The iliopsoas muscle is a primary hip flexor that assists in the femur’s external rotation and maintains the hip joint’s strength and integrity. It also helps to stabilize the lumbar spine and pelvis. Athletes often overuse these muscles with all the sprinting, jumping, kicking, and changing directions when running, causing strains and/or tears. Repetitive hip flexion can result in chronic degenerative tendon changes. Chiropractic care and physical therapy can assist in the early phases of healing, safely transitioning to rehabilitation, and returning to physical activities.
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Iliopsoas Muscle
The hip flexors are the group of muscles, including the iliac and psoas major muscles/iliopsoas and the rectus femoris/quadriceps. One of the largest and thickest muscles in the body, the psoas, extends from the lumbar vertebrae, crosses in front of each hip, and attaches to the inside top of the thigh bone. The muscle works by flexing the hip joint and lifting the upper leg towards the body. These fibers can tear if tension is more than the muscle can bear. An iliopsoas strain occurs when one or more of these hip flexor muscles become overly stretched or begin to tear.
Injury
The injury can occur from sports or everyday physical activities. This leads to inflammation, pain, and scar tissue formation. An iliopsoas injury is commonly caused by sudden movements, including sprinting, kicking, and changing direction fast while running. Individuals participating in any sports, especially cycling, running, dance, tennis, martial arts, and soccer, are more likely to experience this injury. Other contributing factors include:
Muscle tightness
Joint stiffness
Muscle weakness
Inadequate core stability
Not warming up correctly
Improper biomechanics
Decreased fitness and conditioning
Individuals will feel a sudden stinging pain or pulling sensation, usually on the front of the hip, groin, or abdominal area. Other symptoms include:
Healing and recovery depend on the severity of the injury. A minor iliopsoas muscle injury can take around three weeks to recover fully. More serious strains and tears take six to eight weeks before returning to activity, as the tissue needs time to repair before starting rehabilitation.
Chiropractic Rehabilitation and Recovery
The first steps when dealing with this injury should be P.R.I.C.E. protection, rest, ice, compression, and elevation. It is important to rest and seek treatment immediately; if left untreated, the condition could worsen, lead to a chronic condition, and require surgery. A chiropractic treatment and rehabilitation plan will consist of the following:
Soft tissue massage
Joint mobilization
A chiropractor may recommend crutches to keep the weight off the hip.
A brace can help compress and stabilize the hip flexor to expedite healing.
A flexibility and strengthening program will be implemented to target the muscles around the hip.
Core strengthening exercises will improve the stability of the pelvis area to prevent any further overuse problems.
Wearing compression clothing could also be recommended, as the clothing helps maintain muscle temperature.
Labral Tear
References
Dydyk AM, Sapra A. Psoas Syndrome. [Updated 2022 Oct 24]. In: StatPearls [Internet]. Treasure Island (F.L.): StatPearls Publishing; 2022 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK551701/
Lifshitz, Liran BPt, MSc, PT; Bar Sela, Shlomo BPt MPE; Gal, Noga BPt, MSc; Martin, RobRoy PhD, PT; Fleitman Klar, Michal BPt. Iliopsoas the Hidden Muscle: Anatomy, Diagnosis, and Treatment. Current Sports Medicine Reports 19(6):p 235-243, June 2020. | DOI: 10.1249/JSR.0000000000000723
Rauseo, Carla. “THE REHABILITATION OF A RUNNER WITH ILIOPSOAS TENDINOPATHY USING AN ECCENTRIC-BIASED EXERCISE-A CASE REPORT.” International journal of sports physical therapy vol. 12,7 (2017): 1150-1162. doi:10.26603/ijspt20171150
Rubio, Manolo, et al. “Spontaneous Iliopsoas Tendon Tear: A Rare Cause of Hip Pain in the Elderly.” Geriatric orthopedic surgery & rehabilitation vol. 7,1 (2016): 30-2. doi:10.1177/2151458515627309
It is a common scenario, whether sitting or standing when we need to bend down or forward, and suddenly there is a sharp sting on one side of the low back. The sensation can cause the knees to buckle. So we stand up slowly to assess the condition and realize it is almost impossible to stand completely straight and even harder to bend forward. So we sit back down to try and relieve the pressure. It helps a little, but the injury has caused the back muscles to spasm and get tighter and tighter. When we try to get up, there can be one big or several mild to severe electrical shock sensations traveling through the back. A severely over-rotated vertebrae could be the cause and require chiropractic care, massage, and/or decompression therapy.
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Over Rotated Vertebrae
The spinal column is made of 26 interconnected vertebrae. When in motion, each vertebra moves, and as the torso rotates, the spine must rotate as well. The spine can move in several ways, including:
Bending
Rounding forward.
Extending or arching backward.
Twisting
Tilting sideways uses some of the same muscles when twisting.
Although the spine can move in various directions, there are limits to how far it can and should go. For example, when bending forward to lift an object, an individual can unknowingly over-extend and over-rotate vertebrae. This is where the risk of injury increases. A rotational injury of the spine occurs when the torso turns too far, and the spinal cord can’t handle it. This can stretch the ligaments in the spine to the point of snapping, causing the facet joints to dislocate. Ligament strains and facet dislocations are two of the most common rotational spine injuries.
Complications
An over-rotated vertebrae injury can also lead to complications that include.
Chronic Pain
Spinal nerve damage can lead to chronic pain conditions.
Mobility Problems
Mobility problems are common following an injury of the spine.
This comes from damage to the nerves that innervate the legs, causing weakness and coordination problems.
Pressure Ulcers
Numbness following a spine injury can cause individuals not to notice pressure ulcers developing.
These can lead to infections and could require hospitalization.
Individuals accumulate tension and/or weakness in the oblique abdominal muscles and other trunk muscles that can lead to chronic tightness and weakness, affecting movement and decreasing the range of motion.
Chiropractic Treatment Plan
Depending on the time and severity of the injury, a personalized treatment plan may consist of the following:
Chiropractic mobilization to release the spasms and reset the spine.
