Individuals that have gone through a back injury may develop a synovial spinal cyst as a way to protect the spine that could cause pain symptoms and sensations. Can knowing the signs help healthcare providers develop a thorough treatment plan to relieve pain, prevent worsening of the condition and other spinal conditions?
Spinal Synovial Cysts
Spinal synovial cysts are benign fluid-filled sacs that develop in the spine’s joints. They form because of spinal degeneration or injury. The cysts can form anywhere in the spine, but most occur in the lumbar region/lower back. They typically develop in the facet joints or junctions that keep the vertebrae/spinal bones interlocked.
Symptoms
In most cases, synovial cysts don’t cause symptoms. However, the doctor or specialist will want to monitor for signs of degenerative disc disease, spinal stenosis, or cauda equina syndrome. When symptoms do present, they typically cause radiculopathy or nerve compression, which can cause back pain, weakness, numbness, and radiating pain caused by the irritation. The severity of symptoms depends on the size and location of the cyst. Synovial cysts can affect one side of the spine or both and can form at one spinal segment or at multiple levels.
Effects Can Include
Radiculopathy symptoms can develop if the cyst or inflammation caused by the cyst comes into contact with a spinal nerve root. This can cause sciatica, weakness, numbness, or difficulty controlling certain muscles.
Neurogenic claudication/impingement and inflammation of spinal nerves can cause cramping, pain, and/or tingling in the lower back, legs, hips, and buttocks. (Martin J. Wilby et al., 2009)
If the spinal cord is involved, it may cause myelopathy/severe spinal cord compression that can cause numbness, weakness, and balance problems. (Dong Shin Kim et al., 2014)
Symptoms related to cauda equina, including bowel and/or bladder problems, leg weakness, and saddle anesthesia/loss of sensation in the thighs, buttocks, and perineum, can present but are rare, as are synovial cysts in the middle back and neck. If thoracic and cervical synovial cysts develop, they can cause symptoms like numbness, tingling, pain, or weakness in the affected area.
Causes
Spinal synovial cysts are generally caused by degenerative changes like osteoarthritis that develop in a joint over time. With regular wear and tear, facet joint cartilage/the material in a joint that provides protection, a smooth surface, friction reduction, and shock absorption begins to waste away. As the process continues, the synovium can form a cyst.
Traumas, large and small, have inflammatory and degenerative effects on joints that can result in the formation of a cyst.
Around a third of individuals who have a spinal synovial cyst also have spondylolisthesis.
This condition is when a vertebrae slips out of place or out of alignment onto the vertebra underneath.
It is a sign of spinal instability.
Instability can occur in any spine area, but L4-5 are the most common levels.
This segment of the spine takes most of the upper body weight.
Epidural corticosteroid injections can reduce inflammation and could be an option to relieve pain.
Patients are recommended to receive no more than three injections per year.
Surgical Options
For severe or persistent cases, a doctor may recommend decompression surgery to remove the cyst and surrounding bone to relieve pressure on the nerve root. Surgical options range from minimally invasive endoscopic procedures to larger, open surgeries. The best surgical option varies based on the severity of the situation and whether associated disorders are present. Surgical options include:
Laminectomy – Removal of the bony structure that protects and covers the spinal canal/lamina.
Hemilaminectomy – A modified laminectomy where a smaller portion of the lamina is removed.
Facetectomy – The removal of part of the affected facet joint where the synovial cyst is located, usually following a laminectomy or hemilaminectomy.
Fusionof the facet joints and vertebra – Decreases vertebral mobility in the injured area.
Most individuals experience immediate pain relief following a laminectomy or hemilaminectomy.
Fusion can take six to nine months to heal completely.
If surgery is performed without fusion where the cyst originated, the pain could return, and another cyst could form within two years.
Surgery Complications include infection, bleeding, and injury to the spinal cord or nerve root.
