SHOULDER PAIN . . .

We design programs to strengthen the entire shoulder complex. Minor shoulder problems that are left untreated often become major shoulder problems, sometimes requiring surgery. Before we discuss how to correct the various shoulder problems we should discuss shoulder anatomy:

ROTATOR CUFF PROBLEMS
Looking at the shoulder complex reveals the Rotator Cuff. The cuff is made up of four major muscle groups: the Supraspinatus, Infraspinatus, Teres Minor, Teres Major. These muscles give major stability to the shoulder complex. When one of these major muscles is torn the shoulder loses its stability. There are different levels of tears.

Ligaments are graded according to the severity of muscle or tendon damage. Grade 1 strain is a mild strain in which the muscle tendons become stretched with few torn fibers. Grade 2 or second-degree sprains reflect stretching and tearing of some ligament fibers with minimal joint displacement. Grade 3 or third degree sprains involve full thickness tears (rupture) of ligament fibers that result in joint dislocation. More severe sprains may be graded from IV to VI reflecting increased displacement of bony anatomy.

Diagnosis: Grade 1 usually has minimal bruising and no displacement of the boney anatomy. Grade 2 often has bruising and edema but not boney displacement. Grade 3 usually has bruising, edema and boney displacement.

Radiographs will help determine a Grade 3 but not a Grade1 or 2. MRI will better view the soft tissues for a grade 1 or 2.

Treatment: Grade 1 and 2 shoulder sprains and strains are initially treated with Physical Therapy modalities: Ultrasound, Electrical Stimulation, Massage, Ice Massage, Gentle Mobilization and rest. Range of motion exercises should be started fairly soon to prevent scar tissue formation. Eventually exercises should be done to strength the shoulder complex.

Grade 3 shoulder sprains and strains should be put in a sling and checked for possible surgical intervention. Surgical repair of the ligaments and tendons may be necessary.

LOW BACK PAIN . . .

THE LOWER BACK IS MADE UP OF 5 LUMBAR VERTEBRAE
The disk is made up of a Nucleus Pulposus (Gel like substance) made up mostly of water with some proteoglycans. Proteoglycans help the disc retain water. The disc is held to the vertebrae endplates by ligaments. The amount of fluid in the disc varies depending on day and night. The discs act like shock absorbers for the spine. The Annulus Fibrosus is mainly made up of collagen and proteoglycans. Each vertebra has spinal nerves that exit the sides of the vertebrae. These nerves are known as spinal nerves.

DIFFERENT CAUSES OF LOW BACK PAIN
A LOW BACK STRAIN VS A LOW BACK SPRAIN:
A low back strain is a tear to the muscles surrounding the lumbar spine. A low back sprain is a tear to the ligaments surrounding the lumbar spine. The muscles and the ligaments surrounding the lumbar spine need to be flexible and mobile. The spine supports the nervous system and the weight of the body. It is prone to injury. When the body moves the spine moves with it. A sprain or strain is usually localized to lower the back with some pain in the buttocks. It does not have radiating pain down the leg and is usually relieved by rest and aggravated by activity. There may be inflammation (swelling) in the low back can be relieved with Therapy. Usually sprain/strains present with some type of trauma to the low back.

Why are some people more prone to lumbar strain/sprain than others?
• Excessive weight puts strain on the lower back. This increases the tightness of the ligaments and tendons and predisposes a person to back injury. The Sherman Program addresses weight loss as part of a long term recovery from chronic back strain.
• Smoking: weakens the joints. Smoke puts toxins into the body that interfere with the body’s ability to maintain proper homeostasis.
• Improper lifting technique
• Weakness in core strength
• Lack of flexibility in the muscles and ligaments.
• Lack of movement. Having a job where you are sitting the majority of the time creates tightness in the lower back. Gravity is exerting a constant force on the back and sitting for too long in one place can strain an already weak back. Trying getting up periodically and moving around it will help stretch the spine.
• Poor Posture. This often relates to a weak core, being overweight and tight muscles. Correct posture will help prevent back problems and reduce the chances for chronic arthritis.

