Sunday, April 28, 2013

HEADACHES - Finding Relief From Headaches Starts With Identifying Which Type You Have

Headaches: I've been a practicing chiropractor in Miami Beach for nearly the past 20 years. However after graduating, I started my career in a practice in West Palm Beach where we encountered a patient with a very interesting headache. She initially called the office complaining of a headache. I asked her about her symptoms and told her to go directly to the emergency room. Why? Because her headache symptoms weren't from a simple headache, they were something else entirely. 

She showed up at our office anyway and having a good idea what was going on from our telephone conversation, I immediately called 911 and took her back to examine her. Although she was complaining of a headache, there was more going on. Most of the public isn't aware, but chiropractic physicians are trained to be primary care physicians. So, I examined this lady. Things immediately obvious were that the left side of her mouth wasn't moving as she spoke. I asked her to smile and only the right side of her mouth smiled. I asked her to raise her eyebrows and only the right eye brow elevated. The left side of her nose was runny, the left eye was tearing and her speech was somewhat slurred. Yes, she was having a headache, but the headache was merely a symptom – she was having a stroke. The paramedics arrived and took her to the local emergency room to save her life. This brings to light the many different headaches that are our there. Some are simple headaches where the headache is the primary diagnosis. There are several types of ‘primary headache’, then there are situations where the headache is secondary to another condition, just like the situation I described above. Here’s a list of various headaches. Sometimes the symptoms can be similar between the different types.

Do you have a simple headache? or is it something more? Click here to read the rest of the article

Dr. Narson is a 2-term past president of the Florida Chiropractic Association’s Council on Sports Injuries, Physical Fitness & Rehabilitation and was honored as the recipient of the coveted Chiropractic Sports Physician of the Year Award in 1999-2000. He practices in Miami Beach, Florida at the Miami Beach Family & Sports Chiropractic Center; A Facility for Natural Sports Medicine.

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Thursday, April 25, 2013

Back Pain - Car Accident & A Hidden Fracture Herniation; Could An Acute Traumatic Schmorl's Node Be At Fault?

Never heard of a Schmorl's node? Then this may be of interest to you.  Think a Schmorl's node is a normal variant see on x-ray or MRI? Then this may be of interest to you too.

Yep, it’s happened again. Putting a doctor’s name on some condition and making it sound totally benign! It’s too bad, but more and more research is proving my theory true. About 8 years ago, I had a patient who kept on returning with complaints of lower back pain, yet nothing positive on the lumbar MRI. It puzzled me and then I re-read the MRI report and that’s when it hit me. Schmorl’s nodes!!! 


Often times in life we get so use to calling things by the casual names we assign them, forgetting what they really are. For example, a soldier will talk about “Collateral Damage” when they actually mean they've killed an innocent civilian or they've blown up the wrong building. The term “co-lateral damage” sounds much less severe than what had actually taken place. Unfortunately, collateral damage happens.    In the world of medicine,  doctors and scientists often assign their own names to discoveries they make. This has been a common practice for over one-hundred years. Some nice doctors will honor their patient by naming a newly discovered disease or condition after the patient who presented with the disease. These names tend to make the diseases, conditions and tests more palatable for the general public. And for good reason., some of the actual medical/scientific names are so long that they are just too difficult for many to comprehend. So we give them simple benign names. Hence the term “Schmorl’s Nodes”. 

Since I last wrote about them I had a conversation with a neuroradiologist about the phenomenon of acute-traumatic Schmorl’s nodes. I explained to him that if there is enough pressure and the outer fibers of the disc are in great-healthy shape, the force must go somewhere…up through and into the vertebral body. We discussed it a bit further and told me that if I could find it in the American Journal of Neuroradiology, then you’ve got something. So I researched it and found the reference I was looking for, and here it is: 
AJNR Am J Neuroradiol 2000 Feb;21(2):276-81; Relationship of Schmorl's nodes to vertebral body endplate fractures and acute endplate disk extrusions. Wagner AL, Murtagh FR, Arrington JA, Stallworth D. University of South Florida College of Medicine, Department of Radiology, Tampa, USA 

Classically, radiologists and clinical physicians shrugged off Schmorl’s nodes as an incidental finding having nothing to do with acute trauma. However, the more and more I read, the more I find out that these "incidental findings" were actually caused by prior traumatic events and were (again) shrugged off because doctors succumbed to convention and didn't think outside the box. 


Simply put, a Schmorl’s Node is a disc that has herniated up through the bony vertebral endplate and into the body of the vertebrae. It is a herniation that fractured through the bottom or top of the vertebrae. Even more simple, it’s a fracture-herniation! 

So now it’s out in the open. There has been enough research to prove it and from more recent casual browsing of on-line research reports, there's more support since the 2000 publication of the reference above. 

