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Athletes

Sports Spine Specialist Chiropractic Team: Athletes strive to achieve their body’s maximum performance by participating in numerous training regimens consisting of strenuous exercises and physical activity and ensuring they meet all of their body’s nutritional requirements. Through proper fitness and nutrition, many individuals can condition themselves to excel in their specific sport. Our training programs are designed for athletes that look to gain a competitive edge in their sport.

We provide sport-specific services to help increase an athlete’s performance through mobility, strength, and endurance. Occasionally, however, the excess workouts can lead many to suffer injuries or develop underlying conditions. Dr. Alex Jimenez’s chronicle of articles for athletes displays in detail the many forms of complications affecting these professionals while focusing on the possible solutions and treatments to follow to achieve overall well-being.


Increasing Bone Strength: Protecting Against Fractures

Increasing Bone Strength: Protecting Against Fractures

For individuals who are getting older, can increasing bone strength help prevent fractures and optimize bone health?

Increasing Bone Strength: Protecting Against Fractures

Bone Strength

Bone strength is important, as a fractured hip can be serious for older individuals. A study found that for individuals in their 60s who had a hip fracture, 6.5% of women and 9.4% of men died within a year. Among individuals in their 80s, 13.1% of women and 19.6% of men died within a year. (Dimet-Wiley, et al., 2022)

Increasing bone strength can help prevent various issues. A small increase in bone mineral density has been shown to help reduce the risk of fractures, especially hip fractures. A decades-long study found that just a 3% increase in bone strength helps lower the chance of breaking a hip. Researchers enrolled two groups of individuals aged 60 and older, one in 1989 and the second in 1999.

  • The bone mineral density of each subject’s femoral neck joint at the top of the thigh bone near the hip was measured.
  • They then followed the subjects for years to see who experienced hip fractures.
  • While the bone mineral density of the second group was only 3% higher than the first group, these subjects experienced a 46% reduction in hip fractures. (Tran, T. et al., 2023)

Bone Loss

Bone loss is progressive in men and women and increases as the body ages. Osteoporosis is a condition in which bone tissue deteriorates. (Department of Health and Human Services Office of Disease Prevention and Health Promotion. 2020) Bones constantly break down and reform as a normal remodeling process. If the balance of this process is impaired, osteoporosis develops, resulting in more bone breakdown than formation. While men and women experience bone loss, it’s more common in females. (National Institute of Arthritis and Musculoskeletal Diseases. 2022) Menopause is a risk factor because of the decline of estrogen (National Library of Medicine, Medline Plus, 2022). Estrogen reinforces bone strength by protecting against bone breakdown; with estrogen loss, bone breakdown increases. However, anyone of any age or background can experience bone loss due to the following:

  • Endocrine disorders.
  • Gastrointestinal diseases.
  • Inflammatory diseases like rheumatoid arthritis.
  • Certain cancers.
  • Medication taken to treat these conditions, like steroids or oncology meds, can also accelerate bone loss. (National Library of Medicine. Medline Plus, 2022)

Exercise

While some loss of bone strength is common, several strategies exist to maintain bone health. Exercise, specifically weight-bearing activities, can increase bone strength. When bones and muscles are used to hold a position against gravity, this mechanically stresses the bone, causing it to reform stronger. Movement and physical exercise as medicine and the forces transmitted through the bones generate mechanical signals that tell the cells to increase bone formation relative to breakdown. Exercises focusing on posture, balance, gait, and coordination are recommended for individuals with osteoporosis to strengthen the core, quadriceps, and hip flexors. Different types of exercises can include:

  • Walking to strengthen the spine and hips.
  • Walking outside or on a treadmill provides more loading force to the bone.
  • Planks and push-ups can strengthen the forearm and wrist bones.
  • Holding a water bottle in each hand and lifting up and down 10 times together or alternating a few times a day.
  • Side leg lifts can strengthen the hip and forearm bones simultaneously.
  • Weight training provides the bones with a workout by having them support a weight load.
  • Any exercise therapy program should be designed by a healthcare provider, physical therapist, and trainer according to the individual’s condition and appropriate for them.

Diet

What goes into the body definitely affects bone health. Calcium and vitamin D are key to bone building, but both are needed as vitamin D is needed to absorb the calcium ingested. Calcium can be found in:

  • Dairy
  • Dairy products and non-dairy alternatives are fortified with calcium.
  • Leafy greens.
  • Beans.
  • Almonds.
  • The recommended daily calcium intake for adults over 50 is 1,200 milligrams.

Vitamin D can come from:

  • Sunlight
  • Fish.
  • Mushrooms.
  • Fortified milk.
  • Supplements.
  • The recommended daily vitamin D intake for adults aged 70 is 15 micrograms and 20 micrograms for individuals over 70.

Studies have found that increasing calcium and vitamin D intake with supplements can help maintain bone health. Talk to a healthcare provider about whether supplements could be beneficial.

Hormone Therapy

Females also naturally produce testosterone, which promotes bone formation. As levels drop with age and negatively impact bone strength, hormone therapy could be recommended. Declining testosterone levels start with women in their 20s and men in their 30s. The typical drop in women is 1% to 3% yearly before menopause and stabilizes somewhat afterward. Female patients at risk of bone loss may be prescribed testosterone in various forms that continuously emit the hormone. The dosage is low, so patients do not experience unwanted hair growth or skin changes. Combined with estrogen, testosterone effectively increases bone growth in female patients. Not everyone is a candidate for hormone therapy, like individuals with a history of breast cancer, heart disease, blood clots, or liver disease. (National Library of Medicine. Medline Plus, 2019)

Making small adjustments can optimize bone health and overall well-being

At Injury Medical Chiropractic and Functional Medicine Clinic, we passionately focus on treating patients’ injuries and chronic pain syndromes to create personalized care plans that improve ability through flexibility, mobility, and agility programs tailored to the individual. Using an integrated approach, our goal is to relieve pain naturally by restoring health and function to the body through Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine protocols. If the individual needs other treatment, they will be referred to a clinic or physician best suited for them, as Dr. Jimenez has teamed up with the top surgeons, clinical specialists, medical researchers, and premier rehabilitation providers to provide the most effective clinical treatments. We focus on what works for you and strive to better the body through researched methods and total wellness programs.


