Can understanding the location of the funny bone and how pain can be managed after injury help expedite recovery and prevention for individuals who have hit their funny bone?
Contents
Elbow Funny Bone Nerve Injury
Behind the elbow is an area known as the “funny bone,” where the ulnar nerve has less tissue and bone protection. This is where part of the ulnar nerve passes around the back of the elbow. Because less tissue and bone protect the nerve in this area, taking a hit like bumping into something can cause an electric shock-like pain and a tingling sensation down the arm and to the outside fingers typical of an irritated nerve. Most injuries to the funny bone resolve quickly, and the pain disappears after a few seconds or minutes, but sometimes, an ulnar nerve injury can lead to more persistent symptoms.
Anatomy
The funny bone is not a bone but the ulnar nerve. The nerve runs down the arm, passing around the back of the elbow. (Dimitrova, A. et al., 2019) Because the ulnar nerve is on top of the elbow and there is very little fatty cushion, lightly bumping this spot can cause pain and tingling sensations down the forearm. Three bones comprise the junction of the elbow that include:
Humerus – arm bone
Ulna and radius – forearm bones
The humerus has a groove that protects and holds the ulnar nerve as it passes behind the joint. This is where the nerve can be injured or irritated when the nerve is hit or pinched against the end of the bone, causing the funny bone pain.
Electrical Pain Sensation
When hitting the ulnar nerve or funny bone where the ulnar nerve provides sensation, pain, and electrical/tingling sensations are experienced from the forearm to the outside fingers. This part of the arm and hand is called the ulnar nerve distribution. (American Academy of Orthopaedic Surgeons. 2024) The ulnar nerve provides sensation into most of the pinky finger and about half of the ring finger. Other nerves, including the median and radial nerve, supply sensation to the rest of the hand.
Treatment
Usually, a sharp jolt to the elbow quickly resolves. Some recommendations to help symptoms improve faster include:
Shaking the forearm and hand out.
Straightening out and bending the elbow to stretch the nerve.
Decreasing mobility of the elbow.
Applying ice to the area.
Taking anti-inflammatory medications.
Treating Long-Lasting Pain
In rare circumstances, injuries to the ulnar nerve can cause more persistent symptoms, a condition known as cubital tunnel syndrome. Cubital tunnel syndrome can happen after an injury or from elbow overuse. Individuals with cubital tunnel syndrome may benefit from wearing a splint at night. Standard-sized splints can be ordered online, but most are fabricated by an occupational or hand therapist. If symptoms become more long-lasting, surgery may be recommended to relieve pressure and tension on the ulnar nerve (American Academy of Orthopaedic Surgeons, 2024). The procedure decompresses the nerve by relieving any tight constrictions around it and releasing them. In severe cases, the nerve is repositioned to an area that doesn’t place as much pressure on the nerve, known as an ulnar nerve transposition.
Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution that helps individuals return to normal. Our providers create personalized care plans for each patient, including Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine principles through an integrated approach to treat injuries and chronic pain syndromes to improve ability through flexibility, mobility, and agility programs to relieve pain. If other treatment is needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments.
Chiropractic Treatment For Carpal Tunnel Syndrome
References
Dimitrova, A., Murchison, C., & Oken, B. (2019). Local effects of acupuncture on the median and ulnar nerves in patients with carpal tunnel syndrome: a pilot mechanistic study protocol. Trials, 20(1), 8. doi.org/10.1186/s13063-018-3094-5
How can healthcare professionals recognize and establish protocols for individuals who are being trafficked and provide a safe place?
Contents
Introduction
Today, we will look at part two of this series, which is about recognizing trafficking in a clinical setting. Today’s article in this two-part series of recognizing trafficking helps inform many healthcare professionals to understand the roles and protocols for identifying trafficking that is affecting their patients and help provide a safe, positive space for them. We discuss with certified associated medical providers who consolidate our patients’ information to assess and identify trafficking in the clinic while taking the proper protocols to ensure patient safety. We also inform and guide patients while asking their associated medical provider intricate questions to integrate and provide them with a safe and positive space. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer.
Health Care Professional’s Role in Identifying Trafficking
Even though they may come across victims of human trafficking and have the chance to step in, many healthcare professionals believe they lack the knowledge and self-assurance needed to recognize these victims and offer them the kind of aid they need. As an illustration:
Just 37% of social workers and medical professionals surveyed again had any training in recognizing and supporting victims of human trafficking (Beck et al., 2015).
It is extremely hard for processors to identify and aid victims because traffickers move their victims around a lot and employ various strategies to evade discovery. Frequently, it could be your final interaction with the victim (Macy & Graham, 2012).
There can be a companion who comes across as very domineering, who won’t let the patient spend time alone with you, or who insists on filling out paperwork or talking on the patient’s behalf.
It’s possible that neither the victim nor their friend will have identification or insurance paperwork and will just pay in cash.
The victim or their companion may refuse to answer questions.
The victim may decline additional testing and follow-up care.
The victim may have physical injuries, sexually transmitted diseases, and signs of psychosocial stress.
The victim may not know the city and state that they are in.
The victim may appear fearful when asked questions or in the presence of their companion.
The victim may exhibit feelings of shame, guilt, helplessness, or humiliation.
You may notice inconsistencies in basic information, such as age, name, address, work history, or information regarding living status and daily activities.
If the patient does not speak English, where are they from, and how did they arrive?
If the patient is a minor, who and where is the guardian?
The victim may have unusual tattoos to indicate that they are the “property” of their trafficker.
Recognizing the Signs of Trafficking
You can more easily spot possible victims and offer the right help if you are aware of the typical warning indicators of human trafficking. The following are typical signs that someone is being trafficked. Naturally, not all victims or forms of trafficking will exhibit all of the indicators. Work and Living Conditions (National Human Trafficking Hotline, n.d.):
The victim may not be able to come and go on their own or leave their current home or work situation.
Human trafficking victims are often minors who are forced to engage in commercial sex acts.
The individual may work in the commercial sex industry and be under the control of a pimp or manager.
The victim may be required to work unusual or excessively long hours.
The victim may receive little, if any, pay or may only receive tips.
The victim may be subjected to unusual or extreme restrictions at work or may not be allowed to take breaks.
The victim may owe a large debt to their “employer.”
The victim may have been lured to their current work or living situation through false promises about the nature of their work or living environment.
The victim’s home or work location may have unusually high security, such as opaque or boarded-up windows, bars on windows, high fences, and security cameras.
The victim may be required to live at their work location.
The victim may experience various signs of abuse at the hands of their employer.
The victim may not be paid directly. Instead, the money is directed to the supervisor or manager, who deducts a large percentage for living expenses and other debts.
The victim may be forced to meet unreasonable daily quotas.
The victim may be forced to work in unsafe work environments without the proper safety equipment.
Chiropractic Care for Healing After Trauma-Video
Best Practice Guidelines for Interviewing Trafficking Individuals
As a healthcare provider, you must continuously weigh the different courses of action at every interview process step. To establish trust and ensure safety, practitioners must, above all, put aside preconceived notions and assumptions about the victims and their behavior (Hodge, 2014; DeBoise, 2014; Hemmings, Jakobowitz, & Abas, 2016). Zimmerman and Watts (2003) suggest that the World Health Organization has produced rules for every phase of the interview process, which include the following recommendations:
It’s critical to keep in mind that every trafficking scenario and survivor is distinct, making it crucial to pay attention to and accept each person’s account.
It could take some time for victims to open up and be willing to talk about their experiences because it can be hard for them to build rapport and trust.
You should take precautions to protect both you and the victim because you should anticipate that the victim is at risk of psychological, bodily, social, and legal harm.
To prevent further upsetting the victim, you should consider the risks and advantages before beginning the interview process, as it can be a traumatic experience in itself.
While you should direct victims to available resources when necessary, you should avoid making unfulfilled promises or pledges.