TREATMENT FOR LOW BACK SPRAIN/STRAIN
During the initial acute states ice is great for reducing pain and inflammation. As the pain decreases ice and heat can be used in contrast therapy. Remember never use ice more than 20 minutes on 2 hours off. Apply the same rules for heat. Physical therapy involving ultrasound, electrical stimulation, massage therapy are also very helpful. Minimize your dependency on pain medication at this state. Far too often patients will get a prescription for pain medication which will mask the problem.

VERTEBRAE SUBLUXATION
When one vertebrae moves past it’s normal physiological range of motion a subluxation occurs. Chiropractic manipulation fixes vertebrae subluxations.

NECK PAIN . . .

There are seven cervical vertebrae. Inbetween the vertebraes are intervertebral.

The disk is made up of a Nucleus Pulposus (Gel like substance) made up mostly of water with some proteoglycans. They help the disk retain water. The disk is held to the vertebrae endplates by ligaments. The amount of fluid in the disk varies depending on day and night. The disks act like shock absorbers for the spine. The Annulus Fibrosus is mainly made up of collagen and proteoglycans and less water. Each vertebra has spinal nerves that exit the sides of the vertebrae. These nerves are known as spinal nerves.

The muscles and ligaments of the neck are extended past the normal range of motion and tears form in the muscles and ligaments. These tears can appear after a motor vehicle accident, playing sports or some type of trauma. Swelling and pain in the neck are very common. Most patients have difficulty with range of motion and activities of daily living.

Diagnosis: a proper history showing trauma and ruling out more serious injury is advised.

Treatment: physical therapy should be started as soon as possible to prevent scar tissue and adhesions from forming. Manipulation should be performed when the acute phase subsides.

CERVICAL SUBLUXATION
When one vertebra moves out of place it is called a Vertebral Subluxation. Pain is felt in the neck. Depending which vertebra moves out of place will determine where the pain is felt. The C2 vertebra can refer pain to the back of the head and cause headaches. C5, C6, C7 can cause radiating pain into the neck and down the arm. Diagnosis: a proper history with examination may lead towards the diagnosis of Vertebra Subluxation. Palpation of the vertebra and feeling for alignment changes also leads to the diagnosis of Vertebra Subluxation. X-rays will help show alignment issues as well to rule out other conditions.

CERVICAL HERNIATED DISK/PINCHED NERVE
This condition occurs when the gel-like center of a vertebral disc (the Nucleus Pulposus) breaks through the outer ligament (the Annulus Fibrosis) of the intervertebral disc. This bulge of extruded material puts pressure on the adjacent nerve root, causing it to function improperly and send pain signals.

The symptoms of a pinched nerve may vary, depending on the location of the nerve or nerves involved. Some symptoms may appear as:
• Burning
• Numbness
• Tingling ("pins and needles")
• Radiating pain down arm or leg
• Weakness in muscle

In some cases, symptoms may include a combination of these sensations, depending on the extent of the damage and the compression of the nerve.

PINCHED NERVE TREATMENT
Treatment of a pinched nerve can take a significant amount of time to stabilize. In most case manipulation will not be done on a pinched nerve and preferred method of treatment is traction. A special traction table is used to open the disk space and take the pressure off the pinched nerve. Posture issue will be addressed as well as a stretching program. For long term success sometimes all of these measures will be necessary. If you condition does not improve over a significant amount of time you may be referred to a neurosurgeon for more serious intervention. Chiropractic and Physical Therapy should always be your first round of defense.

I am not a big advocate of prescription pain medication as many times addictions are formed. We prefer to use natural means to reduce your pain.

CERVICAL FACET SYNDROME
The facet joints which help to control movement of the spine can wear out over time. Degenerative Arthritis can affect the facet joints. Bone Spurs and degenerative changes can cause pain. Patients typically present hunched over to reduce the facet pain. They are also restricted in motion.

Diagnosis can be made with an X-ray or Cat Scan.

Treatment: physical therapy consisting of electrical stimulation, ultrasound and ice massage can help reduce the inflammation. Traction and stretching should begin when the inflammation is down.

