727 Route 481

Monongahela, PA 15063



June 2013

Inside this Issue

Chiropractic Helps the Knee

Supporting Research

Benefits of Continuing Chiropractic Care

Insurance News - UPMC

Leptin, High Fructose Corn Syrup, and Weight Gain

Weight Loss and Fitness

Positive Thinking

Office Changes

Chiropractic Care Helps Knee Sprains

Although chiropractic care is best known for its effectiveness in treating spinal conditions, it is also highly successful at helping many people with knee sprains. It provides a unique approach that addresses factors which are commonly overlooked in traditional orthopedic or physical therapy management.

Chiropractic May Provide Faster Relief

How fast chiropractic can help depends on the severity of the knee sprain. Trying chiropractic first could be the fastest and most effective path to relief.

Sprains occur when knee ligaments and muscles are caught off guard or overloaded. Usually it is a sudden twist that results in injury.

Signs and symptoms include immediate pain, an inability to put weight on the involved side, buckling or “giving out,” not being able to fully straighten the knee and swelling in and around it.

Treatment usually requires rest, icing, braces or supports, and elevation. An exam can identify the specific ligament(s) and/or muscles involved. Soft tissue therapy may involve hands-on pressure to “reset” normal tone to the injured soft tissues. Light massage can help.

A chiropractic approach will also involve looking for misalignments of the knee or hip joints. Since the main knee muscles attach on one end directly to the pelvis, making sure the hips are properly aligned is essential for achieving the fastest and best results. This is uniquely addressed by chiropractic.

Two to four weeks of care will usually result in at least 50-80% improvement of the problem. Full recovery may take weeks or months depending on the extent and severity of the injury.

Other Measures

Sometimes crutches are needed for a week or two following a bad sprain. A family medical doctor may be able to provide them or refer to an orthopedic doctor to help obtain a pair.

Although icing 15 minutes per hour or at least 3 times per day may provide sufficient relief, over-the-counter anti-inflammatory medication is often used to help manage the pain. Your medical doctor or orthopedic can also prescribe short-term steroidal anti-inflammatories when the pain is unusually severe and debilitating.

X-Rays and MRIs

Many everyday knee sprains do not require diagnostic testing unless sufficient improvement is not seen within 2-4 weeks. Obviously, x-rays are indicated when there is direct trauma capable of fracturing a knee bone. If there is a break, referral to an orthopedic will be made. Even in these situations, it would be wise to have a chiropractic evaluation once the bone is healed.

MRIs are helpful in assessing the location and severity of tears. However, they are usually not necessary during the first month of care as long as satisfactory progress is being made. In rare situations where ligament surgical repair may be necessary, it is often best to simply refer to the orthopedic and have them order the MRI.

Exercise Rehabilitation

Sprains result in weakened ligaments and muscles. Even with great relief and a full return to normal activities, an injured knee is prone to re-injury. Exercising the muscles around the knee provides the best results and minimizes the chance of future episodes.

Rehab done at home has been shown to be just as effective as doing it at an expensive rehab facility. The key factor is understanding the need and making a commitment to do the exercises. The primary advantages of physical therapy are direct supervision and accountability.

Chronic Knee Sprains

Sometimes the damage from an injury is so severe that ongoing management is necessary to maintain the knee at optimum function and comfort. Sprains heal with scar tissue, which is a weaker “patch” over the injury site. Still, periodic chiropractic treatment combined with exercise can keep the knee in good shape for years to come.

Insurance Coverage

Major insurance plans, such as PPO Blue, typically cover chiropractic care for knee sprains. Sometimes they will require two copays per visit if the treatment involves adjusting misaligned hip joints related to the problem. Or if you are treating for other non-related spinal complaints on the same day your knee is worked on.

Limited insurance plans, such as Medicare or Freedom/Security Blue, only cover chiropractic treatment to the spine. You would have to pay for the treatment yourself and sign a form showing that you understand it is a non-covered service but want to receive it anyway.


Chiropractic may be an effective, faster and less expensive alternative to typical orthopedic or physical therapy care. It may also help in cases where traditional physical therapy or surgery provided only limited improvement. Either way, now you know you have options when managing knee sprains. Give it a try!

Research Report

Chiropractic adjustments help improves quadriceps strength in patients with pain in front of the knee:

Evidence exists that shows that lack of full recovery of muscle strength following knee injuries is due to neurological “short-circuiting” of the quadriceps (muscles in front of the thigh which straightens the knee). This study showed that chiropractic adjustments to related sacroiliac joints improved nerve tone to the quadriceps muscle, resulting in increased knee strength.

(Journal of Manipulative and Physiological therapies 1999; 22:149-53)

Bottom line indication from Dr. Wohar:

“Knee injuries kick off the “breaker switch” to the quad muscles. Hip adjustments restore the power to the knee muscles, resulting in more strength and less pain.”

The Benefits and Reasons for continuing Chiropractic Care

Even with the best care and symptom relief, ongoing spinal care is necessary for many people and conditions. It helps you to continue receiving the benefits and avoiding relapses and recurrences. There are numerous reasons for this. A few of the most common are:

1. Scar Tissue: O nly broken bones heal stronger than before the injury. “Soft” tissues (muscles, ligaments, skin, nerves) heal with a lesser quality, generic, path-up scar tissue. It is more pain sensitive (to alert you sooner to avoid re-injuring the same area over and over!). It is also weaker and less flexible. So, like a car repaired after a crash, our bodies are never quite the same after they are injured and repaired.

