What We Treat
Back Pain
Back pain can manifest in three primary regions: the neck (cervical spine), mid-back (thoracic spine), and low back (lumbar spine). Each area has distinct symptoms and causes. For example, neck pain typically appears as discomfort along the back or side of the neck but can radiate into the arms or hands. Mid-back pain is often linked to posture and may involve issues such as rib misalignment or even breathing difficulties. Low back pain is common, especially due to the constant use of core muscles during activities like bending or lifting, and may be accompanied by tingling in the legs or feet.
TMJ
TMJ stands for Temporomandibular joint but is more commonly known as the jaw joint. Located about one finger’s width in front of your ear, the TMJ deals with chewing, opening and moving your jaw side to side. Muscles both inside and outside the mouth influence the mobility of this joint and can influence how the joint is being utilized by the body. Common complaints for people that have issues with the TMJ include difficulty in opening the mouth, clicking/popping or excessive grinding primarily at night.
Shoulders
The shoulder joint is by far one of the most unique joints in the body for a multitude of reasons. The most unique property of the shoulder is also its greatest downfall: mobility. The shoulder has the highest mobility of any joint in the body by far, but high mobility comes at the cost of inherently low stability. Dislocations, rotator cuff tears and labral tears are common injuries that can occur due to the high mobility / low stability of the joint. Due to the naturally low stability of the joint, we have a vast array of muscles capable of providing strength and stability to the joint that come from the arm, chest, shoulder blade and even the low back.
Wrists, Hands, & Elbows
The wrists, hands, and elbows constitute one of the most complex musculoskeletal regions in the human body, featuring the highest concentration of bones, joints, and muscles. The forearm alone comprises over 40 muscles that enable precise control of wrist and hand movements. In the wrist and hand, 27 bones form an equal number of unique joints, supported by an additional 34 muscles and more than 100 distinct tendons and ligaments. Furthermore, discomfort in the hand may be attributable to neurological issues originating in the arm, shoulder, or neck.
Hips
The hips, home to the largest and most powerful muscle in the body, serve as the foundation for both the low back and legs. Pain in the hip region is typically categorized as front, side, back, or groin pain. Front hip pain is often caused by dysfunction in the hip flexor muscles or underlying hip joint issues like cartilage or labral damage. Side hip discomfort may stem from IT band problems, bursa sac irritation, or tendinopathy of muscles such as the gluteus medius, often linked to gluteal muscle issues. The back of the hips, housing the gluteus maximus and the sciatic nerve, can experience pain due to sciatic nerve impingement, with symptoms like burning, cramping, or leg numbness. Groin or inner thigh pain is typically associated with rapid movement or stability dysfunction in the hip, influencing knee stability and weight distribution while walking or running.
Knees
The knees are influenced by the largest and most powerful muscle group in the body: the quadriceps. Able to withstand and produce hundreds of pounds of force within short periods of time, this joint focuses on power generation and less on balance which is instead produced through the hips above, and the ankles below. The force produced through the quadriceps is transmitted through the kneecap or patella. Dysfunction or pain through the patella can result in decreased functionality of the quadriceps, which can produce widespread problems throughout the entire leg. Fun fact: the knee joint is the largest joint in the body by surface area, narrowly beating the more commonly assumed hip joint to be the largest joint.
Ankles and Feet
The ankles are the primary location for the production of balance when standing which is fine-tuned through the feet and toes. The bones that we think of as “ankles” are actually the ends of the two bones in the shin and are heavily influenced by both ligaments and muscles. The inner part or medial aspect of the ankle is innately stable, due to a cluster of ligaments called deltoid ligaments (different from the shoulder muscle). The outer or lateral aspect of the ankle has fewer ligaments and more muscles/tendons that create stability. It is this reason primarily why when we “roll an ankle”, the foot is tilted inward and the outside of the foot is injured and rarely the opposite. Two of the most common issues in this region are Achilles tendinitis and plantar fasciitis which in many cases are closely linked together.
Signature Diagnostic Treatments
Ischemic Compression
This technique allows for precise targeting of specific muscles to release tension and identify which muscles contribute to the patient’s issue. Typically used to address trigger points or muscle knots, ischemic compression works by temporarily restricting oxygen supply to an isolated area of muscle, preventing it from maintaining its contracted state and resulting in a sudden release. Patients will experience a gradual easing of pressure under the therapist’s fingertips, even though the therapist maintains constant pressure throughout the treatment. The expected relief from tension-related symptoms typically lasts between four and eight hours.
IASTM / Graston Technique
Instrument-assisted soft tissue massage (IASTM) involves the use of a plastic or metal tool to glide across the skin with the intent of breaking apart scar tissue and adhesions. These restrictive tissues can lead to chronic muscle and tendon tightness, causing pain and dysfunction that negatively impact joint mechanics. This treatment is primarily effective for tendons but less so for muscles, depending on the thickness of the muscle being treated. Patients should expect mild to moderate discomfort, redness in the treated area, and the formation of petechiae (small red dots). The duration of relief, ranging from two weeks to three months, depends on several factors, including the targeted tissue (muscle, tendon, or ligament), the density of the adhesions, and the depth of tissue involvement.
Mysofascial Decompression
Developed by researchers at UCSF and commonly known as “cupping,” this treatment targets scar tissue and adhesions, similar to IASTM, but with greater effectiveness for musculature. Myofascial decompression (MFD) uses a suction device and a cup to lift the skin, muscle, and adhesions away from the underlying bone. The patient is then asked to perform exercises and stretches while the cup remains applied, creating a stretching or contraction event that pulls the skin, muscle, and adhesions toward the bone. This process facilitates the separation of muscle layers, promoting the breakdown of adhesions in the targeted area. If adhesions are the primary cause of muscle tightness, patients may experience relief lasting up to six months after a single treatment. However, mild soreness and “cupping marks” can be expected for about a week.