The lumbosacral plexus is located on the posterolateral wall of the lesser pelvis, next to the lumbar spine. A plexus is a network of intersecting nerves that share roots, branches, and functions. The sacral plexus is a network that emerges from the lower part of the spine. The plexus then embeds itself into the psoas major muscle and emerges in the pelvis. These nerves provide motor control to and receive sensory information from portions of the pelvis and leg. Sacral nerve discomfort symptoms, numbness, or other sensations and pain can be caused by an injury, especially if the nerve roots are compressed, tangled, rubbing, and irritated. This can cause symptoms like back pain, pain in the back and sides of the legs, sensory issues affecting the groin and buttocks, and bladder or bowel problems. Injury Medical Chiropractic and Functional Medicine Clinic can develop a personalized treatment plan to relieve symptoms, release the nerves, relax the muscles, and restore function.
Sacral Plexus
Anatomy
The sacral plexus is formed by the lumbar spinal nerves, L4 and L5, and sacral nerves S1 through S4.
Several combinations of these spinal nerves merge together and then divide into the branches of the sacral plexus.
Everybody has two sacral plexi – plural of plexus – one on the right side and left side that is symmetrical in structure and function.
Structure
There are several plexi throughout the body. The sacral plexus covers a large area of the body in terms of motor and sensory nerve function.
Spinal nerves L4 and L5 make up the lumbosacral trunk, and the anterior rami of sacral spinal nerves S1, S2, S3, and S4 join the lumbosacral trunk to form the sacral plexus.
Anterior rami are the branches of the nerve that are towards the front of the spinal cord/front of the body.
At each spinal level, an anterior motor root and a posterior sensory root join to form a spinal nerve.
Each spinal nerve then divides into an anterior – ventral – and a posterior – dorsal – rami portion.
Each can have motor and/or sensory functions.
The sacral plexus divides into several nerve branches, which include:
Superior gluteal nerve – L4, L5, and S1.
Inferior gluteal nerve – L5, S1, and S2.
The sciatic nerve – is the largest nerve of the sacral plexus and among the largest nerves in the body – L4, L5, S1, S2, and S3
The common fibular nerve – L4 through S2, and tibial nerves – L4 through S3 are branches of the sciatic nerve.
Posterior femoral cutaneous nerve – S1, S2, and S3.
Pudendal nerve – S2, S3, and S4.
The nerve to the quadratus femoris muscle is formed by L4, L5, and S1.
The obturator internus muscle nerve – L5, S1, and S2.
The piriformis muscle nerve – S1 and S2.
Function
The sacral plexus has substantial functions throughout the pelvis and legs. The branches provide nerve stimulation to several muscles. The sacral plexus nerve branches also receive sensory messages from the skin, joints, and structures of the pelvis and legs.
Motor
Motor nerves of the sacral plexus receive signals from the brain that travel down the column of the spine, out to the motor nerve branches of the sacral plexus to stimulate muscle contraction and movement. Motor nerves of the sacral plexus include:
Superior Gluteal Nerve
This nerve provides stimulation to the gluteus minimus, gluteus medius, and tensor fascia lata, which are muscles that help move the hip away from the center of the body.
Inferior Gluteal Nerve
This nerve provides stimulation to the gluteus maximus, the large muscle that moves the hip laterally.
Sciatic Nerve
The sciatic nerve has a tibial portion and a common fibular portion, which have motor and sensory functions.
The tibial portion stimulates the inner part of the thigh and activates muscles in the back of the leg and the sole of the foot.
The common fibular portion of the sciatic nerve stimulates and moves the thigh and knee.
The common fibular nerve stimulates muscles in the front and sides of the legs and extends the toes to straighten them out.
Pudendal Nerve
The pudendal nerve also has sensory functions that stimulate the muscles of the urethral sphincter to control urination and the muscles of the anal sphincter to control defecation.
The nerve to the quadratus femoris stimulates the muscle to move the thigh.
The nerve to the obturator internus muscle stimulates the muscle to rotate the hips and stabilize the body when walking.
The nerve to the piriformis muscle stimulates the muscle to move the thigh away from the body.
Conditions
The sacral plexus, or areas of the plexus, can be affected by disease, traumatic injury, or cancer. Because the nerve network has many branches and portions, symptoms can be confusing. Individuals may experience sensory loss or pain in regions in the pelvis and leg, with or without muscle weakness. Conditions that affect the sacral plexus include:
Injury
A traumatic injury of the pelvis can stretch, tear, or harm the sacral plexus nerves.
Bleeding can inflame and compress the nerves, causing malfunction.
Neuropathy
Nerve impairment can affect the sacral plexus or parts of it.