2. Degeneration: Cartilage lining joints, discs and even muscles degenerate over time, especially following injuries left to heal on their own without proper treatment. Spinal misalignments, compensations and imbalances cause uneven wear and tear and accelerate this process.

Chiropractic adjustments are unique in their potential to restore normal alignment and function to the spine and re-establish normal communication in the nervous system. Still, once degenerated, it is difficult to permanently stabilize the area; thus the need for periodic checkups and adjustments.

3. Lifestyle: O ur jobs, hobbies and daily activities are often the root cause of our spinal problems. Certain postures and positions are unavoidable and work against attempts to stabilize your spine. These can perpetuate spinal problems and necessitate ongoing care.

4. Inactivity/Weakness/Deconditioning: R egular exercise and maintaining a proper weight are essential to long-term good health. Chiropractic adjustments can result in impressive improvements in your condition. But without well-conditioned muscles and ligaments, relapses are most inevitable.

Insurance News

UPMC denies Dr. Wohar’s request to join network—AGAIN!!

In our last newsletter we informed you that we have attempted to secure network benefits for our UPMC patients for over 10 years. On March 25, 2013, we again applied to become a network Chiropractor for UPMC. And once again, on May 13, 2013, UPMC denied our request.

Their response was as follows:

“At this time, we have deemed our network of providers sufficient to provide geographical coverage for our members.” They say they comply with PA Department of Health regulations requiring they provide you with a network doctor “within 45 miles or 60 minutes travel from an enrollee’s residence or work.”

You may be interested to know that on April 2, 2002, the US Supreme Court ruled unanimously to uphold a Kentucky law forcing HMOs to open up their doctor networks. The managed care industry argued that closed networks forced doctors and hospitals to accept lower fees in return for a guaranteed stream of patients.

Whereas no doubt that increases profit for HMOs, those savings are often not passed along to enrollees. In Pennsylvania, UPMC insurance premiums are comparable to Highmark Blue Cross Blue Shield despite UPMC limiting your choice of doctors and hospitals.

Half the states in America have laws that would make UPMCs practice illegal! Unfortunately, Pennsylvania law currently allows it.

In the meantime, you may want to consider insurance plans like PPO Blue when premiums are competitive. Plans like those cover you nationally and give you much more freedom in choosing your own doctor or hospital. Unfortunately, many times employers do not give you the choice and pick a cheaper plan.

We will continue applying to UPMC for the sake of our patients with UPMC insurance plans. In the meantime, we appreciate your confidence and loyalty and will continue to work hard to earn it.

Leptin, High Fructose Corn Syrup and Weight Gain

Recently, with increased consumption of processed foods, a concern has arisen on the over-consumption of high fructose corn syrup (HFCS) and its relationship to weight gain.

Consumption of HFCS is associated with impaired Leptin function. Leptin is a hormone that helps balance food intake and energy expenditure in the body.

Over time, leptin resistance will develop as the consumption of HFCS continues, and it will develop silently with no adverse side effects.

High fructose levels in the blood fools the brain by altering leptin function and causing the brain to ignore leptin levels so you simply keep eating and never get full.

Research proves that if long term consumption of HFCS is paired with high fat, calorie dense foods, then rapid weight gain will soon follow.

High fructose corn syrup is in nearly all processed foods because it is cheap and easy to manufacture. The best way to reduce your risk of developing leptin resistance and falling victim to weight gain is to stay away from processed foods and focus on fruits, vegetables, lean meats, nuts, seeds and whole grain choices.

Shapiro et al. Fructose-Induced Leptin Resistance Exacerbates Weight Gain in Response to Subsequent High Fat Feeding . AJP Regulatory Integrative and Comparative Physiology , October, 2008

Weight loss and Fitness

If weight loss is your goal for 2013, there's no time like now to get that ball rolling. It's simple math when it comes to losing weight. You have to burn or cut out 3,500 calories from your diet each week in order to lose one pound. That breaks down to 500 calories per day, and the easiest way to do that is to do this combo move: each day, cut out 250 calories from your diet and burn 250 through exercise.

For example:



Swap out your morning bagel with ( 493 calories ) for a bowl of Chobani Nonfat Vanilla Greek Yogurt ( 120 calories ) with an extra small banana ( 72 calories ).

Take a brisk walk with a friend for an hour or do a light jog on a treadmill for 30 minutes.

Positive Thinking

9 ways to overcome negativity and become more optimistic:

1. Turn your “cant’s” into “cans”

2.  Be Kind

3.  Find the Silver Lining

4.  Slow Down

5.  Set your own standards

6.  Practice Gratitude

7.  Surround Yourself with Positive People

8.  Ditch the Drama

9.  Take Responsibility


Recent Office Improvements

We now have Wi-Fi available for you!

We now accept credit cards (VISA, MASTERCARD, DISCOVER)

Many of you have expressed enjoying our new Sirius XM radio!

The tall tree out front has been cut down.  No more risk of falling limbs.

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