Any job-related back injury can significantly complicate an individual’s life. Dealing with the pain, trying to figure out how to get things done while in recovery, and workers’ compensation to protect individuals who are injured on the job, getting them healthy without the stress of worrying about losing money from missing work.
Job-Related Injury
According to the Occupational Safety and Health Administration or O.S.H.A., a job-related injury is one that either contributed to or is caused by something in the work environment that injures an individual or exacerbates/worsens a previous injury. This is a general overview of the definition, and there are some exceptions. For example, being at the place of work as a general public citizen and not working when an injury happens will not be covered. If not sure whether a back injury is job-related, it’s better to be cautious and report the incident as soon as it happens.
Common Back Injuries
Back injuries are the most common job-related injuries. Back injuries are the number one reason individuals cannot work, whether they hurt their back at home or on the job. The Bureau of Labor Statistics found that nearly 40% of all musculoskeletal injuries that resulted in lost workdays were because of back injuries. The most common back injuries include:
Every state’s workers’ compensation program is different; however, the basic components are the same throughout. This means that if a workers’ compensation claim is approved and an individual cannot work because of their injury, they can expect to receive a regular base salary during treatment, rehabilitation, and recovery. Individuals also continue to receive medical coverage through the company, while the workers’ compensation fund should pay for treatment and diagnostics related to the injury.
When A Back Injury Occurs at Work
When a back happens at work, inform the employer as soon as possible. Do not be embarrassed or feel as if it is not a big deal to seek workers’ compensation. It is an insurance program for both the individual and the employer. An employer pays into the state’s workers’ compensation program for limited liability when employees get injured. Individuals don’t pay for the program, but it protects the individual in case something happens.
Letting an injury go untreated might not be anything at first, but months and years later, it can come back and be worse than when it first happened, causing greater damage, added medical costs, and procedures that the individual has to pay for out of pocket.
Once an individual knows they have a back injury, it is recommended to seek treatment as soon as possible to prevent worsening the injury or create new ones and develop a treatment, rehabilitation, and strengthening program. If an individual needs emergency care, tell the doctors about the work injury and precisely what happened. Emergency medical care should be sought out when:
There is a loss of function in any of the limbs.
There is a persistent numbness with the back pain.
There is nausea, dizziness, or vomiting after the injury.
There is a fever with back pain.
Loss of consciousness.
Loss of bowel or bladder control.
If the injury is not immediate and progresses gradually, but suspect that it is from work, it should be reported and examined by a medical professional.
Treatment
Proper treatment for a back injury depends on the severity of the injury. Those who prefer non-invasive, medication-free treatment are able to recover with chiropractic or physical therapy. Chiropractic doctors are experts in the spine and the musculoskeletal system. Chiropractic treatment is safe, and proven, and can help relieve pain, restore function, to get back to work safely.
Body Composition
Resistance Exercise
Resistance workouts are made to stress the muscles resulting in muscle gain. Resistance exercise makes the body adapt by growing the muscles to make them more capable of handling intense forces without strain. The stress of resistance exercise causes the muscle fibers to tear at the cellular level. Then, special muscle cells, known as satellite cells, jump into action to repair, rebuild, and grow the muscle. These types of exercises include high-intensity workouts or compound exercises that increase muscle growth. However, there needs to be a healthy balance between workouts and rest to support healthy hormone levels and maximize muscle gain.
Hormones
There are three primary hormones that stimulate muscle hypertrophy. They are:
Insulin-like growth factor 1 IGF-1
Growth hormone GH
Testosterone
Muscle protein synthesis is a critical process in muscle hypertrophy and happens after weight training. The hormones signal to the muscle to repair and rebuild after workout sessions. GH is released in high quantities during sleep, which is why proper sleep is needed to help reach body composition goals. When nutrition, workouts, and hormonal effects are combined, muscle-building happens. Figuring out the right balance is essential for reaching health goals.
References
Burton, A K, and E Erg. “Back injury and work loss. Biomechanical and psychosocial influences.” Spine vol. 22,21 (1997): 2575-80. doi:10.1097/00007632-199711010-00021
Taking it slow after spinal surgery is recommended to optimize a full recovery. What usually happens is that an individual starts feeling normal/better, so they begin to engage in a few daily activities. Then pain presents, letting the individual know that they have done too much too soon. The pain does not necessarily signal re-injuring the area, but recovery should be treated seriously. More than 50% of patients have successful spine surgery, but repeat surgeries do not tend to be quite as effective. Doing too much too early during recovery can result in severe re-injury or creating new injuries. So when can an individual get back to everyday life?
Surgery Recovery
Recovery after back surgery is different for everyone. Low back lumbar fusion surgeries usually require more recovery time than lumbar non-fusion surgeries, like:
Laminectomy – when the lamina portion of a vertebra is removed.
Microdiscectomy – the removal of abnormal disc material
Cervical spine surgeries.
Individuals who have undergone a procedure where two or more vertebrae have been surgically fused should expect a longer recovery. A typical timeline for lumbar fusion usually involves around three months. What happens is individuals want to get up and move, doing household activities almost immediately because they feel so good, but this is because of the pain medications. Strong pain medication use ends by four to six weeks. It is not until after 12 weeks or three months with post-operative chiropractic rehabilitation and physical therapy that individuals are encouraged to engage in specific physical activities that will optimize the healing process.
Taking It Slow With Certain Activities
Specific activities should not be engaged in after lumbar fusion surgery, as it requires a higher level of caution during recovery.
No Bending, Lifting, and Twisting
Bending, lifting, and twisting all require the direct use of the back muscles. Performing these movements can cause serious damage and hinder proper healing. Therefore it is recommended not to bend, lift, or twist for six weeks.
No Taking Baths or Swimming
Taking showers can be done right away with protective plastic or a sponge bath for a few days after surgery, but it is advised not to take baths or go swimming for three weeks.
No Cardiovascular Exercise
While the back may be feeling better after the spine surgery, cardiovascular exercise is not recommended for at least six to 12 weeks as it is too strenuous on the back. Light walking is fine, but the doctor and a chiropractor and physical therapist will develop a controlled, progressive exercise program for the individual. The program usually starts between 6 weeks and three months after surgery. This can include working out on an elliptical machine, a stationary bike, or easy treadmill walking.
Listening to The Body
The doctor will be clear about what can and can’t be done immediately following back surgery. Therefore it is crucial to follow the instructions to avoid any complications and listen to the body. Don’t push through activity or try taking on too much. Give the body and spine time to heal, taking it slow. There is time to get back to normal activities, but if re-injury or new injuries occur, rehabilitation/recovery could become the regular activity.