Chiropractic Care: Movement Medicine


References

Dimet-Wiley, A., Golovko, G., & Watowich, S. J. (2022). One-Year Postfracture Mortality Rate in Older Adults With Hip Fractures Relative to Other Lower Extremity Fractures: Retrospective Cohort Study. JMIR aging, 5(1), e32683. doi.org/10.2196/32683

Tran, T. S., Ho-Le, T. P., Bliuc, D., Center, J. R., Blank, R. D., & Nguyen, T. V. (2023). Prevention of Hip Fractures: Trade-off between Minor Benefits to Individuals and Large Benefits to the Community. Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research, 38(11), 1594–1602. doi.org/10.1002/jbmr.4907

Department of Health and Human Services Office of Disease Prevention and Health Promotion. (2020). Osteoporosis Workgroup. Retrieved from health.gov/healthypeople/about/workgroups/osteoporosis-workgroup

National Institute of Arthritis and Musculoskeletal Diseases. (2022). Osteoporosis. Retrieved from www.niams.nih.gov/health-topics/osteoporosis

National Library of Medicine. MedlinePlus. (2022). What causes bone loss? Retrieved from medlineplus.gov/ency/patientinstructions/000506.htm

National Library of Medicine. MedlinePlus. (2019). Hormone replacement therapy. Retrieved from medlineplus.gov/hormonereplacementtherapy.html

Banish Neck Pain with Yoga: Poses and Strategies

Banish Neck Pain with Yoga: Poses and Strategies

Can incorporating various yoga poses help reduce neck tension and provide pain relief for individuals dealing with neck pain?

Introduction

Within the hustling and bustling of modern life, it is common for many individuals to carry stress in their bodies. When the body deals with everyday stressors, tension, discomfort, and pain can often manifest in the upper and lower portions of the body. When the body’s upper and lower portions deal with these issues, they can cause overlapping risk profiles in the musculoskeletal system. One of the most common musculoskeletal issues is neck pain. It can cause many problems to the cervical portion of the spine and cause the surrounding muscles to become tense and in pain from the stress of everyday responsibilities. Luckily, there are numerous ways to reduce stress from the neck and help relax the affected muscles from discomfort, including yoga. In today’s article, we will look at how neck pain affects the upper body, the benefits of yoga for neck pain, and various yoga poses to reduce the overlapping effects of neck pain. We discuss with certified medical providers who consolidate our patients’ information to assess how neck pain is correlated with everyday stressors that affect the upper body. We also inform and guide patients on how yoga and the various poses can benefit the body and provide pain relief to the surrounding muscles. We also encourage our patients to ask their associated medical providers many intricate and important questions about incorporating yoga into their daily routine to reduce muscle tension and provide clarity to their bodies. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer.

 

How Does Neck Pain Affect The Upper Body?

Do you feel discomfort or pain in your neck and shoulders after a long, hard workday? Do you notice you hunched more than usual when doing your daily routine? Or do you see yourself developing a hunched posture from looking at the computer screen or phone for an extended period? Many of these normal motions are often correlated with the upper body, especially in the neck and shoulder regions, which causes neck pain. As one of the most common problems affecting many people worldwide, neck pain is a multifactorial disease with numerous risk factors contributing to its development. (Kazeminasab et al., 2022) Like back pain, neck pain can have acute and chronic stages depending on the severity and environmental factors leading to its development. The various muscles, ligaments, and tissues surrounding the neck and shoulders keep the neck stable and mobile. When many individuals overuse these muscles in the neck and shoulders repetitively, it can increase neck pain in the upper body in adulthood. (Ben Ayed et al., 2019

 

 

When acute neck pain turns chronic, it can cause the individual to be in constant discomfort, pain, and misery, so they start to look for various solutions to reduce the correlating symptoms when speaking to their primary doctors. When many individuals begin to explain to their doctors what their daily routine looks like, many doctors will start to assess and formulate a plan that focuses on any specific description of any injuries, including potential mechanisms, inciting and relieving factors, and pain patterns they have encountered throughout the day to come up with a personalized treatment plan to not only reduce neck pain but also provide relief to tension and discomfort to the body. (Childress & Stuek, 2020

 


The Science of Motion- Video


The Benefits Of Yoga For Neck Pain

Many primary doctors will work with associated medical providers to develop a personalized plan to relieve neck pain and its associated symptoms in many individuals. Many of these customized treatment plans include spinal manipulation, acupuncture, massage, decompression therapy, and therapeutic exercises. One of the therapeutic exercises that many individuals have utilized is yoga. Yoga is a holistic practice encompassing breathing control, meditation, and various poses to stretch and strengthen the affected upper muscles. Yoga is excellent for reducing neck pain and helping with upper cervical spine mobility, stretching the neck musculature to help the individual improve mobility and flexibility. (Raja et al., 2021) Additionally, the effects of yoga and its many poses can reduce tension, give clarity to the mind, and allow the nutrients and oxygen to the musculo-articular system to naturally heal the body itself. (Gandolfi et al., 2023)

 

Yoga Poses For Neck Pain

At the same time, many individuals with sedentary jobs that correlate to neck pain have implemented yoga as part of their routine. Yoga improves their range of joint motion and cognitive function and helps relieve musculoskeletal discomfort in the neck and shoulder regions. (Thanasilungkoon et al., 2023) Below are some of the various yoga poses that can help reduce the pain-like symptoms of neck pain and ease the surrounding muscles. 

 

Seated Neck Stretches

 

For seated neck stretches, this yoga pose helps stretch and release the neck muscles that carry tension and stress in the cervical region of the body. 