OSTEOARTHRITIS (DEGENERATIVE JOINT DISEASE)
Osteoarthritis usually is the degeneration of the intervertebral disk. The disk begins to flatten and loses its shape. The vertebral end plates form calcification known as Spurs. The spinal nerves become pinched and pain follows. Osteoarthritis can be accelerated from constant wear and tear of the joints. It is also accelerated from being overweight or smoking. Osteoarthritis presents itself with pain when starting exercise after resting. The joints swell and become inflamed. During motion there may be cracking sounds in the joint. This cracking sound is calcification of the ligaments and end plates. Severe Osteoarthritis can cause constant pain and be very restrictive. Diagnosis can be confirmed with X-ray and MRI.

Treatment: Physical therapy to reduce the inflammation should be started as soon as possible. A regular stretching program should be implemented as soon as possbile.

ELBOW PAIN . . .

TENNIS ELBOW (LATERAL EPICONDYLITIS)
Tennis Elbow (lateral Epicondylitis) An inflammation of the extensor tendons which attach on to the Lateral Epicondyle of the Humerus. It is seen common in Tennis players but may also be seen in any activity that uses the forearm is an aggressive fashion. Racketball players and construction workers also tend to get Lateral Epicondylitis.

SYMPTOMS
• Pain often develops around the outside of the elbow.
• Pain often gets worse with activity.
• It becomes painful to shake hands and use the elbow.
• The elbow becomes sensitive to touch.
• Pain can occur when trying to open jars and activities that require wrist stabilization.

TREATMENT
The goals of treatment are to reduce pain or inflammation, promote healing, and decrease stress and abuse on the injured elbow. This can be accomplished through a series of physical therapy modalities. Electrical Stimulation, Ultrasound, Massage, Ice Massage. A neoprene support will help support the elbow and restrict movement.

GOLFER’S ELBOW (MEDIAL EPICONYLITIS) SYMPTOMS
• Pain on the inside of the elbow
• Stiffness of the elbow
• Numbness and tingling into the ring and little finger
• Weakness of the hands, decrease in grip strength

CAUSES
• Usually repetitive stress to the elbow
• Over use of the wrist and fingers
• Holding a Racket and putting top spin on a ball
• Throwing a ball (baseball etc…)
• Golfing by over swinging the club or hitting the ground
• Painting, hammering, chopping wood can all strain the tendons causing golfers elbow

TREATMENT
• Should begin a course of Physical Therapy as soon as possible to prevent scar tissue formation
• Reduce inflammation and decrease pain
• Increase blood flow
• Restrict motion that exacerbates the pain
• Goals should be to stretch the muscle before activity
• Strengthening the forearm muscle to help support the joint
• Better form and rest when using the joint
• Wearing a splint to restrict over use may help

KNEE PAIN . . .

Here is a brief explanation of some of the types of ligament injuries to the knee. There are four major ligaments that stabilize the knee: The Medial Collateral Ligament, The Lateral Collateral Ligament, The Anterior Cruciate Ligament, The Posterior Cruciate Ligament.

MEDIAL COLLATERAL LIGAMENT (MCL)
The Medial Collateral Ligaments job is to prevent opening of the knee or buckling of the knee. It is most often damaged when there is trauma to the outside of the knee that put pressure on the inside of the knee specifically the MCL. This type of injury is often seen in football "clipping" hits. The MCL attaches from the Femur to the Tibia.

SYMPTOMS OF MEDIAL COLLATERAL LIGAMENT INJURY
The most common symptom of MCL injury is pain directly over the ligament. Swelling is common. In more severe injuries the knee may buckle or become unstable.

There three grades of ligament injuries: Grade 1, 2, and 3.

Grade 1 Injury: is the least traumatic and usually involves a stretching of the ligament. This type of injury is usually last one to two weeks.

Grade 2 Injury: this type of injury involves moderate tearing of the ligament. It is often followed with bruising and swelling. Pain usually occurs when attempting to pivot or cut (football, soccer). Healing time is usually 3-4 weeks and involves the use of physical therapy. Joint strengthening is recommended.

