If you’re like me and you’ve ever had aching shoulder pain before, it can be super frustrating. Now, as humans, right, we depend so much on our hands. So what’s important is our hands are attached to our arm, which is attached to our shoulder. So anytime we are going to grab something, pull, reach, push, do what humans do, it becomes very frustrating when you have an achy or painful shoulder.

Now, this can be dealt with in a very easy, systematic way, if you know what to do.

Hi, my name is Dr. Antonio, I am the owner here at Live Loud Chiropractic and Coaching with my wife, Dr. Nichelle. We are based out of Lafayette, Colorado in Boulder County. Our aim and our focus is to help guide you to the adventurous life you are made for. And we do that through a number of different ways ranging from chiropractic and coaching. Now, in that middle is really where the magic happens, because that’s where we come together as a team to make a plan on how to actually dive in and deal with some of these common conditions such as lower back pain, neck pain, and in this case, shoulder pain.

Now, what’s important to understand about shoulder pain, and this is the same thing we say, with all the other issues that come into our office is outside of significant trauma, there’s a reason why you have pain.

What does that mean? Well, in the case of shoulder, we’re looking at repetitive use injuries. So in this case, or an example we might say is, “Well, I started having shoulder pain after joining a new a bootcamp class or CrossFit class, or some sort of workout class.” okay, well, we see a change in the amount of load in which the shoulder was actually experiencing. So it would make sense that that might be part of the problem. So we have to address treating something, i.e. like a shoulder injury, we have to understand the mechanism of how it actually started. Because if I simply just rub on the tissues, work on adjustments, and help you deal with the pain, what’s going to what’s going to prevent it from coming back, if you don’t address how it actually started in the first place?

if we take a step back, ask you about your lifestyle, ask you about your recovery, ask you about how what you’re doing for training and working out, how intense is it. all of these other factors that actually have more to do with your shoulder pain than simply what your spinal alignment looks like, that’s going to give us way better of an idea of what to do in the program and the plan to set you up with to actually deal with your shoulder pain. Okay?

Now, one thing that I do want to add to that is we are very much about maintaining momentum, right, you’re coming into us because you’re frustrated, you’re not able to work out, you’re not able to pick up your kid, you’re not able to get up and down off the floor, whatever that might be. And you feel like you’re not able to keep moving forward with life and/or you might be even moving backwards. we want to help you maintain that momentum. So we are going to encourage you to keep moving, to keep exercising as best as you can. But what we’re going to be able to do for you and help you through the coaching and the chiropractic assessment model, is help you look at the things that we know to be the main triggers for you, so that we don’t keep spinning around in this pain cycle.

Right. If we can break the pain cycle and get you out of there, then we’re going to be able to layer on top of that, better movements, better rehab, better strength, better mobility, whatever applies to you. And then on top of that, layer in our soft tissue skills, whether that’s dry needling, MRT or cupping, as well as adjustments so that we can maintain the proper range of motion and joint mechanics that you need for your body and especially your shoulder.

So if you have had shoulder pain before, or you have a chronic achy shoulder that you just can’t seem to get over, and or if you have a loved one that’s been dealing with a shoulder issue, constantly reaching over grabbing their shoulder, This video is going to be very helpful.

Alright, so we’re gonna be walking you through what a shoulder evaluation and you know, expedited treatment would look like. So essentially, what we’re going to be deciding through our evaluation, obviously, your history is going to be determining the direction of where we’re going, as indicated in the intro to this video, when we see a peak or a spike or a change in load, or a change in exercise program, whatever that is, we’re gonna see common areas that are aggravated more.

And those are typically impingement type of syndromes, bicep tendonitis, rotator cuff irritation, those are going to be your three kind of primary focuses. Now the reason why those are happening, that’s what we have to decide and dive into. We’re trying to determine the underlying causes of those, it’s very easy to diagnose what is irritated, but it’s harder to figure out what are the actually precipitating factors that led us to that.

Looking at range of motion, proper range of motion for the shoulder blade, shoulder, thoracic spine and the neck are going to be our most critical things to look at.

Basic Shoulder Range of Motion

1. Take both arms straight up overhead. We’re looking for 100 degrees of flexion. And ABduction as she comes up, and we want to see if she can get that nice and vertical. We’re also looking for any catching points, or painful parts within that arc.
2. Next we’re looking at internal-external rotation and extension of the shoulder. So she’s going to take this hand, reach behind her head and touch this opposite shoulder blade. So we want to again, look at nice vertical arm here.
3. Right arm underneath over to here. Great. So now we’re looking at internal rotation of her shoulder and extension. And we want to look at shoulder blade movement here.
4. Left side underneath over to here and we’re looking to see you know, comparatively side. Do we need symmetry? No. You do not need to chase making sure both sides are symmetrical. We are asymmetrical human beings.

5. Tip the chin down, touch her sternum.
6. Extend back, as far as you can.
7. Look over your right shoulder. Awesome, look over left shoulder.
8. Ear to shoulder, tipping side to side. Wonderful.
9. Stand feet together. And she’s going to look over her right shoulder. And then she’s going to twist her whole body to the right. I’m looking at ankles, hips, low back, mid back and neck with this gives me a good global range of motion. Good, back to neutral look left, turn left.

