Skip to main content

Todays Trending Topic ♛

Functional Medicine for Autoimmune Disease Prevention | Functional Chiropractor

Autoimmune disease affects up to 50 million Americans, according to the American Autoimmune Related Diseases Association. Why are so many people affected by these chronic pain conditions? There are a number of factors that may cause the human body to attack its own cells, some of which can be modified.

What lifestyle modifications can help improve autoimmune diseases?
Unfortunately, conventional treatment options often focus on solely relieving symptoms, in the belief that there are no cures for autoimmune diseases. However, autoimmune diseases still undergo cycles of flare-ups and remission. In accordance with Dr. Dempster, a healthcare professional in alternative treatment, functional medicine looks at your complete health picture by addressing fundamental factors of your biochemical, physical, and emotional well-being.

Why is this important? Your body naturally wants to become healthy and at a state of balance. Nonetheless, things occur to upset that balance. It's believed tha…

SLAP Lesions: Post-Op Rehabilitation

Chiropractor, Dr. Alexander Jimenez looks at the surgical interventions required to manage a SLAP lesion and presents in-depth guidelines on the necessary post-surgical rehabilitation following a SLAP repair…

There are a number of varying types of treatment options available in different types of SLAP lesions. The type of lesion, the age of the athlete and the functional level of the athlete will determine the type of treatment plan prescribed for the SLAP lesion. Labrum repair, biceps tenodesis, debridement, tenotomy, and conservative treatment have all been recommended depending on the characteristics of the lesion.

Many variations of SLAP lesions are initially treated conservatively with measures to primarily improve the patho- mechanical factors that impinge on the SLAP lesion such as glenohumeral internal rotation deficit (GHIRD) and scapular dyskinesis. For many of the lower-level type 1 lesions, this may be quite effective in eliminating the symptoms of the SLAP lesion without the need for surgery. However for the purposes of this article, the focus will remain on surgically treated SLAP lesions and their rehabilitation.

Surgery Types

Simple type-1 lesions may only require a simple debridement without disrupting the biceps anchor(1), whereas type-2 lesions are the most commonly seen type in sports medicine clinics, and these involve a detachment of the biceps anchor from the labrum. Type-2 lesions can be treated with arthroscopic fixation of the superior labrum to establish biceps anchor stability.

Type 3 lesions are characterized by bucket-handle tears of superior labrum with intact biceps anchor. This bucket handle fragment can easily be debrided by an arthroscopic shaver, and repair is often not needed(2). However, if the type 3 lesion is associated with a Buford complex then it should be treated as a type 2 lesion(3). The other types of SLAP lesions are not as common as the type 2 lesions, although if they do exist will certainly need surgical intervention.

In a large database search of over 25,000 arthroscopic SLAP repairs, Zhang et al (2012) found that the highest incidence of repair is in the 20-29 years and 40-49 years of age groups(4). This may reflect how the younger population are more likely to be involved in sports and other activities where they may suffer an acute SLAP lesion. In the 40-49 year old group however, the high incidence is most likely down to the degeneration of the labrum, which may be initially make its presence felt around this age. Also there is a significant gender difference, with men having three times higher incidence of repair. This probably reflects how males are more likely to play a sport, or behave in a way that may lead to a SLAP lesion.


A number of guidelines have been proposed when managing post-operative SLAP lesions based on the original mechanism of injury(8). These include:

1. In injuries sustained due to a compressive mechanism, subjects need to avoid weight bearing exercises on the limb in the early stages to avoid the compression and shear effect on the labrum.

2. In injuries sustained due to a sudden traction, subjects need to avoid any heavy eccentric biceps load to minimise the traction effect on the biceps anchor.

3. In injuries sustained due to a ‘peel- back’ mechanism, subjects need to avoid excessive shoulder external rotation in the early post-surgical period.

