Every practicing doctor or therapist has those few patients who just don’t make sense. They have the same complaints as people you have seen before, but they just are not responding to care. Simply put, they are hard to figure out.
If the patient is experiencing it; then, it makes sense. It is our job to understand it – make it make sense to us – and implement the best fit solution.
Knowledge is limited. Not everything about the human body is known. Moreover, the collective body of knowledge that currently exists is not completely known by any one person or profession. This is precisely why medicine is split into various professions, specialties, and subspecialties. Individual physicians can choose to deepen their knowledge about one area while, by necessity, limiting their breadth of knowledge in others. We have chosen to do this within the subspecialty of soft tissue injuries of the musculoskeletal system.
If you were hurt and could not find a solution – What would you do? Who would you see?
What type of injuries should I refer to the Center for Musculoskeletal Function?
1. Anyone who has a soft tissue injury that is not responding to your care.
2. Someone who has responded well to care but has plateaued before complete resolution. Often times a patient will have several problems and specific soft tissue work will be needed to complete the job.
3. Symptoms of pain, numbness, tingling, aching, burning, pulling, and decreased range of motion.
4. When all conventional tests (MRI, CT, EMG, blood work) are negative yet the symptoms persist. There are no technological tests for soft tissue problems. Soft tissue problems are determined by altered tissue texture, tension, and movement.
When referring a patient to our office you can expect:
1. An initial report and periodic update reports. We will keep you informed about your patient’s condition and progress.
2. We will be available for phone consultation.
3. Patients are referred back to your office once we are done. This way you maintain case control.
Nobody knows chiropractic care better than another chiropractor. The adjustment takes care of a lot of musculoskeletal complaints. However, there are times when patients don’t fully recover. This can be a frustrating process for the patient and the doctor, particularly with extremity disorders. If you suspect your patient has a recalcitrant soft tissue problem, send them to us. We will keep you updated with reports and will promptly return the patient to your care once the problem they were referred for is resolved.
We see a lot of “plantar fasciitis” cases. Most of these patients are extremely frustrated with their condition. At this point, their podiatrist too is frustrated when the problem hasn’t fully resolved with orthotics, night splints, stretching, rest, or injections. Most people do well with these, but recalcitrant cases leave the doctor and patient wondering what else can be done. We often find tibial nerve entrapments at the arch soleus and tarsal tunnel, as well as scar tissue in the plantar foot and calf structures impeding further progress. Once corrected the other measures will be sufficient to make continued and sustainable progress. If you and your patient are frustrated let us know and we’ll take a look. If the patient has a soft tissue problem that we can help with, we will treat them appropriately, meanwhile, keeping you updated to their progress. Once the scar tissue is resolved, we will send them back to you for further evaluation and any necessary treatment.
When strength exercises are not making the patient stronger, stretching isn’t making the patient more flexible, or the patient is better objectively but the symptoms are not, they likely have an underlying soft tissue problem.
Any body part that has had enough load placed on it to cause damage and require surgery will also have soft tissue involvement. This is true often in acute cases and always in chronic or degenerative conditions. If soft tissue mechanics are faulty, post surgical recovery can be very slow and incomplete. We find this, for example, with shoulder and hip labrum tears. Depending upon the size and location of the tear, we can see the patient pre or post surgery. Addressing the soft tissue problems prior to surgery will correct load and mechanics, allowing for a faster and more complete recovery period. However, if the damage is causing excessive inflammation or persistent hypertonicity, soft tissue treatment may be best applied a few weeks post surgery. This decision is best made on a case by case basis.
Peripheral nerve entrapments are among the most dramatic and successful problems we treat. Symptoms present as burning aching, numbness, tingling, or weakness in specific distributions, while diagnosis with EMG, MRI, or NCV can be inconclusive. We find that palpation of the involved sites will reveal scar tissue and decreased nerve glide. Proper treatment resolves the scar tissue, eliminating the entrapment and symptoms.