The amount of time it takes for victims of human trafficking to be prepared to embrace change might vary greatly. Some victims can be eager to look for new possibilities and to improve their circumstances. Some people can be less likely to accept assistance because they haven’t developed enough trust issues or because they fear retaliation from their trafficker.
Depending on the situation, many service providers or interpreters must be present during the interview. Everyone taking part in the interview process ought to be reasonably knowledgeable about human trafficking, including how traffickers manipulate their victims and how to interact with them in a way that respects their cultural differences. To maintain anonymity and ensure the victim can communicate freely and honestly, you should refrain from using interpreters who are acquainted with the victim or who live in the same neighborhood.
Having an emergency safety plan in place is crucial to shielding the victim from harm—both from others and self-harm.
Consent must always be obtained voluntarily for all interventions, including interviews. For many victims who have never known autonomy or self-determination, this may be a foreign idea.
Avoid using legal or technical jargon.
Furthermore, it’s critical to remember that trauma survivors may suffer after treatment can have a lasting effect on all facets of their lives, making psychological, emotional, and physical safety a top priority. It is reasonable to presume that the person provides the most accurate account of their experience at that time. A person’s guarded, defensive, and belligerent behavior may be only their coping mechanism for their trauma. (V. Greenbaum, 2017)
How to Report Known or Suspected Trafficking
The best way to report suspected trafficking is by calling the National Human Trafficking Hotline or texting the number 711 if the patient responds affirmatively to the evaluation questions if your findings imply that they might be victims of human trafficking. Additionally, you can text 233733. Basic details about the case will be requested from you, such as (National Human Trafficking Hotline, n.d.):
the location of the suspected trafficking
the name of the alleged trafficker, if possible
your city and state
how you learned about the hotline
Health care providers who know or believe that a youngster is being abused, neglected, or abandoned should report their concerns to law enforcement or the relevant child welfare agency right away, as they are required reporters under child abuse and neglect statutes. You can report abuse online or by calling the Department of Children and Families Abuse Hotline in the state you are residing in.
Documenting Physical Findings
Physical findings should be meticulously and precisely recorded using written descriptions, freehand sketches that have been identified and annotated, and digital or film photos with the patient’s consent. Regarding photography, the picture should show the patient’s face and the lesion or injury measured using a coin, ruler, or other common object. The photo should include a piece of paper bearing the date the picture was taken. More photos can capture up close shots of every pertinent lesion or injury. Serial follow-up photos over seven to ten days can be used to record the healing or advancement of ecchymoses and other injury-related symptoms. A statement identifying the photographer and attesting to the accuracy and integrity of the images ought to be incorporated into the chart. Before any photos are taken, consent for the photographic documentation should be sought and recorded. Patients should be aware of their rights, which include the ability to decline all photographic documentation or limit it to a limited number of specified locations.
In addition to providing essential medical care, the healthcare professional should work to establish an environment where each patient feels respected, comfortable, cared for, validated, and empowered to reveal if they so choose. If the patient does not feel “ready” to demonstrate in the clinical environment, disclosure may happen later. As a result, for at-risk patients, every single clinical interaction should be seen as a step toward their eventual safety.
Laws & Policies for Human Trafficking
The United States has enacted a variety of laws and policies designed to prevent human trafficking, punish the perpetrators, and protect the survivors. One of these laws and policies is the Trafficking Victims Protection Act law or the TVPA (U.S. Congress).
This is the centerpiece of federal human trafficking legislation. The act focuses on three primary areas:
The TVPA seeks to prevent human trafficking through increased training and awareness.
The act seeks to protect trafficking victims by providing them access to services using federal funds similar to other refugees.
The act establishes trafficking and related crimes as federal offenses subject to stiff penalties.
One way that the legislation protects victims of human trafficking is that it absolves them of consequences for engaging in criminal activities that arise from their trafficking experience, such as entering the nation using fraudulent documents or working without the proper authorization. In addition, families of trafficking victims are qualified for T visas, which let them stay in the nation to support federal law enforcement in their pursuit of the offenders. After three years, victims can then apply to become permanent residents. Depending on the specific circumstances, many individuals may be entitled to assistance and benefits, such as access to the Witness Security Program and reparations. In addition, individuals between 16 and 24 could qualify for the Job Corp program and work permits.
Others criticize the TVPA. Usually, the onus is on the victim to prove their innocence or compulsion first. Second, the act emphasizes sex trafficking more than other types of human trafficking, which ignores how intricate human trafficking is. Only victims and survivors of “severe” types of trafficking who are prepared to cooperate with the investigation and prosecution of their offenders are eligible for the services provided under the act. This ignores the severity of the abuse the victims endured and the degree of mistrust and terror they might harbor toward both the abuser and others in positions of power.
Preventing Trafficking Through Awareness, Interventions, & Resources
In the shadows, human trafficking flourishes. We eradicate the shadows where human traffickers lurk by increasing public and health practitioner awareness of the problem (Hodge, 2008; Gozdziak & MacDonnell, 2007). For instance, putting up signs and pamphlets on human trafficking can not only help to enhance public awareness but also boost the chance that victims may come forward on their own. Brochures and posters are free from the Campaign to Rescue and Restore Victims of Trafficking.
When assisting victims of human trafficking, practitioners and service providers need to be able to engage with a variety of governmental, legal, medical, and social service organizations and institutions. Generally speaking, there are three main categories into which the care and services that a victim falls (Dell et al., 2019; Johnson, 2012; Oram & Domoney, 2018):
Immediate Services
Services Related to Recovery
Services About Reintegration
Resources for Providers
The National Human Trafficking Resource Center’s referral database can be consulted by providers looking to connect with local programs that assist victims of human trafficking or who need assistance for a victim or survivor. Many healthcare providers can check out the website to provide helpful resources in their local area.
Conclusion
Any human trafficking violates fundamental rights. Since human trafficking has many underlying roots, eradicating the issue would need different approaches on various fronts. When it comes to addressing racism, poverty, oppression, prejudice, and other factors that lead to human trafficking, healthcare professionals need to be dedicated to facing this issue both within their patient population and in partnership with colleagues from different disciplines. Physicians, social workers, counselors, and other health care professionals are required by their code of ethics to lead in addressing power abuses and advancing social justice. Practitioners can accomplish this, among other things, by teaching others and themselves about the intricate dynamics and international scope of human trafficking.
References
Beck, M. E., Lineer, M. M., Melzer-Lange, M., Simpson, P., Nugent, M., & Rabbitt, A. (2015). Medical providers’ understanding of sex trafficking and their experience with at-risk patients. Pediatrics, 135(4), e895-902. doi.org/10.1542/peds.2014-2814
DeBoise, C. (2014). Human Trafficking and Sex Work: Foundational Social-Work Principles. Meridians: Feminism, Race, Transnationalism, 12(1), 227–233. muse.jhu.edu/article/541879/pdf
Dell, N. A., Maynard, B. R., Born, K. R., Wagner, E., Atkins, B., & House, W. (2019). Helping Survivors of Human Trafficking: A Systematic Review of Exit and Postexit Interventions. Trauma Violence Abuse, 20(2), 183-196. doi.org/10.1177/1524838017692553
Gozdziak, E., & MacDonnell, M. (2013, March 4). Closing the Gaps: the Need to Improve Identification and Services to Child Victims of Trafficking by School of Foreign Service – Georgetown University – Issuu. Issuu.com. issuu.com/georgetownsfs/docs/gozdziak-closing-the-gaps
Greenbaum, V. J. (2017). Child sex trafficking in the United States: Challenges for the healthcare provider. PLoS Med, 14(11), e1002439. doi.org/10.1371/journal.pmed.1002439
Hemmings, S., Jakobowitz, S., Abas, M., Bick, D., Howard, L. M., Stanley, N., Zimmerman, C., & Oram, S. (2016). Responding to the health needs of survivors of human trafficking: a systematic review. BMC Health Serv Res, 16, 320. doi.org/10.1186/s12913-016-1538-8
Hodge, D. R. (2008). Sexual trafficking in the United States: a domestic problem with transnational dimensions. Soc Work, 53(2), 143-152. doi.org/10.1093/sw/53.2.143
Macy, R. J., & Graham, L. M. (2012). Identifying domestic and international sex-trafficking victims during human service provision. Trauma Violence Abuse, 13(2), 59-76. doi.org/10.1177/1524838012440340
Oram, S. (2021). Responding to the mental health needs of trafficked women. European Psychiatry, 64(S1), S12-S12. doi.org/10.1192/j.eurpsy.2021.55
Zimmerman, C., & Watts, C. (2003). Ethical and safety recommendations for intervention research on violence against women. Www.who.int. www.who.int/publications/i/item/9789241510189
Can knowing about the health benefits of hot yoga help individuals decide if it is right for them?