Grade 3 Injury: this is the most traumatic type of ligament tear and involves a complete tear of the ligament. Patient often presents with significant swelling, pain and instability. A knee brace is recommended with an MRI to see the amount of damage. A surgical consultation is also appropriate.

ANTERIOR CRUCIATE LIGAMENT (ACL)
The Anterior Cruciate Ligament attaches the top of the knee to the bottom of the knee and prevents anterior or forward motion of the Femur on the Tibia and Fibula. The ACL forms a cross with two ligaments hence the name Cruciate Ligament. The ACL ligament can tear from jumping or stopping quickly and is often but not always heard with a popping sound followed by knee instability and a feeling of the knee buckling or giving way underneath a person.

SYMPTOMS OF ACL INJURY
ACL injuries usually present with pain in the anterior portion of the knee. The three grades of ligament injuries apply to the ACL. A popping sound is often heard after the injury followed by joint instability. Diagnosis may be made with a series of test depending on the severity an MRI may be ordered. Rehabilitation is very important after an ACL tear to prevent scar tissue from forming and prevent future injury.

LATERAL COLLATERAL LIGAMENT (LCL)
The Lateral Collateral Ligament goes from the Fibular to the Femur on the outside of the leg. It is responsible for preventing the leg from buckling to the outside. Injuries to the LCL usually take place on the medial aspect of the knee buckling the lateral aspect of the knee.

SYMPTOMS OF LATERAL COLLATERAL LIGAMENT INJURY
Symptoms of LCL injury usually present with pain on the outside of the knee. Sometimes the knee seems to catch and become unstable. If the knee is bent to 25 degrees and pressure is place on the inside of the knee pain may be felt on the outside of the knee where the LCL is torn. Rehabilitation is important to restore normal joint function and prevent scar tissue formation.

POSTERIOR CRUCIATE LIGAMENT (PCL)
The Posterior Cruciate Ligament attaches from the Femur to the Tibia and is shaped in a cross hence the name Cruciate Ligament. Its job is to prevent backward displacement of the Tibia on the Femur.

SYMPTOMS OF POSTERIOR CRUCIATE LIGAMENT INJURY
The PCL is thicker than the ACL and is less likely to be torn. Impact directly to the Tibia driving it posterior on the Femur usually results in PCL tears. Very often the Lateral Meniscus is injured when the PCL is injured. Pain is usually in the back of the knee with swelling. Sometimes the calf is also painful and it hurts to walk. The draw test is one test to help diagnosis a PCL tear. There are three levels of PCL tears, grade 1,2,3. Sometimes an MRI is necessary to determine which level of tear is present. Rehabilitation is always important in a PCL tear to prevent scar tissue and restore normal range of motion back to the joint.

MEDIAL MENISCUS AND LATERAL MENISCUS
There exists two wedge-shaped, thick rubbery Menisci located on the medial (inner side) and the lateral (outer side) of the knee joint. Medial Meniscus is slightly larger and not as mobile. The Medial Meniscus is C shaped and the Lateral Meniscus is O shaped. The meniscus is held in place by coronary ligaments. The wedge shape of the meniscus is to prevent the Femur from sliding off the Tibia. The meniscus is divided into zones based on the blood supply. The red zone is on the peripheral which has the most blood supply, red-white zone with blood supply only on the outer region and the white zone (central meniscus) which lacks blood supply.

The Medial Meniscus is asymmetrical with the anterior horn wider than the posterior horn. It is approximately 3.5 cm in length and is attached to the Medial Collateral Ligament. Fibers also attach to the anterior Cruciate Ligament and the joint capsule.

FUNCTIONS OF THE MENISCUS
SHOCK ABSORBER, PROTECTS THE ARTICULAR CARTILAGE, HELPS LUBRICATE THE CARTILAGE, HELPS STABILIZE THE KNEE, HELPS DISTRIBUTE THE BODY WEIGHT, HELPS ABSORB LOAD BEARING.

