In many individuals with degenerative disc disease, how does spinal decompression compare to spinal surgery improve spine flexibility?
Contents
Introduction
The spine is essential to the body’s musculoskeletal system, enabling individuals to perform daily movements while maintaining proper posture. The spinal cord is safeguarded by surrounding ligaments, soft tissues, muscles, and nerve roots. The spinal discs between the spinal column act as shock absorbers to reduce stress from axial overload and promote body mobility and flexibility. The spinal discs can naturally degenerate as a person ages, leading to degenerative disc disease. This condition can result in several spinal issues that can impact the spine’s flexibility. This article explores how degenerative disc disease affects the spine and the treatments available to restore its flexibility. We work with certified medical providers who use our patients’ valuable information to treat individuals suffering from degenerative disc disease affecting their spine’s flexibility. We also inform them about non-surgical treatments to regain spinal mobility and reduce pain-like symptoms. We encourage patients to ask essential questions and seek education from our associated medical providers about their condition. Dr. Jimenez, D.C., provides this information as an educational service. Disclaimer
How Does Degenerative Disc Disease Affect The Spine?
Do you experience neck or lower back pain after a long workday? After physical activity, do you find temporary relief by twisting or turning your torso? Are you experiencing radiating pain in your upper or lower extremities that worsens when standing? These symptoms are common as the body ages over time. Muscles, organs, ligaments, and joints can all be affected, including the spine and intervertebral discs. Research studies reveal that disc degeneration frequently occurs in the spine, leading to changes that can cause misalignment and spinal issues. Degenerative disc disease can disrupt the structure of spinal discs, resulting in pain-like symptoms and accelerating degenerative changes to the spine. Regardless of age, various habits and lifestyle choices can contribute to degeneration. As additional research studies have provided, this condition is characterized by a tension-resisting annulus fibrosus and compression-resisting nucleus pulposus, causing pain and discomfort.
The Symptoms Correlating With Degenerative Disc Disease
Degenerative disc disease is when the spinal disc in the spine experiences wear and tear due to natural aging. The initial indication of this disease is disc cracking caused by repetitive motion trauma. The symptoms associated with this disease are similar but may vary based on the affected spine location. Research shows that degenerative disc disease can cause micro tears in the spinal disc, leading to decreased fluids and water intake, disc space loss, disc bulging, and irritation of the adjacent nerves. This can affect surrounding muscle tissues and disc facet joints, narrowing the spinal canal. Additional studies reveal that people with degenerative disc disease may experience various symptoms that can hinder their ability to function properly. Some common symptoms include:
Pain in the arms, legs, and feet
Sensory abnormalities (loss of sensation in the hands, feet, fingers, and back)
Muscle tenderness and weakness
Instability
Inflammation
Visceral-somatic & somatic-visceral condition
If someone experiences pain-like symptoms in conjunction with degenerative disc disease can negatively impact their quality of life and potentially lead to long-term disability. Fortunately, treatments can slow the degenerative process and alleviate the pain-like symptoms.
Secrets Of Optimal Wellness- Video
When individuals experience pain related to degenerative disc disease, they often seek ways to alleviate it. Some may consider spinal surgery to remove the affected disc and ease the pain caused by the irritated nerve. However, this option is typically only pursued if other treatments have failed and can be expensive. Fortunately, non-surgical treatments are cost-effective and safe, gently addressing the affected area for relief. Non-surgical treatments can be customized to the individual’s specific pain and condition, including spinal decompression, MET therapy, traction therapy, and chiropractic care. These methods work to realign the body and promote natural healing by rehydrating the spine, ultimately restoring flexibility.
Treatments To Improve Spinal Flexibility
Individuals with degenerative disc disease can benefit from non-surgical treatments tailored to their needs. These treatments involve an assessment by a pain specialist, such as a physical therapist, massage therapist, or chiropractor, who will identify the source of the pain and use various techniques to reduce pain, improve flexibility in the spine, and loosen stiff muscles that have been affected by the disease. Additionally, non-surgical treatments can help restore sensory and mobility function to the spine and address factors that may exacerbate the degenerative process.
Spinal Decompression Protocol For Degenerative Disc Disease
Research studies suggest that spinal decompression can effectively reduce the degenerative process of spinal discs through gentle traction. During a spinal decompression treatment, the individual is strapped into a traction machine. The machine gradually stretches the spine to create negative pressure on the spinal disc, which helps to rehydrate it and increase nutrient intake, thereby jumpstarting the healing process. According to Dr. Eric Kaplan, D.C., FIAMA, and Dr. Perry Bard, D.C., in their book “The Ultimate Spinal Decompression,” individuals with degenerative disc disease may require higher pressure during spinal decompression treatment due to its symptomatic problems. Spinal decompression can help restore disc height and be a viable solution for those looking to improve their health.
The brain and body need macronutrients that include carbohydrates, fats, and protein in the right amounts to energize the body. About half of the calories should come from carbohydrates, 30% from fat, and 20% from protein. Food energy density is the amount of energy, represented by the number of calories, in a specific weight measurement.
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Food Energy Density
Energy density is determined by the proportion of macronutrients – protein, fat, carbohydrates, fiber, and water.
Energy-dense foods are high in calories per serving.
Foods with large amounts of fiber and water have a lower density.
Foods high in fat have an increased energy density.
An example of a high-energy-density food is a donut because of the high-calorie count from the sugar, fat, and small serving size.
An example of a low-energy-density food is spinach because it only has a few calories in a whole plate of raw spinach leaves.
Energy Dense Foods
Energy-dense foods contain a high number of calories/energy per gram. They are typically higher in fat and lower in water. Examples of energy-dense foods include:
Full-fat dairy
Butter
Cheese
Nut butter
Fatty cuts of meat
Starchy vegetables
Thick sauces
Nuts
Seeds
Less nutrient-dense foods include:
Sweets
Deep-fried foods
French fries
Pasta
Crackers
Chips
Foods like soups and beverages can be either high or low energy density depending on the ingredients. Broth-based soups with vegetables usually have low density while creamed soups are energy-dense. Non-fat milk is less dense than regular milk, and diet soda is less dense than regular soda.
Low Energy Dense Foods
Foods with low energy density include high-fiber green and colorful vegetables.
Foods with low energy density are often nutrient-dense, which means they have plenty of nutrients per serving size.
Many fruits, berries, and vegetables are low in calories, high in fiber, and packed with vitamins and minerals.
