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Hip Sprain

Hip Sprain

The hips are highly active joints. Hip sprains are rare but do occur. A hip sprain is caused by tearing or stretching the ligaments that surround the hip and join the bones to each other. This is different from a hip strain, which is an injury to the muscles and is generally caused by over-use of the hip flexor muscles and tendons, causing them to tear. Hip sprains usually happen after a fall or a sudden twisting motion, which can occur during sports or an accident.

Individuals involved in sports that require quick stops, body shifting, and sudden direction changes, like soccer, football, basketball, tennis, volleyball, etc., have an increased risk. Most hip sprains can be effectively treated with conservative treatments like self-massage, rest, ice, and nonsteroid anti-inflammatory medications. For more severe cases, physical therapy and chiropractic can treat the condition.

Hip Sprain

Hip Sprain Symptoms

  • Tenderness in the hip increases when lifting the thigh.
  • Cramping sensation/s in the muscles of the upper leg.
  • Swelling in the hip or thigh
  • Bruising in the hip or thigh.
  • Sudden pain in the hip or pelvis.
  • Sharp pain in the hip or pelvis.
  • Pain that worsens when walking, running, or stretching the hip muscles.
  • Loss of strength in the front of the groin.
  • Tugging or pulling sensation.
  • Limping.

Diagnosis

The doctor or chiropractor will:

  • Look into medical history.
  • Inquire about symptoms.
  • Inquire about activities that could cause symptoms.
  • Perform a physical examination.
  • Ask the individual to perform a variety of movements to determine what type of injury has been sustained.
  • Other conditions could cause radiating pain.
  • Pain in one or both hips might not have anything to do with the hips but a pinched nerve root in the lower back.
  • Sciatica can develop when certain nerve roots in the lower back are irritated or compressed, causing symptoms to travel down the sciatic nerve and radiate around the pelvis and leg.
  • X-rays can help rule out hip stress fractures, which can have similar symptoms.
  • MRI or CT scans are used to see if any soft tissue damage has occurred.

Hip Sprain Treatment

  • Treatment usually begins with over-the-counter pain medications and anti-inflammatories to reduce swelling and relieve pain.
  • Resting the hip will help prevent further damage.
  • Applying ice will help prevent tissue damage and reduce swelling.
  • It is recommended to use an ice pack several times a day for the first 48 hours after an injury.
  • Once the swelling goes down, a chiropractor and physical therapy team will create a personalized treatment plan that includes:
  • Adjustments.
  • Exercise therapy.
  • Posture training.
  • Stretching.
  • Massage.

Treatment/Rehabilitation Objectives

  • Reduce inflammation.
  • Relax muscle spasms.
  • Strengthen weakened muscles.
  • Improve joint mobility.

Individuals will be shown how to prevent the risk of sprains in the future. This includes:

  • Avoiding exercising when the body is tired
  • Wearing proper footwear and protective equipment
  • Warming up properly before exercise/physical activities.

Depending on the severity of the sprain, surgery could be the last resort to repair the ruptured or torn ligaments.


Body Composition


Realistic Goals

Not seeing results after putting in the work through exercise and diet can be frustrating. Setting realistic goals can help when results are not showing.

Realistic Fat Loss

  • Do not expect actual fat loss without being in a caloric deficit.
  • The body needs to use more energy than the amount of food/energy taken in; otherwise, excess energy/food gets stored, primarily as adipose tissue.
  • Total Daily Energy Expenditure or TDEE is necessary to set a realistic caloric deficit to achieve measurable fat loss.
  • There are caloric deficit variations, but most doctors, dieticians, trainers, and fitness experts agree that a caloric deficit of around 500 calories a day that equals to about 3,500 calories a week will result in a pound of fat loss per week.
  • One pound of fat a week lost might seem slow, but the one pound of fat is a real pound removed.
  • The long-term goal is not to fall back into unhealthy habits and develop and maintain new healthy ones.
References

Brantingham JW, Globe GA, Cassa TK, et al. A single-group pretest posttest design using full kinetic chain manipulative therapy with rehabilitation in the treatment of 18 patients with hip osteoarthritis. Journal of Manipulative and Physiological Therapy 2012; 33(6): 445-57.

Kamali, Fahimeh and Esmaeil Shokri. The effect of two manipulative therapy techniques and their outcome in patients with the sacroiliac joint syndrome. Journal of Bodywork and Movement Therapies. 2012; 16: 29-35.

McMorland G, Suter E, Casha S, du Plessis SJ, Hurlbert RJ. Manipulation or microdiscectomy for sciatica? A prospective randomized clinical study. Journal of Manipulative and Physiological Therapeutics. 2010; 33(8): 576-584.

Tibor, Lisa M, and Jon K Sekiya. “Differential diagnosis of pain around the hip joint.” Arthroscopy: the journal of arthroscopic & related surgery: official publication of the Arthroscopy Association of North America and the International Arthroscopy Association vol. 24,12 (2008): 1407-21. doi:10.1016/j.arthro.2008.06.019

Wedro, Benjamin. “Hip Pain: Causes, Symptoms, Treatment Information and Diagnosis-eMedicineHealth.” www.emedicinehealth.com/hip_pain/article_em.htm.

Tremors and Spinal Cord Compression

Tremors and Spinal Cord Compression

Tremors are extremely rare, but they can result from spinal compression and not necessarily a brain condition like Parkinson’s disease. Tremors are abnormal, involuntary body movements with various causes, most of which are connected to the brain and not the spine. A study reports that more than 75% of individuals with Parkinson’s experienced a resting tremor, and about 60% experience tremors while moving. Sometimes the spine is the contributor caused by compression of the spinal cord.

