Dr. Kim Leis-Keeling

Dr. Amanda Boccio

 

Serving Albany and Guilderland

2021 Western Avenue, Ste 102

Albany, NY 12203

518-869-3415

PROTECT YOURSELF FROM TICK-BORNE ILLNESS

By: Dr. Amanda Boccio

 

It’s about time we get outside to work in the yard and garden; and if you’re like me, you’ve been itching to get out for a long hike.   Every year we hear more about the prevalence of tick bites, Lyme disease, and other tick-borne illnesses in our area, so it is imperative that we know how to protect ourselves as we venture outdoors.  One of our staff members recently attended an informative seminar hosted by the Lyme Action Network, and we would like to share some valuable information presented by microbiology professor Holly Ahern, and Christina Fisk

So what is Lyme Disease?  Lyme Disease is caused by the bacteria Borrelia burgdorferi, which is transmitted by a bite from an infected deer tick.  Ticks can also pass along other pathogens including Anaplasma, Babesia, Bartonella, Ehrlichia and Powassan, which can result in co-infections.  Lyme Disease is characterized by the presence of a “bulls-eye rash,” but the rash is NOT always present. Only 30% of patients with a confirmed Lyme diagnoses report seeing a rash.  The symptoms of Lyme Disease are highly variable, and tend to mimic other illness, which is why misdiagnosis is very common.  Lyme and its co-infections can attack any or all of the body’s systems including musculoskeletal, neurological, digestive and cardiac systems.  Symptoms include (but are not limited to) fatigue, joint pain, muscle stiffness, headache, changes in vision or hearing, trouble sleeping, poor concentration and brain fog etc… If caught early and treated appropriately, Lyme is less likely to become a chronic illness.

How can we prevent tick bites in the first place? While outdoors, wear long sleeved, light colored clothing, and tuck your pants into your socks.  Treat your outdoor clothing with permethrin (a substance that is effective for killing ticks), and store the treated clothing in plastic bags in the garage to be used the next time you are outdoors.  When using insect repellant with DEET, spray it on outdoors, and reapply as directed.  Natural insect repellents like lemongrass and citrus oil need to be reapplied every 2-3 hours because they may not be as effective as those containing DEET.  Once you and your family are indoors, throw the clothing you were wearing in the dryer for 15 minutes, and take a shower.  Perform frequent “tick checks” on all adults and children; being mindful to check hard to see places like the scalp and back.  Don’t forget to check your pets!

A tick has attached itself to me/ my spouse/ my child. What do I do now?  Since an infected tick can transmit disease fairly quickly, it is imperative to remove the tick from the skin as soon as possible.  Grab the tick where it meets the skin using fine-tipped tweezers and pull straight up.  Save the tick in a plastic zip-lock bag, and send it to the Laboratory of Medical Zoology at the University of Massachusetts (https://www.tickreport.com/). The lab will be able to tell you if the tick was a carrier of any pathogens.  Knowing if you were exposed or not to disease causing agents will help you and your health care provider decide what to do next.

Tick-Borne Disease has become a public health crisis here in New York State and in our community. Please visit the Lyme Action Network website at www.lymeactionnetwork.org to learn more valuable information about this topic.  If you have any questions about this article, please feel free to contact us at the Sports & Spinal Wellness Center at 518-869-3415. Please visit our website for more information at www.sportsandspinalwellness.com. We would be happy to be a part of your healthcare team.

 

June 20, 2019
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VERTIGO

BY: Dr. Kim Leis-Keeling

Everything happens for a reason right? Well, I believe that things happen to me so that I have more material to write about for the Our Towne. Here we go with another brief story from the Chronicles of Dr. Keeling’s Ailments.

Last summer on a trip back to Wisconsin (don’t worry, I didn’t smuggle cheese back on this one), I noticed that there was a chiropractic office in the Minneapolis/St. Paul airport.  It was called Chiroport. I remember commenting to my husband that it was a great idea because people frequently get back and neck pain when traveling.  The day we were to return home, I woke up feeling a little strange. My head felt a little woozy and dizzy.  I’d had a few drinks the night before but certainly not that many as to cause a typical hangover. I ate my breakfast and drank plenty of fluids but my symptoms persisted. I noticed that every time I moved my head I felt the dizziness. As we were driving to the airport, I was processing my symptoms and tried to self -diagnose my condition. I checked my cranial nerve function to assure that I was not having a stroke. After a few minutes, I concluded that I was experiencing Cervicogenic Vertigo because I only got dizzy when I looked down. I feared this was going to be a long and nauseating flight home if I couldn’t fix this before getting on the plane.  I decided I would stop at the Chiroport to get an adjustment to see if that would help.

