New Physical therapist joining the Okinawa Sports and Spinal team from the 14th of October

Extending a very warm welcome to incoming Physical Therapist Serena Mora that will be joining Okinawa Sports and Spinal from Monday the 14th of October 

Serena is an Italian physiotherapist and personal trainer graduating in 2015.

She worked in orthopedic and neuropsychiatric environments, before specializing in manual therapy in Milan. Loving sports (but not just Italian football!) she decided to move to Bali and take a master in water sports, starting to follow professional surfers. Wanting to discover more of the world, she then moved Dubai to work for a year and will soon be calling Okinawa home.

Serena loves Japan having worked at Niseko Physio during the 2024 winter season helping to manage ski and sporting injuries as well as providing sports massage.

You can now make advanced bookings with Serena via per online bookings book by clicking the link below. 

Okinawa Sports and Spinal research review

People often blame arthritis for the neck pain but what is the relationship between the joints in the neck known as facet joints (Zygapophysial) joints and the amount of cartilage damage in the joint ?

A great paper has recently been published in the Journal of Pain medicine by the legendary Australian back pain research Nikolai Bogduk that looks at this question.

It turns out the relationship isn’t very strong at all. So you can can have a great looking x-ray and suffer from neck pain and you can have a terrible looking x-ray and be mostly pain free and everything in between. 

So what is going on here ? 

Studies show that about 36 to 60 percent of chronic neck pain comes from the facet joints in the neck ( 1) but what’s actually the cause of pain is far from understood. In order to understand the authors looked at many of the papers published on osteoarthritis and neck pain to see if was any evidence that degernative changes in the neck causes neck pain. 

What the found when looking at a number of studies was that  pain was although pain was more common in subjects with osteoarthritis (40%) than in those unaffected by osteoarthritis (26%),  and although the prevalence of osteoarthritis in subjects with pain (25%) was greater than in subjects without pain (15%), in neither instance did the difference in prevalence reach statistical significance (1).

In other words if you have osteoarthritis its quite possible that you might not have have neck pain and if you have neck pain its quite possible you dont have arthritis. What the data is not showing is a clear link between progressive arthritis and progressive levels of pain. 

Table from the study

Ok so what does that mean for me ?

Firstly it means that yourself and your health practitioners should not be over concerned about your imaging findings and also that reaching for an image in cases of neck and pain may not be the right step forward.

The study made 2 firm conclusions

1. No study has produced any conclusive evidence that osteoarthritis is a cause of Z joint pain, either in the cervical spine or in the lumbar spine. Rather, the opposite applies. 

2. Osteoarthritis of Z joints is so common in asymptomatic individuals that, even if it was a cause of pain, it could not be diagnosed with any confidence by any form of currently available medical imaging. The prevalence of osteoarthritis is essentially the same in subjects with pain as in subjects with no pain. Simply seeing osteoarthritis on images does not distinguish a painful joint from an asymptomatic one.

What this paper also shows is that your health care team needs to do a better job of understanding your pain and how it affects you and not place to much importance on your imaging findings. As an older mentor used to say ” treat the person, not the image ” 

If you would like to have a chat with the practitioners at Okinawa Sports and Spinal about your neck pain and how to manage it you can make a booking here 

References

1. Bogduk, Macviar ” Osteoarthritis of zygapophysial joints as a cause of back pain and neck pain: a scoping review ”  Pain Medicine, Volume 25, Issue 9, September 2024, Pages 541–554
2. https://doi.org/10.1093/pm/pnae036

Okinawa Sports and Spinal Research update

Iliotibial Band Syndrome, commonly referred to as ITBS, is a condition that affects the connective tissue running along the outside of your thigh, from the hip to the shin.

Working in Okinawa we see a lot in the military community as It’s a frequent issue among athletes, particularly runners, cyclists, and anyone engaged in repetitive leg movements. However, it can affect anyone, leading to pain and discomfort that can hinder your daily activities and athletic performance.

A resent meta analysis published in the Frontiers in Sports and Active Living and shed some fascinating insights in this condition. ITBS is the 2nd most common cause of knee pain in runners and is responsible for 10% of running injuries. Its also twice as common in female athletes than male athletes  (1).

What is Iliotibial Band Syndrome?

