You may or may not already be a patient in my practice in Porter Ranch, CA. If you are a patient, you have seen my exam form where I noted the findings of your exam. The video below will dive into a deeper explanation of my notes on your exam form, so please watch it so that all the information stays fresh in your mind.
If you are not a patient, I encourage you to continue reading and to watch the video below so that you know what to expect from a chiropractic exam in my office.
The following are seven components of my chiropractic exam:
Vital signs such as your pulse, respiratory rate and temperature will tell me if you are a candidate for chiropractic care or if you need to be referred to another professional. It will give me a sense of your overall health.
Your posture tells me a lot about you. During this part of the exam, I observe how you stand. I then manually check the levels of your pelvis, shoulders, head and their tilt. I’m also able to assess the muscle tone at these parts of the body.
RANGE OF MOTION OF NECK AND SHOULDERS
Range of motion exams help me differentiate between muscle issues and joint issues. I normally start at the neck where the patient bends the neck forward and back, also known as flexion/extension. This tells me about the health of the joints. Then I ask the patient to rotate the head from side to side and this tells me about the condition of the muscles in that area. Bending the neck from side to side, also known as lateral flexion, will tell me about both the joints and muscles.
The range of motion test is done two ways, 1) you do it yourself and 2) the doctor does it for you. If the doctor is exerting the force to move the body, it is called passive range of motion. However if you are moving on your own, it is called active range of motion. This gives me a great deal of valuable information to tell if the issue is a muscle or joint disorder.
Oftentimes, I will have to combine the range of motion tests for shoulder, neck and back with the postural, orthopedic and neurological tests to arrive at a more accurate diagnosis.
Also, known as the art of palpation, this test is designed for me to look for four things: misalignments, fixation of the joints, pain and spasms or muscle tone. This is the most important part of the chiropractic exam.
During palpation, I will use my hands to palpate the joints and muscles of the head, neck, shoulders, spine, back and pelvis.
When I palpate the joints, I’m looking for misalignments, which means a joint is out of place. I’m also looking for fixation, which means there is no movement in the joints. When I palpate the muscles I identify their tone, whether they are soft or stiff. I am also looking for spasms. All along the way, I am watchful for areas of pain.
This series of tests are designed to test the muscles, nerves and joints. Each has a particular function. There are over 100 tests available. I obviously do not perform all of them in each exam. Depending on your health history, I will choose appropriate tests for your exam. For example, the Thoracic Outlet Syndrome test helps me diagnose circulation issues and the Straight Leg Raise test helps me diagnose muscle and joint issues of the low back specifically.
Here are some tests that appear in your form:
Shoulder Depression Test
Foraminal Compression Test
Thoracic Outlet Syndrome Test
Straight Leg Raise Test
Patrick Fabere Test
If any of these tests are marked positive on your exam form you can do further research online to find out more about your condition.
The first step in the neurological test portion of the exam is called dermatome mapping. Using an instrument called a pinwheel, I check every part of the spine. I gently run the pinwheel on the skin. Although the test is painless, it does cause sensation. I am looking for sensation to be exactly the same on both sides of the body. Checking the sensory part of your nerves, tells us if there are interferences in your peripheral nerves closer to the spine. If one side is more sensitive than the other, that is a telling sign about the source of the nerve interference. If you have a history of numbness in your hands, feet or numbness that radiates from the back to the feet and ankles, it indicates a neurological problem such as a bulged disc.
Lastly, I perform a reflex test. While the dermatome mapping checks for your peripheral nerves, the reflex test checks your spinal cord. The reflex test will show if there are any abnormalities in the cord and at which level the abnormalities exist. This test is crucial for any patient with suspected or confirmed bulged discs or space-occupying lesions in the spinal cord. The test will show how severe the condition is. I use a reflex hammer to tap the tendons and note the reaction. The reactions vary from normal to diminished to exaggerated or absent.
An accurate diagnosis takes into account the results of all the tests, your health history as well as your own account of the symptoms.
If you are a current patient, I encourage you to study your results by watching the video and reading your form, then come back to my office to discuss your treatment. Consider the following options in the meantime:
If you are looking for chiropractic care in the Los Angeles area and would like to schedule an appointment for a free exam, please call my office at 818-831-0100.
