Dr. Kevin Percuoco

Dr. Kevin Percuoco A chiropractic rehab that specializes in treatment of musculoskeletal pain disorders in a comprehens
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Operating as usual

Classification is key. Different types of low back pain respond different to different types of movement.
07/08/2021

Classification is key. Different types of low back pain respond different to different types of movement.

Please read this book to better understand low back pain. It’s only 205 pages. It’s not a textbook, but is sufficiently academic and yet easy to understand if you’re not a doctor.

Low back pain, like chest pain, is a symptom - not a diagnosis. Some patients with chest pain are having a heart attack. Some have a broken rib. Others have a thoracic derangement. Others are having a panic attack.

You treat the diagnosis accordingly.

Low back pain can be due to a fracture, an infection, prolonged posture, and many other diagnoses. What I find most often is a diagnosis of low back derangement, which means there’s a joint or joints not moving well. Robin McKenzie figured this out in the 50’s.

The good news? These joint tweaks (which can occur in any joint in the body) are rapidly reversible … with the correct diagnosis and treatment. Hence the title of the book.

There is no treatment for low back pain because low back pain is not a diagnosis. If I rule in a neuromusculoskeletal disorder, I next need to diagnose the problem. Nerve? Muscle? Joint? The treatment depends on the diagnosis causing the low back pain.

#McKenzieMDT #orthopedics #lowbackpain #backpain #spine #diagnosis #physicaltherapy

Listen up
06/23/2021

Listen up

As highlighted last week, MRI technology continues to improve and with that comes vast improvements in image resolution and the potential to see more features of any given piece of anatomy. Many folks reading this may have personally experienced or have known someone else who experienced getting an MRI report that showed evidence of “fraying” or even a “partial thickness” rotator cuff tear.

For a quick overview, the rotator cuff consists of four muscles that act to optimize the position of your arm in your shoulder “socket.” For our purposes it is best to think of the rotator cuff complex as a blanket or sheet, and less like a rope. When we think of fraying or tearing in a rope, we immediately conjure up images of impending instability or a full tear in progress. However, a partial-thickness rotator cuff tear is a lot like a small hole in a blanket. Think of a blanket you have laying around the house, just because it may have some fraying or even a hole, is it still able to keep you warm? Does it still ultimately do its job?

The metaphor of “a hole in a blanket” has been gaining traction within the field of musculoskeletal medicine for quite some time as it relates to partial-thickness rotator cuff tears. Yes, there may be some anatomic “abnormality” (compared to when you were younger), but a scan tells us nothing about function or our ability to adapt. Nor does it tell us if a small tear will go on to develop into a full tear. In fact, there is no significant difference in the rate of progression to a full-thickness rotator cuff tear between symptomatic and asymptomatic tears. Our bodies are INCREDIBLE at adapting to imposed demands. Your ability to tolerate load at the shoulder is almost exactly the same in the presence of a partial thickness rotator cuff tear AND continues to have the ability to adapt to greater loads over time.

#resilience#sportsmedicine#rehabilitation#rotatorcuff#antifragile#justloadit

Stress reduction can take many forms. Simply removing our stressors is easier said the done, but if it’s the easier path...
01/29/2021

Stress reduction can take many forms.

Simply removing our stressors is easier said the done, but if it’s the easier path I would recommend.

However, we can build our tolerance or resilience to stressors, ergo increasing our capacity to withstand the stressors life throws at us. So even though all the same stressors are present, your perspective, your attitudes and your physical capacity to tolerate those stressors is more than capable.

Build your cup.

#stress #stressrelief #buildyourcup #physicaltherapy #psychology #mentalhealth #mental #chiro #chiropractor #chiropractic #palmer #palmercollege #health #wellness #mindset #mindsetiseverything #neckpain #backpain #backpainrelief #davenport #davenportiowa

Stress reduction can take many forms.

Simply removing our stressors is easier said the done, but if it’s the easier path I would recommend.

However, we can build our tolerance or resilience to stressors, ergo increasing our capacity to withstand the stressors life throws at us. So even though all the same stressors are present, your perspective, your attitudes and your physical capacity to tolerate those stressors is more than capable.

Build your cup.

