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Top 3 movements for rotator cuff injuries

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Rotator cuff tears* are unique to the individual. Most of the time, imaging is not required since it will not change the approach to treatment. Figuring out what arm motions or directions you can perform without pain is usually the first step to rehab the shoulder. These three movements are ones that I will continuously reintroduce to patients as they heal because they are integral to strengthening and aligning the shoulder joint.

These exercises are demonstrated and listed in order from most likely able to perform after injury to ones that might need some time to “unlock.” 1. External rotation: Isometric → Banded 2. Low Row: Bodyweight (TRX or Ring rows) → Resistance Band → Weights 3. Hanging from a bar: Banded Hold → Supported Hang → Static Hang

* It is advised to have your injury evaluated by a professional to find out the severity of the problem. Only perform these movements if there is no pinching pain during these exercises. Another red flag is your shoulder throbbing or being noticeably more sore after the exercise. Some soreness is okay to work through but this should NOT increase your pain after performing.

Contact with questions.
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Say No! to Tech Neck

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Click to View this Video

Spending a lot of time in front of the computer? Aren’t we all and chances are you take small breaks like me just to look at your phone. Well there is a realistic chance that just like many of us you have begun to develop forward head posture or as we call it in the industry – tech neck. 

Tech neck is horrible for so many reasons: It can create headaches, makes you look unattractive (don’t believe me stick your chin out and look in the mirror) and can even result in jaw pain. Fret not because Onsight has a couple of exercises to help you out on YouTube.

  1. Chin retractions: This one is as simple as pulling in your chin as far back as you can while looking straight forward. Do these while driving your car by pushing back against the headrest and do as many as you can. 
  2. Deep neck flexor training: Lying on your back, bring your chin in and pretend like you are scraping your chest with your chin. Make sure your shoulders stay down for the entire duration of the exercise. This one is more advanced and can leave you sore so stick to about 10 reps.

Contact Dr. Nick Predtechensky if you have questions or comments:

21-Day Purification Cleanse

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20% off during February from Onsight, guidance from Dr. Johanna Lelke

Learn about the Standard Process 21-day Purification Cleanse

What people say about THIS 21-day cleanse:           

“I feel awesome. I have so much energy and I am the leanest I’ve been in 5 years; at least strongest and body fat percentage. This is a BIG deal. I don’t have the healthiest genes coming into 25 years of type 1 diabetes and just over 2 years with a low thyroid. Weight comes off like molasses, and after doing this program, it seems easy. I better be careful, I am going to be jinxed for saying that!” -Kelly Schmidt, RD (read her blog)

“I quite honestly didn’t know how I was going to be able to survive 11 days without protein, but I did it. The protein that was found in the powder was enough to get me through my 6+ hour college classes, work days, and workouts daily. With setting my mentality  was able to get through the program with no problems or complaints, just some willpower.” -Dr. John Beretta

“My husband, an endurance athlete, and I have done this cleanse three times together. It helps when you’re on the same meal routine as your spouse! Confession, we’ve given ourselves small leniencies like allowing for a daily tea or coffee. We’ve always felt enormously lighter (shedding a few pounds each) and more energetic during the cleanse. Afterward, we’re primed to eat even more mindfully. It takes 3 weeks to form a habit, right?!” – Dr. Johanna Lelke

“The 21-day Standard Process Purification Program isn’t just a cleanse diet. It’s a structured program that brings healthy lifestyle habits into focus. It’s designed to purify, nourish and help patients maintain a healthy body weight by eating whole foods, exercising, drinking nutritious shakes and taking supplements made with whole food and other ingredients. The menu includes a varied abundance of fresh vegetables and fruits for the first 10 days, with select proteins added on day 11. The supplements support the body’s ability to remove naturally occurring toxins. This promotes a state that allows for toxin release.” -Standard Process

Want to get started? Email to purchase.

Explicit cleanse directions will be sent to each customer, or upon request, by Dr. Johanna. Guidelines and recipes are also found in the purification guide, and when you sign up for the online challenge at Please email with any questions or concerns before deciding to do the cleanse yourself this winter.

Standard Process (SP) items to purchase per person (all are vegetarian and gluten-free):

1. SP 21-day purification program guide
2. 2 containers of SP Complete Vanilla or SP Complete Dairy Free protein powder
3. 1 bottle SP Cleanse capsule supplements (150 caps)
4. 2 bottles Whole Food Fiber (7oz bottles)
5. 1 bottle SP Green Food (150 caps)

For our February sale, Onsight customers receive a 20% promotional discount* on the SP 21-day cleanse: $210 per person [instead of $262.50] + tax and $13 shipping or free in-office pick-up.

*Our rates are much lower than on Amazon because Dr. Johanna is a medical professional distributor with SP. Standard Process’ and MediHerb’s entire line of 360+ supplements are always discounted by 10% for Onsight customers.

Eddie’s top 3 movements for stopping back pain

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click to visit our instagram page for the video!

