Pregnancy can take a toll on a woman’s body. New aches and pains start to present as the pregnancy progresses. Hormonal changes can affect the state of mind, making trying to relax or relieve stress extremely difficult to impossible, causing more frustration and tensed muscles. It’s absolutely safe and beneficial to get a professional therapeutic massage while pregnant. Most pregnant women are cleared to get massages after their first trimester. However, if it is a high-risk pregnancy, talk to your doctor before scheduling a massage.
Benefits of Therapeutic Massage
A therapeutic massage while pregnant, known as prenatal massage, generates a peaceful and serene mindset. Studies show prenatal massage is beneficial for the mother and baby. Pregnant women that are unable to find discomfort/pain relief benefit from prenatal massage. Benefits include:
Swelling is reduced
Improved hormone regulation helps reduce instances of low birth weight
Joint, back, and nerve pain/sciatica is reduced, and function improved
Headaches lessen in severity and frequency
Blood and nerve circulation improves
Sleep cycles improve
Anxiety, depression, and stress improves
Types of Massage
Safe massages when pregnant. The most common prenatal massage is a Swedish Massage. This type of massage is gentle but forceful enough to provide the aforementioned benefits. Swedish Massage focuses on the topmost layer of muscle with long strokes that incorporate movement of the joints. Avoid deep-tissue massage when pregnant, as this is a more aggressive style of massage.
Back Massage
During pregnancy, posture changes from the added weight. The center of gravity shifts making the spine and back muscles work harder. This regularly makes the muscles achy, sore, and stiff. Prenatal back massage is done while sitting or lying on the side. Long strokes are performed on the muscles, along with gentle kneading. The focus is on the muscles along the spine and the low back. This type of massage is highly beneficial if sciatica is presenting.
Neck Massage
Massaging the neck loosens tight muscles, improves awkward neck posture, alleviates nerve pain preventing tension headaches, and promotes flexibility. Most therapists will start with the neck and arms while the individual sits up, then lie down to work on the rest of the body.
Chiropractic Massage
This type of massage is performed by a licensed chiropractor and/or a physical massage therapist at the direction of a chiropractor. Chiropractic massage therapists have undergone thorough training and always take care to avoid any pressure points or areas that could cause discomfort.
Areas that Are Avoided During Massage
Professional massage therapists know what areas to avoid during the therapeutic massage, but it’s also important for the patient. The areas that will be avoided include:
The pressure points in the wrist and around the ankles. These areas have points that could cause uterine contractions and cervical ripening.
Around the belly. However, it is recommended to perform gentle, low-pressure massaging at home.
Around open wounds, rashes, or skin conditions.
Safety Tips
Other precautions to take when receiving a massage during pregnancy. The massage therapist should look out for blood clot symptoms or varicose veins. Other precautions to follow:
Make sure the massage therapist knows you are pregnant before beginning.
If the massage triggers nausea, discomfort, or is not enjoyable, ask to stop.
Avoid massage tables that have a hole cut out for the belly.
The recommended method is on the side, supported with proper padding to ensure stability and comfort.
The massage should be no more than an hour.
A massage in the first trimester is not recommended.
A trained massage therapist should perform a prenatal therapeutic massage. However, a partner can perform an easy, safe massage at home following a few guidelines.
Avoid the ankles and the areas around the wrists.
Avoid the belly and the area around it.
Back, neck, scalp, and foot rubs are recommended.
Utilize long gentle strokes with all-natural and safe massage oils or lotions.
Talk to your physician if you have an increased risk for blood clots.
Get a Massage
A prenatal therapeutic massage can improve hormone regulation, help sleep, reduce stress and anxiety, and promote a healthy and optimal delivery.
Body Composition
Diastasis Recti Post-Baby Weight
Pregnancy can cause abdominal muscle separation or diastasis recti.
This happens when the outermost abdominal muscles/rectus abdominis, which are the muscles from the breastbone to the pubic bone pull apart from the fibrous attachment point/linea alba. Muscle separation is common after pregnancy, but the degree and location of the separation are what vary from one woman to another. As the pregnancy progresses, the uterus makes room for the growing baby. This can cause the abdominal – recti muscles to stretch and become flabby. This muscle separation is not linked with complications for the mother or the baby and it is not a sign of muscle loss.
References
Hall, Helen et al. “The effectiveness of complementary manual therapies for pregnancy-related back and pelvic pain: A systematic review with meta-analysis.” Medicine vol. 95,38 (2016): e4723. doi:10.1097/MD.0000000000004723
“Perineal Massage in Pregnancy.” Journal of midwifery & women’s health vol. 61,1 (2016): 143-4. doi:10.1111/jmwh.12427
Schreiner, Lucas et al. “Systematic review of pelvic floor interventions during pregnancy.” International journal of gynecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics vol. 143,1 (2018): 10-18. doi:10.1002/ijgo.12513
It is estimated that every adult will experience some form of back pain at least once in their lives. There’s a difference between mechanical and inflammatory back pain. With inflammatory back pain, movement tends to help it, while resting worsens the pain. For some individuals, relief from inflammatory back pain is something they could have to manage for some time. Fortunately, there are effective management and relief options available.