SYMPTOMS OF INJURY TO THE MENISCUS
Twisting or abnormal pressure on the meniscus causing it to get jammed between the bones resulting into tearing or splitting of the meniscus. This is known as a meniscus tear. Symptoms of meniscus tears: pain in the knee, swelling in the knee, increased temperature in the knee (inflammation), stiffness and tightening of the knee, flexing is possible but extending the knee is painful, difficulty squatting, difficulty walking, instability of the knee, knee clicking, knee catching, knee locking. Knee locking occurs when a piece of cartilage gets stuck inside the joint and you cannot fully extend your leg.

TREATMENT FOR MENISCUS NJURYRICE
Rest. Ice Compression. Elevation.
Physical Therapy should begin as soon as possible to reduce scar tissue and improve healing. MRI should be done when a serious tear is suspected. When therapy fails, surgery may be necessary to repair the cartilage.

FOOT PAIN . . .

CAPSULITIS:

Surrounding each joint in the body (joint is made up of two connecting bones) you have a ligament to keep the two bones in proximity of each other. These ligaments are known as capsular ligaments. When the joint is strained the capsular ligaments are the first to inflame. Certain activities like wearing high heel shoes, bending and stooping lead to straining the capsular ligaments. Pain is usually in the bottom of the forefoot.

Treatment: Because Capsulitis is caused by mechanical trauma to the forefoot first and foremost is to stop causing trauma to the forefoot. Whatever activity is causing pain should be stopped. Next, fat metatarsal pads and metatarsal gel pads will help. Wearing a shoe that takes pressure off of the forefoot might help as well. Certain types of rocker shoes like sketcher rockers, clogs or custom made orthotics might help as well. See our section of custom made orthotics. Physical therapy modalities can help to reduce the pain and inflammation. If you still are unable to function due to the pain you should see a Podiatrist for a cortisone injection. In very severe cases surgery may be necessary.

MORTON'S NEUROMA:

Entrapment of the nerve which runs to the toes and passes through the metatarsal bones. It often occurs by putting too much strain on the forefoot. This condition may occur from bending down on the forefoot with pressure for long periods of time or doing lots of walking in high heel shoes.

Treatment: Remove the source of the trauma to the foot. This may mean stop whatever activity produces the pain as well as changing shoes. Physical Therapy may help control the inflammation. A custom orthotic may need to be made to help with any foot abnormalities and to reduce pressure on the metatarsal heads.

BURSITIS:

A bursa is a fluid filled sac between muscles, tendons, ligaments and bone. The sac acts like a shock absorber to reduce friction from between the soft structures sliding over the boney prominences. These sacs can become inflamed and cause pain. An inflamed sac is called Bursitis.

Treatment: The activity that is causing the bursa to inflame should be stopped or reduced as much as possible. Physical Therapy to reduce the inflammation of the bursa. Foot massage may also stimulate blood flow and help reduce inflammation. Custom orthotics may be needed if there are mechanical foot problems.

TURF TOE:

The first toe is hyper-extended, bent upward and back. It often occurs in athletic injuries and is usually not that serious but is dehabilitating and can hinder performance. Turf toe is the result of the capsular ligaments being stretched. These ligaments inflame and cause pain.

Treatment: Physical therapy to reduce the inflammation and restore joint function should be started as quickly as possible. The activity which caused the injury should be stopped from 4 to 6 weeks. Better shoes should be purchased to reduce the chances of the injury happening again. Custom orthotics may be necessary to help mechanical foot issues. Turf toe may happen to any toe and is not limited to the big toe.

SESAMOIDITIS:

There are two small bones located under the first metatarsal bone. When these bones are stressed they become inflamed. Once these bones are inflamed it is called Sesamoiditis.

Treatment: It is important to rule out a Sesamoid Fracture. An X-Ray should be taken when fracture is suspected. If there is no fracture, physical therapy should begin. Orthotics should be casted if a high arch is suspect.

PLANTAR FIBROMATOSIS:

The Plantar Fascia ruptures and forms a nodule. This nodule can form scar tissue and enlarge. It can present as a lump in the foot and may eventually cause pain.

Treatment: Hyper fibroblastic activity very often makes this difficult to treat. Ultrasound to break up the fibromatosis may help. In some cases surgical intervention by a Podiatrist is necessary.