Body Composition
Malnutrition
Malnutrition is defined as deficiencies, excesses, or imbalances in an individual’s energy intake and/or nutrients. Protein-energy deficiency is one of the most common forms of malnutrition, and this health condition has an immediate and negative impact on body composition. The deficit wreaks havoc on skeletal muscle mass as the body progressively goes into starvation mode, breaking down the protein stored in the muscle for fuel.
Micronutrient deficiency is a lack of minerals and vitamins that support vital bodily processes like cell regeneration, immune system health, and eyesight. Common examples include iron or calcium deficiencies. Micronutrient deficiency has the most significant impact on normal physiological functions, processes and can happen in conjunction with a lack of protein-energy. This is because most micronutrients are obtained from food. Nutritional deficiencies of specific micronutrients can affect processes like building and repairing muscle; protein deficiency has a more pronounced effect on body composition because lowered protein intake can lead to muscle mass loss. Malnutrition and nutritional deficiencies in adults include:
Physical function, including handgrip strength and physical performance, diminishes.
Serious medical conditions can result from fluid accumulation like edema.
References
Daniell, James R, and Orso L Osti. “Failed Back Surgery Syndrome: A Review Article.” Asian spine journal vol. 12,2 (2018): 372-379. doi:10.4184/asj.2018.12.2.372
Kinesthesia is the body’s ability to sense movement, position, action, and location, also known as proprioception. An example is when moving the arm, the brain and body are aware that the arm has moved. When dealing with chronic back pain, individuals are unable to function normally with regular everyday movements causing discomfort.
Chronic back pain can make an individual feel like a stranger in their body, altering their perception. Tension develops throughout the body due to the pain, causing tightness and positional adaptations that are unfamiliar, awkward, and unhealthy for the musculoskeletal system. These body positioning changes continue while the individual is unaware of what they are doing, causing further strain and injury.
Kinesthesia
Kinesthesia is essential for overall coordination, balance, and posture as long as the movements are done correctly with proper form. Chronic back pain can affect kinesthesia differently. Individuals can misjudge and estimate that their bodies’ ability to lift, carry, or open something is more complicated or easier than it is. This can exceed the body’s tolerances, causing:
Strains
Sprains
Severe injuries
Once the back starts to hurt, this causes the individual’s sense of kinesthesia to compensate for the pain. As a result, individuals may knowingly or unknowingly attempt to carry out uncoordinated, awkward movements and positions, making things worse.
Motor Control
Motor control is the ability to control movement. When experiencing back pain, individuals adjust their motor control to avoid specific movements that cause back pain. Motor control adaptations and kinesthesia involve body positioning and heightened responsiveness to stimuli, like muscle spasms. Even moderate back pain can cause awkward and dangerous responses causing individuals to overcompensate or become too cautious, worsening or creating new injuries in the process. The body is performing movements that do not follow proper form, even though an individual thinks they are protecting themselves.
Building Healthy Proprioception
A recommended strategy for building kinesthesia to benefit the back and the rest of the body is yoga. Yoga helps build bodily sensory awareness. It trains the body when sending significant signals from the muscles, joints, and tendons back to the proprioceptive centers in the brain. This happens immediately and increases over time.
Yoga Poses
Creating positive awareness of the body’s movements will help relieve back pain as the body learns to feel, understand, and control the muscles. Here are a few poses to help, along with video links.
Body awareness is critical, but if an individual moves in a way that’s not natural to the body, it can cause injury. Kinesthesia and healthy posture can help avoid back pain and other health issues. A professional chiropractor can alleviate back pain, educate on proper form and recommend specific stretches and exercises to strengthen the body to prevent injury.
Body Composition
Magnesium
Magnesium supports a healthy immune system. It helps maintain:
Healthy bone structure
Muscle function
Insulin levels
Magnesium assists the body with ATP energy metabolism and acts as a calcium blocker. This reduces cramping and aids in muscle relaxation after physical activity/exercise. Magnesium is essential in biochemical reactions in the body. A slight deficiency can lead to an increased risk of cardiovascular disease and a higher risk of insulin resistance. Many magnesium-rich foods are high in fiber, like:
Studies have shown that consuming a diet rich in Magnesium also provides a higher intake of dietary fiber. Dietary fiber aids in:
Digestion
Helps control weight
Reduces cholesterol
Stabilizes blood sugar
The best sources of Magnesium include:
Spinach, swiss chard, and turnip greens
Almonds and cashews
Flax, pumpkin, and chia seeds
Cocoa
References
Meier, Michael Lukas et al. “Low Back Pain: The Potential Contribution of Supraspinal Motor Control and Proprioception.” The Neuroscientist: a review journal bringing neurobiology, neurology and psychiatry vol. 25,6 (2019): 583-596. doi:10.1177/1073858418809074
Tong, Matthew Hoyan et al. “Is There a Relationship Between Lumbar Proprioception and Low Back Pain? A Systematic Review With Meta-Analysis.” Archives of physical medicine and rehabilitation vol. 98,1 (2017): 120-136.e2. doi:10.1016/j.apmr.2016.05.016
Wang, Jinsong, et al. “Dietary magnesium intake improves insulin resistance among non-diabetic individuals with metabolic syndrome participating in a dietary trial.” Nutrients vol. 5,10 3910-9. 27 Sep. 2013, doi:10.3390/nu5103910
In today’s podcast, Dr. Alex Jimenez DC, Health Coaches Adriana Caceres and Faith Arciniega, Massage Therapist Amparo Armendáriz-Pérez, and Clinical Nutritionist Ana Paola Rodriguez Arciniega discuss today what they do and offer with Functional Medicine.
Discussion
Dr. Alex Jimenez introduces his guests.
