Thursday, October 26, 2017

Avoid Your Achilles' Heel

The Achilles heel has provided legendary pain and symptoms. Achilles ruptures have been taking down great warriors and athletes for centuries. My heart hurts when I see patients go through the agony of the physical, mental and emotional impacts of this injury. What if these problems could have been avoided or prevented? This newsletter is looking to accomplish just that, a plan for the prevention and reversal of Achilles tendinopathy.

Historically, Achilles pain was diagnosed as Achilles tendinitis. Research on painful tendons in the late 1970s discovered there was no inflammation when looking under a microscope. For decades these problems have been misdiagnosed and mistreated.
The Achilles problem is called tendinosis, which is a degenerative condition resulting from excessive load and decreased blood supply. The tendon becomes tender or painful, the collagen becomes disorganized, and the strength decreases. 
Who is at risk for this type of injury?
People who are in an environment with repetitive use or higher demand. Especially people on their feet all day for their occupation, runners, or athletes that involve frequent jumping (e.g., basketball, volleyball, crossfit).

One in five athletes with Achilles tendinopathy are under 45 years old. When it comes to competitive athletes, one in four will have an Achilles injury in their lifetime. Competitive runners have an even higher risk of tendinopathy, as high as 40-50 percent. 

Why is Achilles Tendinosis important?
Healthy tissue can tolerate the daily activity and training loads. Degenerated, thickened  adhered and weaker tendinosis tissue will not tolerate the load increasing the risk of a full rupture. 97% of all soft tissue injuries and tears happen in degenerated tissue.
Achilles Tendinosis on Left: Degenerated & Thickened
What can I do?
If you or anyone you know have any history of pain in your Achilles, heel, or the back of your ankle… Do this Now.
Action Step: No seriously, stop andcheck yours!

How can Dr. Matt Buffan help me solve this problem?
Solving the problem requires three things.
Best method to reduce tendinosis tissue
1. Decreased activity
2. Adhesion release treatment 
3. When the tendon demonstrates healing and tolerance to basic daily activity, eccentric exercise can be added into your routine

If the steps above are not followed in their specific order, your problem will not be resolved and returning to training or daily activity will be delayed. I have worked with patients who go through multiple rounds of poor management, which includes periods of rest as long as two months and/or poor exercise selection. The results for these patients who do not follow the steps in order end up realizing their problem continues when they re-introduce activity.

Are there any other areas where this problem is common?
Yes, lateral elbow tendon (“tennis elbow”), hamstring tendon attachment, and knee tendon.
"Tennis elbow"

Tuesday, February 21, 2017

Stairway to Hamstring Strength

Many people who come into our office complain about their hamstrings. The hamstrings consist of three distinct muscle tissues located in the back of the thigh. The average person spends the majority of their day sitting: at the office, eating, driving or riding in a vehicle, and watching TV. This frequent sitting creates limitations of the hamstrings. Hamstring limitations can lead to over activation of the muscles in the front of the leg, knee pain, poor balance, as well as calf and foot complaints.
Hamstring muscles

In most cases, this limitation is a combination of muscle adhesion and weak muscle issues. The muscle adhesion needs to be resolved with Manual Adhesion Release. The weak muscle tissues can be strengthened with targeted exercise and incorporating mindful staircase climbing into your daily routine. When climbing stairs, skip a step to have your whole foot in contact with the stair. Now drive through your heels with each step. This activates and strengthens the hamstring muscles.

Stairway to Hamstring Strength

Making the choice to take the stairs mindfully, versus using the elevator or escalator, allows you to work towards strengthening your muscles, as well as improving your balance and health. It is a choice of doing what is right for your body, instead of what is easy. 😤

Monday, October 17, 2016

Sciatica: A Pain in the Rear!