10. Keeping legs straight, toe touch, we want to look for thoracic spine flexion here.
11. Come back up, arms up overhead, and then lean back as far as you can. So we want to look to see what our extension looks like.

Modified Sphinx

1. Come up on your hands and knees. Cat cow. we’re getting a good global assessment of how the spine moves.

2. Move your feet forward just a little bit. Sit your butt back towards your heels. Now move your hands back a little bit, this is going to be you can go back a little bit further. By moving her hips back, that locks the lower back from being able to move more.

3. Now in this position, because again, we’ve locked out the lower back, we can go through the other ranges of motion. So obviously, we get a little bit of hip shift, but from here, I can really start to see how the spine bends side to side. So we’re kinda like windshield-wipering the spine here and going side to side.

4. Now next is we want to look at rotation again. So there’s a way for us to isolate more about the rotation that we want to see from the mid back. So from here, you’re going to put one hand behind your neck, and then your other elbow is going to drop down.

Now, as indicated, right, some of the main things that we run into bicep irritation and impingement type of syndromes. And impingement is something that will happen with range of motion as you come up overhead, it’s the level that how it’s a level of impingement that could be created in an issue as dictated again by the scapular limitations that we might see.

Looking at How the Shoulder Blades Move

So what we’re going to look at here is how the shoulder blades should actually be moving. So as we already were showing, as this arm comes up overhead, we want to see how far this goes. Now, if that shoulder blade is pulled down, and back or too tight, she’s not going to be able to, to raise it as high. So we’ll test this right just as a as a proof of concept. So if I hold her shoulder blade, and I say now take your arm up overhead, you can see how it just kind of stops, right. So we oftentimes do this unintentionally, because we’ve been queued, keep your shoulder blades down and back, thinking that’s the more stable position. But in doing so that actually limits your range of motion. So if I’m locking this down, because I was acute, or I think that’s the better way to do it, and this is coming up and over, you’re basically banging your your arm or your humerus, the ball up into the socket roof. And that creates impingement sensitivity, whether it’s a rotator cuff, the bicep tendon, so on and so forth. So we want to make sure that that shoulder blade is moving well, this is this is one of the primary things that is oftentimes overlooked, we focus on massaging bicep tendon, working on the rotator cuff, the upper trap, and not knowing that we actually have to queue and promote that scapular range of motion.

So some of the things that we talk about is making the arm long. So if she’s here, and let’s just say for instance, she was actually having a pinch here, one of the cues that helps prevent that and or improve her symptoms is by simply asking her to make her arm long. So I’ll say, hey, try to reach out. So in doing so, you’re actually going to promote scapular protraction. And that’s this lateralization of moving away from midline, as opposed to pointed down and back.

Now, this is still stable. Yes, pulling down and back is stable for rows and other things like this. But we have to now train this. So if she was to make a fist, and now to say, make your arm long, and now resist me, she’s craving stability through a protracted shoulder blade position. Okay? Now, this is critical, because more times than not is we just don’t have the stability out there. So we think pull down and back to make us tighter. So that’s something that we have to we have to test out and make sure that that is an appropriate position. Now, this is also important for the rotator cuff because the rotator cuff muscles, they all start from the shoulder blade. So the relationship from the rotator cuff from the shoulder blade to the actual ball, right your arm, the head of the humerus, needs to be defined and improved.

So if I’m again, retracting, but yet this is wanting to come out, well, you see this battle between the rotator cuff muscles, the shoulder blade is being held back, the arms trying to go up and the rotator cuff muscles don’t know what to do, they’re not able to stabilize and adequately hold on to the shoulder if we’re having these opposing forces. So this is another reason when we’re looking at rotator cuff injuries, that we have to improve the scapular mechanics to improve the whole relationship on how everything is moving.

Now, outside of that, if we’re looking at rotator cuff issues, we’re going to do our standard testing of hey, resist here, resist here, fine. This helps us again, determine the exact tissue or the exact area that is angry. Again, that is the easy part that it’s very easy to find, hey, this is the this is the issue that everything’s kind of stemming from, but we have to understand and know why. And more importantly, what are the things that we’re consistently doing on a routine basis, whether it’s at home, whether it’s in your workout, whatever that is, that’s consistently insulting the tissue and making that wound or injury quote unquote, fester and linger. So that’s more important than actually understanding the site of pain. of understanding what you should and should not be doing from an acute injury to a sub acute injury or a chronic injury to allow you to progress further forward to be able to do more things.

Compression

Make a fist. Scaption is going to be about 45 degrees off the midline. Now, what that simply means is the head of the humerus is going right in line with the socket, and the shoulder blade from this position.

So this essentially gives the rotator cuff and a lot of the muscles the best force tension relationship, meaning it’s at its strongest point, right.

