Upper extremity deep vein thrombosis presenting to a chiropractic clinic: a description of 2 cases.

OBJECTIVE: The purpose of this case series is to describe the presentation of 2 patients who presented to a chiropractic teaching clinic with Paget-Schroetter syndrome (PSS) and to discuss the potential role for conservative therapy in the management of symptoms. CLINICAL FEATURES: Two patients presented with a vascular and muscular findings suggesting activity-related upper extremity deep vein thrombosis. One patient presented with recent onset of symptoms (pain in the neck with a "pinched nerve sensation" in the left upper trapezius); and the other presented with chronic, low-grade neck pain of 1 year's duration. INTERVENTION AND OUTCOME: The initial treatment approach for the patient with acute symptoms included soft tissue therapy. During the second appointment, he was immediately referred for medical evaluation and management because of worsening symptoms. He was diagnosed with thrombus in the left brachial vein, started immediately on a thrombolytic agent, and referred to a thrombosis clinic. Treatment for the second patient with chronic symptoms included soft tissue therapy, spinal manipulative therapy, and active care. Two months after 3 treatments, she reported improved symptoms. She remains under supportive care and has reported continued relief of her symptoms. CONCLUSION: Although a rare condition, PSS has the potential to result in significant morbidity and potentially fatal complications; thus, it is critical that practitioners recognize the signs and symptoms to facilitate appropriate and timely referrals. Clinicians should be aware of the presentation and proposed pathogenesis of PSS, and consider this diagnosis in patients with unilateral upper limb and/or neck pain.

Chronic Achilles tendinopathy: a case study of treatment incorporating active and passive tissue warm-up, Graston Technique, ART, eccentric exercise, and cryotherapy.

OBJECTIVE: To describe the subjective pain and functional improvements of a patient with chronic Achilles tendinopathy following a treatment plan incorporating active and passive tissue warm-up, followed respectively by soft tissue mobilization utilizing both Graston Technique(®) and Active Release Techniques(®), eccentric exercise, and static stretching in combination with cryotherapy. BACKGROUND: The primary characterization of chronic Achilles tendinopathy is gradual onset of pain and dysfunction focused in one or both Achilles tendons arising secondary to a history of repetitive use or excessive overload. INTERVENTION AND OUTCOME: Conservative treatment is commonly the initial strategy for patient management. Tissue heating, soft tissue mobilization, eccentric training, and static stretching with cryotherapy were implemented to reduce pain and improve function. SUMMARY: A specific protocol of heat, soft tissue mobilization, eccentric exercise, stretching, and cryotherapy appeared to facilitate a rapid and complete recovery from chronic Achilles tendinopathy.

Chiropractic treatment and the enhancement of sport performance: a narrative literature review.

A literature search and narrative review was carried out with the intent of determining the current level of knowledge regarding the chiropractic treatment of athletes for the purpose of sport performance enhancement. Of the fifty-nine relevant articles retrieved, only 7 articles of variable quality were obtained which specifically investigated/discussed chiropractic treatment and its involvement in sport performance enhancement. The role of the chiropractor in sport, unsubstantiated claims of performance enhancement, theories of how chiropractic treatment may influence sport performance, and the available evidence for the benefit of chiropractic treatment on sport performance are reviewed and discussed. Areas and directions for future studies are postulated. At this time there is insufficient evidence to convincingly support the notion that treatment provided by chiropractors can directly improve sport performance.

The diagnosis and emergency care of heat related illness and sunburn in athletes: A retrospective case series.

OBJECTIVE: Heat illnesses contribute to significant morbidity and occasional mortality in athletic populations. Sunburn increases the risk of various skin carcinomas. This report provides an overview of the etiology, symptomatology, risk identification, prevention, and treatment for heat related illnesses and sunburn. CLINICAL FEATURES: Four cases are presented to illustrate the diagnosis and immediate treatment of exercise related heat illness and sunburn. INTERVENTION AND OUTCOME: Identification of signs and symptoms combined with prompt treatment, achieved resolution in three athletes presenting with exercise related heat illness and one athlete with sunburn. CONCLUSION: The best treatment approach is prevention. Chiropractors can be an important resource for information regarding prevention and treatment strategies. For mild to moderate heat illness, quick identification of signs and symptoms, followed by rapid cooling and re-hydration comprises treatment. For heat stroke, rapid and aggressive cooling is essential to reduce mortality. Best evidence treatment of sunburn is symptomatic relief with emollients and pain control via medications.

A survey of Fellows in the College of Chiropractic Sports Sciences (Canada): their intervention practices and intended therapeutic outcomes when treating athletes.

OBJECTIVE: To compile baseline data regarding the treatment practices and therapeutic outcomes that fellows of the College of Chiropractic Sports Sciences Canada (CCSS(C)) strive for when treating athletes. DESIGN: Cross-sectional self-report mail out survey of CCSS(C) fellows. PARTICIPANTS: Current registered fellows of the CCSS(C) as determined by the College at the time of survey distribution. RESULTS: The majority of questioned fellows believe that they can cause direct and specific improvements in an athlete's sport performance. The most commonly utilized therapeutic intervention was spinal joint manipulation/mobilization. The most anticipated outcomes following the treatment of athletes with the goal of affecting athletic performance were "changing or improving aberrant body mechanics," "restoring or improving aberrant muscle function," and "improving joint function or reducing joint dysfunction." CONCLUSION: The majority of respondent fellows of the CCSS(C) believe their therapy to be effective in enhancing an athlete's sport performance.