Tremors and Spinal Cord Compression

Spinal Compression Study

A 90-year-old man was hospitalized after having tremors, with Parkinson’s being the initial diagnosis. The tremors progressed to the point where the man could not feed himself or walk without support. The case became the focus of a medical report published by physicians in the Department of Orthopaedic Surgery, Division of the Spine, Singapore Tan Tock Seng Hospital. Along with the tremors, symptoms progressed to:

  • Difficulty with fine motor skills like buttoning a shirt.
  • However, it was ruled out because the patient was not presenting with other Parkinson’s symptoms.
  • What was found from the symptoms was cervical spondylotic myelopathy, which is a spinal cord compression in the neck.
  • The compression was caused by a herniated disc impinging the spinal canal and compressing the spinal cord causing spinal stenosis.
  • The compression was resolved by having an ACDF surgical procedure.
  • An anterior cervical discectomy and fusion or ACDF procedure can help manage the condition.
  • An ACDF treats spinal cord compression by removing a degenerative or herniated disc in the neck.

Cervical Myelopathy

Causes of cervical spondylotic myelopathy include:

Common symptoms include:

  • Balance problems
  • Coordination problems
  • Tingling in the hands
  • Numbness
  • Weakness
  • Impairment of fine motor skills

Tremors as a symptom are rare.

Cervical Myelopathy vs. Parkinson’s Disease

There are cases where cervical spondylotic myelopathy and Parkinson’s disease symptoms can overlap. Studies have shown difficulties between the two diagnoses, as well as, individuals with Parkinson’s may exhibit symptoms similar to cervical spondylotic myelopathy that can include:

  • Weakness
  • Lack of coordination
  • Bowel dysfunction
  • Bladder dysfunction

Treatment Cervical Myelopathy Tremors

For individuals with cervical spondylotic myelopathy tremors, surgery can be used to help the condition. However, with cervical myelopathy, there is often some permanent damage. Individuals have shown that post-surgery and decompression, symptoms still present, maybe not as much, but there will be a need for a symptom management plan.

Prevention

The best way to prevent tremors associated with cervical spondylotic myelopathy is to minimize the strain on the spine that can lead to herniated discs and/or other spinal injuries. The discs in the spine degenerate, dry out and start cracking with age, increasing the risk of rupture. If a tremor develops, contact a doctor, spine specialist, or chiropractor to help diagnose the condition. These doctors can perform physical and neurological tests to determine the cause and treatment options.


Body Composition


Aging Health

Steady weight gain throughout life can lead to adult-onset diabetes. This is partly caused by having more body fat and progressive muscle loss. Loss of skeletal muscle mass is linked to insulin resistance that involves:

  • The less muscle is available, the less insulin sensitive the body becomes.
  • As insulin sensitivity decreases, the body becomes more resistant, increasing risk factors for type II diabetes.
  • This can lead to osteoporosis, where the old bone is reabsorbed more and less new bone is created.

Both men and women can experience decreased muscle mass that can lead to:

  • Thinner bones
  • Weaker bones
  • Increased risk of osteoporosis and severe injury from falls.

To help prevent these issues, it is recommended to:

  • Eat sufficient protein throughout the day.
  • It is recommended to space out protein intake across meals rather than consuming it all at once. This helps to ensure the proper amount is acquired.
  • Monitoring body composition regularly can help minimize muscle mass loss and fat mass gain as the body ages.
  • A regular strength training routine will help strengthen bones muscles and maintain optimal circulation.
References

Heusinkveld, Lauren E et al. “Impact of Tremor on Patients With Early Stage Parkinson’s Disease.” Frontiers in neurology vol. 9 628. 3 Aug. 2018, doi:10.3389/fneur.2018.00628

Jancso, Z et al. “Differences in weight gain in hypertensive and diabetic elderly patients primary care study.” The Journal of nutrition, health & aging vol. 16,6 (2012): 592-6. doi:10.1007/s12603-011-0360-6

Srikanthan, Preethi, and Arun S Karlamangla. “Relative muscle mass is inversely associated with insulin resistance and prediabetes. Findings from the third National Health and Nutrition Examination Survey.” The Journal of clinical endocrinology and metabolism vol. 96,9 (2011): 2898-903. doi:10.1210/jc.2011-0435

Tapia Perez, Jorge Humberto et al. “Treatment of Spinal Myoclonus Due to Degenerative Compression Myelopathy with Cervical Spinal Cord Stimulation: A Report of 2 Cases.” World neurosurgery vol. 136 (2020): 44-48. doi:10.1016/j.wneu.2019.12.170

Squat Exercises Causing Low Back Pain

Squat Exercises Causing Low Back Pain

Squat exercises are highly effective, as they strengthen the back and core muscles, helping the prevention of injury. They can be done anywhere with or without equipment like weights and resistance bands and can be part of an aerobic workout. Squatting requires following proper form and posture. Using the improper form, adding too much weight too soon, overdoing it without enough recovery time can cause soreness, back pain, and injury. Having muscle soreness after performing squats is expected; however, if symptoms like chronic soreness, tingling, numbness, or sharp aches that come and go, begin to appear, it is recommended to consult a medical trainer, chiropractor, doctor, or spine specialist to evaluate the symptoms, and if necessary develop a treatment plan, as well as a prevention plan to continue exercising safely.

Squat Exercises Causing Low Back Pain

Squat Exercises

Squatting is a highly beneficial form of exercise. Athletes, trainers, coaches, and individuals just staying healthy use the technique as a part of their training and workouts. This is because squatting increases core muscle strength, increasing body power. Squat exercises benefits include:

Increased Flexibility

  • Improved strength and a range of motion allow the body to move flawlessly in various directions with minimal effort.

Increased Core Strength

  • All major muscles work together during a squat.
  • This increases muscle stabilization, maintains body balance, increasing core strength.

Injury Prevention

  • Squats work all leg muscles simultaneously, synchronizing the body.
  • This increases body stability decreasing the risk of injury.

Back Pain and Potential Injury

The spine is exposed and unprotected during a squat. This is where back pain and injury can happen. Potential causes include:

  • Not warming up/priming muscles properly.
  • Tight muscles and a limited range of motion.
  • Improper form and squatting technique.
  • Adding weight or loading too soon.
  • Weak core muscles.
  • Incorrect or improper footwear with inadequate arch support.
  • Weak ankle muscles are not used to the weight and shift, causing misalignment and awkward positioning.
  • Previous injuries to the lower back can cause a flare-up to the area and potentially worsen.

