Delayed Onset Muscle Soreness – DOMS is when muscle pain or stiffness develops a day or two after playing sports, weight lifting, exercise, or work that involves concentrated physical activity like lifting and carrying objects. DOMS is considered a normal response to extended exertion and is part of the adaptation process that the recovering muscles experience as they undergo hypertrophy or an increase in muscle size. It is common in individuals who have just started exercising, increased the duration or intensity of their workouts, or just beginning a physically demanding job.
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DOMS
When muscle contracts as it lengthens is known as eccentric muscle contractions, which is most associated with DOMS. It is related to increased stress in muscle fibers as they are exerted excessively. This also happens when engaging in movements the muscles are not used to, like a new exercise or helping a friend move heavy boxes, furniture, etc. Examples include:
Individuals will not feel DOMS during the workout or physical activity. Delayed symptoms include:
Swelling in the affected muscles.
Muscles feel tender to the touch.
Muscle fatigue.
Reduced range of motion and movement.
Pain and stiffness when moving.
Decreased muscle strength.
Treatment Options
Time and waiting for the muscles to repair themselves is the natural healing process, but steps can be taken to ease the soreness, stiffness, and pain. This includes:
It is different for everybody; personal experience will determine which works best for the individual.
Active Recovery
Active recovery is a technique that uses low-impact aerobic exercise right after a workout to increase blood flow to the muscles.
The increased blood supply can help relieve the inflammation.
RICE
This technique is used for acute injuries but can be applied to delayed onset muscle soreness. It stands for:
Rest
Ice
Compression
Elevation
Chiropractic
A chiropractic massage is for healing sore muscles, tendons, ligaments after an intense game, workout, etc. Chiropractic increases the blood and nerve circulation around the muscles delivering added oxygen and nutrients. This type of massage helps loosen the muscles/connecting tissues allowing the body to recover and heal quicker.
Body Composition
When Muscles Are Not Rested
Not taking time to recover because of overtraining/working can have consequences on the body. Inflammation that is not given the time to heal can lead to:
Injuries.
Weakened immune system.
Muscle mass loss.
Mental health issues.
The body’s immune system cannot function at total capacity during intense physical stress. This causes difficulty when trying to fight off germs and viruses. Studies have found preventing inflammation and injury requires prioritizing rest. Constantly being on the go and under intense physical stress can take a toll not only on the body but the brain as well. This can lead to irritability, frustration, anger, which leads to other health problems generating a vicious cycle.
References
Cheung, Karoline et al. “Delayed onset muscle soreness: treatment strategies and performance factors.” Sports medicine (Auckland, N.Z.) vol. 33,2 (2003): 145-64. doi:10.2165/00007256-200333020-00005
Guo, Jianmin et al. “Massage Alleviates Delayed Onset Muscle Soreness after Strenuous Exercise: A Systematic Review and Meta-Analysis.” Frontiers in physiology vol. 8 747. 27 Sep. 2017, doi:10.3389/fphys.2017.00747
Reinke, Simon et al. “The influence of recovery and training phases on body composition, peripheral vascular function and immune system of professional soccer players.” PloS one vol. 4,3 (2009): e4910. doi:10.1371/journal.pone.0004910
Pregnant and Chiropractic: Many women experience back/pelvis/leg/feet swelling, soreness, achiness, and pain during pregnancy. A growing belly added weight and changes in connective tissue can cause a variety of musculoskeletal strains and misalignments. Chiropractic care provides health maintenance of the spinal column, discs, nerves, joints, muscles, and bones. It is an art and science of adjusting a misaligned body, reducing stress, and promoting health throughout the body.
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Pregnant and Chiropractic
With a primary doctor’s clearance, chiropractic can provide safe adjustments. Chiropractors trained to work with pregnant women utilize techniques that avoid applying pressure on or around the abdomen. Benefits of chiropractic during pregnancy include:
Restores and maintains spinal alignment and balance.
Helps control symptoms of nausea.
Improves energy levels.
Relieves body pain.
Helps reduce labor time and delivery.
Restores pelvic positioning and balance, improving standing, sitting, and walking mechanics.
A chiropractor trained in the needs of pregnant women will also provide exercises and stretches that are safe during pregnancy. A chiropractor will discuss/recommend treatment options, patient concerns, and a complete medical history assessment. They will monitor symptoms to customize treatments to the individual’s specific needs to get the most relief.