The next time a physician says the MRI or X-ray report is negative, the patient is still in pain and there was an acute trauma as the cause for the patient's pain...go back and read that radiology report again and see if there are any Schmorl's nodes. Ruling out the other causes of a Schmorl's node could leave the not-so-obvious fracture-herniation as the only diagnosis left standing. 

Contact me if you have any questions.

Dr Todd Narson
Miami Beach, FL

 References: 
1) Yochum & Rowe; Essentials of Skeletal Radiology; p. 114 
2) Paul & Juhl; The Essentials of Roentgen Interpretation 
3) V. Fahey MBBS; et al.; The Pathogenisis of Schmorl’s Nodes in Relation to Acute Trauma. Spine 1998;23:2272-2275 
4) Wagner AL, Murtagh FR, Arrington JA, Stallworth D, American Journal of Neuroradiology Feb;21(2):276-81; Relationship of Schmorl's nodes to vertebral body endplate fractures and acute endplate disk extrusions.

Dr. Narson is a 2-term past president of the Florida Chiropractic Association’s Council on Sports Injuries, Physical Fitness & Rehabilitation and was honored as the recipient of the coveted Chiropractic Sports Physician of the Year Award in 1999-2000. He practices in Miami Beach, Florida at the Miami Beach Family & Sports Chiropractic Center; A Facility for Natural Sports Medicine.

#chiropractormiamibeach #MiamiBeachChiropractor #SportsInjuriesFixedHere #DrNarson #TriDoc #TriathlonDoc #ChiropracticSportsMedicine #ACASC #SportsMedicine #MiamiBeachSportsMedicine #SportsMedicineMiami #MiamiSportsMedicine #MiamiChiropractor #Triathlon #Running #Ironman #IFixPeopleInPain #TrainWithoutPain #MiamiBeachChiropractor #GrastonTechnique #FAKTR #IASTM #Chiropractor #FootPain #Narson #NarsonBodyMechanic #NarsonTool #DACBSP #CCSP #ACBSP #BackPain #NeckPain #ShoulderPain #RotatorCuff #ITBandSyndrome #runnersKnee #PlantarFasciitis #Plantarfascitis #AchillesTendonitis #AchillesTendonosis #GettingAthletesBackInTheGame  #MiamiBeachChiropractor #MiamiSportsMedicine #MiamiBeachSportsMedicine #WeFixPeopleInPain #TrainWithoutPain #ChiropracticSportsMedicine #ACASC #ProSportChiropractic #FunctionalMedicineMiami #DrNarson #BackPainRelief #NeckPainRelief #SportsInjuriesFixedHere #LaserTherapy #RockTape #KinesioTape #KTTape #Nutrition #21DayPurificationProgram #DetoxProgram #PaleoDiet #PaleoDoc #FunctionalNutrition #MVA #CarAccidentPainRelief #CarAccidentTreatment #CarAccidentTreatmentMiami #CarAccidentTreatmentMiamiBeach

Graston Technique®, ASTYM, FAKTR, SASTM, Gua Sha - A Brief Explanation & Commentary

The (now patented) Narson Body Mechanic N6

Graston Technique®, ASTYM, FAKTR, SASTM, Gua Sha are all forms of IASTM (Instrument Assisted Soft Tissue Mobilization). The purpose of which is to break down scar tissue and adhesions that are causing multi-layered soft tissue restriction and adversely affecting the dynamic function of the underlying muscles, tendons, fascia & fascial planes, ligaments, etc. These restrictive scars and adhesions can be from old injuries, surgeries, repetitive strain (like carpal tunnel), mis-use or improper use of your body when working, playing, doing sports or just from the day-to-day activities of your normal life. They happen from car accident, sitting in front of a computer too much for too long or from childhood bumps and bruises that were never really attended too properly. 


 There are some minor difference between the techniques I mentioned above however ultimately, all are very effective for the right conditions. However effectiveness doesn't depend so much on the original coursework or specific technique, but the experience of the practitioner and the accuracy of their diagnosis coupled with proper application of the technique. 

 One thing I want to "get off my chest" is that Graston Technique® & ASTYM aren't new techniques. Your doctor or therapist may have just learned it and is all excited about it, but these techniques have been around for over 20 years with the original research being done at Ball State University. Gua Sha actually dates back to the 5th &; 7th centuries (roughly 700-BC to 500-AD). FAKTR & SASTM have been around since the mid to late 2000 respectively


IASTM techniques are not simply the use of instruments to loosen or remove adhesions and provoke an acute inflammatory response, but it’s the follow up treatment, stretching, therapies, resistance, rehab & anti-inflammatory nutrition that completes the techniques and is equally as important. Otherwise, you're simply doing Gua-Sha/Instrument Massage and without the proper follow-up, you can expect the symptoms and condition to return. Sometimes, they’ll return with a vengeance. This is why you want a fully trained (and experienced) practitioner performing this on you or your athletes.

