Nervousness, fear, anxiety, and discouragement are common and natural feelings to have while awaiting surgery. Preparing for spinal surgery can cause individuals to experience what is known as preoperative anxiety. A study suggests that preoperative anxiety affects from 60 to 80% of individuals. There can be a lot of unknowns going into spinal surgery. Individuals can experience preoperative anxiety:
Over the procedure itself.
By imagining what could go wrong?
How is the body going to recover?
The temporary changes in functioning post-surgery.
The post-surgical pain and discomfort.
What will the results be?
Learning how to decrease surgery stress will improve the procedure and recovery. There are ways to overcome this anxiety with tips from a pain psychologist.
Getting Educated and Informed
A pain psychologist recommends spending as much time as needed to discuss the surgery with the surgeon/provider. Ask the doctor if it is possible to speak with other patients who have gone through the same surgery to learn more about the procedure and what to expect with the recovery. Searching the internet is fine, but it is recommended not to get caught up searching non-reputable websites as there is a lot of misleading information that can lead to unnecessary stress. Ask the doctor to share statistics of positive outcomes versus complications to provide reassurance and to determine if surgery is the right option based on the specific condition.
Going In With The Right Mindset
Having a heightened level of anxiety or depression can contribute to poor surgical outcomes. Individuals that focus on the worst-case scenario are more likely to have higher levels of pain after surgery. Having the right mindset, staying calm and positive can decrease preoperative anxiety and can optimize recovery.
Preparation and Planning
Mental preparation and planning for surgery will set the mind and body at ease. This means:
Knowing the anticipated healing timeline.
The recovery phases the body will go through.
How long they will last?
What is needed for optimal recovery?
Support during each step.
Recommended medical follow-up.
Post-surgical treatment/rehabilitation plan.
Understand the Pros and Cons
Before surgery, it can be beneficial to understand the pros and cons of the surgery. Speaking with the surgeon to learn this information can create a clear, concise picture of what to expect and the recovery timeline.
Relaxation
It is important to learn relaxation skills to stay positive and calm before and after surgery. Relaxation exercises can be very effective at all stages of pre-and post-surgery. Learn how to:
Manage thinking positively.
Avoid catastrophizing.
These can be accomplished through:
Meditation
Slow walks
Gentle yoga as long as it is cleared by the doctor.
Understand the Time
Knowing what will go into post-surgery recovery and having realistic expectations will create a sense of confidence.
Support System
Having a healthy support system will increase positivity and can speed up recovery. This can include:
A partner.
Family members.
Close friends.
They can help before and after surgery with physical assistance or just to listen.
Consult a Professional Pain Psychologist
Help from a behavioral health specialist or a pain psychologist can be beneficial in reducing anxiety and promoting positive surgical outcomes. They help deal with the pain, pre, and post-surgery, rehabilitation, life moving forward, etc.
Body Composition
Carbohydrates Simple and Complex
Simple carbs are a quick, scattered source of energy, and complex carbs are a healthy source of steady energy. Complex carbs are not as readily available for immediate energy as simple carbs are, but they are more efficient and healthier. Complex carbs provide sustainable energy, meaning the energy is constant with no crash like simple carbs. Complex carbs release slowly and should be the most significant component of daily energy intake. When it comes to muscle gain, complex carbohydrates can help:
Prevent Muscle Weakness
Glycogen is stored in the muscles. When the muscles are used during physical activity or exercise, the body taps into the glycogen stores for that particular muscle. Athletes take advantage of glycogen by consuming carbs (carbo-loading) a day or more before a workout to maximize the muscle glycogen stores. This helps delay fatigue and improve performance, making for a better workout and stronger muscles.
Prevent Muscle Degradation
One concern about consuming a low-carb diet is muscle loss. A study compared a low-carb diet to other diets and found that restricting carbohydrates results in protein loss. This is because restricting carbohydrates causes an increase in the amount of nitrogen that gets excreted by the body. Nitrogen is a component of amino acids that forms muscle proteins, with a loss in nitrogen indicating that the muscles are breaking down.
References
Beck, Kathryn L et al. “Role of nutrition in performance enhancement and postexercise recovery.” Open access journal of sports medicine vol. 6 259-67. 11 Aug. 2015, doi:10.2147/OAJSM.S33605
Hearris, Mark A, et al. “Regulation of Muscle Glycogen Metabolism during Exercise: Implications for Endurance Performance and Training Adaptations.” Nutrients vol. 10,3 298. 2 Mar. 2018, doi:10.3390/nu10030298
How Attitude Can Affect Recovery: Journal of Neurosurgery. (November 2017) “Influence of catastrophizing, anxiety, and depression on in-hospital opioid consumption, pain, and quality of recovery after adult spine surgery” thejns.org/spine/view/journals/j-neurosurg-spine/28/1/article-p119.xml
International Journal of Surgery Open. (2018) “Prevalence and factors associated with preoperative anxiety among elective surgical patients at University of Gondar Hospital. Gondar, Northwest Ethiopia, 2017. A cross-sectional study” www.sciencedirect.com/science/article/pii/S2405857217300475
The thoracic upper back or middle back is designed for stability to anchor the rib cage and protect the organs within the chest. Compared to the neck and lower back, the upper back is highly resistant to injury and pain. When thoracic upper back pain does present, it is usually brought on from long-term poor posture or an injury that overwhelms the sturdiness. It is less common than lower back and neck pain, but it does affect around 20% of the population and primarily women. It can occur for a variety of reasons, and chiropractic treatment can bring long-term relief.
