Level Up Physical Therapy
Concierge Outpatient PT⭐️Spine/Ortho/Neuro/PostOp⭐️DryNeedling⭐️TITLEIST Golf Fitness LOUDOUN COUNTY, VA
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🇺🇸 INDEPENDENCE DAY 🇺🇸
⭐️Prevention of injury will allow you to enjoy playing the sport better and longer. A thorough analysis of your mechanics may unlock hidden deficits in strength and mobility. Empower yourself with the tools that can launch your golf game to the next level with a swing analysis and custom program from a certified medical golf fitness professional and optimize your potential !
How to Prevent Golf Injuries This Season Dr. Michael D. McCleary of the Orlando Orthopaedic Center points out some of the most common golf injuries, as well as some tips golfers can take to avoid them.
🎊🌲Between the years, we traditionally announce our "Best-of series" of the most influential posts of 2022.
📣 today 🥇 #4
Mechanisms of resorption in lumbar disc herniation
👉 Clinically, the phenomenon of spontaneous shrinkage or disappearance of a herniated lumbar IVD without surgical intervention is called reabsorption.
👉 The spontaneous resorption rate of lumbar disc herniation (LDH) is over 60% according to a meta-analysis by Zhong et al. (2017) and Chiu et al. (2015) https://pubmed.ncbi.nlm.nih.gov/28072796/, https://pubmed.ncbi.nlm.nih.gov/25009200/ with extrusion and sequestration being more prone to regression than other types. https://pubmed.ncbi.nlm.nih.gov/24630494/
But how does this actually happen? 🤓
👉 Resorption of the intervertebral disc tissue can be explained by 3 theories, but the exact mechanism is not conclusively understood:
1. Reduction in disc material size due to gradual dehydration and shrinkage, which could explain the decrease in the signal of the disc on MRI. https://pubmed.ncbi.nlm.nih.gov/11901758/
https://pubmed.ncbi.nlm.nih.gov/11750011/
2 The tension on the posterior longitudinal ligament causes the herniated disc fragment to be retracted back into the intervertebral disc space. This can be a mechanism when the annulus fibrosus (AF) is not damaged, but not with extruded and migrated fragments.
https://pubmed.ncbi.nlm.nih.gov/24316264/
https://pubmed.ncbi.nlm.nih.gov/3875236/
3. The third theory, the most well studied and with the best clinical evidence, is gradual resorption of the disc material by enzymatic degradation and phagocytosis induced by an inflammatory response and neovascularisation.
When protruding IVD tissue squeezes out of the epidural space, it disrupts immune privilege, triggering an autoimmune response, then lymphocytes activate macrophages.
Related factors secreted by IVD cells and macrophages further drive the recruitment of macrophages to the intervertebral disc in paracrine and autocrine forms. Macrophages undergo differentiation from M1 to M2 types.
M1-type macrophages secrete pro-inflammatory factors to initiate angiogenesis, promote the expression of matrix metalloenzymes and apoptosis of herniated IVD nucleus pulposus cells.
M2-type macrophages secrete anti-inflammatory factors to relieve pain response, promote new blood vessel formation, and are responsible for tissue remodeling and repair, and absorb the protruding debris to reduce the total volume of the intervertebral disc, and reduce the mechanical compression of the nerve. Throughout the process, infiltration and activation of macrophages mediate inflammatory responses, matrix metalloenzyme activation, and neovascularization.
https://pubmed.ncbi.nlm.nih.gov/16688039/
https://pubmed.ncbi.nlm.nih.gov/19333096/
https://pubmed.ncbi.nlm.nih.gov/15626982
https://pubmed.ncbi.nlm.nih.gov/35999644/
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“Though Autumn is traditionally a season of letting things go, it can also be a season of renewal and rebirth. A time to adopt a fresh new outlook and find enjoyment in the little things.” Have a great week!🍂
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