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Muscular rehabilitation prescribed in coordination with prior chiropractic therapy as a treatment for sacroiliac subluxation in female distance runners
Abstract
The purpose of this investiagtion was to coordinate chiropractic treatment and muscular rehabilitation to facilitate treatment in female runners with sacroiliac subluxations. Sixteen female runners were diagnosed as having sacroiliac subluxation (SI group) through blind chiropractic screening. Four female distance runners were diagnosed as having no sacroiliac subluxation and/or lower back irregularities (control group). SI subjects underwent 12 sessions of chiropractic therapy followed by 6 weeks of a specialized muscular rehabilitation program. Exercise prescriptions were designed based upon individual subject requirements, chiropractic recommendations, and continued monitoring by the exercise physiologist and chiropractor. There was an average reduction in both pelvic elevation and lumbar assymmetry, as measured through pre- and posttreatment radiographs, of 1.2° and 3.4° (P < 0.05), respectively. Subsequent to the rehabilitation programs, all SI subjects had reinstated their preinjury training mileage. Five SI subjects reported personal records (PR) over the 10 km race distance, while two SI subjects recorded PR times for the marathon (42 km). In all cases, subjective symtomology was reported to have diminished appreciably. It was concluded that muscular rehabilitation programs prescribed in conjunction with prior chiropractic care, may provide an effective means of alleviating sacroiliac subluxation in female runners.
... [2][3][4][5][6][7][8] There is limited research on how spinal manipulation may impact athletic performance. [9][10][11][12][13][14][15][16][17][18][19][20][21][22] Among asymptomatic participants, spinal manipulation has not been shown to acutely improve run time to exhaustion, maximum oxygen consumption, rating of perceived exertion (RPE), blood lactate, exercise heart rate, free throw accuracy, or 30-m sprint time. [9][10][11][12] Spinal manipulation, however, has been shown to increase hip mobility among runners, 9 how far golfers can drive a ball, 14 and handgrip strength of judo athletes. ...
The purpose of this study was to measure the impact of midlumbar spinal manipulation on asymptomatic cyclist sprint performance and hip flexibility.
Twelve cyclists were equally randomized into an AB:BA crossover study design after baseline testing. Six participants were in the AB group, and 6 were in the BA group. The study involved 1 week of rest in between each of the 3 tested conditions: baseline testing (no intervention prior to testing), condition A (bilateral midlumbar spine manipulation prior to testing), and condition B (sham acupuncture prior to testing, as a control). Testing was blinded and involved a sit-and-reach test followed by a 0.5-km cycle ergometer sprint test against 4-kp resistance. Outcome measures were sit-and-reach distance, time to complete 0.5 km, maximum heart rate, and rating of perceived exertion. An additional 8 cyclists were recruited and used as a second set of controls that engaged in 3 testing sessions without any intervention to track test acclimation. An analysis of variance was used to compare dependent variables under each of the 3 conditions for the experimental group and control group #1, and a repeated-measures analysis of variance was used to analyze test acclimation in control group #2.
Lumbar spine manipulation did not demonstrate statistically significant between-group changes in sit-and-reach (P = .765), 0.5-km sprint performance time (P = .877), maximum exercise heart rate (P = .944), or rating of perceived exertion (P = .875).
The findings of this preliminary study showed that midlumbar spinal manipulation did not improve hip flexibility or cyclist power output of asymptomatic participants compared with an acupuncture sham and no-treatment control groups.
... 7 However, the true impact chiropractic manipulative therapy (CMT) has on exercise performance has been poorly studied and warrants further investigation. [8][9][10][11][12][13] Some CMT studies have shown that manipulation may transiently increase volitional strength. [14][15][16] If CMT has some capacity to make muscles stronger transiently, it could have a positive impact on sport performance, particularly with sports that require strong handgrip strength. ...
Objective
The purpose of this pilot study was to collect preliminary information for a study to determine the immediate effects of a single unilateral chiropractic manipulation to the lower cervical spine on handgrip strength and free-throw accuracy in asymptomatic male recreational basketball players.
Methods
For this study, 24 asymptomatic male recreational right-handed basketball players (age = 26.3 ± 9.2 years, height = 1.81 ± 0.07 m, body mass = 82.6 ± 10.4 kg [mean ± SD]) underwent baseline dominant handgrip isometric strength and free-throw accuracy testing in an indoor basketball court. They were then equally randomized to receive either (1) diversified left lower cervical spine chiropractic manipulative therapy (CMT) at C5/C6 or (2) placebo CMT at C5/C6 using an Activator adjusting instrument on zero force setting. Participants then underwent posttesting of isometric handgrip strength and free-throw accuracy. A paired-samples t test was used to make within-group pre to post comparisons and between-group pre to post comparisons.
Results
No statistically significant difference was shown between either of the 2 basketball performance variables measured in either group. Isometric handgrip strength marginally improved by 0.7 kg (mean) in the CMT group (P = .710). Free-throw accuracy increased by 13.2% in the CMT group (P = .058). The placebo CMT group performed the same or more poorly during their second test session.