So for compression, all we’re starting with here is just hey, resist me, I’m gonna push down against her as she fights this. And this is a compressive load into the shoulder. So this allows us to first initiate what a conversation of compression resistance actually looks like. And then we would put her under load, such as a bottoms up carry, or in a plank position, anything in which I’m pushing into her body through a compressive force, and she has to resist that and maintain the shape and the positioning that we want.

Now, you might feel shaky in these positions, and that’s okay, that’s your body’s, that’s your body working with your muscles to figure out how much load or how much strength that it needs to present with what it’s being asked to do.

Distraction

Trust fall. you’re just gonna lean back. Okay, so from here, you can see that there’s traction from her shoulders, right. So if we had a suspension trainer or something set up, go ahead and pull your hips towards me a little bit. Now just bend your elbows and do a row. So pull up right now lean back, right. So this is just a mock kind of what a row would be on a suspension trainer, a TRX. So this is perfect, though, because I’m creating distraction from her shoulder. And she has to resist her body being or her arm being pulled away from her. This strengthens the rotator cuff more than almost anything else that we can do outside of these like just single exercise of internal external rotation.

So these are phenomenal to be able to build more resilience than strength, because we have to be able to pull ourselves up from the ground, or we have to be able to push ourselves up on the ground and starting with these basic exercises are wonderful for rehabbing and retraining the shoulder complex.

Now outside of that, what we’re also going to do is carries, right. we talked about distractive loads, if I was to just grab a couple of weights, couple dumbbells, couple kettlebells, that’s constant distractive load down into my arm. And if I just simply resist that, and walk for distance, as if I was like carrying a wheelbarrow, that’s a great exercise for building a lot of strength and load into the shoulders, and not compromising ways that might be pinching or adding to that.

Downward Facing Dog & Plank Exercise

A full plank has a lot of compressive load. Now what a lot of people have trouble with shoulder pain is getting up into that position. So we can train this by going through compressive loads into a downward facing dog position. So from here, all she’s going to do is lift her hips up towards the ceiling. Right? Now we see a somewhat vertical position here.

So I can retrain an overhead position that might be troublesome with the dumbbell or pressing weight through a compressive load that she’s able to control. Then she’s gonna come back to a plank, right? And now she’s in control.

Conclusion

So if this is something you’re dealing with shoulders are pesky, right?  it’s a ball and socket, so it gives us a great amount of mobility. But because of that, it makes it more complex when dealing with these injuries. Especially if you’re someone who’s hyper mobile, we oftentimes just hear “Stretch, stretch stretch,” you’re oftentimes going to see the need for doing more stability training so that the shoulder feels comfortable while going through ranges of motion. And then we can layer in mobility on top of that.

So if you found this to be helpful, and you’re dealing with the shoulder injury, please do not hesitate to reach out to us. If you have a family member again who’s dealing with something like this and they’ve just kind of been put through the wringer. We’d love to have a conversation with you or that family member or a friend to help them regain shoulder mobility and function so that you guys can live a loud, adventurous life. Thanks for tuning in guys.

If you have been told that you have a disc injury, disc bulge, disc herniation, or anything to do with a disc within your lower back, this video is for you.

Oftentimes, when we hear disk injuries, disc bulges, and disc herniations, and most of us think that means immediate surgical consultation or immediate surgical needs. Now, in some cases, it is very pertinent and important to be co-managing this with an orthopedic surgeon. But for the majority of cases, that is not the case. So my goal here today is to help reassure you and give you some confidence in your body and in your back, if you have been told that you have a disc injury, a disc bulge or a disc herniation.

I’m Dr. Antonio Gurule with Live Loud Chiropractic and Coaching. My wife and I have owned Live Loud  Chiropractic and Coaching in the Lafayette, Colorado in Boulder County area for seven years. I’ve suffered with this. I have treated many patients with disc bulges and disc herniations. In addition to myself, and what we have done through all of our education and learning and teaching and trial and error of working with people is helped to come up with a system that helps you determine:

1. If it is a disc herniation or disc bulge
2. The severity of that
3. What to do next

You have to have a proper assessment and evaluation to determine what are the triggers and the things that make things worse. Disc injuries usually don’t respond well to rotation and flexion. That being said, if you were to be picking something up where I’m flexing over and bending forward, that is going to be compression of your spine under flexion.

And that is what’s going to be putting the most load on the disc. If a disc is trying to heal from an injury, it’s going to be very hard when you keep pushing on that disc and eliciting more pain and damage. If that’s not being addressed from your PCP, your physical therapist or your orthopedist, then what’s the use? Just putting medications, drugs and, you know, maybe some core stabilization exercises on there is not going to help, you’re going to keep spinning yourself in the loop by recreating more pain. the more pain you create, you’re going to be more sensitive to the pain, which only heightens the amount of pain that you feel. And all of a sudden you’re stuck in this loop.

Today we’re going to walk through a basic example of what a disc examination and assessment might look like. And some of the common cues that we give for movement and some of the common active rehab movements that we give early on and throughout to help you get over the disc injury.