How I Gained My Mobility Back With Chiropractic
References
Wilby, M. J., Fraser, R. D., Vernon-Roberts, B., & Moore, R. J. (2009). The prevalence and pathogenesis of synovial cysts within the ligamentum flavum in patients with lumbar spinal stenosis and radiculopathy. Spine, 34(23), 2518–2524. doi.org/10.1097/BRS.0b013e3181b22bd0
Kim, D. S., Yang, J. S., Cho, Y. J., & Kang, S. H. (2014). Acute myelopathy caused by a cervical synovial cyst. Journal of Korean Neurosurgical Society, 56(1), 55–57. doi.org/10.3340/jkns.2014.56.1.55
Epstein, N. E., & Baisden, J. (2012). The diagnosis and management of synovial cysts: Efficacy of surgery versus cyst aspiration. Surgical neurology international, 3(Suppl 3), S157–S166. doi.org/10.4103/2152-7806.98576
For individuals looking to spice up their diet, can jalapeño peppers provide nutrition, and be a good source of vitamins?
Jalapeño Pepper Nutrition
Jalapeños are one of many types of chili peppers that are used to accent or garnish and add heat to a dish. This pepper variety is generally harvested and sold when it is a glossy dark green but turns red as it matures. The following nutrition information for one 14-gram jalapeño pepper. (FoodData Central. U.S. Department of Agriculture. 2018)
Jalapeño peppers contain very little carbohydrates and cannot be tested with the standard GI methodology. (Fiona S. Atkinson et al., 2008)
6 grams of carbohydrates in 1-cup serving has an extremely low glycemic load, meaning the peppers do not raise blood sugar levels rapidly or provoke an insulin response. (Mary-Jon Ludy et al., 2012)
Fat
Jalapeños have a trace amount of fat that is mostly unsaturated.
Protein
The peppers are not a recommended source of protein, as they contain less than a gram of protein in a full cup of sliced jalapeños.
Vitamins and Minerals
One pepper contains about 16 milligrams of vitamin C, about 18% of the recommended daily allowance/RDA.
Jalapeños are a good source of vitamin A, which supports skin and eye health.
In 1/4 cup sliced jalapeño peppers, individuals acquire around 8% of the recommended daily amount of vitamin A for men and 12% for women.
Jalapeños are also a source of vitamins B6, K, and E.
Health Benefits
Many health benefits have been attributed to capsaicin which is the substance that generates the heat in the peppers, including alleviating pain and itching by blocking a neuropeptide that transmits those signals to the brain. (Andrew Chang et al., 2023)
Pain Relief
Research shows capsaicin – supplements or topical ointments/creams – can relieve nerve and joint pain. (Andrew Chang et al., 2023)
Lower the Risk of Heart Disease
A study of individuals with low levels of healthy HDL cholesterol, who are at risk of coronary heart disease/CHD, showed that capsaicin supplements improved risk factors for CHD. (Yu Qin et al., 2017)
Reduce Inflammation
The vitamin C in the peppers acts as an antioxidant, which means it can repair cells damaged by oxidative stress and reduce inflammation.
They can be consumed raw, pickled, canned, or smoked/chipotle peppers and are hotter than fresh or canned because they are dried and treated.
Storage and Safety
Fresh jalapeños can be stored at room temperature for a few days or in the refrigerator for about a week.
Once a jar is opened, keep it in the refrigerator.
For an open can of peppers, transfer to a glass or plastic container for refrigerator storage.
Peppers can be frozen after preparing by cutting off the stems and scooping out the seeds.
Frozen jalapeños are best within 6 months for the best quality, but can be kept for much longer.
Preparation
Removing the seeds can help reduce the heat.
Jalapeños can be eaten whole or sliced and added to salads, marinades, salsa, or cheeses.
Some add jalapeños to smoothies for a spicy kick.
They can be used in various recipes for added heat and tanginess.