Neuropathy can come from:
Diabetes
Vitamin B12 deficiency
Certain medications – chemotherapeutic meds
Toxins like lead
Alcohol
Metabolic illnesses
Infection
An infection of the spine or the pelvic region can spread to the sacral plexus nerves or produce an abscess, causing symptoms of nerve impairment, pain, tenderness, and sensations around the infected region.
Cancer
Cancer developing in the pelvis or spreading to the pelvis from somewhere else can compress or infect the sacral plexus nerves.
Treatment of the Underlying Medical Condition
Rehabilitation begins with the treatment of the underlying medical condition causing the nerve problems.
Cancer treatment – surgery, chemotherapy, and/or radiation.
Antibiotic treatment for infections.
Neuropathy treatment can be complicated because the cause may be unclear, and an individual can experience several causes of neuropathy simultaneously.
Major pelvic trauma like a vehicle collision can take months, especially if there are multiple bone fractures.
Motor and Sensory Recovery
Sensory problems can interfere with walking, standing, and sitting.
Adapting to sensory deficits is an important part of treatment, rehabilitation, and recovery.
Chiropractic, decompression, massage, and physical therapy can relieve symptoms, restore strength, function, and motor control.
Sciatica Secrets Revealed
References
Dujardin, Franck et al. “Extended anterolateral transiliac approach to the sacral plexus.” Orthopaedics & traumatology, surgery & research: OTSR vol. 106,5 (2020): 841-844. doi:10.1016/j.otsr.2020.04.011
Eggleton JS, Cunha B. Anatomy, Abdomen and Pelvis, Pelvic Outlet. [Updated 2022 Aug 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK557602/
Garozzo, Debora et al. “In lumbosacral plexus injuries can we identify indicators that predict spontaneous recovery or the need for surgical treatment? Results from a clinical study on 72 patients.” Journal of brachial plexus and peripheral nerve injury vol. 9,1 1. 11 Jan. 2014, doi:10.1186/1749-7221-9-1
Gasparotti R, Shah L. Brachial and Lumbosacral Plexus and Peripheral Nerves. 2020 Feb 15. In: Hodler J, Kubik-Huch RA, von Schulthess GK, editors. Diseases of the Brain, Head and Neck, Spine 2020–2023: Diagnostic Imaging [Internet]. Cham (CH): Springer; 2020. Chapter 20. Available from: www.ncbi.nlm.nih.gov/books/NBK554335/ doi: 10.1007/978-3-030-38490-6_20
Norderval, Stig, et al. “Sacral nerve stimulation.” Tidsskrift for den Norske laegeforening : tidsskrift for praktisk medicin, ny raekke vol. 131,12 (2011): 1190-3. doi:10.4045/tidsskr.10.1417
Neufeld, Ethan A et al. “MR Imaging of the Lumbosacral Plexus: A Review of Techniques and Pathologies.” Journal of Neuroimaging: official journal of the American Society of Neuroimaging vol. 25,5 (2015): 691-703. doi:10.1111/jon.12253
Staff, Nathan P, and Anthony J Windebank. “Peripheral neuropathy due to vitamin deficiency, toxins, and medications.” Continuum (Minneapolis, Minn.) vol. 20,5 Peripheral Nervous System Disorders (2014): 1293-306. doi:10.1212/01.CON.0000455880.06675.5a
Yin, Gang, et al. “Obturator Nerve Transfer to the Branch of the Tibial Nerve Innervating the Gastrocnemius Muscle for the Treatment of Sacral Plexus Nerve Injury.” Neurosurgery vol. 78,4 (2016): 546-51. doi:10.1227/NEU.0000000000001166
In many individuals with degenerative disc disease, how does spinal decompression compare to spinal surgery improve spine flexibility?
Introduction
The spine is essential to the body’s musculoskeletal system, enabling individuals to perform daily movements while maintaining proper posture. The spinal cord is safeguarded by surrounding ligaments, soft tissues, muscles, and nerve roots. The spinal discs between the spinal column act as shock absorbers to reduce stress from axial overload and promote body mobility and flexibility. The spinal discs can naturally degenerate as a person ages, leading to degenerative disc disease. This condition can result in several spinal issues that can impact the spine’s flexibility. This article explores how degenerative disc disease affects the spine and the treatments available to restore its flexibility. We work with certified medical providers who use our patients’ valuable information to treat individuals suffering from degenerative disc disease affecting their spine’s flexibility. We also inform them about non-surgical treatments to regain spinal mobility and reduce pain-like symptoms. We encourage patients to ask essential questions and seek education from our associated medical providers about their condition. Dr. Jimenez, D.C., provides this information as an educational service. Disclaimer
How Does Degenerative Disc Disease Affect The Spine?