Foods high in water content like citrus fruits and melons are usually less energy-dense.
Low-calorie foods often have a low energy density, but not always.
It’s important to read nutrition labels to know how many calories are being provided daily.
Weight Management
Weight management is about watching how many calories are taken in and how many calories are burned.
Filling up on foods with low energy density will cause the body to feel satisfied while eating fewer high-density calories.
Plan all meals so they include foods with a low energy density and high in nutrients.
However, the opposite can happen if individuals eat mostly low-energy-dense foods, will need a larger volume of food to fill up, and as a result, will take in more calories.
This is not ideal for losing weight, but it could be helpful if trying to gain weight.
High-energy-dense foods that are nutritious include avocados, nuts, and seeds.
Adjustment Recommendations
Add More Fruits and Vegetables To The Plate
At least half of a plate should be covered with low-calorie fruits and vegetables.
Berries are sweet and delicious and provide antioxidants
Leave a quarter of the plate for the protein, and the remaining quarter can hold a serving of starchy foods like pasta, potatoes, or rice.
Eating more fruits and vegetables will partially fill the body leading to eating less high-energy-dense foods.
Picky eaters should try various recipes, sooner or later, they will discover something they enjoy.
Start With Salad or a Bowl of Clear Broth Soup
Soups and salads will fill the body before the main energy-dense course like pasta, pizza, or another high-calorie food.
Avoid heavy cream-based salad dressings and creamed soups.
Water has zero calories and drinking a few glasses can help suppress the hunger until the next meal, or a low-density snack.
Fernandez, Melissa Anne, and André Marette. “Potential Health Benefits of Combining Yogurt and Fruits Based on Their Probiotic and Prebiotic Properties.” Advances in nutrition (Bethesda, Md.) vol. 8,1 155S-164S. 17 Jan. 2017, doi:10.3945/an.115.011114
Horgan, Graham W et al. “Effect of different food groups on energy intake within and between individuals.” European Journal of Nutrition vol. 61,7 (2022): 3559-3570. doi:10.1007/s00394-022-02903-1
Hubbard, Gary P et al. “A systematic review of compliance to oral nutritional supplements.” Clinical nutrition (Edinburgh, Scotland) vol. 31,3 (2012): 293-312. doi:10.1016/j.clnu.2011.11.020
Prentice, A M. “Manipulation of dietary fat and energy density and subsequent effects on substrate flux and food intake.” The American Journal of clinical nutrition vol. 67,3 Suppl (1998): 535S-541S. doi:10.1093/ajcn/67.3.535S
Slesser, M. “Energy and food.” Basic life sciences vol. 7 (1976): 171-8. doi:10.1007/978-1-4684-2883-4_15
Specter, S E et al. “Reducing ice cream energy density does not condition decreased acceptance or engender compensation following repeated exposure.” European Journal of clinical nutrition vol. 52,10 (1998): 703-10. doi:10.1038/sj.ejcn.1600627
Westerterp-Plantenga, M S. “Effects of the energy density of daily food intake on long-term energy intake.” Physiology & behavior vol. 81,5 (2004): 765-71. doi:10.1016/j.physbeh.2004.04.030
How does non-surgical spinal decompression compare with traditional surgery to improve sensory abnornalities for individuals with herniated discs?
Contents
Introduction
The spinal column provides flexibility and stability to the body, consisting of vertebrae, spinal cord, nerve roots, and intervertebral discs. These components work with surrounding tissues, ligaments, and muscles, enabling pain-free mobility. However, activities or work that place excessive stress on the spine can cause damage, leading to misaligned discs and nerve root irritation. This can result in radiating pain in the lower extremities, which may be mistaken for other conditions such as low back pain, leg pain, or sciatica. This article will focus on the pain-like symptoms associated with herniated discs and how non-surgical spinal decompression can help people regain sensory function. We work with certified medical providers who use our patients’ valuable information to treat individuals suffering from herniated discs in their lumbar spine and inform them about non-surgical treatments to regain sensory function in their lower extremities. We encourage patients to ask essential questions and seek education from our associated medical providers about their condition. Dr. Jimenez, D.C., provides this information as an educational service. Disclaimer
The Symptoms Associated With Herniated Discs
Are you experiencing numbness or tingling down your leg that affects your walking? Does twisting or turning make your lower back uncomfortable? Or are you suffering from low back pain caused by sciatic nerve pain, making it difficult to work or do activities? Many people don’t realize they have herniated discs until repetitive movements cause wear and tear on the spine or constant compression causes the disc to crack, allowing the inner layer to protrude and press on the spinal nerve roots. Research studies reveal that herniated discs can result from various changes that cause pain-like symptoms, including limited trunk flexion, sensory abnormalities in the lower extremities, low back pain, radicular pain, sciatica, and intense distress when sitting. Herniated discs are common, and the inflammatory response from surrounding nerve roots can cause immense pain. As additional research shows, autoimmune responses released by the nucleus pulposus play a crucial role in the pathophysiology of sciatic pain and lumbar radiculopathy.
The Causes Of Herniated Disc-Video
Herniated discs can cause discomfort and pain depending on their severity and location. Several factors contribute to their development, including improper lifting of heavy objects, age, weight, and physical inactivity. Repetitive motions, constant stress, and autoimmune conditions also play a role. Disc herniation impacts the spinal structure and can cause sensory abnormalities in the lower extremities, muscular pain in the arms, back, foot, or leg, and affect the quality of life. However, non-surgical treatments are available to reduce disc herniation and restore the spine’s mobility, flexibility, and stability.
Treatments To Restore Sensory Function
If home remedies such as rest, hot and cold packs, and over-the-counter medications do not work, non-surgical treatments can effectively reduce the effects of disc herniation. These treatments are also safe, gentle, and cost-effective for many people who want relief without the financial burden. Chiropractic care, muscle energy techniques (MET), and spinal decompression are examples of non-surgical treatments that can help target the source of pain, reactivate the body’s natural healing process, and realign the body from herniated discs and spinal subluxation. These treatments can restore sensory function affected by herniated discs by addressing these issues.
Spinal Decompression
When dealing with herniated discs, many people turn to spinal decompression to alleviate pain and find relief in their spine. Studies have shown that spinal decompression involves using gentle traction to create negative pressure within the affected herniated disc. This can increase hydration and reduce pressure on the nerve root, easing the pain signals that affect the lower extremities. In “The Ultimate Spinal Decompression,” Dr. Eric Kaplan, D.C., FIAMA, and Dr. Perry Bard, D.C., explained that the duration of treatment for spinal decompression for herniated discs can vary depending on the severity. Mild herniation may require longer treatment, while patients with multiple herniations in different spinal locations may need additional sessions. However, the treatment should effectively reduce sensory abnormalities and relieve pain for the individual.