Contents
Hot Yoga
The body has a system for ridding itself of what it can’t use or doesn’t need, called toxins. Individuals may have heard that they can sweat out toxins by doing various hot yoga styles. Hot yoga, practiced in a heated room, has become popular. The standard room temperature is around 105 degrees Fahrenheit with 40% humidity. (Mayo Clinic 2020) Because of the temperatures, hot yoga is not for everyone, and those with heart problems or dizziness are recommended to stick with regular classes. However, the detoxification medical benefits may not be there, or there is still insufficient research to confirm.
Body Detoxification
Broken down by the liver, the toxins in the blood or bile are filtered in the kidneys or intestines and removed in urine or stool. (Boyer J. L. 2013) Sweat is not part of the removal equation. The function of sweat is to cool the body down when it becomes overheated. This can happen during strenuous activity, when overdressed, or in summer. Sweat comprises primarily water with trace amounts of urea, lactic acid, and minerals. (Baker L. B. 2019) Except for water, none of the products in sweat are excreted in large enough quantities to alter or improve metabolic function. The sodium excreted in sweat is quickly re-absorbed through the skin’s epithelial sodium channels, which does little to alter the sodium levels in the blood. (Hanukoglu I. et al., 2017)
Environmental Toxins
The body is exposed to all sorts of toxins daily, including pollution and pesticides in the air, preservatives in our foods, and detergents and cosmetics on our skin. (Hunt P. 2011) Sweat-based exercise to remove these toxins is still unfounded.
Sweating In Hot Yoga
Many think that sweating in a hot yoga class will cleanse the alcohol or unhealthy foods. Yoga won’t help sweat these things out, but the practice still provides benefits that help burn some fat from the calories consumed. Exercising helps burn fat regardless of the temperature of the surroundings. (Swift, D. L. et al., 2014) The benefits include:
Increased circulation to deliver more oxygenated blood to the muscles.
Improved muscle tone and flexibility.
Stress relief.
Instead of sweating out the toxins, minimize exposure by eating a healthy, balanced diet, using natural products, and reading the labels of products placed on or in the body.
Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness program that fully benefits the individual to get back to normal. Using an integrated approach to treat injuries and chronic pain syndromes, the ability to relieve pain is improved through flexibility, mobility, and agility programs. Our providers create personalized care plans for each patient, including Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine. If other treatment is needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments.
Boyer J. L. (2013). Bile formation and secretion. Comprehensive Physiology, 3(3), 1035–1078. doi.org/10.1002/cphy.c120027
Baker L. B. (2019). Physiology of sweat gland function: The roles of sweating and sweat composition in human health. Temperature (Austin, Tex.), 6(3), 211–259. doi.org/10.1080/23328940.2019.1632145
Hanukoglu, I., Boggula, V. R., Vaknine, H., Sharma, S., Kleyman, T., & Hanukoglu, A. (2017). Expression of epithelial sodium channel (ENaC) and CFTR in the human epidermis and epidermal appendages. Histochemistry and cell biology, 147(6), 733–748. doi.org/10.1007/s00418-016-1535-3
Hunt P. (2011). Toxins all around us. Exposure to the chemicals in everyday objects poses a hidden health threat. Scientific American, 305(4), 14.
Swift, D. L., Johannsen, N. M., Lavie, C. J., Earnest, C. P., & Church, T. S. (2014). The role of exercise and physical activity in weight loss and maintenance. Progress in cardiovascular diseases, 56(4), 441–447. doi.org/10.1016/j.pcad.2013.09.012
For individuals who sit at work for long hours, can years of practicing unhealthy posture be corrected through a step-by-step approach to ensure optimal body position while sitting?
Contents
Sitting Posture
Sitting up straight with a healthy posture requires the conscious alignment of the hips, pelvis, lower back, upper back, shoulders, neck, and head. Learning or retraining oneself to maintain correct sitting posture can relieve lower back pain, improve respiration and digestion, and reduce tension in the neck and shoulders. (Albarrati, A. et al., 2018) It starts by paying attention to posture throughout the day and correcting it whenever forward head posture, leaning, or slouching develops. Targeted exercises can also help build upper-body strength, and stretching can stabilize and strengthen the core muscles, lower back, and pelvic joints. (Albarrati, A. et al., 2018)
Sit Up Straight Guide
Sitting up straight can be uncomfortable because it is not a natural position for the body to be in for an extended time. Nowadays, work, school, appointments, and other activities require us to sit much longer than intended. The muscles also have to work against gravity, leading to muscle exhaustion, slouching, and slumping, which can cause chronic back, leg, neck, and/or shoulder pain. (Jung, K. S. et al., 2020)
Sitting up straight may seem simple, but the focus tends to be on straightening just the lower/lumbar spine. This posture is unsustainable and exhausts and stresses the upper and lower back. (Jung, K. S. et al., 2020) The whole body needs to be considered when protecting the stability and balance of the spine. Learning and maintaining the ability to sit up straight is a process that requires practice. Find a comfortable chair to sit in, and follow these steps to achieve the optimal postural alignment (Canadian Centre for Occupational Health and Safety, 2022)
Knee Spacing
The hips should be at a roughly 90-degree angle.
Knee Position
The knees should be at a 90-degree angle level with the hips.
Use a pillow to achieve the right knee position if the seat is too low.
Keep the Feet Flat on the Floor
If feet don’t reach the floor, place a footstool, box, book, or other flat object underneath them.
Sitting Bones
Also known as the ischial tuberosities, these are two knobby bones on the underside of the pelvis.
Feel around to find them.
Pelvis Adjustment
Shift the body so that the sitting bones are directly under the pelvis rather than situated too far back, stressing the lower back or too far forward, leading to slumping.
Spine Check
There should be a slight spinal curve, and one should be able to slip a hand between the lower back and the back of the chair.
Shoulder Check
The shoulders should be level and vertically aligned with the hips.
If the shoulder blades are pulled back or the shoulders are lifted or curled forward, relax them into a neutral position.
Head Positioning
The head tends to tilt too far forward while sitting as work and the day progresses.
Adjust the head position to align the neck with the upper spine.
The head should be slightly tilted forward, with the ears aligned with the shoulders.
Check for Pain and Discomfort
Pain may be due to structural imbalances of the spine, pelvis, or hips.
Use a lumbar chair support or place a rolled-up towel or cushion at the lower back to keep the back straight.
Added Tips
Tools and tricks to help prevent and avoid back, hip, and neck pain.
Chairs
All the bells and whistles for an ergonomic desk chair are unnecessary.
Focus on features like adjustable seat height and lumbar support. The correct seat depth recommendations are deeper if tall and shallower if short. (van Niekerk, S. M. et al., 2012)
Cushions
If sitting on a cushion or using one to bolster the back or hips, recommendations are not to go too soft.
Cushions that are too soft allow the ability to shift from one hip to the next, often without realizing it.
They usually eventually flatten and lose support.
Monitor Position
There is no point in sitting straight if the monitor is too high or too low.
The monitor should be at eye level to maintain the proper head and shoulder alignment.
If the monitor is too low, place a box or book underneath it.
If it is too high, raise the chair’s height and place a footrest under the feet to keep them flat.
Avoid Crossing Legs or Feet
Crossing the legs or feet places stress on the opposite hip, thigh, and knee and wears the body out faster.