Do you experience neck or lower back pain after a long workday? After physical activity, do you find temporary relief by twisting or turning your torso? Are you experiencing radiating pain in your upper or lower extremities that worsens when standing? These symptoms are common as the body ages over time. Muscles, organs, ligaments, and joints can all be affected, including the spine and intervertebral discs. Research studies reveal that disc degeneration frequently occurs in the spine, leading to changes that can cause misalignment and spinal issues. Degenerative disc disease can disrupt the structure of spinal discs, resulting in pain-like symptoms and accelerating degenerative changes to the spine. Regardless of age, various habits and lifestyle choices can contribute to degeneration. As additional research studies have provided, this condition is characterized by a tension-resisting annulus fibrosus and compression-resisting nucleus pulposus, causing pain and discomfort.
The Symptoms Correlating With Degenerative Disc Disease
Degenerative disc disease is when the spinal disc in the spine experiences wear and tear due to natural aging. The initial indication of this disease is disc cracking caused by repetitive motion trauma. The symptoms associated with this disease are similar but may vary based on the affected spine location. Research shows that degenerative disc disease can cause micro tears in the spinal disc, leading to decreased fluids and water intake, disc space loss, disc bulging, and irritation of the adjacent nerves. This can affect surrounding muscle tissues and disc facet joints, narrowing the spinal canal. Additional studies reveal that people with degenerative disc disease may experience various symptoms that can hinder their ability to function properly. Some common symptoms include:
Pain in the arms, legs, and feet
Sensory abnormalities (loss of sensation in the hands, feet, fingers, and back)
Muscle tenderness and weakness
Instability
Inflammation
Visceral-somatic & somatic-visceral condition
If someone experiences pain-like symptoms in conjunction with degenerative disc disease can negatively impact their quality of life and potentially lead to long-term disability. Fortunately, treatments can slow the degenerative process and alleviate the pain-like symptoms.
Secrets Of Optimal Wellness- Video
When individuals experience pain related to degenerative disc disease, they often seek ways to alleviate it. Some may consider spinal surgery to remove the affected disc and ease the pain caused by the irritated nerve. However, this option is typically only pursued if other treatments have failed and can be expensive. Fortunately, non-surgical treatments are cost-effective and safe, gently addressing the affected area for relief. Non-surgical treatments can be customized to the individual’s specific pain and condition, including spinal decompression, MET therapy, traction therapy, and chiropractic care. These methods work to realign the body and promote natural healing by rehydrating the spine, ultimately restoring flexibility.
Treatments To Improve Spinal Flexibility
Individuals with degenerative disc disease can benefit from non-surgical treatments tailored to their needs. These treatments involve an assessment by a pain specialist, such as a physical therapist, massage therapist, or chiropractor, who will identify the source of the pain and use various techniques to reduce pain, improve flexibility in the spine, and loosen stiff muscles that have been affected by the disease. Additionally, non-surgical treatments can help restore sensory and mobility function to the spine and address factors that may exacerbate the degenerative process.
Spinal Decompression Protocol For Degenerative Disc Disease
Research studies suggest that spinal decompression can effectively reduce the degenerative process of spinal discs through gentle traction. During a spinal decompression treatment, the individual is strapped into a traction machine. The machine gradually stretches the spine to create negative pressure on the spinal disc, which helps to rehydrate it and increase nutrient intake, thereby jumpstarting the healing process. According to Dr. Eric Kaplan, D.C., FIAMA, and Dr. Perry Bard, D.C., in their book “The Ultimate Spinal Decompression,” individuals with degenerative disc disease may require higher pressure during spinal decompression treatment due to its symptomatic problems. Spinal decompression can help restore disc height and be a viable solution for those looking to improve their health.
The brain and body need macronutrients that include carbohydrates, fats, and protein in the right amounts to energize the body. About half of the calories should come from carbohydrates, 30% from fat, and 20% from protein. Food energy density is the amount of energy, represented by the number of calories, in a specific weight measurement.
Food Energy Density
Energy density is determined by the proportion of macronutrients – protein, fat, carbohydrates, fiber, and water.
Energy-dense foods are high in calories per serving.
Foods with large amounts of fiber and water have a lower density.
Foods high in fat have an increased energy density.
An example of a high-energy-density food is a donut because of the high-calorie count from the sugar, fat, and small serving size.
An example of a low-energy-density food is spinach because it only has a few calories in a whole plate of raw spinach leaves.