Rest
Facet Syndrome Treatment
References
Janssen, Michiel M A, et al. “Pre-existent vertebral rotation in the human spine is influenced by body position.” The European spine journal: official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society vol. 19,10 (2010): 1728-34. doi:10.1007/s00586-010-1400-3
Kruger, Erwin A et al. “Comprehensive management of pressure ulcers in spinal cord injury: current concepts and future trends.” The Journal of spinal cord medicine vol. 36,6 (2013): 572-85. doi:10.1179/2045772313Y.0000000093
Passias, Peter G et al. “Segmental lumbar rotation in patients with discogenic low back pain during functional weight-bearing activities.” The Journal of bone and joint surgery. American volume vol. 93,1 (2011): 29-37. doi:10.2106/JBJS.I.01348
Shan, X., Ning, X., Chen, Z. et al. Low back pain development response to sustained trunk axial twisting. Eur Spine J 22, 1972–1978 (2013). doi.org/10.1007/s00586-013-2784-7
Trail mix is a favorite snack for many individuals. A typical mix combines granola, dried fruits, nuts, seeds, cereals, and pretzels. The mix was originally developed as a portable snack/meal for hikers that was lightweight, could be stored in a backpack, and provided plenty of protein and energy. Prepackaged trail mix is available at many grocery stores and online retailers. It’s an excellent choice for traveling or going on a road trip because of its energy and nutritional content. However, not all types are considered equal in terms of nutrition. Some can consist of ingredients loaded with sugar and salt. Added consumption could cause weight gain and contribute to conditions like heart disease, type 2 diabetes, and liver problems. Here we look at choosing healthy mixes.
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Trail Mix
The nutritional power comes from the high amounts of fiber and antioxidants.
Benefits
Protein and Healthy Fats
Protein is essential for tissue repair, immune health, and muscle development.
Nuts and seeds make up the largest portion.
A healthy source of protein, allowing individuals to snack on the go and not become hungry.
One of the greatest benefits of eating these is that they are full of heart-healthy fats.
These healthy fats help decrease unhealthy LDL cholesterol levels and reduce inflammation.
Fiber
The fiber in the seeds and granola helps keep the gut healthy and regular.
It also helps control appetite, aids in digestion, and keeps the body fuller longer.
Energy
Dried fruits and granola consist of healthy sugars.
Healthy sugars help stabilize blood sugar levels, providing the body with a consistent energy source.
Antioxidants, Vitamins, and Minerals
Dried fruit maintains a majority of its nutritional value.
The nuts and seeds are also packed with nutrients and antioxidants.
Choosing Healthy
Check the nutrition label and avoid varieties high in added sugar or sodium.
Look for products containing nutrient-dense ingredients like nuts, seeds, dried fruits, and limited amounts of candy or chocolate chips, if any.
Healthy ingredients include almonds, pumpkin seeds, cashews, sunflower seeds, dried fruit, popcorn, and dark chocolate.
Making trail mix at home allows control of its contents and maximizes its potential health benefits.
It is important to keep an eye on portion control.
A recommended serving is about a fourth of a cup.
Nutritionist
Nutritional consultation can improve an individual’s quality of life, health, and well-being. A nutritionist can help individuals with precision or personalized nutrition that focuses on the individual. Nutritionists can create meal plans for their clients and provide education and knowledge on appropriate food choices.
Potassium
References
Devitt, A A et al. “Appetitive and Dietary Effects of Consuming an Energy-Dense Food (Peanuts) with or between Meals by Snackers and Nonsnackers.” Journal of nutrition and metabolism vol. 2011 (2011): 928352. doi:10.1155/2011/928352
Grillo, Andrea et al. “Sodium Intake and Hypertension.” Nutrients vol. 11,9 1970. 21 Aug. 2019, doi:10.3390/nu11091970
Mehlhose, Clara, et al. “PACE Labels on Healthy and Unhealthy Snack Products in a Laboratory Shopping Setting: Perception, Visual Attention, and Product Choice.” Foods (Basel, Switzerland) vol. 10,4 904. 20 Apr. 2021, doi:10.3390/foods10040904
Vreman, Rick A et al. “Health and economic benefits of reducing sugar intake in the USA, including effects via non-alcoholic fatty liver disease: a microsimulation model.” BMJ open vol. 7,8 e013543. 3 Aug. 2017, doi:10.1136/bmjopen-2016-013543
Chiropractic care has a powerful therapeutic effect on the body’s systems. This includes the nervous, muscular, skeletal, and lymphatic. The lymphatic system is a part of the immune system. It circulates lymph, a fluid comprised of white blood cells that support the immune system, proteins, and fats. The lymphatic system collects toxins, moves waste, and protects the body from foreign invaders. Together with the immune system, the lymphatic system keeps the body balanced. However, imbalances occur due to misalignments, subluxations, compressed nerves, chronic conditions, and injuries. Chiropractic care, massage, and decompression therapy can help mobilize stuck or misaligned joints, reduce muscular tension, alleviate nerve inflammation and discomfort, and restore optimal function.
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Spinal Lymphatic Detox
Lymphatic System
The lymphatic system is a network throughout the body. The system drains lymph fluid from the blood vessels into the tissues and empties it back into the bloodstream through the lymph nodes. The main functions of the system include the following:
Regulates fluid levels in the body.
Activates when bacteria or viruses enter.
Manages and removes cancer cells or cell byproducts that could result in disease or disorders.
Absorbs some of the fats from the intestine.
The lymph nodes and other structures like the spleenand thymushouse specialized white blood cells called lymphocytes. These are ready to go and can rapidly multiply and release antibodies when bacteria, viruses, and other stimuli, enter the body.
Fluid Balance
The blood in the vessels is under constant pressure. Nutrients, fluids, and certain cells need to circulate throughout the body to supply the tissues and maintain the system’s defense. The lymphatic system:
Removes all fluids and contents that leak into the tissues.
Eliminates waste products formed in the tissues.
Eliminates bacteria that enter through the skin.