     What is sciatica? Sciatica gets its name from where the pain is located, in the back of the leg along the sciatic nerve. Many patients come to the office complaining about pain in their “butt muscle” or their hamstring feels tight. This pain can limit day to day activities.. Pain typically continues when left untreated, including a deep dull ache that never subsides. Tingling and burning can also occur nearby the location where the nerve is stuck. Click on the picture to watch a video and learn more.

Sciatica Symptoms

    Case study: Our approach to solve the problem.  Recently a patient came into the office complaining about pain traveling between her upper leg and knee. The pain had been progressively getting worse over the last month. Simple daily tasks such walking and climbing stairs were a painful challenge for her. The patient had tried physical therapy, however the exercise routine made the problem more noticeable. 

 Within our evaluation, we test the ability to bring the straight leg towards the hip. This patient was severely limited at 56 degrees: 90 degrees is normal. Not only was her range limited, but it provoked the complaint.

After ruling out other potential causes of the pain we were able to confirm adhesion along the nerve located at the back of the hip. At that point, we accurately diagnosed the problem as sciatica, caused by adhesion making the muscle stick to the nerve. The method of treatment to resolve this problem is Manual Adhesion Release (TM) twice weekly until the leg has a range of motion of 90 degrees. When the full range of motion goal is achieved, daily activities (and more) will no longer cause pain.

       Results. After a series of four treatments the patient was able to reach 90 degrees with the straight leg raise test and felt 80% better. The following week, the test maintained the results from the prior week and the patient shared she has returned to pain-free living and had increased activity without any setbacks. She was released from care and was excited to continue hiking and her studies.
Getting the diagnosis correct is important. You can have pain in your back and down your leg from others regions, including breaking down of discs in your back and your spinal cord narrowing.

    Conclusion: If you or someone you know is experiencing sciatica, which often feels like constantly tight hamstrings or the lack of ability to bend forward and touch the floor, you or they should be evaluated for sciatica. Book your appointment today or share this post with a friend who may be suffering.

Friday, April 22, 2016

Plantar Fasciitis Solution

Foot pain is a common ailment we see here at Rochester Spine + Sports Chiropractic. Often this starts as a not-so-innocent twinge while running or going up and down stairs. If left untreated, it can progress further to fear of stepping out of bed, knowing a stabbing pain is likely. Pain in the bottom of the foot is known as the medical condition plantar fasciitis. Plantar fasciitis is a disorder of the insertion site of the ligament on the bone characterized by micro tears, breakdown of collagen, and scarring.
Plantar Fasciitis: Site of Pain

Scar tissue, also known as adhesion, is commonly misdiagnosed. It is a mechanical buildup of glue-like substances, medically known as collagen, in the muscles in your foot. Treatment designed to reduce adhesion* is the key element in alleviating the problem. Micro tears are common in people who repetitively overuse their feet. Daily demands that create overuse of your feet include raising children, running, and weight lifting. Although pain is felt on the bottom of your foot, this area may not be the only area affected. Another important area to have examined is the lower leg, where the larger muscles originate that travel through the foot and to the toes. Far too often I see cases where patients tried previous treatments that failed to resolve the problem. This is driven mainly due to the fact that the only site treated was the foot. Improper diagnosis and/or treatment allows for the problem to recur and potentially progress to changing the heel bone, which is also known as a heel spur.

Many people try resting, but often find the problem returning or never fully healing. Resting is difficult, as it is hard to avoid using your feet for long periods of time. Resting does not address the problem of adhesion*. The next attempt often includes trying over-the-counter or prescription medications for inflammation. Recent literature indicates inflammation is not the cause, therefore chemical anti-inflammatories are not the solution. People also try new shoes or foot orthotics. When foot orthotics are properly molded to match your foot, they help stabilize your arch. However, they do not address the adhesion*.

The good news is adhesion* is reversible! Dr. Matt Buffan at Rochester Spine + Sports Chiropractic is a certified expert at locating and fixing adhesion*. If you want to know how to resolve your plantar fasciitis, follow our three step process. 1.) Accurately diagnose the problem. 2.) Address the adhesion*. 3.) Support the foot for your daily activities. This process differs from other health practitioners, and is best in class for treating plantar fasciitis.