Body Composition
Gestational Hypertension
Gestational hypertension develops during pregnancy. It is not preventable and returns to normal levels postpartum. However, there is an increased risk of developing chronic hypertension later if gestational hypertension begins to develop. According to Mayo Clinic, gestational hypertension is diagnosed by the following:
Blood pressure is higher than 140/90 on at least two occasions.
Must be more than four hours apart.
There is no other organ damage present.
References
Gutke, Annelie et al. “Treatments for pregnancy-related lumbopelvic pain: a systematic review of physiotherapy modalities.” Acta Obstetricia et Gynecologica Scandinavica vol. 94,11 (2015): 1156-67. doi:10.1111/aogs.12681
Poděbradská, R et al. “The effect of physiotherapy intervention on the load of the foot and low back pain in pregnancy.” “Vliv fyzioterapeutických postupů na zatížení plosky a bolesti zad v těhotenství.” Ceska gynekologie vol. 84,6 (2019): 450-457.
Schreiner, Lucas et al. “Systematic review of pelvic floor interventions during pregnancy.” International journal of gynecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics vol. 143,1 (2018): 10-18. doi:10.1002/ijgo.12513
Everybody is different in how the body reacts to a chiropractic adjustment. Body misalignment often leads to spinal misalignment or vice versa. Misalignments occur over time; individuals do not notice until soreness and pain begin presenting. Depending on the injury and/or condition, getting the full potential from a chiropractic adjustment means knowing the dos and don’ts following treatment. This involves maintaining a healthy posture, staying hydrated, getting proper rest, and staying active.
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Adjustments
Adjustments are highly effective for the body. Benefits include:
Pain relief.
Restored full range of motion.
Increased strength.
Increased energy.
Improved sleep.
Lowered blood pressure in individuals with hypertension.
It is not recommended to take on intense workouts after an adjustment but to remain active to keep the muscles, tendons, ligaments flexible and strengthen the body during healing.
Activities should be done in moderation and include:
Walking
Jogging
Biking
Swimming
Proper Rest
Getting the proper amount of sleep is essential for the body to heal to the optimal level.
The body getting used to the adjustment can be an exhausting process.
Maintain Healthy Posture
Proper posture is essential to keep the body in healthy alignment and prevent further/new injuries.
A chiropractor and physical therapist will educate and train individuals on maintaining healthy, active postures.
Stretching
Stretching is prescribed as part of the treatment to maintain flexibility and strength.
A chiropractor will recommend and show how to perform specific stretches and exercises between adjustments.
What to Avoid
Recommendations on what to avoid after a chiropractic adjustment.
Explosive Movements
Stay active but limit any explosive movements for a few days after the adjustment.
Avoid Sitting Too Much
Too much sitting, even with a lumbar support chair, can cause the muscles to tighten pulling on the spine.
When sitting, get up and move around every 20 minutes.
Paying attention to the recommended do’s and don’ts will help expedite the healing and create new healthy habits.
Body Composition
Dairy Products
Conventional vs. Organic and Grass-fed Dairy
Studies have found that dairy cows consuming a diet of grass and hay significantly improved nutrient profiles of produced milk.
Milk from grass-fed cows has a higher omega-3 content when compared to organic and conventional grain-fed cows.
Bourrie, Benjamin C T et al. “The Microbiota and Health Promoting Characteristics of the Fermented Beverage Kefir.” Frontiers in microbiology vol. 7 647. 4 May. 2016, doi:10.3389/fmicb.2016.00647
Licciardone, John C et al. “Recovery From Chronic Low Back Pain After Osteopathic Manipulative Treatment: A Randomized Controlled Trial.” The Journal of the American Osteopathic Association vol. 116,3 (2016): 144-55. doi:10.7556/jaoa.2016.031
Maher, C G. “Effective physical treatment for chronic low back pain.” The Orthopedic clinics of North America vol. 35,1 (2004): 57-64. doi:10.1016/S0030-5898(03)00088-9
Will, Joshua Scott et al. “Mechanical Low Back Pain.” American family physician vol. 98,7 (2018): 421-428.
Volleyball is a dynamic game that requires players to be fast on their feet. Players have to be able to quickly shift into various position/s, make quick movements in any direction quickly and reach the ball. Volleyball strength workouts focus on power development and maintaining safe positions when exploding through the plays. Many players include resistance training exercises in their training programs to maximize power and set a solid foundation.