Chiropractic, Fitness, and Nutrition
References
FoodData Central. U.S. Department of Agriculture. (2018). Peppers, jalapeno, raw.
Atkinson, F. S., Foster-Powell, K., & Brand-Miller, J. C. (2008). International tables of glycemic index and glycemic load values: 2008. Diabetes care, 31(12), 2281–2283. doi.org/10.2337/dc08-1239
Ludy, M. J., Moore, G. E., & Mattes, R. D. (2012). The effects of capsaicin and capsiate on energy balance: critical review and meta-analyses of studies in humans. Chemical senses, 37(2), 103–121. doi.org/10.1093/chemse/bjr100
National Institutes of Health Office of Dietary Supplements. (2021). Vitamin C: Fact Sheet for Health Professionals.
Chang A, Rosani A, Quick J. Capsaicin. [Updated 2023 May 23]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK459168/
Qin, Y., Ran, L., Wang, J., Yu, L., Lang, H. D., Wang, X. L., Mi, M. T., & Zhu, J. D. (2017). Capsaicin Supplementation Improved Risk Factors of Coronary Heart Disease in Individuals with Low HDL-C Levels. Nutrients, 9(9), 1037. doi.org/10.3390/nu9091037
American Academy of Allergy Asthma and Immunology. (2017). Ask the Expert: Pepper Allergy.
For individuals working at a desk or work station where the majority of the work is done in a sitting position and increases the risk for a variety of health problems, can using a standing desk help prevent musculoskeletal problems and improve short and long-term wellness?
Stand Desks
More than 80% of jobs are done in a seated position. Stand desks have proven to help. (Allene L. Gremaud et al., 2018) An adjustable stand desk is intended to be the standing height of an individual. Some desks can be lowered to use while sitting. These desks can improve:
Blood circulation
Back pain
Energy
Focus
Individuals who are less sedentary may experience decreased depression, anxiety, and risk of chronic disease.
Improve Posture and Decrease Back Pain
Sitting for prolonged periods can cause fatigue and physical discomfort. Back pain symptoms and sensations are common, especially when practicing unhealthy postures, already dealing with existing back problems, or using a non-ergonomic desk set-up. Instead of only sitting or standing for the whole workday, alternating between sitting and standing is far healthier. Practicing sitting and standing regularly reduces body fatigue and lower back discomfort. (Alicia A. Thorp et al., 2014) (Grant T. Ognibene et al., 2016)
Increases Energy Levels
Prolonged sitting correlates with fatigue, reduced energy, and productivity. A sit-stand desk can provide benefits like increased productivity levels. Researchers discovered that sit-stand desks could improve the general health and productivity of office workers. Individuals in the study reported:
According to the CDC, six in 10 individuals in the U.S. have at least one chronic disease, like diabetes, heart disease, stroke, or cancer. Chronic disease is the leading cause of death and disability, as well as a leading force of healthcare costs. (Centers for Disease Control and Prevention. 2023) While further research is needed to see if standing desks can reduce the risk of chronic disease, one study looked to quantify the association between sedentary time and the risk of chronic disease or death. Researchers reported that sedentariness for prolonged periods was independently associated with negative health outcomes regardless of physical activity. (Aviroop Biswas et al., 2015)
Improved Mental Focus
Sitting for extended periods slows down blood circulation. This decreased blood flow to the brain lowers cognitive function and increases the risk of neurodegenerative conditions. One study confirmed that healthy individuals who worked in a prolonged sitting position had reduced brain blood flow. The study found that frequent, short walks could help prevent this. (Sophie E. Carter et al., 2018) Standing increases blood and oxygen circulation. This improves cognitive function, which also helps improve focus and concentration.
Depression and Anxiety Reduction
Modern lifestyles typically contain large amounts of sedentary behavior.
