Dr Colliver wins Best Bedside Manner Award… Twice!

bedsideMannerAward3At Valley Sports & Spine Clinic, we strive to provide excellent, compassionate care. We are honored to announce that Dr Ethan Colliver received “Best Bedside Manner” award for the categories of Sports Medicine and Physical Medicine, from Our Health magazine.

“It is a privilege to be able to practice the art of medicine.  I don’t view it as a job, but as a passion.  It is fascinating to meet new people and to help them along to recovery from whatever is standing in the way of their goals for pain-free function.  I am also fortunate to have a superb team of Holly Martin, PA, nurses, staff, and others to share these experiences with.”

Congratulations Dr Colliver!


What is Really Causing Your Back Pain?

 Back pain can be a result of height, weight, or posture. Treatments are available for symptoms, but core exercise is the proven method to relieve pain for good.

 

Most people will experience back pain at some point in their lives. Back pain can be caused by an acute injury or from long-term wear and tear on the spine and joints of the back. During evaluation by a physiatrist a holistic approach frequently uncovers the root cause of the pain, and the answer is much simpler than many would suspect.

Frequent Causes of Back Pain

  • Height – While it may seem surprising, your height has a lot to do with your lower back pain. The spine is stabilized by your core muscles which sit in your abdomen. For a tall person, or anyone with an especially long torso, these muscles have to work harder to hold up the spine than the core muscles of a shorter person.
  • Weight – People gain weight differently, and much of this is attributed to genetics. While many women gain weight in the lower half of their bodies, creating what is known as the pear shape, more frequently men gain weight in their trunk or abdomen. Protruding abdominal weight can throw off the body’s natural center of gravity and cause it to be more forward and further away from the spinal column. As a result, the back has to work harder to stop from pitching forward. This is also a common source of lower back pain in pregnant women as their muscles work to hold up the spine and support the weight of the growing womb.
  • Posture – Your mother was not kidding when she would tell you to stand up straight. Posture affects the entire body, whether it is good or bad. Good posture helps to reinforce spinal alignment and connective tissue. This is especially important when exercising, as poor posture can cause over- or under- development of a muscle group and uneven muscle tone which can make posture worse and add more stress to the back.

Correcting the Problem

  • Medications – While many people would like to use a medication to fix their pain, the recommendation for medication is minimal. Non-Steroidal Analgesics (NSaids), such as ibuprofen or naproxen, are effective at relieving pain associated with inflammation, but that is the extent of their usefulness. The pain can only be temporarily relieved with medication therapy.
  • Helpful Therapies – Spinal Manipulation Therapy (SMT) has proven to be an effective method of pain relief for many patients suffering from low back pain. SMT is the practice of applying controlled pressure to a joint in the spine and is commonly performed by a Doctor of Osteopathic Medicine (DO), physical therapist, or chiropractor.
  • Massage can be very effective at relieving back pain associated with stress.  Massage helps to normalize muscle tone and joint alignment, can normalize blood and lymphatic flow to an injured area, and can help release built-up toxins in tense muscles. An added bonus of massage is the overall mental stress relief it can provide which can directly correlate to feeling pain in the body.
  • Acupuncture is the application of pressure to specific points in the body that may relieve pain associated with the nerves. People who use acupuncture regularly find that their pain is greatly reduced over time.

The Cure   

The only proven method of preventing future back pain is with regular exercise and strengthening. It is important to consult your physiatrist before attempting any exercises as certain exercises may be better for you than others.

For more information about back pain, please visit our website at http://valleysportsandspine.com and learn how Valley Sports & Spine Clinic can relieve your pain for good.   


Linking Together the Kinetic Chain

The kinetic chain refers to the system of major joints in the body that connect one section of the body to another and allows the body to create motion.  tennis

 

Did you know that your knee pain can be the result of a weak ankle? Did anyone ever tell you that your neck pain may be a result of weak core muscles? The body is built like a machine with interconnecting systems that rely on one another to work together and do their individual jobs to keep things running smoothly.

What is the kinetic chain?

The kinetic chain refers to the system of joints in the body that connect one section of the body to another. In general, the major joints help to divide the body into functional sections: ankles, knees, hips, lumbar spine (lower back), thoracic spine (mid and upper back), and cervical spine (neck). All of these sections work together to help the body maintain balance. An example of this natural balancing act is when a person swings their arms as they run.

What is kinetic energy, and how does it relate to the kinetic chain?

The kinetic chain is what allows the body to move. When discussing movement, one can point to kinetic energy which is the amount of force created when an object is in motion. Every time you move your body, you create kinetic energy. An example of this is when you are sprinting or running fast. When you attempt to stop quickly, it is difficult because your body is still moving forward. The force propelling your body forward as you attempt to stop is kinetic energy. With this in mind you can say that if your body were a bicycle your kinetic chain would be made of the pedals, wheels, and chain. The kinetic energy produced from pedaling would be the force that keeps the bike rolling down the street even after you have applied the brake.