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Volleyball Strength Workout
A well-rounded volleyball workout will help players strengthen and maintain optimal body health.
A recommended exercise that can be done with a resistance band.
The exercise does not require a lot of space, so it can be done almost anywhere.
It is recommended to do two-three sets of 10-15 reps.
It is recommended to consult a professional trainer that can create a diverse fitness program to make exercising/training/working out much more enjoyable.
Body Composition
How Aerobic and Resistance Training Interact
The body adjusts differently to various types of exercise. Aerobic and resistance training each tells the body to adapt in different ways. Both are important for healthy body composition, and when done in combination, it is known as concurrent training. Aerobic is best for losing fat, resistance training builds muscle that keeps the body functioning throughout the day. However, molecular mechanisms involved in aerobic and resistance adaptations can interfere with each other if not appropriately planned. Two steps to minimize any possible interference and maximize aerobic/resistance benefits:
Nutrition
Adequate protein intake is vital for muscular adaptation from resistance training.
It stimulates muscle protein synthesis after concurrent training.
After workout sessions, consume at least 25g of high-quality protein to achieve strength and hypertrophy improvements.
Recovery
When doing both aerobic and resistance training on the same day, maximize recovery time between the sessions.
Strength and aerobic fitness gains are low when the two are separated by 6 hours or less.
Twenty-four hours between sessions is the recommended time, especially if the priority is on endurance.
References
Camera, Donny M et al. “Protein ingestion increases myofibrillar protein synthesis after concurrent exercise.” Medicine and science in sports and exercise vol. 47,1 (2015): 82-91. doi:10.1249/MSS.0000000000000390
Cools, Ann M et al. “Prevention of shoulder injuries in overhead athletes: a science-based approach.” Brazilian journal of physical therapy vol. 19,5 (2015): 331-9. doi:10.1590/bjpt-rbf.2014.0109
Pereira, Ana et al. “Training strategy of explosive strength in young female volleyball players.” Medicina (Kaunas, Lithuania) vol. 51,2 (2015): 126-31. doi:10.1016/j.medici.2015.03.004
Ramirez-Campillo, Rodrigo et al. “Effects of Plyometric Jump Training on Vertical Jump Height of Volleyball Players: A Systematic Review with Meta-Analysis of Randomized-Controlled Trial.” Journal of sports science & medicine vol. 19,3 489-499. 13 Aug. 2020
Seminati, Elena, and Alberto Enrico Minetti. “Overuse in volleyball training/practice: A review on the shoulder and spine-related injuries.” European journal of sports science vol. 13,6 (2013): 732-43. doi:10.1080/17461391.2013.773090
Silva, Ana Filipa et al. “The Effect of Plyometric Training in Volleyball Players: A Systematic Review.” International journal of environmental research and public health vol. 16,16 2960. 17 Aug. 2019, doi:10.3390/ijerph16162960
Villareal, Dennis T et al. “Aerobic or Resistance Exercise, or Both, in Dieting Obese Older Adults.” The New England journal of medicine vol. 376,20 (2017): 1943-1955. doi:10.1056/NEJMoa1616338
A pinched nerve may not feel like it is healing. This is because of the soreness, aches, discomfort, and tingling feelings/sensations around the affected area. This could be the neck, shoulder, arm, hands, back, legs, and feet. However, when the achiness and tingling move around and shift, it is a sign of the pinched nerve healing.
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Amount of Time For Pinched Nerve Healing
Waiting for the nerve to heal is not a recommended treatment option, as most pinched nerves do not fully recover on their own. A pinched nerve usually takes around six weeks to heal with proper treatment. The longer the nerve stays pinched, the more likely there will be permanent damage. To keep the pinched nerve from returning and getting worse, individuals are recommended to incorporate a pre-habilitation plan that involves continuing rehabilitation exercises to strengthen and keep the muscles, ligaments, and nerves loose, and adjusting posture, work, exercise, and diet habits to prevent re-injuring the nerve or cause new injury/s.
