“Evidence is growing that regular physical activity reduces breast cancer risk, especially in women past menopause. The main question is how much activity is needed. Adults get at least 150 minutes of moderate intensity or 75 minutes of vigorous intensity activity each week (or a combination of these), preferably spread throughout the week.”
American Cancer Society
Research shows that movement is vitally important, especially as we get older. Physical activity not only helps reduce the risk of cardiovascular disease, Type 2 diabetes and even some cancers, it also strengthens our bones and muscles. As we age, the health of our bones and muscles — known as our musculoskeletal system — is key to reducing the frequency and severity of common conditions such as back pain as well as preventing falls and other injuries that can lead to disability. For these reasons, it’s essential to move now, to move later…to move for life…to stay healthy and strong, active and engaged.
There are well over 100 types of adjustment techniques used by chiropractors throughout the world. Typically, chiropractors will focus on and utilize 8 to 10 different approaches in their practice.
The common goal of most chiropractic techniques is to restore or to enhance joint function, with the general goals of resolving joint inflammation and reducing pain. Some approaches use some force (spinal manipulation), while others are more gentle (spinal mobilization).
There are well over 100 types of adjustment techniques used by chiropractors throughout the world. Typically, chiropractors will focus on and utilize 8 to 10 different approaches in their practice.
The common goal of most chiropractic techniques is to restore or to enhance joint function, with the general goals of resolving joint inflammation and reducing pain. Some approaches use some force (spinal manipulation), while others are more gentle (spinal mobilization).
The original chiropractic adjustment approach is generally referred to as spinal manipulation, and may also be called the diversified technique or the high-velocity, low-amplitude (HVLA) thrust. New chiropractic adjustment approaches typically evolve as a variation from an existing technique and are often named after the chiropractor who developed it.
This article reviews a number of the most commonly used spinal manipulation and spinal mobilization techniques currently used by chiropractors.
Spinal Manipulation (High-Velocity Low-Amplitude Thrust)
The most frequently used chiropractic technique, spinal manipulation, is the traditional high-velocity low-amplitude (HVLA) thrust. The manipulation often results in an audible “pop,” as chiropractors use their hands to apply a controlled sudden force to a joint while the body is positioned in a specific way.
Spinal Mobilization (Low-Force or Gentle Chiropractic Techniques)
Some conditions (such as osteoporosis), pathology, the patient’s size, patient comfort, or patient preference, may require a gentler approach generally referred to as spinal mobilization. In addition, some patients and/or clinicians prefer mild spinal mobilization techniques that do not involve twisting of the body or a forceful thrust.
n addition to manipulation, many chiropractors will employ adjunctive therapy, such as ice or heat or physical therapy modalities (such as electric stimulation, ultrasound, etc.), as part of an overall treatment plan. Patients should discuss their symptoms and preferences with their chiropractor, whose role it is to perform a thorough examination to determine the best course of treatment.
Chiropractors are not the only health care providers who utilize spinal manipulation for back pain treatment. Many osteopathic physicians will provide a variety of types of spinal adjustments, such as the spinal manipulation and mobilization described in this article. Occasionally, other types of health care professionals, such as physical therapists or physiatrists, will be trained in providing spinal manipulation as well.
The goal of spinal mobilization is the same as HVLA spinal manipulation – to restore or to enhance joint function. However, unlike HVLA spinal manipulation, slow movement, usually to a firm endpoint of joint movement, is used to mobilize the joint.
Chiropractors may choose spinal mobilization for certain patients for a variety of reasons, such as:
There is a wide range of spinal mobilization approaches and techniques. Several of the more common gentle spinal mobilization methods include:
“Our bodies have the capacity to do a little more than we normally do, but our bodies do not adapt very well to doing a lot more than we normally do. Since the added demands of this season can stress the capacity of our bodies, we need to do everything we can to help ourselves. Eat right, drink plenty of water, stretch, exercise, and take a few minutes to slow down and reflect on what the season is all about.”
According to Dr. Bautch, who was featured in CapeCod.com,
“It is estimated an outstanding 80% of cancer in America is do to our lifestyles particularly DIET and EXERCISE.”