Inflammatory vs. Mechanical Pain
Chronic back pain has two major causes. These are Mechanical and Inflammatory. They have slightly different characteristics when presenting. Chiropractors know what to look for to tell the difference between the two. Then a decision can be made on how to proceed with treatment or management.
Inflammatory
Pain caused by inflammation can be described as:
Not having a known definite cause.
Characterized by stiffness, especially after waking up.
Pain reduces with movement, activity, stretching, exercise.
Is worst during the early hours of the morning.
Is often accompanied by pain in the buttocks/sciatica symptoms.
Mechanical
Mechanical pain can be described as:
Pain that becomes worse with activity, stretching, or exercise.
Pain reduces with rest.
There is no stiffness after sleeping.
This pain is not constant but can become intense/severe for short periods.
Pain in the buttocks/sciatica symptoms do not present.
Inflammatory and Non-Inflammatory
Non-inflammatory is the same as mechanical pain. Mechanical/non-inflammatory back pain has causation related to the mechanics of the back and can result from injury or trauma. The cause of non-inflammatory pain does not necessarily present right away. For example, poor posture that leads to back pain is a mechanical/non-inflammatory cause. However, non-inflammatory back pain can be accompanied by inflammation as a natural reaction to injury. But this inflammation is not the cause of the pain. Non-inflammatory back pain can be treated effectively with conservative treatments. This includes:
Chiropractic adjusting
Physical therapy
Spinal decompression
Contributing Autoimmune Diseases
When inflammation is the cause of pain, it is considered inflammatory pain. Autoimmune disease/s can cause the body to attack different areas of the body mistakenly. Chronic pain can be caused by autoimmune diseases that include:
Rheumatoid Arthritis
Arthritis causes the immune system to attack the joints throughout the body.
Ankylosing Spondylitis
This is a rare type of arthritis that affects the spine. It is found more in men and usually begins in early adulthood.
Multiple Sclerosis
This is a disease where the immune system attacks nerve fibers and can lead to back pain.
Psoriatic Arthritis
This type of arthritis is characterized by patches of psoriasis along with joint pain and inflammation.
Inflammatory Pain Treatment
Individuals that think they might have inflammatory back pain should consult a doctor, spine specialist, and/or chiropractor. A general practitioner can misdiagnose inflammatory back pain as mechanical back pain. Many find relief from taking non-steroidal anti-inflammatory drugs or NSAIDs and following an exercise/physical activity regimen. However, sometimes this is not enough. This is where chiropractic treatment and physical therapy comes in.
Chiropractic and Physical Therapy
These medical professions complement each other well and can be beneficial as a part of an overall treatment plan. A chiropractor, with the help of a physical therapist, can bring significant relief. Management techniques involve:
Chiropractic adjustments
Flexion-distraction
Posture correction
Personalized exercises
Inflammation Night Pain
Inflammatory back pain tends to worsen at night. What happens is the inflammatory markers settle down when the body is not moving. A few simple practices can help you get better sleep.
Stretch Before Bed and When Waking
Performing stretches before going to bed and after waking up helps keep the body limber.
Inspect Pillows and Mattress
Sleeping with the spine out of alignment could exacerbate the problem. Using a too-soft mattress or a too-large pillow could be contributing to the pain. Sleeping on the side is recommended to use a pillow between the legs to keep the low back straight.
Exercises
Some exercises should be discussed with your doctor. Individuals have found that exercise and stretching are essential for relief.
Cardio
These exercises increase heart rate, boost mood, and release natural pain killers. Low-impact cardio exercises:
Swimming
Walking
Cycling
Strength-Building
Strengthening the core muscles will help maintain posture and spine support. Some of these include yoga poses:
Sustainable and easy to follow three basic elements: following the diet, physical activity, and high levels of socializing. For individuals that want to change their diet and lifestyle to the Mediterranean, try the following:
Add more vegetables to meals. This can be salads, stews, and pizzas. Kidney beans, lentils, and peas are common Mediterranean staples.
Switch to whole grains as well as products made from whole grain flour. The high fiber content can improve heart health and can help lower blood pressure. Minimize refined carbohydrates like white bread and breakfast cereals.
Balance rich desserts with fresh fruits like oranges and bananas that can include antioxidant fruits like blueberries and pomegranates.
Treat meat as a side dish instead of the main course. Adding strips of chicken or beef into a vegetable saute/soup.
Balance meat dishes with fish and seafood. This includes sardines, salmon, clams, and oysters.
Go vegetarian for one day a week.