Common Nerve Sites
Nerves run throughout the body, so it’s possible to experience a pinched nerve anywhere. The most common pinched nerve sites occur at joints where there is constant movement. These areas include:
Neck
Shoulders
Lower Back
Arms
Hands
Feet
Healing Signs
Individuals often believe that their pinched nerve is getting worse because of soreness, aches and pains, and weird sensations. When the pain stays in one area, that could be a sign that the nerve has not been fully stretched/released and/or that there is still compression taking place. Treatment and healing include feeling the symptoms but in a different way. The symptoms will move up, down, or around depending on where the pinched nerve is. Treatment takes the nerve/s and stretches/elongates them, but the pinch created a nerve crimp, crease, fold that wants to return to the pinched position. This is why continued treatment and stretching are recommended, as a spasm, trauma, or some awkward movement can cause the nerve to re-fold to the pinched position or cause a whole new pinch.
Chiropractic Release
Chiropractic treats pinched/compressed nerves with several therapeutic modalities. These include:
Body Adjustments
Flexion-distraction
Therapeutic massage
Traction
Inversion
Laser therapy
Ultrasound
Combined, these methods can help heal pinched nerves and keep them from recurring.
Body Composition
Skeletal Muscle
Skeletal muscle is a major muscle group. These muscles are attached to the bone by the tendons. Skeletal muscles incorporate nerves, blood vessels, and connective tissue to operate as a unit. Each skeletal muscle consists of cells that come together that form bundles of skeletal muscle fibers.
Strength training stimulates the muscle fibers. When combined with proper nutrition causes hypertrophy/muscle growth.
Muscles contract and shorten to pull bones and joints, allowing body movement.
The nervous system signals the nerves in the muscle/s and triggers these contractions.
Skeletal muscle helps the body:
Maintain posture
Generate body heat
Stability to the bones and joints
References
Bowley, Michael P, and Christopher T Doughty. “Entrapment Neuropathies of the Lower Extremity.” The Medical clinics of North America vol. 103,2 (2019): 371-382. doi:10.1016/j.mcna.2018.10.013
Campbell, W. “Diagnosis and management of common compression and entrapment neuropathies.” Neurologic clinics vol. 15,3 (1997): 549-67. doi:10.1016/s0733-8619(05)70333-9
England, J D. “Entrapment neuropathies.” Current opinion in neurology vol. 12,5 (1999): 597-602. doi:10.1097/00019052-199910000-00014
Kane, Patrick M et al. “Double Crush Syndrome.” The Journal of the American Academy of Orthopaedic Surgeons vol. 23,9 (2015): 558-62. doi:10.5435/JAAOS-D-14-00176
Healthy sleep plays a vital role in the body’s overall health, as it ensures muscle growth, recovery, and illness prevention. This is especially true for home D.I. Yers’ fitness enthusiasts, weekend warriors, athletes, and physically active individuals. When sleeping, the body goes into recovery mode, releasing hormones and other chemicals to repair and restore muscle. A healthy night’s sleep provides the rest the mind and body need to perform at optimal levels.
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Healthy Sleep
Sleep is vital for recovering from workouts. This could be construction work, exercise, gardening, sports, landscaping, any activity that uses bodyweight or works against some form of resistance. The muscles cannot repair themselves properly without proper sleep. Sleep aids the muscles in releasing protein-building amino acids, helping them grow in size and strength.
Growth hormone is released during non-REM sleep that stimulates tissue growth and repairs muscle.
During REM or rapid eye movement sleep, blood pressure drops, breathing slows and deepens, the brain relaxes, and blood supply to the muscles increases, feeding them oxygen and nutrients.
Unhealthy Sleep
Sleep maintains the muscles’ sharpness, coordination, function, and muscle movement patterns that improve physical performance. The body needs to sleep for at least 7 hours a night for muscles to grow properly. Not getting healthy sleep decreases protein synthesis activity and increases the activity of degradation that leads to muscle loss.
Less Sleep Leads To Eating More
Hormonal changes occur when the body sleeps less, causing individuals to feel hungry more often, increasing the amount of food taken in because after eating, the body does not feel full right away, so the individual continues to eat. Without sleep, the body decreases the production of a hormone that indicates when the body is full and activates a hormone that causes hunger. Insufficient sleep also lowers the body’s sensitivity to insulin. Because of this, the muscle fuel glycogen is not adequately replenished. Without the regular restoration of glycogen, individuals have less energy, insulin sensitivity decreases, increasing the risk of diabetes.
Physical Health
Unhealthy sleep also impacts overall physical health. Individuals that do not get healthy sleep have an increased risk of developing:
Sugar raises blood sugar, which triggers the pancreas to release insulin, fueling the cells causing overstimulation.
Eliminating sugar after dinner can help the body fall asleep.