Conclusions
The results of this preliminary study showed that a single lower cervical spine manipulation did not significantly impact basketball performance for this group of healthy asymptomatic participants. A slight increase in free-throw percentage was seen, which deserves further investigation. This pilot study demonstrates that a larger study to evaluate if CMT affects handgrip strength and free-throw accuracy is feasible.
... [3][4][5] The true impact chiropractic manipulative therapy (CMT) has on exercise performance, however, has been poorly studied and warrants further review. [6][7][8][9][10][11][12][13] Some researchers have argued that most studies demonstrating that chiropractic improves exercise performance have been of questionable quality. 14 As a result, this field warrants further review. ...
The purpose of this study was to determine if thoracolumbar chiropractic manipulative therapy (CMT) had an immediate impact on exercise performance by measuring blood lactate concentration, exercise heart rate, and rating of perceived exertion during a treadmill-based graded exercise test (GXT).
Ten healthy, asymptomatic male and 10 female college students (age = 27.5 ± 3.7 years, height = 1.68 ± 0.09 m, body mass = 71.3 ± 11.6 kg: mean ± SD) were equally randomized into an AB:BA crossover study design. Ten participants were in the AB group, and 10 were in the BA group. The study involved 1 week of rest in between each of the 2 conditions: A (prone Diversified T12-L1 CMT) vs B (no CMT). Participants engaged in a treadmill GXT 5 minutes after each week's condition (A or B). Outcome measures were blood lactate concentration, exercise heart rate, and rating of perceived exertion monitored at the conclusion of each 3-minute stage of the GXT. The exercise test continued until the participant achieved greater than 8 mmol/L blood lactate, which correlates with maximal to near-maximal exercise effort. A dependent-samples t test was used to make comparisons between A and B conditions related to exercise performance.
No statistically significant difference was shown among any exercise response dependent variables in this study.
The results of this research preliminarily suggest that CMT to T12-L1 does not immediately impact exercise performance during a treadmill-based GXT using healthy college students.
Manual medicine techniques are thought to have positive effects in treating athletes. Most of the users believe that they can reduce rehabilitation time after sports injuries, can reduce sports related injuries, and can cause improvements in athlete’s sports performance. This mention is based on neurophysiologic models, suggesting that restricted joint motion can cause abnormal mechanics and reflex muscular incoordination which in turn could result in a higher risk of injuries and reduced performance. Positive effects of manual medicine are evident in the rehabilitation of sports injuries. Referring to the prophylaxis of sports injuries and sport performance enhancement, there are only a small number of studies with inconsistent results. Therefore, no definitive answer can yet be postulated as to whether manual medicine techniques have an appreciable effect in this area and additional research is clearly warranted.
Many original clinical trials and several review papers have come to the conclusion that manipulation is safe and effective for the treatment of low back pain. However, it is necessary to determine which specific types of manipulation and nonmanipulative types of chiropractic adjustive care are most effective for particular types of low back pain across both tissue-specific and functional classifications.
To characterize the quantity and quality of literature gathered for an Expert Panel that was convened to rate various specific chiropractic adjustive procedures for the treatment of common types of low back pain, drawing on the clinical expertise of the panel members and the relevant literature.
Systematic review of treatment-specific, condition-specific trials, studies, and case reports of chiropractic care for low back pain.
Computerized searching and hand searching were used to identify references in the medical and chiropractic literature pertaining to the chiropractic treatment of low back pain in which both the condition and specific treatment procedures were adequately described. This literature was then categorized according to a variety of characteristics and used by a panel to evaluate the specific procedures.
The 3 most studied adjustive procedures are side-posture high-velocity, low-amplitude; distraction (mostly flexion distraction); and mobilization, respectively. The clinical condition most commonly addressed by the included studies is low back pain. The procedure with the widest base of evidence support is side posture manipulation for low back pain.
To discuss the assessment, diagnosis and chiropractic management of a patient with sacroiliac joint dysfunction (SIJ) complicated by psoas major snapping hip syndrome (coxa saltans interna).
A 32-year-old male marathon runner experienced low-back and left hip pain without radiation accompanied by a "popping" in the anterior hip. He ran approximately 100 to 150 km/wk for the prior 3 years. He had stopped running for the previous 3 weeks because of worsening and consistent pain.
Treatment consisted of side posture SIJ "diversified" manipulation and myofascial release to the psoas muscle twice weekly for 2 weeks. The patient was also taught proprioceptive neuromuscular facilitation exercises of the psoas and iliotibial band muscles. He was instructed to substitute swimming instead of running on a daily basis. Reassessment at 3 weeks found the patient without pain in his hip or back and no clicking or popping in his left hip.
Clinicians should consider that runners who present with coexisting SIJ dysfunction and internal snapping hip syndrome may benefit from the combined management of both conditions.
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