Pretty much everyone experiences a muscle cramp at some point. A muscle cramp is an involuntarily contracted muscle that does not relax, similar to a spasm, but a cramp lasts longer and is usually a forcible contraction. During a cramp, the muscles tighten without voluntary input from the brain and over-tighten. They can last anywhere from a few seconds to an hour or longer. They can be prevented through adequate nutrition and hydration, attention to safety when engaged in physical activity or exercise, and attention to posture and ergonomics. Injury Medical Chiropractic and Functional Medicine Clinic can develop personalized treatment plans for individuals experiencing musculoskeletal issues.
Muscle Cramp
Muscle cramps can occur in any muscle. The cramp may involve a portion of a muscle, the entire muscle, or several muscles that function together. A muscle or a few tissue fibers that involuntarily contracts is in a spasm. If the spasm is forcefully sustained, it turns into a cramp. They can cause a noticeable and/or hardening of the involved muscle/s. They can be experienced as mild twitches or can be excruciatingly painful. Some can involve the simultaneous contraction of muscles that normally move body parts in opposite directions. It is not uncommon for a cramp to flare up multiple times until it finally stops.
Causes
They can occur during physical activity, exercise, rest, or night, depending on the cause. There are various causes that, include:
Most times, they are not a cause for alarm; however, depending on the individual, their age, type of physical activity, and medical history, cramps could indicate a more serious underlying problem such as a thyroid disorder, liver cirrhosis, atherosclerosis, ALS, or a problem or condition of the spine or spinal nerves.
Muscles Involved
The muscles involved can indicate the mechanism and cause.
If the cramp is triggered by fatigue, a drop in muscle glycogen, dehydration, or an electrolyte imbalance, it’s most frequently to the calf muscles, feet, or back of the thigh/hamstring muscles.
This is typically due to a combination of fatigue and dehydration.
If it is triggered by nerve irritation, like a spinal disc injury, cramps tend to present in the forearm, hand, calf, and foot, depending on whether the disc injury is in the neck or lower back.
If there is a joint sprain in the neck, mid-back, or lower back, the cramp will present where the injury is and around the surrounding muscles.
A calf cramp happens when lying down because the foot points down, shortening the calf muscles.
A shortened muscle is more likely to go into spasm, especially if it is exhausted from activities and if the body is dehydrated, which is pretty common.
For two muscles that work together performing the same movement, called agonists, and the one muscle is weaker, the secondary muscle has to work harder, often going into a spasm or cramp from the added stress.
For example, if the buttock/gluteal muscles are weak, the hamstrings eventually spasm when exhausted.
Chiropractic
First, the cause needs to be identified through medical history and examination. There can be an underlying nerve irritation and interference, restricting the muscle or muscle group, which needs to be dealt with for the therapy to be effective. Chiropractic care, combined with therapeutic stretching and massage therapy, can:
Relieve muscle cramping
Improve blood circulation
Increase muscle movement
Improve musculoskeletal function
All help to diminish and prevent muscle cramping.
Adjustments will restore proper alignment and restore nerve communication. These treatments help to release toxins, loosen and relax the muscle tissues, and provide relief.
Say Goodbye to Pain With Chiropractic
References
Blyton, Fiona, et al. “Non-drug therapies for lower limb muscle cramps.” The Cochrane Database of systematic reviews vol. 1,1 CD008496. 18 Jan. 2012, doi:10.1002/14651858.CD008496.pub2
FIELDS, A. “Leg cramps.” California Medicine vol. 92,3 (1960): 204-6.