However, there is a small amount about the mental health risks of prolonged sedentary behavior. There have been a few studies aimed at improving public understanding. One study focused on a group of older adults, having them self-report sedentary habits that included television, internet, and reading time. This information was compared to their individual scoring on the Centre of Epidemiological Studies Depression scale. (Mark Hamer, Emmanuel Stamatakis. 2014)
The researchers found that certain sedentary behaviors are more harmful to mental health than others.
Television watching, for example, resulted in increased depressive symptoms and decreased cognitive function. (Mark Hamer, Emmanuel Stamatakis. 2014)
Internet use had the opposite effect, decreasing depressive symptoms and increasing cognitive function.
Researchers theorize that the results come from the contrasting environmental and social contexts in which they are happening. (Mark Hamer, Emmanuel Stamatakis. 2014)
Another study looked at the possible correlation between sedentary behavior and anxiety.
Incorporating a standing desk into the workspace can help to reduce the negative effects of sedentary behaviors, leading to improved productivity, improved mental and physical health, and a healthy work environment for individuals who work long hours at a desk or workstation.
Understanding Academic Low Back Pain: Impact and Chiropractic Solutions
References
Gremaud, A. L., Carr, L. J., Simmering, J. E., Evans, N. J., Cremer, J. F., Segre, A. M., Polgreen, L. A., & Polgreen, P. M. (2018). Gamifying Accelerometer Use Increases Physical Activity Levels of Sedentary Office Workers. Journal of the American Heart Association, 7(13), e007735. doi.org/10.1161/JAHA.117.007735
Thorp, A. A., Kingwell, B. A., Owen, N., & Dunstan, D. W. (2014). Breaking up workplace sitting time with intermittent standing bouts improves fatigue and musculoskeletal discomfort in overweight/obese office workers. Occupational and environmental medicine, 71(11), 765–771. doi.org/10.1136/oemed-2014-102348
Ognibene, G. T., Torres, W., von Eyben, R., & Horst, K. C. (2016). Impact of a Sit-Stand Workstation on Chronic Low Back Pain: Results of a Randomized Trial. Journal of occupational and environmental medicine, 58(3), 287–293. doi.org/10.1097/JOM.0000000000000615
Ma, J., Ma, D., Li, Z., & Kim, H. (2021). Effects of a Workplace Sit-Stand Desk Intervention on Health and Productivity. International journal of environmental research and public health, 18(21), 11604. doi.org/10.3390/ijerph182111604
Centers for Disease Control and Prevention. Chronic disease.
Biswas, A., Oh, P. I., Faulkner, G. E., Bajaj, R. R., Silver, M. A., Mitchell, M. S., & Alter, D. A. (2015). Sedentary time and its association with risk for disease incidence, mortality, and hospitalization in adults: a systematic review and meta-analysis. Annals of internal medicine, 162(2), 123–132. doi.org/10.7326/M14-1651
Carter, S. E., Draijer, R., Holder, S. M., Brown, L., Thijssen, D. H. J., & Hopkins, N. D. (2018). Regular walking breaks prevent the decline in cerebral blood flow associated with prolonged sitting. Journal of applied physiology (Bethesda, Md. : 1985), 125(3), 790–798. doi.org/10.1152/japplphysiol.00310.2018
Hamer, M., & Stamatakis, E. (2014). Prospective study of sedentary behavior, risk of depression, and cognitive impairment. Medicine and science in sports and exercise, 46(4), 718–723. doi.org/10.1249/MSS.0000000000000156
Teychenne, M., Costigan, S. A., & Parker, K. (2015). The association between sedentary behaviour and risk of anxiety: a systematic review. BMC public health, 15, 513. doi.org/10.1186/s12889-015-1843-x
Individuals with neck and shoulder pain may experience what feels like tightened lumps or knots in and around the muscles where the neck and shoulder meet. Can using kinesiology tape for neck and shoulder trigger points help to loosen and release them, restore function, and bring pain relief?
