Rib Pain or Intercostal Neuritis – A NYC Chiropractor/Applied Kinesiologist/NKT Practitioner Explains

Every few times during the year, I get a patient with a displaced rib head. (I’ve had one or two myself)  The sensation is an intense stabbing pain that “takes your breath away” in either the back or the front of the chest; sometimes the pain goes round the rib and sometimes seems to go from the back to the front like a knife.

When a patient comes in, we evaluate them via examination and a detailed history to rule out things like shingles or referred pain for heart, lung and gastrointestinal problems. A lot of the times, the patient has already been evaluated by their M.D. for these conditions with negative results.

But it’s usually a rib head displactment either at the anterior attachment at the sterum [breastbone] or at the posterior attachment at the transverse process of a thoracic vertebrae. The intercostal nerve runs from the anterior rami of the thoracic spinal nerves from T1 to T11 and runs [along with the artery and vein] between the intercostal muscles to the breastbone.

intercostal-nerve

intercostal-muscle

Of course it’s not surprising that a rib displacement “takes yr breath away” as the ribs (& the clavicle) and a lot of the muscles attached to them are involved in inspiration and expiration. Some of these muscles are the diaphragm, the external & internal intercostals, the serratus anticus, pectoralia minor, scalene & SCM muscles.

breathing-muscles

Muscles attached to the ribs or thoracic spine which may not be directly involved in breathing but may be compensating for a problem with the breathing muscles. Some of these muscles are the rectus abdominis, the abdominal oblique muscles, the psoas, the quadratus lumborum, the rhomboids and latissimus dorsi; they may be on the same or contralateral side to the displaced rib.

Before I adjust any displacement of the ribs involved or the breastbone or the clavicle as a doctor of chiropractic; I need to balance the muscle pull on the affected area.

I use the muscle testing used in both Applied Kinesiology and NeuroKinetic therapy.

As a Applied Kinesiologist, I test for the function of individual muscles. The questions to be asked are: why is the muscle weak? Is the muscle on the other side hypertonic or “too stronger.” Is the weakness due to a spinal/nerve problem, a vascular problem, a problem with lymphatic function, a nutritional default, a problem with organ function or an acupoint associated w/ that muscle?

The Use of Applied Kinesiology in a Chiropractic Examination

As a NKT practitioner, I ask “Is there a dysfunction in the coordination of muscles working in patterns?” NeuroKinetic Therapy works with that concept that movement is performed in systems or patterns. NKT identifies muscle imbalances by using muscle testing to determine what muscles are inhibited and what muscles are compensating (facilitating) for them.

How a Combination of Applied Kinesiology, NeuroKinetic Therapy and Chiropractic Works

Once the above muscle related questions are answered, I can adjust the involved rib, clavicle or spinal segment.

Stretches are given to the previously facilitated (or hypertonic) muscles and exercises given to the previously inhibited (or weak/hypotonic) muscles in order to break the pattern that caused the problem.

For a blog on the effects of the breathing muscles on asthma, please check out: The Musculoskeletal Aspects of Asthma

© 2016-Dr. Vittoria Repetto

Want more information on Dr. Vittoria Repetto and her NYC Applied Kinesiology/Chiropractic/ NKT practice at 230 W 13th St., NYC 10011; please go to www.drvittoriarepetto.com

And please check out the Patient Testimonials page on my web site.

 Want to be in the know on holistic information and postings? 

https://www.facebook.com/wvillagechiropracticappliedkinesiologynkt/

Or join me at Twitter: www.twitter.com/DrVRepetto

 

Advertisements

Tingling/Numbness/Weakness in Hand/Arm But Not Carpal Tunnel or Yr Neck; A NYC Chiropractor/Applied Kinesiologist/NeuroKinetic Therapist Explains

Do you have tingling or numbness in your hand that goes beyond your first three fingers?  Do you have weakness in your forearm, arm or shoulder despite your weight training routine?

It’s not carpal tunnel since it involves more than the fist three fingers. And you have no history of neck problems, all orthopedic tests and X-rays/MRI of the neck are negative.

You might have an entrapment syndrome of the brachial plexus nerves or subclavian artery/vein to the before mentioned structures.

This entrapment syndrome called Thoracic Outlet Syndrome is caused by three major conditions; Anterior Scalene Syndrome, Costoclavicular Syndrome and Pectoralis Minor Syndrome as well as some minor causes.

TOS

In the first condition called Anterior Scalene Syndrome, the brachial plexus nerves arising from C5, C6, C7, C8 & T1 nerve roots is trapped between the anterior and middle scalene muscles which may be in spasm or compensating for inhibited neck muscles.

This can be assessed by palpating for a decrease in strength of the radial pulse at the wrist. The patient is asked to ipsilaterally rotate, contralaterally laterally flex, and extend his neck at the spinal joints, while the radial pulse is palpated; this called Adson’s Test. Decrease in strength of the radial pulse is positive for the syndrome.