Garrison, Scott R et al. “Magnesium for skeletal muscle cramps.” The Cochrane Database of systematic reviews vol. 9,9 CD009402. 21 Sep. 2020, doi:10.1002/14651858.CD009402.pub3
Katzberg, Hans D. “Case Studies in Management of Muscle Cramps.” Neurologic clinics vol. 38,3 (2020): 679-696. doi:10.1016/j.ncl.2020.03.011
Miller, Kevin C et al. “An Evidence-Based Review of the Pathophysiology, Treatment, and Prevention of Exercise-Associated Muscle Cramps.” Journal of athletic training vol. 57,1 (2022): 5-15. doi:10.4085/1062-6050-0696.20
Miller, Timothy M, and Robert B Layzer. “Muscle cramps.” Muscle & nerve vol. 32,4 (2005): 431-42. doi:10.1002/mus.20341
Body misalignment can cause various symptoms to be experienced, ranging from headaches, neck and back pain, sore feet, discomfort in the joints, muscles, or nerves, and digestive problems. Improperly aligned vertebrae can press against nerves, pinching or compressing them, causing the nerve signals of the digestive system, including those in the stomach and intestines, to misfire or fail to transmit at the appropriate moment. This can cause the organs to malfunction, resulting in heartburn, gas, constipation, cramping, diarrhea, and other symptoms. Chiropractic realignment adjustments are an effective treatment option for frequent stomachaches, reflux, constipation, and other gastrointestinal conditions.
Body Misalignment Digestive Problems
There are over a million nerve cells within the digestive system. A collection of nerves branch out from the lower part of the spinal cord and travels to the stomach and intestines. Nerve transmission plays an essential role in the following:
Digestion.
Movement of food through the gastrointestinal system.
Absorption of nutrients and minerals.
Removal of waste products.
Misalignments of the vertebrae are known as subluxations. Pressure on nerve roots caused by misalignment can interfere with the function of the bowel and other organs, which can lead to gastrointestinal issues. Muscle tension in the abdomen can also contribute to digestive problems, whether because of stress or sitting for long hours daily.
Misalignment Symptoms
When the body is out of alignment, symptoms of discomfort begin to appear. The most common include:
Fatigue.
Stiff neck.
Sore shoulders.
Chronic headaches.
Sore muscles.
Pain throughout the back.
Joint pain throughout the body.
Chronic aches.
Tight hips.
Difficulty walking.
Tingling, pins and needles, and numbness nerve sensations – sciatica.
Constantly getting sick.
Healthy Gut
A balanced healthy gut will have less difficulty processing food and eliminating waste, leading to reduced and eventually alleviated symptoms. The following show healthy gut function:
Regular, consistent energy levels.
Increased mental clarity.
Regular and healthy bowel movements.
No pain or discomfort symptoms.
A normal amount of gas and bloating.
Healthy stress levels.
Chiropractic
Chiropractic care will realign the body to its proper form, improving gastrointestinal issues. The chiropractic team will use various tools and techniques to guide and correct any subluxations, relax the muscles, and increase nerve and blood circulation.
Healthy Diet and Chiropractic
References
Ernst, Edzard. “Chiropractic treatment for gastrointestinal problems: a systematic review of clinical trials.” Canadian Journal of Gastroenterology = Journal canadien de Gastroenterologie vol. 25,1 (2011): 39-40. doi:10.1155/2011/910469
Hills, Ronald D Jr, et al. “Gut Microbiome: Profound Implications for Diet and Disease.” Nutrients vol. 11,7 1613. 16 Jul. 2019, doi:10.3390/nu11071613
Hornbuckle, William E., et al. “Gastrointestinal Function.” Clinical Biochemistry of Domestic Animals (2008): 413–457. doi:10.1016/B978-0-12-370491-7.00014-3
Leeming, Emily R et al. “Effect of Diet on the Gut Microbiota: Rethinking Intervention Duration.” Nutrients vol. 11,12 2862. 22 Nov. 2019, doi:10.3390/nu11122862
Li, Yuanyuan, et al. “The Role of Microbiome in Insomnia, Circadian Disturbance, and Depression.” Frontiers in psychiatry vol. 9 669. 5 Dec. 2018, doi:10.3389/fpsyt.2018.00669
Redwood, Daniel. “Chiropractic and visceral disorders.” Journal of Alternative and complementary medicine (New York, N.Y.) vol. 13,5 (2007): 479-80. doi:10.1089/acm.2007.7146
Valdes, Ana M et al. “Role of the gut microbiota in nutrition and health.” BMJ (Clinical research ed.) vol. 361 k2179. 13 Jun. 2018, doi:10.1136/bmj.k2179
Softball and baseball require running, jumping, throwing, and swinging movements. Even for the fittest athletes and weekend warriors, the body and the neuromusculoskeletal system will go through overuse injuries, throwing-related injuries, sliding injuries, falls, collisions, and getting hit by the ball. Chiropractic and physical therapy can assist athletes by integrating strength training, body realignment, and rehabilitation injury recovery.