The most frequently asked question asked by my patients here at Soft Touch Chiropractic in Porter Ranch, CA is, “How often do I need to come back for adjustments?” I jokingly point to my belly and ask, “If I want to lose weight, how often should I exercise?” They always laugh and give me their estimation of what they think I should do. But the fundamental question is, “What is the goal? Or what am I trying to achieve? So I ask them the same question.
Chiropractic empowers a person’s body to get the results they want. So in essence, you are in control of the consistency and frequency with which you get adjusted by your chiropractor.
So the short answer to the question is: It’s your decision.
The long answer is: It depends.
In my practice, I give my patients three options to choose from and depending on how they answer, I will make recommendations for future care.
Most of you who come to see me are in pain and your only goal is pain relief. This goal requires intensive care, sometimes daily visits. The next step is to get you through the improvement and recovery phase which includes home exercises and adjustments. Once you feel better you can choose to end chiropractic care, but without follow up, it’s possible that you’ll relapse after that and end up in my office again to manage the pain. We call this the Clinical Care Strategy because you come only when you have symptoms. If this is your case you might have marked the first choice on the form that says, “I have a specific concern and I require help only with this.”
The next choice on the form is, “I want to ensure that my health concerns do not become an ongoing problem and that it will not impact my future.” If you marked this option then you have chosen Preventive Care, which is less intensive and less costly. Preventive care is designed to prevent relapse.
The last option says, “I want to be healthier five years from today.” This means you want to invest in your future health. If you checked this box you have chosen Wellness Care. With this strategy, you’ll be treated more often than with Preventative Care because it’s not symptom oriented. With Wellness Care you can achieve goals like: retrain your muscles, improve your body’s biomechanics, keep your spine aligned and stable which is the most important part of chiropractic care, improve your range of motion, prevent exercise injuries, and basically be at your best. It’s important that you invest in your future health especially if you have others who depend on you.
Regardless of what type of care you choose, we are here to help you and support you in your decision.
If you are outside of the Los Angeles area of California, contact your local chiropractor and ask about their wellness strategies. If you are local to Los Angeles, contact us at 818-831-0100 to make an appointment for a free exam and first consultation.
What are these strange symptoms in my hands, arms and shoulders? It could be Thoracic Outlet Syndrome
It is not uncommon for me to see patients in my office - Soft Touch Chiropractic in Porter Ranch, CA with the following symptoms:
Numbness in the hands
Loss of grip strength
Discoloration in the hands
These symptoms could be signs of thoracic outlet syndrome or TOS. TOS is a muscle issue where the blood flow to the shoulder, arm and hands is being obstructed by a muscle spasm.
We have many muscles in and around our neck which have a profound effect on the health of our limbs. When the neck muscles are spasmed they will contract and block the blood flow at the brachial artery that stems from the aorta in the heart and passes right above the collar bone.
To detect TOS, I check the pulse and ask the patient to rotate the head from side to side. If the pulse diminishes or disappears then we know that the problem is vascular and not neurological.
The aorta, which is the major artery, leaves the heart and from there the brachial artery branches out, goes slightly above the collar bone and all the way to the arm so the heart pulse at the wrist gives an indication of the strength of the blood flow to the arm. The brachial artery goes past the scalenus muscle. When the scalenus is spasmed it interferes with the blood flow. The tighter the spasm the greater the blockage of blood flow and that’s what creates all the symptoms listed above.
The following treatments for TOS are available in my office and in many other chiropractic offices:
Manual therapy: I use stretching and massage to increase the range of motion of the neck and shoulder.
Active electric therapy: Active means that the patient stretches or moves slightly while the electrodes are on the affected muscles. This is done for exponential benefits. Instead of relaxing only three muscles, we can relax twelve so long as movement is coupled with the electric stimulation.
Ultrasound therapy: This is like feeling the vibration from a very loud speaker. Ultrasound uses sound that we cannot hear but the vibration affects the soft tissues like tendons and ligaments. It is most effective at relaxing the muscles. It promotes better posture, so it relieves pressure off the upper back and neck. It also promotes better sleep.
Mindful meditation: Most muscle spasms are caused by stress so we ask patients to manage their stress with mindful meditation which is very helpful.
Chiropractic adjustments can also relieve the pressure off the nerves bringing relief to the neck.
If you are experiencing any of the symptoms listed or anything similar, contact your chiropractor for an exam and evaluation. Watch the video below for a more detailed explanation.