References
Dattilo, M et al. “Sleep and muscle recovery: endocrinological and molecular basis for a new and promising hypothesis.” Medical hypotheses vol. 77,2 (2011): 220-2. doi:10.1016/j.mehy.2011.04.017
Morselli, Lisa et al. “Role of sleep duration in the regulation of glucose metabolism and appetite.” Best practice & research. Clinical endocrinology & metabolism vol. 24,5 (2010): 687-702. doi:10.1016/j.beem.2010.07.005
Murray, Bob, and Christine Rosenbloom. “Fundamentals of glycogen metabolism for coaches and athletes.” Nutrition reviews vol. 76,4 (2018): 243-259. doi:10.1093/nutrit/nuy001
Automobile accidents and crashes can cause all kinds of damage to the body even when the accident/crash is not severe. Physical symptoms might not present at all for several days, even weeks. This is known as having delayed injury symptoms. These can include:
Swelling.
Stiffness.
Aching.
Pain that radiates all over the body.
Sleep problems.
Headaches.
Brain fog.
Disorientation.
Memory problems.
Chiropractic and physical therapy rehabilitation can restore the body’s alignment, stop inflammation, loosen, stretch and strengthen the musculoskeletal system restoring optimal health.
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Adrenaline
When the body is involved in a dangerous physical situation, it protects itself by releasing a surge of adrenaline. This hormone protects the body, causing the fight or flight response when in danger. Adrenaline causes several preservation responses that include:
Intense increase in energy.
Little or no pain.
Enlarged blood vessels and airways increase oxygen flow.
Increased strength from increased blood flow to the muscles.
Changes in vision and hearing that focus on sights and sounds all around.
Endorphins are released that make the body feel calm and in control.
Endorphins affect the way the body responds to pain and stress.
Individuals don’t start feeling aches and pains until the adrenaline and endorphins wear off. However, because everybody is different and the emergency response has turned off, the body still might not feel the injury symptoms. These are delayed injury symptoms.
Rate of Speed
When riding in a vehicle, the body moves at the same speed as the vehicle. During an impact, the vehicle stops, but the body continues moving until it stops, typically with a lot of force from the seatbelt, airbag, or other barriers. The intense momentum change can cause soft tissue damage and ligament or muscle strains from the stretching, pulling, contracting, and tearing. Also, the intervertebral discs can tear, bulge, or herniate over time, creating pressure on nerves and the surrounding tissues.
Delayed Injury Symptoms
Headaches
Headaches that develop days after an accident/crash are common.
They can signal a possible injury to the neck or head, a blood clot on the brain, or a concussion.
Back pain can be caused by injury to the muscles, ligaments, nerves, or damage to the vertebrae.
Low back pain occurs in more than half of rear-impact collisions and almost three-quarters of side-impact crashes.
Chiropractic Rehabilitation
After an accident, soft tissues can sustain minimal damage; however, the minimal damage left untreated can start to worsen and turn into a painful condition. Emergency room visits are to rule out major injuries like brain/nerve injuries, bleeding, punctures, lacerated organs, fractures that require emergency stabilization. Chiropractors look for other symptoms and mechanisms that indicate damage to the body’s soft tissues and nerves to see if they have been stretched or torn and dysfunction in the nervous system.
Body Composition
Calorie Counting
Counting calories can be a stepping stone to change behavior towards food. Tracking what foods are being taken into the body promotes mindfulness of dietary habits. Studies on the subject reveal a significant association between self-monitoring and weight loss. Takeaways include:
Take small steps by saying no to second portions during dinner or take a healthy sweet snack or piece of fruit instead of a pastry, cookie, etc.
Try to start making a habit of eating less processed foods.
Meals high in protein and fiber are generally more filling, making the body feel fuller from fewer calories.
The more attention there is to the food choices, the more likely reexamination occurs.