Cut out processed meats with high levels of preservatives.
Add healthy fats like avocados, sunflower seeds, nuts, and peanuts to meals.
Cornelson, Stacey M et al. “Chiropractic Care in the Management of Inactive Ankylosing Spondylitis: A Case Series.” Journal of chiropractic medicine vol. 16,4 (2017): 300-307. doi:10.1016/j.jcm.2017.10.002
Dahlhamer, James et al. “Prevalence of Chronic Pain and High-Impact Chronic Pain Among Adults – the United States, 2016.” MMWR. Morbidity and mortality weekly report vol. 67,36 1001-1006. 14 Sep. 2018, doi:10.15585/mmwr.mm6736a2
Riksman, Janine S et al. “Delineating inflammatory and mechanical sub-types of low back pain: a pilot survey of fifty low back pain patients in a chiropractic setting.” Chiropractic & manual therapies vol. 19,1 5. 7 Feb. 2011, doi:10.1186/2045-709X-19-5
Santilli, Valter et al. “Chiropractic manipulation in the treatment of acute back pain and sciatica with disc protrusion: a randomized, double-blind clinical trial of active and simulated spinal manipulations.” The spine journal: official journal of the North American Spine Society vol. 6,2 (2006): 131-7. doi:10.1016/j.spinee.2005.08.001
Teodorczyk-Injeyan, Julita A et al. “Nonspecific Low Back Pain: Inflammatory Profiles of Patients With Acute and Chronic Pain.” The Clinical journal of pain vol. 35,10 (2019): 818-825. doi:10.1097/AJP.0000000000000745
Rain generally comes with a drop in barometric pressure. A low-pressure system you may have heard from the local weather forecast. Lower pressure outside can cause tissues inside the body to swell and irritate sensitive nerves. For those who have sciatic nerve pain, rainy, hot, humid weather can cause the nerve tissues to expand causing increased compression, inflammation, and pain.
Rainy Weather
For anyone who is prone to inflammation, there are ways to cope with rainy weather-related symptoms, including:
Stay inside air-conditioned areas where the humidity level is lower.
Use a dehumidifier to keep the indoor air at 40-60% relative humidity for comfort.
Utilize vent fans in the kitchen and in laundry areas and after baths/showers in bathrooms.
Easy Physical Activity
Easing the pain can also be done through:
At work, school, home adjust the seat to work for you. Individuals with sciatic nerve pain already know how to make adjustments to chairs and other places for sitting.
If you’re heading out to a baseball or soccer game, you may want to use a comfortable sideline seat that provides cushion and support. If attending a pro game, check online or call to see if you can bring a therapeutic seat cushion.
Going on a trip whether road or flight, seats might not be comfortable or supportive. Tips that can help maintain comfort to mitigate the pain, include:
Adjust the seat for proper posture to maintain spinal curvature
Use lumbar support
Maintaining a workout routine is key leading up to your trip. If the body is inactive for a period of time, the back muscles are more likely to spasm when having to sit in tight quarters.
Don’t overpack. Carrying around heavy luggage increases the risk of straining the muscles.
Pack pain medication or anti-inflammatories on hand in case of a flare-up.
Inflammation
Target inflammation with ice therapy
Using topical heat or a heating pad can get the blood circulation flowing through the area
Wear compression garments over the affected areas to bring down swelling and promote blood and nerve circulation.
Chiropractic Rainy Day Relief
Chiropractors know the whole musculoskeletal system. Chiropractic massage therapy induces deep muscles relaxation and the release of endorphins/natural painkillers. A regular spa massage can release sore muscles and tension, chiropractic massage focuses on soothing and healing sciatica. Adjustments or spinal manipulations allow the disc/s rest back into position and relieve the pressure on the sciatic nerve. This will lessen the pain and generate nerve signal flow and mobility.
Spinal decompression relieves the compression of the nerves that are causing sciatica pain. This includes techniques to lengthen the spine and enhance the space between the vertebrae.
A chiropractor will recommend exercises to prevent nerve aggravation and help release the pressure that comes from the inflamed and tight muscles.
Exercises include stretching programs that can be done at home to release pressure on the nerve and ease irritations.
Body Composition
About Fat
Fat, also known as adipose tissue, contributes to overall body weight. This is also the type that individuals want to get rid of when talking about weight loss. Two different kinds of fat:
Subcutaneous fat is the fat that is beneath the skin.
Visceral fat lies deep in the abdominal cavity and surrounds the organs.
Having a certain amount of fat tissue is necessary for a healthy body.
The body stores unused energy from food as fat. This is to provide a reliable source of fuel when the body needs it.
Fat tissue acts as insulation to keep the body warm and as a cushion to protect the vital organs.
The problem/issue is excess body fat. This is what leads to higher body weight and altered hormone release that can make the excess weight condition worse.