[01:00:11] Dr. Alex Jimenez DC*: Welcome, guys. We’re here talking today about what we do. Today is a special day. It’s my father’s birthday, Alberto Jimenez. Alberto Augusto Jimenez. He is an immigrant from Colombia who gave me my knowledge. My amazing father. So happy birthday, dad. We’re going to be talking today is we’re going to be talking about what we do. We have a group of wonderful individuals here. We have five individuals. We have a whole lot more people in the background. So what we’re doing today is we’re beginning a process of notifying ourselves of a change that is going on. We’re going to be talking about nutrition, wellness, exercise, what we do in the office, how we do a little bit different techniques within the office, and how we compare and contrast to other services and let people understand what we do as we do change. So today, we’re in a new podcast room where we left the Push Fitness Center, which is now going to be another big, fantastic thing. So as they do the construction, we moved our podcast here. So you’re going to notice that we’re going to be communicating from this particular podcast. Still, we’re so connected to our Push counterparts and our Push Fitness centers and Daniel Alvarado, and we’ll be making that happen as it starts coming up. So today, we’re going to be talking about nutrition. I have Ana Paola Rodriguiez Arciniega here, so say hello there. We have Faith Arciniega. We have Adriana Caceres, and we have Amparo Armendáriz-Pérez as a massage therapist there. So we are going to be talking about different things. So each one of us has different specialties. So I’m going to start with some of the unique things we’re doing in our office, such as the types of treatments we do. We deal with a lot of inflammation, many injuries, a lot of trauma, and many soft tissue injuries. But you can’t get away from soft tissue injuries without discussing inflammation. So at the basis of inflammation, what we do is we associate, collaborate, find out the coincidence of inflammation to injuries, and we deal with the true causation of inflammation and come up with treating protocols and health care plans that affect people and their disorders. So many people come to us with a back injury or a neck injury after, let’s say, a motor vehicle accident, a car accident, or a work-related accident. But they may also have, you know, subclinical issues of inflammation that are just looming and then aggravate the direct trauma that’s going on. So what we’re going to do is introduce our team here one at a time so we can see what’s going on. And we’re going to start with Ana Paola Rodriguez Arciniega. Ana, how are you doing?
[01:02:57] Ana Paola: I am doing fine, and how are you doing?
[01:03:00] Dr. Alex Jimenez DC*: Good, can you hear us OK over there?
[01:03:02] Ana Paola: Yes, I can hear you, OK.
[01:03:04] Dr. Alex Jimenez DC*: Excellent. Tell us a bit of what you do, and we actually because you work hand-in-hand with us all here, and you are our virtual eye in the sky for nutrition at this point. But the nutrition that you deal with works a little bit with functional medicine. Tell us what you do and how we integrate that particular type of practice in our office.
Ana Paola Rodriguez Arciniega
Clinical Nutritionist Ana Paola Rodriguez Arciniega introduces herself and talks about what she does.
[01:03:23] Ana Paola: OK, so I am the head nutritionist, and basically, what I do is I take care of their nutritional assessment. But as you said before, we try to look for the root causes, and this allows us to create a more integral treatment plan for our patients, so that is focusing a little bit more on finding what is the root cause of the inflammation because it is related to injuries, accident, and stress, and to maybe delay the recovery part of our patients. So this is what we are trying to do to get like a fast track recovery for our patients for nutrition because it has to do with that.
[01:04:09] Dr. Alex Jimenez DC*: Yes. And then? Don’t worry.
[01:04:17] Ana Paola: OK, I’m here.
[01:04:18] Dr. Alex Jimenez DC*: It’s all technology. Just keep on going and telling me. We’ll figure it out as we go.
[01:04:22] Ana Paola: So what we always start doing is very simple. I try to focus on what is going on with my patient physically, which has a lot to do with the body composition of my patient. So I find that that is the principle, not the principle, but the first step could do it that way. So we try to integrate this body composition analysis with the Inbody 770 machine that we use. And that way, we can correlate all the body composition, either a fat mass percentage or BMI or muscle mass or lean body mass, that our patient has and try to associate with injuries or correlated with inflammation. And it is often, very often, or all of the time, that we find a direct correlation with inflammation or this type of injury. Specifically, talking about intracellular and extracellular water is one of the most exciting starting with my patients. But the thing about nutritional assessment is that even if it’s like separated into different parts, it kind of overlaps within each other, and that is like the thing that has in common with functional medicine, functional nutrition, then trying to treat your patient as a holistic, like a whole person and try to integrate the nutritional part of it, the fast recovery of an injury, the massage therapist and of course, all the wellness part of their recovery that has to do with our health coaches. So mostly, what I think that I do right here is that I perform for that. I am part of a team that integrates like a holistic care plan for patients.
Adriana Caceres
Health Coach Adriana Caceres introduces herself and explains what she does.
[01:06:28] Dr. Alex Jimenez DC*: Well said. That is very, very good. I have to tell you there is no separating inflammation, nutrition, and injuries that there’s no way. So as we deal with it, we can learn about it. It’s almost like saying exercising and not talking nutrition. We have to deal with nutritional components. Now, specifically that we are talking about exercise. Adrianna, here, she’s our specialist and our expert on exercise physiology. She works with nutrition. She has extensive experience of working with clients online and in video as well as in your home. So she gets in there and exercises with you as she does her thing. Adriana, tell us a bit of your experience and what you do and what you offer these particular dynamics with our team here.
[01:07:14] Adriana Caceres: Sure. Well, my name is Adriana Caceres, and I’m your health coach, fitness trainer, and of course, exercise specialist. And as Ana was saying, nutrition and exercise go hand in hand. Nutrition is the base, but exercise gives you the mobility and gives you that range of mobility that you need to live a proper and, well, life until you know when you age. So definitely, it’s the base for a lot of recovery for injuries. The stretching is super important, and we use that a lot here to stretch our patients and make them do their small stretching so they can grow their range of mobility and have a better life in their daily life, their daily style. Right now, I work online a lot. So since COVID started, we started working out online with our patients and clients, and it’s different. But at the same time is super fun. The difference between going to an in-person exercise session and doing an online session is that you don’t have the time. We always hear excuses like; I can’t make it. I don’t have the time. I’m too busy. I know that I’m in pain, but I just think it’s too far. So the online cuts all those excuses. I mean, you’re doing that from the comfort of your home. You are just opening your TV or your computer, laptop, or tablet and connecting to a session. It’s on your time. So that helps a lot. The second excuse we always hear is if we are parents who watch our kids, what will I do? There’s no daycare, and this is just the same thing. It’s at your home, so you can even involve your family in this new and different lifestyle. Usually, when we have somebody who is overweight, it is a family. It’s the household. Because of course, it’s the same poor nutrition that they have or bad nutrition that they have and the same habits. So starting with the workouts online helps you realize, or your household realize that it’s a group thing, it’s a whole lifestyle, and you want to be the role model for your kids. You always want the best for your kids, so you want to be the role model for them. Normally they will. If you’re overweight or have a little extra pounds on, your kids usually will have the same habits. And of course, we’ll tend to be with the same kind of overweight that you have. So this helps them see a life change experience and get involved in this new experience.