Prevention

Ways to troubleshoot and prevent back pain during squat exercises.

Warmup

  • Using a proper and effective warmup will ensure that the body is ready for the workout stress.
  • Priming each muscle is recommended. This could be:
  • Starting with glute work.
  • Then planks to activate the core.
  • Finish off with stretching and range of motion exercises.
  • A personal trainer can assist in creating a customized workout routine.

Starting Position

  • The feet should always face forward to protect the hips and knees when beginning a squat.
  • If the feet face at an angle, the form can be impacted, leading to back pain or collapsing arches.

Spinal Alignment

  • Maintaining a straight-ahead or upward gaze, which increases center awareness during squat exercises, can prevent the body from leaning forward and placing stress on the spine.
  • Only squat as far as possible, making sure to feel in control and maintain the form.
  • Squatting too deep can cause muscle strain leading to pain.
  • Focus on form, as it is more important than depth.

Joint mobility

  • Ankle mobility and stability are essential to balance and control.
  • If the ankle is compromised, the feet could lift off the floor, forcing the body to compensate, leading to strain and potential injuries.
  • Only squat as far as ankle stability allows.
  • Ankle flexibility exercises will help improve squat form.

Variations

A chiropractor or physical therapist will be able to evaluate spinal health, exercise form, and advise if there is an issue.


Body Composition


Achieve Health and Fitness Goals By Doing What You Enjoy

Don’t engage in workouts or fitness programs that make you miserable. Do workouts/activities that you enjoy and have fun doing. Exercise for the love of the body, keeping it healthy and in shape, not because there is a feeling of obligation.

  • Try and experiment with different workouts/physical activities to see and feel what works for you.
  • Individuals who don’t like lifting weights try using resistance bands or bodyweight exercises.
  • The same goes for nutrition. Don’t base diet and supplement choices on misperceptions about health.
References

Calatayud, Joaquín et al. “Tolerability and Muscle Activity of Core Muscle Exercises in Chronic Low-back Pain.” International journal of environmental research and public health vol. 16,19 3509. 20 Sep. 2019, doi:10.3390/ijerph16193509

Clark, Dave R et al. “Muscle activation in the loaded free barbell squat: a brief review.” Journal of strength and conditioning research vol. 26,4 (2012): 1169-78. doi:10.1519/JSC.0b013e31822d533d

Cortell-Tormo, Juan M et al. “Effects of functional resistance training on fitness and quality of life in females with chronic nonspecific low-back pain.” Journal of back and musculoskeletal rehabilitation vol. 31,1 (2018): 95-105. doi:10.3233/BMR-169684

Donnelly, David V et al. “The effect of the direction of gaze on the kinematics of the squat exercise.” Journal of strength and conditioning research vol. 20,1 (2006): 145-50. doi:10.1519/R-16434.1

Zawadka, Magdalena et al. “Altered squat movement pattern in patients with chronic low back pain.” Annals of agricultural and environmental medicine: AAEM vol. 28,1 (2021): 158-162. doi:10.26444/aaem/117708

Sports Specific Performance Training

Sports Specific Performance Training

Sports-specific performance training is an approach to develop an athlete’s full potential in their sport. This involves three different factors: physical, technical, and experience. Physical ability is the exercise physiology that consists of strengthening and conditioning the body to handle the conditions of the sport. This includes:

  • Strength
  • Power
  • Speed
  • Endurance
  • Mobility
  • Stability
  • Flexibility
  • Balance

Technical ability involves the skill sets needed for the sport. This includes:

  • Running
  • Jumping
  • Kicking
  • Throwing
  • Catching
  • Hitting
  • Sliding

And finally is the athlete’s experience. This takes the knowledge, combined with the physical and technical abilities brought together to perform at optimum levels. However, it all begins with physical ability that needs to be developed. Even naturally gifted individuals need to develop their physical ability.

Sports Specific Performance Training

Sports Specific Performance Training

Strength & conditioning objectives are to develop the whole athlete. This involves:

An athlete’s health takes into consideration their body composition and current or past injuries. Along with injuries, the athlete’s mobility, flexibility, and stability are examined to determine if these were among the contributors or conditions that caused or could lead to an injury. Strength & conditioning is used so an athlete can return to play and allow them to be more resilient to injuries. Maintaining the body’s health means:

  • Keeping track of nutrition by making healthy food choices.
  • Maintaining proper hydration levels.
  • Allowing the body to recover from training thoroughly.
  • Keeping the body loose and flexible through chiropractic sports massage or a personal training therapist.

Mobility, Flexibility, and Stability

If an athlete is mobile and flexible but not stable, it increases the risk of sustaining an injury. The same can be said of an athlete with stability but limited mobility.

Athletic Mindset

An athlete’s mindset can win or lose games.

  • Athletes are encouraged to push themselves to see what they are capable of, which relies on mental strength.
  • Athletes that doubt their ability become their own worst critics and hold themselves in low self-esteem tend to underperform or become overly cautious when competing.
  • This is where a sports psychologist can help an athlete overcome any confidence issues.

Athleticism

Developing athleticism involves strength, power, speed. These physical attributes allow athletes to perform within their technical and strategical abilities.

  • It is recommended to spend 10-15 minutes warming up with each sports-specific performance training session. The warm-up:
  • Primes for the athlete’s nervous system.
  • Increases blood flow to the muscles.
  • Prepares the joints for optimal function.

Warm-ups can consist of:

  • Foam rolling
  • Breathing drills
  • Static stretching
  • Corrective exercises
  • Movement preparation
  • Movement skills

Speed training addresses linear, lateral, and multi-directional speed. The objective is to keep athletes learning and developing better reaction skills while maintaining high-quality movement. Speed training can last 10 to 15-minutes with the number of repetitions.

Strength training follows an individualized system for each athlete based on an initial evaluation. The objective is to eliminate any weaknesses that an individual may have and develop functional strength, giving the athlete the ability to take that strength onto the field, court, mat, etc.