Softball and Baseball Injuries
Baseball and softball injuries are generally defined as either acute/traumatic or cumulative/overuse injuries. Both types can occur in various body areas, for example, a knee injury caused by a fall or quick repositioning shift.
Acute/Traumatic
Injuries occur from traumatic force or impact.
Overuse/Cumulative
These occur over time from repeated stress on the muscles, joints, and soft tissues.
Often athletes return too soon to play, not giving the injury enough time to heal fully.
They begin as small aches and pains that can progress into chronic conditions if not treated.
Shoulder
Shoulder overuse injuries are very common. Constantly performing the throwing movements and high-speed throwing strains the joints, muscles, tendons, and ligaments.
In softball, bicep injuries are more common than shoulder injuries.
In baseball, the overhead throwing position leads to shoulder problems.
Frozen Shoulder
Characterized by a restricted range of motion and pain.
Athletes with frequent shoulder injuries have an increased risk.
Shoulder Instability
Softball and baseball players are more susceptible to injury from overhead throwing, which stretches the shoulder capsule and ligaments.
Shoulder instability can lead to loose joints and dislocation.
Shoulder Separation
This is the tearing of the ligaments that connect the shoulder blade to the collarbone.
This is often a traumatic injury that occurs during a collision or fall with outstretched hands.
Shoulder Tendinitis, Bursitis, and Impingement Syndrome
These are overuse injuries in which the shoulder joint becomes inflamed, restricting movement.
This is an injury to the growth plate on the inside of the elbow.
It can be caused by the wrist flexors pulling on the inside.
It is typically attributed to overuse and improper mechanics when throwing.
Tennis Elbow
This overuse injury on the outside of the elbow makes it difficult to lift or grasp objects.
Hand and Wrist
Softball and baseball can cause hand and wrist injuries from catching, colliding, falling, and overuse. Damage to a hand or wrist is typically caused by repetitive stress and/or a sudden impact.
Finger Fractures
These can be caused by impact on the ball or falls.
This can happen during contact with another player or diving for a ball and hitting the ground hard or at an awkward angle.
Sprains
A fall or impact from the ball or another player can cause these.
Tendinitis
This is an overuse injury, often from pitching and/or throwing.
Back
Catchers are especially prone to back injury because of the crouched position and overhead throwing.
Softball pitchers also experience back strain from the windmill pitching action.
Common conditions include chronic muscle strains, herniated discs, low back issues, sciatica symptoms, and pain.
Knee
Softball and baseball players quickly twist or rotate their knees, making them more susceptible to injuries. Sprains, meniscus tears, ACL tears, and hamstring strains are common.
Aggressive twisting and pivoting can cause swelling, stiffness, and pain.
Running and sudden changes in direction can result in acute knee injuries and overuse injuries.
Knee issues require examination for proper diagnosis.
Other common injuries include ankle sprains, stress fractures, and tendonitis in the foot and ankle.