Athletes regularly take an ice-water bath after training or playing. It is known as cold water immersion/cryotherapy. It is used to relieve and reduce muscle soreness and pain after intense training or competition. From runners to professional tennis and football players, taking an ice bath is a common recovery practice. Many athletes utilize ice baths to help with faster recovery, prevent injury, and cool down the body. Here we provide some research on cold-water immersion therapy.
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Ice Water Bath
Cold Immersion After Exercise or Physical Activity
Exercise causes microtrauma/tiny tears in the muscle fibers. The microscopic damage stimulates muscle cell activity to repair the damage and strengthen the muscles/hypertrophy. However, hypertrophy is linked with delayed onset muscle soreness and pain/DOMS, between 24 and 72 hours after physical activity. An ice water bath works by:
Constricting the blood vessels.
Flushes out waste products (lactic acid), out of the muscle tissues.
Reduces inflammation, swelling, and tissue breakdown.
Then, applying heat or warming up the water increases and speeds up blood circulation, improving the healing process.
There is no current ideal time and temperature for cold immersion, but most athletes and trainers who use the therapy recommend a water temperature between 54 to 59 degrees Fahrenheit and immersion of five to 10 minutes, and depending on the soreness, sometimes up to 20 minutes.
Pros and Cons
The effects of ice baths and cold water immersion on exercise recovery and muscle soreness.
Relieves Inflammation but Can Slow Down Muscle Growth
A study determined that cold water immersion can disrupt training adaptations.
Research suggests that icing muscles right after maximum exercise decreases inflammation, but can slow down muscle fiber growth, and delay muscle regeneration.
Athletes trying to increase muscle size and strength may need to adjust the therapy sessions.
Reduce Muscle Soreness
A review concluded there was some evidence that ice water immersion reduced delayed onset muscle soreness when compared to resting and rehabilitation or no medical treatment.
The most effects were seen in running athletes.
There was no substantial evidence to conclude whether it improved fatigue or recovery.
The studies did not have a standard for adverse effects or follow-up with the participants regularly.
There was no difference in muscle soreness between cold water immersion, active recovery, compression, or stretching.
Pain Relief
Cold water immersion after a physical activity offers temporary pain relief but can help with a faster recovery.
A study of jiu-jitsu athletes found that following a workout with cold water immersion could lead to decreased muscle aches and help reduce lactate levels.
Alternating cold water and warm water baths (contrast water therapy), may help athletes feel better and offer temporary pain relief.
Active Recovery Alternative
More research is needed before a firm conclusion can be reached on ice-water bath therapy. However, active recovery is a recommended alternative for athletes looking to recover faster.
A study suggested that ice baths were equally effective, but not more effective, as active recovery for reducing inflammation.
Cold water immersion is no greater than active recovery upon local and systemic inflammatory cellular stress.
Research determined that active recovery is still the most widely used, and currently the best way to recover after intense exercise or physical activity.
Low-impact workouts and stretches are still considered the most beneficial cool-down methods.
Cold Water Therapy
Ice Bath
Individuals can use their tub at home to perform cold water therapy.
Individuals may want to purchase a large bag of ice, but the cold water from the faucet will work.
Fill the tub with cold water, and if desired, pour in some ice.
Let the water and ice sit to get the cold temperature.
Measure the temperature if necessary before getting in.
Submerge the lower half of the body and adjust the temperature based on feel by adding more water, ice, or warm water if freezing.
It’s like icing with an ice pack, but the whole body swelling reduces and relaxes the muscles.
Don’t overdo it – one review found the best routine was 11 to 15 minutes of immersion at a temperature between 52 and 60 degrees Fahrenheit.
Cold Shower
A few minutes in a cold shower is another way to perform the therapy.
Individuals can get in a cold shower or start with warm water and slowly transition to cold.
This is the easiest and most time-efficient method of cold water therapy.
Safety
Consult with your doctor or a health care practitioner before practicing cold water therapy.
Exposure to cold water can affect blood pressure, circulation, and heart rate.
Cold water immersion can cause cardiac stress and can result in a heart attack.
Be mindful that exposure to cold temperatures can result in hypothermia.
Get out of the cold water if you experience numbness, tingling, discomfort, and/or pain.
Optimizing Wellness
References
Allan, R, and C Mawhinney. “Is the ice bath finally melting? Cold water immersion is no greater than active recovery upon local and systemic inflammatory cellular stress in humans.” The Journal of Physiology vol. 595,6 (2017): 1857-1858. doi:10.1113/JP273796
Altarriba-Bartes, Albert, et al. “The use of recovery strategies by Spanish first division soccer teams: a cross-sectional survey.” The Physician and sports medicine vol. 49,3 (2021): 297-307. doi:10.1080/00913847.2020.1819150
Bieuzen, François, et al. “Contrast water therapy and exercise-induced muscle damage: a systematic review and meta-analysis.” PloS one vol. 8,4 e62356. 23 Apr. 2013, doi:10.1371/journal.pone.0062356
Fonseca, Líllian Beatriz et al. “Use of Cold-Water Immersion to Reduce Muscle Damage and Delayed-Onset Muscle Soreness and Preserve Muscle Power in Jiu-Jitsu Athletes.” Journal of athletic training vol. 51,7 (2016): 540-9. doi:10.4085/1062-6050-51.9.01
Forcina, Laura, et al. “Mechanisms Regulating Muscle Regeneration: Insights into the Interrelated and Time-Dependent Phases of Tissue Healing.” Cells vol. 9,5 1297. 22 May. 2020, doi:10.3390/cells9051297
Shadgan, Babak, et al. “Contrast Baths, Intramuscular Hemodynamics, and Oxygenation as Monitored by Near-Infrared Spectroscopy.” Journal of athletic training vol. 53,8 (2018): 782-787. doi:10.4085/1062-6050-127-17
Sutkowy, Paweł, et al. “Postexercise impact of ice-cold water bath on the oxidant-antioxidant balance in healthy men.” BioMed research international vol. 2015 (2015): 706141. doi:10.1155/2015/706141
How do non-surgical treatments compare with traditional surgical treatments to improve mobility for individuals with hamstring injuries? The hamstrings are muscles in the lower extremities that provide mobility to the legs and stabilize the pelvis. Many athletes rely on their hamstrings to perform strenuous actions such as sprinting, jumping, squatting, and kicking during sporting events. However, the hamstrings are also very susceptible to injury. Athletes who repeatedly overstretch their hamstrings can experience muscle strain until microscopic tears form, which is common. Similarly, individuals who sit for long periods can also experience hamstring issues. When individuals are not physically active, their hamstrings can become weak and shortened, leading to symptoms such as muscle pain, trigger points, and strain on the accessory muscles. Hamstring injuries can also cause other issues that affect the lower body extremities. This article will explore how hamstring injuries affect mobility and how non-surgical treatments help people regain mobility. We work with certified medical providers who use our patients’ valuable information to treat individuals suffering from hamstring injuries and inform them about non-surgical treatments to regain mobility. We encourage patients to ask essential questions and seek education from our associated medical providers about their condition. Dr. Jimenez, D.C., provides this information as an educational service. Disclaimer
Hamstring Injuries Implementing Other Issues
Do you experience stiffness in the back of your thighs when warming up before exercising? Are you feeling radiating pain from the side of your hips and glutes due to prolonged sitting? Or do you tend to limp, affecting your gait and walking? Many people are unaware they are overexerting their hamstrings, which can cause pain. Those who engage in sports or work sedentary jobs may over or underuse their hamstrings, affecting their flexibility and mobility to the lower extremities. According to research studies, hamstring injuries are the most common non-contact muscle injuries caused by two mechanisms of injuries: stretch-type and sprint-type. Sprint-type injuries associated with hamstrings occur when the muscles are overexerted due to maximal or near-maximal action, causing muscle fatigue. To that point, hamstring injuries can also affect a person’s walking mobility.