Most of Dr. Matt’s patients have seen multiple providers before coming to Rochester Spine + Sports Chiropractic. These patients have not received the care they need because adhesion* is one of the most misdiagnosed conditions. Adhesion* is a common issue in almost all people, and it needs to be treated by a certified professional. Part of the issue is the focus being on the site of the pain, and not seeking the site of origin of the pain. Dr. Matt is certified to manually fix conditions from head to toe. If necessary, once the adhesion* is cleared out, custom molded orthotics and or modifications, can be used to help balance the demands on the foot.

Can I run the course again? My feet feel fantastic!
Plantar fasciitis is a condition that can rob you of your ability to start your day with a smile. If this condition is stopping you from being able to walk, run, or get through the work day, give us a call or clickhere to schedule an appointment online.

*Adhesion is also known as scar tissue

Beeson P (September 2014). "Plantar fasciopathy: revisiting the risk factors". Foot and ankle surgery: official journal of the European Society of Foot and Ankle Surgeons 20 (3): 160–5. doi:10.1016/j.fas.2014.03.003. PMID 25103701.

Lareau CR, Sawyer GA, Wang JH, DiGiovanni CW (June 2014). "Plantar and Medial Heel Pain: Diagnosis and Management". The Journal of the American Academy of Orthopaedic Surgeons 22 (6): 372–80. doi:10.5435/JAAOS-22-06-372.PMID 24860133.

Wednesday, February 27, 2013

Sit, Slide & Lean

Tired of work?  Does work, school or your day make your shoulders sore, tight and achy?  Many people carry their stress in their shoulders.  Are you tired of end of the day aches and pains?  Well let’s do something about that!

We tend to be creatures of habit.  What are your habits at work, in the classroom, or at home? These habits continually stress the muscles, ligaments and joints to repetitively produce the habit. One thing most people enjoy is a seat.  Sitting is not a good position for your body and specifically, your spine.   Taking a seat shortens the hip flexors, bends the spine forward, and places strain on the low back, upper back and neck.  Furthermore practically every action we do when sitting involves reaching in front of us; to type, grab the phone, move the mouse, or grab a drink from our water bottle.

As we begin the second half of the school/work year, let’s review a good position for your desk or work station.  It’s really as simple as “Sit, Slide & Lean” (1).

Sit. First, prior to sitting brace your core and drive the hips back to find the chair, as opposed to crashing into it with a thud, gently locate it with your tush. The chair height should allow 90 degree angles for both the knee and the hips.  The feet remain on the floor.

Slide.  This means sliding your rear end all the way to the back of the chair, so that your butt and back make a corner out the intersection between the back of the chair and the base of the chair. When we leave a gap between our back and the back of the chair, we round our back in order to “fit” into the chair.  This worsens as we tire of holding ourselves fully upright.   This places a tremendous of load, specifically flexion, on the lumbar spine, which may irritate discs. Furthermore it allows ligaments to creep, which is a deformation or stretching of the ligaments. Finally, the muscles such as the hip flexors stay in a shortened and unnatural position for many hours.

Lean.  Lean your back into the chair.  This allows you to maintain a neutral spine. Leaning back allows you to maintain proper lumbar, thoracic and cervical curves and good posture.   Your head will rest naturally over your shoulders, reducing stress on your upper back.   From this position you can maintain a relaxed and comfortable “base position” to accomplish your daily greatness.

So take a minute to step outside of yourself in order to look at how you are holding yourself while you are sitting down.  What would it look like if you could see yourself?  Now try “Sit, Slide and Lean”.  Comfortable, relaxed and confident.  Now look at your most frequent places that you sit… your desk, office, kitchen table, comfy chair, etc and apply the above to your environment. Finally, get moving with ladder reaches.  If you have any questions, give me a call, I’m here to help you.  My goal is to help you move well, live well. 