Patients who come to my practice, Soft Touch Chiropractic in Porter Ranch, CA, for treatment of neck pain, arrive with a number of complications which have led to the pain. The video below explains in greater detail the causes of and solutions for neck pain. Here’s a brief summary:
Neck muscle spasms, which are involuntary muscle contractions, do not allow the neck muscles to relax leading to joint restriction and misaligned vertebrae. These two events will send pain signals. The restricted joints and misaligned vertebrae may consequently pinch or irritate the nerves and pain may radiate to the arms and hands. Restricted joints will also lead to joint degeneration, over a period of time, which causes herniated discs.
Muscle spasms are caused by: stress on neck and shoulder muscles caused by poor posture while using a phone, a computer, gym equipment, etc., exposure to cold, poor sleeping position and emotional stress.
Chiropractic care goes beyond adjustments of the joints for pain relief. Our office provides the following therapies to relax the muscles and dissolve spasms: electric stimulation, gentle stretches, massage, ultrasound, mechanical traction and of course, chiropractic adjustments.
If you are experiencing neck pain or discomfort, contact your local chiropractor to schedule an exam and evaluation.
If you have landed on this page, you may or may not have a tilted pelvis. You may be a patient of mine at Soft Touch Chiropractic in Porter Ranch, CA, in which case, you've had a consultation with me and you have been diagnosed with anterior pelvic tilt.
Your back pain stems from an imbalance in the foundation of your spine. Think of yourself as a building. If the foundation of a building is unstable, the walls may crack or break down. You can paint or patch cracked walls, but as long as the foundation is imbalanced, the walls will continue to break down. It is the same for your spine.
Your spine's foundation is made up of the ilium and sacral bones along with the sacroiliac joint that binds them. The walls of your "building" are your spine's vertebrae. During the exam we identified that your pelvis was tilted by palpating the ilium bones and found that they were not level. Your vertebrae are misaligned according to your pelvic tilt. The ligaments in your foundation are unstable, which means one side may be tighter than the other. This phenomenon causes your muscles to take over the job of your ligaments. While the muscles are doing the job of the ligaments, they spasm due to overwork, causing you pain. Your muscles, from your neck to your hamstrings and calf muscles, may be spasmed due to your pelvic tilt.
Both your vertebrae and your sacroiliac joints need regular chiropractic adjustments in order to correct this condition. Adjustments along with home exercises will not only fix your pelvic tilt, but they will also alleviate your muscle tone and return proper function to your ligaments.
Please watch the video below which explains pelvic tilt in a visual format.
If you are a patient, please faithfully follow all instructions given to you during your visit. If you are in pain and have not yet seen a chiropractor, I highly recommend making an appointment for an exam with your local doctor of chiropractic.
During my 19 years in the chiropractic business here at Soft Touch Chiropractic in Porter Ranch, California, I have seen my fair share of patients with knee pain of all sorts. Here are some quick facts about diagnosing and treating knee pain.
NOT ALL KNEE PAINS ARE CREATED EQUAL
Knee pain can be caused by any of the following:
THE SOLUTION TO KNEE PAIN IS SIMPLE
80% of the knee pain cases I treat are caused by misalignments, muscle spasms or tendon issues. If the muscles around the knee or tendons are the cause of the pain, I treat my patients with special therapeutic exercises and I prescribe home exercises as well. In the case of misalignment or sciatica a series of whole-body adjustments
WHAT YOU CAN DO NEXT TO EASE YOUR PAIN
Over the years I have taught my patients at Soft Touch Chiropractic in Porter Ranch, CA how to align their spine in the comfort of their own home. In the chiropractic community, we call it mirroring technique. This technique does not replace chiropractic adjustments, however, it is something a patient can do in between chiropractic visits.
Just as an example, stand in front of a mirror and observe your shoulders, if one is higher than the other, you raise the lower shoulder and push down the higher shoulder for 10 seconds then let go. Do this as many times as desired until your shoulders are level.
Another example of an at-home alignment is to push back the chin. This is for anyone who has a hump on their back upper back and the head has a tendency to shift to the front of the body (aka anterior head carriage). In this case, a person is not able to accurately check the anterior head carriage in the mirror, but can get help from another person to determine if the head is in front of the body. A side view selfie is also not effective because the shoulder is raised. The exercise is easy. A friend has to check that the chin is level to the ground and then push the chin back, hold the position for 10 seconds then let go. This can be done several times throughout the day.