The delicate balance and function can create potential issues and imbalances, causing soreness, strain, and pain. Underlying causes for thoracic upper back pain include:
Direct impact on the area.
Injury from a fall, sports, or automobile accident.
Unhealthy posturing/positions that place added strain on the spine, causing misalignment.
Repetitive motions and overuse like pulling, pushing, reaching, and twisting.
Repetitive/Improper shoulder mechanics can lead to muscle imbalance and poor movement.
Chiropractic can realign the spine and body if experiencing any of the following:
Symptoms that keep returning even with the use of medication.
Home remedies do not bring adequate relief.
Unable to prevent symptoms from presenting.
Chronic pain.
Injury Medical Chiropractic and Functional Medicine Clinic will develop a personalized/customized treatment plan specific to the individual’s needs. Treatment will include:
Spinal adjustments to improve alignment and nerve integrity.
Therapeutic massage.
Posture training to increase spinal alignment.
Exercise training to restore muscular balance.
Health coaching.
Anti-Inflammatory Diet.
Body Composition
Sitting For Prolonged Periods
Weakened Muscles
Metabolism is linked with body composition, meaning that increased muscle increases metabolism helping to burn more calories.
When sitting, the gluteal muscles, abdominal muscles, and legs become inactive.
Sitting for extended periods day after day can cause these muscles to degenerate.
Consistent muscle loss from the lower body can hurt the body’s functional strength and, with age, increase the risk of injury.
Any muscle loss, especially from the lower body, and is the largest muscle group, can lead to consistent fat gain.
Circulation Slows Down
Sitting for too long also slows down blood flow to the brain and the legs, causing them to become sluggish.
Sitting without standing can increase the risk of developing blood clots.
Blood clots can break off and cause blockages throughout the body.
One study showed a significant reduction in the vascular flow after sitting for just three hours.
But individuals who took breaks and got up to walk around for two minutes every hour showed improved circulation.
References
Beddhu, Srinivasan et al. “Light-intensity physical activities and mortality in the United States general population and CKD subpopulation.” Clinical journal of the American Society of Nephrology: CJASN vol. 10,7 (2015): 1145-53. doi:10.2215/CJN.08410814
Briggs AM, Smith AJ, Straker LM, Bragge P. Thoracic spine pain in the general population: Prevalence, incidence and associated factors in children, adolescents and adults. A systematic review. BMC Musculoskelet Disord. 2009;10:77.
Fouquet N, Bodin J, Descatha A, et al. Prevalence of thoracic spine pain in a surveillance network. Occup Med (Lond). 2015;65(2):122-5.
McManus, Ali M et al. “Impact of prolonged sitting on vascular function in young girls.” Experimental physiology vol. 100,11 (2015): 1379-87. doi:10.1113/EP085355
The sciatic nerve is formed through a combination of motor and sensory fibers based on the spinal nerves of the lower back L4 to S3, known as the lumbosacral plexus. It is the largest and longest nerve in the human body and about as wide as an adult thumb. It begins at the base of the spine, runs along the back of each leg, and ends at the foot supplying the areas with fresh blood and nutrients. There are sciatic nerve branches that consist of primary branches and smaller branches.
Sciatic Nerve Branches
The nerve splits into two main branches near the back of the knee called the popliteal fossa.
This fossa is located slightly above the joint behind the knee.
The popliteal fossa is a diamond-shaped space that acts as the conduit for the blood vessels and nerves.
Primary branches
From the popliteal fossa:
The tibial nerve continues down the back of the calf to the heel and bottom of the foot.
The common peroneal nerve, aka common fibular nerve, travels sideways along the outer part of the knee to the outer border of the lower leg and foot.
Both nerves convert into small sensory nerves in the calf that supply the outer side of each foot.
The sciatic nerve breaks off into smaller branches, known as collaterals, that include:
These are muscle branches that supply the muscles in the thigh, including the hamstring group and the adductor magnus muscles along the inner thigh.
Other small branches supply the leg and foot muscles.
Articular branches supply the back of the hip joint, the back and side of the knee joint.
The sciatic nerve does not supply structures in the buttocks; however, pain commonly radiates/spreads into this area when the nerve is impaired, impinged, and inflamed.
Blood Supply
The delivery of nutrients to the sciatic nerve is done through blood vessels that also contribute to the nerve’s function. Any interruption of blood flow to the sciatic nerve can cause pain and dysfunction. The sciatic nerve and the sciatic nerve branches receive their blood supply from two sources that include:
The extrinsic system is made up of nearby arteries and veins.
The intrinsic system includes arteries and veins that run along the nerve and are embedded deep in a sheath known as the epineurium of connective tissue that envelops the nerve.
The intrinsic blood supply can be affected by conditions like diabetes, which can contribute to symptoms associated with diabetic neuropathy.
Both systems connect at various junction points.
Nerve Function
The combination of sensory and motor fibers that make up the sciatic nerve provides the essential functions in the lower limbs allowing the body to:
Stand
Walk
Run
Climb
Lift
A healthy sciatic nerve is well protected around the low back and buttock muscles where it starts, and it cannot be palpated or felt by touching or pressing on the area. When the nerve gets inflamed, injured, or pinched, the leg can feel stiff and inflexible when trying to move and can lead to pain, weakness, and tingling in the lower back, buttock, leg/s, and feet.