HEEL, PAIN, BONE SPUR:

Calcification of the plantar fascia ligament can occur causing heel pain. A spur can form which can trap a nerve causing pain in the heel of the foot.

Treatment: Stretching the Plantar Fascia and physical therapy should be done. If improvement does not take place steroids followed by surgery may be necessary. They should only be used as last resort only if therapy fails. A stretching program as well as change of occupational habits should be done immediately. Orthotics may also help for biomechanical issues.

CORE STABILITY . . .

Core strength is essential for a strong back. Understanding what muscles make up the core and learning what exercises will strengthen the core is essential for a healthy spine.

Major Core Muscles
Your core muscles are actually composed of several major muscle groups including:

Transverse Abdominis (TVA)
The deepest of the abdominal muscles, this core muscle lies under the Obliques (muscles of your waist). It acts like a weight belt, wrapping around your spine for protection and stability.

Multifidus Muscle
The Multifidus Muscle is a thin, yet stiff, core muscle deep in the spine. It stabilizes each joint, makes each vertebra work more effectively, and reduces the degeneration of the joint structures.

External Obliques
These core muscles are on the side and front of the abdomen, around your waist, and lays on top of the Internal Obliques.

Internal Obliques
These core muscles lie under the External Obliques, running in the opposite direction.

Rectus Abdominis
The Rectus Abdominis is a long muscle that extends along the front of the abdomen. This is the 'six-pack' part that becomes visible with reduced body fat.

Transversospinalis Muscle is a set of muscles which extend and rotate the spine, and act to stabilize and protect the spine from injury. From superficial to deep within along the spine, these muscle groups are known as the semispinalis, the multifidus, the interspinales, the rotatores, and the intertranversarii. They connect one series of vertebral columns with other vertebral columns, and can be strengthened with functional core training and conditioning.Despite being so deep within the core of our bodies and not visible externally, the transversospinalis muscles are of the very importance when it comes to core training and conditioning, as they are responsible for keeping our backs and spines protected and fit throughout life

CHIROPRACTIC . . .

What do chiropractors treat?
Chiropractic is a health care profession that focuses on disorders of the musculoskeletal system and the nervous system, and the effects of these disorders on general health. Chiropractic care is used most often to treat neuro-musculoskeletal complaints, including but not limited to back pain, neck pain, pain in the joints of the arms or legs, and headaches.

What do chiropractors do?
Doctors of Chiropractic – often referred to as chiropractors or chiropractic physicians – practice a drug-free, hands-on approach to health care that includes patient examination, diagnosis and treatment. Chiropractors have broad diagnostic skills and are also trained to recommend therapeutic and rehabilitative exercises, as well as to provide nutritional, dietary and lifestyle counseling.

What is Spinal Manipulation?
The most common therapeutic procedure performed by doctors of chiropractic is known as “spinal manipulation,” also called “chiropractic adjustment.” The purpose of manipulation is to restore joint mobility by manually applying a controlled force into joints that have become hypo-mobile or restricted in their movement as a result of a tissue injury. Tissue injury can be caused by a single traumatic event, such as improper lifting of a heavy object, or through repetitive stresses, such as sitting in an awkward position with poor spinal posture for an extended period of time. In either case, injured tissues undergo physical and chemical changes that can cause inflammation, pain, and diminished function for the sufferer. Manipulation, or adjustment of the affected joint and tissues, restores mobility, thereby alleviating pain and muscle tightness, and allowing tissues to heal.

What can you experience after an adjustment?
Chiropractic adjustment rarely causes discomfort. However, patients may sometimes experience mild soreness or aching following treatment (as with some forms of exercise) that usually resolves within 12 to 48 hours. In many cases, such as lower back pain, chiropractic care may be the primary method of treatment. When other medical conditions exist, chiropractic care may complement or support medical treatment by relieving the musculoskeletal aspects associated with the condition.

How does a chiropractor diagnosis different conditions?
Doctor of Chiropractic may assess patients through clinical examination, laboratory testing, diagnostic imaging and other diagnostic interventions to determine when chiropractic treatment is appropriate or when it is not appropriate.