Running without properly warming up the hamstring muscle can cause muscle fatigue. Stretch-type injuries associated with the hamstring muscles involve combination movements that include extreme hip flexion and knee extension. These injuries can also mimic sciatica, leading people to believe their sciatic nerve is acting up. However, treatments available can help reduce the pain associated with hamstring injuries and lengthen the shortened muscle to reduce pain.
Best Lower Body Stretches To Increase Flexibility-Video
If you want to reduce the pain associated with hamstring injuries, incorporating RICE can help prevent it from becoming chronic. This involves gently stretching the affected muscle to avoid cramps and pain while increasing flexibility. Hamstring injuries can also be linked to other chronic issues, which can cause inflammation in the surrounding muscles. Studies show that conditions like piriformis syndrome can cause nerve entrapment in the hamstrings, resulting in radiating pain down the leg that mimics low back pain and sciatica. As previously mentioned, hamstring injuries can limit mobility and be linked to chronic conditions. Thankfully, non-surgical treatments can help reduce pain and provide relief. Check out the video above to learn different stretches that can help reduce pain in the lower body and increase flexibility.
Treatments To Restore Mobility
If rest, ice, compression, and gentle stretching do not provide relief, incorporating treatments for hamstring injuries to restore mobility can benefit many individuals. Seeking the help of a pain specialist, such as a massage therapist or chiropractor, to create a customized plan/program is recommended. There are various approaches that pain specialists can use to regain mobility and treat hamstring injuries.
MET Therapy
Many chiropractors and massage therapists incorporate MET (muscle energy techniques) therapy to gently stretch out the shortened hamstring muscle and help restore joint mobility in the lower extremities. In “Clinical Applications of Neuromuscular Techniques,” written by Leon Chaitow, N.D., D.O., and Judith Walker DeLany, L.M.T., stated that MET is crucial in stretching and strengthening the hamstring muscles through isometric contraction. At the same time, additional research studies reveal that the MET technique allows the hamstrings to have a greater increase in hip flexion ranges. MET therapy also helps strengthen the accessory muscles surrounding the hamstrings to restore mobility.
Spinal Decompression
If hamstring injuries are caused by nerve entrapment, then trying out spinal decompression can help restore mobility to the hips and lower extremities. According to “The Ultimate Spinal Decompression,” written by Dr. Eric Kaplan, D.C., FIAMA, and Dr. Perry Bard, D.C., stated that spinal decompression is safe and gentle on the spine as it provides gentle traction on the spinal disc to reduce pain and increase disc height. When hamstring injuries are associated with nerve entrapment, it could result from a herniated disc that aggravates the nerve root and causes referred pain to the hamstrings. Using gentle traction on the spine can help alleviate the pain caused by the aggravating nerve and reduce pain in the hamstrings. Many individuals can incorporate these treatments to reduce hamstring injuries and regain their mobility back to their legs.
References
Chaitow, L., & Delany, J. (2002). Clinical application of neuromuscular techniques. Vol. 2, The lower body. Churchill Livingstone.
Individuals spend around one-third of their life sleeping or resting. Every person has their own preferred sleeping position. However, not all sleep positions are comfortable and supportive to the body, especially the spine. Individuals that sleep on their side or stomach that experience back pain might want to consider switching to sleeping on their back. Changing preferred sleeping positions can seem impossible, however, learning to sleep on your back is possible with a little training and adjustment period.
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Learning To Sleep On Your Back
After side sleeping, back sleeping is the second most common position. Individuals that are stomach or side sleepers that suffer from:
Learning to sleep on your back is recommended because its health benefits can potentially solve all these problems and more.
Adapting this sleeping position can help maintain proper spinal alignment.
Relieves waking up with tension headaches.
Relieve sinus problems.
Individuals that are not natural back sleepers understand how difficult it is to force oneself to adapt to a new sleeping position. There are ways to condition the mind and body to fall and stay asleep on your back, resulting in healthy rest. These include:
A Pillow Under The Knees
It may help to place a supportive pillow under the knees.
The knees should be slightly bent and feel comfortable.
Check to make sure that the neck and spine feel comfortable and are in alignment.
Make adjustments as needed.
A Pillow Under The Low Back
In the beginning, switching to back sleeping can increase discomfort in the low back.
Placing a pillow under the lower back can help.
Using too large or thick a pillow could create added discomfort.
Try a few different pillows to find what works best and feels right.
Pillow Surround
Individuals that are active sleepers and tend to roll onto their side or stomach soon after falling asleep, can place pillows around the midsection and hips.
A small barrier of pillows around the body can assist in learning to sleep on your back.