The iliotibial band (IT band) is a thick band of fascia that runs along the outside of your thigh. It plays a crucial role in stabilizing your knee during activities like walking, running, and cycling. ITBS occurs when this band becomes tight or inflamed, leading to friction against the outer part of the knee. This friction can cause pain, swelling, and a burning sensation around the knee or along the length of the IT band.

Practitioners used to to think that the pain was cause by rubbing around the knee but recent research points to the femoral head being more of a cause (1).

Causes of ITBS

Several factors can contribute to the development of ITBS, including:

1. Overuse: Repetitive activities like running or cycling can cause the IT band to rub against the bone, leading to irritation and inflammation.
2. Biomechanical Issues: Poor posture, improper running technique, or misalignment of the hips, knees, or feet can increase stress on the IT band.
3. Weak Muscles: Weakness in the hip muscles or the muscles surrounding the knee can lead to increased tension on the IT band.
4. Inadequate Warm-Up or Cool-Down: Skipping proper stretching or warm-up routines before exercise can contribute to tightness in the IT band.

Symptoms of ITBS

The primary symptom of ITBS is pain on the outside of the knee, which may start as a dull ache and progress to sharp pain, especially during activities that involve knee bending.

Clinically, ITBS presents as a sharp or burning pain on the lateral aspect of the knee, typically occurring between 20° and 30° of knee flexion that tends to get worse with running.

• A burning sensation along the outer part of the knee
• Swelling or tenderness at the site of pain
• A feeling of tightness or snapping sensation in the hip or knee

Treatment for ITBS

Physical therapy and Chiropractic care is an effective, non-invasive approach to treating ITBS. The really important thing is to understand and address  help the root causes of the condition, relieve pain, and prevent future flare-ups. Here’s how Okinawa Sports and Spinal can help.

What the recent articles shows is that combine treatments tends to give the best results. By combing stretching, strength training of the hip abductors that move your leg sideways and some manual therapy the team at Okinawa Sports and Spinal can get you back to fitness in the shortest amounts of time.

Combing a few treatment options achieved an average pain reduction of approximately 71%, in contrast to the 61% reduction observed with single treatment methods ( 1)

1. Soft Tissue Therapy

Physical therapists and Chiropractors use various soft tissue techniques, such as Active Release Techniques (ART) or Graston Technique, to break down scar tissue, improve circulation, and reduce inflammation around the IT band. This helps to alleviate pain and restore normal function.

2. Spinal and Joint Adjustments

Irritated joints in the spine Misalignments in the spine or pelvis can contribute to biomechanical issues, increasing stress on the IT band. Chiropractors perform adjustments to correct these misalignments, helping to restore proper alignment and movement patterns.

3. Stretching and Strengthening Exercises

Your chiropractor may prescribe specific exercises to stretch the IT band, strengthen the surrounding muscles, and improve flexibility. Strengthening the hip muscles, in particular, can reduce the strain on the IT band, preventing future injuries.

4. Gait Analysis and Correction

If your ITBS is related to improper running or walking mechanics, our physical therapists at Okinawa Sports and Spinal can assess your gait and make recommendations for improvement. Correcting your biomechanics can help reduce the repetitive stress that leads to ITBS.

5. Lifestyle and Ergonomic Advice

Okinawa Sports and Spinal can provide guidance on how to modify your activities, improve your posture, and use proper ergonomics to avoid putting unnecessary stress on your IT band.

Preventing ITBS

Preventing ITBS involves maintaining proper alignment, strength, and flexibility. Here are some tips:

• Incorporate regular stretching and strengthening exercises into your routine, focusing on the hips, thighs, and knees.
• Gradually increase the intensity and duration of your workouts to avoid overloading your IT band.
• Wear properly fitted shoes that provide adequate support during physical activities.
• Pay attention to your form and posture during exercise, and consider seeking professional guidance if you’re unsure.

Conclusion

Iliotibial Band Syndrome can be a painful and frustrating condition, but with the right treatment and preventive measures, you can overcome it and return to your favorite activities. Chiropractic care offers a holistic approach to treating ITBS by addressing the underlying causes, relieving pain, and promoting long-term healing. If you’re experiencing symptoms of ITBS, consider visiting a chiropractor to develop a personalized treatment plan that will help you get back on track.

Remember, early intervention is key to preventing ITBS from becoming a chronic issue, so don’t hesitate to seek professional help if you’re experiencing pain or discomfort. Your body will thank you for it!