Energy Dense Foods
Energy-dense foods contain a high number of calories/energy per gram. They are typically higher in fat and lower in water. Examples of energy-dense foods include:
Full-fat dairy
Butter
Cheese
Nut butter
Fatty cuts of meat
Starchy vegetables
Thick sauces
Nuts
Seeds
Less nutrient-dense foods include:
Sweets
Deep-fried foods
French fries
Pasta
Crackers
Chips
Foods like soups and beverages can be either high or low energy density depending on the ingredients. Broth-based soups with vegetables usually have low density while creamed soups are energy-dense. Non-fat milk is less dense than regular milk, and diet soda is less dense than regular soda.
Low Energy Dense Foods
Foods with low energy density include high-fiber green and colorful vegetables.
Foods with low energy density are often nutrient-dense, which means they have plenty of nutrients per serving size.
Many fruits, berries, and vegetables are low in calories, high in fiber, and packed with vitamins and minerals.
Foods high in water content like citrus fruits and melons are usually less energy-dense.
Low-calorie foods often have a low energy density, but not always.
It’s important to read nutrition labels to know how many calories are being provided daily.
Weight Management
Weight management is about watching how many calories are taken in and how many calories are burned.
Filling up on foods with low energy density will cause the body to feel satisfied while eating fewer high-density calories.
Plan all meals so they include foods with a low energy density and high in nutrients.
However, the opposite can happen if individuals eat mostly low-energy-dense foods, will need a larger volume of food to fill up, and as a result, will take in more calories.
This is not ideal for losing weight, but it could be helpful if trying to gain weight.
High-energy-dense foods that are nutritious include avocados, nuts, and seeds.
Adjustment Recommendations
Add More Fruits and Vegetables To The Plate
At least half of a plate should be covered with low-calorie fruits and vegetables.
Berries are sweet and delicious and provide antioxidants
Leave a quarter of the plate for the protein, and the remaining quarter can hold a serving of starchy foods like pasta, potatoes, or rice.
Eating more fruits and vegetables will partially fill the body leading to eating less high-energy-dense foods.
Picky eaters should try various recipes, sooner or later, they will discover something they enjoy.
Start With Salad or a Bowl of Clear Broth Soup
Soups and salads will fill the body before the main energy-dense course like pasta, pizza, or another high-calorie food.
Avoid heavy cream-based salad dressings and creamed soups.
Water has zero calories and drinking a few glasses can help suppress the hunger until the next meal, or a low-density snack.
Fernandez, Melissa Anne, and André Marette. “Potential Health Benefits of Combining Yogurt and Fruits Based on Their Probiotic and Prebiotic Properties.” Advances in nutrition (Bethesda, Md.) vol. 8,1 155S-164S. 17 Jan. 2017, doi:10.3945/an.115.011114
Horgan, Graham W et al. “Effect of different food groups on energy intake within and between individuals.” European Journal of Nutrition vol. 61,7 (2022): 3559-3570. doi:10.1007/s00394-022-02903-1
Hubbard, Gary P et al. “A systematic review of compliance to oral nutritional supplements.” Clinical nutrition (Edinburgh, Scotland) vol. 31,3 (2012): 293-312. doi:10.1016/j.clnu.2011.11.020
Prentice, A M. “Manipulation of dietary fat and energy density and subsequent effects on substrate flux and food intake.” The American Journal of clinical nutrition vol. 67,3 Suppl (1998): 535S-541S. doi:10.1093/ajcn/67.3.535S
Slesser, M. “Energy and food.” Basic life sciences vol. 7 (1976): 171-8. doi:10.1007/978-1-4684-2883-4_15
Specter, S E et al. “Reducing ice cream energy density does not condition decreased acceptance or engender compensation following repeated exposure.” European Journal of clinical nutrition vol. 52,10 (1998): 703-10. doi:10.1038/sj.ejcn.1600627
Westerterp-Plantenga, M S. “Effects of the energy density of daily food intake on long-term energy intake.” Physiology & behavior vol. 81,5 (2004): 765-71. doi:10.1016/j.physbeh.2004.04.030
How does non-surgical spinal decompression compare with traditional surgery to improve sensory abnornalities for individuals with herniated discs?