Kinesiology Tape For Neck and Shoulder Trigger Points
The upper trapezius and levator scapula muscles are where the shoulder and neck come together and are often the location of trigger point formations. These trigger points can cause tension, pain, and muscular spasms in the neck and shoulders. Various treatments for releasing trigger points and alleviating the pain symptoms include therapeutic massage, trigger point release, and chiropractic adjustments in a multidisciplinary treatment approach.
Electrical stimulation and ultrasound have often been used to break up the knots, but scientific evidence has shown that these treatments alone are not the most effective. (David O. Draper et al., 2010)
Stretching the neck muscles can bring tension relief and help release the knots.
Kinesiology tape can decrease the pain and spasms and help to release the trigger points.
Therapy
Using kinesiology tape is a form of physical therapy that can be used in various ways.
The tape helps lift the upper tissues from underlying tissues to increase circulation and release muscular spasms.
It can help improve muscular contractions, decrease swelling, and inhibit pain in injured tissues.
Helps stop the trigger points and knots from worsening.
The tape can also be used for managing lymphedema.
Usage
To decrease trigger points, individuals can use a specific kinesiology tape strip called a lift strip. Individuals can consult their healthcare provider or physical therapist to show them the various types of strips to learn how to cut them properly.
Before using kinesiology tape, consult a healthcare provider or physical therapist to assess the injury and situation.
Kinesiology tape is not for everyone, and some people have conditions where the use of kinesiology tape should be avoided altogether.
A therapist can evaluate the neck pain and trigger points to determine if the individual should use kinesiology tape.
To use kinesiology tape for neck and shoulder trigger points:
Get comfortable with the neck and shoulders exposed.
Cut one lift strip for each side of the neck, if necessary.
The lift strip should be around 3 to 4 inches long.
Remove the paper backing in the center with the exposed tape in the center, which should look like a band-aid.
Both ends of the lift strip should still have the paper backing on.
Stretch out the kinesiology tape.
Place the stretched tape directly over the trigger points in the upper shoulder area.
Remove the backing on either side of the lift strip and place the ends on without stretching.
Gently rub the tape to help the adhesive adhere.
Once the tape has been applied, it can be left there for 2 to 5 days.
It’s ok if it gets wet with a bath or shower.
Monitor the skin around the tape to watch for redness or other signs of a negative reaction to the tape.
Kinesiology taping can be a useful tool to decrease pain and spasms but does not replace professional treatment, prescribed exercises and stretches, and posture retraining.
The physical therapy team will teach proper self-care strategies for the individual’s condition.
For individuals with neck and shoulder pain and muscle spasms, a trial of kinesiology taping may help alleviate symptoms and improve the overall injury.
The Non-Surgical Approach to Wellness with Chiropractic Care
References
Draper, D. O., Mahaffey, C., Kaiser, D., Eggett, D., & Jarmin, J. (2010). Thermal ultrasound decreases tissue stiffness of trigger points in upper trapezius muscles. Physiotherapy theory and practice, 26(3), 167–172. doi.org/10.3109/09593980903423079
For individuals experiencing gluteus minimus pain and are unsure where to start to deal with it, can a physical therapist, chiropractor, or general practitioner help diagnose lower extremity pain and develop an appropriate treatment plan?
Gluteus Minimus Muscles
The gluteus minimus is the smallest muscle of the gluteal muscles. Combined with the gluteus maximus and gluteus medius, these muscles make up the glutes. The glutes help form the buttocks shape, stabilize the hips, rotate the legs, and raise the thighs. The gluteus minimus and medius specifically support the gluteus maximus’s ability to raise the leg to the side and rotate the thigh inwards. (ScienceDirect. 2011)
Anatomy
The gluteus minimus muscles are triangular and lie underneath the gluteus medius near the rotators of the hip joints. The muscles start in the lower ilium region, the upper and largest area of the hip bone that makes up the pelvis and attaches to the femur/thigh bone.
The fibers on the top part of the muscle are thick and compact, while the lower fibers are flat and spread out.