With these guidelines in mind, the general rehabilitation plan is staged over six phases. Although time frames have been approximated for each stage, the key decision to move from one stage to the next is the achievement of the exit criteria listed at the end of each stage. In general terms, throwing and contact sport athletes will usually return to competition at 6-9 months post-surgery, depending on the athlete and the sport.


SLAP lesions are a reasonably common injury in the throwing athlete and can also be a source of shoulder pain in the contact athlete. Type II SLAP lesions are more common and will usually require surgical intervention. The rehabilitation program following this type of injury may be quite lengthy and detailed and most athletes will return to sport at six to nine months following surgery.


1. Am J Sports Med 2003; 31: 798-810

2. Clin Orthop Relat Res 2001; (390): 73-82

3. Am J Sports Med 1995; 23: 93-98

4. Am J Sports Med 2012; 40: 1144-1147

5. J Bone Joint Surg Am. 2009;91:1595-603

6. Clin Sports Med. 2004;23(3):321-334, vii

7. Clin J Sport Med. 2007;17(1):1-4

8. The Int J of Sports Phys Th. 2013. 8(5). Pp 579-600

9. N Am J Sports Phys Ther. 2008. 3 (2): 95–106

10. Phys Sportsmed.2011;39(4):90-7

11. North American Journal of Sports Physical Therapy. 2007. 2(3); 159-163

Popular posts from this blog

Pain in the Quadratus Lumborum Muscle

A majority of the population have at some point experienced low back pain in their lifetimes. Although low back pain is recognized to result from numerous conditions or injuries on the lumbar spine, muscle strains such as a quadratus lumborum muscle strain, are believed to be a leading cause for the recognizable symptoms of pain and discomfort.
The quadratus lumborum muscle is a sizable muscle in the shape of a triangle, located deep on each respective side of the lower back. The role of the wide muscular tissue is to grant mobility to the lumbar spine in sequence for the torso to move laterally from side to side as well as extend and stabilize the lower spine to improve posture. When this muscle is strained or pulled, the symptoms can restrict movement on the lower back and since the muscular tissue is so extensive, recovery from this type of injury usually requires more time and patience to fully heal.

Quadratus Lumborum Syndrome V.S. Facet Joint Syndrome
When symptoms of back pa…

Achilles Tendon Injury

Achilles tendonitis is a medical term used to describe a condition resulting in irritation of the large tendon, the Achilles tendon. Found in the back of the ankle, this condition is recognized as a common cause for injury among athletes. Excessive use of the Achilles tendon results in inflammation together with swelling and pain.
The development of Achilles tendonitis can be associated with two important factors, most frequently among athletes, which are, lack of flexibility and over-pronation. With age, the tendons will begin to lose flexibility, just the same as other tissues in the body. This change causes the tendons to become more rigid and more vulnerable to injury. For some people, the ankle may roll too far downward and inward with each step they take. This is called over-pronation, which places more stress on the tendons and ligaments of the foot, contributing to injury if not corrected.
Achilles tendonitis may also develop from other factors. An increase in an athlete’s …

5 Common Causes for Shoulder Pain

The shoulders are the most mobile joints in the human body. Because the ball of the humerus is designed to be larger than the shoulder socket that holds it, the shoulders need to be supported by muscles, tendons, and ligaments to secure them in a stable or natural position. Since the shoulder can be unstable, it is often a site for many common complications. Below are 5 common causes of shoulder pain and their associated symptoms.
Rotator Cuff Tear
Rotator cuff tears within the shoulder are a very common type of shoulder injury. The rotator cuff consists of a set of four muscles: the supraspinatus, the infraspinatus, the subscapularis, and the teres minor. All of these muscles are attached to the bones of the shoulders by tendons, which purspose is to support, stabilize, and grant the arm movement to move up, down and rotate. The rotator cuff ensures that the arm remains in the shoulder socket. Damage or injury from an accident or gradual wear and tear can result in inflammation to t…

Today's Chiropractic

Location Near You