Introduction
The spinal column provides flexibility and stability to the body, consisting of vertebrae, spinal cord, nerve roots, and intervertebral discs. These components work with surrounding tissues, ligaments, and muscles, enabling pain-free mobility. However, activities or work that place excessive stress on the spine can cause damage, leading to misaligned discs and nerve root irritation. This can result in radiating pain in the lower extremities, which may be mistaken for other conditions such as low back pain, leg pain, or sciatica. This article will focus on the pain-like symptoms associated with herniated discs and how non-surgical spinal decompression can help people regain sensory function. We work with certified medical providers who use our patients’ valuable information to treat individuals suffering from herniated discs in their lumbar spine and inform them about non-surgical treatments to regain sensory function in their lower extremities. We encourage patients to ask essential questions and seek education from our associated medical providers about their condition. Dr. Jimenez, D.C., provides this information as an educational service. Disclaimer
The Symptoms Associated With Herniated Discs
Are you experiencing numbness or tingling down your leg that affects your walking? Does twisting or turning make your lower back uncomfortable? Or are you suffering from low back pain caused by sciatic nerve pain, making it difficult to work or do activities? Many people don’t realize they have herniated discs until repetitive movements cause wear and tear on the spine or constant compression causes the disc to crack, allowing the inner layer to protrude and press on the spinal nerve roots. Research studies reveal that herniated discs can result from various changes that cause pain-like symptoms, including limited trunk flexion, sensory abnormalities in the lower extremities, low back pain, radicular pain, sciatica, and intense distress when sitting. Herniated discs are common, and the inflammatory response from surrounding nerve roots can cause immense pain. As additional research shows, autoimmune responses released by the nucleus pulposus play a crucial role in the pathophysiology of sciatic pain and lumbar radiculopathy.
The Causes Of Herniated Disc-Video
Herniated discs can cause discomfort and pain depending on their severity and location. Several factors contribute to their development, including improper lifting of heavy objects, age, weight, and physical inactivity. Repetitive motions, constant stress, and autoimmune conditions also play a role. Disc herniation impacts the spinal structure and can cause sensory abnormalities in the lower extremities, muscular pain in the arms, back, foot, or leg, and affect the quality of life. However, non-surgical treatments are available to reduce disc herniation and restore the spine’s mobility, flexibility, and stability.
Treatments To Restore Sensory Function
If home remedies such as rest, hot and cold packs, and over-the-counter medications do not work, non-surgical treatments can effectively reduce the effects of disc herniation. These treatments are also safe, gentle, and cost-effective for many people who want relief without the financial burden. Chiropractic care, muscle energy techniques (MET), and spinal decompression are examples of non-surgical treatments that can help target the source of pain, reactivate the body’s natural healing process, and realign the body from herniated discs and spinal subluxation. These treatments can restore sensory function affected by herniated discs by addressing these issues.
Spinal Decompression
When dealing with herniated discs, many people turn to spinal decompression to alleviate pain and find relief in their spine. Studies have shown that spinal decompression involves using gentle traction to create negative pressure within the affected herniated disc. This can increase hydration and reduce pressure on the nerve root, easing the pain signals that affect the lower extremities. In “The Ultimate Spinal Decompression,” Dr. Eric Kaplan, D.C., FIAMA, and Dr. Perry Bard, D.C., explained that the duration of treatment for spinal decompression for herniated discs can vary depending on the severity. Mild herniation may require longer treatment, while patients with multiple herniations in different spinal locations may need additional sessions. However, the treatment should effectively reduce sensory abnormalities and relieve pain for the individual.
Athletes regularly take an ice-water bath after training or playing. It is known as cold water immersion/cryotherapy. It is used to relieve and reduce muscle soreness and pain after intense training or competition. From runners to professional tennis and football players, taking an ice bath is a common recovery practice. Many athletes utilize ice baths to help with faster recovery, prevent injury, and cool down the body. Here we provide some research on cold-water immersion therapy.
Ice Water Bath
Cold Immersion After Exercise or Physical Activity
Exercise causes microtrauma/tiny tears in the muscle fibers. The microscopic damage stimulates muscle cell activity to repair the damage and strengthen the muscles/hypertrophy. However, hypertrophy is linked with delayed onset muscle soreness and pain/DOMS, between 24 and 72 hours after physical activity. An ice water bath works by:
Constricting the blood vessels.
Flushes out waste products (lactic acid), out of the muscle tissues.
Reduces inflammation, swelling, and tissue breakdown.
Then, applying heat or warming up the water increases and speeds up blood circulation, improving the healing process.
There is no current ideal time and temperature for cold immersion, but most athletes and trainers who use the therapy recommend a water temperature between 54 to 59 degrees Fahrenheit and immersion of five to 10 minutes, and depending on the soreness, sometimes up to 20 minutes.
Pros and Cons
The effects of ice baths and cold water immersion on exercise recovery and muscle soreness.
Relieves Inflammation but Can Slow Down Muscle Growth
A study determined that cold water immersion can disrupt training adaptations.
Research suggests that icing muscles right after maximum exercise decreases inflammation, but can slow down muscle fiber growth, and delay muscle regeneration.
Athletes trying to increase muscle size and strength may need to adjust the therapy sessions.
Reduce Muscle Soreness
A review concluded there was some evidence that ice water immersion reduced delayed onset muscle soreness when compared to resting and rehabilitation or no medical treatment.
The most effects were seen in running athletes.
There was no substantial evidence to conclude whether it improved fatigue or recovery.