Do Chiropractors refer patients?
Chiropractors will readily refer patients to the appropriate health care provider when chiropractic care is not suitable for the patient’s condition, or the condition warrants co-management in conjunction with other members of the health care team.

Sherman Sports Injury uses the latest techniques:
• Diversified: Moving a subluxation in a specific direction, with a specific thrust, with a specific velocity.
• Activator: Using a specific apparatus called an activator gun to move a vertebrae that has subluxated in a specific direction with a specific velocity.
• Cox: Leander Table-using a specific type of traction table to reduce pressure from herniated disk and pinched nerves.
• Soft Tissue Mobilization: Using massage and stretching to get joints to release and get soft tissue to mobilize.
• Nutrition: Using blood work and other methods to set up diet changes to create a more balance individual.
• Rehabilitation: Using the latest rehabilitation techniques to strengthen weakened joints and return them to normal function.

PHYSICAL THERAPY . . .

Your rehab team members at Sherman Sports Injury Center are dedicated to providing immediate treatment. You receive personal attention from our professional staff. Our Physical Therapists participate in extensive continuing education courses to ensure you receive the best rehabilitation available. We specialize in Orthopedic & Sports P.T., Manual Therapy of Spinal & Peripheral Joints, Aquatic P.T., and Trunk Stabilization & Back School programs. We also offer massage therapy and weight training programs, giving you a personalized feeling of confidence in managing your health to achieve your fitness goals. All Comprehensive Therapeutics support staff are carefully selected to ensure you receive same-day appointments and immediate treatment, timely evaluations and reports.

WEIGHT LOSS . . .

WHY SHERMAN SCIENCES PROGRAM WORKS?
Sherman Sciences weight loss program is different than many of the weight loss programs current in the market place. Sherman Sciences involves a unique approach. By focusing on the individual and designing a specific weight loss program based on their needs Sherman Sciences creates a winning approach.

WHAT YOU CAN EXPECT?
Sherman Sciences weight loss program is natural. There are no medications and no surgeries. We have a very high success rate with individuals averaging 2.5 to 5 lbs per week of weight loss.

WHAT’S INVOLVED?
A complete History is taken involving past eating habits, physical condition and food likes and dislikes. After the history is taken blood work at the laboratory may be requested. From this information a complete nutrition program is created. Patient’s have the option of buying supplements and shakes. They are given a complete food program, along with an exercise program based on their physical limitation. Some people have specific injuries, like shoulder surgery, knee surgery, back pain, hip replacement and have gained significant amount of weight do their injuries. Sherman Sciences designs custom work out programs showing them how to exercise in spite of their limitations. One of the great parts of the Sherman System is the weekly accountability and coaching. At least one time per week and as often as three Dr. Sherman will consult with you helping you to overcome bad habits and teaching you better life style choices. This is the reason why Sherman Sciences succeeds over so many other programs in the market place. Dr. Sherman has the unique ability to help you overcome bad habits and to replace them with good habits. He teaches you each week how to eat better. With over 20 years experience in the weight loss field Dr. Sherman knows how to strengthen your resolve.

HOW TO STAY MOTIVATED AND CONSISTENT?
Dr. Sherman offers many motivation techniques. Sometimes an in depth education as to what food benefits you and which food harms you is needed. Other times Laboratory analysis helps, Sometimes live cell is used for motivational purposes. Whatever technique keeps you eating healthy and exercising regularly your program will be designed on your needs and you what works best for you.

DO YOU HAVE TO BUY THE SUPPLEMENTS AND SHAKES?
No. It is always your option. The Shakes provide an easy way to help get the nutrition you need. They help make sure you get the right amount of protein and are quick to prepare. The program does not require you to buy the shakes it is always your option.

WHAT HAPPENS ONCE I AM OFF THE SHAKES?
A maintenance nutrition program is given and you are coached on how to not gain the weight back. Exercise is very important and by this time better habits are formed.

WHAT IS THE COST?
The initial consultation is $150. This includes the write up on what foods you should eat and what exercise program would work best for your physical condition. If you want a motivation test like live cell or body fat analysis it may also be performed.

