Can neurological physical therapy help individuals diagnosed with a recently acquired or chronic neurological condition gain strength and functioning?
Neurological Physical Therapy
Neurological physical therapy can be extremely beneficial. It aims to restore functional mobility, strength, balance, and coordination in those with neurological conditions that affect their quality of life and ability to move around. It also helps recover from neurological injuries or prevent the progression and worsening of chronic neurological conditions. Depending on the severity of the condition, individuals may receive this therapy as an inpatient or outpatient. Exercise can help improve mobility, increase independence, and decrease the need for assistance, all of which can improve one’s quality of life.
Process
Neurological physical therapy is geared toward treating individuals with conditions affecting the brain and spinal cord, such as stroke, spinal cord injury, and Parkinson’s disease, to help restore mobility and function. The therapy is performed in hospitals, private practice physical therapy clinics, doctors’ offices, rehabilitation facilities, or at a patient’s home. Whether an individual needs inpatient or outpatient physical therapy will depend on the severity of the neurological condition.
Newly acquired neurological conditions such as strokes or traumas like spinal cord injuries and traumatic brain injuries or TBIs often require inpatient rehabilitation.
Once the patient gains enough strength, coordination, and independence with movements like standing and walking, they can progress to outpatient physical therapy.
The patient will undergo a physical exam after a physical therapist has gathered enough information about medical history during the initial evaluation.
The therapist will check muscle strength, coordination, range of motion, reflexes, and the muscle tone of the arms and legs. They may also perform neurological tests to examine coordination, such as following moving objects with the eyes, touching the finger to the nose, and rapidly alternating movements.
The individual general level of attention, cognition, and sensation will also be assessed to determine if these areas have been affected by the neurological condition. (Cleveland Clinic, 2022)
The therapist will then assess the patient’s ability to perform movements called transfers, which are transitions to and from positions such as lying down to sitting up or standing up to sitting.
They will note if the patient can perform these movements independently or if they need assistance.
The initial evaluation will also include an assessment of balance, quality of gait, and whether the therapist needs to assist.
Depending on the severity of the neurological condition, the therapist may provide the patient with or recommend purchasing an assistive device to help walk.
Treatment Sessions
During therapy sessions, patients may receive the following interventions:
Gait Training
To improve walking ability, proper instruction on using assistive devices such as canes, walkers, and crutches.
Balance Training
To improve static/stationary and dynamic/while moving balance, both sitting unsupported to improve core control and standing upright with or without handheld support.
Therapeutic Activities
To improve independence with bed mobility skills like rolling and sitting up from lying down and transfers on and off beds, chairs, and toilets.
Therapeutic exercises for stretching and strengthening muscles and improving coordination and motor control.
Endurance Training
This can be done with cardiovascular equipment like treadmills, stationary bicycles, and ellipticals.
Vestibular Therapy Interventions
Balance exercises with head movements and exercises to treat a common cause of dizziness are used to improve eye movement control.
Examples are the Dix-Hallpike and Epley maneuvers.
Conditions
Neurological physical therapy can treat various conditions. Some neurological conditions are progressive, worsening over time, and require regular physical therapy and at-home exercises to maintain optimal health and wellness. Neurological conditions that can be treated with physical therapy include: (Cleveland Clinic, 2022)
Strokes – loss of blood supply to the brain.
Spinal cord injuries – damage to part of the central nervous system resulting in loss of movement and control.
Polyneuropathies – damage to the peripheral nerves.
Traumatic brain injuries – for example, concussions.
Cerebral palsy – a group of disorders affecting movement, balance, and posture.
Multiple sclerosis – a disabling disease of the brain and spinal cord.
Parkinson’s disease – a progressive nervous system disorder.
Guillain-Barre syndrome – an autoimmune disease attacking the nerves.
Amyotrophic lateral sclerosis/ALS, also known as Lou Gehrig’s disease.
Vertigo, including benign paroxysmal positional vertigo or BPPV.
Neurological conditions, like an automobile collision, can occur suddenly or be progressive, such as Parkinson’s. Physical therapy helps those individuals by increasing their use of weakened muscles, improving their motor control, coordination, and balance, and facilitating their independence with daily tasks and movements. Always seek immediate medical attention for any sudden, unexplained muscle weakness. Individuals who experience skeletal muscle weakness should discuss the type and duration of symptoms with their doctor, specialist, physical therapist, or chiropractor, as this might be a sign of a medical condition such as a neuromuscular disorder. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop a personalized treatment program through an integrated approach to treat injuries and chronic pain syndromes, improving flexibility, mobility, and agility, relieving pain, and helping individuals return to normal activities. If other treatments are needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments.