Anatomical Variations of the Nerve
Individuals can have variations in the anatomical structure of the sciatic nerve. These variations are considered normal, but they can increase the risk of developing sciatica brought on by impingement, entrapment, or irritation of the nerve root/s. Variations in sciatic nerve branches include:
The nerve divides above the piriformis muscle; one portion passes through the piriformis, with the other portion exiting the pelvis below the muscle. This is the most common variation.
The nerve divides above the piriformis muscle; one portion passes through the piriformis, with the other portion exiting the pelvis above the muscle.
The nerve divides above the piriformis, with one portion traveling in front while the other travels behind it.
Undivided sciatic nerve exits through the piriformis muscle.
Undivided sciatic nerve exits from behind the top part of the piriformis.
Around 10% of individuals have a nerve that divides above the popliteal fossa and does not merge but courses down in two separate branches.
The sciatic nerve and the sciatic nerve branches are significant components of the body. It supplies motor functions to move the legs and feet and provides sensory functions along the nerve path. Keeping the sciatic nerve healthy is key in helping to prevent back and spinal issues. Chiropractic can help realign the sciatic nerve and educate on maintaining the nerve’s health.
Body Composition
Fitness Motivation
New workout routine
Individuals that don’t feel like returning to previous workout routines are recommended to try out other fitness options. If the gym isn’t cutting it or there is burnout with the current routine, switch things up. This can include:
Virtual group classes.
1-on-1 personal training.
Outdoor activities.
All are valid options to explore if in a rut with the current routine.
The important thing is to find what works for you.
Allow the body to rest
Individuals may want to push it to the limit to get back into shape, but rest days are essential for healthy muscle development and improved performance.
Noticing the body is more sore and exhausted after a workout is an indication that the body needs rest. This also includes:
Maintaining proper hydration.
Stretching out the muscles regularly.
Taking days off from exercising are necessary to:
Prevent muscle fatigue.
Reduce the risk of injury.
Allow for adequate muscle recovery.
Long term commitment is key
It can be discouraging to commit to a workout schedule only to notice minor changes to strength and fitness.
However, small improvements do accumulate over time.
Small increases over time can have a huge impact on overall strength and fitness.
Keep the bigger picture in mind to remain positive.
References
Davis D, Vasudevan A. Sciatica. [Updated 2019 Feb 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK507908/
Barral J, Croibier A. Manual Therapy for the Peripheral Nerves. Elsevier Health Sciences; 2007.
Ryan MM, Jones HR Jr. Mononeuropathies. In: Neuromuscular Disorders of Infancy, Childhood, and Adolescence. Elsevier; 2015:243-273. doi:10.1016/b978-0-12-417044-5.00014-7
In today’s podcast, Dr. Alex Jimenez and PUSH Fitness owner, Daniel Alvarado discuss how PUSH was created and demonstrate how the right motivation can help people achieve their goals as well as, improving their overall health and wellness.
Discussion
Dr. Alex Jimenez and PUSH Fitness owner, Daniel Alvarado introduce today’s podcast.
[00:00:01] Daniel Alvarado: You know what keeps them moving and growing and living? Tell me. It is another catfish or that predator. So we never have predators in our lives. We stay stuck, and we don’t progress anything. So every time we ask God to take away the stress or God take away this issue. We’re asking God to make us weaker, not stronger. OK. Because instead of asking like, “Hey God? Make me more creative. Make me more passionate, make me more patient.” We ask for, hey, take away this, but then we still want everything else that comes along with it. How does that work? It’s not easy.
[00:00:41] Dr. Alex Jimenez DC*: I don’t know. I mean, if you think about it’s from the first time we’re born. It’s not easy. You got to be one in a trillion sperm, really, and only God is very clear that if you don’t get to that egg first, you’re done. So from the moment where we’re given a chance, we’re on the point of destruction from the beginning. Exactly. So, in essence, why did that sperm get to that egg? So you can pass and fight through it.
[00:01:19] Daniel Alvarado: All right, so then you think of everything else as far as how people complain, how people say, you know, I want more money, I want this, but they don’t look at everybody’s backstory, the backend and the behind the curtains. They think, “Oh man, Jimenez, you are a doctor?” You don’t know how many times you’ve lost and rebuilt your practice or if you’re a gym owner and you haven’t made it. You don’t know how often you have to go in at 4:00 in the morning to get a workout in because you have to train people all day long to ensure that this business stays afloat. You know, people don’t see the back. You see, they’re quick to say, Oh, must be easy. No, it’s not easy until you step into the person’s shoes because you’re the one that has to sign the checks. You’re the one that has to stay up at night and figure out payroll. You’re the one that has to be creative and figure out how you’re going to make ends meet. You are the one that constantly has to be on it. You know, as much as you want to kick back and say whatever and do this, and I would love to work out four or five hours a day. That’s my passion and your passion.
[00:02:23] Dr. Alex Jimenez DC*: It’s my passion too.
[00:02:24] Daniel Alvarado: And can we? No, right. What do we have to do? Do we have to be meticulous? We have to be disciplined and ensure we have a proper order to stay on top of the schedule. Yes or no? Absolutely. Exactly. You know, so I’m saying at the end of the day that if you don’t have something chasing you, I mean, you become fat and dormant and become lazy.