Now again, this is the basic example that helps. This is in no way intended to say that this is for you. Because every disc injury is different in how it happens, the chronicity of the cycle will change and dictate what we need to do. You need a custom plan to help you once and for all get over the disc injury to create more confidence so that you can lead a healthy, active loud life. And if you’re interested in that, please follow along and I think you’ll enjoy this video.

Flexion Intolerant Low Back Pain

So as we already indicated, the more common presentations of lower back pain that we see are what we refer to as flexion intolerant low back pain. Now flexion intolerant, low back pain simply means your back does not tolerate flexion. How is flexion presented out throughout the day? well bending over to pick things up. We have to also consider though when you’re sitting, right and we kind of slump. compression is where things most gets sensitive or irritated when we’re talking about flexion intolerant low back pain.

Now with that, as we already indicated in the intro, these are commonly seen with disc injuries. Now disc injuries does not mean herniations, it does not mean bulges, you can have an annular tear, or some sort of disc sensitivity from an injury, and or from trauma-based and or repetitive based loading patterns that create a essentially desensitized disc. So these are the important things to understand. And what we’re going to try to show today is how we tease out or understand that this is more disrelated, or some sort of compression and flexion irritation.

Now, if you already have been told you have a disc injury, and has been confirmed or an MRI, the good part about that is we can expedite that and just understand the sensitive patterns, as we already indicated, we want to know how sensitive is inflection, whether that’s standing or sitting, load, so on and so forth. But if you’re unsure, and you just have this this back pain that’s been either chronic subacute or whatever that is, we want to determine what is actually the sensitized issue and what are the positions and movements again, that are craving this recurrent pattern of pain that you’re not able to get out of.

Because once you understand that, then we can very temporarily splint this so that we can allow the body to not become so sensitized to that pain cycle, and then reintroduce that later on.

The example that we commonly use is if you had a cut on your knuckle and you kept bending your fingers, that scab or that cut would essentially keep opening up in prolonging the healing process. Whereas sometimes you might need to actually splint or hold that finger straight for a while to allow the healing process to occur. And then after everything’s healed, we regain mobility and function back to that. That’s essentially how we treat disc injuries and these flexion intolerant lower back injuries.

So what we want to look for is, again, what are the positions that are most problematic for you? And then we have a few early intervention tools that I’m going to share with you today that will help you in that early sensitive or painful process.

Now, again, these are great for this early intervention, they’re also very well used and beneficial for just kind of like a daily spinal mobility or scrub, even if you’re not having pain. And if you’re someone who commonly is bending over a lot, labor workers, even those that are more sedentary in a desk position.

Movements for Looking at Range of Motion

1. Bend down and attempt to touch toes. Any pain there?
2. Feet together, arms up overhead, and then lean back. But we do have to keep in mind, if this hurts so much, what your body will commonly do is throw you into an extension where oftentimes you’re kind of walking around like this, because you don’t want to go forward.
3. Heel drop test. Stand up on the toes, and with legs straight, drop hard on the ground.
4. Compression of the spine. Sit at the end of the table, sit up nice and tall, then grab the end of the table and pull yourself down. Any issues?
5. Still seated, kick one leg out in front of her and hold that up. Any tension? Does that go down the leg? Does it create burning symptoms, numbness on and so forth?

When we’re looking at disc mechanics, the disc sits in between the vertebral bodies. So if we flex the spine, round it, and add that compression, we want to see if there’s more sensitivity. More likely than not, if it’s a disc injury, we’re going to see with that compression and flection and these types of movements, increases a pain, potentially symptoms down leg if it is more of a disc herniation or bulge. And that’s what we need to determine for the extent of the injury.

Basic Movement Patterns for Herniated Discs

Now, in knowing all that, what do we do, right? Well, we already know that the disc is injured, and we have a flexion base injury. So this is where we come into the knuckle model, right? We need to temporarily help her “splint” this so that we don’t keep putting more and more pressure to the back of the disk where the injury is.

These are great for two main reasons. They help reduce the pain sensitivity, and help with the healing process.

1. Hip Hinge

The reason why this is important is we’re always bending forward, right, you’re bending forward to pick something up, you’re unloading the dishwasher, you’re washing your face, your hands, we’re typically in a bent over flexed position. If this causes pain, we need to get to a position here where I can load more of my hamstring and my hips to reduce the load on the lower back. The lower back is still being loaded here. But the but the load is reduced.

2. Supported Squat

So in our office, we have a suspension trainer or a TRX. You can also use rings or anything like that. At home, though you might not have that equipment. So what we use is a banister, or a kitchen sink, and you’d essentially just hook your sink, she’s going to be using my hands though to just demonstrate this moment.

Stand with a wide, open stance. Holding on to your support, lean back into your heels a little bit, not just your hips, like your whole body leaning back like you’re waterskiing, right?

So there’s two ways in which I try to coach this. So what I want you to try to do is, don’t let your hips go backwards as much, I want you to try to go straight up and down.

Now the second way we coach this is I want you to waterski more, so I want you to really set your hips back away from me. Really move the hips away from her hands. So in doing this, we’re actually decompressing the lower back.