References
National Institutes of Health. (2019.) “Sciatica.” medlineplus.gov/sciatica.html.
Zwart, J A et al. “Warm and cold sensory thresholds in patients with unilateral sciatica: C fibers are more severely affected than A-delta fibers.” Acta neurologica Scandinavica vol. 97,1 (1998): 41-5. doi:10.1111/j.1600-0404.1998.tb00607.x
Zwart, John-Anker, and Trond Sand. “Repeatability of dermatomal warm and cold sensory thresholds in patients with sciatica.” The European spine journal: official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society vol. 11,5 (2002): 441-6. doi:10.1007/s005860100333
Bowling is a fun physical activity that is enjoyable for all ages. Today, there are college bowlers, recreational bowlers, amateur, semiprofessional, professional leagues, and tournaments worldwide. Although it might not be the first sport that comes to mind when thinking of injuries and chronic pain conditions, it can place significant stress on the muscles and tendons of the upper and lower body. It is important to know and understand how to avoid injuries.
How Bowling Injuries Happen
There are two main causes of injuries and chronic pain related to bowling. The first is poor mechanics, and the second is repetitive over-use. Both cause/develop painful symptoms that can turn into injuries that become chronic conditions. Many injuries are caused by:
Slip and fall accidents
Players dropping the ball on their feet
The majority of injuries come from overuse/repetition and improper body mechanics.
Overuse injuries result from repetitive and/or strenuous actions/movements that place profound stress on the body’s musculoskeletal system.
For example, a semi-pro and professional bowler will play fifty or more games a week. This means throwing a sixteen-pound ball for ten frames per game. When consistently repeated over and over, this can cause serious wear and tear to the body. With amateur and recreational bowlers, they don’t play as much, so they don’t experience overuse injury as much, but what they do experience is improper/poor form techniques that shift the body in non-ergonomic ways, wrong equipment like oversized/too-small shoes that can cause awkward postures and body motions, a ball that is too heavy causing an individual to overthrow and strain their arms, backs, hips, and legs. Or a ball with small finger holes that get stuck or too large, causing finger, hand, arm, shoulder pulls strains, and sprains.
Common Bowling Injuries
The most common injuries and conditions associated with bowling include:
Many of the injuries can lead to tendonitis or arthritis later in life.
Trigger/Bowler’s Finger
Symptoms include:
Hand pain after bowling, specifically in the fingers
A clicking or popping when moving the fingers
A finger gets locked in a bent position
Rest, and no bowling is recommended. How long a rest depends on how long the symptoms have been presenting. Physical therapy, along with chiropractic exercises, can help improve finger strength. Splinting the finger could be required to improve the condition. If all fails or does not generate adequate relief, hand surgery could be optioned with a trigger finger release. The surgery allows the finger to move more freely.
Bowler’s Thumb
This usually happens to bowlers that want to generate a lot of spin on the ball. If the thumb’s hole is too tight, it can pinch the ulnar nerve inside the thumb. If the thumb injury is not serious, rest and getting the correct ball size can correct the issue. This is where purchasing a personal bowling ball can help.
Finger Sprain
This is an injury to one or more of the ligaments in the fingers. It most often takes place in the collateral ligaments along the sides of the fingers inside the ball. The ligament/s gets stretched or torn when the finger is forced beyond its normal range of motion. Common symptoms of a finger sprain include swelling, tenderness, stiffness, and pain in the affected finger. This usually occurs from:
The weight of holding the ball with the fingers alone
A poor release
Using a ball that doesn’t properly fit the fingers
A finger sprain falls into grades on the severity of how much the ligament is stretched or torn:
Grade 1
Stretching or microscopic tearing.
Grade 2
Less than 90% of the ligament is torn.
Grade 3
More than 90% of the ligament is torn. Grade three sprains can be accompanied by joint instability and immobility.
Herniated Disc
A herniated disc is when the discs get injured/damaged from overuse, wear, and tear, or a traumatic injury to the spine. The disc can dry out, become less flexible, bulge out, or rupture. Bowlers are constantly:
Bending during the final approach and throw
Carrying a heavy ball
Shifting, twisting, and releasing, increasing the pressure within the discs
In bowling, the majority of herniated discs happen in the low back. The most common symptom is backaches and back pain. Lumbar herniated discs left untreated can cause sciatica.
Avoid and Prevent Injury
The best way to prevent injury is to stay aware of body position, mechanics, equipment, and what the body says.
Stretching
Stretching is one of the best things to avoid injury before practicing, competing, or just playing. Stretching will increase flexibility, especially in the wrist, hand, arm, and low back.
Improving technique
Continually using poor techniques over and over is a perfect set-up for injury. Working with a coach will ensure the proper form. This is important when it comes to generating spin on the ball, as well as, making sure the grip does not place too much strain on the hands.