Treatment consists of using spindle work on the bellies of the scalene muscles or golgi tendons of the scalene attachments and of balancing the other neck muscles which can be either inhibited or compensating.

In the second condition Costoclavicular Syndrome, the brachial plexus and subclavian artery and vein run between the first rib and clavicle in the medial pectoral region. If the posture of the relationship of the clavicle and first rib changes and they approximate each other as often happens with rounded and slumped shoulders and impingement may occur.

This can be assessed by palpating for a decrease in strength of the radial pulse at the wrist when the patient is asked to stick his chest out and pull the shoulder girdle back and down similar to the military posture of attention. Again, weakening of the strength of the radial pulse would be considered to be a positive sign. This is called Eden’s test.

Treatment consists of checking muscles such as the SCM and the subclavius that attach to the area, improving the patient’s posture and checking muscles that resist this bad postural pattern such as the rhomboids and the middle trapezius.

In the third condition Pectoralis Minor Syndrome, a tight pectoralis minor muscle compresses the brachial plexus and/or subclavian vessels against the rib cage. The assessment is to bring the patient’s arm up and back. This position called Wright’s Test stretches and pulls the pectoralis minor taut against the rib cage

Treatment consists of checking for either an inhibited or facilitated pectoralis minor, or other muscles that can be inhibiting or compensating such as the serratus anterior, latissimus dorsi or the lower trapezius.

Other minor conditions such as  when both the medial and ulnar nerve getting entrapped by a spastic muscle such as the pronator or by a misalignment of the radius and ulna bone can happen and need to be ruled out.

forearm muscles

For additional information, please check out:  https://drvittoriarepetto.wordpress.com/2015/09/20/a-nyc-chiropractorapplied-kinesiologist-starts-adding-neuro-kinetic-therapy-to-the-mix/

https://drvittoriarepetto.wordpress.com/2010/06/21/muscle-balancing-in-applied-kinesiology/

https://drvittoriarepetto.wordpress.com/2012/05/23/how-a-nyc-chiropractorapplied-kinesiologist-treats-carpal-tunnel-syndrome/

 

© 2015-Dr. Vittoria Repetto

© Revised 2016 – Dr Vittoria Repetto

Want more information on Dr. Vittoria Repetto and her NYC Applied Kinesiology/Chiropractic/ NKT practice at 230 W 13th St., NYC 10011; please go to www.drvittoriarepetto.com

And please check out the Patient Testimonials page on my web site.

 Want to be in the know on holistic information and postings? 

https://www.facebook.com/wvillagechiropracticappliedkinesiologynkt/

Or join me at Twitter: www.twitter.com/DrVRepetto

PTSD and Applied Kinesiology Techniques to Help

Post-traumatic stress disorder (PTSD) is a type of anxiety disorder that’s triggered by a traumatic event; sufferers may have the following symptoms of nightmares, insomnia, flashbacks, rage, emotional numbing, hypervigiliance, hyperarousal, depression, anxiety, intrusive thoughts and avoidance.

http://www.mayoclinic.com/health/post-traumatic-stress-disorder/DS00246

 There are a number of techniques that can help the PSTD patient cope better w/ their stresses and there are even techniques that the patient can practice at home.

 The first one involves the adrenal glands, an organ involved in our sympathetic reflex or “the fight or flight reaction” Continuous stress can cause the adrenals not to function optimally; symptoms can include fatigue, insomnia, depression brain fog, etc. if the adrenals are involved, then the PTSD patient might present w/ weak Sartorius muscle, a craving for salty foods, blood pressure that drops upon sudden standing or their pupils may have a sluggish reaction to light.

 Help for the adrenals involves stimulation of the neurolymphatics and neurovascular points associated w/ the Sartorius muscle and it’s link via the Chinese meridian system to the adrenals. This is a technique that the patient can do at home.

 Another muscle to look at is the Pectoralis Clav. Major that is associated to the stomach via the Chinese meridian system. We know that anxiety and stress being a predisposing factor in stomach dysfunction raging form “butterflies” in the stomach, to a gastric ulcer to emotional chest pain.

 The patient’s Pectoralis muscle would be tested while recalling a traumatic event If the muscle tests weak, then the doctor contacts the emotional neurovascular reflex pt until a synchronous pulse is felt bilaterally. Then the patient again recalls the traumatic event and the pectorals are re-tested. If the pectorals test strong, then the emotional recall is lessened in its ability to affect the patient. And the patient is taught to do the reflex work at home.