[00:02:45] Dr. Alex Jimenez DC*: I think nature is designed to eliminate you. Alex would say, you know, it’s survival, the fittest limiting the species or whatever he’d call it when he’s in biochemistry. You see, I got to tell you it’s not easy to be a business owner. It’s not. It’s not easy when you have no sleep. Ever since I’ve known you, you’ve put the time in from early hours, and you here at 4:30 in the morning and here what time it is? Now you’re here, and we’re here sharing some stories. You know, it’s one of those things where it’s going to be nonstop all our lives. But here’s the thing if you don’t do it, it doesn’t stimulate you to become good at what you do, right? You become lethargic. Everything goes bad. You slowly begin the process of ceasing to exist.
[00:03:36] Daniel Alvarado: Right. So we all need rest to rejuvenate. Get creative. It’s scientifically proven. You need that to reset. You have to. Otherwise, you burn out. Right? But after how many days of rest, one or two where you get this disconnect spastic. Then afterward, you are like, “Alright, cool. I rested enough.” So you don’t stay stuck there.
[00:04:04] Dr. Alex Jimenez DC*: No, and I pray for vacation, right? And when I get it, after about three days, I’m like, OK, all right. I’m done.
[00:04:10] Daniel Alvarado: Let’s go.
[00:04:11] Dr. Alex Jimenez DC*: Yeah, OK, what I’m going to break. What am I going to do? That’s how we are.
[00:04:15] Daniel Alvarado: Exactly. But that’s what makes you so successful.
[00:04:17] Dr. Alex Jimenez DC*: Yeah. Well, it drives us, and it drives us to create who we are. And it also gives us a vision as to what we’re going to do. When we start this podcast, you know, Daniel, we want to get or tell the people a bit of the story of what you do and tell them about, you know, where you’ve been and what’s been happening with you. OK. So for me, it’s very important to share with the people what is happening. I’ve always been one to say, you know, I see how hard you work, and I see how much effort you put into things. But I’d like to know a bit of you as to what made you and what kind of makes you click a little bit. When I discuss these things, I want to ask you what made you begin PUSH? What made you start this massive organization?
How PUSH Fitness Started
PUSH Fitness owner, Daniel Alvarado explains how PUSH started.
[00:05:16] Daniel Alvarado: I want to reach the masses of people and help people. So in all reality, my sister, my brother-in-law, my brother, we’ve all come from platforms as far as I’m speaking, preaching, singing, whatever it is. I was always kind of the black sheep. And I mean it in a good way because I wasn’t trained differently. I just was very rebellious. That makes any sense. I wanted to create my own. So if someone is going right, I go left. If the people go right, I go left. I was always trying to find a different way, and I was stubborn enough to become the most successful by the end. But that’s what allowed me to create this place to reach the masses of people and have my platform of change in people’s lives.
[00:06:14] Dr. Alex Jimenez DC*: Let me ask you when you first started PUSH; what was your reason you started it out? You were always into fitness ever since I’ve known you; you’ve always been into a deep understanding. You see, I love sharing that story with people about when I first met you; you were driven. I mean, you were hunting for knowledge. You were trying to figure out what it was that made people tick, and you wanted to teach people… A little cocky, I’d say. But being 18 years old, I mean, who isn’t right at that age? You haven’t been thumped in the head a couple of times. But you did, and you shared it with people, and you did that. But what made you? What drove you? Because I got to tell you, I’m a big believer, Daniel, about when you evaluate families, I see how hard your dad works. I see how your mom’s incredible in terms of what she does. She wins these CrossFit competitions just on meer drive. You have to turn off the lights to get her off the wall because she keeps on going, right? I mean, what is it that what do you feel drove you and what started the whole philosophy of trying to help people out?
[00:07:24] Daniel Alvarado: I mean, you put in my parent’s work ethic; they just never stop. They still don’t stop and try to move forward despite what life throws at them, and they’re successful in their way. They never stop working towards their marriage, towards their love, towards serving each other. They showed me that we always have to help people, and they serve each other. They serve at the church, and they serve wherever they go. No matter where my dad is, he’s always trying to help. It doesn’t matter. You try to take out your trash can and table; whatever it is, he will help. But that’s where I learned it from him. You don’t just go anywhere and just be wherever you go. You always serve. And that’s my interfaith mentality. You know, it’s biblical. Wherever you are, we are supposed to serve people as husbands and wives. We’re supposed to serve each other. That’s what makes us so successful. You know, you look at Jesus in the Bible, and what do you do? You serve people. He helped people. Not the norm. The most unorthodox, nonreligious people. You know, all the people there that needed the most help, not the most religious. And I think that’s what I love to do. I love helping the people that need the most help. The unconventional. Not the people that are all ready to let go. I mean, don’t get me wrong, I do love helping them. But I guess I like helping the unorthodox.
[00:09:08] Dr. Alex Jimenez DC*: Yeah. You know what, when you mentioned that about your dad, one of the things I noticed is that I came here to work out at around six o’clock in the morning and it was freezing outside, literally freezing. You had a flat tire. Your dad was lifting in the car by himself to get that tire up. Yeah, it was crazy. By the time I got there, I was like, Is this guy working on it? There was no jack, and he was picking up the car himself. He’s pushing that thing up and lifting the vehicle to fit the tire on. I was like; You got to be kidding me. You didn’t even know until I told you, and you said, “Man, my dad never asked for help.”, you know, he does it. That’s one of the things you said, and that’s who we are. We are our parents. We eventually become our parents to some extent, and that’s very much how you are. Your philosophies have guided the PUSH fitness entourage, and the people who come here have been like extreme athletes. Tell me a bit of that in terms of what drove you to pick athleticism as your way of serving.