Using the right ball
The ball being used might not be the right fit for your hand or strength. The holes could be too far apart, causing strain on the fingers. Get as much information as possible and try out different styles and weights to get a comfortable feel for the right ball.
Bowling less
Hard-core bowlers could be overdoing it. Cutting back, and creating a balance will allow the body to recover thoroughly and not cause flare-ups.
Getting in shape
Studies show that individuals who bowl and do not exercise significantly increase the risk of a back injury than those who exercise their back and core. Bowling is not as strenuous as other sports, but it still requires the body to be able to handle the stress.
Body Health
Test Body Composition
Testing body composition regularly is the best way to ensure the body stays healthy. Tracking body composition tracks Lean Mass and Fat Mass gain or loss. The information provided allows the individual to make the necessary changes to ensure they stay fit and healthy.
Diet adjustment
Diet needs to be adjusted to match the individual’s current activity level, or risk running a caloric surplus. A great way to optimize diet is to use Basal Metabolic Rate which will make sure the body is getting enough nutrients to fuel muscle growth, and lose belly fat.
Physical activity that fits the new lifestyle
Increase physical activity levels that work with current lifestyle. This does not mean performing at high levels every day. Be active on a schedule that works for you. Two days of strength training a week offer great physical and mental benefits. The key is to maintain the balance between food consumption and exercise/physical activity that fits your current lifestyle.
References
Almedghio, Sami M et al. “Wii knee revisited: meniscal injury from 10-pin bowling.” BMJ case reports vol. 2009 (2009): bcr11.2008.1189. doi:10.1136/bcr.11.2008.1189
Kerr, Zachary Y et al. “Epidemiology of bowling-related injuries presenting to US emergency departments, 1990-2008.” Clinical pediatrics vol. 50,8 (2011): 738-46. doi:10.1177/0009922811404697
Kisner, W H. “Thumb neuroma: a hazard of ten pin bowling.” British journal of plastic surgery vol. 29,3 (1976): 225-6. doi:10.1016/s0007-1226(76)90060-6
Miller, S, and G M Rayan. “Bowling related injuries of the hand and upper extremity; a review.” The Journal of the Oklahoma State Medical Association vol. 91,5 (1998): 289-91.
The hands are a magnificent piece of work. Its intricate design and functional form follow the hand. However, any injury to the underlying structures of the hand can overlap with other injuries/conditions. Even the smallest hand injuries require a proper medical examination. The objective is a quick and accurate initial evaluation along with treatment. Early treatment is done quickly to minimize short and long-term effects.
Anatomy
The hand consists of 27 bones that include 8 bones in the wrist. If the associated structures:
Nerves
Arteries
Veins
Muscles
Tendons
Ligaments
Joint cartilage
Fingernails
Get injured or damaged in some way; there is increased potential for various injuries.
Causes
The most common cause of injury/s is blunt trauma, followed by injury from a sharp object. Hand injuries are divided into categories:
Symptoms vary depending on the type of injury, how the injury occurred/mechanism, the depth, severity, and location. Common symptoms:
Lacerations
Tenderness
Pain
Bleeding
Numbness
Decreased range of motion
Difficulty moving
Weakness
Pale appearance
Fractures and Dislocations
Swelling
Discoloration
Tenderness
Deformity
Reduced range of motion
Numbness
Weakness
Bleeding
Soft Tissue Injuries and Amputations
Swelling
Discoloration
Tenderness
Deformity with or without tissue loss/bone loss
Bleeding
Weakness
Numbness
Infection
Tenderness
Swelling
Warmth/Heat around the area
Redness
Deformity
Reduced range of motion
Fever is rare in hand infections
Burns
Redness
Tenderness
Blistering
Complete numbness
Discoloration
Loss of tissue
The texture of the skin change
Areas of tissue blackened
Deformity
High-pressure Injection Injury
Pain
Swelling
Bleeding
Skin discoloration
Muscle, tendon, ligament tears
Cracked/Broken bones
Medical Care
Anyone with a hand injury is recommended to call a doctor or seek medical attention. When medical attention is delayed, the possibility of worsening or creating further injuries increases. Even the smallest cut or what looks like a minor injury could require advanced treatment to prevent infection or loss of function. Any cut or laceration that requires stitches to repair should also have a medical evaluation to make sure the musculoskeletal system of the hands is functioning properly. Injuries causing the following symptoms require emergency medical attention at an emergency clinic.
Severe bleeding
Severe pain
Numbness
Loss of motion
Loss of strength
Deformity
Signs of infection – tenderness, warmth/heat, redness, swelling, pus, or fever
Exposure of structures – tendons, bones, joints, arteries, veins, or nerves
Diagnosis
A medical examination can include a medical history and physical examination.
Medical History
Past medical history
Does the patient have diabetes or arthritis?
Is the patient right or left-handed?
Occupation
Extracurricular activities and hobbies
How does the patient use their hands?
How did the injury occur, mechanism of injury?