#stress #stressrelief #buildyourcup #physicaltherapy #psychology #mentalhealth #mental #chiro #chiropractor #chiropractic #palmer #palmercollege #health #wellness #mindset #mindsetiseverything #neckpain #backpain #backpainrelief #davenport #davenportiowa

09/24/2020
Bigfork Valley Chiropractic

Great info

The purpose of this video is to provide some key recognition aspects (signs and symptoms) with regards to concussion.

The profession has come a long way.
09/19/2020

The profession has come a long way.

In recognition of the 125th anniversary of the chiropractic, September 18 has been proclaimed Chiropractic Founder’s Day by the state of Iowa and the city of Davenport, home to Palmer College.

WHEREAS, the chiropractic profession was founded by D.D. Palmer on September 18, 1895 in Davenport, Iowa; and

WHEREAS, an estimated 50 million Americans seek chiropractic care each year; and

WHEREAS, Palmer College of Chiropractic, the oldest and largest college of chiropractic in the world is headquartered in Davenport, Iowa; and

WHEREAS, approximately one-third of all chiropractors are graduates of Palmer College of Chiropractic; and

WHEREAS, the Palmer Center for Chiropractic Research advances the profession as the largest chiropractic research facility in the nation; and

WHEREAS, Palmer Chiropractic Clinics provide more than $5 million in pro-bono care annually, much of it to veterans and active-duty military members and their families; and

WHEREAS, Palmer College of Chiropractic is known worldwide as The Trusted Leader in Chiropractic Education®:

NOW, THEREFORE, I, Kim Reynolds, Governor of the State of Iowa, do hereby proclaim September 18, 2020 CHIROPRACTIC FOUNDER'S DAY and urge all Iowans to celebrate the 125th anniversary of the founding of the chiropractic profession; celebrate Palmer College of Chiropractic as one of the high-education pillars of the great state of Iowa; and recognize the chiropractic profession's continuing contributions to the health and well-being of the citizens of Iowa, the United States, and the world.

“The U.S. Department of Veterans Affairs (VA) announced today it has successfully reduced prescription opioid use in pat...
08/02/2020
VA.gov | Veterans Affairs

“The U.S. Department of Veterans Affairs (VA) announced today it has successfully reduced prescription opioid use in patients within the VA health care system by 64%, from more than 679,000 Veterans in fiscal year 2012 to 247,000 in fiscal year 2020 through quarter three.”

This is such an accomplishment, the VA is doing an excellent job of leading the way on this opioid crisis!

https://www.va.gov/opa/pressrel/pressrelease.cfm?id=5492

#va #opioidcrisis #opioid #opioidaddiction #health #evidencebased #evidence #leadership #leaders #chiropractor #chiro #chiropractic #physio #physiotherapy #physicaltherapy

Apply for and manage the VA benefits and services you’ve earned as a Veteran, Servicemember, or family member—like health care, disability, education, and more.

The disease is important, but in the event that life threatening conditions have been ruled out,  illness behavior is ju...
07/29/2020

The disease is important, but in the event that life threatening conditions have been ruled out, illness behavior is just at relevant.

Understanding the patient and HOW they are experiencing the disease aids in establishing effective doctor-patient communication and patient centered care. Understanding the patients motivations, values, and beliefs can be a clarifying glimpse into Illness management.

#pain #illness #mentalillness #chronicillness #mentalhealthawareness #mentalhealthmatters #mental #mentalhealth #chiropractor #chiropractic #chiro #chiropractic #physiotherapy #physio #physiotherapist #health #healthy #management #communication #communicationiskey #behavior #behavioralhealth #behaviormodification #backpainsolutions #backpainmanagement #backpain #backpainrelief #neckpain #neckpainrelief #suffering #percuocochirorehab

07/14/2020
HBD Cannon

The big boy turns two today.

I was blessed to be able to work on my forced exhalation exercise. Carli even helped 3 times.

Happy birthday Cannon. 🎈🎈🎈

#balloons #birthday #toddlerlife #toddlersofinstagram #family #familytime #chiropractor #chiro #chiropractic #palmer #exhale #exercise #smallbusiness #funny #fun #pregant #pregnantbelly #happybirthday #happy #twoyearsold

Happy to live In a Country that provides the freedom to explore your own beliefs. Happy Independence Day #independenceda...
07/05/2020

Happy to live In a Country that provides the freedom to explore your own beliefs. Happy Independence Day

#independenceday #4thofjuly #freedom #usa #usa🇺🇸 #liberation #choices #choices #chiropractor #chiro #chiropractic #palmer #healthylifestyle #health #wellness #physio #physioterapy #physicaltherapy #lake #boating #family #familytime #percuocochirorehab #pain #relax #relaxing

Sleep is important, like really important. This is an excellent graphic showing recommended sleep ranges through life. A...
07/01/2020

Sleep is important, like really important. This is an excellent graphic showing recommended sleep ranges through life.