Having become certified in Graston Technique® M1 & M2 in 2002 and several years ago, trained in FAKTR-PM (now known simply as FAKTR), 11 years of the last 20 years using IASTM full time in my practice, weekend excursions as a member of the sports medicine team at local sporting events, a 10 day rotation at the 2006 Central American & All Caribbean Games and 10 days at the 2011 Pan American Games, all gives me a unique experience and perspective in the practical application of IASTM. You’ll find many others with varied but similar experience. 

Some of the most important factors for providing good IASTM are: 
1. A good physical exam 
2. Sports specific examination of their injury 
3. Creativity -Thinking outside the box (and sometimes outside the walls of your clinic) 

As a result of my experience with Graston Technique®, FAKTR and IASTM in general, I developed my own instrument design known as the Narson Body Mechanic N6. The design is patented in Canada and I’m very proud to announce that it has been awarded a US Patent as well (just received the certificate today!!). The reason I designed this instrument was out of my constant need to be more efficient with IASTM. The design affords me the ability to carry all of the most useful IASTM instruments with me in one convenient tool. No longer do I have to carry a kit of tools with me. No longer do I have to clean multiple instruments between patients. I have everything in one hand at all times. The design includes a non-slip gripping surface which reduces tool slippage and reduces practitioner finger & hand fatigue which, the longer you do IASTM with real highly polished stainless steel instruments, you’ll come to appreciate. The other thing most of us in the USA can appreciate is that it’s the only useful “multi-tool” for IASTM that is made from 100% U.S. steel and made 100% by hand right here in the U.S.A., although I have seen some copycats popping up here and there.

When it comes to giving effective IASTM, the most important thing to remember is after a good base education, it’s the wealth of experience along with the doctor’s (or therapist) ability to be creative. From my experience, it's thinking outside the box that matters most, coupled with a good nutrition plan, rehab and anti-inflammatory therapies and the results will astound. It’s very possible with IASTM to take long time chronic injuries-treat them with IASTM and have the athlete back out playing the same day or the next day. 

This year I have helped a multitude triathletes get back into their training to complete in the full Ironman triathlon. Others are back training to complete 26.2 distance marathons and half marathons and some people are back into their workout routine because of the proper application of IASTM. Often you’ll find me at the pool, the track, with a cyclist on an indoor trainer or running on the sidewalk with a patient working with them while they do their sport. For me, putting a person in the exact environment that produces their symptoms is the only way to resolve the problem. Just like anything else in life, experience matters and creative matters. Even with IASTM.

'nuff said 

 Dr. T 

_________________________________________________________________________________
 Dr. Narson is a 2-term past president of the Florida Chiropractic Association’s Council on Sports Injuries, Physical Fitness & Rehabilitation and was honored as the recipient of the coveted Chiropractic Sports Physician of the Year Award in 1999-2000. He practices in Miami Beach, Florida at the Miami Beach Family & Sports Chiropractic Center; A Facility for Natural Sports Medicine.

#chiropractormiamibeach #MiamiBeachChiropractor #SportsInjuriesFixedHere #DrNarson #TriDoc #TriathlonDoc #ChiropracticSportsMedicine #ACASC #SportsMedicine #MiamiBeachSportsMedicine #SportsMedicineMiami #MiamiSportsMedicine #MiamiChiropractor #Triathlon #Running #Ironman #IFixPeopleInPain #TrainWithoutPain #MiamiBeachChiropractor #GrastonTechnique #FAKTR #IASTM #Chiropractor #FootPain #Narson #NarsonBodyMechanic #NarsonTool #DACBSP #CCSP #ACBSP #BackPain #NeckPain #ShoulderPain #RotatorCuff #ITBandSyndrome #runnersKnee #PlantarFasciitis #Plantarfascitis #AchillesTendonitis #AchillesTendonosis #GettingAthletesBackInTheGame  #MiamiBeachChiropractor #MiamiSportsMedicine #MiamiBeachSportsMedicine #WeFixPeopleInPain #TrainWithoutPain #ChiropracticSportsMedicine #ACASC #ProSportChiropractic #FunctionalMedicineMiami #DrNarson #BackPainRelief #NeckPainRelief #SportsInjuriesFixedHere #LaserTherapy #RockTape #KinesioTape #KTTape #Nutrition #21DayPurificationProgram #DetoxProgram #PaleoDiet #PaleoDoc #FunctionalNutrition #MVA #CarAccidentPainRelief #CarAccidentTreatment #CarAccidentTreatmentMiami #CarAccidentTreatmentMiamiBeach

Tuesday, April 9, 2013

Spira’s Stinger 2: Running Shoe Review


Spira's Stinger-2 Marathon & Triathlon Shoe

As a sports medicine physician I found myself in the medical tents taking care of athletes at triathlons, marathons, pro-beach volleyball and other sports events over the years and the one sport that really intrigued me was triathlon. It involved all the things I loved to do as a kid, swim, bike and run. But as an adult, running was a problem for me.  Being the sports techie that I am, I began searching for technological advances in running shoes. I found several articles about a new sneaker company out of El Paso, Texas called Spira that put “Wavesprings” in the heal and fore-end of their sneakers. The more I read, the more I was intrigued.