[01:10:12] Dr. Alex Jimenez DC*: You know, now that you mention that, you know, it’s essential to be the change that you expect in the world. I think Gandhi or something that says, might that be the change you want to see? Right. So the thing is, when you go purchase foods or exercise in front of your kids and see what you do, this is who they will become and what do we want for our children? We want the best. Our legacy is our family sometimes or our friends. And when you have family, they’re watching you. They learn they observe and appreciate mom, you know, wiggling around the living room and dealing with it. Everyone’s got memories of their parents exercising or doing something. And then, you know what happens, later on, we end up becoming our parents? Right. So if we have good habits, we eventually will become habits. I have become my father, and it’s the truth. The reality is in my son, and I listen to him. He doesn’t realize it, but he says everything I used to say. So it’s a continuous change. So if you’ve got nutrition and exercise, which seems to be one of the most extraordinary kinds of collaborative associative and treatment protocols, you can’t separate exercise from recovery. So Parkinson’s… exercise, Alzheimer’s… exercise, diabetes… exercise, brain disorder… exercise, health issues… exercise is such an essential component of fitness that by not doing it and not being part of it, you’re going to minimize the ability to return to an optimal configuration. Now, whether you like it or not, exercising mobility is one of the most important key factors. I realize that when you start working on so many patients over the years, you kind of start kind of seeing the intent of God. Right. So the intent of God is mobility, and he gives you tons of joints. I mean, why does he give you so many joints so we can wiggle, OK? To move, right? So using that and integrating the brain and the function of the brain with your body moving and pumping, and blood does heal a lot of issues and should be part of most treatment protocols. Even if exercise doesn’t look like, let’s say, a Zumba class, maybe it’s just wiggling around in a chair or doing certain things. We can do it for a lot of people. People think that I’ve seen from, you know, a nine-month literally about to have a baby, women doing CrossFit, and the baby is born fine. The body is designed to handle certain things too. Older adults about 100 years old, exercising. And children, they love to exercise. So it’s an essential component. So yes, that is what you do, Adriana, and we integrate that in the office, and we look or minimize the excuses to do that, so that’s very important. So do you also do nutrition a little bit?
[01:13:06] Adriana Caceres: Yes, I do. I’m a nutrition consultant, so I do help a lot with that part. As I said, it goes hand in hand, definitely to have a higher health span. You want to have a healthy habit, so one thing is lifespan, and one thing is healthspan, and lifespan comes out of years we’re going to live. Yes, eventually, we’ll die, and then our health span is how we want to live them. Are we going to leave them healthy our last ten years? Are we going to be able to walk? Are we going to able to say, are we going to be able to get out of a bathtub? So that’s what you want to have, and that’s what we don’t think about when we say, Oh, you know what? I know what I’m doing, and I don’t think exercising is for me. Everybody has a fitness level, and everybody has a way. And the trick for this is to find what you want to do. And what we do here is a lot of that we build up people and save injury, save from injuries and, you know, prolong their life and prolong how they live, their life, their daily activities.
Amparo Armendáriz-Pérez
Massage Therapist Amparo Armendáriz-Pérez introduces herself and talks about what she does.
[01:14:15] Dr. Alex Jimenez DC*: You know, it’s excellent that approach. Now we also have a young lady named Amparo Armendáriz-Pérez. So for Amparo, she does our massage. And what she does is she works on individuals with a deep level of knowledge of fitness. Now, she comes to us with a vast amount of personal experience working with people and her desire for health care. So I would like her to tell us. Welcome. And tell us about what you do in terms of massage as a component within this group.
[01:14:55] Amparo Armendáriz-Pérez: Thank you. Being here as a part of this family, this community of servers, because that’s what we do. We serve those that come to us. We’re all about education. So we’re listening to, you know, nutritional education, physical education on how to help them to make better choices for themselves. What I do is I discuss with our patients what I’m going to do for them, what’s happening as I put my hands on their muscles. What I feel, and they even ask me questions, Well, what is that? Why do I feel so restricted? What’s happening? So I enjoy helping them understand their own body with all my heart because they’re in their own body. We exist in our body, and we know we have hands and feet and all these components. But sometimes, when they’re not operating correctly, we don’t know why, and that’s very frustrating. And so, I enjoy discussing with the patients. OK, well, this is what I’m feeling, and how do you feel as I’m, you know, applying pressure here as we’re moving and grooving here? And the feedback is what helps them to accelerate. They want to learn more. They want to know; well, what else can I do? You know, when I go home, how do I prolong this feeling of feeling like I’m standing up straight now? Like I feel more empowered? You know, I didn’t realize my feet felt that way. I didn’t know my arm felt that way. And I understand where they’re coming from because massage therapy was one of my avenues of healing when I went through a healing process. So it’s just a fantastic tool to reach out to the patients and allow them to know that this is another way that we support them is not just OK; we’re going to do this one two three. No, it goes further than that. These are your muscles, and this is how you can assist yourself, and this is what we’re going to do for you. And you can take it a step further and understand that you have the power to help these muscles become more pliable through nutrition, exercise, movement, and anyway, shape or form. And you can put your hand on yourself and feel like, you know, that’s tight today. I think I can kind of touch that a little and massage that, and you don’t need a license to touch your arm. And I think that that’s what’s beautiful about what we do. We empower our patients, and that’s important.
[01:17:16] Dr. Alex Jimenez DC*: You know, when you were saying that in your approach, because I see that when you work on the patients, sometimes there are areas in the body that hurt. However, the human dynamics is that the body was designed with duality, such as one muscle affects another. The tricep, you know, pushes the bicep disengages. There’s a constant synergy with the muscular structure. Sometimes the pain or discomfort in those areas is remote or not, even in the area where you had, you know, you were initially told where the person’s issues were. Tell us a bit of that, Amparo. How you kind of tracked down the discomfort in, let’s say, an area over a problem that you’ve treated in the past.