The digestive and respiratory systems are lined with lymphatic tissue because the systems are exposed. The most important sites are the tonsils, the intestinal region, and the appendix. Lymph nodes are the filters. Viruses and cancer cells get trapped and destroyed in the lymph nodes. More lymphocytes are produced when an infection is present, which is why the nodes experience swelling. When the lymphatic system does not drain fluids from the tissues properly, the tissues swell and can cause symptoms of discomfort. If the swelling is only for a short period, it is called edema. If it lasts more than three months, it is called lymphoedema.
Symptoms of Unhealthy Circulation
Unhealthy circulation can include the following symptoms:
Fatigue
Concentration problems
Cold hands or feet
Swelling
Muscle cramps
Numbness
Tingling
Stinging
Throbbing
Development of ulcers on the feet, ankles, and legs.
Chiropractic Care
A chiropractic spinal lymphatic detoxtreatment releases stagnant fluid collected in the joints, muscles, and tissues. A personalized treatment plan will consist of massage therapy to increase circulation, release and relax the muscles and nerves, chiropractic to realign the body, decompression to open the spine, stretching techniques to improve flexibility, and nutritional guidance to support optimal circulation. The benefits include:
Discomfort and pain relief.
Stress and anxiety relief.
Balanced and realigned body.
Relaxed muscles.
Helps with allergy symptoms.
Detoxes bacteria along the spine.
Lymphatic Anatomy
References
Dmochowski, Jacek P et al. “Computational Modeling of Deep Tissue Heating by an Automatic Thermal Massage Bed: Predicting the Effects on Circulation.” Frontiers in medical technology vol. 4 925554. 14 Jun. 2022, doi:10.3389/fmedt.2022.925554
Majewski-Schrage, Tricia, and Kelli Snyder. “The Effectiveness of Manual Lymphatic Drainage in Patients With Orthopedic Injuries.” Journal of sport rehabilitation vol. 25,1 (2016): 91-7. doi:10.1123/jsr.2014-0222
Mihara, Makoto et al. “Combined conservative treatment and lymphatic venous anastomosis for severe lower limb lymphedema with recurrent cellulitis.” Annals of vascular surgery vol. 29,6 (2015): 1318.e11-5. doi:10.1016/j.avsg.2015.01.037
Mortimer, Peter S, and Stanley G Rockson. “New developments in clinical aspects of lymphatic disease.” The Journal of clinical investigation vol. 124,3 (2014): 915-21. doi:10.1172/JCI71608
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
Dr. Alex Jimenez, D.C., presents how anti-inflammatory botanicals and phytochemicals can reduce inflammatory cytokines that can cause pain-like issues in the body. We dive into how different pharmaceuticals could influence NF-kappaB and how chronic conditions can affect inflammation. We refer our patients to certified providers that incorporate techniques and multiple therapies for many individuals suffering from inflammation, and its correlating symptoms can affect the musculoskeletal system. We encourage and appreciate each patient by referring them to associated medical providers based on their diagnosis when it is appropriate. We understand that education is a fantastic way when asking our providers intricated questions at the patient’s request and understanding. Dr. Jimenez, D.C., only utilizes this information as an educational service. Disclaimer
How Does The Body Deal With Inflammation
Dr. Alex Jimenez, D.C., presents: Our objectives are to look at the evidence for using selective phytochemicals and botanicals as anti-inflammatory and analgesic agents. Controlled studies have grown into mass numbers over the years, and we can feel more confident in some of their findings because a lot of these studies have been done with good-quality investigators and well-designed studies. And even though we get those studies published, the problem is that we rarely hear about them. The media needs to pick them up, and they usually don’t make it into the medical community despite their studies. If you compare that to when pharmaceutical research is done, you know it often makes the headlines and news. Let’s look at some of these botanicals and phytochemicals today.
In autoimmune conditions, pain is a huge issue in the body, and we also want to use its analgesic properties. And then, we have to identify the most appropriate phytochemicals and botanicals for specific inflammatory and pain conditions. So, before we jump into that, we want to review some of the mechanisms of the pharmaceuticals that are very commonly prescribed for inflammatory and autoimmune conditions. Even some of the newer biologics we’ve referred to a little bit, we want to look into them and, and look at how they work and some of their drawbacks, and then we’ll delve into these botanicals that are at our disposal. So it is important to remind anyone that all degenerative diseases have this pro-inflammatory state or inflammation as part of their underlying biochemical ideology. And that inflammation is a final common pathway for all these different dysfunctions. Diabetes, Alzheimer’s, atherosclerosis, cancer, and even some psychiatric disorders like schizophrenia and depression all have inflammation as one of their root causes. Now in this module, we’re focusing on the ones that are in the circles and these.
As you know, most chronic diseases are linked to excessive, persistent inflammation. We’ve pounded that point home well enough, as chronic inflammation occurs when the injury is ongoing or when a predisposed immune system just doesn’t shut off. It fails at counter-regulation and acute inflammation, which is beneficial; however, it can turn into a chronic inflammation if left untreated. Many chronic diseases have been associated with excessive or persistent inflammation. When it comes to chronic inflammation develops when an injury or traumatic event is ongoing, causing the muscles to tense up or when the immune system begins to attack the body when there are no pathogens that are affecting the body. And that the conventional pharmacological treatment focuses on specific pathways that are often really downstream in that inflammatory process, and from a functional medicine perspective, we want to look a bit more upstream to figure out what is the cause of chronic inflammation that is causing this many issues to this person and how anti-inflammatory botanicals and phytochemicals can dampen these inflammatory effects in the body.
How Do Pharmaceuticals Affect The Body?
Dr. Alex Jimenez, D.C., presents: One of the factors that can enhance inflammatory markers is pharmaceutical drugs. So, for example, pharmacologic controls like NSAIDs can inhibit the COX enzyme, while leukotriene inhibitors inhibit the LOX enzyme. DMARDs can affect various immune mechanisms that can influence the development of chronic inflammation. Biologics can inhibit multiple cytokines in the body, including the TNF-alpha and steroids, which can affect NF-kappaB and phospholipase-A2. So there are numerous ways to influence the inflammatory pathway and cause muscle and joint pain issues.