[00:10:11] Daniel Alvarado: I think I’ve seen the potential of what people can be pushed to if you believe in them. Often, people will, you know, people do believe in themselves, but it’s amazing what you see people become or individuals or athletes. When you say, Hey, I believe you. Someone that is not your mom, not your dad, because it’s kind of expected. You know, not that they have to tell you that, but you know, it’s kind of sometimes expected. You’re right. Yes, exactly. But then you have this stranger saying, I believe you genuinely wholeheartedly, and it brings out that much more in you. I know that’s how I was, and I still remember various times where you tapped me on the shoulder and said, you know. What are you doing? You can, and I’m very different; I don’t need someone to preach to me. It might get going, and that gets you going to move on to the next level of the mountain. And that’s what I love seeing as a potential that you could bring down in all individuals.
[00:11:32] Dr. Alex Jimenez DC*: When you see it, pretty much you’ve been able to see everyone crack. What is it you look for when you see them kind of hit that wall when you start working with an individual with a specific set, whatever sport they’re in, or whatever their dreams are? Weight loss or whatever it is. What is it you look for?
[00:11:50] Daniel Alvarado: To see the reason why they’re quitting. Are they genuinely tired, or have they been babied so much by society that they don’t know how to push for themselves anymore? It’s a sensitive society nowadays; you can’t push kids because they get their feelings hurt or feel this way or that way. And sometimes it’s like you got to wake your butt up; if not, you will not make it in this life. Nothing comes easy, and I think we’re expecting things to become easy because we’re, you know, microwave generation, where everything wants to be done so quickly. So I look for the reason as to why they’re quitting. This is genuinely why they are tired, and are they going to throw up? All right. But you remember firsthand that when I worked out with you, I went to the restroom and threw up. I came right back. Why? Because it’s what you build with that person that respect, you know, why would you want someone who is an equivalent you when he gets hard, you know?
[00:12:59] Dr. Alex Jimenez DC*: Yeah, exactly right.
[00:13:00] Daniel Alvarado: How are you going to count on them? How do you depend on them? When it gets tough, they are going to jump off the wagon; that’s it. You are left alone.
The Right Motivation
PUSH Fitness owner, Daniel Alvarado explains to Dr. Alex Jimenez how the right motivation can influence not only kids but adults as well.
[00:13:09] Dr. Alex Jimenez DC*: You know you’re given responsibility. A huge one with a lot of the El Paso kids in whatever sports they do and whatever the sport, whether it be agility, sport-based or just some sort of sport-based system where they’re just kind of, you know, let’s say, hockey or even things like tennis or golf. But they all have a moment of reaching within. I love how you do that in terms of going ahead and seeing the depths of what is wrong with them, and you can connect with them like no other. I’ve noticed that every single time with my kids, too, when you train them. Did you ask why? So really, at that point, you know, no one cares what you know, they care that you care and that caring allows them to open up, huh?
[00:13:55] Daniel Alvarado: Right? Yeah, it does. You know, it makes them feel like, you know, I do have it in me. I need a quit babying in myself. And I need to get up and get after this because no one will give it to me, and I got to get up after it and work for it. Period.
[00:14:11] Dr. Alex Jimenez DC*: I would tell my daughter when they would come in and say, “You know what? I’m not coming in, you know, I’m not going today.” And I said, All right, well, let me call Daniel. “No!” Now they sense the obligation and trust you have put into their hearts like no other? Because that’s what they want. They want someone to believe in them.
[00:14:35] Daniel Alvarado: Exactly, to push them.
[00:14:37] Dr. Alex Jimenez DC*: That’s why the push to PUSH, you know, there’s another way there’s the adage the push. You know, these are vital points. Do you have to deal with the mind-stuff while working with them? How do you work on developing a child’s mind or working them through their mental impediments or their mental kind of dynamics to make them better of who they are? If that makes sense.
[00:15:04] Daniel Alvarado: You had to build a foundation with them. First, you had to build trust with them. You can just go in and yell at them, Hey, let’s go. Move your butt! You know, you can’t do that. You have to build a relationship first, have them trust you, and understand why you’re pushing them. And then when they’re at the brink of giving up, and you yell at them, and they know why you’re screaming at them. A good parent after they spank them and ground them. They’ll tell them the reason why they did that. But they don’t stop loving them. They appreciate it because they know they’re wrong. Right? It’s the same concept here. Obviously, I yell at them after they know, like, hey yeah, I was sulking, and you start feeling sorry for myself and get after it, right?
[00:15:53] Dr. Alex Jimenez DC*: You know, from my own experience with what you did. You see, you have a lot of moms watching you train their kids. Moms are sharp. There’s nothing more intelligent than a mother in this world. And they intuitively, they understand, and they feel the depths of the change in the child. Right? So when they see the depths of the difference in the child, they trust you. And this is in mass because I have like a whole wall of families, moms, dads. They bring their kids no matter what. Tired, cold, sleet, rain, snow. They bring their kids here to train with you and your entire crew with the philosophies of pushing to those limits. You know, how does that feel when you see those kids excel?
[00:16:45] Daniel Alvarado: I feel proud. I’m pretty much over the moon because you see the hard work you took to instill that time into them and make sure their full potential came out. So it’s rewarding, and it’s inexplicable.