[01:18:07] Amparo Armendáriz-Pérez: One of the most common areas I’ve experienced with many patients is when they discuss low back pain or sometimes even sciatic pain. And they tell me, you know, this is restricting me from sitting up straight. It’s restricting me from just going in the grocery store and walking to and from and not having to feel like I need to sit. And so, OK, I understand. And then they get on the table, and as I’m working on their back, I’m listening to what they’re saying. I also married together, what my hands are saying, and basically, my hands are just interpreting what their muscles are saying because sometimes, we can say something. I know in and out ourselves, OK, I feel this pain right here. However, the muscle is saying, well, something else is happening, and it’s extending, so they’ll tell me my pain is in the lower back while I follow the connection from that low back. And as I’m feeling alongside the side of their leg, I feel how tight it is, and it’s like, that’s got to be very restrictive down to the knee. And I’m like, OK, so let’s release that. And then as I’m working on that, it’s very powerful to hear the patient say, Wow, I can feel that, but you’re on my knee, and I’m like, It all goes together because the knee attachments go straight into the low back or into the hip area. And it was beautiful. Is that when they love to, everybody loves to learn about themselves? Why wouldn’t you want to know about yourself? It helps you become a better you. And so when I love to explain that to them, they’re like, Wow, so if I do this, I can feel better doing this. Absolutely. You know, ma’am or sir, right in here is where I’m touching. I’m massaging, and I’m applying compressions. It’s straightforward. It’s even over your clothes. I’m just playing some pressure right there, gently releasing, and they’re like, Wow, the movement is a lot better. And it’s interesting that just to the right around the knee, in the back and the front even, and it helps to release that low back pain.
[01:20:05] Dr. Alex Jimenez DC*: You know, you mentioned just like the referral pain patterns, it’s incredible. How the body adapts is like that gecko, you know, when it’s hot and lifts its left leg and throws up on a different leg; that’s what the human body works. So if you have a lower back problem, it will affect the mid-back. It will affect your knees. The knees and lower back are directly and indirectly related. So as we look at those dynamic changes. One of the things we look at as we track down the problem. OK, it’s not just so easy to treat a low back problem for what it is. We have to find out the problem for every person and every person’s design, and we can track it down quickly after a couple of minutes of working in your body. We got the suspect in, and it’s not so apparent many times that it’s just a low back problem. You mentioned sciatica. Sciatica is one of these things where it isn’t a disorder. It’s a group of syndrome disorders that creates a lot of drama, and it almost has its mind. It’s like, it’s like you’ve got stress or sciatica flares up. You got, you know, you get upset about financial worries, sciatica flares up. It’s like it sits there looming, and it bites you, and it causes a whole array of problems and hinders a lot of people, which we don’t want to do surgically. And sometimes, there are issues where it does require surgical intervention. We have diagnostic procedures to determine the differences over a thousand reasons, and I would venture to say there are even more than a thousand reasons for causing sciatica. So we got to get to the root cause of it. And does nutrition play? Yes. Will exercise play? Yes, we have to look at all these components. Now we have another individual here, that is Faith Arciniega. So Faith comes to us with a lot of great experiences. She’s going to be an incredible doctor, nurse practitioner. That’s the goal right now. She’s in the process of going through that, but she also does our health coach integration. So she does many different things from, you know, body compositions, as Ana mentioned, all the way to in laboratory tests and X-rays are integrated with Ana. So we facilitate the ability to communicate the issues, treat the problems, and develop an appropriate care plan. So Faith, tell us a bit of what you do here in this particular group of people?
Faith Arciniega
Health Coach Faith Arciniega introduces herself and explains what she does.
[01:22:27] Faith Arciniega: Absolutely. So as Dr. Jimenez mentioned, my name is Faith Arciniega. I bridged the gap between Ana and Adriana, and Amparo. We all work very closely together to ensure the patients leave here to understand better how their bodies should operate and function. So if the doctor goes in and finds out they’re having issues with their sciatica, I will go in before that gather together their medical history, see what’s going on, and see if they have problems with the gut. Depression, anxiety. And then, I would then communicate with Ana about those issues, and we can work together to find supplements or with the correct diet for them. So I work together with Ana and Adriana to ensure that the patient leads healthier and better understands their body because a car wouldn’t operate correctly. If we fill it with water, the human body will not function if we don’t fuel it correctly, so we teach them. How they should eat, what supplements they should take, and how they should exercise so that they’re moving and operating as they should be like the body was created to.
[01:23:26] Dr. Alex Jimenez DC*: You know, as like you, as you kind of work with patients, we mean right before we have this little unified meeting together. We noticed that we had a patient that had, you know, chronic inflammation and pain everywhere. And it’s crazy. But you know, the problem comes as a low back problem and leads to ankle issues. But we could see that there was a dietary issue, and it was almost like inflammation. No injury; keeps on inflaming. Then we find out that there’s a lot of sugar, many processed foods, a lot of meat. Well, to say that those are bad, it’s not just that easy, but we have to figure out the cause for that particular individual. We assess food sensitivities, and we do laboratory diagnostics. We figure out what it is the root cause. Not everything is a surgical procedure; as a matter of fact, most things are non-surgical. So what we try to do is is allow the intelligence of the body wants to figure it out, using the knowledge that we have and the expertise that we have in functional wellness and functional nutrition to be able to come up with a treatment plan that’s appropriate with exercise and the protocols that we use. So we have a lot going on here. So we wanted to do this as a beginning because we will be doing quite a few different presentations. But as we do changes, we haven’t been communicating well. So now what we’re going to be doing is we’re going to be coming back at different presentations, discussing particular topics. If you have a specific topic that you want us to discuss, particularly about an injury, inflammation, and a disorder that falls into the world of functional wellness and even functional medicine, we commonly associate and look for corporations related to the musculoskeletal system. So what we want to do is to be able to assess and determine the true causes because once we fix you, we want to improve you, right? We want to give you the tools to go on and live an extraordinary life because everyone here knows that I touted as much as possible. And man, if we’re designed to live 100 years and probably more, according to even the statisticians out there, if you take care of everything, the heart will continue to pump years after it’s removed from the body. So our body doesn’t get clogged with some atherosclerotic plaques or inflammatory disorders or some diseases or cancers; if we can keep it healthy, we will live a good life. God willing, God wants you to take you now. OK, so we all know that. So the focus of today was to present a little bit of a review. So Ana, thank you very much for helping us out. You know, a little bit of information there. You know, Faith, you’re out there. You’ve got the calm, soothing voice, and she’s cool with her voice there; you’ve got Amparo, which is our therapist that finds and tracks down. We got everyone here. We have many massage therapists that track down the issues. She’s just the one that has been able to formulate the ability to communicate the intention of the human body, which is and also the results, and that takes years to do. You can’t just go ahead and present yourself. Doctors worldwide will tell you a doctor that graduates, whether it’s in any clinical practice on his first day, is not the same doctor ten years later. And they’re like wine. They get better each time, and most of the time, you’ll find that doctors, the wiser they become, the more they rely on the wisdom of the body to manipulate and facilitate the healing process. So for Adriana, she’s our exercise, and she’ll have you dancing and doing the Zumba and seeing, you know, what’s best for you. And by the way, if you feel ugly that day, you can put the screen off, so you don’t have to be showing your body. You just know that she’s there, and you just tell her you’re doing the exercise. It’s pretty funny. Someone probably has the video off and is sitting there, you know, eating something. Yeah, I’m exercising, but we do have tools for that, like a cardio thing. They’ll tell us what your heart rate’s at; we will know if you are fibbing, but it doesn’t happen anyway. But anyway, it was a tremendous little connection today. It was the first, and we looked forward to more. Thank you, guys. Thank you very much, and does anyone have anything else to say. Faith, anything good, anything you want to add.