Individuals with the autoimmune disease lupus may be more sensitive to sun exposure. Are there ways to help protect the skin?
Lupus Sun Exposure
Lupus is an autoimmune disease in which the body mistakenly attacks the joints, muscles, and skin. Around 5 million individuals worldwide, and 1.5 million in the United States, have been diagnosed with lupus. The disease is most common in early to mid-adulthood, and 90% develop in women. (Lupus Foundation of America, 2021) For some, the symptoms manifest as joint swelling or muscle soreness. Skin rashes, mottling or red or purple marbled skin, and sun sensitivity are common lupus symptoms. (Medline Plus, 2024) While exposure to UV radiation from natural and artificial light can be damaging to everyone, minimal exposures can cause a flare-up for those with chronic lupus.
Certain medications can impact individual sensitivity to the sun and UV radiation.
Sun Exposure
Lupus can increase photosensitivity or immune system reaction to the sun’s rays. This symptom affects 40% and 70% of individuals with lupus. (Lupus Foundation of America, 2021) UV radiation damages cells and alters DNA. However, the damage can be more severe in those with lupus because their cells are more sensitive, and damaged cells are removed from the body more slowly, which can cause an attack on the immune system. (Lupus Foundation of America, 2021)
Symptoms
UV light and certain artificial light sources can trigger reactions in those with lupus. These reactions can happen immediately or develop weeks later and include: (Lupus Foundation of America, 2013)
Rashes or skin lesions that appear after sun exposure can come and go within hours or days, or they can last for months. (Lupus Foundation of America, 2013) UV light can also cause a lupus flare-up of symptoms, including fatigue, joint pain, tingling, and numbness. (Lupus Foundation of America, 2021)
Protection
Protecting the skin from UV radiation is recommended for everyone, but it is especially important for individuals with photosensitivity from lupus. Some strategies to protect the skin include.
Sunscreen
Applying sunscreen to the skin provides a chemical or physical barrier to UV radiation. (MD Anderson, 2024) Most commercial sunscreens offer a combination of protection:
Physical Barriers
These include minerals like titanium dioxide or zinc oxide.
The finely ground minerals lay on top of the skin’s surface and reflect UV rays away.
Chemical Absorbers
These offer a thin, protective film that absorbs UV rays before they can penetrate the skin.
Proper sunscreen application is crucial, regardless of which type is chosen. The recommended application is to apply a palmful of sunscreen every two hours or more often if it gets wet or sweaty. Look for sunscreens that offer broad-spectrum protection against:
Ultraviolet A (UVA) rays
Ultraviolet B (UVB) rays
A sun protection factor (SPF) of at least 30 is recommended.
Most clothing offers protection against UV radiation.
Individuals can purchase clothing or hats with UV-blocking properties or washing products for their clothes to increase their level of UV protection. (American Cancer Society, 2024)
Sunglasses are also important against UV radiation, eye damage, and other problems.
Utilize Shade Areas
In the summer, the sun is strongest in most locations between 10 a.m. and 4 p.m. UV rays can pass through windows, and the body is exposed to UV radiation on cloudy days (American Cancer Society, 2024). Avoiding sunlight or other strong sources of UV radiation will help protect the skin. Staying indoors or in shaded areas is the best choice during these hours.
Seeing a Healthcare Provider
Lupus treatment varies and changes over time. Individuals with lupus schedule regular appointments with their healthcare provider to review treatment and symptoms, especially after sun exposure. Avoiding sun exposure by seeking shade and wearing sunscreen and protective clothing can help reduce the chances of experiencing a flare-up. Some cases of photosensitivity are mild, while others can require more intense treatments to avoid larger flare-ups.
Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop a personalized care plan for each patient through an integrated approach to treating injuries and chronic pain syndromes, improving flexibility, mobility, and agility programs to relieve pain and help return to normal and optimal function. If other treatments are needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments.
Can incorporating walking help accomplish health goals for individuals trying to burn fat?
Walking To Burn Calories and Fat
Walking has many wonderful benefits that include:
Improving fitness
Strengthening bones
Easing joint pain
Improving mental health
What to know
Taking it easy at first and steadily working on the basics can help individuals reach their health goals. Two keys to burning more fat when walking are:
Walk with enough speed and intensity to burn fat for energy.
The longer you walk, the more stored fat is burned instead of the sugars for quick bursts of exercise.