[00:17:03] Dr. Alex Jimenez DC*: Let me ask you this. You’re not young, and you’re in your 30s, which is a very young age. However, you’ve lived long enough to see some of these kids go on in to do their thing. Tell me how that feels in terms of you watching them develop in terms of their they’re who they are, and what they develop because of the foundation, or at least influenced by the foundation of just don’t give up and keep on pushing through it. How does it feel? What do you think?
[00:17:36] Daniel Alvarado: In a lot of sense, a lot of pride, because you can see what they could have been in there, what they couldn’t have been in times. Some kids do come from poor extremities. And so to see them excel believing themselves, go to college, get a successful job, and be something of a higher profession that otherwise they thought they couldn’t build or settle for less and not letting them settle for less is amazing. That’s why I keep doing what I’m doing.
[00:18:17] Dr. Alex Jimenez DC*: Do these kids keep calling you and talking to you personally?
[00:18:21] Daniel Alvarado: Yeah, they do. They still keep up with me as far as what they’re doing, how they’re doing. They’ll come in and work out. So, you know, to share with me everything. It’s fun. You build that long-lasting relationship.
[00:18:35] Dr. Alex Jimenez DC*: If you could come up with a couple of words indicating what makes PUSH unique and you can look deep inside your heart and figure out what it would be a word to get an obituary being read about you. What would they say about PUSH and you, huh? Would you want them to say?
[00:18:55] Daniel Alvarado: Honestly, that they had somebody other than their parents believe in them.
[00:19:03] Dr. Alex Jimenez DC*: That’s amazing. That’s a considerable component of everything that’s going on. When do you think someone actually should be coming out to this place and enjoying the kind of lifestyle that this place, you know, helps enhance their lives with? When is that time?
[00:19:21] Daniel Alvarado: Whenever. Whenever you want to be a better version of yourself.
[00:19:25] Dr. Alex Jimenez DC*: What do you think people sometimes think about, you know, why shouldn’t they come in? What should not be an impediment of them coming in here?
[00:19:35] Daniel Alvarado: Their image. They can’t do it, that they’re not like, you know, they’re obese, having problems, low back problems, and looking foolish. You know, the whole thing is that in the day, we’ve all looked foolish to an extent or another. But the point is if I always assumed what others thought and paid attention to how I felt this was for members and not being good enough, then I wouldn’t be where I’m at.
[00:20:03] Dr. Alex Jimenez DC*: I tell you, I’ve learned a lot from you, and if anything, my kids have learned a lot from you by just your persistence. You know, I can honestly tell you that my son is better as an athlete because of your relationship with you. But let me ask you, what kind of physical and emotional changes have you watched your clients attain their goals?
[00:20:34] Daniel Alvarado: Hearing people say. “He saved me from diabetic medications.” We hear people say like I would have died, been in this obese state, and you saved my life. And that’s how do you not get emotional with things like that? How do you not get emotional and people saying, like, you know, I thought I couldn’t walk or had this muscle imbalance, or how do you say where I have this one client that couldn’t build muscle? I can’t remember the terminology, but the fact that she can build muscle now, where the doctor told her she wouldn’t be able to squat a bar, and now she’s squatting over one hundred and thirty-five pounds, that’s phenomenal. How does that not keep you motivated to get up every day when you don’t feel like getting up? You know, and I’ll repeat it, in King David’s words. You know when you had to encourage yourself because somebody is not always there to inspire you. So you do have to encourage yourself so you can be the best or somebody else that needs it more than you. Ultimately, someone has more complicated than you, and you can always help somebody under you.
Conclusion
Dr. Alex Jimenez recaps today’s podcast.
[00:21:52] Dr. Alex Jimenez DC*: Well, Daniel, you said it is very short and essential keywords. You know, we appreciate you. We’re here at the push fitness center. You know you got some information there that you can use to find Mr. Alvarado. The PUSH fitness center is a monster center with many people who care and change people’s lives. Suppose you guys have any questions, comments, or ideas about what we do for people. Let us know, and we’re here to serve as Daniel is. Thank you very much, brother, and I appreciate everything you’ve done. And God bless, brother.
Muscle spasms also referred to as muscle cramps, are painful contractions and tightening of the muscles. They are common, involuntary, and unpredictable. Temperature drops and cold weather can cause the muscles and joints to contract and tighten, leading to spasms and pain. Chiropractic, physical therapy massage, exercises, stretching, and an anti-inflammatory diet can bring relief and help strengthen the muscles to prevent future episodes.
Muscle Spasms
Spasms are common and can affect any of the muscles. They can involve part of a muscle, all of a muscle, or several muscles in a group. Spasms occur when the muscle/s involuntary and forcibly contract uncontrollably and are unable to relax. The most common sites for muscle spasms include:
As the weather gets colder, this causes the muscles in the body to lose heat, causing them to contract. As a result, the muscles and joints become tighter, stiffer, and decrease mobility and range of motion. This forces the muscles to work harder than usual to compensate. This can increase the fatigue of the muscles, leading to more prolonged bouts of pain and discomfort after physical activity, movement, exercise, etc.
Symptoms and Causes
A cramp can last a few seconds or last up to 15 minutes. During a muscle spasm, the following may be experienced:
Twitching in the muscle.
Pain in the muscle.
Throbbing.
Hardness and/or stiffness.
The muscles appear physically distorted.