Conclusion
Dr. Alex Jimenez and crew recap on Functional Medicine.
[01:27:40] Faith Arciniega: No, just super excited for you all to come in here so that we can work together to find the best treatment plan for you. We’re all very passionate about patient care, and we’re excited to work with you.
[01:27:49] Dr. Alex Jimenez DC*: All right, Amparo?
[01:27:50] Amparo Armendáriz-Pérez: Just like, she said. We’re ready to help you be empowered. Understand that you are the boss of you.
[01:27:58] Dr. Alex Jimenez DC*: I’m the boss of me. I tell my wife that you know what she says all the time; you think you’re the boss of you, right?
[01:28:02] Dr. Alex Jimenez DC*: And like I’m saying, OK. Anyways.
[01:28:05] Dr. Alex Jimenez DC*: Ana, anything you have to say.
[01:28:10] Ana Paola: We’re so excited to work with all our patients, and we try to follow through and listen to all of the symptoms you’re having. So I guess that from our part, you will always have ears to follow through.
[01:28:32] Dr. Alex Jimenez DC*: Thank you so much. Adriana, anything?
[01:28:34] Adriana Caceres: Well, we are here waiting for all of you, and we have a great team, all very passionate, as you see. And we are just here waiting for you to come in, and we will help you resolve.
[01:28:47] Dr. Alex Jimenez DC*: We’re going to tear it up, guys. We’re going to tear it up. We’re going to make it. We’re going to happen. OK, so this is called Cobra Kai Chiropractic Center. OK, so if you think you’re going to come in here and just have a little talk? We’re going to get it on. We’re going to get it on with your body, and we’re going to take it to the next level. And yeah, we got to go, OK, we’re going to make the body what it should be, OK. And we’re going to release it without in pain, and it’s going to be a very comfortable dynamic. So thank you, guys, and we look forward to being connected the next one. So God bless you guys. Have a good one.
Psoriatic arthritis can develop in individuals who have psoriasis, affecting various joints, especially the knees. Psoriasis is a skin condition that causes skin cells to build up and form patches of itchy, dry skin known as plaques. Psoriatic arthritis is a long-term inflammatory disease that can cause inflammation, stiffness, and pain. Symptoms can progressively worsen over time without treatment. Early diagnosis is vital to minimize damage to the joints and slow the condition’s progress with treatment.
Psoriatic Arthritis
Psoriatic arthritis symptoms like stiffness and swelling can present differently from person to person. For example, some individuals with psoriatic knee arthritis will experience stiffness or pain in one knee, while others experience symptoms in both knees. Psoriatic arthritis in the knee can also cause swelling in the surrounding:
Ligaments
Tendons
Synovial membranes
Symptoms can also present in the:
Elbows
Feet
Hands
Symptoms
Symptoms usually begin between the ages of 30 and 50. Common symptoms include:
Stiffness after resting or sleeping.
Swelling.
Inflammation in the knee and surrounding area.
Warm or hot skin on the knee from the inflammation.
Pain in and around the joints, tendons, or ligaments.
Joint sticking, difficulty moving, or reduced range of motion.
Other symptoms include:
Back pain
Fatigue
Pain and redness in the eyes
Swollen fingers or toes
Difficulty walking from pain in the feet or Achilles tendon.
The severity of psoriasis does not determine psoriatic arthritis symptoms. Symptoms can go through a pattern of relapses and remissions. Individuals can have a sudden attack where symptoms get worse over a short time. After the flare-up, symptoms can improve as the condition goes into remission. Symptoms may not present for a long time until another flare-up. For example, an individual may have severe psoriasis but only mild psoriatic arthritis.
Causes
Psoriatic arthritis develops when the body’s immune system mistakenly attacks healthy cells and tissues. The faulty immune response causes the body to quickly generate new skin cells that stack on top of each other forming plaques. When the condition affects the joints, it leads to inflammation. While there is no apparent cause for psoriatic arthritis, researchers have found connections to genetics and the environment, as well as, individuals with close relatives that have psoriatic arthritis could be more likely to develop the condition. Other factors that could influence the development include:
Severe psoriasis
Traumatic injury/s
Obesity
Nail disease
Smoking
The condition can happen at any age, but according to the National Psoriasis Foundation, most individuals first notice symptoms about ten years after their psoriasis begins. However, only 30% of individuals with psoriasis develop psoriatic arthritis.
Diagnosis
Doctors use imaging tools to diagnose psoriatic arthritis in the knee. They will use:
MRI
X-rays
Ultrasound
To help them check for irregularities or signs of inflammation in the joint and surrounding tissues.
Additional tests are used to rule out other common forms of arthritis like rheumatoid and osteoarthritis.
Blood tests check for inflammation and specific antibodies.
In some cases, a small amount of fluid from the joint is taken to help eliminate the possibility of other underlying conditions like an infection.
Treatment
There is currently no cure for psoriatic arthritis, but treatments are being developed and show promise for long-term management. Current treatments focus on managing symptoms and improving the quality of life for the individual.
Biologics
Biologic medications like tumor necrosis factor or TNF inhibitors are recommended as the first-line therapy for most individuals with a new diagnosis of psoriatic arthritis. These meds help block TNF, which plays a crucial role in inflammation. They have shown to be effective at reducing the severity of symptoms and the frequency of flare-ups. Biologics can cause unwanted side effects, especially in individuals that experience frequent infections and need routine monitoring.
Small Molecule Medications
Individuals that cannot use biologic medications may be recommended a new class of medication called oral small molecules or OSMs. Examples include apremilast – Otezla and tofacitinib – Xeljanz.
Disease-modifying Antirheumatic Drugs
Disease-modifying antirheumatic drugs – DMARDs are a long-term option. They are used to slow the progression of psoriatic arthritis, and examples include methotrexate and cyclosporine. DMARDs work best when an individual begins taking them as early as they can take time to work. However, individuals are encouraged to continue taking them, even if symptoms do not improve right away.