While any exercise can burn calories, brisk walking and other aerobic exercises are especially recommended for burning internal abdominal visceral fat. This fat contributes to the waistline and increases the risk of diabetes and heart disease. (Bairapareddy, K. C. et al., 2018)
Fat-Burning Zone
The American Heart Association categorizes brisk walking at a pace of 2.5 miles per hour as a moderate-intensity aerobic activity. (American Heart Association, 2024) The target heart rate for exercising at this level of intensity should be 50% to 70% of an individual’s maximum heart rate. For more vigorous activities, the heart rate should be about 70% to 85% of an individual’s maximum heart rate. (American Heart Association, 2021) Working out at a low to moderate intensity can help burn fat because the body uses stored fat as fuel compared with workouts of higher intensity that depend on carbohydrates. (Carey D. G. 2009)
The heart rate range for this zone varies by age. An age heart rate zone chart can help individuals find the right numbers. While exercising, take your pulse to check your heart rate. Heart rate apps and pulse monitors have been built into activity monitors and smartwatches. While exercising in this zone, breathing is heavier, and there is a feeling of increased exertion and sweating, but individuals should be able to carry on a conversation. (Centers for Disease Control and Prevention, 2022)
Beginners should gradually build up walking time and speed.
A beginner’s walking plan starts with 15 minutes daily, five days a week, and continued improvement in walking technique.
Increase walking time by 5 minutes per session each week.
Increasing Walking Intensity
If the heart rate is still below 60% of the maximum heart rate, individuals need to intensify the workout to burn fat. Ways to do this include:
Adding Distance and Time
Make the walk longer to keep the body working harder and maintain a brisk pace. Adding additional minutes will burn additional stored fat. However, since not everyone has the time there are other options.
Picking Up The Pace
Even for a short walk, make a goal to perform faster than normal, walking faster using correct posture, arm motion, and a powerful stride. It can help to time the walking route and challenge yourself to complete it faster each time. One study looked at individuals walking 3.6 miles per hour, 4.1 mph, and 4.6 mph. Accelerating to 4.6 mph burned more than 50% more calories than going from 3.6 mph to 4.1 mph. (Schwarz, M. et al., 2006)
Adding Intervals
Intervals add intensity and also help increase the overall pace. The aforementioned strategies to walk faster incorporate intervals, where individuals increase their speed for a set distance or time, alternating with a slower pace. Research on individuals with diabetes found that those who did interval walking for four months lost six times as much weight as those who walked steadily. (Karstoft K. et al., 2013)
Adding Hills and/or Stairs
Incorporating hills or stair-climbing into some walking sessions helps you stay challenged and makes workouts more intense. If there is no access to outdoor hills or stairs, use a treadmill – start with a slight incline and work up to a steeper one, or get on a stair-stepping machine at the gym. There is no need to walk briskly on hills, as one study showed that walking slowly on an incline was an effective workout that didn’t cause knee joint stress, especially for obese individuals. (Haight, D. J. et al., 2014)
Switch Up Workouts
Mix up different walking workouts like intervals, short and fast walks, and long and moderate walks. Meditative, mindful walks also have stress-reducing benefits that help lower cortisol, which can contribute to weight gain. Individuals who can’t spend 45 continuous minutes walking make the most of the available time. Try and fit in two to four 15-minute walks at a brisk pace. It’s also recommended to include other types of moderate-intensity exercise and activities that include:
Bicycle riding on level terrain
Water aerobics
Using an elliptical trainer
Ballroom dancing
Gardening
Doubles tennis or pickleball
Challenge the body in new ways to burn fat, build muscle, and raise basal metabolic rate. With a boosted metabolism, the body burns more calories all day.
Sample Walking Workout
You can use a treadmill or walk outside. Make sure you have athletic shoes that are flat and flexible and have the proper support and cushioning for a long walk. Wear breathable clothing, which allows freedom of movement and wicks away sweat.
Warmup
Start with 5 to 10 minutes of easy walking, increasing speed gradually.
The warmup is important to burn stored blood sugar and deplete the ready energy stored in the muscles.
This signals the body that a longer exercise session is underway.
As a result, the body prepares to burn stored fat.
Pick Up The Speed
To burn fat, the body needs to be in the fitness zone, with a heart rate of 60% to 70% of the maximum heart rate.
Check heart rate every 10 minutes to stay in the zone.
Stay In The Fitness Zone
For 30 to 50 minutes or more.
If your heart rate dips, pick up the speed.