Chiropractic
Chiropractors work with a massage therapy team to treat various musculoskeletal conditions. Chiropractic specializes in spinal adjustments and other treatments, including joint manipulation, myofascial release, MET techniques, trigger point therapy, and electrical stimulation. It encourages expedited recovery for sports-related injuries because instead of focusing on just the injuries, chiropractic assesses the mechanics of the whole body through proper alignment and release of constricted tissues. Adjustments of the spine and extremities allow the body to realign for better overall functionality, reduce pressure, improve blood circulation, and reduce inflammation to promote increased and thorough healing.
Improving Athletic Performance Through Chiropractic
References
Greiner, Justin J et al. “Pitching Behaviors in Youth Fast-Pitched Softball: High Pitching Volumes With Unequal Pitch Counts Among Pitchers are Common.” Journal of pediatric orthopedics vol. 42,7 (2022): e747-e752. doi:10.1097/BPO.0000000000002182
Janda, David H. “The prevention of baseball and softball injuries.” Clinical orthopedics and related research,409 (2003): 20-8. doi:10.1097/01.blo.0000057789.10364.e3
Shanley, Ellen, and Chuck Thigpen. “Throwing injuries in the adolescent athlete.” International Journal of sports physical therapy vol. 8,5 (2013): 630-40.
Shanley, Ellen, et al. “Incidence of injuries in high school softball and baseball players.” Journal of athletic training vol. 46,6 (2011): 648-54. doi:10.4085/1062-6050-46.6.648
Trehan, Samir K, and Andrew J Weiland. “Baseball and softball injuries: elbow, wrist, and hand.” The Journal of hand surgery vol. 40,4 (2015): 826-30. doi:10.1016/j.jhsa.2014.11.024
Wang, Quincy. “Baseball and softball injuries.” Current sports medicine reports vol. 5,3 (2006): 115-9. doi:10.1097/01.csmr.0000306299.95448.cd
Zaremski, Jason L et al. “Sport Specialization and Overuse Injuries in Adolescent Throwing Athletes: A Narrative Review.” Journal of athletic training vol. 54,10 (2019): 1030-1039. doi:10.4085/1062-6050-333-18
Intercostal muscles are the muscles within the rib cage, commonly called the intercostals, which connect the ribs and make up the chest wall. An intercostal muscle strain refers to an injury between two or more ribs. If these muscles become overstretched, restricted, or suffer damage, it can cause inflammation and significant pain in the middle and upper back. Intercostal muscle strain is a common injury in athletes and physically demanding jobs. Chiropractic care and massage therapy can realign the vertebrae with the ribs and loosen and relax the muscles to increase circulation and restore mobility and function.
Intercostal Muscle Strain
The intercostal muscles have different layers attached to the ribs to help build the chest wall and assist in breathing. There are 11 intercostal muscles on each side of the rib cage. Each set is located between connected ribs in the upper and mid-back and consists of the following:
External
These are the outermost intercostals, responsible for expanding the chest during breathing to help inhale air and allow full deep breaths.
The external intercostals originate at the lower edge of a rib and run diagonally to attach to the upper edge of the rib below.
They are found in the rib cage’s back, sides, and front.
Internal
These sit directly underneath the externals and help collapse the chest during breathing to exhale.
The muscle fibers run perpendicular to the external intercostals, moving diagonally from front to back along the ribs, and are in the entire rib cage.
Innermost
These sit directly underneath, run parallel to the internal intercostals, and run from the back of the rib cage to each side.
The veins, arteries, and nerves lie between the internal and innermost intercostals.
When an intercostal muscle gets twisted, overused, or stretched too far, it can tear, causing muscle strain. Often radiating pain along the rib cage is experienced that extends to the back.
Causes
An intercostal muscle strain often occurs as the result of an injury or overexertion of the muscles. Common causes include:
Trauma to the rib cage, such as from a fall or automobile collision.
Impact trauma from sports or physical activities.
Over twisting the torso beyond its normal range of motion from lifting weights, sports, yoga postures, or dance positions.