  • In a seated upright position, turn the head to the right and gently lift the chin.
  • You should feel a stretch along the left side of the neck and shoulders.
  • Hold the position for three to five breaths and repeat on the left side.

 

Camel Pose

 

For the camel pose, this yoga pose helps strengthen the front neck muscles while easing tension on the shoulders and back of the neck.

  • You can kneel on a yoga mat by keeping your knees and feet hip-distance apart while keeping the pelvis neutral. 
  • Lift the chest while arching your back and pressing the pelvis slightly forward.
  • Bring the fingertips to the heels or yoga blocks beside the ankles.
  • Focus on drawing the chin close to the neck while pressing the feet to the mat.
  • Hold the position for three to five breaths before releasing and lifting the sternum to rise back up.

 

Sphinx Pose

 

The sphinx pose allows you to lengthen and strengthen the spine while stretching the shoulders and releasing tension. 

  • On a yoga mat, lie on your stomach with the elbows under the shoulders.
  • Press your palms and forearms on the mat and tighten the lower half to support you as you lift your upper torso and head.
  • Keep looking straight ahead as you are being mindful of lengthening the spine.
  • Hold this position for three to five breaths.

 

Thread The Needle Pose

 

The thread-the-needle pose helps release tension stored in the neck, shoulders, and back.

  • On a yoga mat, start in an all-fours position with the wrist under the shoulders and the knees under the hips.
  • Lift the right hand and move it to the left along the floor with the palm facing up.
  • Hold the position for three to five breaths for thirty seconds and release.
  • Return to the all-fours position and repeat to the left side.

 

Conclusion

Overall, incorporating yoga as part of a daily routine can provide beneficial results in reducing neck pain and its associated comorbidities. Yoga does not require hours of practice or even contorting into various poses, as just a few minutes of gentle stretching and mindful breathing each day can provide positive results. When people start to utilize yoga as part of their daily activities, they will notice their posture improving, their minds clearer than ever, and live a happier, healthier life without dealing with neck pain.


References

Ben Ayed, H., Yaich, S., Trigui, M., Ben Hmida, M., Ben Jemaa, M., Ammar, A., Jedidi, J., Karray, R., Feki, H., Mejdoub, Y., Kassis, M., & Damak, J. (2019). Prevalence, Risk Factors and Outcomes of Neck, Shoulders and Low-Back Pain in Secondary-School Children. J Res Health Sci, 19(1), e00440. www.ncbi.nlm.nih.gov/pubmed/31133629

www.ncbi.nlm.nih.gov/pmc/articles/PMC6941626/pdf/jrhs-19-e00440.pdf

Childress, M. A., & Stuek, S. J. (2020). Neck Pain: Initial Evaluation and Management. American Family Physician, 102(3), 150-156. www.ncbi.nlm.nih.gov/pubmed/32735440

www.aafp.org/pubs/afp/issues/2020/0801/p150.pdf

Gandolfi, M. G., Zamparini, F., Spinelli, A., & Prati, C. (2023). Asana for Neck, Shoulders, and Wrists to Prevent Musculoskeletal Disorders among Dental Professionals: In-Office Yoga Protocol. J Funct Morphol Kinesiol, 8(1). doi.org/10.3390/jfmk8010026

Kazeminasab, S., Nejadghaderi, S. A., Amiri, P., Pourfathi, H., Araj-Khodaei, M., Sullman, M. J. M., Kolahi, A. A., & Safiri, S. (2022). Neck pain: global epidemiology, trends and risk factors. BMC Musculoskelet Disord, 23(1), 26. doi.org/10.1186/s12891-021-04957-4

Raja, G. P., Bhat, N. S., Fernandez-de-Las-Penas, C., Gangavelli, R., Davis, F., Shankar, R., & Prabhu, A. (2021). Effectiveness of deep cervical fascial manipulation and yoga postures on pain, function, and oculomotor control in patients with mechanical neck pain: study protocol of a pragmatic, parallel-group, randomized, controlled trial. Trials, 22(1), 574. doi.org/10.1186/s13063-021-05533-w

Thanasilungkoon, B., Niempoog, S., Sriyakul, K., Tungsukruthai, P., Kamalashiran, C., & Kietinun, S. (2023). The Efficacy of Ruesi Dadton and Yoga on Reducing Neck and Shoulder Pain in Office Workers. Int J Exerc Sci, 16(7), 1113-1130. www.ncbi.nlm.nih.gov/pubmed/38287934

www.ncbi.nlm.nih.gov/pmc/articles/PMC10824298/pdf/ijes-16-7-1113.pdf

Disclaimer

Understanding the Benefits of Fitness Assessment

Understanding the Benefits of Fitness Assessment

For individuals looking to improve their fitness health, can a fitness assessment test identify potential areas and help evaluate overall health and physical status?

Understanding the Benefits of Fitness Assessment

Fitness Assessment

A fitness test, also known as a fitness assessment, helps evaluate an individual’s overall and physical health. It comprises a series of exercises to design an appropriate exercise program for general health and fitness. (National Strength and Conditioning Association. 2017) Fitness assessment testing benefits include:

  • Identifying areas that need improvement.
  • Assisting professionals in understanding what types of exercise are safest and most effective.
  • Helping measure fitness progress over time.
  • Allowing for an individualized plan that can help prevent injuries and maintain the body’s overall health.

An assessment can comprise a wide range of tests, including:

  • Body composition tests.
  • Cardiovascular stress tests.
  • Endurance tests.
  • Range of motion tests.

They are meant to ensure the individual won’t be at risk of injury and provide the trainer with the insights needed to establish clear and effective fitness goals. Individuals who wonder whether fitness testing would benefit them should consult their healthcare provider.