Cool Down
End with 5 to 10 minutes at an easier pace to cool down.
Injury Medical Chiropractic and Functional Medicine Clinic
Using an integrated approach to treat and prevent injuries and chronic pain syndromes, improve flexibility, mobility, and agility, and help individuals return to normal activities, Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers, trainers, and specialists to develop a personalized fitness program. Each case is different and requires reviewing individual medical history and physical examination to determine the proper training plan. Dr. Jimenez has partnered with top trainers, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments and fitness training plans.
Weight Loss Techniques
References
Bairapareddy, K. C., Maiya, A. G., Kumar, P., Nayak, K., Guddattu, V., & Nayak, V. (2018). Effect of aerobic exercise on echocardiographic epicardial adipose tissue thickness in overweight individuals. Diabetes, metabolic syndrome and obesity : targets and therapy, 11, 303–312. doi.org/10.2147/DMSO.S145862
Carey D. G. (2009). Quantifying differences in the “fat burning” zone and the aerobic zone: implications for training. Journal of strength and conditioning research, 23(7), 2090–2095. doi.org/10.1519/JSC.0b013e3181bac5c5
Schwarz, M., Urhausen, A., Schwarz, L., Meyer, T., & Kindermann, W. (2006). Cardiocirculatory and metabolic responses at different walking intensities. British journal of sports medicine, 40(1), 64–67. doi.org/10.1136/bjsm.2005.020198
Karstoft, K., Winding, K., Knudsen, S. H., Nielsen, J. S., Thomsen, C., Pedersen, B. K., & Solomon, T. P. (2013). The effects of free-living interval-walking training on glycemic control, body composition, and physical fitness in type 2 diabetic patients: a randomized, controlled trial. Diabetes care, 36(2), 228–236. doi.org/10.2337/dc12-0658
Haight, D. J., Lerner, Z. F., Board, W. J., & Browning, R. C. (2014). A comparison of slow, uphill and fast, level walking on lower extremity biomechanics and tibiofemoral joint loading in obese and nonobese adults. Journal of orthopaedic research : official publication of the Orthopaedic Research Society, 32(2), 324–330. doi.org/10.1002/jor.22497
For individuals who are feeling back pain, neck pain, or shoulder pain, can using postural techniques help decrease pain and develop strategies to maintain correct posture?
Maintaining Correct Posture
Exercise and postural correction are two of the most important strategies to manage pain. (Robin McKenzie, the great spine guru PT, (May S. and Donelson R. 2008) However, it is not easy to maintain correct posture as the day progresses. While working or driving, most of us forget to be mindful of our posture; we slip back into unhealthy habits of sitting slouched, to the side, forward, etc, which often leads to continued pain and movement limitations. Studies on postural correction and its effect on overall back or neck pain levels are limited. (Lederman E. 2011) However, some studies show that a forward-head posture increases stress and load on the neck. (Hansraj K. K. 2014) If an individual has pain that improves with sitting upright, perhaps checking posture as the day progresses could be beneficial. There are ways to start changing posture and maintain the change. First, visit a physical therapist, spine specialist, or chiropractor to learn how to sit or stand to manage posture problems. They can teach individuals how to attain healthy posture and manage their condition. These strategies can then be used to maintain correct posture.
Lumbar Support
A lumbar roll/support is one of the simplest ways to attain and maintain a healthy sitting posture. These specialized pillows can help maintain the forward curve in the lower back. Maintaining the lumbar lordosis curve is essential for keeping stress off the back muscles, joints, and discs. Lumbar support pillows can be found in various stores, office supply stores, or purchased online. A physical therapist PT can help train individuals to use a lumbar roll properly.
Utilize the Slouch Overcorrect Exercise
The slouch overcorrect exercise is a simple maneuver for training the body to find and maintain its neutral position. It involves slowly shifting from a slouched position to an overcorrected postural position. Once posture is overcorrected, a slight relaxation from a fully erect posture will return to sitting properly. Practicing this exercise daily can help train the body to feel the muscles, listen to the body, and maintain proper posture. The muscles have memory, and the more often the body is placed in optimal posture, the muscles memorize their healthy, pain-free positioning.
Kinesiology Tape
Kinesiology tape is a flexible cotton adhesive that facilitates muscle contractions and inhibits muscle spasms and pain. (Han J. T. et al., 2015) Using the tape is a simple way to help facilitate the postural support muscles. The tape can be applied to the middle trapezius and rhomboid muscles to help support the shoulder blades and spine. Kinesiology tape for postural control also gently pulls on the muscles when slouching to remind the individual to sit up or stand straight.