References
Burke, Lora E et al. “Self-monitoring in weight loss: a systematic review of the literature.” Journal of the American Dietetic Association vol. 111,1 (2011): 92-102. doi:10.1016/j.jada.2010.10.008
D’Elia, Michael A et al. “Motor vehicle collision with seatbelt sign and traumatic abdominal wall hernia should raise suspicion for hollow viscus injury.” Trauma case reports vol. 22 100206. 25 May. 2019, doi:10.1016/j.tcr.2019.100206
Kacprzynski, Gregory, and Joshua Bucher. “Delayed vertebral artery dissection after mild trauma in a motor vehicle collision.” The American Journal of emergency medicine vol. 45 (2021): 678.e1-678.e2. doi:10.1016/j.ajem.2020.11.028
Olinger, Catherine, and Richard Bransford. “Upper Cervical Trauma.” The Orthopedic clinics of North America vol. 52,4 (2021): 451-479. doi:10.1016/j.ocl.2021.05.013
Sterling, Michele. “Whiplash-associated disorder: musculoskeletal pain and related clinical findings.” The Journal of manual & manipulative therapy vol. 19,4 (2011): 194-200. doi:10.1179/106698111X13129729551949
Chiropractic is a form of neuromusculoskeletal care that repairs and re-optimizes the nervous system that helps to relieve tension, inflammation, pain and restore body health. Like any piece of machinery that requires regular maintenance to operate correctly without issues, so too is the body an exquisite machine that needs regular maintenance. Treatment restores and maintains optimal function to the nervous system, muscles, bones, tendons, ligaments, and joints.
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Neuromusculoskeletal Care
Central Nervous System – CNS
The Central Nervous System or CNS is the body’s computer.
It processes functions in the body and mind.
It s made up of the brain and spinal cord.
It helps process external information through sight, sound, touch, smell, and taste.
The CNS interprets sensory information that goes through the spinal cord to the brain, and the body responds accordingly.
It controls voluntary movements like walking, talking, exercising.
It controls involuntary movements like blinking, breathing, digestion.
It allows thoughts, emotions, and perceptions to be created and expressed.
When the Central Nervous System works correctly, the body is coordinated, all senses send and receive information effectively, and cognition/thinking is clear.
Peripheral Nervous System – PNS
The Peripheral Nervous System or PNS transmits signals from the outside to the Central Nervous System.
The PNS is comprised of all the nerve bundles that run throughout the body.
The PNS is responsible for transmitting information back and forth from the CNS to the rest of the body by electrical impulses and current.
When the PNS is functioning correctly, and there is thorough nerve circulation throughout the body, there are no issues like numbness, weakness, pain, and digestion is in top form.
Enteric Nervous System – ENS
The Enteric Nervous System or ENS is a branch of the peripheral nervous system that signals the digestive system.
It comprises nerves that stretch across the entire gastrointestinal tract.
It allows the nervous system to communicate with the digestive tract and regulate activity.
It can stop the digestive process when the body is under stress or strain, i.e., fight or flight response.
Inflammation and stress can cause the enteric system to disrupt and cause digestive problems.
Pain Relief
Body pain can be an indication of an imbalance in the nervous system. Misalignment from work, home activities, trauma, injury, or posture problems, a subluxation/misalignment can turn into discomfort that leads to pain and neuromusculoskeletal system issues. Pain in the neuromusculoskeletal system can result from spinal misalignment and a shifting skeletal structure. The joints and misaligned bones compress the surrounding nerves and tissue, causing inflammation that results in pain symptoms. This causes the muscular system to compensate for the lack of stability support from the skeletal structure causing awkward body posturing. A chiropractor realigns the spinal structure, removing the compression/pressure from the nerves, tissues, muscles, ligaments, and tendons.
Body Composition
Chiropractic Medicine
The nervous system is highly responsive to chiropractic care because of chiropractic’s focus on the spine, which restores and rejuvenates. Chiropractic medicine and a properly aligned spine:
Reduces and eliminates pain.
Reduces and eliminates headaches and migraines.
Improves balance and coordination.
Improves digestive function.
Improves quality of sleep.
Increases energy.
Increases flexibility and mobility.
Enhances cognition and clear thinking.