Repeatedly reaching overhead for work or tasks like cleaning or painting.
Lifting heavy objects above shoulder height.
Repetitive torso movements.
A sudden increase in physical activity that the body is not used to can also lead to intercostal muscle strain.
This can happen when a lack of conditioning or unhealthy postures weaken muscles.
Symptoms
The signs and symptoms can vary, depending on the severity and cause. Symptoms can include:
Intercostal muscle spasms.
Mobility difficulties.
Inflammation, swelling, and sensitivity in the affected area.
Stiffness and tension, causing upper back pain.
Upper back and rib pain.
Tenderness in the area between the ribs.
Muscle rigidity when bending or twisting the upper body.
Gradual worsening pain after repetitive movements.
Worsening pain when coughing, sneezing, or breathing in deeply.
Severe and sudden pain, particularly if caused by direct trauma to the chest or back.
Chiropractic
Diagnosis involves the individual’s medical history and a physical exam to check for movement limitations and assess affected and sensitive areas. Once the inflammation is reduced, chiropractic and physical therapy will focus on the following:
Pain relief treatment.
Breathing exercises.
Posture training.
Stretching under supervision.
Strengthing exercises.
Most cases fully heal within 6 to 8 weeks.
Rib Muscle Injury
References
De Troyer, A et al. “Mechanics of intercostal space and actions of external and internal intercostal muscles.” The Journal of clinical investigation vol. 75,3 (1985): 850-7. doi:10.1172/JCI111782
Lord, Michael J, and William G Carson Jr. “Multiple Rib Stress Fractures.” The Physician and sports medicine vol. 21,5 (1993): 80-91. doi:10.1080/00913847.1993.11947575
Morrison W. What is an intercostal muscle strain? Medical News Today. Jan 2020
Page P. Current Concepts in Muscle Stretching for Exercise and Rehabilitation. International Journal of Sports Physical Therapy. 2012;7(1):109-119.
Park, Kyung-hee, et al. “Difference in selective muscle activity of thoracic erector spinae during prone trunk extension exercise in subjects with slouched thoracic posture.” PM & R: the Journal of Injury, Function, and Rehabilitation vol. 7,5 (2015): 479-84. doi:10.1016/j.pmrj.2014.10.004
Tran H. Causes of Intercostal Muscle Strain. Spine-health. October 2017
Yoo, Won-Gyu. “Effect of a combined thoracic and backward lifting exercise on the thoracic kyphosis angle and intercostal muscle pain.” Journal of physical therapy science vol. 29,8 (2017): 1481-1482. doi:10.1589/jpts.29.1481
Yoo, Won-Gyu. “Effect of thoracic stretching, thoracic extension exercise and exercises for cervical and scapular posture on thoracic kyphosis angle and upper thoracic pain.” Journal of physical therapy science vol. 25,11 (2013): 1509-10. doi:10.1589/jpts.25.1509
Muscle knots or trigger points are tissues/segments of muscle fibers stuck in a contracted state and balled up or become entangled. To the touch, they can feel like small bumps, nodules, or knots. They are primarily found in muscles, but they can also be found in tendons, fascia, periosteum, and ligaments. Tight muscles can limit flexibility, increase discomfort and pain symptoms, and cause further injury that can develop into chronic conditions. Trigger points can develop in all muscles and multiple muscles simultaneously. The Injury Medical Chiropractic and Functional Medicine Team can create a personalized treatment plan for trigger point alleviation.
Muscle Knots Trigger Points
When muscle fibers are stuck in contraction, blood circulation decreases in and around the affected area, and the necessary nutrients and oxygen cannot be delivered. The excessive accumulation of the chemicals – acetylcholine, and calcium leads to a lack of oxygen in the area, which causes muscle fiber contraction and spasms. As the muscle fibers overly contract, they form a knot. Waste materials build up in the fibers as the blocked circulation doesn’t allow removal. This irritates the trigger point, which reacts by sending out pain signals. The brain responds by telling the body not to use that muscle, causing the muscle to tighten, become weak, and lose range of motion. The other muscles have to work harder to compensate.