Scapular Stabilization Exercises
A physical therapist or chiropractor can help improve posture through targeted exercises. Strengthening the muscles attached to the shoulder blades can help individuals better control their posture. (Shiravi S. et al., 2019) Exercises like the prone T, I, or Y can help improve the muscles’ neuromuscular recruitment to maintain correct posture.
Use an Alarm
Setting an alarm while working can help train the body to maintain correct posture. Most of us sit at a computer, desk, or workstation with proper posture, but depending on what we’re working on, we eventually slouch, lean to the side, or have a forward head posture. Pretty much all computers and phones have an alarm setting or app. Use the alarm or timer to go off every 20 to 30 minutes. When the alarm rings, look at your posture to recognize what you’re doing, get up and move around to stretch the body, sit and readjust, reset the alarm, and continue working. As you get better at maintaining appropriate posture, you won’t need the alarm anymore, and readjusting will become automatic.
Chiropractic Team
Sitting and standing with unhealthy posture can significantly cause back, neck, and shoulder pain. By visiting a chiropractic and physical therapy team and learning to attain and maintain correct posture, you can quickly relieve pain, resolve musculoskeletal issues, and prevent future pain symptoms. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop a personalized care plan for each patient through an integrated approach to treating injuries and chronic pain syndromes, improving flexibility, mobility, and agility programs to relieve pain and help return to normal and optimal function. If other treatments are needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments.
Scapular Winging In-Depth
References
May, S., & Donelson, R. (2008). Evidence-informed management of chronic low back pain with the McKenzie method. The spine journal : official journal of the North American Spine Society, 8(1), 134–141. doi.org/10.1016/j.spinee.2007.10.017
Lederman E. (2011). The fall of the postural-structural-biomechanical model in manual and physical therapies: exemplified by lower back pain. Journal of bodywork and movement therapies, 15(2), 131–138. doi.org/10.1016/j.jbmt.2011.01.011
Hansraj K. K. (2014). Assessment of stresses in the cervical spine caused by posture and position of the head. Surgical technology international, 25, 277–279.
Han, J. T., Lee, J. H., & Yoon, C. H. (2015). The mechanical effect of kinesiology tape on rounded shoulder posture in seated male workers: a single-blinded randomized controlled pilot study. Physiotherapy theory and practice, 31(2), 120–125. doi.org/10.3109/09593985.2014.960054
Shiravi, S., Letafatkar, A., Bertozzi, L., Pillastrini, P., & Khaleghi Tazji, M. (2019). Efficacy of Abdominal Control Feedback and Scapula Stabilization Exercises in Participants With Forward Head, Round Shoulder Postures and Neck Movement Impairment. Sports health, 11(3), 272–279. doi.org/10.1177/1941738119835223
Skeletal muscles attached to the arms, legs, neck, back, and trunk bones are voluntary and consciously controlled. Weakness or inability to control these muscles can signal a health issue like a neuromuscular disorder or electrolyte imbalance. Can recognizing the symptoms can help healthcare providers develop effective treatment programs?
Voluntary Muscles
Voluntary muscles are the skeletal muscles that attach to bones and control movement of the limbs, head, neck, and body under an individual’s conscious control. Skeletal muscles are controlled by neuromuscular signals from the brain that communicate with individual muscle fibers and cause them to contract.
Difference
Voluntary muscles are skeletal muscles that contract and relax under conscious control.
These muscles attach to bones and regulate movement of the body.
Involuntary muscles are not under conscious control.
Involuntary muscles involve automatic internal processes needed for survival, like controlling blood vessels and organs like the heart, lungs, and digestive system.
They contract and relax automatically and receive signals from the autonomic nervous system, which regulates internal bodily functions.
Voluntary
Voluntary muscles are skeletal muscles that comprise 40% of the body’s weight and 50% to 75% of the body’s proteins. These muscles can convert chemical and mechanical energy to cause voluntary muscle contraction and movement. (Trovato F.M. et al., 2016) Skeletal muscle comprises fascicles or bundled units of multiple muscle fibers or muscle cells. Each muscle fiber consists of a cross-banded structure further divided into myofibrils containing thick myosin and thin actin myofilaments, which give the muscle its stripe appearance, and the structure gives the characteristic striated structure. (Trovato F.M. et al., 2016) Muscle contraction occurs when these myofilaments move closer together, stimulated by the release of the neurotransmitter acetylcholine from nerve cells that communicate with the muscle fiber.