General Health

Before starting a fitness program, it is important to inform the trainer of individual medical history and get the necessary approval from a primary healthcare provider. (Harvard Health Publishing. Harvard Medical School. 2012) Fitness specialists usually use one or more screening tools to help determine individual baseline health.
This may include obtaining vital sign measurements like height and weight, resting heart rate/RHR, and resting blood pressure/RBP. Many trainers will also use a physical activity readiness questionnaire/PAR-Q comprising questions about general health. (National Academy of Sports Medicine. 2020) Among the questions, individuals may​ be asked about the medications being taken, any problems with dizziness or pain, or medical conditions that may impair their ability to exercise.

Body Composition

Body composition describes total body weight components, including muscles, bones, and fat. The most common methods for estimating body composition include:

Bioelectrical Impedance Analysis – BIA

  • During BIA, electrical signals are sent from electrodes through the soles of the feet to the abdomen to estimate body composition. (Doylestown Health. 2024)

Body Mass Index – BMI

Skinfold Measurements

  • These measurements use calipers to estimate the amount of body fat in a fold of skin.

Cardiovascular Endurance

Cardiovascular endurance testing, also known as stress testing, measures how efficiently the heart and lungs work to supply oxygen and energy to the body during physical activity. (UC Davis Health, 2024) The three most common tests used include:

12-minute Run Tests

  • Twelve-minute run tests are performed on a treadmill, and an individual’s pre-exercise heart and respiration rates are compared with post-exercise heart and respiration rates.

Exercise Stress

  • Exercise stress testing is performed on a treadmill or stationary bike.
  • It involves using a heart monitor and blood pressure cuff to measure vital signs during exercise.

VO2 Max Testing

  • Performed on a treadmill or stationary bike.
  • V02 max testing uses a breathing device to measure the maximum rate of oxygen consumption during physical activity (UC Davis Health, 2024)
  • Some trainers will incorporate exercises like sit-ups or push-ups to measure response to specific exercises.
  • These baseline results can be used later to see if health and fitness levels have improved.

Strength and Endurance

Muscle endurance testing measures the length of time a muscle group can contract and release before it fatigues. Strength testing measures the maximal amount of force a muscle group can exert. (American Council on Exercise, Jiminez C., 2018) The exercises used include:

  • The push-up test.
  • Core strength and stability test.

Sometimes, a trainer will use a metronome to measure how long the individual can keep up with the rhythm. The results are then compared to individuals of the same age group and sex to establish a baseline level. Strength and endurance tests are valuable as they help the trainer spot which muscle groups are stronger, vulnerable, and need focused attention. (Heyward, V. H., Gibson, A. L. 2014).

Flexibility

  • Measuring the flexibility of joints is vital in determining whether individuals have postural imbalances, foot instability, or limitations in range of motion. (Pate R, Oria M, Pillsbury L, 2012)

Shoulder Flexibility

  • Shoulder flexibility testing evaluates the flexibility and mobility of the shoulder joint.
  • It is performed by using one hand to reach behind the neck, between the shoulders, and the other hand to reach behind the back, toward the shoulders, to measure how far apart the hands are. (Baumgartner TA, PhD, Jackson AS, PhD et al., 2015)

Sit-And-Reach

  • This test measures tightness in the lower back and hamstring muscles. (American Council of Exercise, Metcalf A. 2014)
  • The sit-and-reach test is performed on the floor with the legs fully extended.
  • Flexibility is measured by how many inches the hands are from the feet when reaching forward.

Trunk Lift

  • Trunk lift testing is used to measure tightness in the lower back.
  • It is performed while lying face-down on the floor with arms at your side.
  • The individual will be asked to lift their upper body with just the back muscles.
  • Flexibility is measured by how many inches the individual can lift themselves off the ground. (Baumgartner TA, PhD, Jackson AS, PhD et al., 2015)

Fitness assessment testing has various benefits. It can help trainers design a personalized workout program, help individuals identify fitness areas that need improvement, measure progress, and add intensity and endurance to their routine, which can help prevent injuries and help maintain overall health. We focus on what works for you and strive to better the body through researched methods and total wellness programs. These natural programs use the body’s ability to achieve improvement goals. Ask a healthcare professional or fitness professional for guidance if you need advice.


PUSH Fitness


References

National Strength and Conditioning Association. (2017). Purposes of assessment. www.nsca.com/education/articles/kinetic-select/purposes-of-assessment/

Harvard Health Publishing. Harvard Medical School. (2012). Do you need to see a doctor before starting your exercise program? HealthBeat. www.health.harvard.edu/healthbeat/do-you-need-to-see-a-doctor-before-starting-your-exercise-program

National Academy of Sports Medicine. (2020). PAR-Q-+ The Physical Activity Readiness Questionnaire for Everyone. www.nasm.org/docs/pdf/parqplus-2020.pdf?sfvrsn=401bf1af_24

Doylestown Health. (2024). Bio-Electrical Impedance Analysis (BIA)-Body Mass Analysis. www.doylestownhealth.org/service-lines/nutrition#maintabbed-content-tab-2BDAD9F8-F379-403C-8C9C-75D7BFA6E596-1-1

National Heart, Lung, and Blood Institute. U.S. Department of Health and Human Services. (N.D.). Calculate your body mass index. Retrieved from www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmicalc.htm

UC Davis Health. (2024). VO2max and Aerobic Fitness. health.ucdavis.edu/sports-medicine/resources/vo2description

American Council on Exercise. Jiminez C. (2018). Understanding 1-RM and Predicted 1-RM Assessments. ACE Fitness. www.acefitness.org/fitness-certifications/ace-answers/exam-preparation-blog/2894/understanding-1-rm-and-predicted-1-rm-assessments/

Heyward, V. H., Gibson, A. L. (2014). Advanced Fitness Assessment and Exercise Prescription. United Kingdom: Human Kinetics. www.google.com/books/edition/Advanced_Fitness_Assessment_and_Exercise/PkdoAwAAQBAJhl=en&gbpv=1&dq=Strength+and+endurance+tests+muscle+groups+are+stronger+and+weaker&pg=PA173&printsec=frontcover#v=onepage&q=Strength%20and%20endurance%20tests%20muscle%20groups%20are%20stronger%20and%20weaker&f=false