 Another technique involves negating a patient’s self-sabotaging behavior. We have the patient speak a positive statement such as “I want to be healthy” and if that statement causes any muscle to be weak then we know that there is a conflict in the mind-body connection. We then have the patient say the positive phase again while holding either points on the Small Intestine meridian; the point used is the one that allows the previously weak muscle to test strong. An acu-aid is placed on the point and the patient instructed to tap the point if they feel their symptoms creeping up on them.

 Another technique is the Temporal Tap which works as an auto-suggestion. The patient is taught to tap the temporo-sphenoidal line on the side of his head while inputting a negative statement such as “I have no need to yell.” on the right side  And then the patient inputs a positive statement such “I will be calm”.

 This technique works wonders for insomnia.

 Another technique involves holding acupuncture points while the patient thinks about his fears or anger or anxiety and we observe if that “causes a muscle to go weak; meridians associated w/ fear may be the kidney/bladder meridian or the stomach or the liver/gall bladder for anger issues. Then the patient (or the doctor) taps the beginning and end point of the meridian involved and the muscle is re-tested as the patient thinks again about his problem. A positive outcome would be a strong muscle test and the patient feeling that his fear has lessened

As you see with testing by a doctor using applied kinesiology, the patient can actively take a role in becoming healthier, more calm, more social. etc

© 2010-Dr. Vittoria Repetto

Common Medications for PTSD Tied to Increased Dementia Risk

Want more information on Dr. Vittoria Repetto and her NYC Applied Kinesiology/Chiropractic practice at 230 W. 13th St., NYC 10011; please go to www.drvittoriarepetto.com

And please check out the Patient Testimonials at my web site.

 Want to be in the know on holistic information and postings? Follow me at https://www.facebook.com/wvillagechiropracticappliedkinesiologynkt/

Or join me at Twitter: www.twitter.com/DrVRepetto

The Musculoskeletal Aspects of Asthma

Like most of you, I’ve been watching the Olympics and as I watched, I remembered a previous Summer Olympics and watching the start of the Women’s Marathon. I noticed something in the body language of one of the front runners and said to my friends, “That runner has asthma; look at her neck.”  My friends chuckled and then the announcer talking about the runner I pointed out said that she suffered from asthma.

“How did you know?’ asked my surprised friends. Her SCM (sternocleidomastoid) muscle http://en.wikipedia.org/wiki/Sternocleidomastoid_muscle was very pronounced. Instead of using her primary muscles of inspiration, her diaphragm, the external intercostals and the sternocostalis; she was using an accessory one.  http://skeletalmuscularsystem.suite101.com/article.cfm/muscles_of_inspiration It was causing her rib cage to be higher in position on her torso and more barrel shaped: a classic visual for asthma patients

In  my Applied Kinesiology practice, I see a number of patients with breathing problems. To a person they all have problems using their diaphragm muscle properly, they use small muscles higher up in the chest and shoulders creating  a “barrel-shaped” chest. And many have problems w/ their intercostal muscles and the up of down movement of the ribs; their rib joints don’t move properly therefore not allowing the movement of the chest.

Tightness and/or weakness is also found in the Pectoralis major & minor, SCM, the Anterior & Middle Scalenes and the Serratus anterior as well as other accessory muscles, they tested to find out if they are inhibited or compensating. The Psoas muscle is also tested as the upper end of the muscle blends into the diaphragm.

breathing muscles

With applied kinesiology, I can use golgi tendon and muscle spindle reflexes to re-set the muscles and use neuro-lymphatic & neuro-vascular points to flush toxics out of the muscles. I restest the inhibited/weak muscles to get a neural lock in the brain’s muscle center.

I use neuro-lymphatic & neuro- vascular pts to help lymph and blood flow to the diaphragm and also give the patient breathing exercises to strengthen the diaphragm.

I also stimulate acu-points for the lung meridian and it’s brother/sister pair- the large intestine meridian which may indicate that the patient needs probiotics.

The cervical & thoracic spine are checked for subluxations/somatic dysfunction as the nerves from these areas  innervate the before mentioned muscles and the lung and are adjusted as needed.  The articulations of the rib joints to both the vertebrae and the sternum are also important to check.

Once the above is done, the patient is given breathing exercises to do daily in order to strengthen the formerly weak muscles

Working on all these aspects causes the bio-mechanics of the chest to work better and breathing is freed up.

Of course causes of both bronchial and lung and general inflammation need to be found and worked on via nutrition and lifestyle changes; but that is another blog.

Self-taught Breathing Retraining Helps Asthma Patients

©  2010-Dr. Vittoria Repetto

©  Revised 2015/2017 -Dr. Vittoria Repetto

Want more information on Dr. Vittoria Repetto and her NYC Applied Kinesiology/Chiropractic practice at 230 W. 13th St., NYC 10011; please go to www.drvittoriarepetto.com

And please check out the Patient Testimonials at my web site.