To make an appointment at Okinawa Sports and Spinal click here 

References

1. Effects of conservative treatment strategies for iliotibial band syndrome on pain and function in runners: a systematic reviewFrontiers in Sports and Active Living, volume 6 2024 

   https://www.frontiersin.org/journals/sports-and-active-living/articles/10.3389/fspor.2024.1386456

   DOI=10.3389/fspor.2024.1386456

    

Manual practitioners have long suspected that regular walking is helpful for people suffering recuring lower back but we finally now have some research that directly addresses this question. Even better is comes from our one of the Universities that trained one of the practitioners working at Okinawa Sports and Spinal. 

Researchers from Macquarie university Australia recently published an article in the prestigious journal The Lancet asking the question ” What happens if we prescribe regularly walking to people with the lower back pain ? “.

And the short answer is that helps !

Using a control group they randomly divided 700 people to either a group that did some regularly walking each week and a control group that did nothing different. The group that started walking more reduced their occurrence of a lower back pain episode within a 12 month period by about 50%.

It’s important to note that we can’t generalize these results too much. If you are already walking a fair amount each week then result of walking more may be less, the subjects studied did not walk much before the study. It was also performed on people that did not have a specific diagnosis so perhaps some types of lower back pain may not respond as well.

..But ! if you are somebody that gets the occasional bout of lower back pain and you are not walking regularly just increasing your weekly walking by amount you feel comfortable and achievable may decrease the number of episodes of lower back pain you experience. It’s certainly worth a try and cardio vascular system will thank you too. 

Fortunately here in Okinawa we have some amazing seawalls and hiking trails just waiting for you to find them so get out there and move.

If you would like to consult a professional here in Okinawa about how you can integrate walking into managing your lower back pain feel free to schedule an appointment with our native English staff here 

References

1. ” Effectiveness and cost-effectiveness of an individualized, progressive walking and education intervention for the prevention of low back pain recurrence in Australia (WalkBack): a randomized controlled trial ”  Pocovi et al. 2024 The Lancet Volume 404, ISSUE 10448, P134-144, July 13, 2024

https://doi.org/10.1016/S0140-6736(24)00755-4

The team at Okinawa Sports and Spinal will be supporting a tteam at the Nago Mayor’s cup Hari this Sunday so the clinic in Sunabe will be closed for treatment on Sunday the 4th of August.

If you are seeking a weekend appointment in sunabe we still have some Saturday 3rd appointment spots available for English speaking Physical therapy, Chiropractic and Sports massage in Okinawa.

If you would like to make an appointment at Okinawa Sports and spinal click here

Cupping is a great technique to work on the fascia and also pull the tissue as opposed to Just pushing it 

This service is available upon request at no additional charges for any Sports Massages booked at Okinawa Sports and Spinal.

Due to your support of Okinawa Sports and Spinal we have been able to extend our Chiropractic services.

 Chiropractic services at Okinawa Sports and Spinal is now available 6 days a week ( closed for Chiropractic Tuesdays )  across the full month. 

For bookings with experienced english speaking Western trained Chiropractors in subane Okinawa Click here

Your guide to insurance reimbursement at

Okinawa Sports and Spinal

Your guide to insurance reimbursement at Okinawa Sports and Spinal 

“Can I claim for my physical therapy, chiropractic and massage expenses at your clinic?”

The short answer is usually yes if you have international insurance such as foreign service benefit plans (FSBP) like those from Aetna, Cigna Health, Blue Cross or other medical insurance company plans covering DoDEA staff, GS and NAF employees, and defence contractors.

Many of our clients have found the process very easy over the last few years by simply submitting our receipts for reimbursement from their insurance provider through online portals.  We are happy to provide item and treatment codes on receipts if needed when you let us know what insurance company you are with. 

We are unable to accept Tricare and Japanese national health insurance (NHI) claims.  You are most welcome to pay out of pocket to use our expert services.

We can provide receipts for claims on most travel insurances for tourists and visitors.

If you would like to know more about claiming for chiropractic, physical therapy, and massage services we recommend you first contact your insurance provider for more information.

Ariel Thorpe has been by far our most popular Chiropractor at Okinawa Sports and Spinal and she returns this Saturday the 30th of March until the 4th of April.

If you would to book a Chiropractic appointment with Ariel, an American trained Chiropractor,  at Okinawa Sports and Spinal you can do so on the link below.

https://niseko-chiropractic.cliniko.com/bookings?business_id=94455