I checked into Chiroport, talked to the doctor about my symptoms. We had a brief chat about where we went to chiropractic school. We actually did internships with some of the same doctors and the same professors. He did an exam, re-checked my cranial nerves and blood pressure...all was still good. He performed trigger point massage on my neck, a few stretches and a small cervical adjustment. I got up from the table feeling better. By the time I walked to my gate the dizziness was gone. YIPPIE! Two thumbs up for Chiroport! Thank goodness…I didn’t have to worry about puking on the airplane.

There are many reasons someone may experience vertigo. Two of the most common types that we see are Cervicogenic vertigo and Benign Paroxysmal Positional Vertigo (BPPV). Cervicogenic vertigo typically presents with dizziness that is due to changes in cervical spine position which may or may not be accompanied with cervical pain. Treatment includes manual therapy to the cervical spine to alleviate muscle tension or trigger points and mobilization techniques to address any cervical malalignment.

Benign paroxysmal positional vertigo (BPPV) occurs when calcium crystals become displaced and relocate within the inner ear. Patients with BPPV will experience dizziness associated with changes in head position in relation to gravity. For example, standing to laying down or vice versa. These patients may also report a feeling of fullness in their ears. Due to the nature of BPPV, there will also be a condition called nystagmus, described as involuntary changes in eye movement patterns. These will subside when vertigo repositioning maneuver is performed.

Often these two condition will occur together and multiple procedures will be needed to address the vertigo. As always, if you have questions about this article, please feel free to contact me at the Sports & Spinal Wellness Center at 518-869-3415. Follow us on Facebook or visit our website at www.sportsandspinalwellness.com. We would love to be a part of your healthcare team.

 

SPRING TRAINING: RUNNING TIPS

By: Dr. Kim Keeling

Yippie! It’s spring! Time to come out of hibernation and get outside. Let your neighbors know your still alive because they may not have seen you in the past 6 months. There is something about spring that motivates us to move, to work in the yard, take a walk or run. Maybe you are planning for your upcoming running season.  Before you hit the pavement running too hard or too fast, lets talk injury prevention. Runners are one of the hardest groups of athletes to work with. They are notorious for avoiding stretching and training though injuries. They often come hobbling into the clinic in pain and say “fix me but don’t tell me to stop running because I have a race in 3 days.”

Your first step to ward off injuries this running season is to prevent them.  Common injuries that we see with runners are plantar fasciitis, hamstring strains, IT band syndrome, patellofemoral pain syndrome, Achilles tendonitis and hip tendonitis/bursitis. These injuries all happen from improper muscle firing patterns, faulty gait patterns or overuse and all can be prevented. Knowing when to stop could save you a load of pain and agony. 

Here are a few tips to get you started on the right track:

  1. The pressure on your joints is 2 times your body weight while walking and 5 times during jogging. If you have been fairly sedentary this winter and are beginning a running program, you may need to start with a walk/jog program to get you started.

  2. Never increase your mileage more than 10% from the previous week.

  3. Get some help picking out running shoes. Have your feet, knees, hips and running gait evaluated to help pick the perfect shoe for you.

  4. If you can hear yourself running, then you are either pounding down into the ground too hard on contact or the muscles in front of your shins (Tibialis Anterior muscle) are too weak and needs strengthening. Either way, it is slowing you down. Practice a little barefoot running in the spring to keep you light on your feet.

  5. Invest in a foam roller and learn how to use it. This is a great tool to use before and after you run to prepare your legs for movement and for muscle recovery.

  6. Static stretching is best done after you run. The goal of stretching is to relax and lengthen your muscles. However, you do not want a “relaxed” muscle during activity; you want a muscle that is activated. Save your long hold stretches (at least 30-60 seconds) for post-run.Make sure to do an active warm up before you take off on your run.

 

If you start to develop pain in the joints of your legs (ankles, knees, hips or lower back) then follow these training guidelines:

  1. If you only have pain after your running session for a few hours: Cut running by 50% until your pain subsides and gradually progress by adding 10% a week. If pain persists then come see us. You haven’t officially injured yourself yet and may only need a few recommendations to your stretching and training to get you back on track.

  2. If you only have pain during your running session: Take a break from running for 1-2 weeks. During this time focus on foam rolling, stretching and rebuilding core strength. If you don’t know how to do any of that, come see us and we will teach you.  Begin running again with this 10-minute workout:  Four-minute run/1-minute walk (repeat 2 cycles). If no pain, add 5 minutes every 3 days, working up to 30 minutes, progressing as tolerated.

  3. If you have continuous pain while running and walking: STOP RUNNING UNTIL YOU ARE PAIN FREE! Come see us – you have officially injured yourself!

 

One of the best tools we have in our office to help athletes have an injury free season are the NormaTec Recovery Pants. This is a muscle recovery system that is commonly used by elite athletes in the Olympic Training Centers, professional athletes, Ironman triathletes and marathon runners. The pants are worn after a training session to aid in muscle recovery. The pants gently inflate 5 separate chambers to flush your muscles of training byproducts and give them a gentle massage. A typical session is 30 minutes. Call us to schedule an appointment to try them out.