Pharmaceuticals are not the only factors that can cause inflammatory triggers to affect the body; it can be the food we eat or the environment that we live in that can trigger NF-kappaB, which disassociates from I-kappaB while going into the nucleus and binding to the DNA. That point leads to the transcription of many different genes. The body’s genes not only make DNA but can make RNA. When the body makes RNA, it is then biotransformed into DNA, leading to the turning of different inflammatory pathways. So when the pharmaceutical starts entering the body, it can inhibit the other cytokines and enzymes from turning on and cause chronic inflammation, thus causing the anti-inflammatory markers to dampen and causing the immune system to focus on the NF-kappaB.
NSAIDs
Dr. Alex Jimenez, D.C., presents: So let’s start looking at the non-steroidal anti-inflammatories or NSAIDs, which are ubiquitous as they are very common for many people to reach for when they are in pain. And the reason they use them is that they do work. NSAIDs inhibit cyclooxygenase enzymes and prevent those inflammatory prostaglandins, which cause inflammation and pain in the muscles or joints. Now paracetamol is on here, or acetaminophen is not technically an NSAID, but we will look at that separately.
But these NSAIDs, you know, aren’t without issues, as 70 million prescriptions for NSAIDs are written in the U.S. annually. And that over-the-counter uses included 30 billion doses of NSAIDs. That’s an enormous amount, and it’s no wonder most of us have taken them; we’re part of that 30 billion. However, that amount can lead to a leaky gut in our body system. We know their association with peptic ulcers and G.I. bleeding while inhibiting that resolving pathway, which is important to shut off the inflammatory response. So let’s look at DMARDs or disease-modifying anti-rheumatic agents. They’re the first-line therapy for rheumatoid arthritis. And one of the reasons they’re the first line of treatment is that they’re inexpensive but are slow acting and do decrease inflammation, but they don’t work very well to relieve pain directly.
So methotrexate is hydroxychloroquine, or Plaquenil is a very well-known one right now, especially with its use today. Still, methotrexate inhibits RNA and DNA synthesis, which has been used as a chemotherapy agent in cancer. And when it inhibits, it affects the dihydrofolate reductase, which is needed to make DNA and RNA; however, it also suppresses T and B-cell activation while inhibiting IL1 beta from binding to its receptors. So, unfortunately, even though they’re the first-line therapy, they come with several fairly severe side effects. But we keep talking about this idea of side effects; it’s no side effects. They’re the direct effects of the medication.
The Effects Of Pharmaceuticals
Dr. Alex Jimenez, D.C., presents: You know, they may be unwanted effects like rashes, stomach upset, liver, bone marrow, toxicity, congenital disabilities, and, of course, which we’ll see repeatedly. Any time that you shut down your immune system, you open yourself up for infections. So you become much more susceptible to infections. So, look at these biological DMARDs, which work as TNF-alpha blockers. These biological DMARDs work by curbing either T-cell activation or blocking TNF, which is the most common one, but they also can stop things like IL-six, deplete T-cells, and work in other ways. These biologics are called biologics because they’re actually monoclonal antibodies. And so these monoclonal antibodies, as antibodies do, they have very strong specific binding affinities.
And so, using antibodies as medications has been a great advance. Now, as we’re going to see, they may not be the ultimate solution for treating autoimmune disease, but they hold a lot of promise, especially when we need their specificity. So there are many chronic conditions that NSAIDs DMARDs or Biologic DMARDs that can mask inflammation and cause pain to the muscles and joints. Some of the chronic conditions include:
Ankylosing-spondylitis
Arthritis
Crohn’s disease
Endometriosis
Psoriasis
Rheumatoid Arthritis
Osteoarthritis
Fibromyalgia
Lupus
Conclusion
Dr. Alex Jimenez, D.C., presents: These pharmaceuticals can reduce the pain that the person is experiencing with these conditions, but they are short-termed and only mask the issue until a person goes into treatment. When a person has an autoimmune or chronic disorder associated with inflammation, the cost of any medication is high. Even though good pharmaceuticals are important, we need to look at treatments that can examine the lesser-known or rarer conditions that can reduce the inflammatory effects that cause joint and muscle pain. Incorporating anti-inflammatory botanicals and supplements like:
Fish oil
Curcumin
Ginger extract
Green Tea Extract
Resveratrol
All have anti-inflammatory properties that can reduce inflammatory cytokines from the muscle and joints and combine with physical therapy. Physical therapy can allow the body to heal itself and will enable the individual to be pain-free naturally.
Table tennis is a sport that individuals of all ages and abilities can play. The small scale and reduced movement make it more accessible. It has become more physical, with professional players making fitness an important part of their training. However, at all levels, it offers moderate-intensity activity, which is good for the heart, mind, and body. Recreational table tennis has been found to increase concentration, stimulate brain function, help develop tactical thinking skills and hand-eye coordination, and provide aerobic exercise and social interaction.
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Table Tennis
The setup and rules are similar to tennis and can be played solo or in doubles. The skills needed to develop are learning to hit and control the ball consistently. Table tennis can be complex, with various shots, spins, and styles, but the foundational skills required include:
Proper Footwork
Although the body does not move that far, footwork is essential with the quick movements that are made in a short period.
Basic footwork techniques include fast dynamic movement, balance, and weight distribution.
Serving
Basic serving is necessary to get the point going.
Different stroke styles can be used, but forehand and backhand strokes are the most common.
Learning how the body activates and responds to the swing, the point of contact and the follow-through of each stroke is essential to get the most out of each stroke.
Speed and Agility
Table tennis is a fast-twitch muscle sport that utilizes quick bursts of energy and explosive strength.
Coaches and players use a combination of hybrid, high-intensity, and functional training to condition the body.
High-intensity interval training incorporates explosive movements, like squat jumps, to activate the muscles and the anaerobic threshold.
Hand-eye coordination
Playing improves hand-eye coordination skills and stimulates mental alertness and concentration.
This is great for sharpening overall reflexes.
Health Benefits
Table tennis offers several health benefits that include:
It is a social sport that provides a fun way to spend time with family and friends.