But hands are anchored this way, what’s in the middle? lower back. So on each rep, that lower back is getting a little bit of traction and a little bit of decompression to help relieve a lot of the tension and aches and pains that we get from that compressive feeling of having these lower back injuries.

3. McKenzie Extension Variation

On the ground, get onto your stomach in an upward-facing dog motion. Shift your weight into your hands and let your hips drop gently. Do multiple reps.

Conclusion

So again, these are the basics. First and foremost, understand pain. Second of all, work on some of the stabilizing muscles that help stabilize the lower back so you feel more comfortable.

These are kind of like your core exercises, but done in a specific way so that we’re not again picking at the scab, then we look at mobility for the mid back and the hips to make sure we have everything we need, then that’s our foundation of getting back to strength, power, agility, or whatever sport or activity that you enjoy doing.

It’s got to go through this progressive plan. We layer in again, soft tissue, dry needling adjustments, all the things that help act as a catalyst. But if I can give her these tools, she’s able to control her pain, so much better at home. And then it doesn’t feel like this end, this end diagnosis, “oh, I have a disc herniation. And all I can do is take medications and sit around.” No, we say this is your medication. These things work oftentimes better than muscle relaxers and ibuprofen and drugs because it maintains your mobility and it gets your body more confident about how to move rather than just sitting and waiting for the pain to return only to come back super stiff and weak.

So if you want to deal with your low back in a very progressive yet conservative way, this is this is how to do it. If you want to just take drugs and wait till it works, that’s totally fine. But most people want to get back to their life. And if you want someone advocating for you to help you through a disc herniation, disc bulge, or disc injury, we’d love to be that advocate and that support team for you. If you found this helpful, please feel free to reach out to us. If you have a family member who is dealing with low back pain, which is extremely common, and they’ve been through the wringer over the years, We would love to have a conversation with them to see how we can support them, whether in the office or even virtually having a consult or conversation over the computer. Thanks for tuning in guys, live loud.

Typically, it’s estimated that roughly three out of 10 people currently are experiencing some form of neck pain, discomfort, or upper back pain. Now, based on how we live in Western society, I actually think it’s slightly more. But there’s a lot of reasons from that as to why we think this is happening.

Now, argumentatively we’ve been reading books and reading newspapers and looking down for many years outside of the cell phone, but with the way modern technology is and how much more time we actually spend on computers, we’re actually seeing our world lives in this box. Right? Currently, you are watching this video on an iPad or an iPhone or your computer and our world lives right here. We very rarely, often look outside of this box where we live in. And that is, I think, a lot of the reason why we are experiencing a lot of neck pain.

Now, what do we do about that?

My name is Dr. Antonio, I am the owner here with my wife of Live Loud Chiropractic and Coaching. We are based out of Lafayette, Colorado, in Boulder County. Our big focus is to help guide you to the adventurous life you are made for, to help build stronger families and a stronger community.

Now, that is oftentimes very challenging when you’re dealing with pain. So not only are we trying to push and be very proactive about an active lifestyle, sometimes we have to deal with the pain and discomfort that is preventing us from enhancing our life and being able to do the things that we want to do.

Now neck pain is one of those things that really wreak havoc on people’s lifestyles and their daily activities because so much of our proprioception and awareness, and our senses come through our head. If you can’t turn your head and your neck very well, it’s very hard to see, it’s very hard to hear when you want to be able to turn your head, right? So these are the important things that we want to address when we’re looking at neck pain.

Now, as we always state, we are very much about setting an example about a patient, active care model, meaning we need you to move–we need you to play an active role in this process. It is not simply just adjust, soft tissue work, and all of a sudden things go away. Because what you have to know and consider is outside of major trauma; major trauma–automobile accidents, falls, so on and so forth. There is a reason why you are starting to feel neck pain.

What does that mean? Well, it might be the way you’re sitting eight hours a day, it might be the way that you’re moving, it might be the way that you’re exercising. We have to determine what changes need to be made. Because if I simply just do adjustments and soft tissue work, and you go back to the same lifestyle that got you here, what’s to say it’s not going to happen again?

Our role is to make sure that you’re set up for success. Not just turn into this model, which is adjust, fix something which makes it feel good. Come back when it hurts. That’s the old model. That’s the old chiropractic model. That’s the old PT model. It’s very much a band-aid. “I Hope the pain gets better, come back and see me when it’s getting worse.”

I want to set our patients up for success. And I know you want success too. What is success? Well what are the goals you want to be able to do? Hike, walk, play with your kids, wrestle, jujitsu, weightlifting, I don’t know, it doesn’t matter what it is, but we want to meet you where you are to get there.

Now, as we already stated, changes need to be made. If we don’t change the behavior or the lifestyle that elicited the pain in the first place, again, outside of trauma, then we’re not going to get anywhere. So what we’re going to do today is walk you through what a what a neck complaint, examination and assessment looks like, and the common ways that we help treat neck pain.