The pillows help prevent the body from rolling.
It’s recommended to place pillows closely against either side of the body.
Using the pillows as an enclosure will force the body to remain in a neutral position throughout the night.
Sleeping On The Right Pillow
Individuals will want to make sure they are using the right sleeping pillow.
In addition to supporting the spine’s alignment, a quality pillow will also support the neck.
The recommended pillow for back sleeping should cradle the head and ensure it stays elevated.
A pillow that is too flat or too thick can cause the head to become unlevel with the body leading to:
Neck and upper body pain
Restricted airflow, which may cause you to snore or suffer from sleep apnea.
Digestive issues like acid reflux and heartburn.
Consider a pillow that’s made out of some type of memory foam to assist with learning to sleep on your back.
The thickness and hugging sensation can help to stay on the back and prevent inadvertently flipping over.
Sleeping On The Right Mattress
A positive back sleeping experience begins with the right mattress. There are so many mattress types to choose from. It is recommended to consider the materials, the firmness level, and the size. For comfortably sleeping on your back, the firmness level is essential.
Consider the positioning of your spine.
The objective is to keep the spine as straight as possible, which is achieved with the proper firmness.
A mattress that is too firm will create unwanted pressure and tension on the shoulders and the pelvic region.
A mattress that is too soft will cause the hips to sink, throwing spinal alignment off and causing back pain symptoms.
A medium-firm mattress is recommended.
Memory foam is a great option for learning to sleep on your back.
Memory foam cradles the natural curve of the body, and hugs the body during sleep, which helps avoid accidentally rolling onto your side or stomach.
Memory foam mattresses with integrated gel can provide cooling and ventilation to keep the body refreshed throughout the night.
A medium-firm memory foam mattress will make sure the body stays straight, with the proper cushioning around the pelvis and hips.
Training To Sleep On Your Back
References
Anderson, Ngaire H et al. “Association of Supine Going-to-Sleep Position in Late Pregnancy With Reduced Birth Weight: A Secondary Analysis of an Individual Participant Data Meta-analysis.” JAMA network open vol. 2,10 e1912614. 2 Oct. 2019, doi:10.1001/jamanetworkopen.2019.12614
Desouzart, Gustavo, et al. “Effects of sleeping position on back pain in physically active seniors: A controlled pilot study.” Work (Reading, Mass.) vol. 53,2 (2015): 235-40. doi:10.3233/WOR-152243
Khan, Bashir Ahmad, et al. “Effect of bed head elevation during sleep in symptomatic patients of nocturnal gastroesophageal reflux.” Journal of Gastroenterology and Hepatology vol. 27,6 (2012): 1078-82. doi:10.1111/j.1440-1746.2011.06968.x
Portale, G et al. “When are reflux episodes symptomatic?.” Diseases of the esophagus: official journal of the International Society for Diseases of the Esophagus vol. 20,1 (2007): 47-52. doi:10.1111/j.1442-2050.2007.00650.x
Skarpsno, Eivind Schjelderup, et al. “Sleep positions and nocturnal body movements based on free-living accelerometer recordings: association with demographics, lifestyle, and insomnia symptoms.” Nature and Science of Sleep vol. 9 267-275. 1 Nov. 2017, doi:10.2147/NSS.S145777
Surdea-Blaga, Teodora, et al. “Food and Gastroesophageal Reflux Disease.” Current medicinal chemistry vol. 26,19 (2019): 3497-3511. doi:10.2174/0929867324666170515123807
The musculoskeletal system comprises muscles, ligaments, and tissues surrounding the skeletal structure and vital organs. These components have various functions, including transporting blood and nutrients throughout the body and facilitating movement. However, chronic conditions or aging can cause pain-like symptoms, disrupting daily life and leading to disability. There are many available treatments, both surgical and non-surgical, that can help alleviate chronic pain. This article will explore how chronic pain affects individuals and how treatments like Muscle Energy Technique (MET) therapy can help address it. We work with certified medical providers who use our patients’ valuable information to treat individuals suffering from muscle pain while informing them about non-surgical treatments like MET therapy that can help reduce the effects of chronic pain associated with the musculoskeletal system. We encourage patients to ask essential questions and seek education from our associated medical providers about their condition. Dr. Jimenez, D.C., provides this information as an educational service. Disclaimer
How Does Chronic Pain Affect The Individual?
Have you been dealing with shooting pain in your joints or muscles? When you wake up in the morning, do you feel constant stiffness in your joints? Or do you experience muscle pain slowly throughout the entire day? When it comes to chronic pain in the musculoskeletal system, it can be hard to pinpoint where the pain is located in the body. Research studies reveal that chronic musculoskeletal pain is a challenge for the individual and their doctors and a main contributor to disability worldwide. Chronic musculoskeletal pain can be non-specific and specific depending on the severity and factors contributing to its development. For many individuals experiencing chronic pain associated with the musculoskeletal system, the homeostatic and adaptive function in their muscle fibers has been stretched past their limits.
Additional research studies stated that factors like mechanical forces, ischemia, and even inflammation are all primary stimuli for chronic muscle pain. Factors like lifting/carrying heavy objects, persistent sitting, physical inactivities, and dietary habits all correlate to chronic muscle and joint pain, as repetitive motions or prolonged inactivity can either shorten or overstretch the muscle fibers. At the same time, chronic musculoskeletal diseases like fibromyalgia and myofascial pain syndrome can cause the affected muscles to stiffen, contract, and tender to the touch, which then causes the other surrounding muscles to take over and compensate for the pain. To that point, chronic musculoskeletal pain can cause many individuals to decrease their productivity, call off work constantly, and lead a life of disability.
From Consultation To Transformation- Video
Have you been dealing with constant muscle and joint pain throughout your life? Has the pain been unbearable that it is affecting your routine? Or do you feel aches or stiffness in your sides or different body areas? Throughout the entire world, many individuals suffer from chronic musculoskeletal pain at one point in their lives, and it has become a social/economic burden. Research studies reveal that chronic pain associated with musculoskeletal disorders can affect many other aspects of a person’s life. When chronic pain starts to affect a person’s ability to function, it can have a negative effect on the person’s mental health. When chronic pain is associated with musculoskeletal disorders, it also correlates with work, as many individuals with chronic pain have reduced work productivity, lost wages, and lost hours that can take a toll on their income. However, there is hope, as many affordable treatments can reduce the effects of chronic musculoskeletal pain and its associated symptoms. Non-surgical treatments like chiropractic care and MET therapy can help many individuals with chronic musculoskeletal pain find the relief they deserve. The video above explains how non-surgical treatments approach chronic musculoskeletal pain, from assessing patients through consultation to transforming their health and wellness. By taking back their health, many individuals can find relief from their pain and get back to their routines.