If you are experiencing posture imbalances, call your chiropractor today to schedule an appointment for an exam and evaluation.
Every year, for as long as I have practiced chiropractic at Soft Touch Chiropractic in Porter Ranch, CA, I see our culture's seasonal patterns of stress. During the holiday season, we take to the malls, online shopping sites and big box stores to get the best possible deals for our holiday gifting. So what does chiropractic have to do with the stresses of holiday preparation? A whole lot as I'll explain.
When we shop at malls for long periods of time, we spend all our time walking hard flooring surfaces. This causes our joints to act as shock-absorbers more than usual, which leads to joint stress. As we shop online late night, after the kids have gone to bed, we spend endless hours bending our neck forward as we find the perfect gift for a loved one. This forward neck position causes us to develop humps in our upper back and joint fixation. Our muscles bear more weight than when we sit up straight. Shopping the big discount days of the year at big box stores comes with the stress of little sleep, a rush of adrenaline and cortisol as we navigate aisles, interactions with other shoppers and store employees. Let's face it, it's a stressful time before the days of rest and relaxation.
Here are three things you can do to reduce holiday shopping stress:
1. Get enough sleep. Nothing can replenish the body or heal it quite like sleep.
2. When shopping online, keep your chin parallel to the floor even if that means you have to bring your phone, tablet or screen up a bit. If you have already been shopping online and have been hunching over, try the exercise in the video below.
3. Use proper shoes to go shopping at mall or stores. Wear shoes that have shock-absorbing capabilities and fit properly around the toes and heel.
For as long as I have been in practice at Soft Touch Chiropractic in Porter Ranch, CA, I noticed that many of my patients who are involved in car accidents choose to ignore their bodies' cries for help and bypass getting chiropractic treatment solely based on level of discomfort, fractures or the lack of severity of their injuries.
Whiplash in a car accident, for example, could lead to major spasms in the neck, midback or low back which causes the vertebrae to become fixated or locked. The fixation leads to toxic build up in the joints which happens in our body naturally. The build up of toxicity leads to joint degeneration. Most of the joints in our bodies detox through movement. When you are in any kind of car accident, whether major or minor, it could lead to spasms around the joints which creates premature degeneration. Unfortunately, you wont notice the damage until years later. Watch the videos below to learn about degenerative joint disease and motions.
If you have been in a car accident, call your chiropractor immediately for a check up
The most common cause of back pain in men is their wallet! Not because of the money they spend, but because they habitually store their wallets in their back pockets. In over 20 years of practice at Soft Touch Chiropractic in Porter Ranch, CA, I see most of my male patients live with their wallets in their pants' back pockets. I've noticed that as times change, we acquire more credit cards, membership cards and rewards cards and I see the wallets getting thicker and thicker.
While walking with a wallet in the back pocket does less damage to the spine, most of the damage happens when men sit on their wallets. The wallet causes an unnatural shift on a man's pelvis creating imbalance in the pelvic bone. Especially when we are seated, the pelvis acts as the foundation of our spine. Like any foundation, when it is shifted, the integrity of the entire structure it supports is compromised. Imbalance starts with the lower vertebra and over time it affects every vertebra all the way to the neck.
Another way a wallet can create back pain, is by injuring the gluteal muscles and piriformis muscle. Sitting on the wallet causes micro injuries to both glutes and piriformis. Additionally, the piriformis muscle will spasm in order to protect itself. In turn, spasms in the piriformis and gluteal region create tremendous pressure on sciatic nerve, which goes from the spine all the way down to the ankles. We call this condition, pseudo-sciatica.
Chiropractors use something called a block technique where the patient lays on blocks to realign the pelvis while they receive physiotherapy. Ironically, the chiropractic blocks align the pelvis very much in the same way tha the wallet mis-aligns it.
This condition can be aggravated while driving and worsened if rear-ended in a car accident. This is the reason why, in some car accident cases, the victim driver may only experience more pain on one side of the body than the other.
If you are currently carrying a wallet or any other object in your back pocket as a habit, I highly recommend that you store it in your front pocket or find an alternative way to carry it. Call your chiropractor today to schedule an exam and find out if your pelvis needs to be realigned. Don't wait to experience debilitating back pain to visit your chiropractor, call for an appointment today.
Watch the video below to learn more.