Now, I’ll say it again, what we do is layered on top of everything else. What does that mean? Well, I can do adjustments, I can do soft tissue care. Whether that’s MRT, whether that’s dry needling, or cupping, etc. And then that’s going to be only supplemental to the active care model that we would need you to be a participant in.

What does that mean? Well rehab care might include strengthening exercises, very commonly for the neck, this is strengthening the upper back with more pulling. We’re going to talk about posture awareness. We are not very strict on posture, but we like to highlight the role in which posture plays with neck pain so that you have a better awareness about how it influences it. When you have more awareness and you understand it then it’s going to apply better rather than simply saying, “you need to have better posture.”

We oftentimes get so many people saying I know my posture sucks, but they don’t even know what to do about it, or why it sucks and what that means. So that’s going to be part of the process and part of the conversation.

But today’s video is simply to help show you how we go about this and some of the ways that we can help someone with neck pain, address the issue, set up a plan, and more importantly, look at that end range goal, and to help build that plan to the end range goal outside of just slapping on band aids and saying come back when it hurts.

So if you have neck pain, I know this video will be very important to you and will have a lot of great tips of showing you what a proper assessment, evaluation, and treatment plan should look like. And if you have a loved one, family friend, or co worker that has been experiencing neck pain, you peek over and they’re always rubbing their neck or doing something like this, I highly encourage you to share this with them. This is something that can really change someone’s life by getting the right direction, and the right care, and the right provider to help dig them out of this hole, which can sometimes feel very daunting. So thanks for tuning in, guys, and I hope you enjoy.

Examination Process for Neck Pain

There’s a number of different ways in which neck pain can start. But again, outside of trauma, there’s usually a reason or an indication as to why it’s happening. And that’s first and foremost what we have to understand and discuss with the patient through our consultations and our history and the examination. But now what we’re going to be doing is actually breaking down the examination process.

1. Sit up nice and tall and bring chin to sternum.

Perfect, we look at how does everything flex over? How does everything look on the backside? Any pain?

2. Look up towards the ceiling and extend back as far as you can.

This one’s always interesting, right? As we already indicated, everything we look at is in front of us. very rarely are we looking completely up, completely down, or over to the side, right? Even when we’re looking at our phones, it’s never just straight down. So we want to start looking at those end range positions to see how much mobility do we have there, And does it elicit pain?

3. Look all the way over right shoulder. Then look all the way over left shoulder.

4. Ear to shoulder, ear to shoulder.

What we commonly see, right, people think ear to shoulder, that’s the same thing, that’s shoulder to ear. We want to look at pure cervical range of motion.

5. Take the right hand, reach behind her head and touch the shoulder blade.

Switch sides. Oftentimes, you see a lot of upper trap tension with neck pains, we want to see how does her shoulder mechanics work since the upper traps are such a major player with shoulder mechanics.

6. Now I’m going to push down on the spine there, check for symptoms.

7. Then I move the head sideways, add compression, and then tip it back a little bit, add compression and then just straight back, add compression.

Okay, so next, if that is the case, if someone having this pain down their arm, then we can look at does distraction improve it. So I’m simply just trying to lengthen her spine there. For some of you that are having ridiculer pain down your arm or a pinched nerve better known as, this could elicit a response of improvement and that would be a good sign, and something important for us to know.

So that’s how we differentiate the type of pain that we have. We’re dealing with localized joint pain or something more of a pinched nerve that’s going down the arm.

Non-Weight Bearing Evaluation for Neck Pain

This allows me to palpate and feel how the joints move and operate. So if someone during their active range of motion have them moving themselves, they don’t have a lot of good range of motion, I can now test it non-weight bearing to see if it feels any different.

Start to feel around. This allows me through my hands to feel if there’s specific areas that seem to be stuck, or kinked, if you will, and that’s where we’re going to try to focus our treatment. that treatment could be the active treatment that we give her, or the manual treatment that we’re going to do for her. 

Ask for any tender spots, how does that feel? Because that’s going to give us an idea of certain muscle groups or muscle bellies that need to be addressed.

• Soft tissue work
• Dry needling
• Cupping
• Manual therapy

We’ll be doing our standard adjustments, which would have been essentially be if I feel stuck spot, I’m going to basically just try to have a wiggle. And we’re just going to do small adjustments like that. Very light, very delicate adjustments, that elicit movement in the stuck joints where we need them to start moving.

Now outside of that, right, we have to look at the movement side. So here’s a few things that we do.

Movements to Help with Neck Pain

1. Chin Tucks

simply put, your chin is going to move back and forth like it’s on a drawer slide again, a drawer side does not go up and down, it simply goes forward and backwards.

What we want to make sure is just the head is kind of tilting and moving back and forth to allow the chin to move back and forth. We don’t want to see a lot of movement from the back or the lower back or the mid back from here, it should be simply just coming back and forth from the chin.

Now similar to what we did for our lower back exercises, sets of 12, 15 and 20 seem to be a sweet spot.

2. Movement Mapping

Movement mapping is exploring all the corners of range of motion that your neck should have. We don’t force any range of motion, but this gives us a good proprioceptive awareness and map of what range of motion is limited.