The superior gluteal nerves and blood vessels separate the gluteus minimus and the medius.
The gluteus medius muscles start on the upper ilium region, which covers the gluteus minimus muscle entirely. The location of the gluteus minimus muscles envelopes the sciatic notch or the area in the pelvis that houses the piriformis muscle, superior gluteal vein, and superior gluteal artery, which provide a certain amount of protection.
Function
Movement depends on the location of the femur. The gluteus minimus muscle’s function is to:
Flex
Rotate
Stabilize
When the thigh is extended, it helps abduct or swing the leg out away from the body.
When the hip bones are flexed, the gluteus minimus rotates the thigh inward with the help of the gluteus medius.
The movements are done with the support of the muscle fibers, which contract to move the thigh in both directions. (ScienceDirect. 2011)
The gluteus minimus and the medius also stabilize the hips and pelvis during movement and when resting.
Associated Conditions
One of the most common injuries is muscle wearing and tearing, which can cause pain over and around the greater trochanter. This is known as greater trochanteric pain syndrome or GTPS, a condition usually caused by a gluteus medius or minimus tendinopathy, which can include inflammation of the surrounding bursae. (Diane Reid. 2016) For a gluteus minimus tear, the pain/sensations will be felt outside the hip, especially when rolling or applying weight on the affected side. A tear can happen suddenly with no particular activity causing the tear to occur aside from normal use and stress on the muscle. Physical activities like walking may be painful.
Rehabilitation
Treatment depends on the severity of the condition. Usually, rest, ice, and over-the-counter medication can help reduce swelling and pain symptoms. For pain symptoms that are not subsiding, it’s recommended to see a healthcare provider who can run an MRI or X-ray to see the condition of the muscle and rule out other causes of pain. The healthcare provider will refer the patient to a physical therapy team that can evaluate the strength of the gluteus minimus and provide a list of exercises and stretches to help repair the muscle while conditioning the surrounding muscles. (SportsRec. 2017) Depending on the level of pain, sometimes the healthcare provider will prescribe a cortisone injection to the gluteus minimus muscle in conjunction with physical therapy. This will help alleviate the pain so that the physical therapy exercises can be done comfortably, allowing the gluteus maximus muscle to heal properly and strengthen. (Julie M. Labrosse et al., 2010)
Reid D. (2016). The management of greater trochanteric pain syndrome: A systematic literature review. Journal of orthopaedics, 13(1), 15–28. doi.org/10.1016/j.jor.2015.12.006
Labrosse, J. M., Cardinal, E., Leduc, B. E., Duranceau, J., Rémillard, J., Bureau, N. J., Belblidia, A., & Brassard, P. (2010). Effectiveness of ultrasound-guided corticosteroid injection for the treatment of gluteus medius tendinopathy. AJR. American journal of roentgenology, 194(1), 202–206. doi.org/10.2214/AJR.08.1215
For individuals experiencing a turf toe injury, can knowing the symptoms help athletes and non-athletes with treatment, recovery time, and returning to activities?
Turf Toe Injury
A turf toe injury affects the soft tissue ligaments and tendons at the base of the big toe under the foot. This condition usually occurs when the toe is hyperextended/forced upward, such as when the ball of the foot is on the ground and the heel is lifted. (American Academy of Orthopaedic Surgeons. 2021) The injury is common among athletes who play sports on artificial turf, which is how the injury got its name. However, it can also affect non-athletes, like individuals working on their feet all day.
Recovery time after turf toe injury depends on the severity and the type of activities the individual plans to return to.
Returning to high-level sports activities after a severe injury can take six months.
These injuries vary in severity but usually improve with conservative treatment. In severe cases, surgery could be required.
Pain is the primary issue that stops physical activities after a grade 1 injury, while grades 2 and 3 can take weeks to months to heal completely.