Trigger Point Types
Active and Latent
One type is an active trigger point.
The trigger point causes pain and discomfort even when the muscle or tissue rests.
The other type is latent, which means that the point does not cause pain or is sometimes even noticed until pressure is applied to the point or area.
Because key trigger point muscles are weakened, the muscles around that point need to work harder, causing multiple knots to form.
Referred pain happens when a satellite trigger point causes sensations in a different area from the point itself.
Causes
The main causes include the following:
Direct Trauma
Muscle trauma or injury can cause fibers not to heal properly, causing segments to stay deprived of oxygen and knotted.
Excessive and Extended Exercising
During exercise/physical activity, profound muscle strain and injury can occur from pushing too hard for too long without proper recovery and repair.
Maintaining Healthy Posture
Unhealthy postures can cause tension, stiffness, and aches and pains.
Stress and Fatigue
Emotional and physical stress takes a toll on the body, which can result in excessive muscle contraction.
Most of the time, it happens subconsciously without realizing that the body is tensing up.
This is why engaging in relaxation activities, including therapeutic massage, is important.
Inactivity
Lack of physical activity and a sedentary lifestyle can cause muscle spasms and over-contracting, leading to muscle knots.
Medical Conditions
Conditions that affect muscles, like arthritis and fibromyalgia or medications, can cause muscle spasms and the development of trigger points.
Chiropractic and Massage Therapy
Chiropractic and therapeutic massage is an effective treatment to relieve muscle knots and symptoms and restore the body to optimal function. Massage uses various techniques to increase blood circulation, break down inflexible scar tissue and stretch and loosen muscles. Pain and discomfort decrease by allowing the muscles to move and restoring blood flow.
Massage Therapy Chiropractic Care
References
Barbero, Marco, et al. “Myofascial pain syndrome and trigger points: evaluation and treatment in patients with musculoskeletal pain.” Current Opinion in Supportive and palliative care vol. 13,3 (2019): 270-276. doi:10.1097/SPC.0000000000000445
Cheung, Karoline, et al. “Delayed onset muscle soreness: treatment strategies and performance factors.” Sports medicine (Auckland, N.Z.) vol. 33,2 (2003): 145-64. doi:10.2165/00007256-200333020-00005
Money, Sarah. “Pathophysiology of Trigger Points in Myofascial Pain Syndrome.” Journal of Pain & palliative care pharmacotherapy vol. 31,2 (2017): 158-159. doi:10.1080/15360288.2017.1298688
Moraska, Albert F et al. “Responsiveness of Myofascial Trigger Points to Single and Multiple Trigger Point Release Massages: A Randomized, Placebo-Controlled Trial.” American Journal of physical medicine & Rehabilitation vol. 96,9 (2017): 639-645. doi:10.1097/PHM.0000000000000728
Weerapong, Pornratshanee, et al. “The mechanisms of massage and effects on performance, muscle recovery, and injury prevention.” Sports medicine (Auckland, N.Z.) vol. 35,3 (2005): 235-56. doi:10.2165/00007256-200535030-00004
The hamstring muscles attach, through a tendon called the proximal hamstring tendon, to the ischial tuberosity, the bones used to sit deep in the buttock muscles. When the tendon is subjected to overuse/repetitive stresses and strains, the internal structure can become compromised, leading to weakness and pain symptoms. This is known as proximal hamstring tendinopathy. Tendinopathy is an overuse injury where the tendon is repeatedly strained until microscopic tears form. It is common in athletes that do a lot of running but also in individuals that sit for prolonged periods. If left untreated, high hamstring tendinopathy can lead to progressive degeneration of the tissues, leading to chronic weakness, pain, and dysfunction.