(1) Dr. William Brady,DC- Personal communication &

Tuesday, January 15, 2013

Snorkeling, Posture, and Neck Pains

So we're a couple of weeks into 2013 - how are those New Year's resolutions holding up?

On vacation this past week I was recharging for the coming year, and snorkeling provided a great lesson to be shared with others. No, not that more fish hang out near you, (almost follow you) if you wear the natural sunscreen, but that it’s easy to lose sight of our Movement Rx activities in the “busy-ness” of life.   Personally this hit home when I noticed neck pain after spending time chasing fish around the reef.

Pictured: My nemesis!

Now I know you are thinking, “Well I ain’t snorkeling, I’m working at my computer, hoping I don’t have to shovel, so I can stop reading." Not so fast. The positions are functionally very similar, and when we sit, drive or eat we tend to slouch (Movement Rx- Sit, Slide, & Lean) bringing our head forward, or into flexion.  In order to keep our eyes up on the screen, we raise our upper neck, extending the upper cervical spine.  This overloads the upper neck muscles & joints as well as the upper thoracic region. We need to consistently remind ourselves to avoid overloading this area to avoid both neck pain and headaches. 

So as we prepare for our day, we have to prepare our bodies for the activities that we are going to do repeatedly, such as sit, look forward and do things in front of us.  Instead of focusing on toast and coffee, I encourage to revise your resolutions and recommit to your Movement Rx for 2013. For me this includes heavy doses (3 sets x10 reps) of the neck exercise, the Glory V and the reverse lunge. 2-5 minutes out of your day and you're done. If you can’t recall your Movement Rx stop in to review them.  In the meantime I've posted a pic of the neck exercise below. Happy New Year!

Thursday, September 27, 2012

Kayaking as Exercise

The beautiful weather we’ve been receiving has had many of my friends yearning to get out on the water. So today I thought I’d write about one way to receive great exercise while getting outside and enjoying the incredible fall foliage: kayaking. Kayaking not only offers an affordable way to get out and explore some of our area’s picturesque waterways and autumn scenery; it also helps the muscles in the upper-body while providing a great cardiovascular workout. Below I’ve listed some answers to very common questions about kayaking.

Where can I go kayaking and how much will it cost?

If you don’t own your own kayak or have a friend’s that you can borrow, there are plenty of options to get you out on the water. Typically, a kayak rental center will offer hourly blocks for rentals. We recommend renting for at least two hours as the time you spend transporting the kayak and preparing to set out will eat into the time you are going to spend in the water. 

An example of a local spot for kayak rentals is Bay Creek Paddle Center in Irondequoit ( At Bay Creek you’ll save money by renting for longer periods of time, so that while it’s $28 to rent a kayak for two hours, it’s only $34 to have it for four hours, and $44 to have it for eight.

Additional kayaking spots include:
-Rochester Canoe and Kayak Park (Rock Park) on the Genesee near Driving Park Bridge.
-Letchworth State Park which also offers whitewater rafting trips (check out: for more information).
-Mendon Ponds Park offers scenic, serene waterways for a relaxing kayaking experience.

How should I prepare?

As with any activity a proper warm-up is recommend. In addition to stretching, with emphasis placed on your arms and shoulders, also consider adding push-ups and/or shoulder presses to your pre-kayaking workout. As proper kayaking involves repetitive movement of the arms and shoulders to paddle your kayak forward you will want to address these upper body areas prior to setting out, as you’ll be able to effectively reduce the potential for a repetitive use injury in these areas.

What else?

Again, the same advice applies to kayaking that applies to so many activities. Warm up and make sure to eat some protein prior to setting out. Kayaks typically have small storage compartments, so if you’re setting out for a long session – say four hours or more – make sure to pack some water and a protein/energy bar to help keep you energized for return trips and lifting the kayak out of the water. I highly recommend kayaking as a great way to work your shoulder and upper back, while having an experience to remember!