If the hips or legs are tiring prematurely, the individual is not sitting correctly or in the wrong chair.
Use Comfortable Footwear
Maintaining flat feet on the floor while sitting is imperative.
This is not possible in high heels or platform shoes.
Change into a comfortable pair of flat shoes while sitting.
Take Regular breaks
Even with an ergonomic desk chair, the body is not meant to be sitting for hours and hours.
Get up at least every hour, walking and stretching to reactivate the muscles and circulation.
Sitting up straight requires body alignment awareness, stable core muscles, and balanced pelvis, hips, spine, shoulders, neck, and head positioning. It may take some time before these steps become normal, but they will become second nature with perseverance and practice. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution that fully benefits the individual to get back to normal. Using an integrated approach to treat injuries and chronic pain syndromes to improve ability through flexibility, mobility, and agility programs to relieve pain. Our providers create personalized care plans for each patient, including Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine principles. If other treatment is needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments.
Posture and Mobility
References
Albarrati, A., Zafar, H., Alghadir, A. H., & Anwer, S. (2018). Effect of Upright and Slouched Sitting Postures on the Respiratory Muscle Strength in Healthy Young Males. BioMed research international, 2018, 3058970. doi.org/10.1155/2018/3058970
Jung, K. S., Jung, J. H., In, T. S., & Cho, H. Y. (2020). Effects of Prolonged Sitting with Slumped Posture on Trunk Muscular Fatigue in Adolescents with and without Chronic Lower Back Pain. Medicina (Kaunas, Lithuania), 57(1), 3. doi.org/10.3390/medicina57010003
van Niekerk, S. M., Louw, Q. A., & Hillier, S. (2012). The effectiveness of a chair intervention in the workplace to reduce musculoskeletal symptoms. A systematic review. BMC musculoskeletal disorders, 13, 145. doi.org/10.1186/1471-2474-13-145
How do healthcare professionals provide a clinical approach to recognizing trafficking to individuals seeking a safe environment?
Contents
Introduction
Around the world, there is a phenomenon that local media and organizations are paying more attention to and that many people should be aware of. This is known as trafficking, and it can encompass a wide range of activities, from forced labor in various industries to sex work. While most individuals of trafficking are usually young women or children, it can affect many individuals of all ages and backgrounds. Many survivors of trafficking are compelled to live with the psychological and physical injuries they sustained from the mistreatment they endured at the hands of their traffickers. This course aims to give medical professionals and others in allied fields an understanding of the realities of human trafficking, as well as the kinds of resources and interventions that can be used to help many individuals trafficking in this two-part series. Today’s article overviews trafficking and how it can impact the individual. In part two, we will discuss the roles and protocols of how healthcare professionals can identify trafficking while providing a safe and positive space for the individual. We discuss with certified associated medical providers who consolidate our patients’ information to assess and identify trafficking in the clinic. We also inform and guide patients while asking their associated medical provider intricate questions to integrate a customized treatment plan for their pain and provide them with a safe and positive space. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer.
The Definition of Trafficking
It can be challenging to define trafficking since it frequently coexists with other problems like forced marriage, sexual assault, domestic abuse, and forced labor. (Hume & Sidun, 2017) As the United Nations stated, trafficking encompasses the following activities: “as recruitment, transportation, transfer, harboring, or receipt of many individuals using the threat or use of force to achieve the consent of a person having control over another person, for exploitation.” (United Nations Human Rights Office of the High Commissioner, n.d.) The following components of this definition include:
Act: This is a reference to the different forms of human trafficking, including the hiring, transferring, receiving, and harboring of individuals.
Means: Coercion, force, fraud, kidnapping, deception, abuse of power or weakness, or providing cash or other rewards to someone in a position of authority over the victim are typically used to carry out trafficking.
Purpose: Traffickers engage in forced labor, prostitution, sexual exploitation, forced servitude, slavery, and even organ harvesting to further their financial interests.
While the terms are occasionally used synonymously, human trafficking and people smuggling are not the same. Human smuggling is the transportation of a person into the nation by illicit means; it is voluntary, as the person smuggled usually offers compensation to another individual or party to achieve this purpose (Lusk & Lucas, 2009).
The broad term of human trafficking in the Trafficking Victims Protection Act includes both labor trafficking and sex trafficking. Sex trafficking is when someone is under the age of 18 and is obtained, patronized, or solicited for a commercial sex act by deception, force, or compulsion. The forced, coerced, or fraudulent submission of an individual to slavery, debt bondage, involuntary servitude, or peonage is considered labor trafficking. According to the U.S. Congress, the TVPA does not require that trafficking take place if a person is physically moved from one location to another.
The Statistics Of Trafficking
Determining the actual extent of the problem is challenging due to the complexity of the human trafficking issue and the fact that both the offenders and the victims frequently go unnoticed. A few published estimates from academics, researchers, and organizations and agencies responsible for recording and monitoring occurrences of human trafficking are as follows:
According to estimates from the International Labour Organization, there are over 40 million victims of human trafficking worldwide. (International Labour Organization, n.d.)
Over 51,000 complaints of cases of human trafficking have been received by the National Human Trafficking Hotline since 2007 (National Human Trafficking Hotline, n.d.).
The number of persons thought to be trafficked in the United States varies greatly from year to year, with estimates ranging from 40,000 to 50,000. (Weizter, 2007)
In 2017, the United States Department of Justice obtained 1,045 convictions for offenses related to human trafficking, a 78% increase from 2015. (International Labour Organization, n.d.).
According to the International Labour Organization, over 15 million people are in forced marriages, 4.8 million people are victimized by sex trafficking, and forced labor trafficking claims the lives of almost 25 million people globally. (International Labour Organization, 2017)
In the US, Florida is the third-most popular destination for victims of human trafficking. In 2018, there were 767 reports of human trafficking incidents in Florida and close to 1,900 contacts with the National Human Trafficking Hotline. There was almost 70% of sex trafficking, 16.5% of labor trafficking, and 7.5% of both sex and labor trafficking combined. Of the victims, 56% were adults, and 69% were female (National Human Trafficking Hotline, n.d.).
Data Collection Challenges
The current ICD-10-CM abuse codes could not adequately distinguish victims of human trafficking from other abuse victims, even though an increasing number of caregivers are trained to recognize and record individuals of different forms of human trafficking. Clinicians couldn’t properly identify a condition or arrange the resources needed to administer treatment without the right codes. Additionally, this made it impossible to critically monitor the existence and recurrence of human labor or sexual exploitation.
June 2018 saw the publication of the first ICD-10-CM codes for categorizing abuse related to human trafficking, as requested by the American Heart Association’s Hospitals Against Violence program. The proposal for the modification came from the AHA’s Central Office on ICD-10, which collaborated with Catholic Health Initiatives, the Human Trafficking Initiative at Massachusetts General Hospital, and the Freedom Clinic. With effect from FY 2019, certain ICD-10-CM codes can be used to collect data on adult or child forced labor or sexual exploitation, whether it is proven or suspected. These new codes may be issued in addition to other current ICD-10-CM codes for abuse, neglect, and other maltreatment. These codes received support from different hospitals and health systems. Furthermore, there exist novel codes that can be utilized to record an individual’s past labor or sexual exploitation history, examine, rule out, and observe instances of exploitation, and identify multiple, repeating perpetrators of maltreatment and neglect through an external cause of code (Macias-Konstantopoulos, 2018).
The ICD-10-CM provides specific abuse codes for a range of abuse experiences, such as physical abuse of an older adult, sexual abuse of a child, and violence against a spouse or partner. Similar to how disease diagnosis codes are used, tracking the frequency and trends of particular abuse types, their relationships to other injuries and illnesses, and the kinds of resources that might be needed to stop the abuse are all made feasible by recording abuse using the relevant ICD-10-CM code. Adopting prevention strategies, creating best practices for treatment, introducing new services and payment methods, and establishing new financing and research fields are all made possible by using these codes as the primary diagnosis (Macias-Konstantopoulos, 2018).