McKenzie Press up for pain:

-Place arms under shoulders and press up to your level of comfort
– Aim to fully straighten arms but only press up to your comfort level, propping up to forearms is a safer alternative
– 10-20 reps or 2 minute hold
– Breathe out completely before coming back down 
*** It is okay to feel some discomfort while you are performing this but it should decrease the more you hold or perform this movement.  

Bird-Dog for stability: 

– Hands and knees are directly under shoulders / hips
– Perform a “cat/camel” to find neutral spine 
– Start with raising one limb at a time, progress to opposite arm/leg
– Spine should not move, only limbs 
– Attempt to hold each pose for 5 seconds/ 10 reps

Hip hinge to restore motion: 

– Therapeutic when repeated
– Use a golf club, broom, or dowel to ensure neutral spine 
– After 8-12 reps, switch to picking something up to load the spine
– Perform another 8-12 reps w/ weight remember to brace the core by holding a big breath (back pack, laundry detergent, car battery are great alternatives to a kettle bell) 

July Massages $10 off!

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Enjoy relief for your aching muscles EVEN MORE with a $10 discount all month

We are proud to offer our highly skilled massage therapy sessions at a discount if you book between July 1 and July 31, 2019. Certified Massage Therapist Amanda Upchurch has availability each Wednesday, Thursday, Friday, Saturday and Sunday. Check her online calendar and book your massage today! At these discounted rates, spots will fill up fast:

1-hour massage $90
90-min. massage $130
90-min. Aromatherapy massage $140
2-hour massage $170

Looking for a little something extra?

Free Wednesday Night Runs

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Our group run is coached by Karina JP and is welcome to anyone. Fast or slow, long distance or short distance, you are definitely welcome to join us! No matter your distance preference, experience and/or fitness level, we put this group together to promote fitness, a healthier and more active lifestyle and to strengthen our community bond. This fun group run is also a great way to meet other local runners or like-minded individuals!

We meet every Wednesday at 5:45pm and launch at 6pm from the Onsight/PacWest office. We run anywhere from around the Aquatic Park to over the bridge and along the SF Bay Trail or even just around the block. 
Don’t get FOMO and join us on a fun yet rewarding adventure!

Questions? Email

Meet out partner acupuncturist, Sarah Hart

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Through our partner, you can now receive acupuncture care at Onsight!

Sarah uses acupuncture and herbal medicine to reconnect patients to their sense of well-being and empower them on their healing journey. She has background in biology and pre-med from Colby College and and earned her MSOM from AIMC -Berkeley. She completed a clinical internships at UCSF Benioff Children’s Hospital and in China. Sarah serves on the Board of Directors for CSOMA, the California State Oriental Medical Association. When not practicing Chinese medicine, she likes climbing, hiking, embodiment dance, yoga, qi gong, kayaking, mountain biking and long distance bike touring from Seattle to Maine. She is thrilled to join the Onsight team for private practice.

Availability at Onsight: Mondays 8:00-1:00
Schedule from any of our BOOK AN APPOINTMENT icons.

Initial Visit, 75 min – $125   New patients and existing patients with a new condition. Examination, medical and lifestyle history, complete diagnostic questioning for acute, chronic, pain, injuries and illness. Acupuncture treatment that may also included cupping, medical qigong, herbal medicine prescription, and dietary and lifestyle coaching.

Follow-up visit, 60 min – $95   Follow-up for returning patients.

Follow-up visit extended, 75 min – $110   Longer session to include longer time on the treatment table and multiple treatment modalities if necessary.

Herbal Medicine Consultation, 25 min – $60 +market value of herbs   
Custom Chinese herbal medicine prescription without acupuncture. Initial appointment will included examination medical and lifestyle history, complete diagnostic question for acute, chronic, pain, injuries and illness.

Tinnitus, Teeth Grinding, and Jaw Pain

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Tinnitus, Teeth Grinding, and Jaw Pain
Getting in the way of sleep, focus and energy?

Over the years, we’ve met lots of patients who’ve experienced the terrible trio of tinnitus (ringing in the ears), teeth grinding, and jaw or head pain. As they know too well, these are usually chronic and debilitating conditions. Most of them didn’t know that we could help them until they asked.

Muscle tensions in these patients get “stuck” because the brain is reinforcing a signal to contract, contract, contract, contract. The pattern that we want is contract, relax, contract, relax, correlating with use and rest. For example, we need our jaw muscles to contract when we’re chewing or speaking, and to relax when we’re not.

The intervention that has worked for so many people entails a complete neuromusculoskeletal approach. Put simply, we use exercises to help regulate your nervous system, hands-on myofascial release to relax muscle spasms, and chiropractic adjustments or mobilizations to regain joint ranges of motion in your neck, head and jaw.

If you’re afflicted by any part of this terrible trio, then I imagine you’re waiting for the day when your concentration, focus, ease of sleep, and energy return to normal! Let’s give you a little more detail on how our approach results in alleviation of headaches, jaw and neck pain, ear ringing, and even reduction of teeth grinding.