Meaning
A turf toe injury refers to a metatarsophalangeal joint strain. This joint comprises ligaments that connect the bone on the sole of the foot, below the big toe/proximal phalanx, to the bones that connect the toes to the larger bones in the feet/metatarsals. The injury is usually caused by hyperextension that often results from a pushing-off motion, like running or jumping.
If experiencing turf toe symptoms, see a healthcare provider for a proper diagnosis so they can develop a personalized treatment plan. They will perform a physical exam to assess pain, swelling, and range of motion. (American Academy of Orthopaedic Surgeons. 2021) If the healthcare provider suspects tissue damage, they may recommend imaging with X-rays and (MRI) to grade the injury and determine the proper course of action.
Grades 2 and 3 come with partial or complete tissue tearing, severe pain, and swelling. Treatments for more severe turf toe can include: (Ali-Asgar Najefi et al., 2018)
Limited weight bearing
Using assistive devices like crutches, a walking boot, or a cast.
Physical therapy also includes proprioception and agility training exercises, orthotics, and wearing recommended shoes for specific physical activities. (Lisa Chinn, Jay Hertel. 2010)
A physical therapist can also help ensure that the individual does not return to physical activities before the injury is fully healed and prevent the risk of re-injury.
Grade 1 – Subjective as it varies depending on the individual’s pain tolerance.
Grade 2 – Four to six weeks of immobilization.
Grade 3 – Eight weeks minimum of immobilization.
It can take up to six months to return to normal function.
Returning To Normal Activities
After a grade 1 turf toe injury, individuals can return to normal activities once the pain is under control. Grades 2 and 3 take longer to heal. Returning to sports activities after a grade 2 injury can take around two or three months, while grade 3 injuries and cases that require surgery can take up to six months. (Ali-Asgar Najefi et al., 2018)
Sports Chiropractic Treatment
References
American Academy of Orthopaedic Surgeons. (2021). Turf toe.
American College of Foot and Ankle Surgeons. Foot Health Facts. (2023). RICE protocol.
Najefi, A. A., Jeyaseelan, L., & Welck, M. (2018). Turf toe: A clinical update. EFORT open reviews, 3(9), 501–506. doi.org/10.1302/2058-5241.3.180012
Pinter, Z. W., Farnell, C. G., Huntley, S., Patel, H. A., Peng, J., McMurtrie, J., Ray, J. L., Naranje, S., & Shah, A. B. (2020). Outcomes of Chronic Turf Toe Repair in Non-athlete Population: A Retrospective Study. Indian journal of orthopaedics, 54(1), 43–48. doi.org/10.1007/s43465-019-00010-8
Chinn, L., & Hertel, J. (2010). Rehabilitation of ankle and foot injuries in athletes. Clinics in sports medicine, 29(1), 157–167. doi.org/10.1016/j.csm.2009.09.006
For individuals trying to optimize muscle growth, protein intake is essential. However, the body is limited by how much protein can synthesize to repair and grow muscles. Can knowing protein intake timing, amount, and how to best stimulate muscle growth help achieve better results?
