The Q or quadriceps angle is a measurement of pelvic width that is believed to contribute to the risk of sports injuries in women athletes. Can non-surgical therapies and exercises help rehabilitate injuries?
Quadriceps Q – Angle Injuries
The Q angle is the angle where the femur/upper leg bone meets the tibia/lower leg bone. It is measured by two intersecting lines:
One from the center of the patella/kneecap to the anterior superior iliac spine of the pelvis.
The other is from the patella to the tibial tubercle.
On average the angle is three degrees higher in women than men.
Women have biomechanical differences that include a wider pelvis, making it easier to give birth. However, this difference can contribute to knee injuries when playing sports, as an increased Q angle generates more stress on the knee joint, as well as leading to increased foot pronation.
Injuries
Various factors can increase the risk of injury, but a wider Q angle has been linked to the following conditions.
Patellofemoral Pain Syndrome
An increased Q angle can cause the quadriceps to pull on the kneecap, shifting it out of place and causing dysfunctional patellar tracking.
With time, this can cause knee pain (under and around the kneecap), and muscle imbalance.
Foot orthotics and arch supports could be recommended.
Some researchers have found a link, while others have not found the same association. (Wolf Petersen, et al., 2014)
Chondromalacia of the Knee
This is the wearing down of the cartilage on the underside of the kneecap.
An increased Q angle can be a factor that increases stress and causes the knee to lose its stability.
However, this remains controversial, as some studies have found no association between the Q angle and knee injuries.
Chiropractic Treatment
Strengthening Exercises
ACL injury prevention programs designed for women have resulted in reduced injuries. (Trent Nessler, et al., 2017)
The vastus medialis obliquus or VMO is a teardrop-shaped muscle that helps move the knee joint and stabilize the kneecap.
Strengthening the muscle can increase the stability of the knee joint.
Strengthening may require a specific focus on muscle contraction timing.
Closed-chain exercises like wall squats are recommended.
Glute strengthening will improve stability.
Stretching Exercises
Stretching tight muscles will help relax the injured area, increase circulation, and restore range of motion and function.
Muscles commonly found to be tight include the quadriceps, hamstrings, iliotibial band, and gastrocnemius.
Foot Orthotics
Custom-made, flexible orthotics decrease the Q angle and reduce pronation, relieving the added stress on the knee.
A custom orthotic ensures that the foot and leg dynamics are accounted for and corrected.
Motion-control shoes can also help correct overpronation.
Knee Rehabilitation
References
Khasawneh, R. R., Allouh, M. Z., & Abu-El-Rub, E. (2019). Measurement of the quadriceps (Q) angle with respect to various body parameters in young Arab population. PloS one, 14(6), e0218387. doi.org/10.1371/journal.pone.0218387
Petersen, W., Ellermann, A., Gösele-Koppenburg, A., Best, R., Rembitzki, I. V., Brüggemann, G. P., & Liebau, C. (2014). Patellofemoral pain syndrome. Knee surgery, sports traumatology, arthroscopy: Official journal of the ESSKA, 22(10), 2264–2274. doi.org/10.1007/s00167-013-2759-6
Vaienti, E., Scita, G., Ceccarelli, F., & Pogliacomi, F. (2017). Understanding the human knee and its relationship to total knee replacement. Acta bio-medica : Atenei Parmensis, 88(2S), 6–16. doi.org/10.23750/abm.v88i2-S.6507
Mitani Y. (2017). Gender-related differences in lower limb alignment, range of joint motion, and the incidence of sports injuries in Japanese university athletes. Journal of Physical Therapy Science, 29(1), 12–15. doi.org/10.1589/jpts.29.12
Nessler, T., Denney, L., & Sampley, J. (2017). ACL Injury Prevention: What Does Research Tell Us? Current reviews in musculoskeletal medicine, 10(3), 281–288. doi.org/10.1007/s12178-017-9416-5
Temporomandibular joint disorder causes pain and jaw locking that can be worsened with certain activities. How individuals can manage and prevent flare-ups by learning what not to do to worsen the condition?
What Not To Do Temporomandibular Joint Disorder
Tenderness, aching, pain, and jaw locking are symptoms of temporomandibular joint disorder or TMJ. The temporomandibular joint connects the jaw to the skull. It is used daily for eating, drinking, and talking. It is a small disc in the joint that allows the jaw bones to slip and slide correctly. With TMJ, the disc shifts out of place, leading to clicking, snapping, and limited jaw movement. It can also cause pain in the jaw and face, neck pain, and headaches, and the muscles around the jaw and neck can become sore and/or go into spasm. Any type of activity that stresses or overworks the joint can trigger a flare-up and worsen TMJ symptoms. (Schiffman E, et al. 2014) This article looks at avoiding activities that make TMJ worse and what not to do to help keep TMJ symptoms in check.
Chewing Gum
Gum chewing is not recommended for individuals with TMJ.
The jaw is one of the most used joints in the body.
Limiting excessive use alleviates pressure allowing the joints and muscles to rest.
Resting sore muscles and joints is the first step in injury recovery.
Eating Chewy and Hard Foods
Chewy and hard foods make the jaw have to work overtime.