MET Therapy’s Approach To Chronic Pain
Non-surgical treatments like MET (muscle energy technique) therapy has a unique approach to reducing chronic pain in the musculoskeletal system. In the book, “Clinical Applications of Neuromuscular Techniques,” Dr. Leon Chaitow, N.D., D.O., and Dr. Judith Walker DeLany, L.M.T., mentioned that the fascia and the characteristics of the connective tissues are relevant for MET by commencing stretching the affected muscles that are in chronic pain and use biomechanical forces to initiate a low intense force to lengthen the tissues and increase their flexibility. MET therapy helps many individuals with chronic pain associated with musculoskeletal disorders, as research studies reveal that MET therapy can help increase the strength of weakened muscles and help increase the spinal ROM. MET therapy is non-surgical, cost-effective, and safe to reduce chronic pain associated with musculoskeletal disorders.
Identifying The Patterns
Many pain specialists who incorporate MET will begin by assessing the individual with chronic pain associated with musculoskeletal disorders. They will get examined by testing their range of motion, spinal and joint mobility, and any additional factors to develop a personalized plan that caters to the individual. Once the pain issue is found, the individual will work with other medical professionals to help strengthen their muscles and help reduce the pain-like symptoms that are causing them. To that point, MET therapy combined with other treatments is beneficial for those with chronic illnesses and needs relief from pain.
Conclusion
Many individuals suffering from chronic musculoskeletal pain often experience limited mobility, shortened muscles, and referred pain in different areas of their bodies. Chronic musculoskeletal pain is a social/economic problem that has affected many individuals and left them missing out on important life events. Treatments like MET (muscle energy technique) therapy can help reduce pain by stretching the muscle fibers to alleviate pain and restore joint mobility to the body. When many individuals start to utilize MET therapy, it can reduce chronic pain and allow them to get back their health and wellness.
Pesto is a sauce that is made with garlic, pine nuts, basil, cheese, and olive oil, which creates a strong, rich flavor. It is used as a marinade, dip, salad dressing, sandwich spread, and a topping for dishes like pasta and pizza. It can be homemade or bought premade, including vegan varieties. It is made with nutritious ingredients and can be consumed as part of a balanced diet. The sauces can vary in nutrition, but in general, it is a rich source of healthy fats and is also part of the Mediterranean Diet.
Contents
Pesto
Carbohydrates
The sauce is not a significant source of complex carbohydrates, dietary fiber, or sugar.
A spoonful contains under 1 gram of carbohydrates.
It is often paired with foods rich in carbohydrates, like sandwiches, pizza, and pasta.
Fats
Nearly 60% of the calories in pesto come from fats, provided by the olive oil, cheese, and pine nuts.
There are 9.47 grams of fats per spoonful, which includes:
5.63 grams of monounsaturated fatty acids.
1.53 grams of saturated fatty acids.
1.68 grams of polyunsaturated fatty acids.
It also contains 2.56mg of cholesterol.
According to U.S. Dietary Guidelines for Americans, 20% to 35% of daily calories should come from fat.
Protein
The sauce is not a protein-rich food with only 1.38 grams of protein per tablespoon.
It is often used as a condiment, it can add flavor to other foods higher in protein.
Vitamins and Minerals
Pesto contains:
33.1mg of calcium.
36.8mg of phosphorus.
31.8mg of potassium.
9.76mg of magnesium.
Health Benefits
Some of the potential health benefits of pesto.
Antioxidant Properties
Garlic, pine nuts, olive oil, and basil are rich sources of antioxidants.
Antioxidants have an essential role in defending the body against free radical damage, which can lead to disease.
Diets high in antioxidants reduce the risk of various diseases, like heart disease and cancer.
Consuming antioxidant-rich foods like pesto on a regular basis can increase antioxidant levels.
Cardiovascular Benefits
Olive oil health benefits include the reduced risk of heart disease.
Substituting other high-fat foods like margarine, butter, and mayonnaise with olive oil can help lower the risk of heart disease and stroke.
Help Lower Cholesterol
Four different types of fats – saturated, trans, monounsaturated, and polyunsaturated fats.
Saturated fats can raise LDL/unhealthy cholesterol levels.
Foods rich in monounsaturated and polyunsaturated fats like pesto can help lower LDL cholesterol levels in the blood and support HDL/healthy cholesterol levels.
Weight Management
Pesto is commonly consumed on the Mediterranean diet and can be part of a nutritious lifestyle that supports a healthy weight.
Research has shown that following a Mediterranean diet can lead to and maintain long-term changes in weight management.
Store-bought pesto can contain a large amount of sodium.
Individuals following a low-sodium diet or taking heart medications should check with their doctor before consuming these products.
To control the amount of sodium, consider making a homemade recipe that uses less salt and aligns with individual dietary preferences.
Basil is the main ingredient but some varieties are made with other herbs.
Pesto traditionally contains parmesan cheese/milk products and pine nuts/tree nuts which are common food allergens.
The sauce is a vegetarian-friendly sauce, but vegans can look for cheese and dairy-free versions.
It is possible that an allergic reaction can occur in individuals allergic to dairy products and nuts.
Individuals allergic to nuts can choose nut-free varieties.