Because the muscles have to work harder, the cold weather can increase muscle spasms. One of the most common causes of muscle spasms is overuse and fatigue. However, exact causes vary from person to person. Some experts believe that one or more of the following contribute to the spasms/cramps, and they include:
Dehydration.
Stress.
Not stretching the body regularly.
Muscle fatigue.
Restricted blood circulation.
Involuntary nerve discharge/s.
Over-exercising.
Exercising in the heat.
Exhaustion of salts and minerals:
Potassium
Magnesium
Calcium
Possible causes for leg cramps at night or nocturnal leg cramps specifically include:
Sitting for too long without moving around to keep circulation healthy.
Sitting with unhealthy posture.
Overusing the muscles.
Standing or working on hard floors.
Dealing With The Cold
One way to deal with the cold is to warm up before any physical activity. Taking a few minutes to get the heart rate up can increase the blood flow and flexibility of the muscles. This will ensure the muscles are functioning correctly and avoid the need to work harder to stop spasms. When a cramp strikes, there are a few steps to try to alleviate the spasm:
Stretching the affected area.
Massaging the affected area manually with a massage roller, percussive massager.
Stand up.
Move around.
Apply heat or ice.
A warm bath, shower with massage setting if possible.
Herzberg J. Stevermer J. Treatments for Nocturnal Leg Cramps. (www.aafp.org/afp/2017/1001/od3.pdf) Am Fam Physician 2017;96(7):468-469. Accessed 3/1/2021.
A neuromuscular massage is a form of manual massage used to release strained muscles. Strained areas are also known as trigger points that tend to be the cause of muscular pain symptoms. Trigger points are small areas of the muscle that contract the tissue. The lack of blood and nutrients in these areas causes an inability for the muscles to relax. The area becomes hypersensitive, causing fatigue, weakness, inflammation, and pain. Trigger points can lead to referred pain in which other areas of the body experience sensations of pain, tingling or numbness.
Neuromuscular Massage
Neuromuscular massage treatment involves applying alternating levels of concentrated pressure on the trigger point/s done through manual and instrument manipulation. Neuromuscular therapy is also called trigger point myotherapy. The American Academy of Pain Management recognizes this form of treatment as an effective treatment for pain caused by soft tissue injury.
Deep Tissue Massage
A deep tissue massage is generally used to address muscle aches and pains and is administered on an on-off basis. Neuromuscular manual therapy techniques are specialized and designed to correct pain and movement dysfunction by treating:
Neuromuscular massage is considered an ongoing treatment.
Massage Reduces Pain
Muscles, when spasming, are painful to the touch. The pain is caused by ischemic muscle tissue. Ischemia means the muscle is lacking proper blood flow because of the spasm. This causes adverse effects because the muscles are not receiving enough blood; the muscles also do not receive enough oxygen.
The lack of oxygen causes the muscles to produce lactic acid.
The lactic acid causes the muscles to feel sore following physical activity.
Neuromuscular massage therapy relaxes the muscles releasing the lactic acid, allowing the muscles to receive enough blood and oxygen. Neuromuscular therapy can feel painful at first, but the pressure of the massage will alleviate the muscle spasm/s. It is crucial to communicate with the chiropractor and massage therapist about the pressure – whether it is too much, too little, feels better, feels worse, etc. Massage therapy pressure should never be overly painful. Individuals often describe the pressure as good pain, where they can feel the difference. Following a neuromuscular massage, the soreness should fade after twenty-four to thirty-six hours. The tight muscles should remain relaxed for four to fourteen days, depending on activities and stress levels.
Massage Treatment
Medical issues and conditions for which neuromuscular massage can treat include:
Tendonitis
Headaches
Temporomandibular joint pain – TMJ disorders
Jaw pain
Carpal tunnel
Upper back pain
Low back pain
Sciatica
Hip pain
Knee pain
Iliotibial band syndrome
Calf cramps
Plantar fasciitis
Neuromuscular Massage Benefits
Individuals who undergo neuromuscular massage therapy can experience the following benefits:
Reduced and/or complete elimination of pain.
Increased blood circulation.
Body toxin release.
Increased flexibility and strength.
Better movement.
Improved posture.
Balanced musculoskeletal and nervous systems.
Increased energy and vitality.
Body Composition
Fatigue
When it comes to getting fit, remember it is a long-distance marathon, not a quick sprint. Whether physical, mental, or a combination, fatigue is a common obstacle for successfully reaching health goals. Physical fitness requires energy:
Energy for work or school.
Energy to set up the gear or get to the gym.
Energy for the workout.
Energy to prepare regular healthy meals.
Combined with the pressures of everyday life can make it a challenge to work out consistently. The objective is to make gradual changes rather than significant immediate changes. This will help prevent/avoid early burnout and help lead to maintaining healthy habits. One tip could be scheduling the workouts and meal prep time for the day or week when most active. For example, knowing that after work or school, the body can’t take a workout and needs to crash at the end of the day, set up the exercise for the morning or afternoon. And once the workouts become a routine, energy levels will improve, allowing for more activity.