Avoid eating hard foods like chewy candies, hard and chewy breads, vegetables like corn on the cob, and fruits like apples.
These foods can place excessive stress on the jaw, and prevent the joint from properly resting and healing.
Chewing Only On One Side
Many individuals chew their food on only one side of the mouth.
This can stress out one side of the temporomandibular joint and surrounding muscles, leading to pain and dysfunction. (Urbano Santana-Mora, et al., 2013)
Stay aware of chewing habits and make sure to utilize both sides of the mouth.
Individuals with dental issues or tooth pain are recommended to see a dentist.
Non-Functional Jaw Activities
Going through each day, individuals tend to do things unconsciously or out of habit.
For example, individuals:
Reading or writing might chew on a pen or pencil.
Bite their nails or chew on the inside of their mouth while watching TV or internet browsing.
These activities can place stress on the joint, worsen the condition, and extend the healing process.
Resting on The Chin
Individuals will rest their jaw in their hands while studying, on social media, or watching TV.
This position can be comfortable, but it can affect the jaw.
This position can build pressure against the side of the jaw and push against the joint, causing the disc to shift out of place affecting how the jaw opens and closes.
Breaking the chin resting habit can allow the joint to relax and heal correctly.
Teeth Clenching
Bruxism is the medical term for clenching the teeth.
This can occur during the day or during sleep.
Teeth clenching is often brought on by stress and can place incredible pressure on the jaw’s muscles and worsen TMJ.
A dentist can prescribe a mouth guard to be worn while sleeping to protect the teeth from excessive clenching. (Miriam Garrigós-Pedrón, et al., 2019)
Slouching
The function of the jaw is closely related to body posture.
The jaw operates optimally when the head is above the cervical spine and the posture is upright.
Slouching can change how the jaw muscles work and the way the jaw opens and closes.
Part of physical therapy for TMJ is working on posture adjustments and training.
This can involve strengthening the back and shoulder muscles and setting up posture reminders.
Sitting and standing correctly can keep the jaw operating properly.
Postponing Treatment
Many with musculoskeletal issues and symptoms wait for the pain to go away.
Individuals having problems with their jaw should not wait to get treatment.
TMJ has a positive rate of recovery with conservative treatment, which is all the more reason to seek treatment. (G Dimitroulis. 2018)
A dentist or healthcare provider can provide an accurate diagnosis if TMJ is suspected.
Individuals can benefit from visiting a physical therapist to learn exercises and strategies to self-treat the condition. (Yasser Khaled, et al., 2017)
Treatment
Treatment can involve:
Initial treatment focuses on pain relief and jaw function opens and closes improvement.
A guard can help with night teeth grinding/bruxism.
Anti-inflammatory treatments.
In severe cases, surgery may be recommended to correct the problem, as a last resort. (Meghan K Murphy, et al., 2013)
Follow recommendations on what not to do and avoid certain activities.
Quick Patient Initiation
References
Schiffman, E., Ohrbach, R., Truelove, E., Look, J., Anderson, G., Goulet, J. P., List, T., Svensson, P., Gonzalez, Y., Lobbezoo, F., Michelotti, A., Brooks, S. L., Ceusters, W., Drangsholt, M., Ettlin, D., Gaul, C., Goldberg, L. J., Haythornthwaite, J. A., Hollender, L., Jensen, R., … Orofacial Pain Special Interest Group, International Association for the Study of Pain (2014). Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for Clinical and Research Applications: recommendations of the International RDC/TMD Consortium Network* and Orofacial Pain Special Interest Group†. Journal of oral & facial pain and headache, 28(1), 6–27. doi.org/10.11607/jop.1151
Santana-Mora, U., López-Cedrún, J., Mora, M. J., Otero, X. L., & Santana-Penín, U. (2013). Temporomandibular disorders: the habitual chewing side syndrome. PloS one, 8(4), e59980. doi.org/10.1371/journal.pone.0059980
Garrigós-Pedrón, M., Elizagaray-García, I., Domínguez-Gordillo, A. A., Del-Castillo-Pardo-de-Vera, J. L., & Gil-Martínez, A. (2019). Temporomandibular disorders: improving outcomes using a multidisciplinary approach. Journal of multidisciplinary healthcare, 12, 733–747. doi.org/10.2147/JMDH.S178507
Dimitroulis G. (2018). Management of temporomandibular joint disorders: A surgeon’s perspective. Australian Dental Journal, 63 Suppl 1, S79–S90. doi.org/10.1111/adj.12593
Khaled Y, Quach JK, Brennan MT, NapeÑas JJ. Outcomes after physical therapy for the treatment of temporomandibular disorders. Oral Surg Oral Med Oral Pathol Oral Radiol, 2017;124(3: e190. doi:10.1016/j.oooo.2017.05.477
Abouelhuda, A. M., Khalifa, A. K., Kim, Y. K., & Hegazy, S. A. (2018). Non-invasive different modalities of treatment for temporomandibular disorders: a review of the literature. Journal of the Korean Association of Oral and Maxillofacial Surgeons, 44(2), 43–51. doi.org/10.5125/jkaoms.2018.44.2.43
Murphy, M. K., MacBarb, R. F., Wong, M. E., & Athanasiou, K. A. (2013). Temporomandibular disorders: a review of etiology, clinical management, and tissue engineering strategies. The International journal of oral & maxillofacial implants, 28(6), e393–e414. doi.org/10.11607/jomi.te20
In individuals with herniated discs, how does non-surgical decompression compare to traditional surgery repair the spine?