Pate R, Oria M, Pillsbury L, (Eds). (2012). Health-related fitness measures for youth: Flexibility. In R. Pate, M. Oria, & L. Pillsbury (Eds.), Fitness Measures and Health Outcomes in Youth. doi.org/10.17226/13483

Baumgartner, T. A., Jackson, A. S., Mahar, M. T., Rowe, D. A. (2015). Measurement for Evaluation in Kinesiology. United States: Jones & Bartlett Learning. www.google.com/books/edition/Measurement_for_Evaluation_in_Kinesiolog/_oCHCgAAQBAJ?hl=en&gbpv=1&dq=Measurement+for+Evaluation+in+Kinesiology+(9th+Edition).&printsec=frontcover#v=onepage&q&f=false

American Council of Exercise. Metcalf A. (2014). How to improve flexibility and maintain it. ACE Fitness. www.acefitness.org/resources/everyone/blog/3761/how-to-improve-flexibility-and-maintain-it/

The Complete Guide to Ehlers-Danlos Syndrome

The Complete Guide to Ehlers-Danlos Syndrome

Can individuals with Ehlers-Danlos syndrome find relief through various non-surgical treatments to reduce joint instability?

Introduction

The joints and ligaments surrounding the musculoskeletal system allow the upper and lower extremities to stabilize the body and be mobile. The various muscles and soft connective tissues that surround the joints help protect them from injuries. When environmental factors or disorders start to affect the body, many people develop issues that cause overlapping risk profiles, which then affect the stability of the joints. One of the disorders that affect the joints and connective tissue is EDS or Ehlers-Danlos syndrome. This connective tissue disorder can cause the joints in the body to be hypermobile. It can cause joint instability in the upper and lower extremities, thus leaving the individual to be in constant pain. Today’s article focuses on Ehlers-Danlos syndrome and its symptoms and how there are non-surgical ways to manage this connective tissue disorder. We discuss with certified medical providers who consolidate our patients’ information to assess how Ehlers-Danlos syndrome can correlate with other musculoskeletal disorders. We also inform and guide patients on how various non-surgical treatments can help reduce pain-like symptoms and manage Ehlers-Danlos syndrome. We also encourage our patients to ask their associated medical providers many intricate and important questions about incorporating various non-surgical therapies as part of their daily routine to manage the effects of Ehlers-Danlos syndrome. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer.

 

What Is Ehlers-Danlos Syndrome?

 

Do you often feel extremely tired throughout the day, even after a full night of sleep? Do you bruise easily and wonder where these bruises are coming from? Or have you noticed that you have an increased range in your joints? Many of these issues are often correlated with a disorder known as Ehlers-Danlos syndrome or EDS that affects their joints and connective tissue. EDS affects the connective tissues in the body. The connective tissues in the body help provide strength and elasticity to the skin, joints, as well as blood vessel walls, so when a person is dealing with EDS, it can cause a significant disruption to the musculoskeletal system. EDS is largely diagnosed clinically, and many doctors have identified that the gene coding of the collagen and proteins that interact in the body can help determine what type of EDS affects the individual. (Miklovic & Sieg, 2024)

 

The Symptoms

When understanding EDS, it is essential to know the complexities of this connective tissue disorder. EDS is classified into numerous types with distinct features and challenges that vary depending on the severity. One of the most common types of EDS is hypermobile Ehlers-Danlos syndrome. This type of EDS is characterized by general joint hypermobility, joint instability, and pain. Some of the symptoms that are associated with hypermobile EDS include subluxation, dislocations, and soft tissue injuries that are common and may occur spontaneously or with minimal trauma. (Hakim, 1993) This can often cause acute pain to the joints in the upper and lower extremities. With its broad range of symptoms and the personal nature of the condition itself, many often don’t realize that joint hypermobility is common in the general population and may present no complications that indicate that it is a connective tissue disorder. (Gensemer et al., 2021) Additionally, hypermobile EDS can lead to spinal deformity due to the hyperextensibility of the skin, joints, and various tissue fragility. The pathophysiology of spinal deformity associated with hypermobile EDS is primarily due to muscle hypotonia and ligament laxity. (Uehara et al., 2023) This causes many people to reduce their quality of life and daily living activities significantly. However, there are ways to manage EDS and its correlating symptoms to reduce joint instability.

 


Movement Medicine: Chiropractic Care-Video


Ways To Manage EDS

When it comes to looking for ways to manage EDS to reduce pain and joint instability, non-surgical treatments can help address the physical and emotional aspects of the condition. Non-surgical treatments for individuals with EDS commonly focus on optimizing the body’s physical function while improving muscular strength and joint stabilization. (Buryk-Iggers et al., 2022) Many individuals with EDS will try to incorporate pain management techniques and physical therapy and use braces and assistive devices to reduce the effects of EDS and improve their quality of life.

 

Non-surgical Treatments For EDS

Various non-surgical treatments like MET (muscle energy technique), electrotherapy, light physical therapy, chiropractic care, and massages can help strengthen while toning the surrounding muscles around the joints, provide sufficient pain relief, and limit long-term dependence on medications. (Broida et al., 2021) Additionally, individuals dealing with EDS aim to strengthen the affected muscles, stabilize the joints, and improve proprioception. Non-surgical treatments allow the individual to have a customized treatment plan for the severity of EDS symptoms and help reduce the pain associated with the condition. Many individuals, when going through their treatment plan consecutively to manage their EDS and reduce the pain-like symptoms, will notice improvement in symptomatic discomfort. (Khokhar et al., 2023) This means that non-surgical treatments allow individuals to be more mindful of their bodies and reduce the pain-like effects of EDS, thus allowing many individuals with EDS to lead fuller, more comfortable lives without feeling pain and discomfort.