The studies did not have a standard for adverse effects or follow-up with the participants regularly.
There was no difference in muscle soreness between cold water immersion, active recovery, compression, or stretching.
Pain Relief
Cold water immersion after a physical activity offers temporary pain relief but can help with a faster recovery.
A study of jiu-jitsu athletes found that following a workout with cold water immersion could lead to decreased muscle aches and help reduce lactate levels.
Alternating cold water and warm water baths (contrast water therapy), may help athletes feel better and offer temporary pain relief.
Active Recovery Alternative
More research is needed before a firm conclusion can be reached on ice-water bath therapy. However, active recovery is a recommended alternative for athletes looking to recover faster.
A study suggested that ice baths were equally effective, but not more effective, as active recovery for reducing inflammation.
Cold water immersion is no greater than active recovery upon local and systemic inflammatory cellular stress.
Research determined that active recovery is still the most widely used, and currently the best way to recover after intense exercise or physical activity.
Low-impact workouts and stretches are still considered the most beneficial cool-down methods.
Cold Water Therapy
Ice Bath
Individuals can use their tub at home to perform cold water therapy.
Individuals may want to purchase a large bag of ice, but the cold water from the faucet will work.
Fill the tub with cold water, and if desired, pour in some ice.
Let the water and ice sit to get the cold temperature.
Measure the temperature if necessary before getting in.
Submerge the lower half of the body and adjust the temperature based on feel by adding more water, ice, or warm water if freezing.
It’s like icing with an ice pack, but the whole body swelling reduces and relaxes the muscles.
Don’t overdo it – one review found the best routine was 11 to 15 minutes of immersion at a temperature between 52 and 60 degrees Fahrenheit.
Cold Shower
A few minutes in a cold shower is another way to perform the therapy.
Individuals can get in a cold shower or start with warm water and slowly transition to cold.
This is the easiest and most time-efficient method of cold water therapy.
Safety
Consult with your doctor or a health care practitioner before practicing cold water therapy.
Exposure to cold water can affect blood pressure, circulation, and heart rate.
Cold water immersion can cause cardiac stress and can result in a heart attack.
Be mindful that exposure to cold temperatures can result in hypothermia.
Get out of the cold water if you experience numbness, tingling, discomfort, and/or pain.
Optimizing Wellness
References
Allan, R, and C Mawhinney. “Is the ice bath finally melting? Cold water immersion is no greater than active recovery upon local and systemic inflammatory cellular stress in humans.” The Journal of Physiology vol. 595,6 (2017): 1857-1858. doi:10.1113/JP273796
Altarriba-Bartes, Albert, et al. “The use of recovery strategies by Spanish first division soccer teams: a cross-sectional survey.” The Physician and sports medicine vol. 49,3 (2021): 297-307. doi:10.1080/00913847.2020.1819150
Bieuzen, François, et al. “Contrast water therapy and exercise-induced muscle damage: a systematic review and meta-analysis.” PloS one vol. 8,4 e62356. 23 Apr. 2013, doi:10.1371/journal.pone.0062356
Fonseca, Líllian Beatriz et al. “Use of Cold-Water Immersion to Reduce Muscle Damage and Delayed-Onset Muscle Soreness and Preserve Muscle Power in Jiu-Jitsu Athletes.” Journal of athletic training vol. 51,7 (2016): 540-9. doi:10.4085/1062-6050-51.9.01
Forcina, Laura, et al. “Mechanisms Regulating Muscle Regeneration: Insights into the Interrelated and Time-Dependent Phases of Tissue Healing.” Cells vol. 9,5 1297. 22 May. 2020, doi:10.3390/cells9051297
Shadgan, Babak, et al. “Contrast Baths, Intramuscular Hemodynamics, and Oxygenation as Monitored by Near-Infrared Spectroscopy.” Journal of athletic training vol. 53,8 (2018): 782-787. doi:10.4085/1062-6050-127-17
Sutkowy, Paweł, et al. “Postexercise impact of ice-cold water bath on the oxidant-antioxidant balance in healthy men.” BioMed research international vol. 2015 (2015): 706141. doi:10.1155/2015/706141
How do non-surgical treatments compare with traditional surgical treatments to improve mobility for individuals with hamstring injuries? The hamstrings are muscles in the lower extremities that provide mobility to the legs and stabilize the pelvis. Many athletes rely on their hamstrings to perform strenuous actions such as sprinting, jumping, squatting, and kicking during sporting events. However, the hamstrings are also very susceptible to injury. Athletes who repeatedly overstretch their hamstrings can experience muscle strain until microscopic tears form, which is common. Similarly, individuals who sit for long periods can also experience hamstring issues. When individuals are not physically active, their hamstrings can become weak and shortened, leading to symptoms such as muscle pain, trigger points, and strain on the accessory muscles. Hamstring injuries can also cause other issues that affect the lower body extremities. This article will explore how hamstring injuries affect mobility and how non-surgical treatments help people regain mobility. We work with certified medical providers who use our patients’ valuable information to treat individuals suffering from hamstring injuries and inform them about non-surgical treatments to regain mobility. We encourage patients to ask essential questions and seek education from our associated medical providers about their condition. Dr. Jimenez, D.C., provides this information as an educational service. Disclaimer
Hamstring Injuries Implementing Other Issues
Do you experience stiffness in the back of your thighs when warming up before exercising? Are you feeling radiating pain from the side of your hips and glutes due to prolonged sitting? Or do you tend to limp, affecting your gait and walking? Many people are unaware they are overexerting their hamstrings, which can cause pain. Those who engage in sports or work sedentary jobs may over or underuse their hamstrings, affecting their flexibility and mobility to the lower extremities. According to research studies, hamstring injuries are the most common non-contact muscle injuries caused by two mechanisms of injuries: stretch-type and sprint-type. Sprint-type injuries associated with hamstrings occur when the muscles are overexerted due to maximal or near-maximal action, causing muscle fatigue. To that point, hamstring injuries can also affect a person’s walking mobility.
