Dr. Fox trained in Chiropractic Extremity Adjustment to the Foot and Ankle

Dr. Fox recently participated in additional training for Sports and Occupational Injuries of the Foot and Ankle, presented by International Speaker Dr. Mitch Mally, who is considered a "10th degree black belt in extremity adjusting.



Common injuries and pathologies of the foot and related mechanics were covered, including inversion sprains, plantar fascitis, achilles tendonitis, high ankle sprains, avulsion fractures, and arch problems, just to name a few. Specific Chiropractic adjustments were demonstrated by Dr. Mally for each type of foot imbalance. Major areas of focus were in adjustments to the Calcaneus, Talus, Navicular, Tarsals, Cuneiforms, Metatarsals, and Phalanges.



Dr. Mally's review of the literature further supported altered gait and mechanics throughout the body, including tibial torsion at the knee, femoral bone anteversion, sacral & lumbar spine unleveling, piriformis muscle strain, and other global symptoms.



The emphasis is added that the imbalance of the foot, in any situation, is going to alter muscle and other supporting structures of the body which are likely to cause pain. This is clear evidence that a doctor must have a whole view of the body when treating pain disorders.



The most common type of foot and ankle pain is due to inversion sprains of the ankle. Over time, the affect on the arch is usually pronation of the foot and a valgus deformity of the ankle or mortise joint. This type of fallen arch causes the tibia bone to internally rotate and force the quadricep muscle to over-work in order to keep the knee aligned. Medial knee pain or anterior knee pain over the infrapatellar tendon is a common result. This can lead to a condition called Osgood Shlatter's in children or Chondromalacia Patella in adults. Dr. Fox received specific one-on-one instruction in correcting this type of tibial torsion or rotation in the weekend symposium.



Furthermore, an inverted type foot imbalance will cause femoral head anteversion, which literally means the femoral head has internally rotated and move anterior to the acetabulum. This type of motion stretches the piriformis muscle and psoas muscle, causing multiple biomechanical and postural changes. The piriformis muscle is particularly problematic because it may cause a general imbalance to the entire spine by shifting the sacrum from its normal position and causing a mal-alignment of the foundation of the spine.

The most common symptom of a Piriformis imbalance or Piriformis Syndrome is Sciatica. A properly trained Chiropractor can easily detect if the imbalance lies in the spine, pelvis, or lower in the foot and ankle. At times, an orthotic may be necessary to correct a foot and ankle problem once the ankle has been adjusted into a correction position and supported by muscular rehab.

Due to the precision of the body's proprioceptive mechanism, foot imbalance can cause pain symptoms throughout the body, including head and neck (including headaches), jaw & TMJ, low back, pelvis, and knees. After a visit to a Chiropractor, symptomatic relief of pain usually occurs in a short amount of time yet stabilization and correction of the imbalance take time in order to allow proper healing.

Chapel Hill Clinic Offers New Innovative Approach to Sleep Apnea Using Alternative Methods Chiropractic Applied Kinesiology and Physical Therapy

The Chapel Hill Chiropractic Centre has a new approach to helping individuals with Sleep Apnea, particularly a type of Sleep Apnea called Obstructive Sleep Apnea (OSA), the most common form of Sleep Apnea that affects millions of people.

Chiropractic combined with innovative techniques utilized from Applied Kinesiology, massage, physical therapy, dentistry, and cranial manipulation create a powerful arsenal of treatment options that may make sleep apnea sufferers breathe a sigh of relief. This comprehensive approach evaluates the entire body, utlizing many methods which would be otherwise missed by a professional who specializes in one particular region of the body. Due to the widely varying causes of sleep apnea, specialists can often be too focused to be able to evaluate the "big picture". After all, the body is connected in every aspect.

With Sleep Apnea, individuals are forced to use a CPAP machine (Continuous Positive Airway Pressure) to be able to breathe regularly and effectively throughout their sleep cycle because the airway is not remaining patent, or open. The typical method of diagnosis of this condition is performed at a sleep study clinic using Polysomnography. This testing can be useful but also disruptive because the person being studied has to sleep in an unfamiliar environment with different bedding.

An effective and simpler method of testing is done with oximetry often combined with pulse measurement, sometimes called pulsoximetry. This is a simple device that clips over the end of the finger during sleep, measuring the blood oxygen percentage while a person sleeps. Typical blood oxygen saturation levels should reach about 98-99%, yet can be often found as low as the 80's with sleep apnea. The co-morbidities of low oxygen saturation in the blood has many implications in diabetes, cardiovascular disease, and blood/tissue related diseases.

Sleep Apnea patients often present to a chiropractors office with little awareness of their physical, neurological, and chemical imbalances. The reason for the visit is often neck, mid-back or low-back pain. Common physical and palpatory findings include an anterior head carriage, muscular strain to the SCM muscle, or Sternocleidomastoid, fascial shortening of the posterior neck extensors, a visible Buffalo Hump, External auditory meatus shifted anterior to the acromion process, loss of cervical spine lordosis or curve, TMJ palpatory pain, Temporalis muscle hypertonicity, Tooth wear from grinding teeth, and obesity.

From a chiropractic perspective, these typical Sleep Apnea patients generally sleep with several pillows stacked behind their heads which force the head and neck into flexion and reverse the natural cervical spine curve or lordosis. Other common causes of this type of subluxation, or misalignment is chronic poor posture and whiplash injuries to the head and neck. Often a 5MPH car collision is enough to create neck imbalances which can later lead to an airway dysfunction.

A reversed cervical lordosis or loss of the natural "C" curve in the neck creates a mechanical change in the opening of the airway and breathing passage, often resulting in breathing problems due to a narrowed airway in the glossopharyngeal region of the neck. Tightness in the TMJ or Tempormandibular Joint can further compound the issue by causing pharyngeal spasming. This is the primary reason that many well-informed dentists use a device called a Mandibular Advancement Splint to improve sleep apnea. The fact is, when the Temporomandibular Joint is opened inferiorly and translated anteriorly, the airway opens up. When the TMJ moves posterior and superior it closes the airway and makes it less patent, restricting the normal motions of the kinematic chain in the neck.

Chiropractic does the same thing, yet does not use the aid of a Splint to open the airway. Chiropractic treatment of the head and neck retrain the neck muscles and improve the neck and cervical spine posture. The significant difference between this and a mandibular advancement splint is that a proper chiropractic manipulation aids in correcting the joint imbalance by treating the temporomandibular joint and supporting muscles, ligaments, and tendons.

Both the chiropractic manipulation and mandibular advancement splint are an effective method of improving sleep apnea. The combination of these two methods is likely to be a match made in heaven for sleep apnea sufferers.

For more information, or to find out if Chiropractic and Applied Kinesiology is right for you, the Chapel Hill Chiropractic Centre schedules complimentary consultations as a courtesy to our patients.