Introduction
When many individuals begin to add unnecessary pressure on their backs, it can lead to damaging results to their spine. The spine is the backbone of the body, allowing the upper and lower sections to be mobile and stabilizing the axial weight overload without the person feeling pain or discomfort. The spinal structure is surrounded by muscles, soft tissues, ligaments, nerve roots, and joints that support the spine. In between the spinal facet joints and structure are flat discs that absorb the shock and pressure from the axial overload. However, when unwanted stress starts to compress the disc, it can lead to the development of herniation. Depending on the location, it can cause pain-like symptoms like lower back and neck pain or sciatica. Other times, herniated discs can be due to natural degeneration, where the spinal disc height decreases, and it can crack under pressure, leading to disc dehydration, which, to this point, causes spinal issues to many individuals, thinking they are experiencing referred pain in different body locations. Coincidentally, many people can find the relief they seek through non-surgical treatments to restore the disc height and repair herniated discs. Today’s article focuses on the casing effects of herniated discs and how spinal decompression, a form of non-surgical treatment, can help reduce pain-like symptoms associated with herniated discs. Additionally, we communicate with certified medical providers who incorporate our patients’ information to reduce herniated disc pain, causing many musculoskeletal issues. We also inform them that non-surgical treatments can help mitigate the referred pain-like symptoms related to herniated discs and restore disc height in their spines. We encourage our patients to ask amazing educational questions for our associated medical providers about their referred pain correlating with herniated discs. Dr. Jimenez, D.C., incorporates this information as an educational service. Disclaimer
The Changing Effects Of Herniated Discs
Have you experienced unwanted pain in your upper and lower extremities after a long work day? What about experiencing pain within your spines that are causing symptoms of numbness or tingling sensations in your hands, feet, or legs? Or are you dealing with excruciating lower back pain that is affecting your ability to work? Many individuals don’t realize that the pain-like symptoms they are experiencing are not low back, neck, or shoulder pain, but they correlate to herniated discs in their spines. Herniated discs are when the nucleus pulposus (inner disc portion) starts to protrude out of its original position from the intervertebral space. (Dydyk, Ngnitewe Massa, & Mesfin, 2023) Herniated discs are one of the common causes of lower back pain, and often, many individuals will remember what caused the herniation in their spine.
Some of the effects that lead to disc herniation are that many people will carry heavy objects constantly from one location to another, and the shifting weight can cause the disc to be continuously compressed and thus lead to herniation. Additionally, when the intervertebral disc starts showing signs of stiffness, it can result in abnormal spinal motion. (Haughton, Lim, & An, 1999) This causes morphologic changes within the intervertebral disc and causes it to be dehydrated. The chondroitin sulfation of the proteoglycan in the disc goes through changes in the disc itself, and when degeneration is associated with herniated discs, it can lead to musculoskeletal disorders. (Hutton et al., 1997)
The Root Cause Of Pain- Video
When degenerative changes start to affect the intervertebral discs, it can lead to intervertebral height loss, abnormal pain signaling, and nerve root entrapment associated with disc disruption. (Milette et al., 1999) This causes a cascading effect as the outer annulus of the spinal disc is cracked or ruptured, causing pain to the spine. When the outer annulus of the spinal disc starts to have nerve ingrowth in the affected discs, which then leads to individuals dealing with musculoskeletal disorders associated with pain. (Freemont et al., 1997) Many people will seek non-surgical therapies when finding treatment to alleviate the pain caused by herniated discs due to their cost-effectiveness and how it’s safe for their spine. Chiropractic care, massage therapy, spinal decompression, and traction therapy are available treatments that can be used in a personalized, inclusive treatment care plan to mitigate any pain the person is dealing with. The video explains how these treatments can use functional wellness principles to identify where the pain is located and treat any health issues with any potential underlying causes.
Spinal Decompression Reducing Herniated Disc
Regarding non-surgical treatments reducing herniated discs, spinal decompression can help mitigate the pain affecting the spine’s mobility. Spinal decompression utilizes mechanical traction to gently stretch the spine and allow the herniated disc to return to its original position. Spinal decompression incorporates negative pressure, which helps the nutrients increase the disc’s regenerative factors. (Choi et al., 2022) This allows the facet joints and aggravated nerves to have reduced pressure and increased disc space height. At the same time, spinal decompression can be combined with physical therapy to reduce the pain-like symptoms associated with herniated discs and provide beneficial results. (Amjad et al., 2022) Some of the beneficial factors related to spinal decompression include:
Pain improvement in the upper and lower extremities
Spinal range of motion
Muscle endurance restored
Joint ROM restored
When many individuals become more mindful of how different factors are causing spinal issues, they can make small routine changes in their daily lives, and that can reduce the chances of pain from returning. This allows them to enjoy life fully and continue their health and wellness journey.