The Kinetic Chain and Your Pain

As stated above, the kinetic chain refers to the series of joints that make the body move. These joints work together with a check and balance system to ensure that the body continues to have unhindered motion as much as possible. An example of how the kinetic chain can cause you pain is when looking at the knees. Among other functions of the knee, it stabilizes the body to allow a person to stand up and walk. In the kinetic chain the knees are directly connected to the ankles. If an ankle has suffered an injury or is weak the kinetic chain places extra stress on the knee to compensate for the ankle. While the individual may feel pain in their knee and think the problem is related to the location of the pain, the real problem is in their weak ankle which has no pain. Upon assessment from a physiatrist the patient will learn that their ankle has reduced range of motion and needs to be strengthened through exercise in order to relieve the stress on the knee.

Ask your provider for more information on the kinetic chain and how it can play a role in your pain. Also visit us at www.valleysportsandspine.com for tips on preventing injuries and recognizing pain related to your own body’s kinetic chain.  

 


Why Finding an Osteopathic “Function Expert” Might Be the Best Way To Treat Your Pain

150px-Muybridge_human_male_walking_animatedThe physicians at Valley Sports and Spine specialize in Physical Medicine & Rehabilitation. Their proven methods identify the root of your pain and prevent further injury.  

 

Are you struggling with pain in your neck, back, or knees? Have you been back and forth to your regular practitioner but still have no idea what is causing the discomfort? Have you considered being evaluated by a function expert? You may be surprised to find that osteopathic medicine can offer you the relief you have been looking for and so much more.

What is a Function Expert?

Physiatrists, also called function experts, specialize in the nerve, muscle, and bone functions of the body. Another way of stating this is to say that they are experts in how the body moves. While a general practitioner may be looking specifically at your aching knee, a function expert will be looking at your back, hips, and ankles simultaneously and watching how they are all working together in support of your knee.

Why Movement Matters

The body is a machine with many working parts that all have a job to do. Like a machine, if one part starts to get worn out and stiff, it can cause a chain reaction of stress throughout the system. The bones, muscles, nerves, joints, and connective tissue are all an interconnected system that work together to produce movement. If a specific area begins to have trouble the body will naturally compensate and attempt to shift the stress to another area. An example of this is a runner with knee pain. Once evaluated by a function expert it is identified that the runner is actually suffering from a stiff ankle. The ankle’s limited motion when running is putting extra stress on the knee. Once identified, specific exercises can be very effective at restoring the ankle’s mobility and eliminating the knee pain.olderStretchers

Why Choose Rehabilitative Medicine?

Rehabilitative medicine is about more than just your specific injury. Physiatrists evaluate each patient as an individual. Diagnosis and treatment of an ailment involve learning about the patient’s lifestyle and hobbies and understanding how their life is being affected by their current limitations. Understanding a patient’s daily activities can help the practitioner find clues to the greater cause of the ailment. Additionally, this type of consideration helps to create a treatment plan that can accommodate the patient’s lifestyle and hopefully allow them to continue conducting their favorite activities. Patients get the satisfaction of knowing that not only is their chief complaint being addressed but that they also are reducing their risk for further injuries.

For more information about function experts, please visit our website at http://valleysportsandspine.com and find out what Valley Sports & Spine Clinic can do for you!



Introducing our newest team member, Shannon

IMG_4074I love my staff. We have had many of the same faces at Valley Sports & Spine since the beginning. Their dedication and knowledge are an integral function of the clinic and I am finally getting around to writing about them on the blog.

A recent addition to our Medical Assistant position is Shannon. Shannon recently graduated from VT and is now in a Masters Program with an ultimate goal of Public Health work. She has a passion for Africa and desires to work in West Africa where the Ebola outbreak is exploding.

She recently completed the Eagle Man triatholon with three generations of her family, her mother and grandmother in a team named TriGenerational.  Their team placed 2nd in the relay division.  Her mother swam for 1.2 miles, her grandmother biked for 56 miles, and Shannon finished with a 13.1 mile run.  Shannon called the experience “Awesome!” and looks forward to more races with her family.

Her family has always been into competing and exercise.  Shannon’s grandmother, who was born in 1939, has competed in the Iron Man triathlon at least 5 times and stars in her own Spinning training videos.  Shannon has been a competitive swimmer since 5 years of age and participated in District and Regional swimming competitions in high school.  She admits she likes the competition more than the practice, and always try to beat her best time in any given sport.

Shannon has an upcoming 1/2 marathon and continues to swim and run regularly. She wants to master bicycling next so she can compete in triathlons, like her grandmother.