It is essential to understand how the body moves. Kinesiology and programming parameters involve – sets, repetitions, overall training volume, and the body’s response to the stimulus.


Body Composition


Exercise and Blood Pressure

Blood pressure typically rises naturally as the body ages.  The American Heart Association recommends individuals get at least 150 minutes of moderate-intense aerobic exercise or 75 minutes of vigorous aerobic activity each week. This can be split up into 30 minutes per day on at least five days a week or in 10 minute short sessions throughout the day.  Aerobic exercise can include:

  • Walking
  • Dancing
  • Running
  • Cycling
  • Hiking
  • Swimming

Resistance Training

Research suggests that resistance training with bands or weights can supplement aerobic exercise to reduce blood pressure. It is recommended to complete 2 to 4 sets of 8 to 12 repetitions for each major muscle group during workouts. It is recommended that resistance training be spaced out throughout the week to limit the potential muscle soreness that can lead to injury. Resistance training can include:

  • Weight machines like chest press, shoulder press, etc.
  • Free weights like dumbbells, barbells, etc.
  • Resistance band exercises
References

Bahr, R, and T Krosshaug. “Understanding injury mechanisms: a key component of preventing injuries in sport.” British journal of sports medicine vol. 39,6 (2005): 324-9. doi:10.1136/bjsm.2005.018341

Iaia, F Marcello et al. “High-intensity training in football.” International journal of sports physiology and performance vol. 4,3 (2009): 291-306. doi:10.1123/ijspp.4.3.291

Jeukendrup, Asker E. “Periodized Nutrition for Athletes.” Sports medicine (Auckland, N.Z.) vol. 47,Suppl 1 (2017): 51-63. doi:10.1007/s40279-017-0694-2

Kraemer, William J, and Nicholas A Ratamess. “Fundamentals of resistance training: progression and exercise prescription.” Medicine and science in sports and exercise vol. 36,4 (2004): 674-88. doi:10.1249/01.mss.0000121945.36635.61

Nagorsky, Eugen, and Josef Wiemeyer. “The structure of performance and training in esports.” PloS one vol. 15,8 e0237584. 25 Aug. 2020, doi:10.1371/journal.pone.0237584

Neuroregeneration: Growing Nerve Cells

Neuroregeneration: Growing Nerve Cells

Neuroregeneration could become an option for spinal cord injury treatments in the future. A spinal cord injury or SCI is when there is damage to the bundle of nerves and cells that send and receive signals from the brain and body. A spinal cord injury can be caused by direct trauma/injury to the cord or damage to the tissue and vertebrae. The damage can result in temporary or permanent changes in:

  • Sensation
  • Movement
  • Strength
  • Body function/s below the injury site.

There are incomplete and complete injuries. Injuries that cause limited or no cell death can achieve a full recovery. Injuries that are more serious and/or are higher on the spinal cord can cause permanent damage and/or paralysis. Automobile crashes, accidents, and serious falls are the most common causes of spinal cord injuries.

  • An incomplete injury means the cord can still transmit messages, but there is interference/disturbance.
  • A complete injury means communication and motor function/voluntary body movement is not transmitting.

Neuroregeneration: Growing Nerve Cells

Symptoms

Symptoms of a spinal cord injury include:

  • Unnatural or awkward positioning of the spine or head.
  • Pain or pressure in the head, neck, or back.
  • Numbness
  • Tingling
  • Loss of or changes in sensation in the hands and feet.
  • Problems with walking.
  • Weakness or inability to move parts of the body.
  • Loss of movement.
  • Paralysis can occur immediately or develop over time as swelling and bleeding affect the cord.
  • Loss of bladder and bowel control.
  • Changes in sexual function.
  • Difficulty breathing.

SCI Damage Control

A spinal cord injury affects the central nervous system, the body’s central headquarters. Damage can cause complications through what’s called the secondary injury cascade, which is a series of chemical reactions the body activates to help the situation. However, if the chemical response does not stop and stays active, it can worsen the injury. The body recognizes that an emergency has occurred and tries to go into a shut-down mode that kills off some of the cells in the central nervous system. When a spinal injury happens, treatment focuses on stopping the damage as quickly as possible to stop the injury cascade and prevent as much cell death as possible. This act is called neuropreservation, meaning that the team is trying to preserve and save as many nerve cells as possible.

Injury Neuroregeneration Treatment Studies

While current treatment primarily focuses on stopping as much damage as possible then going through physical therapies to maintain spinal alignment and rehabilitate the body, the future of injury treatment is looking towards regrowing and repairing the damaged nerve cells through a process known as neuroregeneration. Repairing nerves that have been damaged could change life for many. Neuroregeneration Treatments being studied include:

Surgery

  • A study in The Lancet Neurology presents how getting surgery as soon as possible after an injury can provide significant benefits.
  • The findings could change all of the guidelines for spinal cord injury.

Medication

  • A study on Riluzole, a medication that has shown promise to slow down nerve cell damage.
  • A team completed a randomized controlled trial for the medication; soon, the final results will be available.

Antibody treatment

Antibodies are being studied in two ways.

  • To stop nerve cells from being damaged.
  • To help damaged nerve cells regenerate.

Stem cells

  • Scientists are studying ways to grow new nerve cells from an individual’s stem cells without the need for embryonic stem cells.
  • Specialized stem cells could also be used to help other nerve cells regenerate.

Electrical stimulation

  • Another approach is using electrical stimulation to restore function in the spinal cord.
  • Therapy that could help a paralyzed individual walk again.

The Future of Neuroregeneration

Aside from early surgery intervention, most neuroregenerative treatments are not ready or accessible yet. There’s still much more research before it can become a mainstream treatment option. Treatment that involves regenerating nerve cells will take longer than a treatment designed to protect nerve cells. However, more clinical trials are expected to be done in the next few years, with stem cell therapies taking the longest. Some of these therapies could be ready to be used on actual patients in 5-10 years.