Does the patient smoke?
Physical Exam
Visual inspection look at the injury
Sensory nerve exam feeling
Vascular exam circulation of blood supply
Muscular and tendon exam movement and strength
Bone exam broken bones or dislocated joints
Tests
A doctor will order X-rays after the history and physical exam if necessary. Certain injuries will require imaging to identify fractures/dislocations or to rule out foreign bodies. Many types of injuries can lead to compartment syndrome. Compartment syndrome is a condition in which there is swelling and an increase in pressure within a limited space or a compartment that presses on and compromises blood vessels, nerves, and/or tendons that run through that particular area. Once the immediate injury is addressed, a personalized treatment plan can be developed .to rehabilitate the hand/s to optimal function quickly
Body Composition
Artificial Sweeteners And Muscle Gain
Artificial sweeteners don’t individuals that are trying to build lean body mass. The body needs carbs after a workout for replenishing the depleted glycogen stores. Many commercially prepared protein supplements are made with artificial sweeteners that don’t provide an adequate source of carbohydrates. If an individual consumes only protein made with sugar substitutes after a workout, they are missing essential components of post-workout recovery. A study found that supplementing with carbohydrates before and during strength training can increase performance, compared to participants that were taking the artificial sweeteners saccharin and aspartame. To properly refuel after a workout, remove the artificially sweetened protein powders and replace them with a snack packed with protein and high-quality carbohydrates. These include:
Greek yogurt
Fruit with nuts or nut butter
Hummus with whole-grain crackers
Tuna
Hard-boiled eggs
References
Banting, Joshua, and Tony Meriano. “Hand Injuries.” Journal of special operations medicine: a peer-reviewed journal for SOF medical professionals vol. 17,4 (2017): 93-96.
Fuhrer, Reto et al. “Tipps und Tricks in der Behandlung offener Handverletzungen in der Notfallpraxis” [Treatment of acute injuries of the hand]. Therapeutische Umschau. Revue therapeutique vol. 77,5 (2020): 199-206. doi:10.1024/0040-5930/a001177
Harrison, BP, and M W Hilliard. “Emergency department evaluation and treatment of hand injuries.” Emergency medicine clinics of North America vol. 17,4 (1999): 793-822, v. doi:10.1016/s0733-8627(05)70098-5
MedscapeReference.com. High-Pressure Hand Injury.
MedscapeReference.com. Soft Tissue Hand Injury Differential Diagnoses.
Siotos, C et al. “Hand injuries in low- and middle-income countries: a systematic review of existing literature and call for greater attention.” Public health vol. 162 (2018): 135-146. doi:10.1016/j.puhe.2018.05.016
Anyone from young children, adults, and the elderly can get a spinal infection. Individuals can have an infection:
In vertebral bone tissue
An intervertebral disc
The spinal canal – space where the spinal cord runs through
The spinal cord’s protective lining
These types of infections can happen anywhere along the spine, from the atlas at the base of the neck to the coccyx all the way to the lowest part of the back. Individuals should expect unpredictability if dealing with a spinal infection. During testing, lab results could be misleading or inaccurate. What can happen is white blood cell counts are normal, X-rays might not show any abnormalities, and sensitive diagnostic tests like a CT or MRI scan might not show positivity of infection for a week or more. What to know about spinal infections.
Spinal Infection Types
They are classified according to the type of tissue they infect. The most common include:
Vertebral Osteomyelitis
This is a common infection type. Bacteria most often cause the cause. It can develop after trauma to the spine, post-surgery, or bacterial infections located in other body parts that travel via the blood to the vertebra. Symptoms include:
Persistent, chronic back pain that can become severe worsens at night and becomes aggravated from moving.
The pain radiates/spreads into the arms and legs
Tingling, numbness, and burning sensations
Inflammation
Fever
Weight loss
Vomiting
Post-surgery wound drainage, redness, and swelling near the surgical site
Treatment includes:
Intravenous antibiotics
Antibiotics
Over-the-counter analgesics like nonsteroidal anti-inflammatory meds for pain relief.
Prescription pain medications
Back brace
Surgery is recommended if antibiotic treatment fails, nerve damage develops, a spinal deformity develops, or to remove infected bone and/or soft tissues.
Discitis
This type of infection develops between the intervertebral discs. It is also rare, but it is more common in children and adolescents, but it can still happen in adults. Discitis can be potentially deadly, despite advanced treatment. The most common causes are bacterial and viral infections.