References
Goudman, Lisa et al. “The Link Between Spinal Cord Stimulation and the Parasympathetic Nervous System in Patients With Failed Back Surgery Syndrome.” Neuromodulation: journal of the International Neuromodulation Society vol. 25,1 (2022): 128-136. doi:10.1111/ner.13400
Gyer, Giles et al. “Spinal manipulation therapy: Is it all about the brain? A current review of the neurophysiological effects of manipulation.” Journal of integrative medicine vol. 17,5 (2019): 328-337. doi:10.1016/j.joim.2019.05.004
Millet, Guillaume Y et al. “The role of the nervous system in neuromuscular fatigue induced by ultra-endurance exercise.” Applied physiology, nutrition, and metabolism = Physiologie appliquee, nutrition et metabolisme vol. 43,11 (2018): 1151-1157. doi:10.1139/apnm-2018-0161
Stoll, T et al. “Physiotherapie bei lumbaler Diskushernie” [Physiotherapy in lumbar disc herniation ]. Therapeutische Umschau. Revue therapeutique vol. 58,8 (2001): 487-92. doi:10.1024/0040-5930.58.8.487
For older individuals, experiencing frequent low back pain could turn out to be a sacral fracture. They tend to occur in individuals over the age of 60 often because there has been a degree of bone loss. Sacral fractures tend not to be the first thing doctors think of when low back pain symptoms are presenting. They are often not picked up on X-rays and are either not diagnosed early enough to take steps or not diagnosed at all. However, they are common.
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Sacrum
The sacrum is shaped like a triangle and comprises five segments fused into one large bone. It sits at the base of the spine, between the two halves of the pelvis, connecting the spine to the lower half of the body. It stabilizes the body when walking, sitting, or standing. The nerves in the lower spine control the bowels bladder and provide sensation to the region.
The two dimples that can be seen on individuals’ backs are where the sacrum joins the hipbones or the sacroiliac joint.
The point where the low back joins the sacrum can develop discomfort, soreness, and pain.
This area experiences stress from bending, twisting, reaching, lifting, carrying during physical activities or sitting for long periods.
Sacral Fracture
Most sacral fractures result from trauma, like slips, falls, and automobile accidents. Stress fractures that happen without a specific injury are also called insufficiency fractures.
Types of Sacral Fractures
Low-energy fractures usually happen to older individuals with weak bones due to osteoporosis.
An individual trips on something, lands hard on their butt, lifts a heavy object awkwardly, or over-exerts themselves from some physical activity.
Then persistent back or buttock pain begins to present.
The pain is often centered in the lower back, the hips, and butt.
It is more than just back achiness.
The individual goes to the doctor, and X-rays are ordered.
A lot of the time, these fractures are missed on X-rays.
The doctor may diagnose a sprain, but the pain symptoms do not improve.
Sometimes there is no apparent cause for the pain.
It can be misdiagnosed as a lower back compression fracture or urinary tract infection.
High-energy fractures are due to trauma and are more common among the young.
The individual sustains injuries from an auto accident, has fallen from a significant height, or suffers a sports injury.
It results in severe pain.
A woman who has just had a baby and gone through some bone loss because of the pregnancy can experience a sacral stress fracture.
For individuals that have been to a doctor and had an X-ray that reveals no fracture, and there is no improvement after 5 to 7 days, it is recommended to schedule another appointment and ask for a CAT scan or MRI, which is highly effective at finding a sacral fracture.
Treatment
Treatment consists of resting the bone but still being safely active in most cases.
Medication is prescribed for pain relief.
Many individuals have been found to do well with anti-inflammatory medications, topical medications, and lidocaine patches.
Older individuals may be recommended to use a walker during the treatment/healing process.
Depending on the severity, crutches may be recommended.
Engaging in regular exercise is not recommended, but too much bed rest is also not recommended.
Too much rest may not allow the injury to heal correctly, worsen the injury, and/or cause new injuries.
Chiropractic and physical therapy are not recommended to let the sacrum naturally heal.
After the pain subsides, chiropractic and physical therapy can be implemented to maintain agility and flexibility and strengthen the pelvic and core muscles.
In some cases, if the bone does not heal correctly or some other issue, sacroplasty could be recommended. This is a minimally invasive procedure that injects bone cement into the fracture. It offers quick and long-lasting pain relief with a low percentage of complications. It is considered low risk and can be done by an interventional radiologist or spine surgeon.
Prevention
To minimize the risk of a sacral fracture, it is highly recommended to maintain bone strength. This consists of:
Try to keep moving with different exercise stretches, or take a lap around the building.