Running without properly warming up the hamstring muscle can cause muscle fatigue. Stretch-type injuries associated with the hamstring muscles involve combination movements that include extreme hip flexion and knee extension. These injuries can also mimic sciatica, leading people to believe their sciatic nerve is acting up. However, treatments available can help reduce the pain associated with hamstring injuries and lengthen the shortened muscle to reduce pain.
Best Lower Body Stretches To Increase Flexibility-Video
If you want to reduce the pain associated with hamstring injuries, incorporating RICE can help prevent it from becoming chronic. This involves gently stretching the affected muscle to avoid cramps and pain while increasing flexibility. Hamstring injuries can also be linked to other chronic issues, which can cause inflammation in the surrounding muscles. Studies show that conditions like piriformis syndrome can cause nerve entrapment in the hamstrings, resulting in radiating pain down the leg that mimics low back pain and sciatica. As previously mentioned, hamstring injuries can limit mobility and be linked to chronic conditions. Thankfully, non-surgical treatments can help reduce pain and provide relief. Check out the video above to learn different stretches that can help reduce pain in the lower body and increase flexibility.
Treatments To Restore Mobility
If rest, ice, compression, and gentle stretching do not provide relief, incorporating treatments for hamstring injuries to restore mobility can benefit many individuals. Seeking the help of a pain specialist, such as a massage therapist or chiropractor, to create a customized plan/program is recommended. There are various approaches that pain specialists can use to regain mobility and treat hamstring injuries.
MET Therapy
Many chiropractors and massage therapists incorporate MET (muscle energy techniques) therapy to gently stretch out the shortened hamstring muscle and help restore joint mobility in the lower extremities. In “Clinical Applications of Neuromuscular Techniques,” written by Leon Chaitow, N.D., D.O., and Judith Walker DeLany, L.M.T., stated that MET is crucial in stretching and strengthening the hamstring muscles through isometric contraction. At the same time, additional research studies reveal that the MET technique allows the hamstrings to have a greater increase in hip flexion ranges. MET therapy also helps strengthen the accessory muscles surrounding the hamstrings to restore mobility.
Spinal Decompression
If hamstring injuries are caused by nerve entrapment, then trying out spinal decompression can help restore mobility to the hips and lower extremities. According to “The Ultimate Spinal Decompression,” written by Dr. Eric Kaplan, D.C., FIAMA, and Dr. Perry Bard, D.C., stated that spinal decompression is safe and gentle on the spine as it provides gentle traction on the spinal disc to reduce pain and increase disc height. When hamstring injuries are associated with nerve entrapment, it could result from a herniated disc that aggravates the nerve root and causes referred pain to the hamstrings. Using gentle traction on the spine can help alleviate the pain caused by the aggravating nerve and reduce pain in the hamstrings. Many individuals can incorporate these treatments to reduce hamstring injuries and regain their mobility back to their legs.
References
Chaitow, L., & Delany, J. (2002). Clinical application of neuromuscular techniques. Vol. 2, The lower body. Churchill Livingstone.
Individuals spend around one-third of their life sleeping or resting. Every person has their own preferred sleeping position. However, not all sleep positions are comfortable and supportive to the body, especially the spine. Individuals that sleep on their side or stomach that experience back pain might want to consider switching to sleeping on their back. Changing preferred sleeping positions can seem impossible, however, learning to sleep on your back is possible with a little training and adjustment period.