What this looks like: we start off with just the basic cue. So chin down, chin up. Chin down, chin up, we get an idea of what we’re doing. Now we’re gonna say go chin down and hold. Okay, now I want you to turn your head like you’re saying no when you’re down. So we can take all those joints through flexion. And now add some rotation, well, what we can then do is go down again, and we can say ear to shoulder. Right, so now it’s a little bit more lateral flexion.

Now, we can combine all of those together and say, chin down, ear to shoulder. Now, hold that and then turn no. But we’re really challenging a lot of the joints within the neck to see what their movement is. And this is actually very therapeutic, because we’re starting to loosen up a lot of the tight joints that have not moved in a certain way, in a long time, more range of motion that you have and more mobility, oftentimes, you’ll see a significant reduction in pain as itself.

3. The Dissociation Exercise

in addition to what we just described as the upper back strength, having significant influence with neck range of motion, we can now dissociate those two movements, so that we can make sure that the neck can move independently of the upper back. All you need is a band.

Hold one end of each band, straight arm pull the arms away from each other. Hold back here. So now in doing this, you feel all these muscles are tight, right? So it’s gonna feel a little weird. But now move your head by almost doing that same kind of movement mapping side to side up and down.

So here we’re setting the stabilizers, we’re setting the back the way that it should be set, and then we’re asking the neck to move independently, which helps loosen up a lot of the tight joints and muscles that are dependent on that upper back support.

Conclusion

It always starts with proper evaluation and a movement criterion first to determine what triggers are constantly picking and irritating at it so we get out of that negative feedback loop. Then we put on the movements, the movement mapping the chin, tuck some of the basic things that help you scrub out and maintain better range of motion within the neck joints and muscles, as well as then layering on the soft tissue care whether that’s MRT, dry needling, cupping, and adjustments to help sweeten the deal and supplement more motion and more pain reduction, if you will.

So if you are dealing with neck pain, I’ve been there. We’ve been there. it sucks but it really limits a lot that you can do. And no one wants to walk around all day all stiff-neck not being able to drive and do other things. So if you’ve been dealing with this for a while, please, please give us a call. We’d love to help take you through this good evaluation and help you set you up with a better plan of success. Once and for all, stop neck pain.

It’s estimated that 70% of Americans will be suffering from some form of lower back pain at some point in their life. Now, if you have experienced low back pain before, you know what it’s like, and you’ve been there before, if you haven’t, I hope that it doesn’t happen for you, but this is going to be a short informational video about addressing some of the common lower back conditions that we see across the United States as well as in our office.

Hi, my name is Dr. Antonio Gurule. I’m a chiropractor here at Live Loud Chiropractic and Coaching. We are based out of Lafayette, Colorado, just outside of Boulder, Colorado, in Boulder County.

Today we’re going to dive in and show you what we do here at Live Loud Chiropractic and the philosophy and the approach that we take to lower back pain.

We focus on a movement methodology, a movement mentality. Meaning, movement first. If I can show you and prove to you, and help you gain confidence in the way that you move, especially if it’s painful movements that are exacerbating or triggering your pain, then you’re gonna have a lot more confidence going around your daily activities.

As an example, parents, if you are a new parent, or if you’ve ever been a parent, when you have a new baby, you are constantly bending forward, whether you’re sitting on the couch, or a loveseat, whether you’re bending over to pick up your baby leaning over a crib. And in order to change diapers, you oftentimes will experience some lower back pain or tightness.

So that’s our whole process. That’s our whole methodology, is helping you find those different nuances of movements that help reduce the triggers in the amount of pain that you’re experiencing. And then we’ll layer on top of that better ways to improve your mobility or your strength through a active rehab process.

And then on top of that, we’re gonna layer in obviously, the things that we’re good at, which is manual therapy, whether that’s soft tissue treatments, such as using our hands or our thumbs, whether that’s dry needling, cupping, Graston, scraping, and then on top of that, obviously being chiropractors is being able to perform adjustments to help maintain the mobility and the movements within the joints that we want.

Now, this is a group process, we have to be working at this together. Oftentimes we get individuals coming in expecting a chiropractor to fix them, when that’s the whole reason why they’re stuck in this feedback, this negative feedback loop and not being able to get out of it, because they’re expecting a quick fix–an adjustment or a muscle to be worked on in order for this to get better.

We have to remember that there is more to this outside of trauma or an accident, but even then there is a rehab process that needs to happen that got you into this in the first place. And movement, skill acquisition, strength, endurance, and mobility is going to be the way for you to get out of it, and stomp on that back pain once and for all.

The most common back pain that we see, at least in our clinic, and that most people experience is what we refer to as flexion intolerant back pain, meaning your back does not tolerate flexing forward very well.

What does our movement assessment and evaluation look like? As well as the orthopedic assessment, And some of the common ways that we treat lower back pain, again, as a layer on top of the mobility, rehab, and movement that we already talked about.