Documenting particular types of violence and abuse alone does not give a full picture of the abuse experience. Every abuse experience is a result of a complex interaction between several variables, including the physical surroundings, social and familial dynamics, and personal risks and vulnerabilities. Healthcare professionals can respond to illnesses and injuries connected to abuse as well as underlying health-related social and mental requirements more effectively when these aspects are assessed, documented, and coded using ICD-10-CM Z codes. Similarly, applying ICD-10-CM S, T, V, W, X, and Y codes to record and classify external causes of morbidity as well as the nature, purpose, and mechanism of injury can help shed light on how abuse and violence are committed and pave the way for further preventative measures (Macias-Konstantopoulos, 2018).
Required Actions
Coders should be aware of and start using the ICD-10-CM codes for forced labor and sexual exploitation as they examine a patient’s medical records to determine which ICD-10-CM codes to include.
Hospitals and health systems should inform those who need to know—doctors, nurses, other medical professionals, and coding specialists, among others—about the significance of gathering data on forced labor and sexual exploitation of people.
By keeping track of verified and suspected cases within the healthcare system, hospitals, and health systems can better monitor victim requirements and find ways to enhance community health.This practice also offers an additional means of gathering data to help the systemic creation of a service and resource infrastructure, as well as attempts to prevent harm and inform public policy.
The accompanying chart illustrates the distinction between focused and comprehensive assessment, documentation, and coding of abuse. It also highlights how these differences may affect medical professionals’ reactions to cases and their comprehension of the kinds of resources that may be required to help victims of human trafficking (Macias-Konstantopoulos, 2018).
Beyond the Surface: Understanding the Effects of Personal Injury- Video
Common Misconceptions of Trafficking
There is a misconception that trafficking entails the kidnapping and crossing of national or international borders for various activities to individuals. This misconception fails to acknowledge that individual trafficking can be of any ethnicity, gender, or country and that it can happen almost anywhere and in any sector of the economy. A handful of the widespread myths about human trafficking are as follows:
Myth: Physical violence is a common part of trafficking. Traffickers frequently employ nonviolent tactics, such as deception, manipulation, intimidation, and deceit, to coerce their victims into exploitative circumstances, even while physical violence plays a role in many of their crimes.
Myth: Sexual exploitation is a necessary component of trafficking. It’s likely the most well-known type of trafficking, but commercial sexual exploitation of victims is also a frequent practice. However, experts think that labor trafficking is more commonplace throughout the world.
Myth: Only undocumented foreign nationals are victims of trafficking.The Polaris Project operates the National Human Trafficking Hotline, which has handled thousands of cases of trafficking involving foreign nationals who are lawfully employed or residing in the United States.
Myth: Only illicit or covert sectors are involved in trafficking. Trafficking has been documented concerning several legitimate industries, including manufacturing, restaurants, cleaning services, and construction.
Myth: Transporting a person across state or national borders is a part of trafficking. Human smuggling is the illicit movement of persons across state or national borders. There can be trafficking even when there is no cross-border travel. A person may even become a victim of trafficking in their own house or hometown.
Myth: Trafficking is always a part of the commercial sex trade. Any commercial sex with kids is invariably seen as human trafficking. Adult commercial sex is only classified as trafficking when the victim is coerced, compelled, or deceived into doing it against their will.
Common Forms of Trafficking
There are many forms of trafficking as many individuals that were trafficked are categorized into the following:
Sex Trafficking
Bonded Labor/Forced Labor
Child Labor
Child Conscription
The Impact & Consequences of Trafficking on Individuals
For someone who has never experienced human trafficking, it might be challenging to understand why so many victims choose to remain silent or show such a strong willingness to cooperate with their traffickers (Johnson, 2012). According to Baldwin, Fehrenbacher, and Eisenman (2015), the victim’s compliance and quiet are influenced by the following elements, which the quiet Compliance Model explains:
Coercion: Traffickers use violence, intimidation, and depriving the individual of basic needs to force them into obedience. Traffickers may employ psychological strategies, including isolation, degrading treatment, and induced tiredness in addition to physical force. As a result, the individual experiences a distorted sense of reality and feels helpless.
Collusion: The victim’s cooperation with their traffickers in trafficking or other illicit activities may result from a combination of factors, including fear, loneliness, total dependence, and even a sense of identification with the trafficker.
Contrition: The victims’ guilt and regret for their acts, despite the coerced collaboration, only serve to guarantee their quiet (Johnson, 2013).
Trafficking individuals are susceptible to a wide range of health issues, including chronic illnesses brought on by inadequate working conditions or malnourishment, unwanted pregnancies, severe injuries, and STDs. It’s crucial to remember that emotional issues are often experienced as physical illnesses or sensations in certain cultures. For instance, depression, stress, or anxiety may manifest as symptoms of exhaustion, headaches, or gastrointestinal issues (Greenbaum, 2018; Zimmerman, Hossain, & Fun, 2008).
Conclusion
It is important to recognize the signs of trafficking in individuals who have been dealing with these issues. In part 2 of this series, we will look at how healthcare workers are identified and what procedures to take when a patient is trafficked. This allows the individual to know they are in a safe and positive environment to get the help they deserve.
References
Baldwin, S. B., Fehrenbacher, A. E., & Eisenman, D. P. (2015). Psychological Coercion in Human Trafficking. Qualitative Health Research, 25(9), 1171-1181. doi.org/10.1177/1049732314557087
Greenbaum, V. J. (2017). Child sex trafficking in the United States: Challenges for the healthcare provider. PLoS Med, 14(11), e1002439. doi.org/10.1371/journal.pmed.1002439
Hume, D. L., & Sidun, N. M. (2017). Human Trafficking of Women and Girls: Characteristics, Commonalities, and Complexities. Women & Therapy, 40(1-2), 7-11. doi.org/10.1080/02703149.2016.1205904
Lusk, M., & Lucas, F. (2008). The challenge of human trafficking and contemporary slavery. Journal of Comparative Social Welfare, 25(1), 49–57. doi.org/10.1080/17486830802514049
Macias-Konstantopoulos, W. L. (2018). Diagnosis Codes for Human Trafficking Can Help Assess Incidence, Risk Factors, and Comorbid Illness and Injury. AMA J Ethics, 20(12), E1143-1151. doi.org/10.1001/amajethics.2018.1143
Parreñas, R. S., Hwang, M. C., & Lee, H. R. (2012). What Is Human Trafficking? A Review Essay. Signs: Journal of Women in Culture and Society, 37(4), 1015–1029. doi.org/10.1086/664472
Saiz Echezarreta, V., Alvarado, C., & Gómez-Lorenzini, P. (2018). Advocacy of trafficking campaigns: A controversy story. Comunicar, 26(55), 29–38. doi.org/10.3916/c55-2018-03
Weitzer, R. (2007). The Social Construction of Sex Trafficking: Ideology and Institutionalization of a Moral Crusade. Politics & Society, 35(3), 447-475. doi.org/10.1177/0032329207304319
Zimmerman, C., Hossain, M., Yun, K., Gajdadziev, V., Guzun, N., Tchomarova, M., Ciarrocchi, R. A., Johansson, A., Kefurtova, A., Scodanibbio, S., Motus, M. N., Roche, B., Morison, L., & Watts, C. (2008). The health of trafficked women: a survey of women entering posttrafficking services in Europe. Am J Public Health, 98(1), 55-59. doi.org/10.2105/AJPH.2006.108357
Can incorporating tonic water benefit individuals who want to drink more water?
Contents
Tonic Water
Tonic water is more than just water. Its bitter taste comes from quinine, a natural substance found in the bark of the Peruvian cinchona tree. Most store-bought tonic water contains quinine, with natural or artificial flavors from fruits or herbs to temper the bitterness, varying from brand to brand.
Tonic water calories can be high. Some brands can have up to 114 calories per bottle. The reason is they use a sweetener. Some brands have a diet version with zero calories and no sugar but may contain more sodium.