References
Bervoets, Diederik C et al. “Massage therapy has short-term benefits for people with common musculoskeletal disorders compared to no treatment: a systematic review.” Journal of physiotherapy vol. 61,3 (2015): 106-16. doi:10.1016/j.jphys.2015.05.018
Field, Tiffany. “Massage therapy research review.” Complementary therapies in clinical practice vol. 24 (2016): 19-31. doi:10.1016/j.ctcp.2016.04.005
Furlan, Andrea D et al. “Massage for low-back pain.” The Cochrane database of systematic reviews,9 CD001929. 1 Sep. 2015, doi:10.1002/14651858.CD001929.pub3
Qaseem, Amir et al. “Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians.” Annals of internal medicine vol. 166,7 (2017): 514-530. doi:10.7326/M16-2367
A sports hernia is a soft tissue injury that happens in and around the groin area. It is a strain or tear of any soft-tissue muscles, tendons, or ligaments in the lower abdomen or groin area. It usually happens during physical sports activities that require fast, quick, sudden changes of direction and/or intense twisting movements. Despite its name, a sports hernia is not a hernia in the classic sense. The condition’s proper term is athletic pubalgia. However, a sports hernia can lead to an abdominal hernia. The condition can happen to both men and women.
Anatomy
The soft tissues most affected by sports hernias are the oblique muscles in the lower abdomen, along with the tendons that attach the oblique muscles to the pubic bone, are the most at risk. In many cases, the tendons that attach the thigh muscles to the pubic bone or adductors are also stretched or torn.
Core Muscle Injury
A core muscle injury is when the deep layers of the abdominal wall weaken or tear. This can cause nerve irritation and contribute to uncomfortable symptoms of numbness or tingling. The most common causes include:
Planting the feet and turning or twisting with maximum force.
Constant repetitive hip and pelvic twisting motions.
Imbalances between the hip and abdominal muscles can also, over time, cause overuse injuries.
Weakness in the abdominals and improper or no conditioning can also contribute to injuries.
Chronic groin pain is the primary symptom of a core muscle injury.
Sharp groin pain with exertion.
Basic movements like sitting down or getting out of bed can also present with pain or discomfort.
Pain on one side of the groin.
Pain or numbness that radiates into the inner thigh.
Pain when coughing or sneezing.
Tenderness or pressure on the lower abdominal area.
Pain decreases with rest.
Diagnosis
A doctor will discuss symptoms and how the injury occurred. They will run a series of strength tests like a sit-up or trunk flex against resistance. If it is a sports hernia, there will be tenderness in the groin or above the pubis, along with discomfort and pain. Further tests will include MRI, ultrasound, or X-rays to rule out hip, low back, or pelvis injuries to confirm a core muscle injury.
Non-Surgical Treatment
Rest
In the first 7 to 10 days after the injury resting and icing the area is recommended.
If there is a bulge in the groin, compression or a wrap can help relieve symptoms.
Chiropractic and Physical therapy
Two weeks after the injury, chiropractic adjustments and physical therapy exercises are recommended to improve strength and flexibility in the abdominal and inner thigh muscles.
For most cases, 4 to 6 weeks of chiropractic and physical therapy will resolve any pain and allow the individual to return to their exercise or sports activity.
Anti-inflammatory Medications
A doctor could recommend non-steroidal anti-inflammatory medications to reduce swelling and pain.
If the symptoms persist over a prolonged period, a doctor may suggest a cortisone injection.
If the pain comes back when resuming the physical activities, surgery could be needed to repair the torn tissues.
Surgical Treatment
Repairing the torn tissues can be done with a traditional open procedure that involves one long incision or a minimally invasive endoscopic procedure. In an endoscopy, the surgeon makes smaller incisions and uses a small camera, called an endoscope, to see inside the abdomen. The results of traditional and endoscopic procedures are the same. Most individuals can return to sports and physical activities 6 to 12 weeks after surgery.
Body Composition
Muscle Gain
Individuals can’t lose fat forever. At some point, they need to work on developing muscle or work to preserve the muscle that is already present. This requires a different diet and exercise plan than one designed for fat loss. Instead of getting the body into a catabolic state, the body needs to be in an anabolic state where the body builds tissue instead of breaking it down. To build muscle, the body needs resources meaning proper nutrition and sufficient protein intake to increase muscle mass. Maintaining an energy surplus of around 15% is appropriate for developing musculature, meaning a moderately active individual with a BMR of 1,600 calories would want to their intake to about 2,852 calories a day.
References
Hoffman, Jay R et al. “Effect of protein intake on strength, body composition and endocrine changes in strength/power athletes.” Journal of the International Society of Sports Nutrition vol. 3,2 12-8. 13 Dec. 2006, doi:10.1186/1550-2783-3-2-12
Larson, Christopher M. “Sports hernia/athletic pubalgia: evaluation and management.” Sports health vol. 6,2 (2014): 139-44. doi:10.1177/1941738114523557
Poor, Alexander E et al. “Core Muscle Injuries in Athletes.” Current sports medicine reports vol. 17,2 (2018): 54-58. doi:10.1249/JSR.0000000000000453
Thorborg, Kristian et al. “Clinical Examination, Diagnostic Imaging, and Testing of Athletes With Groin Pain: An Evidence-Based Approach to Effective Management.” The Journal of orthopedic and sports physical therapy vol. 48,4 (2018): 239-249. doi:10.2519/jospt.2018.7850
Tyler, Timothy F et al. “Groin injuries in sports medicine.” Sports health vol. 2,3 (2010): 231-6. doi:10.1177/1941738110366820
IFM's Find A Practitioner tool is the largest referral network in Functional Medicine, created to help patients locate Functional Medicine practitioners anywhere in the world. IFM Certified Practitioners are listed first in the search results, given their extensive education in Functional Medicine