References
Amjad, F., Mohseni-Bandpei, M. A., Gilani, S. A., Ahmad, A., & Hanif, A. (2022). Effects of non-surgical decompression therapy in addition to routine physical therapy on pain, range of motion, endurance, functional disability and quality of life versus routine physical therapy alone in patients with lumbar radiculopathy; a randomized controlled trial. BMC Musculoskelet Disord, 23(1), 255. doi.org/10.1186/s12891-022-05196-x
Choi, E., Gil, H. Y., Ju, J., Han, W. K., Nahm, F. S., & Lee, P.-B. (2022). Effect of Nonsurgical Spinal Decompression on Intensity of Pain and Herniated Disc Volume in Subacute Lumbar Herniated Disc. International Journal of Clinical Practice, 2022, 6343837. doi.org/10.1155/2022/6343837
Freemont, A. J., Peacock, T. E., Goupille, P., Hoyland, J. A., O’Brien, J., & Jayson, M. I. (1997). Nerve ingrowth into diseased intervertebral disc in chronic back pain. Lancet, 350(9072), 178-181. doi.org/10.1016/s0140-6736(97)02135-1
Haughton, V. M., Lim, T. H., & An, H. (1999). Intervertebral disk appearance correlated with stiffness of lumbar spinal motion segments. AJNR Am J Neuroradiol, 20(6), 1161-1165. www.ncbi.nlm.nih.gov/pubmed/10445464
Hutton, W. C., Elmer, W. A., Boden, S. D., Horton, W. C., & Carr, K. (1997). Analysis of chondroitin sulfate in lumbar intervertebral discs at two different stages of degeneration as assessed by discogram. Journal of Spinal Disorders, 10(1), 47-54. www.ncbi.nlm.nih.gov/pubmed/9041496
Milette, P. C., Fontaine, S., Lepanto, L., Cardinal, E., & Breton, G. (1999). Differentiating lumbar disc protrusions, disc bulges, and discs with normal contour but abnormal signal intensity. Magnetic resonance imaging with discographic correlations. Spine (Phila Pa 1976), 24(1), 44-53. doi.org/10.1097/00007632-199901010-00011
For individuals with pelvic pain, how does MET treatment strategies reduce muscle weakness in the hips region?
Introduction
The pelvis’s main job is to ensure that the person’s body weight is distributed evenly for everyday movement within the upper and lower body. At the same time, the core muscles, ligaments, and joints surround the skeletal structure of the pelvis, which provides normal function while protecting the vital organ systems within the pelvic region. When normal or traumatic factors start to affect the body’s pelvic area, many individuals will often mistake the pain for low back pain, and the core muscles surrounding the pelvic bone can become weak and lead to pelvic pain. At the same time, normal factors like improper posture can cause anterior pelvic tilt and develop into other musculoskeletal disorders with overlapping risk profiles. When pelvic pain affects the lower extremities, it can also lead to reproductive issues that can cause even more stress to the individual. Luckily, many people opt for non-surgical treatments to reduce pelvic pain and its associated musculoskeletal condition by strengthening the weakened core muscles and reducing muscle weakness. Today’s article examines how referred pain symptoms affect the pelvis and how non-surgical treatments like MET therapy can reduce muscle weakness correlating with pelvic pain. Additionally, we communicate with certified medical providers who incorporate our patient’s information to reduce muscle weakness associated with pelvic pain. We also inform them that MET therapy can help mitigate the referred pain-like symptoms related to pelvic pain. We encourage our patients to ask amazing educational questions for our associated medical providers about their pelvic pain. Dr. Jimenez, D.C., incorporates this information as an educational service. Disclaimer
Referred Pain Symptoms Affecting The Pelvis
Have you noticed that you are taking more frequent trips to the bathroom and that your bladder still feels full? Do you experience muscle stiffness within your lower back or pelvic region from excessive sitting at your desk during work? Or do you notice that you are experiencing weak core muscles affecting your workout routine? These scenarios are associated with pelvic pain and can cause issues within the lower body extremities, affecting the person’s performance when doing normal activities. Pelvic pain is a multifactorial musculoskeletal disorder that can affect the corresponding body systems to induce referred pain. (Grinberg, Sela, & Nissanholtz-Gannot, 2020) Pelvic pain can cause referred pain to the gastrointestinal, pelvic musculoskeletal, and nervous systems, which then causes anatomic malfunction to the pelvic floor muscles. Pelvic pain can easily be mistaken for low back pain since the lumbar spine creates stressors for the muscles surrounding the pelvis.
When the pelvis is affected by mechanical stressors associated with the lumbar spine, it can cause pelvic dysfunction and causes the individual to be unbalanced when in motion. At the same time, the pelvic muscle structures will be overworked, leading to hip and joint destabilization, causing them to be weak. (Lee et al., 2016) When the pelvic muscle structures begin to destabilize, it can lead to sciatic nerve entrapment to the lower extremities, which leads to overlapping risk profiles for musculoskeletal disorders. When the surrounding pelvic muscles begin to entrap the pelvic nerve roots causing radiating pain down the legs. (Kale et al., 2021) However, there are ways to reduce referred pain affecting the pelvic region and restore muscle strength.