Neurologic Approach

Factors like stress, anxiety, sleeplessness, and generally being overworked all contribute to a sympathetic nervous system dominance. The fight-flight mode becomes too pervasive and overrides our body’s ability to move back into the normal state of a parasympathetic (relaxed) nervous system. Our doctors train our patients in a number of appropriate exercises that incorporate eye movements, balance, and breathing techniques.

Muscular Approach

In order to break the cycle of muscle spasm, your body needs to receive the appropriate therapeutic contact. AMR (a technique called Advanced Muscle Reconditioning) works extremely well for these patients. It’s a hands-on therapy technique that relaxes the muscle trigger points that are commonly found around your head, neck and jaw. Sometimes, thickened adhesions build up in the muscles which renders them both tight and weak. For this problem, we often use a light scraping technique with Graston instruments.

Skeletal or Joint Approach

Chiropractic adjustments, or slower mobilizations, are usually the final step in a typical treatment session. In order to improve and render pain-free neck and jaw ranges of motion, our docs use their hands to apply the right amount of torque into a neck and/or head joint. Decades of academic research supports the observation that patients who receive chiropractic adjustments experience a calming input to their nervous systems and a relaxation of guarding muscle spasms around those joints.

Just as the debilitating aspects of these conditions arose gradually over time, the healing is also expected to take time to resolve completely. As doctors, we evaluate and offer a treatment plan that we believe, based on clinical experience, will resolve your problem as swiftly as possible. Patients respond at a rate that is dependent upon many health factors. Whereas some patients experience dramatic shifts early on in their care, others may shift more slowly over the course of treatment.

If I can answer any further questions about this topic, please don’t hesitate to reach me, Dr. Johanna Lelke, at

Achieve Balance

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Your Vestibular System

Did you know we spend 80% of our time walking on one leg and practically all of our time running on just one support. This is why it’s very important to develop a good balance system to keep all of our joints in alignment during these task, whether you are a runner or a fighting athlete. Before I give you some exercises here is a little something about the system that keeps us balanced: the vestibular system. Arguably the first nervous system to develop in the evolutionary process, it served the purpose of keeping us oriented in space as cute little jellyfish. The vestibular system takes input from three separate senses. The eyes, joints and inner ear. With that in mind, we want to strengthen and challenge the inner ear by removing the other two senses.


Exercise 1: Single Leg Balance. Simply stand on one leg by bending the knee of the other leg backwards. That alone should be enough to make some of us wobble and if it does, you have to seriously consider doing these balancing exercises or at least getting tested for gluten sensitivity.

Exercise 2: Same as exercise 1, but this time close your eyes. This takes out our most dominant balance system, the eyes. We tend to overly rely on eyes to keep us balanced, but true balance should come from the inside.

Exercise 3: Finally do the same thing as in exercise 2, only on a soft uneven surface. I recommend an Airex pad for best results, but a pillow will do just as well. This takes out the steady input from your ankle joint and makes the exercise progressively harder. If you can hold for 30 seconds in this position your vestibular system is in great shape!

This article was written by Dr. Nick Predtechensky. He may be reached via email at

Knee Pain Solutions for Runners

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Having to Limit your Runs due to Knee Pain?

I may have the solution to your problem, but it will take a little work.

If you have been having pain on the outside of the knee or close to the knee cap after long runs, then chances are your muscles (gluteus max, mid, min and the TFL) are not doing the best job of stabilizing your hips. Same thing goes to all you lifters out there, if your hips are not stable, it’s the knee and ankle that end up paying the price.

Here is a quick and dirty rehab program:

  1. Hip Abductions: Start by lying down on your side and bending your bottom leg for stability. Make sure your hips are perpendicular to the floor and your pelvis is in neutral. While keeping your spine and leg straight start lifting the top leg to about 45 deg. You should feel a burn on the outside of your butt. Progress to an elastic band and then to standing.
  2. Hip Hikes: Find something to hold on to like a wall and stand next to it. If you have a platform use it like in the picture, but these work just as well on a flat surface. Stand on one leg and bring your opposite hip up to the ceiling. You should feel the burn in the exact same spot on the standing leg. Train until you can do 50 on each side, at that point you should be stable enough for even the most gruesome runs.

    Notes: It takes a while to build up the endurance in your glut muscles. The hip abduction must be in proper form to reap the benefits, which means the pelvis remains immobile during the exercise. Once you can do 30 good ones standing with an elastic band on both sides, then progress to the hip hikes. Don’t exercise this muscle every day and give it 24-48 hours rest for best progress.

    Your glutes make bodybuilders jealous, but you are still having knee pain? There is a number of other factors that could be contributing, such as ankle stability. Why not come into the clinic and we would be more than happy to figure out how to help you.

    Dr. Nick Predtechensky is the author of this blog. He may be reached at