Body Composition


The Importance of Measuring Body Composition

Most diet and fitness programs focus on weight loss or gain. However, they tend to overlook that individuals have completely different body compositions. Body composition describes the amount of:

  • Fat
  • Bone
  • Water
  • Muscle
  • In the body.

Measuring body composition can tell a body’s unique makeup and help identify areas to work on to improve overall health and wellness. Body composition analysis provides a snapshot of an individual’s health/fitness levels to help achieve health goals from the inside out.

References

Aguilar, Juan et al. “Spinal cord injury immediately changes the state of the brain.” The Journal of neuroscience: the Official Journal of the Society for Neuroscience vol. 30,22 (2010): 7528-37. doi:10.1523/JNEUROSCI.0379-10.2010

Badhiwala, Jetan H; Wilson, Jefferson R; Witiw, Christopher D; et al. (February 2021). The Lancet Neurology Vol. 20, No. 2, P. 117. The Influence of Timing of Surgical Decompression for Acute Spinal Cord Injury: A Pooled Analysis of Individual Patient Data. DOI: 10.1016/S1474-4422(20)30406-3

Chari, Aswin et al. “Surgical Neurostimulation for Spinal Cord Injury.” Brain sciences vol. 7,2 18. 10 Feb. 2017, doi:10.3390/brainsci7020018

Post Spine Surgery Physical Therapy

Post Spine Surgery Physical Therapy

Post spine surgery physical therapy or PT is the next phase after a discectomy, laminectomy, fusion, etc., to gain optimal mobility and ease the transition for a full recovery. A chiropractor and physical therapist team will help with proper muscle training and activation, pain and inflammation relief, postural training, exercises, stretches, and educate the individual on an anti-inflammatory diet. Physical therapy post spine surgery reduces:

  • Scar tissue
  • Inflammation
  • Muscle weakness
  • Muscle tightness
  • Joint stiffness

Post Spine Surgery Physical Therapy

The therapy also identifies and treats any issues that caused or contributed to the spinal damage/injury. A study found physical therapy to improve postoperative ambulation, pain, disability, and decreased surgical complications.

Post Spine Surgery Physical Therapy Goals

Physical therapy goals are to return the individual to full function before chronic pain or injury. These include:

  • Decrease pain and stress around the surgical site.
  • Loosen and stretch the muscles surrounding the surgical site.
  • Strengthen the back and neck muscles.
  • Stabilize the back and neck muscles.
  • Learn to move around safely.
  • Prepare for everyday physical activities like standing up or sitting down, lifting, and carrying objects.
  • Improve posture.

The therapy team will develop a customized treatment/rehabilitation plan as well as post-surgical recovery at home to help the individual and family to understand what to expect, including psychological factors like not wanting to perform the exercises or stretches to avoid pain, frustration, anger, depression, and wanting to give up. However, individuals can maximize the benefits to ensure an optimal outcome before surgery by pre-conditioning identifying structural and functional issues contributing to the injury.

Physical Therapy Involves

Therapy can be done at home, in a hospital or rehab setting, or at a chiropractic/physical therapy clinic. Therapists use:

  • Massage
  • Heat or cold therapy
  • Thermotherapy
  • Electrotherapy
  • Ultrasound

Also included are active therapies like:

  • Therapeutic stretches
  • Therapeutic mobility exercises
  • Therapeutic resistance training

A physical therapy session can last 45 minutes to an hour. It’s essential to discuss hopes and expectations post-surgery and after the therapy has finished. The therapists will explain the healing process, the treatment progression, and any questions a patient may have. Understanding the treatment process will help the individual want to engage in the treatment plan. The therapist team will also interface with the surgeon to prevent adverse outcomes.

Optimal Health

The physical therapy team will help the individual feel better with each session and stay motivated. Having a solid relationship with the therapy team makes it easier to share goals, worries, and challenges that the team can adapt to as progress is made. To gain the most from the therapy:

  • Try working with a therapist that the surgeon recommends can be helpful as they already have a working relationship.
  • Keep communication open between the surgeon and team.
  • Adhere to any precautions and restrictions set by the surgeon and therapy team.
  • Maintain recommended exercises at home between sessions.
  • Ease into activity and avoid overexertion.

Post spine surgery physical therapy helps accelerate the healing process and serves to help individuals regain their quality of life.


Body Composition


Power Of Protein

Protein is an essential component of muscle development, bone density, muscle mass, and lean tissue when building a healthy body. Protein is necessary for all the body’s physiological functions.

References

Adogwa, Owoicho et al. “Assessing the effectiveness of routine use of postoperative in-patient physical therapy services.” Journal of spine surgery (Hong Kong) vol. 3,2 (2017): 149-154. doi:10.21037/jss.2017.04.03

Atlas, S J, and R A Deyo. “Evaluating and managing acute low back pain in the primary care setting.” Journal of general internal medicine vol. 16,2 (2001): 120-31. doi:10.1111/j.1525-1497.2001.91141.x

Gellhorn, Alfred Campbell et al. “Management patterns in acute low back pain: the role of physical therapy.” Spine vol. 37,9 (2012): 775-82. doi:10.1097/BRS.0b013e3181d79a09

Jack, Kirsten et al. “Barriers to treatment adherence in physiotherapy outpatient clinics: a systematic review.” Manual therapy vol. 15,3 (2010): 220-8. doi:10.1016/j.math.2009.12.004

Lindbäck, Yvonne et al. “PREPARE: Pre-surgery physiotherapy for patients with degenerative lumbar spine disorder: a randomized controlled trial protocol.” BMC musculoskeletal disorders vol. 17 270. 11 Jul. 2016, doi:10.1186/s12891-016-1126-4

Most Common Form Of Pain The Headache

Most Common Form Of Pain The Headache

The most common form of pain is the headache. Whether dealing with a mild, dull ache, severe throbbing, or painful tension along the scalp and neck, headaches can disrupt and get in the way of everyday life. Over-the-counter pain medications can offer temporary relief, but they don’t get to the root and solve the cause. Chiropractic is a safe and effective treatment option that will bring head pain relief and treat what is causing the headache/s.