Sciatica, Causes, Symptoms, & Tips- Video
Since pelvic pain is a multifactorial musculoskeletal disorder that can lead to the development of referred pain to the lower body extremities, many individuals often think it is low back pain or sciatica. Referred pain is when pain affects a body location instead of where the source originated. Not treated immediately causes nerve entrapment, muscle weakness, and chronic pain within the reproductive and urinary organs. Many individuals seek non-surgical treatments to alleviate the pain and restore muscle strength to the body’s pelvic region. Non-surgical treatments like MET(muscle energy techniques) can help restore muscle strength to the pelvis through soft tissue stretching. Pain specialists specializing in MET therapy, like chiropractors and massage therapists, use hands-on maneuvers to relax, elongate, stretch, and massage the affected tight muscles and reduce any tender points that may have developed over time. (Grinberg et al., 2019) MET therapy can help stretch the pelvic stabilizing muscles. It can be combined with physical therapy and chiropractic care to realign the body and reduce nerve entrapment caused by pelvic pain. Check out the video above to learn more about the causes of sciatica and how non-surgical treatments may be the answer to alleviate pain.
MET Treatment Strategies For Pelvic Pain
MET therapy can reduce the effects of pelvic pain by including soft tissue manipulation methods to use controlled isometric and isotonic contraction to improve the normal physiologic function of the surrounding pelvic muscles and decrease pain and help stabilize the alternating structures within the pelvic region. (Sarkar, Goyal, & Samuel, 2021) MET therapy can also encourage self-regulating influences to reduce pain within the pelvic area, resulting in a greater range of motion. (Chaitow, 2009)
MET Treatment Reducing Muscle Weakness
MET therapy can also be part of a personalized health plan that can help restore muscle strength in the core and stabilize muscle within the pelvis. The positive effects of the combination of MET therapy and exercise, it can be more effective in reducing pain while improving physical function. (Hu et al., 2020) This allows the pelvis to realign itself and help stretch the shortened muscles. MET therapy can help restore low extremity function and improve a person’s quality of life. (Danazumi et al., 2021) MET therapy is an excellent way to stretch out tired muscles and restore pelvic function, as it can make individuals more mindful of their bodies while reducing the chances of pelvic pain associated with musculoskeletal disorders reoccurring again in the lower extremities.
Danazumi, M. S., Yakasai, A. M., Ibrahim, A. A., Shehu, U. T., & Ibrahim, S. U. (2021). Effect of integrated neuromuscular inhibition technique compared with positional release technique in the management of piriformis syndrome. J Osteopath Med, 121(8), 693-703. doi.org/10.1515/jom-2020-0327
Grinberg, K., Sela, Y., & Nissanholtz-Gannot, R. (2020). New Insights about Chronic Pelvic Pain Syndrome (CPPS). Int J Environ Res Public Health, 17(9). doi.org/10.3390/ijerph17093005
Grinberg, K., Weissman-Fogel, I., Lowenstein, L., Abramov, L., & Granot, M. (2019). How Does Myofascial Physical Therapy Attenuate Pain in Chronic Pelvic Pain Syndrome? Pain Res Manag, 2019, 6091257. doi.org/10.1155/2019/6091257
Hu, X., Ma, M., Zhao, X., Sun, W., Liu, Y., Zheng, Z., & Xu, L. (2020). Effects of exercise therapy for pregnancy-related low back pain and pelvic pain: A protocol for systematic review and meta-analysis. Medicine (Baltimore), 99(3), e17318. doi.org/10.1097/MD.0000000000017318
Kale, A., Basol, G., Topcu, A. C., Gundogdu, E. C., Usta, T., & Demirhan, R. (2021). Intrapelvic Nerve Entrapment Syndrome Caused by a Variation of the Intrapelvic Piriformis Muscle and Abnormal Varicose Vessels: A Case Report. Int Neurourol J, 25(2), 177-180. doi.org/10.5213/inj.2040232.116
Lee, D. W., Lim, C. H., Han, J. Y., & Kim, W. M. (2016). Chronic pelvic pain arising from dysfunctional stabilizing muscles of the hip joint and pelvis. The Korean Journal of Pain, 29(4), 274-276. doi.org/10.3344/kjp.2016.29.4.274
Sarkar, M., Goyal, M., & Samuel, A. J. (2021). Comparing the Effectiveness of the Muscle Energy Technique and Kinesiotaping in Mechanical Sacroiliac Joint Dysfunction: A Non-blinded, Two-Group, Pretest-Posttest Randomized Clinical Trial Protocol. Asian Spine Journal, 15(1), 54-63. doi.org/10.31616/asj.2019.0300
Should individuals with existing gastrointestinal problems eat bananas?
Bananas
Bananas can be easy to digest and are often recommended for nausea and diarrhea, however, not everyone can tolerate them. (MedlinePlus. 2021)
Bananas are high in fructose, sorbitol, and soluble fiber, which makes them a common trigger for gastrointestinal problems.
Additionally, individuals not used to eating a high-fiber diet may find it helpful to gradually increase fiber and drink more water to alleviate unpleasant symptoms.
If there is a suspicion of intolerance, IBS, or malabsorption, it is recommended to speak with a healthcare provider for an evaluation.
Bananas can make the stomach hurt due to:
Irritable bowel syndrome (IBS)
Cramping
Gas
Bloating
Other gastrointestinal (GI) problems.