Involuntary
The autonomic nervous system controls involuntary muscles, regulating their contraction and relaxation. This system also controls the activity of organs and blood vessels for essential daily functions, including breathing, circulation, digestion, heartbeat regulation, and urination. Most involuntary muscles are composed of smooth muscles. Smooth muscles do not have the striated structure of skeletal muscles and consist of sheets or layers of smooth muscle cells. When the autonomic nervous system stimulates these muscle cells to contract by releasing hormones or other chemical signals, smooth muscle cells shorten through the movement of actin and myosin myofilaments. Involuntary smooth muscles include the blood vessel walls, diaphragm, intestines, and bladder. (Webb R. C. 2003) One exception of an involuntary muscle is the myocardium, or heart muscle. The myocardium comprises a specialized cardiac muscle cell found only in the heart. Cardiac muscle is striated like skeletal muscle but is controlled by the autonomic nervous system and pacemaker cells, causing it to contract automatically and rhythmically.
Weakened Voluntary Muscles
Skeletal muscle diseases, neuromuscular disorders, and other causes can weaken muscles. Neuromuscular or skeletal muscle disorders affect the nerves that send electrical signals to voluntary skeletal muscles to control movement. When the nerves are damaged, communication between the nerves and muscles becomes disrupted. This can result in significant muscle weakness, atrophy, and loss of function. Most neuromuscular disorders are genetic or caused by issues with the immune system. Nerves communicate with muscles through the release of neurotransmitters at the neuromuscular junction, which is the space between a nerve cell and muscle fiber. Neuromuscular disorders can damage the nerve or the neuromuscular junction. Neuromuscular disorder symptoms can include: (Cleveland Clinic, 2023)
Numbness and tingling
Muscle weakness
Muscle twitches, cramps, or spasms
Muscle pain
Muscle atrophy
Decreased coordination
Balance problems
Drooping eyelids and double vision from eye muscle weakness.
Difficulty swallowing due to weakness of the pharynx.
Difficulty breathing due to weakness of the diaphragm.
Common Neuromuscular Disorders
Amyotrophic Lateral Sclerosis – ALS
More commonly known as Lou Gehrig’s disease, it is a genetic disorder that results from hardening of the spinal cord.
It causes damage to the nerves that control muscles and voluntary movement.
Charcot-Marie-Tooth Disease
This is a class of peripheral nerve disorders that cause muscle weakness, atrophy, and loss of sensation, most commonly in the legs and feet.
It is a genetic disorder caused by a gene mutation that damages myelin, or the insulating sheath that surrounds all nerves and supports the conduction of electrical signals.
Multiple Sclerosis – MS
MS causes degeneration of the myelin sheath surrounding nerves, decreasing the impulses along the nerves to muscles.
It can result in muscle weakness, which is often more severe on the dominant side of the body.
There are different forms of MS, but the condition is often progressive and gets worse over time if left untreated.
Muscular Dystrophies
These are genetic diseases characterized by gradual loss of motor function, muscle weakness and atrophy, walking gait problems, progressive respiratory failure, and cardiomyopathy.
There are nine types of muscular dystrophy, all caused by genetic mutations.
Myasthenia Gravis
This is an autoimmune disease that causes inflammation throughout the body.
An autoimmune disease occurs when the immune system attacks healthy cells by mistake.
With myasthenia gravis, the body produces antibodies that attack the receptors for acetylcholine, reducing the body’s ability to contract muscles.
This leads to muscle weakness, atrophy, and fatigue.
Myopathies
These are diseases of muscles that cause muscle weakness and atrophy.
Depending on the type, they may progress and get worse over time.
Electrolyte Imbalances
Muscle weakness can result from altered sodium, potassium, calcium, or magnesium levels.
Always seek immediate medical attention for any sudden, unexplained muscle weakness. Individuals who experience skeletal muscle weakness should discuss the type and duration of symptoms with their doctor, specialist, physical therapist, or chiropractor, as this might be a sign of a medical condition such as a neuromuscular disorder. Working with a chiropractic team can help expedite healing. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop a personalized treatment program through an integrated approach to treat injuries and chronic pain syndromes, improving flexibility, mobility, and agility, relieving pain, and helping individuals return to normal activities. If other treatments are needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments.
