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Pain Management

MMA Training Tradition Comes Under Scrutiny With Injured Champ

Old School Vs. New Class

A fit man kicks high during an Mixed Martial Arts training.In a press conference this morning, the often outspoken UFC President Dana White scrutinized training techniques that he asserts led to a champ’s career-threatening MCL tear. White charges that American Kickboxing Academy (AKA)— training facility of current UFC Heavy Weight Champion Cain Velasquez—is “still in the stone ages” when it comes to their fight prep regimen.

Cain Velasquez has a string of injuries that have kept him out of title bouts with eager challengers. He last fought in 2013, when he dethroned former heavy weight champ Junior dos Santos at UFC 166, but has since been sidelined by training-induced shoulder and knee injuries.

White has become so frustrated by injuries sustained in training (and the events that don’t happen because of them) he announced that UFC’s new headquarters in Las Vegas will include a “huge facility for rehab and therapy” that will focus on “educating the fighters on training better.”

It’s important to note that Velasquez, whose professional record is 14 and 1 (his latest win in the form of a championship belt), is obviously doing something right. In fact, AKA is home to number of top MMA contenders. And, while other fighters, trainers, and sideline commentators will surely contest White’s words, he does bring to light the importance of aligning injury prevention and fight preparation.

The details of UFC’s new HQ have yet to be divulged and the initial announcement leaves much to the imagination. But, it will be interesting to see if White’s vision for a bigger, better training compound will reduce injuries and still produce champions. In the meantime, we hope Cain Velasquez recovers well and look forward to seeing him back in action again soon.

If you’d like to include injury prevention in your training program, or need therapy from an injury that’s already happened, we’re here to help. Some of our own patients are making a living in the octagon, so we have an intimate understanding of what kinds of injuries occur and how to help them heal.

Greenback Therapy; Starting with PT for Back Pain Equals Bigger Cost Savings

When new patients suffering lower back pain begin their treatment with physical therapy, they spend less and accrue fewer medical costs associated with their condition. Those are the findings posted in a recent study in the scientific journal Health Services Research.

A Hawaiian Man holds his lower backResearchers found that patients who were referred to physical therapy compared to those who were referred for MRI (Magnet Resonance Imaging) for lower back pain paid almost a third of the costs. Initial referral for physical therapy cost $504 on average (for an average 3.8 visits), compared with an average of $1,306 for MRI. Subsequent costs over the next year also came in less—nearly 72% lower for patients who began with a physical therapy referral.

The study also discovered that patients who receive imaging as a first referral increased the likelihood of surgery and injections as well as specialist and emergency department visits within a year. “This is one of many studies demonstrating that physical therapy is a cost-effective alternative to medication and surgery,” said American Physical Therapy Association President Paul Rockar Jr, PT, DPT, MS. “Patients benefit from an active approach to their care and, in turn, society is transformed through the benefits from reduced financial burdens on our health care system.”

Read about more about this research at the APTA:

Kill All Pain!

A Clinical Pearl by Adriaan Louw, PT, PhD, CSMT

There is a wonderful article from Medbridge (medbridge.com) regarding a refreshing pain management strategy. “We know now: pain is a lot more complex and warrants a more comprehensive approach to make meaningful changes in our patients.”

“The day I found out that pain is a normal biological process aimed to protect us, it set me free. Pain is normal. Without the ability to experience pain, you wouldn’t survive very long. Now I feel much less pressure to “kill all pain” in my clinical practice. I became interested in the issues that keep the normal pain going longer than it biologically should, in coping skills and in teaching people that pain is a normal human experience. Guess what? My patients started having epiphanies and seeing pain as an informant rather than an enemy.”

a man jumping through a wave in Hawaii

Read more at: https://www.medbridgeeducation.com/h/clinical-pearl-adriaan-louw-kill-all-pain-n-fb

Acetaminophen does NOT effect recovery time in Low Back Pain

Or should that be a question: Acetaminophen does NOT effect recovery time in Low Back Pain?

photo of acetaminophenDespite being recommended by more than 15 different Clinical Practice Guidelines (CPGs) for Low Back Pain (LBP) Since 1987, it seems as if maybe Tylenol doesn’t help recovery time.

A large and compelling recent study titled “Efficacy of paracetamol for acute low-back pain: a double blind, randomized controlled trial” recently evaluated the role of paracetamol (acetaminophen) in managing acute LBP.

It found there were NO statistically significant differences between the placebo group or either of the acetaminophen groups for recovery time, adherence to tablet usage, and adverse events.

For all the juicy details read “Tylenol does NOT effect recovery time in Low Back Pain (LBP) OR stated another way… Why Clinical Practice Guidelines are ”developing” tools that should be viewed with healthy critical skepticism” OZPT.com.


For Meniscus Tear, Exercise Therapy Outperforms Surgery

For Patients With Meniscus Tear, Exercise Therapy Outperforms Surgery in Key Muscle Strength Measure

Meniscus-Injury, young girlIn a study that turned the tables on common research that uses exercise therapy evaluate the effectiveness of arthroscopic surgery, used a surgery group as a control to measure improvements in quadriceps strength and neuromuscular function. They write that such improvements, “can provide functional improvements, pain relief, and possibly also a delay in the onset of osteoarthritis (OA)” in individuals with the tears.