The overall risk for injury is low.
Easy on the muscles and joints.
Increases energy.
Improves balance.
Improves reflexes.
Burns calories.
Keeps the brain sharp.
Relieves stress.
Table Tennis
References
Biernat, Elżbieta, et al. “Eye on the Ball: Table Tennis as a Pro-Health Form of Leisure-Time Physical Activity.” International journal of environmental research and public health vol. 15,4 738. 12 Apr. 2018, doi:10.3390/ijerph15040738
Picabea, Jon Mikel, et al. “Physical Fitness Profiling of National Category Table Tennis Players: Implication for Health and Performance.” International journal of environmental research and public health vol. 18,17 9362. 4 Sep. 2021, doi:10.3390/ijerph18179362
Pilis, Karol, et al. “Body composition and nutrition of female athletes.” Roczniki Panstwowego Zakladu Higieny vol. 70,3 (2019): 243-251. doi:10.32394/rpzh.2019.0074
Zagatto, Alessandro Moura, et al. “Energetic demand and physical conditioning of table tennis players. A study review.” Journal of sports sciences vol. 36,7 (2018): 724-731. doi:10.1080/02640414.2017.1335957
Zhu, Ke, and Lina Xu. “Analysis on the Influence of Table Tennis Elective Course on College Students’ Health.” Journal of healthcare engineering vol. 2022 8392683. 17 Jan. 2022, doi:10.1155/2022/8392683
The hips in the lower portions of the body allow the legs to move the host from one location to another and provide stability to support the upper body’s weight. The hips will enable the torso to twist and turn without feeling pain. This is due to the various muscles and ligaments surrounding the pelvic bone and hip joint socket that allow the motion to be possible. However, when various injuries or factors start to affect the multiple muscles surrounding the pelvis or there is a chronic condition like osteoarthritis that causes wear and tear on the hip joints can cause underlying symptoms associated with the hips and cause many individuals to have difficulty when moving around. Luckily there are ways to improve hip mobility and the surrounding muscles in the hip and pelvic region of the body. Today’s article looks at the causes of the development of tight hips in the body and how different stretches can release tight hip flexor muscles. We refer our patients to certified providers that incorporate techniques and multiple therapies for many individuals suffering from hip pain and its correlating symptoms that can affect the musculoskeletal system in the hips, legs, and lumbar region of the spine. We encourage and appreciate each patient by referring them to associated medical providers based on their diagnosis when it is appropriate. We understand that education is a fantastic way when asking our providers intricated questions at the patient’s request and understanding. Dr. Jimenez, D.C., only utilizes this information as an educational service. Disclaimer
What Causes The Body To Develop Tight Hips?
Have you been dealing with hip mobility issues? When you sit, do you feel uncomfortable, and your hip muscles become tight? Or do you have a decreased range of motion when moving your hips? It could correlate with your hips if you have been experiencing muscle pain issues in the lower extremities. The hips help stabilize the upper and lower portions of the body while providing the full leg’s range of motion. When a person begins to sit for long periods or twist their body in a weird position, it can cause the muscles that surround the hips to become shortened. Other issues, like chronic conditions, can play a role in developing tight hip flexors. Studies reveal that various pathologies affecting the hips, lumbar spine, and lower extremities could strongly correlate with restricted hip mobility that can cause harmful effects that can affect the hips. To that point, some of the symptoms associated with tight hip flexors include:
Instability
Hypermobility
Limited range of motion
Reduce muscle strength in the groin
Muscle cramps
Sharp, sudden pain in the hips, pelvis, or groin
Low back pain
Piriformis syndrome
Other research studies mentioned that hypermobility disorders could affect the hip joints. Hypermobility disorders like EDS (Ehlers-Danlos syndrome) could cause micro or macro-trauma on the hip joint and affect the ligaments surrounding the hip joint. To that point, it can cause the hip flexor muscles to become tense and potentially affect how a person moves, which then causes soft tissue injuries and chronic pain.
Hip Flexor Stretches-Video
Do you feel tight along your hips? Do you see yourself hobbling around when walking? Or do you feel aches or strains when stretching? Many of these issues correlate with tight hip flexors that could result from hip pain in the lower extremities. When a person has tight hip flexors, it could be due to them constantly sitting down, causing the hip muscles to be shortened, or chronic conditions that can affect the hip joint and muscles. However, there are various ways to prevent tight hip flexors and regain mobility back to the hips. Studies reveal that stretching combined with core stabilization can help improve the hip’s range of motion while ensuring core endurance exercises can help strengthen the surrounding muscles in the hip area. The video above shows stretches targeting the hip flexor muscles and helps improve hip mobility.
Different Stretches To Release Tight Hip Flexors
Studies have shown that the hip flexor muscles are the main contributors to lumbar spine stability when releasing tight hip flexor muscles. So when there are tight hip flexors, it can cause overlapping risk profiles to the lumbar spine, which leads to pain and impairment in performance. The best way to reduce the pain-like symptoms associated with tight hip flexors is by stretching the lower half of the body to reduce muscle strain and tightness in the hip flexors. Additional studies have found that stretching combined with exercises targeting the low back can reduce the pain caused in the low back and help improve stability and strengthen the surrounding muscles located in the hips. Now it is important to remember that stretching for at least 5-10 minutes before and after working out allows the muscles to warm up and improve flexibility. Below are some different stretches that can release tight hip flexors.
High Crescent Lunge
While standing on the mat, take a step forward to allow your right foot to be in a staggard stance *Think in a lunge position.
Bend the front knee gently while keeping the back leg straight, as this allows the heel in the back leg to be lifted off the mat; the bent front knee enables the thigh to be parallel to the floor, and the right foot is pressed flat on the mat.
Square up the hips, so they face toward the mat’s front.
Extend the arm up towards the ceiling to stretch upwards while pressing into the mat to feel the hips stretch
Hold for five breaths before slowly rising out of the lunge position and repeating on the other side.
This stretch helps release tension in the hip flexors and quads while warming up the muscles and increasing blood flow to the legs.