Fats and Protein
There is no fat or protein in tonic water.
Sugar
Some brands use high fructose syrup, while others use cane sugar or sugar from the other ingredients. For example, adding an alcoholic ingredient to make a tonic cocktail can significantly increase the calorie count.
Sodium
Depending on the variety and the amount drunk, tonic water can be a source of sodium. However, sodium intake should be 1500 milligrams per day.
Carbohydrates
There are 33 grams of carbohydrates per serving with the estimated glycemic load or the numerical value that estimates how much a food will raise an individual’s blood sugar to around four.
Micronutrients
There are no significant vitamins or minerals but a small amount of sodium, zinc, and copper.
Health
Quinine is FDA-approved in specific doses to treat malaria. However, the quinine in tonic water is less than prescribed for medicinal purposes. (Achan, J. et al., 2011) Some individuals have tried to use quinine for leg cramps. However, the FDA has warned that this is not recommended and can cause harm. (U.S. Food and Drug Administration. 2017)
Other Water Beverages
There are other water alternatives to reduce calories, sodium, and added sugar.
Seltzer
Seltzer is carbonated water, similar to club soda, with no calories or added sweeteners.
Add lemon or other fruit for flavor.
Mineral water
Mineral water tastes like seltzer, but the carbonation is usually natural.
Flavored water
Flavored water provides some nutrients and antioxidants from the vegetables and fruits.
It is a great alternative if the other options don’t work.
Allergies
It is possible to have an allergy to quinine that could cause a reaction when drinking tonic water. (Winter F. D., Jr. 2015) In these cases, the research suggests, the allergy may cause:
Individuals can make tonic water with online recipes using different herbs and flavors. Tonic water made at home may or may not be lower in calories than store-bought brands, but the ingredients can be controlled to create beverages that cater to personal tastes. Using tonic or sparkling water, keep the bottled water tightly capped and chilled to maintain carbonation and ready to serve.
Injury Medical Chiropractic and Functional Medicine Clinic focuses on and treats injuries and chronic pain syndromes through personalized care plans to restore health and function to the body through Nutrition and Wellness, Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine protocols. If the individual needs other treatment, they will be referred to a clinic or specialist best suited for them, as Dr. Jimenez has teamed up with the top surgeons, clinical specialists, medical researchers, nutritionists, and health coaches to provide the most effective clinical treatments.
Achan, J., Talisuna, A. O., Erhart, A., Yeka, A., Tibenderana, J. K., Baliraine, F. N., Rosenthal, P. J., & D’Alessandro, U. (2011). Quinine, an old anti-malarial drug in a modern world: role in the treatment of malaria. Malaria journal, 10, 144. doi.org/10.1186/1475-2875-10-144
Howard, M. A., Hibbard, A. B., Terrell, D. R., Medina, P. J., Vesely, S. K., & George, J. N. (2003). Quinine allergy causing acute severe systemic illness: report of 4 patients manifesting multiple hematologic, renal, and hepatic abnormalities. Proceedings (Baylor University. Medical Center), 16(1), 21–26. doi.org/10.1080/08998280.2003.11927884
Winter F. D., Jr (2015). Immune thrombocytopenia associated with consumption of tonic water. Proceedings (Baylor University. Medical Center), 28(2), 213–216. doi.org/10.1080/08998280.2015.11929233
For individuals wanting to try Pilates for back pain and exercise, can learning how to find their neutral spine help improve flexibility and increase the range of motion in the joints?
Contents
Pilates Neutral Spine
Pilates is a functional exercise modality emphasizing core stability, which is fundamental to developing a balanced body. The exercises strengthen the muscles, improve flexibility, and increase the range of motion in the joints. (Kloubec J. 2011) It is considered a functional fitness method because its principles work to establish more graceful, efficient movements from everyday life, such as improving posture. Pilates has shown its effectiveness in that it is often used in physical therapy and rehabilitation settings. (Byrnes, K., Wu, P. J., and Whillier, S. 2018) However, knowing how to find the neutral spine is essential for performing various Pilates exercises correctly. (Barbosa, A. C. et al., 2018) This subtle adjustment during practice may help prevent injury and increase overall performance. A neutral spine is the natural position of the spine when all three curves:
Cervical (neck)
Thoracic (middle)
Lumbar (lower)
Are active and in healthy alignment.
This is the strongest position for the spine when standing or sitting, allowing the body to move more naturally.
Alignment
The following exercise can help find the Pilates neutral spine.
Basic Position
Lie on the back with knees bent and feet flat on the floor.
Ensure the legs are parallel to the hips, knees, heels, and toes.
Let the arms rest at your sides.
Relax
Relax the body, including the shoulders, neck, and jaw.
Allow the back to melt into the floor.
The rib cage will drop when the lower ribs are released to the floor.
Breathe Deep
Inhale all the way into the body, allowing it to move into the back and sides of the rib cage and all the way to the pelvis.
Pelvic Tilt
Exhale and use the abdominals to press the lower spine into the floor in a pelvic tuck. (Eickmeyer S. M. 2017)
Inhale to release.
Exhale and pull the lower spine off the floor, creating a pelvic tilt.
Inhale to release.
Pilates exercises don’t use excess energy or tension. Proper alignment and a neutral spine position can ensure that tension is released and excess energy is not exerted. (Byrnes, K., Wu, P. J., and Whillier, S. 2018) When performing the exercise, ensure that the shoulders, neck, and legs are relaxed and not involved in the movement.
When Exercising
Once a neutral spine is achieved, the goal is to maintain this spinal position during the exercises and when changing positions.
Start by lifting the right leg and placing it back down without letting the hips move.
Then, repeat the motion with the left leg.
Engage the abdominal muscles to help stabilize the pelvis, keeping it from moving and maintaining a neutral spine.
Repeat this process with each leg.
Once each leg can be lifted easily, test with both legs.
Exhale deeply and lift the legs while keeping the core and pelvis stable.
Then, lower them back down.
When performing this progression, there may be a want to release the abs and let the back arch.
This will cause a tuck and tilt position away from the neutral spine position.
If this progression is difficult, keep practicing until you can maintain a neutral spine.
Once this basic progression feels easy, try additional progressions and positioning.
Visualization Tips
Most people have their spines in one of two positions: tucked or tilted. A neutral spine requires individuals to be in between, with the lower abdominals flat and the lower spine’s natural curve slightly off the floor. The following visualization can help establish a neutral spine.
Balanced Pelvic Placement
Imagine a cup of water sitting on the lower abdomen, a couple of inches below the belly button.
Allow the abdominal muscles to drop toward the spine, flattening the belly.
You don’t want the water to spill, so the pelvis cannot be tipped forward or tucked under.
Body Scan Meditation
Once the body is relaxed with a balanced alignment on the floor.
Allow breathing to become deep and full and the abdominals to drop toward the floor.
The natural neck and lower spine curves should be off the floor.
Ensure the lower spine is not pressed into the floor, as this indicates a pelvic tilt.
If there is any discomfort or pain when working to increase endurance, seek advice from a healthcare professional. Injury Medical Chiropractic and Functional Medicine Clinic uses an integrated approach to treating injuries and chronic pain syndromes. It offers personalized care plans that improve ability through flexibility, mobility, and agility programs to relieve pain. Our providers use an integrated approach to create personalized care plans for each patient, including Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine principles. Our goal is to relieve pain naturally by restoring health and function to the body. If other treatment is needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments.
Is Motion Key to Healing?
References
Kloubec J. (2011). Pilates: how does it work and who needs it?. Muscles, ligaments and tendons journal, 1(2), 61–66.