Exercise therapy can improve certain functions to a degree not possible through arthroscopic surgery for middle-aged patients with degenerative meniscus tears, according to a new study from Denmark. Researchers believe the improvement in function through exercise—more than 16% greater than improvement experienced by the surgery group—may lead to better long-term outcomes.

To read more on this subject, click here.


Effective Therapy for Golfer’s Elbow

Researchers from the Nicholas Institute of Sports Medicine and Athletic Trauma  found a simple exercise using an inexpensive rubber bar is effective at reducing pain associated with golfer’s elbow, according to a news release.

young woamn swings a golf club“The success and popularity of the Tyler Twist led us to develop and evaluate an exercise for golfer’s elbow,” lead research author Timothy Tyler, PT, MS, ATC, said in the release. “The Tyler Twist, a novel exercise using the TheraBand FlexBar, was shown to significantly improve strength and reduce pain for individuals with chronic tennis elbow. This new golfer’s elbow exercise, dubbed the Reverse Tyler Twist, also employs a FlexBar and was found to be effective at reducing the pain for patients suffering from golfer’s elbow.”

“Additional benefits of this treatment are many,” Tyler said in the release. “It can be performed as part of a home exercise program, it doesn’t involve continued medical supervision or expensive equipment, and treatment dosage is not limited by the patient needing to come to a clinic. All of these greatly reduce the costs associated with treatment.”

 TheraBand FlexBar

available online at Amazon.

For exercise instructions visit


Exercise video


Scapulothoraticic Bursitis, or as most people call it, “My shoulder hurts.”

The shoulder is a complicated and often over-used joint prone to various pain-causing issues. Between swelling of the bursa, bony abnormalities and insufficient musculature, the shoulder can become a painful and noisy joint. Sound familiar? The first step to healing and returning to pain-free movement is see your P.T.

Ther are many types of shoulder injuries and pain. In Kauai go to Action PT

Motion in the shoulder depends on adequate coordination of the concave scapula on the convex thoracic wall by the periscapular musculature. Incongruence, which has several possible causes, such as bony abnormalities, insufficient muscular control and the thickening and scarring of connective tissue may result in a painful grating sound or sensation produced by friction between bone and cartilage during movement.

If you are interested in learning more read here or contact Action PT today.

Chronic Neck Pain

A recent study reveals that an effective exercise regimen and its components regarding frequency, intensity, time and type (FITT) will improve Chronic Neck Pain.

Woman touching her painful neck.

Chronic Neck Pain (CNP) is treated by many therapists with exercise therapy, but what delivers the best results? According to a recent study published by Elsevier Inc. / American Congress of Rehabilitation Medicine, the objective was to identify the most effective components in an active exercise physiotherapy treatment intervention for CNP based on the frequency, intensity, time, and type (FITT) exercise method.

The study revealed that education and exercise training has the most beneficial effect on reducing pain and improving function and quality of life in patients with CNP. It was also noted that targeting deep neck flexors through strength training has positive effects on quality of life when combined with endurance and aerobic training. Progress was seen in patients that performed 30-60 minutes exercise sessions at least three times per week for 6-12 weeks.

Click here to view the article posted on www.anatomy-physiotherapy.com’s web site.

Get a Massage. It’s Good For You!

There are lots of benefits of massage therapy. It can help pain management for cancer,  insomnia, anxiety, multiple sclerosis, post-operative recovery and will help heal the heart.

Woman getting a massage

Many Americans suffer from high blood pressure and massage therapy can help you maintain optimal vascular health.

Long-term studies have shown that a consistent massage program can decrease diastolic and systolic blood pressure; decrease salivary and urinary cortisol stress-hormone levels; and lower sources for depression, anxiety and hostility.

If you or someone you know is looking for natural ways to help lower blood pressure, please contact our office today to set up an appointment with Cece our Certified Massage & Zen Muscular Therapist. (808) 246-0144

Click here to read Why Massages Really Do Keep You Healthy: A Cardiologist Explains

Coffee, Is It Good or Bad?

Check out this great article by Robert T. Gonzalez about the 10 Reasons Coffee is Both the Best and the Worst Beverage Ever Invented.

Cup of coffee with coffee beans.

Do you represent the over 50% of Americans that drink coffee on a daily basis? We’ll let you decide if this compelling list of pros and cons will change your coffee drinking habit. I know what side I’m picking. What about you?

10) Pro: Coffee + pain medication = extra pain relief

9) Con: Just kidding — because coffee is also linked to headaches. Sort of. Probably.

8) Con: Those who French-press need to watch their cholesterol

7) Pro: Cancer isn’t fond of coffee

6) Con: Ulcers

5) Con: Coffee — not so good for the babies

4) Pro: Coffee likely has a preventive effect against type 2 diabetes

3) Pro: Same goes for cognitive disorders

2) Toss-up : It makes you have to poop

1) Toss up: Drink coffee, see ghosts?

Click here to read 10 Reasons Coffee is Both the Best and the Worst Beverage Ever Invented.