Symptoms
Individuals with discitis can present with minimal symptoms when the infection initializes, but it does worsen and can cause:
Abdominal pain and discomfort
Posture changes
Mobility issues
Difficulty performing everyday tasks
Fever
Severe back pain that worsens at night or by moving
Treatment options include:
Antibiotics
Anti-inflammatory medications
Supportive devices
Rest
Steroids to alleviate inflammation in chronic and severe cases
Severe cases could require surgery to restructure areas of the affected spine to improve function and mobility
Epidural Abscess
This is an infection that can develop in the spaces between the bones of the spine, the skull, or soft tissues surrounding the brain and spinal cord. This is a medical emergency that needs to be addressed immediately. The infection is often caused by a bacterial or fungal infection in or around the affected area. This is commonly a Staphylococcus aureus bacteria. In some cases, an abscess can develop from an infection in another part of the body. This could be a urinary tract infection that spreads out to the spine. Symptoms include:
Inflammation and swelling
Mid to low back pain
Headache
Fever
Nausea and/or vomiting
Neurological weakness, numbness in the arms and legs, bowel or bladder incontinence
Walking problems
Treatment consists of intravenous antibiotics to combat the infection that caused the abscess. In some cases, if there is difficulty moving around or are experiencing numbness, then surgery is required to drain the abscess or completely remove it.
Risk Factors
Spine infections can affect anyone. However, there are individuals with certain chronic health problems that have an increased risk. They include those with:
Kidney disease
Liver disease
Auto-immune diseases
Immune systems compromised like cancer and HIV
Individuals that have undergone a spinal surgical procedure are at greater risk post-surgery
Risk factors include:
Individuals that have had a spinal infection could be more susceptible to developing another.
Age – older adults
Malnutrition
Diabetes mellitus
Obesity
Smoking
Intravenous drug use
Certain areas of the back are more prone to infection. This includes the cervical/back of the neck and the lumbar/low back.
Surgical risk factors:
Long surgical procedure
Massive loss of blood
Multiple surgeries of the same area
Diagnosis
Early diagnosis can be the difference in treating the infection before damage to the spine develops or before the damage worsens. They are diagnosed through a variety of lab and imaging tests. These include:
Various lab tests
Blood work to examine white blood cell counts and markers for inflammation
X-Rays
CT scan
MRI
Outcome
These infections are rare, but they are serious and early treatment is recommended for optimal outcomes. Early diagnosis in the early stages can be successfully treated with antibiotics, rest, and spinal braces. Doctors, spine specialists, chiropractors, and physical therapists will work with the individual to provide a thorough diagnosis, personalized treatment plan, and long-term outcomes.
Body Composition
Practice Mindfulness
Practicing mindfulness can help identify triggers of negative thoughts and behavior. Mindfulness is unique to each individual. Sitting quietly and meditating for 20 minutes is not for everyone. Instead, try a five-minute guided meditation, writing, or music listening. The best time to meditate is in the morning after waking up. This helps set the day’s objectives, what’s important and what can wait in a clear fashion. Mindfulness practice has been shown to reduce stress and feelings of anxiety.
Journaling is a great way to find out about yourself. It can be done with pencil/pen and paper, on a computer, tablet, or phone. Take a few minutes to write some ideas, feelings, emotions that can help put things in perspective. Examples could be, writing something that makes you happy/proud, something that you want to improve, and a goal. There is also mindful listening that can help reduce stress by focusing attention. Instead of turning on the news or checking email first thing, listen to a favorite podcast or music. The same applies to over-phone use. During some downtime instead of scrolling through social media, etc, take a breath and listen to your mind and self.
References
American Association of Neurological Surgeons. Spinal Infections. http://www.aans.org/Patient%20Information/Conditions%20and%20Treatments/Spinal%20Infections.aspx. Published May 2016. Accessed December 29, 2016.
Stat Pearls. (2021). Diskitis. https://www.ncbi.nlm.nih.gov/books/NBK541047/
Stat Pearls. (2021). Spinal Epidural Abscess. https://www.ncbi.nlm.nih.gov/books/NBK441890/
Frontiers in Medicine. (2014). Surgical site infections following spine surgery: eliminating the controversies in the diagnosis. https://www.frontiersin.org/articles/10.3389/fmed.2014.00007/full
Microorganisms. (2020). Spinal Infections: An Update. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7232330/
The Spine Journal. (2021.) “Long term quality of life outcome after spondylodiscitis treatment.” https://www.thespinejournalonline.com/article/S1529-9430(21)00783-X/fulltext
The latissimus dorsi or lats are the large flat muscles on each side covering the width of the middle and lower back. They connect the bone of the upper arm to the spine and the hip. When pain presents in these muscles, it is typically caused by:
Repetitive overuse in a job or doing a task/chore that requires constant
Bending
Pulling
Pushing
Reaching
Twisting
Kneeling
A result of poor technique in sports or similar physical activities.
Chiropractic treatment, along with exercises, can help prevent and relieve this pain.
