general key we have created to help you decide when you should visit a doctor or specialist because ultimately it is up to you. But don’t worry, we aren’t copping out – we are going to guide you through a self-diagnosis soon. But firstly, due to the nature of sports injuries we cannot all diagnose over the internet for two reasons:

i)                 Everyone heals differently

ii)               Injuries vary in severity

It is therefore difficult to determine when the ideal time is to visit a doctor without knowing more. Of course, if you have recently suffered from a sport related injury and cannot see a physician, remember the PRICE procedure we discussed earlier this month (click here to learn more).

The first question you need to ask yourself is: is this injury preventing me from functioning? Generally, if your pain isn’t bad enough to shut you down completely but still preventing you from performing at your peak day-to-day then you should see your physician. This makes it difficult to time stamp when is most appropriate as it depends on your circumstances. A bricklayer who sustained a painful blow to shoulder while playing American football will want to be seeing a physician almost immediately as it would affect his capability to function day-to-day. An office clerk may on the other hand want to wait it out as it doesn’t affect their functionality.

Secondly, and this response is mostly applicable to sportspeople, are you doing what want to do as well as you could be doing it? That is, if you have a niggle that is preventing you from functioning at your highest potential level – then you should get it seen by a physician or doctor. A slight pain in the shoulder can be ignored by most people and left to heal by itself; however, a slight pain in the shoulder for a pitcher or quarterback can diminish their performance week-in and week-out. It is also at a higher risk of deteriorating as you are using the joint more frequently and more intensely. If this is you, get it checked out!

If you have suffered from anything mentioned above and believe you could benefit from a rehab plan or require medical attention, please contact us at Mount Sinai Department of Rehabilitative Medicine for a bespoke rehab plan. We’ll get you back on the field ASAP. Contact our switchboard at (212) 241-6321

What is Tennis Elbow? What Can You Do About It?

Noting that baseball season is well underway, let’s take a look at one of the more common issues affecting baseball players – tennis elbow. Most baseball players don’t play tennis, or at least that we know of, however, they seem to get this strange pain in their elbow? Why is that? This week, we will identify what tennis elbow is and how we can cure it.

What is Tennis Elbow?

Tennis elbow is a condition that causes pain around the outside of the elbow. It is clinically known as lateral epicondylitis and is often the result of strenuous overuse of the muscles and tendons of the forearm, near the elbow joint.

The elbow joint is surrounded by muscles that give dexterity to the elbow, wrist, and fingers. The tendons in your elbow join muscle and bone together and are what allow you to control the muscles of your forearm. Damage to this area causes the symptoms of tennis elbow.

Common symptoms of tennis elbow are pain around the outside of the upper forearm – below the bend of the elbow. This pain is usually exaggerated when lifting or bending the arm, gripping small objects such as pens, or when twisting your forearm – when turning a door handle or opening a jar. It is often difficult to fully extend your arm when suffering from tennis elbow.

Pain can range from mild discomfort to severe pain even when the elbow is still and worsens when you use the damaged arm. The episode usually lasts between six months and two years depending on treatment. The majority of people will make a recovery within a year.

What Can You Do About It?

Tennis elbow will tend to get better by itself and you can recover without treatment. In most cases, you won't need to do anything but rest. There are some things you can to help speed along recovery.

It’s important that you rest your injured arm and stop doing the activity that’s causing the problem. That can mean you will have to stop playing baseball, take a break from painting and decorating, and stop doing whatever activity that is damaging the area. Compressing the area with ice several times a day can help reduce internal swelling – alongside taking paracetamol or other pain reliefs.

You should follow our PRICE procedure which you can read about here.

Physiotherapy may be recommended by your physician for more serious cases. Massaging and manipulating the affected area can reduce stiffness and improve the range of motion in your arm.

If you have suffered from Tennis elbow, please contact us at Mount Sinai Department of Rehabilitative Medicine for a bespoke rehab plan. Contact our switchboard at: (212) 241-6321