Most Common Form Of Pain The Headache

Triggers

Individuals engage in more sedentary activities, and more hours spent in one fixed position combined with poor posture can increase joint irritation and muscle tension in the neck, upper back, and scalp. Headaches can have a variety of causes or triggers. These can include:

  • Stress is the most common trigger
  • Muscle tension
  • Insomnia
  • Environmental stimuli – noises, lights, smells
  • Dehydration
  • Weather changes
  • Foods
  • Blood sugar changes
  • Excessive exercise

Most Common Types

There are two main categories: primary and secondary headaches.

Primary headaches

Primary headaches are when the headache itself is the main problem and is not a symptom of underlying diseases or conditions. These include:

Secondary headaches

These are related to medical condition/s like:

  • Sinus congestion
  • Medication overuse
  • Infection
  • High blood pressure
  • Trauma
  • Head injury
  • Diseased blood vessels in the brain
  • Tumor

Frequency

Headache pain comes from interacting signals in the brain, blood vessels, and nerves. A mechanism activates specific nerves that affect the muscles and blood vessels, sending pain signals back to the brain. If any of the following is occurring it is recommended to contact a doctor, headache specialist, or chiropractor.

  • Three or more headaches a week.
  • Headaches that get worse or don’t go away.
  • Having to take a pain reliever every day or almost every day.
  • Need more than 2-3 doses of over-the-counter medications a week to relieve symptoms.
  • Headaches triggered by strenuous activity, hard work/exertion, bending, coughing.
  • Recent changes in headache symptoms.
  • Family history of headaches.

Clinical Description

To get to the root a doctor will ask:

  • What time of day/night the headache usually occurs?
  • How long does the headache last?
  • Where the pain is located?
  • Type of pain –  throbbing, comes and goes, dull aching, one-sided, etc.
  • Does the headache come on suddenly without warning or slowly progress?
  • Are there other symptoms like weakness, nausea, sensitivity to light or noise, decreased appetite, changes in attitude or behavior?

Chiropractic

A chiropractor will assess, diagnose, conduct a physical examination to determine the cause and develop a personalized treatment plan to alleviate the pain and help to manage and prevent headaches. Treatment approaches include:

  • A combination of chiropractic manipulative therapy.
  • Activate trigger points to release tension and allow for optimal nerve and blood circulation.
  • Active and passive exercises.
  • Massage.
  • Health coaching.

Body Composition


Water

Most of the body is made up of water with the percentage of body composition that is water changing based on individual functional needs. Essential functions of water include:

  • Help to build/repair almost every cell in the body.
  • Regulating body temperature through sweating and respiration.
  • Energy from carbohydrates and proteins is transported by water through the blood.
  • Assists in the removal of metabolic waste through urination.
  • Acts as a shock absorber to protect the brain and spinal cord.
  • Creates saliva/fluids to lubricate the joints.

The amount of water in the body depends on various factors that include:

The most common water comes from lean body mass. This includes blood, organs, and muscle. Major body organs’ water content:

  • Lungs – 83%
  • Muscles and kidneys – 79%
  • Brain and heart – 73%
  • Skin – 64%
  • Bones – 31%
References

Bryans, Roland et al. “Evidence-based guidelines for the chiropractic treatment of adults with headache.” Journal of manipulative and physiological therapeutics vol. 34,5 (2011): 274-89. doi:10.1016/j.jmpt.2011.04.008

Tyagi, Alok. “New daily persistent headache.” Annals of Indian Academy of Neurology vol. 15,Suppl 1 (2012): S62-5. doi:10.4103/0972-2327.100011

Alexander Technique

Alexander Technique

Improving posture can be challenging. Poor posture is often the source of various musculoskeletal issues like chronic pain throughout the body. Poor posture can be so ingrained in the brain that it becomes an unconscious positioning reflex that feels right but could be worsening spinal, hip, and leg problems. The Alexander Technique could be a treatment option that could help long-term.

Alexander Technique

Alexander Technique

The approach focuses on learning mind-body awareness. It is an educational process to teach individuals to become aware of their body positioning and change unhealthy posture/movement habits into healthy ones. The objective is learning to utilize sufficient levels of muscle tension for everyday activities, like sitting, standing up, and walking in a healthy way to maintain optimal health of the musculoskeletal system.

  • The theory is that less tension minimizes wear and tear on the muscles and structures of the spine vulnerable to compression.
  • The fundamental goal of the Alexander Technique is to undo all the unhealthy tension habits to decompress the spine and retrain the mind and body to approach movement and body positioning in a new and healthy way.

Teachings

The technique can be done in a class setting or one-on-one teaching because everyone’s postural and movement habits are unique. A teacher helps identify the tension-inducing postures and educates the individual on how to correct them. Human touch is an integral part of the Alexander Technique. Using their hands gently to adjust the individual to a proper upright position, a teacher helps release pressure from the head, neck, shoulders, and upper back. The individual learns to release the tension throughout their body. The Alexander Technique is a type of hands-on therapy; it is not manipulation or massage. It uses a light touch with no risk of injury to the spine, allowing anyone to participate. However, individuals must be willing to participate/engage in the process to get the benefits. Most individuals can tell if it’s right for them during the first lesson. A typical program teaches:

  • Comfortably sitting up straight.
  • Reducing overuse of superficial musculature.
  • Increasing proprioceptive awareness.
  • Staying alert to the body’s warning of tension and compression.

Tension Build Up

Individuals usually don’t even realize they’re constantly placing pressure on their spine from unhealthy postural habits, building up muscular tension they never knew they created. For example, unhealthy neck position habits include:

  • Pushing the head forward
  • Slumping over
  • Pinning the shoulders back
  • These postures generate/build pressure and tension that radiates outward and down to the large muscles of the spine.
  • Habitual downward pressure can pull and change the spine’s shape, leading to degenerative forms of spinal deformity in severe cases.
  • When the tension is released, the neck and body begin to stand upright comfortably, without pulling down or pulling back.