Symptoms of lat pain
The objective is to diagnose whether the pain is located in the latissimus dorsi or other muscles in the shoulders or back. If the latissimus dorsi is injured, an individual might feel pain in several areas, these include:
Lower, middle, and upper back
Back of the shoulders
The base of the shoulder blade
Lower arms
Inside of the arms, extending down to the fingers
In certain cases, the pain will present without warning and can be felt in the surrounding muscles. This type of pain often gets worse when the individual:
Extends their hands forward and out in front
Raises their hands above their head
Tosses or throws an object
Damage or injury to the latissimus dorsi
Tissue damage or injury can cause other symptoms to present. These include:
If the source of the back pain cannot be identified, or if it is accompanied by:
Fever
Breathing problems
Abdominal pain
Consult a doctor as these could be symptoms of a more serious condition.
Uses and Causes
The lat muscles are used in everyday activities. These include:
Picking up objects like grocery bags
Opening heavy doors
Chest expansion for breathing
Pushing against the armrests of a chair to stand up
Using handrails to climb stairs
For sports or working out, the lats are used in:
Weightlifting exercises using the upper body
Bench-presses
Rowing
Swimming
Throwing
Common causes of pain include:
Overusing the muscles
Using poor techniques
Exercising without warming up
Risk of injury
Individuals that are at risk of developing this injury include those that:
Are continually reaching overhead
Regularly chop wood
Perform regular shoveling
Move furniture or other heavy objects
Regularly practice poor posture
Tearing the latissimus dorsi is possible, especially for athletes. Some athletes with increased risk include:
Golfers
Baseball pitchers
Gymnasts
Swimmers
Tennis players
Exercises that can help bring relief
Certain exercises can alleviate the aches, pain, and strengthen the lat muscles to prevent and/or worsen the injury. It is recommended to consult a doctor, sports chiropractor, or personal trainer before beginning a therapeutic exercise regimen. This is to ensure that the exercises are right for the individual and their condition and that they use the correct form. Here are two exercises that can help reduce the pain. The doctor, chiropractor, or trainer will recommend the frequency the individual should perform the exercises.
Back bow
This pose is known as the superman pose. To perform:
Lay facedown on the floor
Extend the legs so they are straight
Stretch arms away from the body, so they are in front of the head
Bend the knees like for a sit-up with the heels close to the buttocks
Keeping the hands and feet in place
Lift the pelvis upward
Slowly lower back to the floor
Prevention
Individuals can prevent lat pain with lifestyle adjustments. These include:
Using proper technique and posture during work, sports, and exercise
Staying aware to not overuse the muscles
Staying hydrated
Warming up and cooling down thoroughly before and after a workout, sports, physical activities
Regular stretching
Applying ice and heat before and after work, sports, and physical activities
Chiropractic care
Physical therapy massage
Body Composition
Nutrition and Recovery Advantage
Two important steps to achieve optimal health include:
Nutrition
Having a proper protein intake is important for muscle adaptability or the way muscles adapt to stress during exercise and/or strength training. This is also important to stimulate muscle protein synthesisafter exercising and/or strength training. To ensure the body is getting the strength and hypertrophy improvement from exercise and strength training, it is recommended to eat around 25g of high-quality protein after workout sessions.
Recovery
For those doing aerobic and strength training, maximize recovery time between workout sessions. This is because strength and aerobic fitness health gains are low when the two only have a separation of 6 hours or less. Twenty-four hours between sessions is recommended especially if the priority is endurance performance.
References
Anderson, S. E., Hertel, R., Johnston, J. O., Stauffer, E., Leinweber, E., & Steinbach, L. S. (2005, November). Latissimus dorsi tendinosis and tear: imaging features of a pseudotumor of the upper limb in five patients. American Journal of Roentgenology, 185(5), 1145–1151
https://www.ajronline.org/doi/abs/10.2214/AJR.04.1247
Donohue, Benjamin F et al. “Sports Injuries to the Latissimus Dorsi and Teres Major.” The American journal of sports medicine vol. 45,10 (2017): 2428-2435. doi:10.1177/0363546516676062http://journals.sagepub.com/doi/abs/10.1177/0363546516676062?journalCode=ajsb
Henseler, J. F., Nagels, J., Nelissen, R. G. H. H., & de Groot, J. H. (2014, April). Does the latissimus dorsi tendon transfer for massive rotator cuff tears remain active postoperatively and restore active external rotation? Journal of Shoulder and Elbow Surgery, 23(4), 553–560
http://www.jshoulderelbow.org/article/S1058-2746(13)00399-6/fulltext%20
George, Michael S, and Michael Khazzam. “Latissimus Dorsi Tendon Rupture.” The Journal of the American Academy of Orthopaedic Surgeons vol. 27,4 (2019): 113-118. doi:10.5435/JAAOS-D-17-00581
Lehman, Gregory J et al. “Variations in muscle activation levels during traditional latissimus dorsi weight training exercises: An experimental study.” Dynamic medicine: DM vol. 3,1 4. 30 Jun. 2004, doi:10.1186/1476-5918-3-4
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