From Consultation to Transformation
References
Agnoli C, Sieri S, Ricceri F, et al. Adherence to a Mediterranean diet and long-term changes in weight and waist circumference in the EPIC-Italy cohort. Nutr Diabetes. 2018;8(1):22. doi:10.1038/s41387-018-0023-3
Bolling, Bradley W et al. “Tree nut phytochemicals: composition, antioxidant capacity, bioactivity, impact factors. A systematic review of almonds, Brazils, cashews, hazelnuts, macadamias, pecans, pine nuts, pistachios, and walnuts.” Nutrition research reviews vol. 24,2 (2011): 244-75. doi:10.1017/S095442241100014X
Bower, Allyson, et al. “The Health Benefits of Selected Culinary Herbs and Spices Found in the Traditional Mediterranean Diet.” Critical Reviews in food science and nutrition vol. 56,16 (2016): 2728-46. doi:10.1080/10408398.2013.805713
Guasch-Ferré M, Liu G, Li Y, et al. Olive oil consumption and cardiovascular risk in U.S. adults. J Am Coll Cardiol. 2020;75(15):1729-1739. doi:10.1016/j.jacc.2020.02.036
Liu, Qing, et al. “Antibacterial and Antifungal Activities of Spices.” International journal of molecular sciences vol. 18,6 1283. 16 Jun. 2017, doi:10.3390/ijms18061283
Marcelino, Gabriela et al. “Effects of Olive Oil and Its Minor Components on Cardiovascular Diseases, Inflammation, and Gut Microbiota.” Nutrients vol. 11,8 1826. 7 Aug. 2019, doi:10.3390/nu11081826
Nicastro, Holly L, et al. “Garlic and onions: their cancer prevention properties.” Cancer prevention research (Philadelphia, Pa.) vol. 8,3 (2015): 181-9. doi:10.1158/1940-6207.CAPR-14-0172
Sestili, Piero, et al. “The potential effects of Ocimum basilicum on health: a review of pharmacological and toxicological studies.” Expert opinion on drug metabolism & toxicology vol. 14,7 (2018): 679-692. doi:10.1080/17425255.2018.1484450
Sun, Liangzi, et al. “Tryptophan targeted pulsed electric field treatment for enhanced immune activity in pine nut peptides.” Journal of food biochemistry vol. 44,6 (2020): e13224. doi:10.1111/jfbc.13224
Regarding the musculoskeletal system, the various muscles, tissues, and ligaments help protect the spine and vital organs that make the body functional. These muscles are sectioned into different groups that help provide movement and motion to the host without feeling pain. However, when normal factors or traumatic forces begin to affect the musculoskeletal system, it can cause unnecessary stress on the muscle fibers. These environmental factors can lead to muscle pain and correlating symptoms affecting the upper and lower body portions. When muscle pain affects the body, it can mask other pre-existing conditions that can make the individual feel miserable. Fortunately, many individuals will go to therapy treatment to reduce the effects of muscle pain and have a personalized plan that they can follow to prevent muscle pain from returning in the future. Today’s article focuses on one of the non-surgical treatments known as MET (muscle energy technique) therapy that can help reduce the effects of muscle pain and what is the protocol treatment plan to relieve muscle pain in the body. We work with certified medical providers who use our patients’ valuable information to treat individuals suffering from muscle pain while informing them about non-surgical treatments like MET therapy that can help reduce the effects of musculoskeletal pain. We encourage patients to ask essential questions and seek education from our associated medical providers about their condition. Dr. Jimenez, D.C., provides this information as an educational service. Disclaimer
How Does Muscle Pain Affect The Body?
Do you experience muscle aches, stiffness, or pain in one or more parts of your body? These pain-like symptoms are often caused by muscle pain. Research studies revealed that free nerve endings in muscle fibers can send pain signals to the brain, leading to decreased productivity and economic burden. Overstretching muscles during daily routines can cause trigger points, small nodules in muscle fibers that cause stiffness and contraction. This can lead to misalignment and additional problems over time.
Muscle pain can be a symptom of different conditions, with severity ranging from acute to chronic. Research studies stated that when musculoskeletal pain affects more than 30% of the world, it can significantly impact an individual’s life. This type of pain can be related to sensory innervation of the bones, joints, and muscles and can negatively affect a person’s daily routine. However, there are various ways to reduce muscle pain, which individuals can incorporate to relieve muscle pain and reduce its chances of returning.
Movement As Medicine- Video
When it comes to musculoskeletal pain, it can have a significant impact on a person’s body. It can affect their daily routine, causing them to have limited mobility and feel miserable. Musculoskeletal pain causes the involved muscle fibers to stiffen up and contract. This causes the surrounding muscles to compensate for the pain the affected muscle feels and causes body misalignment. However, all is not lost, as available treatments can help reduce the effects of muscle pain and can bring back a person’s mobility. One of these treatments is MET (muscle energy technique) therapy. Research studies reveal that MET is an osteopathic technique that many pain specialists like chiropractors and massage therapists use to improve musculoskeletal function by mobilizing joints, stretching tight muscles and facia to reduce pain, and improving circulation and lymphatic flow. Since many individuals don’t stretch their bodies as often as needed, their muscles can become tight and stiff, which causes the development of muscle pain. So by utilizing MET therapy, a person dealing with muscle pain can regain mobility. MET therapy can also be combined with other treatments like chiropractic care to help realign the body out of subluxation and strengthen/lengthen tight muscles. The video above explains how movement is used as medicine to reduce the effects of muscle pain.
MET Treatment Protocol
According to “Clinical Application of Neuromuscular Techniques,” written by Leon Chaitow, N.D., D.O., and Judith Walker DeLany, L.M.T., when the body is experiencing restricted joints, incorporating MET therapy can indicate where the problem is located in the soft musculoskeletal tissues. When it comes to many individuals going to MET therapy for muscle pain, many doctors have their protocol approach when assessing patients for muscle pain treatment.
Looking At Body Language
When assessing patients with muscle pain, looking at their body language and how they carry themselves is important. Many doctors and pain specialists should note how the individual is breathing, their posture, and if there is any perspiration on the skin. By taking note of how the individual looks physically, many doctors will begin to formulate a treatment plan while communicating with the patient to gather more information and create a trusting relationship. Afterward, the doctor can start the physical examination to locate where the pain is in the body.
Physical Examination
The MET treatment protocol’s physical examination portion allows the doctor to go through a sequential assessment involving observation, joint and muscle testing, palpations, evaluation of accessory movement, etc., to create a basic formula to create a personalized treatment plan. The physical examination of MET allows the muscles to influence muscle contractions on the surrounding fascia and alter the muscle’s physiology by reflex mechanisms. These stretches help the restricted joints be re-mobilized, and help stretch the tightened muscles to feel relief from metabolic waste.
Therapeutic Plan
The therapeutic plan for MET treatment is personalized and customizable for the individual to follow through to reduce muscle pain from re-occurring in the body. Many doctors specializing in MET therapy work with other associated medical providers to ensure that the person in pain has the help they need. Physical therapy, dietary nutrition, non-surgical treatments, and health coaches all work together to create a personalized health and wellness plan to make sure that muscle pain and its associated factors are being treated. This allows individuals to be more mindful of their bodies and regain their health and wellness.