 


References

Broida, S. E., Sweeney, A. P., Gottschalk, M. B., & Wagner, E. R. (2021). Management of shoulder instability in hypermobility-type Ehlers-Danlos syndrome. JSES Rev Rep Tech, 1(3), 155-164. doi.org/10.1016/j.xrrt.2021.03.002

Buryk-Iggers, S., Mittal, N., Santa Mina, D., Adams, S. C., Englesakis, M., Rachinsky, M., Lopez-Hernandez, L., Hussey, L., McGillis, L., McLean, L., Laflamme, C., Rozenberg, D., & Clarke, H. (2022). Exercise and Rehabilitation in People With Ehlers-Danlos Syndrome: A Systematic Review. Arch Rehabil Res Clin Transl, 4(2), 100189. doi.org/10.1016/j.arrct.2022.100189

Gensemer, C., Burks, R., Kautz, S., Judge, D. P., Lavallee, M., & Norris, R. A. (2021). Hypermobile Ehlers-Danlos syndromes: Complex phenotypes, challenging diagnoses, and poorly understood causes. Dev Dyn, 250(3), 318-344. doi.org/10.1002/dvdy.220

Hakim, A. (1993). Hypermobile Ehlers-Danlos Syndrome. In M. P. Adam, J. Feldman, G. M. Mirzaa, R. A. Pagon, S. E. Wallace, L. J. H. Bean, K. W. Gripp, & A. Amemiya (Eds.), GeneReviews((R)). www.ncbi.nlm.nih.gov/pubmed/20301456

Khokhar, D., Powers, B., Yamani, M., & Edwards, M. A. (2023). The Benefits of Osteopathic Manipulative Treatment on a Patient With Ehlers-Danlos Syndrome. Cureus, 15(5), e38698. doi.org/10.7759/cureus.38698

Miklovic, T., & Sieg, V. C. (2024). Ehlers-Danlos Syndrome. In StatPearls. www.ncbi.nlm.nih.gov/pubmed/31747221

Uehara, M., Takahashi, J., & Kosho, T. (2023). Spinal Deformity in Ehlers-Danlos Syndrome: Focus on Musculocontractural Type. Genes (Basel), 14(6). doi.org/10.3390/genes14061173

Disclaimer

Managing Hinge Joint Pain and Conditions

Managing Hinge Joint Pain and Conditions

 Can understanding the body’s hinge joints and how they operate help with mobility and flexibility problems and manage conditions for individuals with difficulty fully bending or extending their fingers, toes, elbows, ankles, or knees?

Managing Hinge Joint Pain and Conditions

Hinge Joints

A joint forms where one bone connects to another, allowing motion. Different types of joints differ in structure and movement depending on their location. These include hinge, ball and socket, planar, pivot, saddle, and ellipsoid joints. (Boundless. General Biology, N.D.) Hinge joints are synovial joints that move through one plane of motion: flexion and extension. Hinge joints are found in the fingers, elbows, knees, ankles, and toes and control movement for various functions. Injuries, osteoarthritis, and autoimmune conditions can affect hinge joints. Rest, medication, ice, and physical therapy can help alleviate pain, improve strength and range of motion, and help manage conditions.

Anatomy

A joint is formed by the joining of two or more bones. The human body has three main classifications of joints, categorized by the degree to which they can move. These include: (Boundless. General Biology, N.D.)

Synarthroses

  • These are fixed, immovable joints.
  • Formed by two or more bones.

Amphiarthroses

  • Also known as cartilaginous joints.
  • A fibrocartilage disc separates the bones that form the joints.
  • These movable joints allow for a slight degree of movement.

Diarthroses

  • Also known as synovial joints.
  • These are the most common freely mobile joints that allow movement in multiple directions.
  • The bones that form the joints are lined with articular cartilage and enclosed in a joint capsule filled with synovial fluid that allows for smooth motion.

Synovial joints are classified into different types depending on differences in structure and the number of motion planes they allow. A hinge joint is a synovial joint that allows movement in one plane of motion, similar to a door hinge that moves forward and backward. Within the joint, the end of one bone is typically convex/pointed outward, with the other concave/rounded inward to allow the ends to fit smoothly. Because hinge joints only move through one plane of movement, they tend to be more stable than other synovial joints. (Boundless. General Biology, N.D.) Hinge joints include:

  • The finger and toe joints – allow the fingers and toes to bend and extend.
  • The elbow joint – allows the elbow to bend and extend.
  • The knee joint – allows the knee to bend and extend.
  • The talocrural joint of the ankle – allows the ankle to move up/dorsiflexion and down/plantarflexion.

Hinge joints allow the limbs, fingers, and toes to extend away and bend toward the body. This movement is essential for activities of daily living, such as showering, getting dressed, eating, walking, standing up, and sitting down.

Conditions

Osteoarthritis and inflammatory forms of arthritis can affect any joint (Arthritis Foundation. N.D.) Autoimmune inflammatory forms of arthritis, including rheumatoid and psoriatic arthritis, can cause the body to attack its own joints. These commonly affect the knees and fingers, resulting in swelling, stiffness, and pain. (Kamata, M., Tada, Y. 2020) Gout is an inflammatory form of arthritis that develops from elevated levels of uric acid in the blood and most commonly affects the hinge joint of the big toe. Other conditions that affect hinge joints include:

  • Injuries to the cartilage within the joints or ligaments that stabilize the outside of the joints.
  • Ligament sprains or tears can result from jammed fingers or toes, rolled ankles, twisting injuries, and direct impact on the knee.
  • These injuries can also affect the meniscus, the tough cartilage within the knee joint that helps cushion and absorb shock.

Rehabilitation

Conditions that affect hinge joints often cause inflammation and swelling, resulting in pain and limited mobility.