Chiropractic Massage Therapy
References
Trovato FM, I. M., Conway N, Castrogiovanni P. (2016). Morphological and functional aspects of human skeletal muscle. J Funct Morphol Kinesiol., 1(3), 289-302. doi.org/https://doi.org/10.3390/jfmk1030289
Webb R. C. (2003). Smooth muscle contraction and relaxation. Advances in physiology education, 27(1-4), 201–206. doi.org/10.1152/advan.00025.2003
Replenishing electrolytes and maintaining hydration is essential for individuals who work out, fitness enthusiasts, and those who play recreational or serious sports and want to improve overall health. Can making a homemade sugar-free electrolyte drink help individuals achieve health goals faster?
Homemade Electrolyte Drink
Sports drinks can help replenish the body’s lost electrolytes. Individuals who follow a low-carb diet and exercise or who are on a low-carb diet and get sick need double the added electrolytes. There is evidence that electrolytes are very effective in regulating the body’s fluid balance, especially during and after exercise or illness, and for those on a strict low-carb diet. (Maughan R. J. 1991)
Why More Electrolytes Are Needed
On a low-carb diet, insulin levels drop, so the kidneys retain less sodium. As the body excretes water, important minerals, such as the electrolytes calcium, sodium, magnesium, chloride, and potassium, are also excreted from the body’s system. Therefore, it is important to replenish them to avoid negative symptoms like lightheadedness and dehydration—especially when exercising or ill. (Bostock E. C. S. et al., 2020)
Two tablespoons of lemon juice contain almost the same amount of potassium in an 8-ounce sports drink.
A pinch of salt supplies 110 milligrams of sodium, the same amount in 8 ounces of a sports drink.
Individuals can make a low-carb homemade electrolyte sports drink. Many sports drinks contain a lot of sugar and other additives. The science behind why many of these drinks contain sugar is that a quick hit of sugar provides glucose for replenishing energy stores. Most individuals benefit from having small amounts of carbohydrates during heavy exercise. However, those who want to avoid sugar might want a sugar-free option to replace fluids and electrolytes.
Basic Recipe
Homemade Electrolyte Drink Mix:
1 cup or 8 ounces of non-carbonated water
Two tablespoons of lemon juice
A small pinch of salt—a teaspoon contains 2,300 milligrams of sodium, but the body needs 1/20th of a teaspoon.
Flavoring and sweetener for taste are optional. Try unsweetened Kool-Aid, Crystal Light Drink Mix, or sugar-free flavored syrups.
If avoiding artificial sweeteners, Stevia could be an option.
Sports Drink Ingredients
What goes into most sports drinks and adapting to a low-carb diet?
Water
Water is a primary ingredient, as the goal is to hydrate the body.
Sugar
Sports drinks can contain a lot of sugar, but only about half the sugar of most commercial beverages. For example,
A 20-ounce bottle of Gatorade has about 34 grams of sugar.
A 20-ounce soda has about 69 grams of sugar.
Sports drinks have less sugar to prevent gastrointestinal cramping during exercise and strenuous physical activity. Although Gatorade contains less sugar than soda, depending on individual health goals, it may not be the best option. Studies of nutritional needs during exercise for those restricting carbohydrates are not extensive. However, it is known that when individuals cut carbs, their bodies switch from primarily using carbohydrates to using fat for energy. This change, known as keto-adaptation, can take two to three weeks. Native populations, like the Inuit, traditionally ate a very low-carbohydrate diet and could maintain vigorous endurance for a long time without ill effects. (Phinney S. D. 2004) This suggests that bodies adapt to using fat for energy during physical activity and exercise over time. However, cutting carbohydrates too much and too soon can lead to symptoms like the keto flu. (Harvard Medical School, 2018). Individuals may need to replace carbohydrates during training for longer, more vigorous workouts, such as running longer than an hour. In addition, what is eaten before and after exercise can also affect physical performance. Working with a registered dietitian, nutritionist, or health coach could be helpful to achieve specific fitness goals.
Electrolytes
Electrolytes are molecules of certain minerals that contain an electrical charge. The nervous system runs on those charges generated by manipulating molecules called ions. (Faber D. S. and Pereda A. E. 2018) Every body function that depends on the nervous system, which includes muscle movement, breathing, digestion, thinking, etc., requires electrolyte activity. Those who exercise strenuously for long periods, individuals who follow a low-carb diet, or those with illness may need extra salt and potassium. Sports drinks contain small amounts of sodium and potassium. A balanced diet will supply plenty of minerals for electrolyte needs for individuals engaged in moderate exercise.
Using an integrated approach to treat and prevent injuries and chronic pain syndromes, improve flexibility, mobility, and agility, and help individuals return to normal activities, Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop a personalized treatment, nutrition, and fitness programs. Each case is different and requires reviewing individual medical history and physical examination to determine the proper and most effective plan. Dr. Jimenez has teamed up with top trainers, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments and training.