Good Luck, Shannon!


Student Reflection – Shadowing Dr Colliver

Shadowing a physician can be a wonderful opportunity for students, such as myself, who are interested in a career in medicine.  With consent from patients, one may attend visits alongside the physician.  This experience can give great insight into what a physician’s typical day may be like.

I am currently a graduate student at Virginia Tech studying to earn a master’s degree in Human Nutrition, Foods, and Exercise.  After having a hard time finding a local physician to shadow, I consulted two friends who are medical students at VCOM for suggestions.  They both recommended that I reach out to Dr. Colliver who has a strong passion for teaching students.  After contacting his office, I was pleased to learn that he would be able to accommodate me.

My week-long shadowing opportunity provided me with invaluable clinical exposure to patient care.  During patient visits, I was able to stand back and observe Dr. Colliver. The first thing that I noticed right away was his impeccable bedside manner.  Of all my previous clinical experiences with volunteering and shadowing, Dr Colliver has by far the best doctor-patient relationship.  He introduced himself to all his new patients and created a welcoming environment by taking his time with all his patients.  Dr. Colliver addressed and reassured his patients’ concerns as well as ensured that patients did not leave with any unanswered questions.  I feel that such etiquette-based communication is very important and that every healthcare professional should model themselves after this behavior.

With 14 years of training, Dr Colliver truly is an expert in pain management.  I was amazed at how effortlessly he was able to evaluate and diagnose patients, analyze imaging, and perform nerve conduction testing.  I was able to observe a few procedures that were performed at the clinic as well. The ultrasound-guided injections and electromyography were fascinating to witness.

Something that I especially appreciated was his incorporation of Osteopathic Manipulative Treatment (OMT) in his practice.  It was satisfying to hear patients stating that they instantly felt lower levels of pain after Dr. Colliver performed OMT. Observing OMT in interesting and made me appreciated the vast amount of training involved.

While Dr. Colliver filled out paperwork in between patient visits, I would observe his staff.  Dr. Colliver selected a great tem of healthcare professionals for his practice.  All the members of his staff were very knowledgeable, friendly, and also practiced excellent bedside manners.

At the end of each day, I was able to ask Dr. Colliver questions that had developed throughout the day. My questions ranged from his experiences in medical school and residency to how he believes medicine is changing.  I was very pleased to learn that he and the Physician Assistant, Holly, participated in a scientific journal club.  My graduated program stresses the importance of translational research, the
“bench to bedside” transition of scientific discovery to clinical application.  Those who conduct health-related research, including myself, ultimately seek to fulfill the purpose of finding new discoveries and ways to improve health. When that research is published, we rely on the front-line professionals, the health providers, to engage in evidence-based practice.  It is reassuring to know that Dr. Colliver and Holly keep up-to-date with current research and new findings that may be useful for his practice.

In addition to being informative, this shadowing experience was also quite humbling. I observed patients that suffer from debilitating pain caused by accidents, injuries, and non-injuries. I saw how drastically the pain had changed people’s lives, from loss of work productivity to decreased physical activity.  I witnessed Dr. Colliver’s passion for patient care put to work as he helped patients after patient regain control of his or her life and provide relief.  Follow-up patients that praised him for their pain relief and improvements with their range of motion were inspiring and satisfying.  This experience only served to strengthen my decision to pursue a career in medicine.

 

Thank you Valley Sports & Spine Clinic for providing me with an excellent clinical experience!

Tamima Hossain


What’s in a breath?

Put simply, a lot!

Next to the heart, the diaphragm is the most important muscle in the body. Recent research shows that dysfunction of the diaphragm is associated with low back pain.  The diaphragm is a large muscle separating the chest from the

abdomen, is the primary breathing muscle, as well as part of the core muscles.

The core muscles are a spherical boundary of muscles that surrounds the abdominal cavity. They include the: diaphragm, pelvic floor, lumbar musculature, abdominal muscles and rectus abdominis. These muscles work together to stabilize the spine, pelvis, hips, and support the function of chest and abdominal organs.

 

Gray's picture of diaphragm. Note the circumferential attachments to back, ribs, and sternum.

Gray’s picture of diaphragm. Note the circumferential attachments to back, ribs, and sternum.

Proper breathing requires the diaphragm to flatten and descend into the abdomen with inspiration, and doming upwards into the chest cavity with exhalation (there is much more, but to keep it simple we will stop there).  Because the diaphragm connects from the back to the front of the body, it requires coordinated muscle activity from the anterior abdominal muscles and core muscles, in order to function efficiently.