ARE THE SHAKES AND SUPPLEMENTS REFUNDABLE?
No they are not. Because they are perishable items and can be contaminated once you buy them you own them. They are optional and you do not have to get them to be successful. They are an aid.

HOW DO I KNOW WHAT IS MY HEALTHY WEIGHT?
We use many different methods for determining your best body weight. Body fat and composition test may be performed. Body Mass Index may be calculated. And other testing and charting may be used.

IS THE PROGRAM EFFECTIVE AND SAFE?
Because it is a noninvasive program and does not use medications it is very safe and natural.

WHAT IF I HAVE BEEN HEAVY MOST OF MY LIFE WILL IT WORK?
That depends on you. The program works when you follow the instructions. Dr. Sherman will help coach you to break old past bad habits. Ultimately success will always be how hard you are willing to work at it.

WILL IT AFFECT MY METABOLISM?
Yes, one of the goals of the programs is to improve your metabolism.

NUTRITION . . .

Restoring your body to maximum health and wellness is very important. Our bodies our not intended to be sick and run down. Individual nutrition programs are created to restore your body to maximum wellness and performance.

A healthy body can improve the overall quality of your life. We recommend various products that can lower your body fat percentage, help you get a good nights sleep, improve your posture or simply soothe sore muscles.

ORTHOTICS . . .

Tired of foot pain? Did you know that improper foot biomechanics can cause knee and lower back pain?

A very important aspect of foot biomechanics is the angle your foot hits the ground. Improper foot strike can radiate pain into the foot, knee and low back. The correction of this problem is custom made orthotics.

Our orthotics are the best in the market. Made from carbon fiber our orthotics are semi rigid giving you excellent shock absorption upon heel strike. Athletes are especially prone to foot pain. Cumulative trauma to the feet exacerbates even the smallest foot abnormality.

The following test can help u determine if orthotics are right for you:
• Do you stand or walk on hard surfaces for more than 4 hours daily?
• Do you participate regularly in any physical sport?
• Are you age 40 or over?
• Have you had a prior injury to your knee, back or neck?
• Do your shoes wear unevenly?
• Do you have joint pain while standing, walking or running?
• If one of your legs shorter than the other?
• Do you have knock-knees or bow legs?
• Do you have obvious foot problems (bunions, corns, flat feet, etc.)
• Do your feet toe our when walking?
• Do you have frequent ankle sprains?
• Do your feet hurt during exercise?

If the answer to any of the questions is yes, see sherman sports injury center for a full foot examination and custom orthotics.

Orthotics Help The Following Conditions:
• Low back pain
• Functional short leg
• Sciatica
• Spinal instability
• Sacro Illiac Lesions
• Rotation of pelvis
• Chondromalcia Patellae
• Collateral ugament injury
• Knee pain
• Ankle inversion
• Eversion sprain
• Excessive Pronation
• Arch pain
• Bunion
• Stress fracture
• Plantar Fascitis
• Calcanea heel spurs
• Achilles tendinitis
• Plantar neuroma

PERSONAL INJURY . . .

After a car accident your head may be whipped forward and backward. This movement can cause injury to the delicate tissues of the neck and back. Sherman Sports Injury Center specializes in correcting damage from auto accidents. With over 27 years of experience you will have the best possible care in restoring you to pre-accident condition.

Dr. Sherman works with many of the attorney’s in the area so you will get the best possible treatment while your case is handled with expert care. Many times the pain and inflammation occurs after the accident so don’t wait for treatment. An injury left untreated can cause scar tissue and permanent injury.

WORKER'S COMP . . .

Sherman Sports Injury Center has been treating injured workers for over 20 years. Our goal is to get you as healthy as possible as quickly as possible. We use Chiropractic, Acupuncture, Physical Therapy and Massage Therapy to get people back to work. We supply reports at 30, 60 and 90 days. Patients respond quickly to care or they are referred out.

Typical injuries are: slip and falls, carpal tunnel, repetitive stress injuries, cumulative trauma injuries, back and neck sprain/strains and a variety of other injuries.

Sherman Sports Injury Center gives preventive injury speeches at many local companies. Classes and seminars are given on a contracted rate.