References
Gibbs, Wende Nocton, and Amish Doshi. “Sacral Fractures and Sacroplasty.” Neuroimaging clinics of North America vol. 29,4 (2019): 515-527. doi:10.1016/j.nic.2019.07.003
Holmes, Michael W R, et al. “Evaluating Abdominal and Lower-Back Muscle Activity While Performing Core Exercises on a Stability Ball and a Dynamic Office Chair.” Human factors vol. 57,7 (2015): 1149-61. doi:10.1177/0018720815593184
Santolini, Emmanuele et al. “Sacral fractures: issues, challenges, solutions.” EFORT open reviews vol. 5,5 299-311. 5 May. 2020, doi:10.1302/2058-5241.5.190064
Stretching Fundamentals: Stretching benefits the body by keeping the muscles flexible, strong, healthy, and able to maintain optimal physical performance. As with any other discipline stretching correctly requires using the proper form, correct technique, and practicing regularly. The angles need to be accurate; the body has to move at the right speed and maintain correct posture. The focus should be moving the joint as little as possible as the muscle/s stretch and elongate.
Contents
Stretching Fundamentals
Stretching should become a daily activity that turns into a healthy habit. The muscles need frequent maintenance from daily/nightly bending, twisting, reaching, carrying, and lifting work. This is especially true for individuals dealing with constant soreness, aches, pains, and problems with tight, tense, and stressed-out muscles. When the body is stressed, heart rate increases, and individuals tend to tighten up. Stretching benefits include:
Stress relief.
Increased muscle blood flow.
Increased body flexibility.
Helps joints move through their full range of motion.
Improves performance in physical activities.
Decreases soreness, aches, and pains.
Injury prevention.
Improves posture.
Improves sleep.
Preps the body for exercise and activities.
Improves mental health.
Human nature is to take the path of least resistance, which makes the body feel flexible and comfortable. This is a common reason individuals consider stretching unnecessary or too painful to engage in. However,stretching fundamentals need to be maintained as stretching carelessly or poorly can negatively affect other muscles and joints and worsen injuries/conditions.
Guidelines
To stretch safely, it is recommended to do a proper warm-up, stretch slowly, working the right muscles and joints. The guidelines make stretching safer, more effective, and increase body awareness.
Warm-Up
Warming the muscles increases blood flow.
Warming up muscles before physical activity/workout is crucial for preventing injuries and maximizing effectiveness.
Dynamic stretching involves moving into and out of positions through a full range of motion rather than holding a stretch for a prolonged period.
Dynamic stretches are recommended to be held for 2-3 seconds for 4-6 repetitions.
Take It Slow
Stretching out too fast can make the body think that the muscle is about to get torn or injured.
To protect the muscle, it contracts, preventing it from reaching the full stretch.
This is why the correct technique needs to be observed.
A couple of degrees in the wrong direction can mean the difference between a healthy stretch and pulling a joint capsule causing injury.
Body Composition
Muscle Recovery
When engaged in physical activity, exercise, or working, microscopic tears are happening to muscle cells. Because of the body’s stress and fatigue, hormone and enzyme levels fluctuate, and inflammation increases. This helps in fat loss, increases metabolism, increases strength and muscle growth. However, these benefits only happen with proper recovery. Different types of recovery include:
Immediate Recovery
These are the quick moments’ in-between physical movements.
For example, the time between each stride when jogging.
Short-Term Recovery
This is the time between activities or sets of exercises.
For example, the rest periods between doing a heavy job or sprint intervals.
Training Recovery
This is the time between when one workout or job ends, and the next begins.
There is no one size fits all, as everyone’s body is different; it is recommended to consult with a trainer or fitness expert and experiment with what feels right.
For some individuals, 24 hours is enough.
For others, it can take 48 or 72 hours to feel fully recovered.
Other factors that affect recovery are:
Age
Fitness level
Work/exercise intensity
Diet
Sleep
References
Behm, David G, and Anis Chaouachi. “A review of the acute effects of static and dynamic stretching on performance.” European Journal of applied physiology vol. 111,11 (2011): 2633-51. doi:10.1007/s00421-011-1879-2
Freitas, S R et al. “Stretching Effects: High-intensity & Moderate-duration vs. Low-intensity & Long-duration.” International journal of sports medicine vol. 37,3 (2016): 239-44. doi:10.1055/s-0035-1548946
Hotta, Kazuki et al. “Daily muscle stretching enhances blood flow, endothelial function, capillarity, vascular volume and connectivity in aged skeletal muscle.” The Journal of physiology vol. 596,10 (2018): 1903-1917. doi:10.1113/JP275459
Kataura, Satoshi et al. “Acute Effects of the Different Intensity of Static Stretching on Flexibility and Isometric Muscle Force.” Journal of strength and conditioning research vol. 31,12 (2017): 3403-3410. doi:10.1519/JSC.0000000000001752
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