Dysfunction from the diaphragm can occur from a problem with the muscle itself or from any of the components of the core musculature; examples include: smoking, prior abdominal or pelvic surgery, deconditioning, abdominal hernias, open heart surgery, etc.  A less efficient diaphragm leads to overactivity of the secondary breathing muscles (intercostals, scalenes, and sternocleidomastoids), and back muscles.  Dysfunction of the diaphragm can also lead to core dysfunction.  This cascade of events can then lead to back pain, neck pain, pelvic floor problems, hip problems, etc.

Without addressing the function of the diagphram, exercises to treat neck pain, back pain, pelvic floor problems, and hip problems can fail.  Treatment should be aimed at restoring the function of the diaphragm through special breathing exercises that work on coordinating the activity of the diaphragm with core musculature and restoring balance to the secondary breathing muscles.

Valley Sports and Spine Clinic has trained alongside select physical therapists from Blacksburg, Christiansburg, and Radford to develop techniques, adapted from the Postural Restoration Institute, for evaluating and treating diaphragm problems.  If you have neck pain, back pain, urinary incontinence, bowel difficulty, or hip problems, you may need to have your diaphragm function evaluated and treated. We can help!

Good Luck,

 

Ethan Colliver, DO

Valley Sports & Spine Clinic Giving you Back your Life

 


The Future of Medicine will be Regeneration

Sports Medicine is rapidly changing.  The old days of giving steroid injections for every ache and pain are numbered.  Most treatments for sports injuries are not able to treat the root cause.  In stead, treatment has been aimed at controlling the symptoms through medications or devices.  In fact, many traditional treatments (think steroid injections) can damage tissues like cartilage and tendons.

Regenerative Medicine is a game-changer.  It is has the potential to heal damaged tissues and organs.  It has three elements: Rejuvenation, Replacement, and Regeneration.

Rejuvenation: Rejuvenation means enhancing the body’s natural ability to heal.  Some tissues like skin heal very quickly after injury; but others like organs, tendons, and nerves heal poorly or slowly.  Recent research has shown that these tissues possess stem cells and the ability to heal better than previously thought- rejuvenation is the branch of medicine aimed at optimizing the body’s ability to use these healing processes.

Replacement: Replacement is exchanging damages cells/tissues for healthy ones from either a living or deceased donor.  Think of kidney transplants, or knee meniscus and Achilles tendon transplants.  Also, technology exists that allows your own cartilage to be grown in a lab and transplanted back into a damaged knee.

Regeneration: Regeneration involves delivering specific types of cells or cell products to diseased tissues or organs, where they will ultimately restore tissue and organ function, as defined by the Mayo Clinic.  Examples are inserting stem cells or growth factors into a damaged tissue.  We commonly use Platelet Rich Plasma injections for tendon and joint injuries for this very reason.

Regenerative medicine may provide the definitive treatment for many of the degenerative problems faced by Sports Medicine like back or knee pain.  Valley Sports & Spine Clinic focuses on the emerging evidence in this field to provide cutting-edge treatments and protocols for our patients.

We can help you!

 

Ethan Colliver, DO

Valley Sports & Spine Clinic Giving you Back your Life


Health Benefits of Self- Discipline

Everyday physical activity is beneficial to your health in many aspects. After a long day of work, many of us find it challenging to push ourselves to work out. The rewards of being self-disciplined to at least 30 minutes of exercise a day are endless. Exercise can help prevent excess weight gain, aid weight loss or help maintain a goal weight. Regular physical activity can help you prevent or manage a wide range of health problems including stroke, type 2 diabetes, depression, certain types of cancer, arthritis and risk of falls, just to name a few.

Working out improves muscle and bone strength. It also delivers oxygen and nutrients to your tissues and helps your cardiovascular system work more efficiently. When your heart and lungs work more efficiently, you have more energy to go about your daily chores.

In my experience, as a physician assistant at VSSC, I see many patients who begin to feel better, then 6 months later the individual returns with the same pain as before. What happens most of the time, is the patient has failed to continue their home exercise program (HEP), provided to them by their physical therapist; in fact, 75% of patients will stop their HEP within 6 months of stopping physical therapy.

I’ve had the privilege of caring for a particular patient who presented with low back and right leg pain with a pain intensity 10/10 and 90% limitation of function. Lumbar MRI revealed a disc herniation and narrowing where the nerve exits the spine. Following two lumbar epidural steroid injections and completing 1 month of physical therapy the patient improved 90%. This individual became so motivated and passionate about her improvement that she purchased a home gym and posted her exercises on the wall. Daily, she exercises 45 minutes in the morning and 45 minutes in the evening. Her self-discipline and accountability have been the most crucial part of maintaining her improvement and keeping her back and leg pain to a minimum and most days eliminated.

At some point we all experience pain. Take control of your life; be active, responsible and passionate about your health. Ultimately, it is really up to you!

 

Good Luck!

Valley Sports & Spine Clinic Giving you Back your Life

Holly Williams, PA-C