 Want to be in the know on holistic information and postings? Follow me at https://www.facebook.com/wvillagechiropracticappliedkinesiologynkt/

Or join me at Twitter: www.twitter.com/DrVRepetto

The Correct Use of Muscle Testing in Nutritional Evaluation in Applied Kinesiology

When I’m meeting new people at a social or a networking event, I introduce myself as a Doctor of Chiropractic and an Applied Kinesiologist. Sometimes they have no idea what AK is and I fill them in. But most of the time, they will say something like “I had someone touch a spot on me and then pull down on my outstretched arm. It was weak. Then I held a bottle of pills and was told I needed them. Is that Applied Kinesiology?”

This is one of the big abuses of muscle testing.

In Applied Kinesiology, muscles are related to themselves and the joints they cross, their spinal innervation, their neuro-lymphathic & neuro-vascular points, the Chinese acupuncture meridian associated with them and the organs/glands via the meridian system.

So how does nutritional muscle testing work? First it is muscle specific, pulling down on an outstretched arm is not specific as it involves a number of muscles. And holding a bottle in hand stimulates nothing in your brain except maybe a placebo effect.

Here’s an example: a patient comes in with a shoulder problem and upon examination I find that one of the patient’s internal rotators – the Pectoralis Clavicular Major is weak.

The Pectoralis Clavicular is innervated by the lateral pectoral nerve that comes from the 5th & 6th cervical spinal nerves, it is associated w/ the Stomach meridian and in Chinese five-element theory is associated with worry.

Does the patient have a weak Pectoralis on one or do both sides tested together come up weak – a possible sign of cranial faults that need to be fixed? Does the patient have a history of digestive problems, heartburn, bloating, blenching, constipation? Is the patient experiencing emotional worries?

If no, then I proceed w/ either stretching or toning the muscle, rubbing out the neuro-lymphatic and neuro-vascular points for the muscles and seeing if the meridian is involved and seeing if the C5-6 spinal segments, the shoulder joints, clavicle or the sternum (breastbone ) or the ribs need to be adjusted. I then re-test the muscle to see if the problem is now fixed.

IMG_9084Retouched & crop

If yes, I proceed with the above as correcting the structural first sometime will help the digestive problems. A case in point is a patient with a lack of hydrochloric acid, indicated by bilateral pectoralis major weakness. Taking hydrochloric acid may clear the weakness.

But if the HCl is given, it hides the indicator for a temporal bulge or other cranial fault. A cranial fault may be causing entrapment of the Vagus nerve, thus causing hypochlorhydria that is responsible for the digestive problem in the first place. The proper approach is to correct the cranium and any other structural factor that is causing the hypochlorhydria.

I then talk to the patient about their diet, what foods or food combinations may be problematic for them and what supplements and medications – over the counter & prescription that they may be taking and to keep a food diary in which the patient also notes any digestive problems.

For example, the patient may have been advised to take Tums in order to get calcium; unfortunately the calcium carbonate in Tums is acting as an antacid and is adversely affecting the patient’s ability to digest and absorb food (including calcium) Take the patient off the Tums and the HCL problem resolves

I also talk to the patient about any emotional problems or stresses that may be affected them and we work w/ emotional meridian releasing techniques that the patient can also do at home.

On the next visit if the structural and emotional interactions have cleared then I test for nutritional factors such as HCL, or food allergies/sensitivities The patient is tested by placing sample of either the supplement or food in their mouth and having them chew in order to stimulate gustatory receptors in the brain and then the Pectoralis is then re-tested to see if there is a change in the muscle strength. The patient is then advised take whatever strengthened the indicator muscle and asked to note any changes in their food diary.

If nutritional testing doesn’t resolve the muscle weakness, then the patient may be advised to have some standard testing done such as testing for H. Pylori or anemia which can be affecting digestion such as iron, folic acid or B12 deficiencies.

On the following visit, the patient will continue to be evaluated to see if the digestive problems have resolved, if the structural and emotional indicators have resolved and when the patient no longer needs to take the supplementation.

As you see, the proper use of applied kinesiology in evaluating nutrition is made within the total framework of the triad of health – structural, emotional, chemical and includes both standard and kinesiologicial diagnostic procedures that confirm the need for the nutrition.

Correlation of applied kinesiology muscle testing findings with serum immunoglobulin levels for food allergies

©  2010-Dr. Vittoria Repetto

Want more information on Dr. Vittoria Repetto and her NYC Applied Kinesiology/Chiropractic/ NKT practice at 230 W 13th St., NYC 10011; please go to www.drvittoriarepetto.com

And please check out the Patient Testimonials page on my web site.

 Want to be in the know on holistic information and postings? 

https://www.facebook.com/wvillagechiropracticappliedkinesiologynkt/

Or join me at Twitter: www.twitter.com/DrVRepetto