Byrnes, K., Wu, P. J., & Whillier, S. (2018). Is Pilates an effective rehabilitation tool? A systematic review. Journal of bodywork and movement therapies, 22(1), 192–202. doi.org/10.1016/j.jbmt.2017.04.008
Barbosa, A. C., Vieira, E. R., Silva, A. F., Coelho, A. C., Martins, F. M., Fonseca, D. S., Barbosa, M. A., & Bordachar, D. (2018). Pilates experience vs. muscle activation during abdominal drawing-in maneuver. Journal of bodywork and movement therapies, 22(2), 467–470. doi.org/10.1016/j.jbmt.2017.05.002
Eickmeyer S. M. (2017). Anatomy and Physiology of the Pelvic Floor. Physical medicine and rehabilitation clinics of North America, 28(3), 455–460. doi.org/10.1016/j.pmr.2017.03.003
Can increasing endurance help individuals who want to improve their physical abilities or extend the time they perform these activities?
Contents
Endurance
Individuals tend to think of endurance in terms of exercise and fitness, such as running, biking, swimming, and strength training. While this is true, endurance is involved in nearly every task we perform. For example, an individual has to have enough endurance to complete a full day of activities. This includes:
Carpooling the kids
Professional responsibilities
Home chores
Preparing dinner
Helping out kids with homework, etc.
Nearly every activity requires some level of endurance, which means the ability to maintain activity for an extended period of time. When endurance begins to wane, it usually results from not performing certain activities regularly. The body gets used to daily routines and activities. When it stops engaging in certain activities, like walking and exercising regularly, endurance slowly declines, and the ability to perform at the same caliber.
What Is It?
Endurance is an ability that is acquired after extensive physical and mental training. Physiological and psychological factors reinvigorate individuals to continue doing what they are doing longer. Factors include:
Fatigue
Individuals who didn’t sleep well the night before or are worn out may have difficulty following through with certain activities that require extensive output or stamina.
Fitness Levels
Current fitness levels are also a predictor of endurance.
How physically fit an individual is, coupled with their level of training, will impact endurance abilities.
Genetics is another factor, as everybody has different muscle fibers that can influence physical capabilities. While research shows that individuals can gradually alter the amount of these fibers, it also emphasizes the role of genetics in determining one’s muscle makeup. (de Souza, E. O. et al., 2014)
Individuals who constantly challenge themselves mentally and physically are continually building endurance.
Endurance and Stamina Difference
Endurance is often used interchangeably with stamina. However, the two are very different.
Stamina refers to how long an individual can perform a certain activity at maximum capacity or without getting tired.
Endurance revolves around an individual’s ability to perform a certain activity without performing at maximum capacity.
Types
Endurance can be divided into classifications defined by type. Here are the main types of endurance in physical fitness and what they mean.
Cardiovascular
Cardiovascular endurance is the stress an individual’s heart can take during physical activity.
When building cardiovascular endurance, the body becomes more efficient at pumping blood while performing a specific activity.
Individuals with more cardiovascular endurance can sustain longer and more intense overall training.
Muscular
Muscular endurance is the length of time muscles can continue to contract enough to allow the body to finish a certain activity.
An individual lacking in muscular endurance will succumb faster to excess lactic acid build-up, causing cramps.
An individual with significant muscular endurance can lift a weight for more repetitions before failure.
Anaerobic
Anaerobic means without oxygen, so anaerobic endurance refers to how long a muscle can continue working at a certain physical level without much or any oxygen.
Weightlifting is a great example of this.
Anaerobic exercise tends to be shorter in duration but more intense than aerobic exercise, like swimming or cycling.
Improvement
Through endurance training, individuals can improve their ability to carry out certain activities longer. Recommendations for how to improve include.
Interval Training
Interval training, or high-intensity interval training, involves increasing the intensity of the workout for a short period of time.
If running, intentionally push the pace harder than normal for 20-second intervals.
Followed by a slower recovery pace for about a minute.
This increases endurance and improves insulin sensitivity.
Pedaling on an air bike is another recommended activity to build strength and endurance.
Rest Less Between Sets
Resting in between certain types of physical activity is beneficial, it can also lower heart rate and endurance threshold.
Taking less rest between workout sets so that the heart rate stays elevated increases endurance with each workout.
Perform a Few More Reps On Each Set
Whatever the type of exercise being done, one way to enhance endurance is to add one more rep, one more mile, or a few more minutes to the fitness schedule.
The body will slowly adapt to that level, making it the new norm.
Increase Core Strength
No matter the workout—running, swimming, cycling, or weight lifting—it’s important to focus on strengthening the core. This will help improve endurance in any activity and prevent injuries.
Individuals having trouble taking their workouts to the next level and feeling that their endurance has flattened should consider enlisting the help of a certified personal trainer. If there is any discomfort or pain when working to increase endurance, seek advice from a healthcare professional. Injury Medical Chiropractic and Functional Medicine Clinic uses an integrated approach to treating injuries and chronic pain syndromes. It offers personalized care plans that improve ability through flexibility, mobility, and agility programs to relieve pain. Our providers use an integrated approach to create personalized care plans for each patient, including Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine principles. Our goal is to relieve pain naturally by restoring health and function to the body. If other treatment is needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments.
Unlocking Athletic Potential
References
de Souza, E. O., Tricoli, V., Aoki, M. S., Roschel, H., Brum, P. C., Bacurau, A. V., Silva-Batista, C., Wilson, J. M., Neves, M., Jr, Soares, A. G., & Ugrinowitsch, C. (2014). Effects of concurrent strength and endurance training on genes related to myostatin signaling pathway and muscle fiber responses. Journal of strength and conditioning research, 28(11), 3215–3223. doi.org/10.1519/JSC.0000000000000525
Can understanding the nucleus pulposus help in body positioning and prevention for individuals wanting to practice spinal hygiene and protect their discs from injury?
Contents
Nucleus Pulposus
The spinal discs are located between the spine’s vertebrae and are the body’s natural impact and shock absorbers. Within the disc is the nucleus pulposus, which plays a major role in providing the spine with shock absorption during movement. (Zhou Z. et al., 2014) The discs have a tough outer portion and a soft inner core. They are the:
It forms the tough circular exterior and comprises concentric sheets of collagen fibers or lamellae surrounding the inner core.
It has cartilaginous endplates that firmly attach to the vertebrae above and below.
Nucleus Pulposus
The nucleus pulposus is the inner core soft filling of the discs.
It contains a network of fibers suspended in a mucoprotein gel with a water base to maintain strength and pliability.
The near-liquid consistency makes it responsive to movement to handle the body’s axial load.
It helps maintain spinal suspension to prevent pressure on the bones and prevent bone-to-bone contact, reducing the potential for injuries and pain.
Shock Absorber
Each intervertebral disc is a shock-absorbing cushion, with the nucleus pulposus providing shock-absorbing properties (Zhou Z. et al., 2014). The intervertebral discs move as the body moves. For example, when arching the back, the disc moves forward slightly, and when twisting, the disc twists as well.
Spinal Action
The intervertebral disc supports spinal movements. When bending, twisting, arching, or tilting the spine, the nucleus pulposus swivels to accommodate these actions. These repeated spinal actions, which occur throughout the day and night, contribute to shifting positions while sitting, working, playing sports, carrying groceries, performing house chores, etc. An example is bending forward to pick something up. This action involves forward spinal flexion, which is bending the spine forward, flattening, or rounding. When bending using flexion, the spinal bones come closer together, pushing the nucleus pulposus toward the back.
Injuries
The disc can be pushed too far back with persistent or excessive spinal flexion. If the fibers of the annulus fibrosus become weak, they can tear, causing the nucleus pulposus to leak out and disc herniation. Generally, the nucleus pulposus will leak to the side and back; however, this corresponds to the location of the very sensitive nerve root/s with which it can come into contact, causing pain and other symptoms. The most common causes of disc herniation are degenerative wear and tear changes of the disc and trauma. Disc degeneration occurs as the body ages; it weakens the annulus fibers, allowing the nucleus pulposus to distend, bulge, or herniate.
Aging
Disc degeneration occurs with age but can also occur with injuries to the area. In young individuals, the nucleus pulposus is mostly water. For this age group, a herniation from trauma is more likely than in older individuals. (Ucar, D. et al., 2021) But as the body ages, the discs, especially the nucleus pulposus, begin to dry out. This dehydration leads to a significant loss of disc height. (UCLA Health, 2024) By age 60 or 70, the discs may be composed entirely of fiber, which can cause the shock absorption function not to work and disappear.