Frederick Matthias Alexander

Developed the technique in the 1890s to help his muscle tension problems affecting his acting career. When performing, he would stiffen his neck and pull his head back and up, building tension that caused him to tighten his throat and lose his voice. He did not know he was doing this until he performed in front of a mirror and saw his awkward positioning. He realized this and retrained himself to pose naturally, stay relaxed, and be aware of any tension building in the muscles to release it immediately. Alexander Technique educators/practitioners practice all over the world. The American Society for the Alexander Technique or AmSAT website has a Find A Teacher Tool that connects individuals to AmSAT-approved teachers.


Body Composition


Practicing Mindfulness

Developing a mindfulness practice can help identify triggers of negative behavior or thoughts. Just like diet and exercise, practicing mindfulness is unique to everyone. It is recommended to try different things like:

  • Journaling is another way to tune into oneself. Grab a pen and paper, a computer, tablet, or phone, and take a few minutes to write every day.
  • Write one thing that makes you happy.
  • One thing you want to improve.
  • One goal you want to accomplish that day or that week.

Mindful music listening can help reduce stress by allowing the individual to focus their attention when their mind is going in all directions.

  • Instead of turning to the news or email when waking up, grab a cup of coffee or tea and listen to a favorite podcast or music.
  • Put the phone away and listen to your mind and self.

Try to meditate in the morning when waking up. This helps set the day’s goals/plans. Goal-setting mindfulness has been shown to reduce stress levels and anxiety. However, if the morning is not possible then at night before bed can be used to reflect on the day’s activities, what went well, what didn’t, how to improve something, whatever the case, the point is to make time for yourself to reflect, set goals, and develop a plan to achieve those goals.

References

Becker, Jordan J et al. “Preliminary evidence for feasibility, efficacy, and mechanisms of Alexander technique group classes for chronic neck pain.” Complementary therapies in medicine vol. 39 (2018): 80-86. doi:10.1016/j.ctim.2018.05.012

Cacciatore et al., Improvement in automatic postural coordination following Alexander technique lessons in a person with low back pain. Physical Therapy Journal, 2005; 85:565-578. Accessed January 5, 2011

Chin, Brian et al. “Psychological mechanisms driving stress resilience in mindfulness training: A randomized controlled trial.” Health psychology: official journal of the Division of Health Psychology, American Psychological Association vol. 38,8 (2019): 759-768. doi:10.1037/hea0000763

Little P, Lewith G, Webley F, et al. Randomised controlled trial of Alexander technique lessons, exercise, and massage (ATEAM) for chronic and recurrent back pain. The BMJ. 2008;337:a884. doi: doi.org/10.1136/bmj.a884.

Paolucci, Teresa et al. “Chronic low back pain and postural rehabilitation exercise: a literature review.” Journal of pain research vol. 12 95-107. December 20 2018, doi:10.2147/JPR.S171729

Musculoskeletal Nutrition

Musculoskeletal Nutrition

Musculoskeletal Nutrition: Musculoskeletal conditions are non-communicable conditions/disorders and are the most common conditions that chiropractors and physiotherapists treat. Unhealthy lifestyle practices like smoking, an unhealthy diet, and little to no exercise or physical activity impact musculoskeletal disorders and remain the most common causes of physical disability and pain. Musculoskeletal conditions include:

  • Back pain
  • Carpal Tunnel Syndrome
  • Tendonitis – inflammation of the fibrous tissues that connect the muscles to the bones.
  • Rheumatoid Arthritis
  • Osteoarthritis
  • Bone Fractures
  • Fibromyalgia

Musculoskeletal Nutrition

A lack of proper nutrients increases the risk for bone, muscle, and joint disease. A proper diet combined with strengthening and stretching will help with injury recovery and help prevent disorders, injury, and pain. For example, inadequate consumption of calcium and vitamin D intake can lead to osteoporosis. Both nutrients are necessary for musculoskeletal health. Calcium helps build bone tissue, and vitamin D promotes calcium absorption.

Musculoskeletal Nutrition

Even physically active and healthy individuals’ can go through inadequate nutrition intake, increasing the risk of injury from its effect/s on rehabilitation and recovery. There are mechanisms to insufficient nutrient intake that can lead to muscle injury.

  • Intense training causes skeletal muscle breakdown that can worsen from poor dietary protein intake.
  • Not hydrating the body can compromise blood flow to working muscles, increasing the risk for injury and other health issues.
  • Hydration influences the amount and composition of joint fluid and helps maintain articular cartilage.
  • Deficiencies in nutrients like:
  • Potassium
  • Iron
  • Zinc
  • Magnesium
  • Chromium
  • Copper
  • Vitamins
  • The lack of micronutrients and their role in bone and muscle metabolism increases the risk for injury and the development of musculoskeletal conditions.

Overall Health

Connective tissue holds the body’s bones and muscles together and is essential for joint integrity. Athletes and individuals with physically demanding jobs and lifestyles need to take care of their connective tissues to prevent degradation, injuries, and joint conditions, like arthritis and tendon injuries. It is recommended to have a diet that is:

Proper nutrition will help the body build, repair, and maintain healthy connective tissue. Things like:

Achieving optimal health requires all-around healthy lifestyle choices and musculoskeletal nutrition.


Body Composition


Superfoods

Many nutrient-rich foods can be incorporated into an individual’s diet to improve overall well-being. Superfoods are high in antioxidants and contain vast amounts of vitamins and minerals. A superfood is a food rich in compounds that are beneficial to an individual’s health. These compounds include:

  • Phytochemicals – include antioxidants like polyphenols that provide anti-inflammatory properties.
  • Fiber
  • Omega-3 fatty acids

Superfoods are recognized by national nutrition guidelines as Powerhouse Fruits and Vegetables or PFV. Antioxidants reduce free radicals and prevent and repair damage caused by oxidative stress. Oxidative stress occurs when free radicals accumulate in the body and can lead to chronic and degenerative illnesses like arthritis, cardiovascular disease, and cancer. A diet rich in antioxidants can expedite recovery time from injury, illness, and physical activity/exercise-induced stress.