Individuals can experience stomach discomfort if there is a fructose intolerance or a rare banana allergy.
Stomach Pain
Bananas are used to replenish potassium and other essential nutrients lost from vomiting or diarrhea.
Some individuals can experience bloating and gas after eating them.
One reason is because of their soluble fiber content.
Soluble fiber dissolves in water and is more readily fermented in the colon than insoluble fiber.
Bananas also contain sorbitol – a naturally occurring sugar that acts as a laxative and can cause gas, bloating, and diarrhea when consumed in large amounts. (U.S. Food and Drug Administration. 2023)
Irritable Bowel Syndrome – IBS
Bananas can be a common trigger food for individuals with IBS.
Bananas are also high in fructose/simple sugar especially when they have overripened.
Individuals who have IBS are advised to avoid bananas because they can trigger many of the same side effects as undigested lactose/sugar in milk. (Johns Hopkins Medicine. 2023)
Ripe bananas are considered to be high in FODMAPS – fermentable oligosaccharides, disaccharides, monosaccharides, and polyols.
Individuals following a low FODMAP diet to manage IBS may want to avoid or limit consumption.
Fructose malabsorption is when the body cannot digest or absorb fructose correctly. This causes bloating gas and abdominal discomfort.
Hereditary fructose intolerance is very rare. It happens when the liver cannot assist in the breakdown of fructose.
This condition often causes more severe symptoms and requires additional treatment besides removing fructose from an individual’s diet. (UW School of Medicine and Public Health. 2019)
Most can tolerate small amounts of fructose found in fruits like bananas.
If you’re eating bananas that are too green or unripe, you may also experience stomach discomfort.
Unripened bananas contain high amounts of resistant starch. In large quantities, this can cause mild symptoms like gas and bloating. (Jennifer M Erickson, et al., 2018)
Jackson Siegelbaum Gastroenterology. Colon gas and flatus prevention.
U.S. Food and Drug Administration. Sorbitol.
Capili, B., Anastasi, J. K., & Chang, M. (2016). Addressing the Role of Food in Irritable Bowel Syndrome Symptom Management. The journal for nurse practitioners: JNP, 12(5), 324–329. doi.org/10.1016/j.nurpra.2015.12.007
Johns Hopkins Medicine. 5 foods to avoid if you have IBS.
Monash University. Bananas re-tested.
Dayıoğlu A, Akgiray S, Nacaroğlu HT, Bahçeci Erdem S. The clinical spectrum of reactions due to banana allergy. BMB. 2020;5(2):60-63. doi: 10.4274/BMB.galenos.2020.04.013
Family Medicine Austin. Banana allergy.
UW School of Medicine and Public Health. Fructose-restricted diet.
Erickson, J. M., Carlson, J. L., Stewart, M. L., & Slavin, J. L. (2018). The Fermentability of Novel Type-4 Resistant Starches in In Vitro System. Foods (Basel, Switzerland), 7(2), 18. doi.org/10.3390/foods7020018
The Johns Hopkins Guide to Diabetes. What is resistant starch?
In individuals with discogenic low back pain, how does incorporating decompression reduce muscle strain in the back?
Introduction
When it comes to low back pain, many people often complain that the surrounding muscles will ache constantly, and there is no relief from their primary doctors. Muscle strain associated with low back pain is one of the pain-like symptoms that many individuals experience when normal or traumatic factors start to cause issues in the lower back region of the body. When people begin to make constant repetitive motions correlating with normal daily activities like heavy lifting objects, poor posture, or stepping wrong, it can cause micro-tears to the surrounding muscles and the spinal discs in the lumbar region. When the spinal discs degenerate over time and have been under constant pressure, it can aggravate the surrounding nerve roots causing pain-like problems to the surrounding muscles, ligaments, and tissues, leading to musculoskeletal disorders corresponding with discogenic low back pain. Pain affecting the lower back can lead to a life of disability and make a person feel miserable. To that point, many individuals will seek non-surgical treatment to reduce discogenic pain associated with the low back and can find the relief they have sought. Today’s article examines how discogenic low back pain causes low back pain and how non-surgical treatments like decompression reduce discogenic low back pain and restore muscle strength. Additionally, we communicate with certified medical providers who incorporate our patient’s information to reduce muscle strain correlating with discogenic low back pain. We also inform them that decompression can help mitigate the pain-like symptoms associated with degenerated discs affecting the lower back region. We encourage our patients to ask amazing questions while looking for education from our associated medical providers about their low back issues. Dr. Jimenez, D.C., incorporates this information as an educational service. Disclaimer
Discogenic Low Back Pain Causing Muscle Strain
Do you often experience a pinched nerve or muscle strain in your lower back that hurts when standing? Do you feel symptoms of muscle spasms in your lower back or behind your legs? Or do you and your loved ones feel numbness or tingling sensations in your back, legs, and feet after sitting down excessively? These pain-like issues are associated with discogenic low back pain, which can lead to the development of disability in many people. Discogenic low back pain is developed when the intervertebral (spinal) disc degenerates over time and can contribute to disability. (Mohd Isa et al., 2022) When there are structural changes to the spinal disc that causes the degeneration to progress, it can lead to dysfunction and instability in the lumbar spine. The spinal discs in the spine have the primary job of absorbing the unwanted pressure load that the body is experiencing. Over time though, the spinal disc can degenerate and crack under pressure, leading to discogenic low back pain. Discogenic low back pain can lead to increased pain in the lower back region’s paraspinal muscles and muscle atrophy, inflammation, and muscle strain in the lower back muscles and lumbar spinal discs. (Huang et al., 2022) When the spinal disc is under constant pressure, the inflammatory cytokines can induce nerve ingrowth, structural and biomechanical changes, and a release of pain factors to contribute to the effects of discogenic low back pain. (Lyu et al., 2021) When people are dealing with discogenic low back pain associated with muscle strain, it can make them miss out on their daily activities.