High Hamstring Tendinopathy
The hamstrings are a powerful muscle group that extends the hip and flexes the knee. They experience stress and pressure during activity and inactivity/sitting and are susceptible to strain injuries. Tendons attach muscle to bone and are designed to take compressive and tensile weight/loads that stretch or flex. A tendon is made up of fibrous tissue containing organized type 1 collagen. Tendons receive blood; however, the supply is less where the tendon attaches to the bone and is commonly where tendinopathy occurs.
Injury
A hamstring injury involves the bruising, irritation, or tearing of the hamstring tendon or muscle tissue. Severity can range from:
Microtears that cause stiffness and pain symptoms but heal fast on their own.
Severe ruptures that cause debilitating pain, dysfunction and require medical intervention.
The tendon attaches to the ischial tuberosity or sitting buttock bone. Tendons can have a spasm-like reaction to sudden or quick shift changes. A sudden change can cause adverse changes to the tendon. Too much load on the tendon beyond its ability to recover can cause the structure to change and the collagen to break down/tear like a rope tearing and unraveling. High hamstring tendinopathy happens around the hip area and presents as buttock or upper thigh pain. Individuals report deep, dull, radiating buttock pain during walking, running, and prolonged sitting or driving. Sometimes the sciatic nerve can become irritated or entrapped by an affected tendon’s scar tissue, causing sciatica-like symptoms.
Stages of Tendon Pathology
Reactive Phase
Caused by an acute overload of physical activity or inactivity.
The tendon will thicken temporarily to decrease the stress; however, there may be no inflammation.
The tendon can return to normal if the load is reduced or sufficient time for recovery and repair is allowed.
Disrepair
Chronically overloaded.
Unsuccessful healing.
More negative tendon changes occur.
Reversibility is possible with load management and targeted exercises to stimulate the tendon and surrounding tissues.
Degenerative
Continual progression of adverse tendon changes.
More common in older individuals.
Continue load management and strength training to maximize the tendon’s tolerance.
Chiropractic Treatment
A chiropractic therapy team will develop a personalized treatment program to improve tendon structure and strengthen the hamstrings, gluteal, and side abdominal muscles. They will begin with tendon symptom-relieving massage to loosen the muscles and get the blood circulating, MET-targeted stretches to lengthen the muscles, and spinal and pelvic adjustments to realign the body.
Sciatica Explained
References
Buckley, Mark R et al. “Distributions of types I, II and III collagen by region in the human supraspinatus tendon.” Connective tissue research vol. 54,6 (2013): 374-9. doi:10.3109/03008207.2013.847096
Lempainen, Lasse, et al. “Expert opinion: diagnosis and treatment of proximal hamstring tendinopathy.” Muscles, ligaments, and tendons journal vol. 5,1 23-8. 27 Mar. 2015
Mattiussi, Gabriele, and Carlos Moreno. “Treatment of proximal hamstring tendinopathy-related sciatic nerve entrapment: presentation of an ultrasound-guided “Intratissue Percutaneous Electrolysis” application.” Muscles, ligaments, and tendons journal vol. 6,2 248-252. 17 Sep. 2016, doi:10.11138/mltj/2016.6.2.248
Ono, T et al. “Estimation of tensile force in the hamstring muscles during overground sprinting.” International Journal of sports medicine vol. 36,2 (2015): 163-8. doi:10.1055/s-0034-1385865
White, Kristin E. “High hamstring tendinopathy in 3 female long-distance runners.” Journal of chiropractic medicine vol. 10,2 (2011): 93-9. doi:10.1016/j.jcm.2010.10.005
Wilson, Thomas J et al. “Sciatic Nerve Injury After Proximal Hamstring Avulsion and Repair.” Orthopedic Journal of sports medicine vol. 5,7 2325967117713685. 3 Jul. 2017, doi:10.1177/2325967117713685
Individuals may not be aware that back discomfort/pain symptoms can be connected to not staying hydrated. When the body is dehydrated, it reduces the amount of fluid in the spinal discs making them smaller, resulting in decreased cushioning and support for the spine. The stress can lead to swelling, causing further back discomfort, even a herniated disc. Individuals that experience frequent back pain could find relief by increasing their H2O consumption.