The National Cancer Institute
“Worldwide, breast cancer is the most common disease in women and constitutes the second leading cause of cancer death in this population. The factors that contribute to the risk of occurrence are divided into nonmodifiable and modifiable factors.”
NCBI US National Library of Medicine National Institutes of Health
“There are many types of breast cancer. The most common types are ductal carcinoma in situ, invasive ductal carcinoma, and invasive lobular carcinoma. The type of breast cancer is determined by the specific cells in the breast that are affected. Most breast cancers are carcinomas. Carcinomas are tumors that start in the epithelial cells that line organs and tissues throughout the body.”
American Cancer Society
“Patients sometimes latch on to a particular buzzword, he notes: They go, ‘Well, I want X, Y and Z – you know, an anterior approach and metal-on-metal; I want minimally invasive; and I want this and that.’” That’s all fine, he adds, but what you really want is a surgeon who’s done plenty of procedures. You want a specialist in hip and knee replacements rather than a generalist. Especially if you’re in a metropolitan area where there’s a lot of expertise, really alot of this is just pure common sense.”
Mathias Bostrom, the orthopedic surgeon at the Hospital for Special Surgery
Do your research before definitely deciding on a surgeon and hospital doing this treatment. It’s your body, not theirs. See what their history is and why they are so great to select in doing this invasive procedure. We have many in N.Y. just do your research. The higher the odds less problems with more experience and good hospital overall reviews.
Hospital of Special Surgery (HSS) is nationally ranked No. 1 in orthopedics (for the ninth consecutive year) and No. 3 in rheumatology by U.S.News & World Report (2018-2019). HSS has been among the top-ranked hospitals for orthopedics and rheumatology for 27 consecutive years. Hospital of Special Surgery is in Manhattan, N.Y.
Because an infection can be a devastating outcome for an orthopedic patient, Hospital for Special Surgery takes infection control extremely seriously and is proud of the recognition received for our significantly low infection rates.
Recommended as an excellent hospital in NY understanding hip surgical procedures is Hospital of Special Surgery in Manhattan and also a doctor on board their understanding hip surgery is Dr. Padgett.
From 1985-1989, Dr. Padgett was a resident in orthopedic surgery at Hospital for Special Surgery and subsequently performed a one-year postdoctoral fellowship at The Rush Presbyterian Medical Center in Chicago in Adult Reconstructive Surgery of the hip and knee (1989-90). From 1990-1993, Dr. Padgett was the Director of the Adult Reconstructive Service at the Naval Hospital, San Diego and developed the Adult Reconstructive Education Program. In 1991, Dr. Padgett was deployed to the Persian Gulf with Fleet Hospital #6 in support of military operation during Operations Desert Shield and Desert Storm.
In 1993, Dr. Padgett joined Hospital for Special Surgery as an attending surgeon on the Hip and Knee Service. In 2006, Dr. Padgett became the chief of the Hip Service, and in 2008 chief of the Adult Reconstruction and Joint Replacement Service. In addition to his duties at Hospital for Special Surgery, Dr. Padgett is also a consulting physician for the Bronx V.A. Medical Center.
Under the U.S. News for Health they do ranking of hospitals in the U.S.
Hospital for Special Surgery in New York, N.Y. is nationally ranked in 2 adult specialties and 1 pediatric specialty and rated high performing in 2 adult procedures and conditions. It is an orthopedic facility. It scored high in patient safety, demonstrating commitment to reducing accidents and medical mistakes. It is a teaching hospital.
The U.S. News analysis of hospitals includes data from nearly 5,000 centers across multiple medical specialties, procedures and medical conditions including neurology, orthopedics, psychiatry and more. Scores are based on a variety of patient outcome and care-related factors, such as patient safety and nurse staffing. U.S. News ranks hospitals in 16 adult and 10 pediatric specialties. Hospitals also receive a rating in 9 common procedures and conditions, including hip replacement and COPD. Read more about how we rank and rate hospitals.