  • After an injury or during an inflammatory condition flare-up, limiting active movement and resting the affected joint can reduce increased stress and pain.
  • Applying ice can decrease inflammation and swelling.
  • Pain-relieving medications like NSAIDs can also help reduce pain. (Arthritis Foundation. N.D.)
  • Once the pain and swelling start to subside, physical and/or occupational therapy can help rehabilitate the affected areas.
  • A therapist will provide stretches and exercises to help improve the joint range of motion and strengthen the supporting muscles.
  • For individuals experiencing hinge joint pain from an autoimmune condition, biologic medications to decrease the body’s autoimmune activity are administered through infusions delivered every several weeks or months. (Kamata, M., Tada, Y. 2020)
  • Cortisone injections may also be used to decrease inflammation.

At Injury Medical Chiropractic and Functional Medicine Clinic, we passionately focus on treating patients’ injuries and chronic pain syndromes and improving ability through flexibility, mobility, and agility programs tailored to the individual. Our providers use an integrated approach to create personalized care plans that include Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine protocols. Our goal is to relieve pain naturally by restoring health and function to the body. If the individual needs other treatment, they will be referred to a clinic or physician best suited for them. Dr. Jimenez has teamed up with the top surgeons, clinical specialists, medical researchers, and premier rehabilitation providers to provide the most effective clinical treatments.


Chiropractic Solutions


References

Boundless. General Biology. (N.D.). 38.12: Joints and Skeletal Movement – Types of Synovial Joints. In. LibreTexts Biology. bio.libretexts.org/Bookshelves/Introductory_and_General_Biology/Book%3A_General_Biology_%28Boundless%29/38%3A_The_Musculoskeletal_System/38.12%3A_Joints_and_Skeletal_Movement_-_Types_of_Synovial_Joints

Arthritis Foundation. (N.D.). Osteoarthritis. Arthritis Foundation. www.arthritis.org/diseases/osteoarthritis

Kamata, M., & Tada, Y. (2020). Efficacy and Safety of Biologics for Psoriasis and Psoriatic Arthritis and Their Impact on Comorbidities: A Literature Review. International journal of molecular sciences, 21(5), 1690. doi.org/10.3390/ijms21051690

Healing Time: A Key Factor in Sports Injury Recovery

Healing Time: A Key Factor in Sports Injury Recovery

What are the healing times of common sports injuries for athletes and individuals who engage in recreational sports activities?

Healing Time: A Key Factor in Sports Injury Recovery

A young, happy sportswoman is getting tens-electrotherapy treatments at a medical clinic.

Healing Times for Sports Injuries

Healing time from sports injuries depends on various factors, such as the location and extent of the injury and the health of the skin, joints, tendons, muscles, and bones. It is also important to take the time to recuperate or not rush back into physical sports activities before the bones or tissues have fully healed. To prevent re-injury, ensure the doctor clears health before returning to sports or strenuous physical activity.

According to CDC research, an average of 8.6 million sports and recreation-related injuries occur annually. (Sheu, Y., Chen, L. H., and Hedegaard, H. 2016) However, most sports injuries are superficial or caused by low-grade strains or sprains; at least 20% of injuries result from bone fractures or more serious injuries. Bone fractures take longer than sprains or strains, and complete tendon or muscle ruptures can take months before one can fully return to activities. Individuals in decent physical shape with no underlying illness or impairment, here is what they can expect when recovering from the following sports injuries:

Bone Fractures

In sports, the highest rate of bone fractures occurs with football and contact sports. Most are centered around the lower extremities but can involve the neck and shoulder blades, arms, and ribs.

Simple Fractures

  • Depends on the individual’s age, health, type, and location.
  • Generally, takes at least six weeks to heal.

Compound Fractures

  • In this case, a bone is broken in several places.
  • It may require surgery to stabilize the bone.
  • Healing time can take up to eight months.

Fractured Clavicle/Collarbone

  • It may require the immobilization of the shoulder and upper arm.
  • It can take five to ten weeks to heal fully.
  • Fractured fingers or toes can heal in three to five weeks.

Fractured Ribs

  • Part of the treatment plan includes breathing exercises.
  • Painkillers may be needed short term.
  • Usually, it takes around six weeks to heal.

Neck Fractures

  • It may involve any one of the seven neck vertebrae.
  • A neck brace or a halo device that is screwed into the skull for stability may be used.
  • It can take up to six weeks to heal.

Sprains and Strains

According to the CDC report, sprains and strains account for 41.4% of all sports injuries. (Sheu, Y., Chen, L. H., and Hedegaard, H. 2016)

  • A sprain is the stretching or tearing of ligaments or the tough bands of fibrous tissue that connect two bones at a joint.
  • A strain is the overstretching or tearing of muscles or tendons.

Sprained Ankles

  • It can heal in five days if there are no complications.
  • Severe sprains involving torn or ruptured tendons can take three to six weeks to heal.

Calf Strains

  • Classified as grade 1 – a mild strain can heal in two weeks.
  • A grade 3 – severe strain may require three months or more to heal completely.
  • The use of calf suppression sleeves can expedite the recovery of strains and sprains in the lower leg.

Acute Neck Strain

  • A tackle, impact, fall, quick shifting, or whipping motion can cause a whiplash injury.
  • Healing time can take a couple of weeks to six weeks.

Other Injuries

ACL Tears

  • Involving the anterior cruciate ligament.
  • Usually, it requires months of recuperation and rehabilitation, depending on several factors, including the type of sports activity.
  • Full recovery from surgery takes six to 12 months.
  • Without surgery, there is no specific timeline for rehabilitation.

Achilles Tendon Ruptures

  • It is a serious injury.
  • These occur when the tendon is either partially or completely torn.
  • Individuals will more than likely require surgery.
  • Recovery time is four to six months.

Cuts and Lacerations

  • Depends on the depth and location of the injury.
  • It can take anywhere from a week to a month to heal.
  • If there are no accompanying injuries, stitches can be removed within two to three weeks.
  • If a deep cut requires stitches, more time is necessary.