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References
Maughan R. J. (1991). Fluid and electrolyte loss and replacement in exercise. Journal of sports sciences, 9 Spec No, 117–142. doi.org/10.1080/02640419108729870
Bostock, E. C. S., Kirkby, K. C., Taylor, B. V., & Hawrelak, J. A. (2020). Consumer Reports of “Keto Flu” Associated With the Ketogenic Diet. Frontiers in nutrition, 7, 20. doi.org/10.3389/fnut.2020.00020
Phinney S. D. (2004). Ketogenic diets and physical performance. Nutrition & metabolism, 1(1), 2. doi.org/10.1186/1743-7075-1-2
Faber, D. S., & Pereda, A. E. (2018). Two Forms of Electrical Transmission Between Neurons. Frontiers in molecular neuroscience, 11, 427. doi.org/10.3389/fnmol.2018.00427
Proper shoes are highly recommended when playing sports, whether professional or recreational. Can wearing pickleball footwear help increase optimal performance and prevent injuries?
Pickleball Footwear
Pickleball has become quite popular because individuals of all ages and abilities can play it. Although it is a relatively new sport, it emerged in 1965. (USA Pickleball, 2021) It’s now one of the fastest-growing sports, with over 8 million players nationwide. (Brandon, 2023) The game can be played with most shoes designed for sports, like running or cross-fit shoes. There are shoes specifically for pickleball that improve traction, enhance stability and cushioning, and increase impact absorption. For those getting into the game long-term, investing in high-quality pickleball footwear is a worthwhile investment that can contribute to long-term enjoyment and injury prevention.
The Demands of Pickleball
Like tennis or table tennis, pickleball involves dynamic and fast-paced movements, including lateral strides, pivoting, and quickly changing direction. The body has to move forward, backward, and side to side across the court and pivot. When chasing the ball, to control the shots, produce power, decrease the risk of injury, and change direction while maintaining balance, the feet, body, and shoes must work together to make all this possible. One consideration depends on where the game will be played, whether flat ground or a harder surface. Wearing sneakers or tennis shoes is recommended for flat-ground play, as they provide supportive cushioning and shock absorption. For harder surfaces like concrete or hardwood courts, specialized shoes like those designed for pickleball are recommended.
Benefits
Some of the benefits of investing in pickleball footwear include.
Optimal Traction
Traction is incredibly important in pickleball. Optimal traction can help players execute quick movements, maintain stability, and prevent slips and falls. When looking for the right shoes, consider traction-specific materials like rubber, nylon, and leather. Individuals are most likely to find rubber pickleball shoes because they’re cheaper and commonly used in other outdoor sport-specific shoes, such as soccer. Nylon is more expensive but offers better traction than rubber and is often used in high-tech sneakers because it provides significant shock absorption and long-term durability. Leather is the most expensive material but offers the best grip. Because of its natural look and feel, it is also becoming more popular in sneakers.
Stability and Support
Moving from side to side in a lateral fashion requires players to be on top of their balance and maintain steadiness when making shots. Pickleball shoes are designed to support stability and can help reduce injuries like sprains.
Impact Absorption Cushioning
Pickleball footwear is designed similarly to running shoes, with cushioned comfort and a midsole that offers shock absorption and reduces the impact felt in the joints, including the knees, lower back, and feet. Individuals can find pickleball footwear that utilizes various sports technologies, like gel inserts or responsive foam, which can help cushion and reduce the impact on the joints. When cushioned, the body can maintain more balance, promote positive movement habits, prevent muscular fatigue and joint pain, help reduce overall stress, and allow individuals to play harder without experiencing pain. Long-term benefits result in a stronger, more flexible body.
Proper Fit and Considerations
Make sure that the pickleball shoes fit well and provide adequate support. Measure your feet using a ruler or measuring tape, and have the measurements handy while shopping. Suggestions include:
Look for shoes that fit snugly but don’t allow the feet to move around too much during play.
Pay attention to arch support.
Individuals with high arches should look for shoes with adjustable straps or more supportive materials built into the sole.
Using an integrated approach to treat and prevent injuries and chronic pain syndromes, improve flexibility, mobility, and agility, and help individuals return to normal activities, Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop a personalized fitness program. Each case is different and requires reviewing individual medical history and physical examination to determine the proper training plan. Dr. Jimenez has teamed up with top trainers, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments if other training is needed.
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