Do your research.
What should you consider when choosing this hip surgery?
It’s the time you are expecting to get this done and are you an appropriate candidate.
Timing of surgery is another important consideration in predicting successful outcomes. “Generally I advise patients that it’s reasonable to consider surgery when the disability and pain in the knee or hip is affecting your quality of life and you’ve tried all other means available to alleviate your symptoms,” stated Dr. Russell Windsor.
If learning from this topic, you might be asking yourself who is Dr. Russell Windsor? Go no further here is who he is:
Dr. Russell E. Windsor received his medical education at the Georgetown, Thomas Jefferson, and Cornell Universities. He completed his orthopedic training at the University of Pennsylvania and did a Fellowship in Knee Reconstructive Surgery at the Hospital for Special Surgery under John Insall, MD, who was one of the original developers and father of total knee replacement surgery. Dr. Windsor has presented his work and served as faculty member in over 250 national and international seminars and has written over 60 original publications and contributed chapters in reconstructive surgery in 40 textbooks. He has been featured on Good Morning America with Diane Sawyer and the NBC Today Show where he discussed total knee replacement and total hip replacement surgery.
Dr. Windsor was Chief of the Knee Service at the Hospital for Special Surgery between 1990 and 2006 and was President of the American Knee Society in 2005. He has been an active design consultant for various total knee replacement designs and has approximately 15 American and international patents for the design of Zimmer’s unicompartmental replacements (ZUK) and rotating hinge knee replacement (RHK).
His research concentrates on minimally invasive unicompartmental and total knee replacement. Additionally, he has a special interest in total knee replacement in the athlete and the younger, active patient with arthritis. He has a substantial experience in revision surgery and has performed thousands of knee and hip replacements. He also is a world expert in gender specific knee replacement and ligament reconstruction. His expertise is also strong in sports medicine of the knee. Again, do your research.
Prospective patients should also take into account the importance of having surgery while they are otherwise in good health. In the past, some middle-aged patients have elected to wait for a joint replacement, because of their concern about the longevity of the new joint; that is, that a second joint replacement surgery might eventually be required. However, not only does the data indicate that knee and hip replacements are lasting as long as twenty-five or even thirty years, but delaying surgery may result in the surrounding muscles becoming de-conditioned owing to reduced function. In turn, this may make recovery from surgery more difficult.
Older individuals, including those in their 80s and 90s may also want to consider the benefits of scheduling surgery sooner versus “living with” disability. While the ability to tolerate surgery and recovery, as well as the existence of coexisting medical conditions must be taken into account, recent data shows that joint replacement that helps to preserve function can have an overall positive effect on the health of older patients. Those who are able to be more active have a reduced risk – when compared to their more sedentary counterparts – of various medical conditions including pulmonary embolism, deep vein thrombosis and pneumonia.
“Knee and hip replacement surgery improves the quality of life of thousands of patients each year,” Dr. Windsor notes. “However, both advertising claims and misinformation on the Internet can lead to confusion about which implant works best or even an exaggerated sense of risk associated with the surgery. In many cases, a discussion with your surgeon can clarify implant options and establish realistic expectations about hip and knee replacement surgery.”
“As with any surgery there is always some risk involved. There have been a few knee and hip implant systems that have not worked well,” Dr. Windsor says, “and isolated recalls of specific models have occurred. But people should be aware of the shared commitment on the part of industry, hospitals, and surgeons to the welfare of the patient and to addressing any problems with implants that do occur.”
One method to monitor performance of hip and knee implants is through a patient registry. The orthopedic surgeons at HSS are dedicated to following the long-term patient centered outcomes of joint replacement surgery in our Total Joint Prospective Clinical Outcomes Research Registry. Using this registry, long term implant performance may be followed and hopefully surgeons can identify as early as possible any poor performing implants.
“Total hip replacement surgery, sometimes called total hip arthroplasty, is considered one of the most reliable surgeries ever developed. As many as 96% of patients who have had elective total hip replacement surgery say they would make the same choice again.”
Arthritis-Health (www.arthritis-health.com)