Learning To Sleep On Your Back
After side sleeping, back sleeping is the second most common position. Individuals that are stomach or side sleepers that suffer from:
Learning to sleep on your back is recommended because its health benefits can potentially solve all these problems and more.
Adapting this sleeping position can help maintain proper spinal alignment.
Relieves waking up with tension headaches.
Relieve sinus problems.
Individuals that are not natural back sleepers understand how difficult it is to force oneself to adapt to a new sleeping position. There are ways to condition the mind and body to fall and stay asleep on your back, resulting in healthy rest. These include:
A Pillow Under The Knees
It may help to place a supportive pillow under the knees.
The knees should be slightly bent and feel comfortable.
Check to make sure that the neck and spine feel comfortable and are in alignment.
Make adjustments as needed.
A Pillow Under The Low Back
In the beginning, switching to back sleeping can increase discomfort in the low back.
Placing a pillow under the lower back can help.
Using too large or thick a pillow could create added discomfort.
Try a few different pillows to find what works best and feels right.
Pillow Surround
Individuals that are active sleepers and tend to roll onto their side or stomach soon after falling asleep, can place pillows around the midsection and hips.
A small barrier of pillows around the body can assist in learning to sleep on your back.
The pillows help prevent the body from rolling.
It’s recommended to place pillows closely against either side of the body.
Using the pillows as an enclosure will force the body to remain in a neutral position throughout the night.
Sleeping On The Right Pillow
Individuals will want to make sure they are using the right sleeping pillow.
In addition to supporting the spine’s alignment, a quality pillow will also support the neck.
The recommended pillow for back sleeping should cradle the head and ensure it stays elevated.
A pillow that is too flat or too thick can cause the head to become unlevel with the body leading to:
Neck and upper body pain
Restricted airflow, which may cause you to snore or suffer from sleep apnea.
Digestive issues like acid reflux and heartburn.
Consider a pillow that’s made out of some type of memory foam to assist with learning to sleep on your back.
The thickness and hugging sensation can help to stay on the back and prevent inadvertently flipping over.
Sleeping On The Right Mattress
A positive back sleeping experience begins with the right mattress. There are so many mattress types to choose from. It is recommended to consider the materials, the firmness level, and the size. For comfortably sleeping on your back, the firmness level is essential.
Consider the positioning of your spine.
The objective is to keep the spine as straight as possible, which is achieved with the proper firmness.
A mattress that is too firm will create unwanted pressure and tension on the shoulders and the pelvic region.
A mattress that is too soft will cause the hips to sink, throwing spinal alignment off and causing back pain symptoms.
A medium-firm mattress is recommended.
Memory foam is a great option for learning to sleep on your back.
Memory foam cradles the natural curve of the body, and hugs the body during sleep, which helps avoid accidentally rolling onto your side or stomach.
Memory foam mattresses with integrated gel can provide cooling and ventilation to keep the body refreshed throughout the night.
A medium-firm memory foam mattress will make sure the body stays straight, with the proper cushioning around the pelvis and hips.
Training To Sleep On Your Back
References
Anderson, Ngaire H et al. “Association of Supine Going-to-Sleep Position in Late Pregnancy With Reduced Birth Weight: A Secondary Analysis of an Individual Participant Data Meta-analysis.” JAMA network open vol. 2,10 e1912614. 2 Oct. 2019, doi:10.1001/jamanetworkopen.2019.12614
Desouzart, Gustavo, et al. “Effects of sleeping position on back pain in physically active seniors: A controlled pilot study.” Work (Reading, Mass.) vol. 53,2 (2015): 235-40. doi:10.3233/WOR-152243
Khan, Bashir Ahmad, et al. “Effect of bed head elevation during sleep in symptomatic patients of nocturnal gastroesophageal reflux.” Journal of Gastroenterology and Hepatology vol. 27,6 (2012): 1078-82. doi:10.1111/j.1440-1746.2011.06968.x
Portale, G et al. “When are reflux episodes symptomatic?.” Diseases of the esophagus: official journal of the International Society for Diseases of the Esophagus vol. 20,1 (2007): 47-52. doi:10.1111/j.1442-2050.2007.00650.x
Skarpsno, Eivind Schjelderup, et al. “Sleep positions and nocturnal body movements based on free-living accelerometer recordings: association with demographics, lifestyle, and insomnia symptoms.” Nature and Science of Sleep vol. 9 267-275. 1 Nov. 2017, doi:10.2147/NSS.S145777
Surdea-Blaga, Teodora, et al. “Food and Gastroesophageal Reflux Disease.” Current medicinal chemistry vol. 26,19 (2019): 3497-3511. doi:10.2174/0929867324666170515123807
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