Easing Inflammation
A doctor may prescribe nonsteroidal anti-inflammatory drugs – NSAIDs and corticosteroid injections when knee symptoms flare-up. These are short-term treatments that provide immediate relief, as long-term use can lead to side effects. Individuals can find relief with combined self-care that includes:
Taking over-the-counter NSAIDs like ibuprofen/Advil or naproxen/Aleve.
Applying ice and heat packs.
Gentle exercise to promote a full range of motion.
Gentle stretching or yoga can help relax tight muscles.
However, chiropractic is not the primary treatment for arthritis but is intended to be used in combination to relieve pain, loosen and stretch the muscles and balance the body.
InBody
Strength, Balance, and Improved Body Composition
Functional fitness is the ability to move comfortably every day. The benefits of physical activity also contribute to improved body composition. Working to reach a certain level of functional fitness can help the aging process that has been shown to reduce metabolic rate. Inactivity is why individuals lose Lean Body Mass as they age, leading to increased body fat. Lean Body Mass contributes to the body’s overall Basal Metabolic Rate or BMR, also known as metabolism. This is the number of calories the body needs to support essential functions. Everyone is encouraged to engage in strength training or resistance exercises, but specifically older adults. This can help regain muscle loss which can lead to an increase in lean body mass. The increase in Lean Body Mass increases BMR, which helps prevent fat gain.
References
Chang, K. L., et al. (2015). Chronic pain management: Nonpharmacological therapies for chronic pain [Abstract]. www.ncbi.nlm.nih.gov/pubmed/25970869
Chiropractic care for arthritis. (n.d.). arthritis.org/health-wellness/treatment/complementary-therapies/physical-therapies/chiropractic-care-for-arthritis
The previous article talked about how photobiomodulation or low laser therapy can help improve the gut microbiome. Today’s article gives an in-depth look at how photobiomics can provide the therapeutic potential to the gut. When it comes to the gut, an individual must take care of it. Supplying it with wholesome, nutritional food feeding the good bacteria will provide outstanding results like more energy throughout the day, the feeling of being full, weight loss, and healthy brain function. By eating these nutritional foods, the body can feel good; however, when harmful bacteria come into play and starts attacking the gut, it causes the gut microbiome to have all sorts of problems that can turn into chronic pain. Some of the ailments can be leaky gut, IBS, and inflammation, to name a few. When these harmful pathogens affect the gut, it can cause the body not to function correctly and dampen a person’s ability to go about their everyday life.
Photobiomodulation Works With The Gut
So how does photobiomodulation work with the gut microbiota? Research studies show that when photobiomics are being applied to the gut, the low laser wavelength can help rebalance what is happening to the gut and maintain diversity in the gut microbiota. It can sustain a healthy production of vital metabolites, and the diversity can help the gut from getting many harmful bacteria from causing too much trouble in the gut. Not only that, but photobiomodulation therapy affecting the gut, directly and indirectly, gives it a mimicry of the circadian clock from the brain. Since the brain and gut are connected with the brain giving signals to the gut microbiota to regulate and produce the bacterial metabolites.
The Brain-Gut Connection
The brain and gut connection is more of consistent bidirectional communication between the brain and gut. Studies show that the gut and brain connection ensures the proper maintenance of gastrointestinal homeostasis and has multiple effects on motivation and cognitive functions in the body. When inflammation comes to play in the gut; however, it can affect the gut to not work properly and disrupt the signals it is receiving from the brain and vice versa. When there is a disruption in the bacterial diversity in the gut, it can decrease the brain’s circadian rhythm. The disruption of the bacterial diversity of the gut can even reduce vitamin D absorption in the gastrointestinal tract, causing inflammation and heightening the effects of autoimmune properties that the body is experiencing.
Vitamin D and Photobiomics
Studies have shown that vitamin D plays an essential role in bone health and regulating gastrointestinal inflammation. This is huge since vitamin D has anti-inflammatory properties and can dampen the effects of Crohn’s disease, ulcerative colitis, and IBD or inflammatory bowel diseases. Vitamin D has many beneficial properties since it can help improve the body’s immune system and has anti-inflammatory properties. Anyone who takes vitamin D in supplement form or food form as part of their daily ritual will notice that they have more energy in their system and feel good overall. That is because vitamin D can modify the integrity of the epithelial cell in the gut and increase the composition and immune response to the gut microbiome. When vitamin D and photobiomics are combined, it can restore the vitamin D receptors in the gut and cause improvements to body immunity and bone health and dampen the inflammatory effects that were causing harm to the body.
The Vagus Nerve
Another unique fact that photobiomodulation can help is that it can improve low vagus nerves in the brain. Since the brain and gut are connected, it shows that photobiomics can help the brain by decreasing the inflammation receptors that are disrupting the brain-gut connection and causing problems to the body. The vagus nerve is a part of this connection since it sends the information back and forth from the brain to the gut. Studies show that the vagus nerve is represented as the main component of the parasympathetic nervous system. This means that the vagus nerve can oversee many crucial bodily functions, including sending information between the brain and gut. Not only that, but the vagus nerve represents an essential link to neurological and inflammatory responses to the body. When inflammation affects the gut and the vagus nerves, it can disrupt the signals to the brain, causing the inflammation to become worse and hurting the body. Treatments like photobiomodulation can target the vagus nerve and help increase the vagal tone in the body and inhibit cytokine productions.
The 4 R’s
When the body is being affected by inflammation, treatments can help the body feel a bit better and start recovering. With photobiomodulation therapy and natural foods that are beneficial to the gut can bring the balance of a healthy lifestyle back to a person. For a better gut, doctors have recommended the 4’s for gut health.
The First R: Remove
REMOVE– Removing foods that a person has a food sensitivity or allergic reaction to can help dampen the effects of inflammation to the gut. These can be common foods like dairy and wheat or processed food containing high fats and added sugars.
The Second R: Replace
REPLACE– By replacing processed food with wholesome, nutritional food that is chalked up with the necessary vitamins and minerals can give the body more energy and put the person in a good mood. Thus, helping the gut produce more enzymes to digest the nutritional foods.
The Third R: Reinoculate
REINOCULATE– Adding prebiotics and probiotics into your recovery process can help improve the beneficial bacteria in the gut. Fermented food is a great way to get the necessary probiotics and prebiotics into the gut.
The Fourth R: Repair
REPAIR– Eating certain food that can help repair the gut lining in the gut microbiota ensures that inflammation won’t flare up due to gut stress. Adding fermented foods, butyric acid, L-glutamine, and aloe vera into a person’s diet is excellent in gut repair.