From Injury To Recovery With Chiropractic-Video
When many individuals are experiencing discogenic low back pain, it can be difficult for pain specialists and doctors to identify the underlying source of pain since it is a multifactorial musculoskeletal disorder. (Fujii et al., 2019) However, numerous ways exist to reduce the pain and allow the individual to return to their daily routines. Non-surgical treatments are an excellent way to minimize the pain-like symptoms associated with discogenic low back pain. Treatments like decompression therapy and chiropractic care can create a happy experience for many individuals dealing with discogenic low back pain as it is safe, cost-effective, and gentle on the spine. Decompression can help reduce the pain in the posterior segment of the lumbar spine while relaxing the surrounding muscles and ligaments and pulling the affected disc back to its original position. (Choi et al., 2022) This creates negative pressure on the spinal column and increases disc height on the spine, which allows the fluids and nutrients to flood back into the spine and rehydrate the disc. Decompression therapy can also be combined with chiropractic care, as the spine can be manipulated mechanically or manually to allow the body to realign itself. This, in turn, promotes the body’s natural healing properties to work its magic and provide relief. The video explains how these treatments can positively impact many suffering individuals and help them regain their health.
Decompression Reducing Discogenic Low Back Pain
Decompression therapy allows the individuals to be strapped into a traction machine in a supine position and gently pulls the spine to enable the affected disc to return to the spine and lay off the pressure on the aggravating nerve root that is causing muscle strain. This causes the intervertebral disc space to change through negative pressure, which allows the height to increase in the intervertebral height without stimulating the surrounding fibers around the disc. (Oh et al., 2019) This allows the facet joints in the spine to be realigned, allowing them to be in their moveable location back to the spine to alleviate pain, thus restoring normal posture and activating body functions. When individuals incorporate decompression therapy consecutively, it can minimize the pain caused by discogenic low back pain and allows the individual to have a personalized plan to ensure the pain doesn’t return. (Macario et al., 2008)
Restoring Muscle Strength In The Low Back
Decompression therapy allows the affected muscle to be stretched gently, which can be strengthened through other treatments like physical therapy. This can effectively reduce discogenic low back pain associated with the affected discs and positively influence spinal mobility and muscle strength. (Wang et al., 2022) Even though degeneration in the spinal disc is a natural process, it is important to be mindful of the body to prevent pain-like symptoms from occurring and causing issues to the back. Decompression therapy can positively influence many individuals looking to regain their health and reduce the pain they are experiencing from discogenic low back pain so they can return to their daily activities.
References
Choi, E., Gil, H. Y., Ju, J., Han, W. K., Nahm, F. S., & Lee, P. B. (2022). Effect of Nonsurgical Spinal Decompression on Intensity of Pain and Herniated Disc Volume in Subacute Lumbar Herniated Disc. International Journal of Clinical Practice, 2022, 6343837. doi.org/10.1155/2022/6343837
Fujii, K., Yamazaki, M., Kang, J. D., Risbud, M. V., Cho, S. K., Qureshi, S. A., Hecht, A. C., & Iatridis, J. C. (2019). Discogenic Back Pain: Literature Review of Definition, Diagnosis, and Treatment. JBMR Plus, 3(5), e10180. doi.org/10.1002/jbm4.10180
Huang, Y., Wang, L., Luo, B., Yang, K., Zeng, X., Chen, J., Zhang, Z., Li, Y., Cheng, X., & He, B. (2022). Associations of Lumber Disc Degeneration With Paraspinal Muscles Myosteatosis in Discogenic Low Back Pain. Front Endocrinol (Lausanne), 13, 891088. doi.org/10.3389/fendo.2022.891088
Lyu, F. J., Cui, H., Pan, H., Mc Cheung, K., Cao, X., Iatridis, J. C., & Zheng, Z. (2021). Painful intervertebral disc degeneration and inflammation: from laboratory evidence to clinical interventions. Bone Res, 9(1), 7. doi.org/10.1038/s41413-020-00125-x
Macario, A., Richmond, C., Auster, M., & Pergolizzi, J. V. (2008). Treatment of 94 outpatients with chronic discogenic low back pain with the DRX9000: a retrospective chart review. Pain Pract, 8(1), 11-17. doi.org/10.1111/j.1533-2500.2007.00167.x
Mohd Isa, I. L., Teoh, S. L., Mohd Nor, N. H., & Mokhtar, S. A. (2022). Discogenic Low Back Pain: Anatomy, Pathophysiology and Treatments of Intervertebral Disc Degeneration. Int J Mol Sci, 24(1). doi.org/10.3390/ijms24010208
Oh, H., Choi, S., Lee, S., Choi, J., & Lee, K. (2019). Effects of the flexion-distraction technique and drop technique on straight leg raising angle and intervertebral disc height of patients with an intervertebral disc herniation. Journal of Physical Therapy Science, 31(8), 666-669. doi.org/10.1589/jpts.31.666
Wang, W., Long, F., Wu, X., Li, S., & Lin, J. (2022). Clinical Efficacy of Mechanical Traction as Physical Therapy for Lumbar Disc Herniation: A Meta-Analysis. Comput Math Methods Med, 2022, 5670303. doi.org/10.1155/2022/5670303
Can weight and strength training increase speed and power in athletes that participate in throwing sports?