Mild Contusions/Bruises

  • Are caused by a trauma to the skin, causing blood vessels to break.
  • In most cases, a contusion will take five to seven days to heal.

Shoulder Separations

  • When treated properly, it usually takes around two weeks of rest and recovery before the patient returns to activity.

Multidisciplinary Treatment

After the initial inflammation and swelling have subsided, a doctor will recommend a treatment plan that usually involves physical therapy, self-performed physical rehabilitation, or supervision by a physical therapist or team. Fortunately, athletes and individuals who regularly exercise tend to have a faster healing time because they are in top physical shape, and their cardiovascular system provides a stronger blood supply that speeds up the healing process. At El Paso’s Chiropractic Rehabilitation Clinic & Integrated Medicine Center, we passionately focus on treating patients’ injuries and chronic pain syndromes. We focus on improving ability through flexibility, mobility, and agility programs tailored to the individual. We use in-person and virtual health coaching and comprehensive care plans to ensure every patient’s personalized care and wellness outcomes.

Our providers use an integrated approach to create personalized care plans that include Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine principles. Our goal is to relieve pain naturally by restoring health and function to the body.

If the chiropractor feels the individual needs other treatment, they will be referred to a clinic or physician best suited for them. Dr. Jimenez has teamed up with the top surgeons, clinical specialists, medical researchers, and premier rehabilitation providers to provide the top clinical treatments for our community. Providing highly noninvasive protocols is our priority, and our personalized patient-based clinical insight is what we provide.


Lumbar Spine Injuries in Sports: Chiropractic Healing


References

Sheu, Y., Chen, L. H., & Hedegaard, H. (2016). Sports- and Recreation-related Injury Episodes in the United States, 2011-2014. National health statistics reports, (99), 1–12.

Choosing the Right Exercise Ball for an Optimal Workout

Choosing the Right Exercise Ball for an Optimal Workout

For individuals wanting to improve core stability, can using the right size exercise or stability ball help improve workouts and achieve goals?

Get Fit and Improve Your Posture with an Exercise Stability Ball

Exercise Stability Ball

An exercise ball, stability ball, or Swiss ball is a piece of fitness equipment used in gyms, Pilates and yoga studios, and HIIT classes. (American Council on Exercise. 2014) It is inflated with air to supplement bodyweight workouts or improve posture and balance. It can also be used as a chair. They add a core stability challenge to almost any exercise (American Council on Exercise, N.D.) Getting the appropriate exercise ball size and firmness for your body and purpose will ensure an optimal workout.

Size

  • The exercise ball size should be proportional to individual height.
  • Individuals should be able to sit on the ball with their legs at a 90-degree angle or slightly more, but not less.
  • The thighs should be parallel to the ground or angled slightly down.
  • With the feet flat on the floor and the spine straight, not leaning forward, backward, or sideways, the knees should be even with or slightly lower than the hips.

Here is the American Council on Exercise guide when choosing. (American Council on Exercise. 2001)

Height – Ball Size

  • Under 4’6”/137 cm – 30 cm/12 inches
  • 4’6” – 5’0”/137-152 cm – 45 cm/18 inches
  • 5’1”-5’7”/155-170 cm –  55 cm/22 inches
  • 5’8”-6’2”/173-188 cm – 65 cm/26 inches
  • Over 6’2”/188 cm – 75 cm/30 inches

Getting the right exercise ball for weight is also important. Individuals who are heavy for their height may need a larger ball to keep the knees and legs at the correct angle. It is recommended to check the weight rating of the ball, its durability, and its high burst resistance before buying.

Inflation

Individuals want a little give on the ball’s surface for exercise. When sitting on the exercise stability ball, body weight should create a little seat and provide more stability. More importantly, it allows sitting evenly on the ball, which is essential for exercising with proper spinal alignment. (Rafael F. Escamilla et al., 2016) Inflation is a matter of preference, but the more inflated the ball is, the more difficult it will be to balance the body, whether sitting or in other positions. It is recommended not to over-inflate the ball at the risk of bursting. The ball may require reinflation occasionally, so many are sold with a small pump for this purpose.

Exercises and Stretches

Exercise balls are highly versatile, inexpensive, and easy-to-use workout tools. They are beneficial for improving core strength and stability. Ways to be used include:

  • Active sitting in place of a chair.
  • Stretching on the ball.
  • Balance and stability exercises.
  • Pilates or yoga.
  • Strength workout.
  • Target exercises for core activation and strengthening.

At Injury Medical Chiropractic and Functional Medicine Clinic, we focus on what works for you and strive to create fitness and better the body through research methods and total wellness programs. These natural programs use the body’s ability to achieve improvement goals and athletes can condition themselves to excel in their sport through proper fitness and nutrition. Our providers use an integrated approach to create personalized programs, often including Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine principles.


Home Exercises For Pain Relief


References

American Council on Exercise. Sabrena Jo. (2014). Core-strengthening Stability Ball Workout. ACE Fitness® & Healthy Lifestyle Blog. www.acefitness.org/resources/pros/expert-articles/5123/core-strengthening-stability-ball-workout/

American Council on Exercise. (N.D.). Exercise Database & Library. Featured Exercises from ACE. Stability Ball. Healthy Living Blog. www.acefitness.org/resources/everyone/exercise-library/equipment/stability-ball/

American Council on Exercise. (2001). Strengthen your abdominals with stability balls. Healthy Living Blog. acewebcontent.azureedge.net/assets/education-resources/lifestyle/fitfacts/pdfs/fitfacts/itemid_129.pdf

Escamilla, R. F., Lewis, C., Pecson, A., Imamura, R., & Andrews, J. R. (2016). Muscle Activation Among Supine, Prone, and Side Position Exercises With and Without a Swiss Ball. Sports health, 8(4), 372–379. doi.org/10.1177/1941738116653931