1. Bend down and attempt to touch toes. Does this create any symptoms? Does it cause any pain?
2. Go down, touch your toes. and let the head drop as well. Does that increase any tension or pain anywhere?
3. Go feet together again, arms straight up overhead both sides, and extend backwards as far as you can. Any pain or symptoms there? We also want to look for any dumping.
4. Feet together. Look over your right shoulder, and then turn your whole body to the right. So twist shoulders and hips. We’re looking for good global range of motion within the hips, the spine, and the feet. Any symptoms there? Then look left, turn left.
5. Sit down and grab either side of the chair. Keeping yourself nice and tall, pull yourself down into the chair. Any symptoms with that? This creates compression of the spine.
6. Still seated, slump into your lower back. Grab this chair, and I want you to pull yourself down. For most that are having symptoms here, this would elicit more pain, again, helping us through the diagnostic criteria of determining what part of the spine in the tissue is most irritated or sensitive.

Non-Weight Bearing Evaluation

So oftentimes, commonly, what we see with lower back pain is we can get referral pains on the back of the leg or the hips.

1. Straight leg raise.

This helps assess the neural tension of the sciatic nerve in the back of her leg. So I’m going to have you just relax this leg on my shoulder here. First and foremost, we want to see if this elicits any pain or creates any symptoms. From here, I’m going to simply ask her to tell me when she feels the first sign of tension in her hamstring.

2. Now I’m going to pull the toes up.

Does that change the tension? More intense? And does it go anywhere else down the calf down the feet, or anything like that?

3. Heel drop test. Stand tall and just plop down. With my leg straights, I’m basically trying to send an impulse or an impact up through my spine.
4. Testing for Facettes Syndrome. Give yourself a big hug. And essentially, I’m going to kind of move her around to determine if there’s any sticky spots or spots that create pain for her in that lower back area, or the facettes.

Movements to Reduce Lower Back Pain

Decompression. All you need is a banister, a rail, a doorknob, or a sink in which you can hold on to.

1. The Supported Squat

We’re gonna face each other with a nice open stance, like we’re gonna be doing squats, and hold hands. So by her hanging on, if you notice from that profile view, her butt is essentially moving her hips in the opposite direction of her hands. If I was to draw a straight line down from her hands to her hips, we see a relatively straight profile here. what’s in the middle? Lower back. So hips go one way, hands go the other. That offers a little bit of decompression or traction in the lower back.

2. Hinging Pattern

Hips go back, spine stays nice and long.

Widen Your Stance. Spread the feet apart a little bit more, and then toe out. Do the same hip hinge, but your stance is now wider. This actually gives her a little bit more range of motion, allowing her to go down to the ground more.

3. Extension-based Movements

Use your hips to shift your hips back and forth.

If you’re able to just bend that those joints back and forth nice and easily, it creates this pump, which allows the joints and everything to kind of get re lubricated and loosened up without eliciting pain.

4. Modified Upward Dog

This is going to be very similar to the classic Upward Facing Dog movement. The only difference is we’re not actively trying to lift ourselves and create extension, we’re going to try to do this in a more passive manner.

Get on your hands and knees, and walk your hands forward just a little bit. Shift your weight more into her hands and let your hips drop to the floor. This creates a nice bit of extension in our lower back, and then we’re going to come back up. Perfect, and we’re gonna go back and forth. The sweet spot for these reps seems to be about 20. When you do about 20 of these, everything seems to loosen up really nicely.

Manual Therapy Care for Lower Back Pain

So we’re going to briefly walk you through palpation and care, manual therapy care for lower back pain. Alright, so after we’ve done the movement assessment, we’re trying to determine what movements feel good based on the pain you’re experiencing.

Major focus is the movement in the mid-back and the hip.

How do we work on this? Well, we work on soft tissue as we normally would, working digging into trigger points. we would go through the adjustments that you would obviously expect from seeing a chiropractor.

And especially when we’re talking about the hip, we want to make sure that we’re seeing good hip range of motion. There’s a number of stretches that we can work on and give. And there’s obviously certain areas within the soft tissue around the hip complex in the lower back, that can help unlock the hip joint as well.

Chiropractic Adjustments for Low Back Pain

So we’re just going to do one lower back adjustment here. Now, a lot of times people are concerned, is this going to be aggressive? Is this going to hurt? it really just depends on obviously, the provider you’ve seen, obviously, growing up with my wife, Nichelle, and learning how to adjust gentle from an early age. That’s our whole focus. if adjustments aren’t for you, obviously, we’ve described a number of different tools that will still help you. That’s why we do not focus solely on adjustments, because it’s not for everybody.

Conclusion

Here’s the plan. Figure out the movements that are painful, figure out the things that are painful, figure out the joint dysfunctions and the areas that are not performing as we would like to see and set up a plan on how to gain mobility, gain more strength, and gain more confidence so that you can systematically scale those and progressively load that to get stronger and stronger and more mobile.

That’s how you beat lower back pain and really create a better long term plan for that. Please do not hesitate to reach out to us with any questions. Again, our goal is to guide and support you to that adventurous life that you are made for, and we want to be an advocate through being that coach and leader, as a provider for you.