Chiropractic therapy is among the more conservative treatment options for a herniated disc and may be tried first before proceeding with more invasive treatments. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution that fully benefits the individual to get back to normal.
The Science of Functional Healing
References
Zhou, Z., Gao, M., Wei, F., Liang, J., Deng, W., Dai, X., Zhou, G., & Zou, X. (2014). Shock absorbing function study on denucleated intervertebral disc with or without hydrogel injection through static and dynamic biomechanical tests in vitro. BioMed research international, 2014, 461724. doi.org/10.1155/2014/461724
Nosikova, Y. S., Santerre, J. P., Grynpas, M., Gibson, G., & Kandel, R. A. (2012). Characterization of the annulus fibrosus-vertebral body interface: identification of new structural features. Journal of anatomy, 221(6), 577–589. doi.org/10.1111/j.1469-7580.2012.01537.x
Ucar, D., Duman, S., Bayram, Y., & Ucar, B. Y. (2021). Extruded disc herniations are experienced earlier by inactive young people in the high-tech gaming era. Journal of medicine and life, 14(3), 402–407. doi.org/10.25122/jml-2021-1059
How do healthcare professionals provide a clinical approach to recognizing HIV for individuals in pain and providing relief?
Contents
Introduction
The human body has dealt with various environmental factors, injuries, and pathogens that can cause issues to the body system. As many individuals are always on the go from one location to another, being healthy is extremely important. Making time to make an appointment for a person’s health and well-being is extremely important, as many people have experienced comorbidities and overlapping risk profiles that are causing them pain. When individuals experience onset issues of fatigue, muscle and joint pain, or immune disorders, many healthcare professionals must assess the situation and ask the individuals when they experienced these overlapping risk profiles and how they affect their daily activities. One of the overlapping risk profiles that seems to affect the body is a viral infection known as Human Immunodeficiency Virus or HIV. This can get many healthcare professionals to come up with a personalized treatment plan to reduce these overlapping risk profiles and educate the individual on what to do to manage HIV symptoms. Today’s article looks at how HIV can impact a person, their symptoms, and non-surgical treatments to manage HIV. We discuss with certified associated medical providers who consolidate our patients’ information to assess the effects of HIV and its associated symptoms. We also inform and guide patients on how to be aware of the impact of HIV and ask their associated medical providers intricate questions to integrate a customized treatment plan to incorporate multiple non-surgical therapies to manage the symptoms. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer.
What Is HIV?
Do you constantly feel tired even after taking a good night’s rest? Do you feel your throat being sore without the flu symptoms? Or are you experiencing muscle and joint pain in different locations of your body? Worldwide, many individuals have often experienced these symptoms from a viral infection known as Human Immunodeficiency Virus or HIV. HIV belongs to the retroviridae family, which targets the body’s immune system, especially the CD4+ T cells. The CD4+T cells play an important role in the body’s immune response, but when HIV starts to deplete the receptors and terminate the host cells. (Masenga et al., 2023) This causes individuals to have acute stages of HIV and, if not treated immediately, can lead to the progression of severe stages. However, how do individuals contract HIV? Well, the most common mode is through unprotected sexual intercourse, sharing needles, or through maternal-infant exposure, which diminishes the T-helper cell population and, over time, can increasingly weaken the immune system. (van Heuvel et al., 2022) This causes many individuals to develop various symptoms from HIV that can vary, depending on the severity and the progression stages of the virus.
The Symptoms
Now, for the progression of HIV to infect the body’s immune system and cause various symptoms to affect the individual, many healthcare professionals have to look at the process of the host’s exosomes and their correlation role with HIV. The generational process of exosomes causes overlapping risk profiles with the viral assembly of HIV as exosomes can transport the virus from the infected cells to the uninfected cells of the body by helping it regulate the host’s immune response to the virus infection. (Chen et al., 2021) To that point, it can lead to the progression of several stages of HIV and its associated symptoms. When a person is dealing with an HIV infection in its acute stages, the symptoms can be mild and easily mistaken for a common viral infection. Some of the symptoms can include:
Muscle aches
Joint pain
Difficulty falling asleep
Fatigue
Neuropathy
Shortness of breath
Swollen glands
This is because the inflammatory cytokines from the immune system are heightened and influenced by HIV. When inflammatory cytokines become associated with HIV, symptoms have a huge impact on an individual’s life, causing them to be miserable. (Schnall et al., 2020) Additionally, when HIV is in a clinical latency stage, the virus is less active but can still replicate without exhibiting any symptoms in the body. However, when HIV progresses to its severe stage, it can lead to the development of AIDS. Luckily, treatment advancements to treat HIV from its acute stages can help manage the associated symptoms.
The Non-Surgical Approach To Wellness- Video
Non-Surgical Treatments For HIV
When it comes to treating HIV, non-surgical treatments can help manage its associated symptoms while dramatically improving the life expectancy and quality of life of the individual who is affected by the virus. For non-surgical treatments, the main goal is to diagnose HIV as early as possible and to assess the situation by coming up with new and innovative HIV testing initiatives to increase the frequency and prevention of HIV in both clinical and non-clinical settings. (Delaney & DiNenno, 2021) Below are some non-surgical treatments to manage HIV.
Antiretroviral Treatments
Now, some of the non-surgical treatments to manage HIV is by taking antiretroviral therapy. This allows the individual with HIV to be more mindful of taking antiretroviral medications daily, which then helps improve sustained viral suppression of HIV and provides effective strategies of therapeutic approaches to enhance antiretroviral activities. (Huerta, 2020) Additionally, the primary goal of antiretroviral therapy is to reduce the HIV load to an undetectable level, keep the immune system functioning, and prevent the progression development of AIDS.
Lifestyle Adjustments
While living with HIV today is vastly different from decades past, thanks to significant medical advancements. Many individuals can go to their healthcare providers for an early diagnosis and effective treatment to live long and healthy lives. Awareness, education, and staying proactive with health checks remain key in the fight against HIV and its progression. Additionally, proper nutrition, regular exercise, and mental health support are also crucial for people living with HIV, helping to boost the immune system and manage symptoms. At the same time, regular visits to a healthcare provider for blood tests are essential to monitor the effectiveness of ART and adjust the treatment regimen as needed to live a healthier life.
References
Chen, J., Li, C., Li, R., Chen, H., Chen, D., & Li, W. (2021). Exosomes in HIV infection. Curr Opin HIV AIDS, 16(5), 262-270. doi.org/10.1097/COH.0000000000000694
Delaney, K. P., & DiNenno, E. A. (2021). HIV Testing Strategies for Health Departments to End the Epidemic in the U.S. Am J Prev Med, 61(5 Suppl 1), S6-S15. doi.org/10.1016/j.amepre.2021.06.002
Huerta, L. (2020). Editorial: Anti-infective 2020: HIV-From pathogenesis to treatment. Curr Opin Pharmacol, 54, x-xii. doi.org/10.1016/j.coph.2020.12.001
Masenga, S. K., Mweene, B. C., Luwaya, E., Muchaili, L., Chona, M., & Kirabo, A. (2023). HIV-Host Cell Interactions. Cells, 12(10). doi.org/10.3390/cells12101351
Schnall, R., Jia, H., & Reame, N. (2020). Association Between HIV Symptom Burden and Inflammatory Cytokines: An Analysis by Sex and Menopause Stage. J Womens Health (Larchmt), 29(1), 119-127. doi.org/10.1089/jwh.2019.7749
van Heuvel, Y., Schatz, S., Rosengarten, J. F., & Stitz, J. (2022). Infectious RNA: Human Immunodeficiency Virus (HIV) Biology, Therapeutic Intervention, and the Quest for a Vaccine. Toxins (Basel), 14(2). doi.org/10.3390/toxins14020138
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