Muscle Protein Synthesis
Muscle protein synthesis is a physiological process of producing new muscle protein and is an important component of how the body maintains and builds muscle. Muscle growth is achieved with resistance training and protein intake. (Tanner Stokes, et al., 2018)
How Protein Synthesis Works
Protein is the building block of muscles, while protein synthesis is a natural metabolic process in which protein is produced to repair muscle damage caused by exercise. This happens from amino acids binding to skeletal muscle proteins, increasing muscle size. It counteracts muscle protein breakdown (MPB) due to protein loss during exercise. The breakdown of muscles is a necessary part of building muscle. When damaged, muscles will build back larger, so long as enough calories and protein are consumed to repair and grow the muscles. Muscle protein synthesis can be enhanced by increasing protein intake immediately following exercise. Learning to stimulate muscle protein synthesis through exercise and diet can help accelerate muscle growth, expedite recovery, improve physical performance, and increase overall endurance. (Cameron J. Mitchell et al., 2014)
Effects of Exercise
Protein balance describes the relationship between muscle protein breakdown and muscle protein synthesis. When the body is in protein balance, no muscle growth or wasting occurs, and the individual is considered in a healthy state of biological equilibrium/homeostasis, also known as maintenance. To stimulate muscle growth, individuals need to shake up the protein balance. Although it may seem counter-intuitive, exercise can break down muscle protein, but not more than the amount of protein the body can synthesize. (Felipe Damas, et al., 2015) The more intense the workout, the greater the muscle protein synthesis, as the muscle breakdown stimulates the repair and growth of tissues. Scientists measure intensity by the one-repetition maximum – 1-RM – meaning the maximum weight an individual can lift for one repetition. According to a research study, workout intensities of under 40% of the 1-RM will not affect muscle protein synthesis. And intensities greater than 60% will double or triple muscle protein synthesis. (P. J. Atherton, K Smith. 2012)
Food Impact
The relationship between diet and protein balance is not so straightforward. Even with increased protein intake, muscle protein synthesis occurs for a specific period. This is because the body can only utilize a certain amount of the essential amino acids it receives, with anything more being broken down and excreted by the liver. Nutritionists recommend about 1.4 to 2.0 grams of protein per kilogram of body weight per day for building muscle and strength. (Ralf Jäger, et al., 2017) Enough protein can be obtained by focusing on dairy, eggs, lean meats, nuts, and legumes. It is also recommended to consume enough whole grains, healthy fats, fruits, and vegetables to help the body perform and repair properly. For example, carbohydrates are necessary for muscle building as they stimulate insulin release that supports muscle cell protein absorption. (Vandré Casagrande Figueiredo, David Cameron-Smith. 2013) A study looked into response rates in men prescribed 10, 20, or 40 grams of whey protein immediately following resistance training. Researchers noted the following results: (Oliver C. Witard et al., 2014)
10 grams of whey protein – No effect on muscle protein synthesis.
20 grams – Increased muscle protein synthesis by 49%.
40 grams – Increased the muscle protein synthesis by 56% but also caused the excessive accumulation of urea.
Consuming 20 grams to 40 grams of whey protein after resistance training also increased other essential amino acids associated with lean muscle growth. (Lindsay S. Macnaughton et al., 2016)
Whey protein is a fast-digesting protein.
Increased results can be obtained by consuming slower-digesting protein throughout the day.
Muscle gains vary from person to person as everyone’s body is different. Individuals considering consuming protein beyond the recommended dietary intake should consult their doctor or a registered nutritionist to understand the potential benefits and risks.
Building A Stronger Body
References
Stokes, T., Hector, A. J., Morton, R. W., McGlory, C., & Phillips, S. M. (2018). Recent Perspectives Regarding the Role of Dietary Protein for the Promotion of Muscle Hypertrophy with Resistance Exercise Training. Nutrients, 10(2), 180. doi.org/10.3390/nu10020180
Mitchell, C. J., Churchward-Venne, T. A., Parise, G., Bellamy, L., Baker, S. K., Smith, K., Atherton, P. J., & Phillips, S. M. (2014). Acute post-exercise myofibrillar protein synthesis is not correlated with resistance training-induced muscle hypertrophy in young men. PloS one, 9(2), e89431. doi.org/10.1371/journal.pone.0089431
Damas, F., Phillips, S., Vechin, F. C., & Ugrinowitsch, C. (2015). A review of resistance training-induced changes in skeletal muscle protein synthesis and their contribution to hypertrophy. Sports medicine (Auckland, N.Z.), 45(6), 801–807. doi.org/10.1007/s40279-015-0320-0
Atherton, P. J., & Smith, K. (2012). Muscle protein synthesis in response to nutrition and exercise. The Journal of physiology, 590(5), 1049–1057. doi.org/10.1113/jphysiol.2011.225003
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