A lot of stuff happens during sleep, quality sleep is paramount for musculoskeletal health and recovery. Poor Sleep quality has large implications in chronic pain sufferers.

Different therapies and strategies can be performed to increase sleep quality, don’t assume since enough have always slept bad there isn’t room for improvement.

#sleep #sleepy #sleepingbeauty #sleeping #healthylifestyle #health #wellbeing #chiropractor #chiropractic #chiropractor #physicaltherapy #physiotherapy #physio #brain #brainhealth #mentalhealth #mentalhealthmatters #smallbusiness #smallbusinessowner #quarantine #quarantinelife #pain #chronicpain

Im happy to report completion of my first continuing education presentation, available through @palmercollege ’s online ...
06/17/2020

Im happy to report completion of my first continuing education presentation, available through @palmercollege ’s online platform. 👏🏻

🟢Chiropractic Management of Lumbar Radiculopathy: Stratifying Risk.🟢

For all my chiro ppl out there, check it out if you need CE.👍🏻

#education #continuingeducation #learn #palmer #palmercollege #palmerchiropracticcollege #palmerchiro #palmerchiropractor #chiropractor #chiro #chiropracticadjustment #chiropractic #loganchiropracticcollege #nychirocollege #lifechiropractic #nationaluniversityofhealthsciences #nationaluniversity #newyorkchiropracticcollege #parker #parkerchiropractic #texaschiropracticcollege #universityofwesternstates

Americans have been through a lot lately, but I can’t help but remain hopeful and optimistic for growth and progress. We...
06/15/2020

Americans have been through a lot lately, but I can’t help but remain hopeful and optimistic for growth and progress. We see a lot of things, we hear a lot of things, but keep in mind, growth is not always linear, remain hopeful for a better future for all.

#change #grow #growth #growthmindset🌱 #positivevibes #positivity #chiropractor #chiropractic #chiro #physiotherapy #physio #physicaltherapy #improvement #improve #improveyourself #physicaltherapist #optimism #optimistic #hope #hopeful #obama #iowa #desmoines #desmoines #davenport #davenportiowa #mentalhealth #percuocochirorehab #hate #hatersgonnahate

06/11/2020
Pain with Sit to Stand?

Low back pain can be be a nuisance. But there are things you can do that can help mitigate those stabs and jabs.

When going from a seated to a stand position, the spine goes from relative flexion to relative extension.

This may not seem like a big deal, to someone not in pain, but this can be really annoying and provocative for those experiencing it. 😫

In this video I demonstrate a spine sparing stabilization based exercise that helps to mitigated the extreme flexion to extension movement.

🟢Give it a shot, let me know if you feel a difference. 🟢

#lowbackpain #lowbackpainrelief #pain #hiphinge #glutes #stability #chiropractor #chiropractic #sportschiro #move #backpain #backpainrelief #sciaticarelief #sciatica #pinch #moveright #movementismedicine #movement #smallbusiness #smallbusinessowners #iowa #desmoines #davenport #davenportiowa #adjustment #palmerchiro

06/09/2020
Non-Specific Low Back Pain.

The real cause of low back pain has been reported to be a running loose with Bigfoot in the hills of the Pacific Northwest. 👀 Until we find that sucker, we will have to reframe our focus.

Back pain is a symptom, not a disease process. Saying the disc, facet, SI joint, fascia, ligaments, muscles, or whatever else you may have seen in an image are responsible for your pain can be a stretch as there is not a whole lot of data to support specific diagnosis of any specific tissue as a thee pain generator.🆘

When people believe that their back pain is caused by a specific tissue that they have seen on imaging, it is extremely challenging to derail this thought train.🧐

This can be a problem. If conditions are visible on imaging, they will often continue to be visible throughout your history regardless of your symptoms and regardless of the care you get. Symptoms will get better as they typically do, however, when symptoms act up again, all attention is given back to that specific tissue.