Knee-To Chest Stretch
Lie on the mat with both legs extended out and feet flexed.
Pull on the left knee to the chest while keeping the right leg straight, and the lumbar portion of the back is pressed into the mat.
Hold the position while taking deep breaths for 30 seconds to 2 minutes.
Release slowly and repeat on the right leg *You can lift both knees to your chest and rock slowly from side to side to relieve low back tension as an alternative.
This stretch is extremely helpful for tight hamstrings and allows the tense muscles on the hips and lower back to relax while increasing blood flow back to the muscles.
Piriformis Stretch
On the mat, sit with both legs extended out.
Cross the right leg over the left and place the other flat on the floor while the left foot is flexed
Place the right hand behind the body while the left elbow is on the right knee.
On inhale, press the right leg to the left while allowing the torso to twist on the right.
Take five breaths for a deeper stretch and switch sides to repeat the action with the left hand *If you have low back pain issues, the modified version allows you to use your left hand to pull the right quad in and out to the left and vice versa.
This stretch helps loosen tight muscles in the lower back, hips, and glutes. If you have sciatic nerve pain associated with piriformis syndrome, this stretch helps release muscle tension from the piriformis muscle aggravating the sciatic nerve.
Happy Baby Pose
Lie on the mat with both knees bent and feet on the ground.
On inhale, lift the feet off the ground and grab the outer sections of the feet with your hands.
Then gently pull the feet towards the chest and allow the knees to lower to the ground, on either side of the body, while keeping the back flat on exhale.
Hold the position for at least five breaths.
This stretch helps with the inner thigh muscles or hip adductors and helps them become loose and mobile without feeling any strain or tension.
Bridge Pose
On the mat, lie on your back and sides, and extend your arms while your feet are flat on the floor with your knees bent.
Press with your heels to lift the hips and allow the feet to walk a few steps toward the body. *Keep the feet and knees hip-width apart.
Clasp hands together underneath the body and press them into the mat
Hold the position for five breaths.
This stretch helps take the pressure off the hip muscles while strengthening the glutes and abdominal muscles.
Conclusion
When it comes to releasing tight hip flexors after sitting for a long time or having hip issues affecting your low back or pelvis, Doing different stretches that target the hips can reduce the pain and release tight muscles associated with other conditions that can affect the body. The hips are important to take care of since they provide mobility and stability to the upper and lower portions of the body. They support the upper body’s weight while providing a huge range of motion to the legs. Incorporating these different stretches can reduce the pain that they have been under and help warm up the other muscles that surround the lower extremities.
References
Lee, Sang Wk, and Suhn Yeop Kim. “Effects of Hip Exercises for Chronic Low-Back Pain Patients with Lumbar Instability.” Journal of Physical Therapy Science, U.S. National Library of Medicine, Feb. 2015, www.ncbi.nlm.nih.gov/pmc/articles/PMC4339134/.
Moreside, Janice M, and Stuart M McGill. “Hip Joint Range of Motion Improvements Using Three Different Interventions.” Journal of Strength and Conditioning Research, U.S. National Library of Medicine, May 2012, pubmed.ncbi.nlm.nih.gov/22344062/.
Reiman, Michael P, and J W Matheson. “Restricted Hip Mobility: Clinical Suggestions for Self-Mobilization and Muscle Re-Education.” International Journal of Sports Physical Therapy, U.S. National Library of Medicine, Oct. 2013, www.ncbi.nlm.nih.gov/pmc/articles/PMC3811738/.
Neck injuries and whiplash symptoms can be minor and go away within a few days. However, whiplash symptoms can manifest days later and become varied and chronic, ranging from severe pain to cognitive problems. These are collectively called whiplash-associated disorders because of the varied complexity of the symptoms. A common condition is a whiplash nerve injury. These injuries can be severe and require chiropractic treatment.
Contents
Whiplash Nerve Injury
Surrounding muscles, tissues, bones, or tendons can cause a whiplash nerve injury. The neck’s spinal nerve roots become compressed or inflamed, leading to cervical radiculopathy symptoms of tingling, weakness, and numbness that can radiate down the shoulder, arm, hand, and fingers. Typically, cervical radiculopathy is only felt on one side of the body, but in rare cases, it can be felt on both sides if more than one nerve root is affected.
Neurological Cervical Radiculopathy
Neurological problems can become severe and can reduce the ability to perform many routine tasks, such as gripping or lifting objects, writing, typing, or getting dressed.
Cervical radiculopathy involves one or more of the following neurological deficiencies.
Sensory – Feelings of numbness or reduced sensation. There can also be tingling and electrical sensations.
Motor – Weakness or reduced coordination in one or more muscles.
Reflex – Changes in the body’s automatic reflex responses. An example is a diminished ability or reduced hammer reflex exam.
Symptoms
Because every case is different, symptoms vary depending on the location and severity. Symptoms can flare up with certain activities, like looking down at a phone. The symptoms then go away when the neck is upright. For others, symptoms can become chronic and do not resolve when the neck is resting and supported. Common symptoms include:
Fatigue
Decreased energy levels could be related to sleep problems, depression, stress, pain, concussion, or nerve damage.
Memory and/or concentration problems
Cognitive symptoms could involve difficulty with memory or thinking.
Symptoms can start shortly after the injury or not appear until hours or days later.
Cognitive problems could be from a brain injury or related to various types of stress.
Headaches
This could be neck muscles tightening or a nerve or joint becoming compressed or irritated.
Dizziness
Dizziness could be from neck instability, a concussion/mild traumatic brain injury, and nerve damage.
Vision problems
Blurry vision or other visual deficits could result from any number of causes, including concussion or nerve damage.
Vision problems could also contribute to dizziness.
Ringing in the ears
Also called tinnitus, this can be ringing or buzzing in one or both ears and can range from intermittent and minor to constant and severe.
Whiplash complications such as injury to the brain region that controls hearing, nerve or vascular damage, jaw injury, or stress can lead to tinnitus.