Conclusion
Overall, gut health is essential to the human body as it helps the body function properly. With the help of photobiomodulation, it can help the recovery process. Since photobiomics are still providing excellent results to treat patients with inflammation, it is necessary to combine whole, nutritional foods and the proper supplements into the everyday lifestyle so the body doesn’t have specific ailments like inflammation. This new combination has opened the doors to many new avenues of effective treatments for inflammation and improving overall body health and wellness.
References:
Breit, Sigrid, et al. “Vagus Nerve as Modulator of the Brain-Gut Axis in Psychiatric and Inflammatory Disorders.” Frontiers in Psychiatry, Frontiers Media S.A., 13 Mar. 2018, www.ncbi.nlm.nih.gov/pmc/articles/PMC5859128/.
Carabotti, Marilia, et al. “The Gut-Brain Axis: Interactions between Enteric Microbiota, Central and Enteric Nervous Systems.” Annals of Gastroenterology, Hellenic Society of Gastroenterology, 2015, www.ncbi.nlm.nih.gov/pmc/articles/PMC4367209/.
Silverman, Robert G. “Photobiomics: A Look to the Future of Combined Laser and Nutrition Therapy.” Chiropractic Economics, 5 Oct. 2021, www.chiroeco.com/photobiomics/.
Tabatabaeizadeh, Seyed-Amir, et al. “Vitamin D, the Gut Microbiome and Inflammatory Bowel Disease.” Journal of Research in Medical Sciences: The Official Journal of Isfahan University of Medical Sciences, Medknow Publications & Media Pvt Ltd, 23 Aug. 2018, www.ncbi.nlm.nih.gov/pmc/articles/PMC6116667/.
Video gaming has grown to over 150 million individuals in the United States playing. Around 60% of Americans play video games every day, with the average gamer being 34 years old. Playing video games for an extended amount of time takes a toll on the body. Individuals are experiencing the same kind of pains and aches from sitting and standing all day at work or school. Sitting positions, holding the controllers, and the different accessories can impact the nerves, muscles, and Posture. E-sports professionals understand the physical toll their bodies take with constant practice, tournaments, clinics, etc. They do cardiovascular conditioning, strength train, and stretch to improve their gaming abilities and also take into account:
Taking steps can prevent strain, injuries and minimize the risk of long-term damage. If strain and injuries are present, professional chiropractic treatment can help alleviate the pain, rehabilitate/strengthen the muscles, ligaments, tendons, and recommend exercises and stretches.
Video Gaming Posture
Proper Posture is vital to maintaining spinal as well as overall health. Poor Posture is the most common cause of back and neck pain.
Video Gaming Positions
Common gaming positions include the couch slouch where the gamer is slumped back into the couch with their feet up. This can lead to low back pain and sciatica. The full-on position is where the individual leans forward, elbows on their knees, head tilted forward, and staring up at the screen. Hours in these positions cause the neck, back, and other body areas to stiffen, generating soreness from the restricted movement. Many gamers use ergonomic gaming chairs. They have found that using the gaming chair improves Posture, eliminating the forward head and rounded shoulders. Gaming chairs can provide the health benefit of sitting correctly, reducing and eliminating neck and back tension or strain.
Injuries and Health Issues
Common musculoskeletal issues caused by excessive gaming and lack of movement include:
Eyestrain
Headaches
Neck pain
Elbow, arm, wrist pain
Thumb pain
General hand pain
Carpal tunnel syndrome
Postural stress
Back pain
Chiropractic Treatment
Shoulder Massage
The intensity of gaming can cause the shoulders to tense up and stiffen. When using the controller, the shoulders can slightly lift, building up lactic acid, interrupting blood circulation, causing an accumulation of unwanted toxins inflaming trigger points. A chiropractic massage will release tightened muscles, provide relaxation, and increase the blood flow.
Hand and Wrist Treatment
The most used body parts for video games include the hands and wrist. Individuals grip the controllers or constantly use the keyboard and mouse. No matter what form of input is used, prolonged use can cause hand and wrist injuries. Injuries include:
Inflammation
Hand muscle aches
Chiropractic focuses on specific areas to help treat the body through a hand and wrist massage. Advanced techniques include electrical muscle stimulation to help stimulate and loosen the muscles. A chiropractor will recommend stretches and exercises, and hand/wrist supports, guards, or special gloves to alleviate muscle pains while still playing.
Neck and Back Adjustments
Poor posture can result in a misaligned spine or back muscle spasms. During extended game sessions, pain and fatigue can begin to present. A chiropractic adjustment can realign the muscles and set them back in place. The tissue surrounding the neck may thicken and focus on a specific area. Leaning too far forward or using a heavy gaming headset can result in a forward head posture placing a constant strain on the neck. Chiropractic adjustments will loosen the tissue and release any tension. Stretches and exercises will be recommended as well.
Body composition refers to how various substances in the body are proportioned. A few examples of the components that make up the body include:
Water
Protein
Fat
Minerals
All of these components generate balance in the body. When individuals exercise, they begin to notice changes in their body composition. For individuals that exercise regularly, it is vital to track weight gain, weight loss, and changes in body composition. This is to ensure that they aren’t losing muscle mass. As individuals exercise, muscle fibers are torn. During the recovery process, muscles are rebuilt. Overtraining can lead to muscle mass reduction because the body cannot catch up and rebuild the number of muscle fibers, eventually leading to lost muscle.
References
Emara, Ahmed K et al. “Gamer’s Health Guide: Optimizing Performance, Recognizing Hazards, and Promoting Wellness in Esports.” Current sports medicine reports vol. 19,12 (2020): 537-545. doi:10.1249/JSR.0000000000000787
Geoghegan, Luke, and Justin C R Wormald. “Sport-related hand injury: a new perspective of e-sports.” The Journal of hand surgery, European volume vol. 44,2 (2019): 219-220. doi:10.1177/1753193418799607
McGee, Caitlin, et al. “More Than a Game: Musculoskeletal Injuries and a Key Role for the Physical Therapist in Esports.” The Journal of orthopedic and sports physical therapy vol. 51,9 (2021): 415-417. doi:10.2519/jospt.2021.0109
McGee, Caitlin, and Kevin Ho. “Tendinopathies in Video Gaming and Esports.” Frontiers in sports and active living vol. 3 689371. 28 May. 2021, doi:10.3389/fspor.2021.689371
Zwibel, Hallie et al. “An Osteopathic Physician’s Approach to the Esports Athlete.” The Journal of the American Osteopathic Association vol. 119,11 (2019): 756-762. doi:10.7556/jaoa.2019.125
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