Running is a great sport that most people can enjoy for a lifetime. The key to staying injury free is good running form, maintain adequate hip and core strength and knowing when to take a break and give your legs a rest. As always, if you have question about this article, feel free to call me at the Sports & Spinal Wellness Center at 518-869-3415. Follow us on Facebook or visit our website at www.facebook.com/sportsandspinalwellness. We would love to be a part of your health care team.

 

 

 

 

 

 

June 20, 2019
Category: Uncategorized
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Coming soon.


Carpal Tunnel Syndrome VS Cervical Radiculopathy

By: Dr. Amanda Boccio

It’s just before lunchtime, and you’ve had a busy morning at the office.  Calls have been coming in non-stop, so you’ve had the phone clenched between your right ear and right shoulder as you simultaneously work at your computer.  You start to notice a faint pins and needles sensation in your right index finger, and your forearm starts to cramp and stiffen up.  You hang up the phone, shake out the hand and notice how tight your neck and shoulder feel from hunching over the keyboard.  “Thank goodness I can take a break to move and stretch out”, you think to yourself. “It’s been so crazy at work, I can’t tell if I’ve aggravated my disc bulge from two years ago, or if I’m starting to get carpal tunnel!”

Patients commonly seek advice from their health care provider when they experience numbness, tingling or pain in the hand or upper extremity.  The key to developing an effective treatment plan to address these symptoms is to find the source of the problem.The nerves that provide sensation, power muscles, and elicit pain in the upper extremity exit the spinal cord as nerve roots in the neck, or cervical spine. These nerves can be irritated in several predictable locations, especially at the wrist, as they traverse from the neck to the fingertips.  Irritation of the 7th cervical nerve root in the neck and irritation of the median nerve at the wrist can both cause symptoms into the hand.  How can we determine the difference between carpal tunnel syndrome and a cervical spine issue when symptoms seem to overlap?

Carpal Tunnel Syndrome is the compression of the median nerve at the wrist.  Symptoms include pain, numbness, tingling and weakness typically affect the palm, thumb, index, middle and part of the ring finger.  These symptoms can be caused by arthritis in the wrist, repetitive motion, or even swelling and fluid retention during pregnancy.  With a true carpal tunnel syndrome, symptoms are often aggravated by repetitive hand and wrist motion such as with typing, gripping a screwdriver, or even using equipment that vibrates- like a snow blower.  Patients will complain of numbness and tingling when they sleep, especially if they curl their wrists and hands under the pillow.  They will have the urge to “shake out” their hand upon waking in the morning.  If symptoms persist, weakness in grip strength or clumsiness with fine motor activities may result.   Carpal Tunnel Syndrome can be treated conservatively with manual therapy, modalities, forearm and wrist stretching exercises, and night splinting.

Cervical Radiculopathy is a condition where hand and arm symptoms are caused by compression or irritation of the nerve roots exiting the spine in the neck.  Symptoms include pain, changes in sensation, muscle weakness and diminished reflexes in a predictable pattern based on which nerve is affected. The cervical nerve roots can be irritated by common neck conditions including disc bulge or herniation, and arthritis.  Degenerative changes in the cervical spine that occur with aging include decreased disc height, and formation of bone spurs.  Decreased disc space combined with bony hypertrophy leads to narrowing of the spaces for the cervical nerve roots.  Mechanical impingement of these nerves can lead to symptoms into the arm and hand.  C6-C7 disc pathology, or degenerative changes in this motion segment impinge upon and irritate the C7 nerve root.  This is the most commonly affected nerve root- and it just so happens to overlap the areas of the hand and arm innervated by the median nerve.

When hand symptoms are caused by cervical radiculopathy, patients often have concurrent neck pain, stiffness and decreased range motion.  Pain, numbness and tingling in the hand are often reproduced with neck extension and rotation (like when turning your head to check your blind spot in the car) or prolonged sitting with poor posture (like the office worker described above).  Conservative management is very effective for symptoms caused by cervical radiculopathy.  Treatments include cervical traction, chiropractic adjustments, soft tissue therapy, modalities, stretches and exercises to improve posture. 

Differentiating between carpal tunnel syndrome and cervical radiculopathy can be challenging.  At the Sports & Spinal Wellness Center, we are more than happy to work with you to determine the root cause of your symptoms and formulate a treatment plan to get you back to feeling well.  As always, if you have questions about the article, please feel free to contact me at 518-869-3415.  Follow us on Facebook or visit our website at www.sportsandspinalwellness.com.





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Chiropractor - Albany and Guilderland, Sports & Spinal Wellness Center (Spinal Wellness Center), 2021 Western Ave, Albany NY, 12203 518-869-3415