Chiropractic Care
The appropriate chiropractic treatment is unique to each whiplash nerve injury and is directed at the primary dysfunctions detected during the initial examination. A personalized treatment plan addresses factors in an individual’s work, home, and recreational activities. Treatment includes:
Massage manual and percussive for nerve and muscle relaxation
Goldsmith R, Wright C, Bell S, Rushton A. Cold hyperalgesia as a prognostic factor in whiplash-associated disorders: A systematic review. Man Ther. 2012; 17: 402-10.
McAnany SJ, Rhee JM, Baird EO, et al. Observed patterns of cervical radiculopathy: how often do they differ from a standard “Netter diagram” distribution? Spine J. 2018. pii: S1529-9430(18)31090-8.
Murphy DR. History and physical examination. In: Murphy DR, ed. Conservative Management of Cervical Spine Syndromes. New York: McGraw-Hill, 2000:387-419.
Shaw, Lynn, et al. “A systematic review of chiropractic management of adults with Whiplash-Associated Disorders: recommendations for advancing evidence-based practice and research.” Work (Reading, Mass.) vol. 35,3 (2010): 369-94. doi:10.3233/WOR-2010-0996
Travell JG, Simons DG. Myofascial Pain and Dysfunction: The Trigger Point Manual. Vol. 1, 2nd ed. Baltimore, MD: Williams and Wilkens, 1999.
The various muscles and ligaments that encompass the back help protect the spine’s thoracic region. The spine has three sections: cervical, thoracic, and lumbar, which assist the body with bending, turning, and twisting. For the thoracic spine, various muscles like the rhomboid, trapezoid, and other superficial muscles provide functionality to the scapula or shoulder blades to stabilize the ribcage. When the body succumbs to injuries or traumatic forces, it can develop myofascial pain syndrome associated with upper back pain. Upper back pain can lead to unwanted symptoms affecting their quality of life. Fortunately, various exercises target the upper portion of the back and can strengthen multiple muscles from injuries. Today’s article looks at the effects of upper back pain in the body and shows a few stretches and exercises that can support the various muscle groups in the upper back region. We refer our patients to certified providers that incorporate techniques and multiple therapies for many individuals suffering from upper back pain and its correlating symptoms that can affect the musculoskeletal system in the neck, shoulders, and thoracic region of the spine. We encourage and appreciate each patient by referring them to associated medical providers based on their diagnosis when it is appropriate. We understand that education is a fantastic way when asking our providers intricated questions at the patient’s request and understanding. Dr. Jimenez, D.C., only utilizes this information as an educational service. Disclaimer
The Effects Of Upper Back Pain In The Body
Have you been experiencing stiffness around or near your shoulder blades? Do you feel muscle strain when you are rotating your shoulders? Or does it hurt when you stretch your upper back in the morning? Many of these issues are signs and symptoms of upper back pain. Studies reveal that back pain is one of the most common complaints many individuals would go for emergency care. Back pain can affect the different regions in the back and cause unwanted symptoms in various areas in the upper back. Additional studies mentioned that persistent pain in the thoracic region could cause hyper-sensitization of the intercoastal nerves that mimic other conditions affecting the back. Some of the causes and effects that can lead to the development of upper back pain include:
When this happens, it can lead to overlapping conditions that mimic other issues and, if not treated right away, leave individuals with chronic disabling symptoms that correlate with upper back pain.
Upper Back Pain Relief-Video
Have you been experiencing stiffness in your shoulders or neck? Do you feel aches and pains when stretching your arms? Or what about feeling muscle strain when lifting a heavy object? Many of these factors correlate with upper back pain affecting the thoracic spine region. When this happens, it can lead to overlapping risk profiles that can develop into different issues that can cause even more pain to the body. There are various ways to prevent upper back pain from causing further issues to the individual and can relieve the pain associated with it. Many people would go to chiropractic therapy to have their spine re-aligned to bring adequate relief or incorporate upper back exercises and stretches to relieve tension accumulated in the neck and shoulder regions. The video above explains how stretches work for different muscle regions in the upper back and provide relief to the thoracic spine.
Exercises For Upper Back Pain
Regarding the upper back, it is important to understand that incorporating various exercises that target the thoracic region can cause prolonged injuries. Studies reveal that different back exercises focus not only on the back but the shoulders, arms, chest, core, and hips providing stability, balance, and coordination to the individual. This allows the muscles in the back region to improve strength and endurance over time when a person continues to work out. More studies reveal that protocols like the McKenzie back exercise are effective programs to treat various musculoskeletal conditions that can cause pain in the back. Many physical therapists use this protocol on their patients to relieve back pain and help improve their muscular structure to have better posture.
Warm Up
Just like any individual that is starting to get back to their health and wellness through exercise, the most important step that anyone has to do is warming up their muscles before getting into a workout. Warming up each muscle group can prevent future injuries and increase blood flow before starting the exercise. Many individuals would incorporate stretches and foam rolling for 5-10 minutes to ensure that each muscle is ready to perform with maximum effort.
Exercises
After the body is warmed up, it is time to begin the exercise regime. Many different exercise movements target each muscle group and help build muscle mass and improve functionality. It is important to build up momentum when it comes to working out. Starting slowly with minimum reps and sets is important to ensure the exercise is done correctly. Afterward, the individual can increase the workout reps and go with a heavier weight. Below are some of the exercise routines that are suited for the upper back.
Superman
Lie on your stomach and extend your arms above the head
Keep neck in a neutral position and lift legs and arms off the floor at the same time
Make sure to use the back and glutes to lift
Briefly pause at the top, then return to starting position
Complete three sets of 10 reps
This exercise helps strengthen the spine and surrounding muscles to support the spine and reduce any future injuries from upper back pain.
Reverse Dumbbell Flies
Grab light weighted dumbbells
Hinge at the waist at 45 degrees while standing
Make sure the arms are hanging down with the weights
Keep the neck in a neutral position while gazing down
Lift the arms (with the dumbbells) out to the side and upwards
Squeeze the shoulders together at the top during this movement
Complete three sets of 8-12 reps
This exercise is excellent for strengthening the muscles that surround the shoulder and upper back.