Thus, all attention and care go back to the same tissue, and then you start climbing the treatment hierarchy of procedures and interventions for that specific tissue.

This reinforces the biomedical model of healthcare and reduces the patient before you to a specific tissue on their image. Thus, you disregard the fact that it is a living breathing person who has emotional, psychological, and social dynamics that play into every facet of their condition and their pain. Treat the person, not the condition. 🙏🏼

Maher, Chris, et al. “Non-Specific Low Back Pain.” Lancet (London, England), U.S. National Library of Medicine, 18 Feb. 2017, http://www.ncbi.nlm.nih.gov/pubmed/27745712%22%20%5Co%20%22http://www.ncbi.nlm.nih.gov/pubmed/27745712

#lowback #lowbackpainrelief #lowbackpain #spine #imaging #biopsychosocial #chiropractor #chiro #chiropractic #physicaltherapy #ortho #biomedical #mentalhealth #psychology #patient #pain #painrelief #painreliever #nonspecific #xray #mri #percuocochirorehab #desmoines #desmoinesiowa #iowa #movement #movementismedicine

06/05/2020
Wrong Answers Only !

❓What am I doing here❓

✅Wrong answers only.✅

#therapy #theragun #chiropractor #chiro #chiropractic #physicaltherapy #massage #softtissuetherapy #smallbusiness #cantstopwatching #waves #muscle #muscles #musclerecovery

06/04/2020
Low Back Xrays do NOT Improve Outcome!

❗️Alert❗️

✅LUMBAR SPINE imaging for low back pain does not improve outcomes❗️

👀🚩once red flags are ruled out.

✅ Research shows unless you have sinister pathology within your low back, which is 2-5% of the time....rare. Getting and X-ray or MRI for acute back pain does not improve your clinical outcome.

🔴 Stop managing care based off of an image.

👏🏻examine the person in front of you.

Chou, Roger, et al. “Imaging Strategies for Low-Back Pain: Systematic Review and Meta-Analysis.” Lancet (London, England), U.S. National Library of Medicine, 7 Feb. 2009, www.ncbi.nlm.nih.gov/pubmed/19200918/

#imaging #spine #lowbackpain #lowbackpainrelief #xray #mri #sciatica #sciaticarelief #chiropractor #chiro #chiropractic #physicaltherapy #quarantine #covid19 #covid_19 #smallbusinessowner #smallbusiness #desmoines #iowa #desmoinesiowa #radiology #medicine #movement #excercise #movementismedicine #healthylifestyle #health #education #literature #educationmatters

06/01/2020
Spinal movmement

Test subjects spent 4.9 hours in a flexion based posture and 23min in an extension based posture within a 24hr period .

Simple mechanics and load tolerance would indicate this being an unsustainable ratio for extended periods of time. Somethings gotta give.

Movement is vital to musculoskeletal integrity.

Musculoskeletal pain can be as complex or as simple as you want to make it.

Move that spine.

#movement #movementismedicine #exercise #chiropractor #chiropractic #palmer #chiro #physicaltherapy #lowbackpain #lowbackpainrelief #neckpain #spine #spinehealth #healthylifestyle #health #ortho #healthyliving #smallbusiness #smallbusinessowner #move #flexion #extension #mobility #percuocochirorehab #opposites #change #changeisgood #onthemove #makingmoves

05/27/2020

Centralization is a clinical phenomenon that observes pain in the leg return to the back with either repeated motion exercises or sustained positions.

This happens very quickly typically with the appropriate directional exercises.

The literature surrounding centralization reports a good to excellent prognosis if this phenomenon occurs.

For cases that do not centralize with directional exercises, a poorer prognosis for recovery may be expected.

If you have sciatica, this is one of only a few physical examination indicators that can predict a good outcome.

Don’t guess, get assessed.

#centralization #directionalpreference #mdt #chiropractic #chiropractor #chiro #sportschiro #sports #mckenziemethod #smallbusiness #smallbusinessowner #quarantine #coronavirus #corona #exercise #healthylifestyle #health #sciaticarelief #sciatica #sciaticapain #radiculopathy #lowbackpain #pain #spine #adjustment #physicaltherapy #physicalexam #education #learn

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