Throwing Sports
Top-throwing athletes have amazing arm speed. To succeed in throwing sports athletes need to be able to generate quick explosive power. This means the ability to propel the arm forward with substantial velocity for maximum object delivery like a baseball, javelin, hammer throw, shot put, discus, etc. Combined with sports technique training, throwing strength and power can be increased by training with weights. Here is a three-phase training plan to improve throwing performance.
Full Body
The arm provides only one part of the delivery process.
The legs, core, shoulders, and general flexibility need to work cooperatively to exert maximum thrust and achieve maximum object speed.
The natural ability to throw fast with power is largely determined by an individual’s muscle type, joint structure, and biomechanics. (Alexander E Weber, et al., 2014)
Preparation
Preparation should provide all-around muscle and strength conditioning for early pre-season conditioning.
Athletes will be doing throwing training as well, so fieldwork will need to be able to fit in.
It is recommended not to do weight training prior to throwing practice.
This leads to the start of competition and tournament play.
Frequency
2 to 3 sessions per week
Type
Strength and power – 60% to 70% for one-rep max/1RM
The one-repetition maximum test, known as a one-rep max or 1RM, is used to find out the heaviest weight you can lift once.
When designing a resistance training program, individuals use different percentages of their 1RM, depending on whether they’re lifting to improve muscular strength, endurance, hypertrophy, or power. (Dong-Il Seo, et al., 2012)
Throwing practice and competition are the priorities.
Before competition begins, take a 7- to 10-day break from heavyweight sessions while maintaining throwing workouts.
Weight training during competition should provide maintenance.
Frequency
1 to 2 sessions per week
Type
Power – lighter loads and faster execution than in the preparation stage.
Exercises
3 sets of 10
Rapid movement, 40% to 60% of 1RM.
Squats
Power hang clean and press
Romanian deadlift
Lat pulldown
Incline bench press
Crunches
Rest
Between sets 1 to 2 minutes.
Training Tips
Athletes have individual needs, so a general program like this needs modification based on age, sex, goals, skills, competitions, etc.
A certified strength and conditioning coach or trainer could help develop a fitness plan that can be adjusted as the athlete progresses.
Be sure to warm up prior to weight training and cool down afterward.
Don’t try to train through injuries or try to progress too fast – it is recommended not to throw or do weights when treating or recovering from an injury. (Terrance A Sgroi, John M Zajac. 2018)
Focus on the fundamentals and practice proper form.
Take a few weeks off at the end of the season to recover after hard training and competition.
Body Transformation
References
Weber, A. E., Kontaxis, A., O’Brien, S. J., & Bedi, A. (2014). The biomechanics of throwing: simplified and cogent. Sports medicine and arthroscopy review, 22(2), 72–79. doi.org/10.1097/JSA.0000000000000019
American College of Sports Medicine (2009). American College of Sports Medicine position stand. Progression models in resistance training for healthy adults. Medicine and science in sports and exercise, 41(3), 687–708. doi.org/10.1249/MSS.0b013e3181915670
Zaras, N., Spengos, K., Methenitis, S., Papadopoulos, C., Karampatsos, G., Georgiadis, G., Stasinaki, A., Manta, P., & Terzis, G. (2013). Effects of Strength vs. Ballistic-Power Training on Throwing Performance. Journal of sports science & medicine, 12(1), 130–137.
Seo, D. I., Kim, E., Fahs, C. A., Rossow, L., Young, K., Ferguson, S. L., Thiebaud, R., Sherk, V. D., Loenneke, J. P., Kim, D., Lee, M. K., Choi, K. H., Bemben, D. A., Bemben, M. G., & So, W. Y. (2012). Reliability of the one-repetition maximum test based on muscle group and gender. Journal of sports science & medicine, 11(2), 221–225.
Sakamoto, A., Kuroda, A., Sinclair, P. J., Naito, H., & Sakuma, K. (2018). The effectiveness of bench press training with or without throws on strength and shot put distance of competitive university athletes. European journal of applied physiology, 118(9), 1821–1830. doi.org/10.1007/s00421-018-3917-9
Sgroi, T. A., & Zajac, J. M. (2018). Return to Throwing after Shoulder or Elbow Injury. Current reviews in musculoskeletal medicine, 11(1), 12–18. doi.org/10.1007/s12178-018-9454-7
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