I ordered my first pair of spira’s and began training. I loved the sneakers because they really reduced the shock to my heel and strain on my foot. Somewhere along the line I started to enjoy running, taking in the scenery and taking that relaxing breath as you run by some truly beautiful scenery and you forget you’re actually running.


A view of Spira's Patented
Wavespring Technology

So now I’ve been doing triathlons for the past 4 years and ran my first race in Spira’s new Stinger-2. I have been training in it for several months and found the shoe to be extremely light and responsive. The Stinger-2 is incredibly comfortable and even with my nasty ingrown toenail (I know-I know...T.M.I.), I finished my triathlon without a peep from my feet.  My training over the past 4 months has been on the road, on gravel and on hard packed beach sand and the shoes have stood up very well and continue functioning and looking great.    They seem to be very well constructed and I’m definitely going to be purchasing another pair. 

Other companies have more recycled conventional technologies to absorb shock. Air or gel pockets, various rubber compounds to add some extra bounce, but Spira has successfully developed a stainless steel spring called wavesprings that seem to be based on a leaf-spring design (much like the natural arch of a foot)  and provide lateral stability while absorbing shock and returning energy back into your stride.  The did this in a manner that keeps the spring low profile (unlike coil springs).  The size of your foot determines the relative strength of your wavesprings. Obviously someone who is 6’2” and has a size 12 foot needs a different strength than someone 5’4 with a size 7.  The wavesprings are geared towards your shoe size and relative body weight.

Me (Left) with Dr. Darren Kreitman
of Ft. Lauderdale, FL at the 2013
Nautica South Beach Triathlon
For me, I need something durable, light, responsive, stable, comfortable and of course stylish.  My last 4 months training with the Stinger-2 and my recent triathlon finish made me really appreciate all of the technology that Spira and especially, the Stinger-2 brings to the table. If you have stopped training because of back pain, knee pain, foot or ankle pain, I’d give the Spira Stinger-2 some serious consideration. I can tell you that more and more marathon winners are crossing the finish lines with new PRs sporting the Spira technology. Now that I’ve adopted a more “natural” forefoot running style, the wavesprings do even more to reduce shock and add that much more to the comfort of my running. For more info, go to: www.spira.com






'Nuff Said

Dr. T

Dr. Narson is a 2-term past president of the Florida Chiropractic Association’s Council on Sports Injuries, Physical Fitness & Rehabilitation and was honored as the recipient of the coveted Chiropractic Sports Physician of the Year Award in 1999-2000. He practices in Miami Beach, Florida at the Miami Beach Family & Sports Chiropractic Center; A Facility for Natural Sports Medicine.

#chiropractormiamibeach #MiamiBeachChiropractor #SportsInjuriesFixedHere #DrNarson #TriDoc #TriathlonDoc #ChiropracticSportsMedicine #ACASC #SportsMedicine #MiamiBeachSportsMedicine #SportsMedicineMiami #MiamiSportsMedicine #MiamiChiropractor #Triathlon #Running #Ironman #IFixPeopleInPain #TrainWithoutPain #MiamiBeachChiropractor #GrastonTechnique #FAKTR #IASTM #Chiropractor #FootPain #Narson #NarsonBodyMechanic #NarsonTool #DACBSP #CCSP #ACBSP #BackPain #NeckPain #ShoulderPain #RotatorCuff #ITBandSyndrome #runnersKnee #PlantarFasciitis #Plantarfascitis #AchillesTendonitis #AchillesTendonosis #GettingAthletesBackInTheGame  #MiamiBeachChiropractor #MiamiSportsMedicine #MiamiBeachSportsMedicine #WeFixPeopleInPain #TrainWithoutPain #ChiropracticSportsMedicine #ACASC #ProSportChiropractic #FunctionalMedicineMiami #DrNarson #BackPainRelief #NeckPainRelief #SportsInjuriesFixedHere #LaserTherapy #RockTape #KinesioTape #KTTape #Nutrition #21DayPurificationProgram #DetoxProgram #PaleoDiet #PaleoDoc #FunctionalNutrition