Staying Hydrated
Physical activity and healthy nutrition are important for healthy living. However, individuals can forget the basic need for water, often resulting in dehydration. The body needs to maintain hydration levels to function correctly. Dehydration can cause the body’s fascia/connective tissue which supports every cell and organ, to lose lubrication that allows the muscles to move, slide, and glide smoothly, causing stiffness, and tangled knots/trigger points, making movement difficult and painful.
The Body’s Overall Health
The body is 60% water.
Hydration replaces body fluids lost through exhaling, sweating, and waste elimination.
The body loses and needs to replace around 2-3 quarts of water daily.
Proper hydration regulates temperature, keeps the joints functioning smoothly, protects the spine, and facilitates waste removal.
Dehydration
Even being a little dehydrated is not healthy. Studies have shown that losing 1-2% of body weight without replacing fluids causes thinking and memory problems. A 4% deficit causes headaches, irritability, and sleepiness. Physical work or working outdoors without proper hydration impairs muscle endurance and strength. Dehydration stresses the spine even more which can cause painful swelling and bulged discs. Chronic pain conditions can be worsened by dehydration. This includes:
Overall stiffness
Headaches
Migraines
Joint pain
Arthritis
Fibromyalgia
All can be affected by dehydration.
Lack of water levels can lead to back pain because the discs between the vertebrae need fluid to cushion the bones. They begin to dry out when not properly hydrated, exacerbating back discomfort symptoms that could lead to similar symptoms in the neck or legs.
The spinal discs are filled with a gel substance of around 75% water.
The inner and outer rings/nucleus pulposus are made almost entirely of water.
Water is slowly released from the spinal discs throughout the day.
The discs absorb most of the shock from everyday movements while protecting the spinal cord.
The discs rehydrate during sleep.
Indicators of Dehydration
Other than back pain and discomfort, other symptoms of dehydration.
Fatigue
Irritability
Muscle Cramps
Headaches
Dark Urine
Dry Skin
Dry Eyes
Blurry Vision
Bad Breath
Dizziness
Fever
Caffeinated beverages – soft drinks, tea, and coffee count partly toward daily fluid intake. They do not dehydrate the body, but they can increase urination and are recommended not to be the primary source of liquids during the day.
Hydration
Throughout the day, drink plenty of water and move around and stretch to circulate the H2O.
Increase Water Intake
Sixty-four ounces, eight glasses per day, is the common recommendation.
Water intake encompasses all the liquids consumed in a day, including coffee, tea, and soup.
Foods like cantaloupe and watermelon count toward daily water consumption.
The best sources are water and drinks, primarily water sport replacement drinks, herbal teas, lemon water, and vegetable broth.
Drink more when working out and being active. More water is needed on top of the 64 ounces when active.
Keep hydrating long after the physical activity or workout is over.
When the brain signals thirst, the body is already dehydrated.
Stay ahead by sipping water throughout the day.
Keep a water bottle close by at school or work, refill it twice daily, and increase refills on hot days.
Monitor Hydration Levels
An easy way to assess dehydration is by looking at urine color.
Light yellow or clear is healthy.
Dark yellow or cloudy indicates dehydration.
The Injury Medical Chiropractic and Functional Medicine Team can realign the spine and body to optimal function and assist in developing a nutrition plan to maintain health and wellness.
Benefits Of Healthy Eating and Chiropractic Care
References
El-Sharkawy, Ahmed M et al. “Acute and chronic effects of hydration status on health.” Nutrition Reviews vol. 73 Suppl 2 (2015): 97-109. doi:10.1093/nutrit/nuv038
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