Rows
Use a resistance band or a light weighted dumbbell.
For the resistance band, affix the band to a stable surface above eye level. For the light weighted dumbbells, extend the arms in front of the body above eye level.
Use an overhead grip when holding the resistance band handles and the light weighted dumbbells.
Pull resistance bands or dumbbells toward the face.
Flare out the upper arms to the sides
Squeeze the shoulders together
Pause for a bit and then return to starting position
Complete three sets of 12 reps
This exercise helps strengthen the shoulder muscles and prevent future injuries from occurring in the upper back.
Conclusion
Some various muscles and ligaments encompass the back and help protect the spine’s thoracic region. These muscles help with the stabilization of the ribcage and help provide the functionality to the upper back. When multiple factors cause traumatic injuries to the upper back, it can lead to pain-like symptoms that can cause overlapping features and affect a person’s quality of life. Luckily, various exercises target the upper back and surrounding muscle groups. Each activity targets all the muscles in the upper back and allows a person to regain health and wellness without constant pain.
References
Atalay, Erdem, et al. “Effect of Upper-Extremity Strengthening Exercises on the Lumbar Strength, Disability and Pain of Patients with Chronic Low Back Pain: A Randomized Controlled Study.” Journal of Sports Science & Medicine, U.S. National Library of Medicine, 1 Dec. 2017, www.ncbi.nlm.nih.gov/pmc/articles/PMC5721192/.
Casiano, Vincent E, et al. “Back Pain – Statpearls – NCBI Bookshelf.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 4 Sept. 2022, www.ncbi.nlm.nih.gov/books/NBK538173/.
Louw, Adriaan, and Stephen G Schmidt. “Chronic Pain and the Thoracic Spine.” The Journal of Manual & Manipulative Therapy, U.S. National Library of Medicine, July 2015, www.ncbi.nlm.nih.gov/pmc/articles/PMC4534852/.
Mann, Steven J, et al. “McKenzie Back Exercises – Statpearls – NCBI Bookshelf.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 4 July 2022, www.ncbi.nlm.nih.gov/books/NBK539720/.
Neck aches, soreness, and pain symptoms are not always neck-related. Tight thoracic or mid-back muscles can pull on the neck muscles causing various symptoms. Upper back tightness occurs anywhere from the neck’s base to the bottom of the rib cage. The bones in the upper area don’t move or flex as much as the neck and low back. This can lead individuals to believe there is nothing wrong with the mid-back, as there are no pain symptoms or signs of discomfort. However, individuals don’t realize how tight the muscles are, which can go on for years, causing neck issues. Injury Medical Chiropractic and Functional Medicine Clinic can relieve symptoms, release, and relax tight muscles, increase circulation, and restore optimal function.
Contents
Mid-Back Muscle Tightness
The upper and middle back is the thoracic spine. The thoracic spine has twelve small bones called vertebrae. Each vertebra on the thoracic spine is connected to a pair of ribs. The ribs wrap around the body and attach to a long, flat sternum bone. This forms the rib cage. The bones in the upper back work with the ribs to stabilize the back and protect vital organs, including the heart and lungs. The tightening and pulling eventually cause neck aches that can come out of nowhere; even when not moving and looking straight ahead, there can be persistent dull achiness or stinging sensations.
Causes
Unhealthy posture, disc problems, injuries, fractures, or other issues or conditions can cause mid-back muscle tightness.
Posture
Constant sitting or standing combined with unhealthy posture and being hunched over can cause the muscles to tighten, limiting mobility.
Holding Onto Stress
Chronic stress can cause muscle tightening, whether it is in the low back, mid-back, neck, or elsewhere.
Hereditary
Individual genetic makeup may make the body more susceptible to muscle tightness.
For example, individuals with a lot of muscle tone vs. individuals with less muscle tone may experience muscle tightness more often.
Adequate Hydration
Being properly hydrated is important for muscle and joint lubrication.
Water provides nutrients to contracting muscles.
This keeps the body loose and ready for movement.
Muscle Imbalance and Underlying Weakness
Individuals that tend to work one side of the body more than the other or have repeatedly been moving in a certain way for years can cause muscle imbalances and trigger points to develop.
If muscle tightness continues, even after stretching, it could be an underlying weakness.
The muscles can sometimes seize up and guard, so they feel tight when they have become chronically weak and not strong enough to meet the physical demands.
Chiropractic Care
Chiropractic care involves various therapies to address the root cause fully and relieve neck aches. These include:
Massage therapies to break up compacted muscle tissue.
Remove trigger points.
Relax the muscles to a pliable state.
Perform chiropractic adjustments to realign the spine.
Stretching and strengthening.
Posture training that includes stretches/exercises.
Nutritional plans to help strengthen muscles.
Thoracic Tension Release
References
Gatt, Adrianna, et al. “Anatomy, Fascia Layers.” StatPearls, StatPearls Publishing, Jul 25, 2022.
Liebsch, Christian, and Hans-Joachim Wilke. “How Does the Rib Cage Affect the Biomechanical Properties of the Thoracic Spine? A Systematic Literature Review.” Frontiers in bioengineering and biotechnology vol. 10 904539. Jun 15, 2022, doi:10.3389/fbioe.2022.904539
Maciejewska-Skrendo, Agnieszka et al. “Genetics of Muscle Stiffness, Muscle Elasticity and Explosive Strength.” Journal of human kinetics vol. 74 143-159. 31 Aug. 2020, doi:10.2478/hukin-2020-0027
Modes RJ, Lafci Fahrioglu S. Anatomy, Back. [Updated 2022 Feb 5]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK539746/
Page, Phil. “Current concepts in muscle stretching for exercise and rehabilitation.” International journal of sports physical therapy vol. 7,1 (2012): 109-19.
Petrofsky, Jerrold et al. “The Efficacy of Sustained Heat Treatment on Delayed-Onset Muscle Soreness.” Clinical journal of sports medicine: official journal of the Canadian Academy of Sports Medicine vol. 27,4 (2017): 329-337. doi:10.1097/JSM.0000000000000375
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Whiplash Nerve Injury