Anthocyanins are a type of polyphenol that become antioxidants that help reduce the incidence of chronic disease. They are different types of pigments found in plants, giving fruits and vegetables their vibrant colors. These include:

  • Black beans
  • Berries
  • Cherries
  • Pomegranates
  • Peaches
  • Eggplant
  • Purple sweet potatoes

A diet rich in anthocyanins can reduce oxidative stress and inflammation, help prevent cardiovascular disease, and control and prevent diabetes.

References

Craddock, Joel C, et al. “Vegetarian and Omnivorous Nutrition – Comparing Physical Performance.” International journal of sports nutrition and exercise metabolism vol. 26,3 (2016): 212-20. doi:10.1123/ijsnem.2015-0231

Mendonça, Carolina Rodrigues et al. “Effects of Nutritional Interventions in the Control of Musculoskeletal Pain: An Integrative Review.” Nutrients vol. 12,10 3075. 9 Oct. 2020, doi:10.3390/nu12103075

Sale, Craig, and Kirsty Jayne Elliott-Sale. “Nutrition and Athlete Bone Health.” Sports medicine (Auckland, N.Z.) vol. 49,Suppl 2 (2019): 139-151. doi:10.1007/s40279-019-01161-2

Slavin, Joanne L, and Beate Lloyd. “Health benefits of fruits and vegetables.” Advances in nutrition (Bethesda, Md.) vol. 3,4 506-16. 1 Jul. 2012, doi:10.3945/an.112.002154

Tucker, K L et al. “Potassium, magnesium, and fruit and vegetable intakes are associated with greater bone mineral density in elderly men and women.” The American journal of clinical nutrition vol. 69,4 (1999): 727-36. doi:10.1093/ajcn/69.4.727

Sports Chiropractic Athletes

Sports Chiropractic Athletes

Sports chiropractic athletes: A sports chiropractor is a specialist that works with athletes to improve their performance. These doctors specialize in assessing and treating sports injuries. Treatment also prevents future damage/injury by providing a customized rehabilitation, strengthening, flexibility, and mobility program, that includes:

  • Exercise prescription
  • Ergonomic recommendations
  • Health coaching/counseling
  • Therapeutic sports massage

Sports chiropractic deals with preventing, diagnosing, and treating sports-athletic-based injuries to muscles, tendons, ligaments, and joints. Sports chiropractors have extensive training in evaluating muscular-skeletal problems related to sports participation overuse. Diagnosis is acquired through:

Sports Chiropractic Athletes

Sports Chiropractic Athletes

Chiropractors are masters of the human body and trained to use advanced diagnostics tools. A sports chiropractor evaluates individuals from all levels of sports and fitness, including:

  • Athletes – professional or recreational
  • Weekend warriors
  • Military personnel

The objective is to identify musculoskeletal problems related to sporting activity or overuse, alleviate pain, rehabilitate, and strengthen to prevent future injury. They can diagnose and treat sports-related injuries from common overuse injuries like:

  • Hip pain from frequently running on pavement.
  • Shoulder pain from damage caused by continued overhead throwing or hitting.
  • Low back and leg issues from twisting, bending, jumping, and reaching.

Balance

Athletes need a healthy balance of endurance, strength, and structure. Through biomechanics training, sports chiropractic restores the body’s natural balance and proper function. The goal is to get the athlete re-engaged and protected against further injury and play without any problems or limitations. Sports chiropractic athletes can return in a short amount of time from injuries that include:

  • Torn ACLs
  • MCL Sprain
  • Ankle Sprain
  • Achilles Tendonitis
  • Rotator cuff tears
  • Quadriceps Strains
  • Hamstrings Strains
  • Shin Splints
  • Sports Hernia
  • Neck Pain
  • Back Pain
  • Spondylolisthesis

Prevention Regimen

They can recommend prevention programs to prevent potential problems before an athlete gets hurt. A chiropractor will detect developing muscle imbalances before they turn into a chronic condition that can lead to damage to the rest of the body. Additional therapies include:

  • Massage
  • Hot/cold treatments
  • Ultrasound therapy
  • Low-level laser therapy

Adjustments, stretching, core training, therapeutic sports massage, health coaching, and nutritional counseling will strengthen the body, allowing for performing physical activities and sports at optimum levels.


Body Composition


Sports Performance

Working with sports chiropractic athletes means achieving a balance of lean mass to maintain sports performance and reduce the risk of injury. Athletes, doctors, and trainers monitor gains over time to maximize performance and watch for signs of potential injury. A method of monitoring for potential injury is the ECW/TBW Analysis. When training and engaging in sports, the body is under physical stress. The proper amount of rest and recovery are needed to allow muscles to recover and regrow. Inflammation is reflected in the ECW/TBW by monitoring changes over time. A steady increase can indicate a sign of overtraining or improper recovery. Monitoring this progression can alert doctors and trainers that an athlete needs a less intense workout or longer recovery to reduce the potential for overtraining injury.

References

Corcoran, Kelsey L et al. “Association Between Chiropractic Use and Opioid Receipt Among Patients with Spinal Pain: A Systematic Review and Meta-analysis.” Pain medicine (Malden, Mass.) vol. 21,2 (2020): e139-e145. doi:10.1093/pm/pnz219

Naqvi U, Sherman Al. Muscle Strength Grading. [Updated 2021 Sep 2]. In: StatPearls [Internet]. Treasure Island (F.L.): StatPearls Publishing; 2022 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK436008/

Nelson, Luke et al. “A descriptive study of sports chiropractors with an International Chiropractic Sports Science Practitioner qualification: a cross-sectional survey.” Chiropractic & manual therapies vol. 29,1 51. 13 Dec. 2021, doi:10.1186/s12998-021-00405-1

Williams, Sean et al. “Kinesio taping in treatment and prevention of sports injuries: a meta-analysis of the evidence for its effectiveness.” Sports medicine (Auckland, N.Z.) vol. 42,2 (2012): 153-64. doi:10.2165/11594960-000000000-00000