Conclusion
Muscle pain can affect a person’s ability to move around and can affect multiple areas in the upper and lower body portions. Muscle pain correlates to tight muscle fibers that become stiff and can develop trigger points in the fascia and cause restricted movement. When this happens, it can cause the individual to miss out on daily activities and prevent them from working. Luckily available treatments can help reduce muscle pain by re-mobilizing the joints and stretching out the tight muscle. MET, or muscle energy technique therapy, helps stretch muscle fascia and mobilize joints to regain the body’s range of motion and help reduce muscle pain. Many people who incorporate MET into their daily routine can restore mobility and continue their health and wellness journey.
References
Chaitow, L., & Delany, J. (2002). Clinical application of neuromuscular techniques. Vol. 2, The lower body. Churchill Livingstone.
Fitness, exercising, weight, and strength training programs use terms like sets, reps, and rest intervals. Knowing what they mean and how to use them for optimal results is important to achieve health goals. An individual’s training program will differ in the weights, reps, sets, rest intervals, and execution speed depending on whether the training is for fitness, muscle growth, strength, power, or endurance. Here we offer a strength training guide on understanding these terms and how they apply to a workout program.
Contents
Strength Training Guide
Reps
Rep means repetition.
A rep is one completion of an exercise, such as one bench press, or one bicep curl.
So, one bicep curl equals one rep, and 10 bicep curls equals 10 reps.
Reps make up a set, which is typically the total number of reps done before taking a break.
A repetition maximum – 1RM is an individual’s personal best or the most they can lift once in a single repetition.
A 10RM would be the most an individual could lift and successfully perform 10 reps with proper form.
Sets
A set is a series of repetitions performed sequentially.
For example, one set of bench presses could be eight reps
Sets are designed according to the individual’s workout program.
Rest
The rest interval is the time of resting between sets that allow the muscles to recover.
The rest period between sets can range from 30 seconds to two minutes.
Exercises can have short or long rests between reps.
The ideal rest period depends on the objective of the workout and health goals.
Not resting long enough and starting with another set too soon can fatigue the muscles too soon, increasing the risk of injury.
Resting too long between reps can cool the muscles down and release tension before starting again.
Execution Speed
The speed at which one rep of an exercise is performed is contraction velocity.
Concentric – shortening of the muscle is often the lifting part of a rep.
Eccentric – lengthening of the muscle, often the lowering part of a rep helps to build muscle mass.
Strength: 1 to 2 seconds concentric and eccentric
Hypertrophy: 2 to 5 seconds concentric and eccentric
Endurance: 1 to 2 seconds concentric and eccentric
Power: Less than 1 second concentric and 1 to 2 seconds eccentric
Choosing Weights
The distribution of repetitions against a percentage of 1RM maximum lift is as follows. This example uses a bench press where 1RM is 160 pounds.
100% of 1RM: 160 pounds, 1 repetition
60% of 1RM: 96 pounds, warm-up reps
85% of 1RM: 136 pounds, 6 repetitions
67% of 1RM: 107 pounds, 12 repetitions
65% of 1RM: 104 pounds, 15 repetitions
An individual should be able to do one lift at 1RM, six reps at 85%, 15 reps at 65%, and so on.
Goals to Build a Program
A training program is a schedule of exercise types, frequency, intensity, and volume, for weight training or any other type of fitness training. Individuals can devise various combinations of sets, reps, rest, and exercise types to find what works best for them. A qualified strength and conditioning trainer can help develop a program. The variables can be adjusted and include:
Exercise selection
Weights or resistance used
Number of reps
Number of sets
Execution speed
Rest time between sets
Rest time between training sessions and days of the week
General Fitness
A basic strength training fitness program targets strength and muscle-building.
Between eight and 15 repetitions for two to four sets will help achieve both.
Choose eight to 12 exercises, making sure to hit the lower and upper body and core.
Strength
Building strength uses the most weight, the least number of reps, and the longest rest periods.
The neuromuscular system responds to heavy weights by increasing the body’s ability to lift heavy loads.
For example, individuals with a strength goal could use a 5×5 system.
This means five sets of five repetitions.
Muscle Growth
Muscle growth and bodybuilding training use lighter weights, more reps, and less rest periods.
Muscle requires metabolic stress to increase in size.
This means working the muscles to the point where lactate builds and the muscle suffers internal damage, sometimes called “training to failure.”
Then resting and proper nutrition help muscle repair and the muscle grows larger in the process.
A program could be three sets of 8 to 12 reps, with loads that reach or near the failure point on the last few reps.
Power
Power training uses slightly lighter weights, takes longer rest periods, and focuses on execution speed.
Power is the ability to move an object at high speed.
Each push, pull, squat, or lunge is done at a quick tempo.
This type of training requires practicing the acceleration of a lift, resting properly, and repeating.
Muscular Endurance
Endurance weight training requires more reps in each set, up to 20 or 30, with lighter weights.
Individuals should ask themselves what is the day-to-day physical activity that requires the most muscular endurance?
For example, runners will want to concentrate on increasing endurance in their legs.
Swimmers may shift and focus on their arms one day then legs another.
Movement as Medicine
References
Liu, Chiung-Ju, and Nancy K Latham. “Progressive resistance strength training for improving physical function in older adults.” The Cochrane Database of systematic reviews vol. 2009,3 CD002759. 8 Jul. 2009, doi:10.1002/14651858.CD002759.pub2
Loturco, Irineu, et al. “Muscle Contraction Velocity: A Suitable Approach to Analyze the Functional Adaptations in Elite Soccer Players.” Journal of sports science & medicine vol. 15,3 483-491. 5 Aug. 2016
Rønnestad, B R, and I Mujika. “Optimizing strength training for running and cycling endurance performance: A review.” Scandinavian Journal of Medicine & Science in Sports vol. 24,4 (2014): 603-12. doi:10.1111/sms.12104
Suchomel, Timothy J et al. “The Importance of Muscular Strength: Training Considerations.” Sports medicine (Auckland, N.Z.) vol. 48,4 (2018): 765-785. doi:10.1007/s40279-018-0862-z
Tøien, Tiril, et al. “Maximal strength training: the impact of eccentric overload.” Journal of Neurophysiology vol. 120,6 (2018): 2868-2876. doi:10.1152/jn.00609.2018
Westcott, Wayne L. “Resistance training is medicine: effects of strength training on health.” Current sports medicine reports vol. 11,4 (2012): 209-16. doi:10.1249/JSR.0b013e31825dabb8
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