Back Clinic Mobility & Flexibility: The human body retains a natural level to ensure all its structures are functioning properly. The bones, muscles, ligaments, tendons, and other tissues work together to allow a range of movement and maintaining proper fitness and balanced nutrition can help keep the body functioning properly. Great mobility means executing functional movements with no restrictions in the range of motion (ROM).
Remember that flexibility is a mobility component, but extreme flexibility really is not required to perform functional movements. A flexible person can have core strength, balance, or coordination but cannot perform the same functional movements as a person with great mobility. According to Dr. Alex Jimenez’s compilation of articles on mobility and flexibility, individuals who don’t stretch their body often can experience shortened or stiffened muscles, decreasing their ability to move effectively.
The shoulder is a ball-and-socket joint. The shoulder has several muscles that help it move and allow a wide range of motion. A strain or pulled shoulder muscle can affect the slightest movements, making simple activities difficult and painful. Pulling a muscle in the shoulder can be caused by an injury, overuse, and general wear and tear. Minor shoulder injuries usually heal on their own with rest and self-care. Severe shoulder muscle injuries should be addressed by a medical professional.
Pulled Shoulder Muscle Causes
Pulling a muscle in the shoulder can happen quickly. This could be from falling on the shoulder, an auto accident, or a work accident. It can develop after weeks, months, and years of repetitive motion and overuse. It is common among individuals that play certain sports or jobs that require repetitive activities with the shoulders. They can also happen with no apparent cause. Treatment and recovery depend on the type and severity of the injury.
How to Tell If It’s a Pulled Muscle
It can be hard to tell the cause unless the individual has experienced the specific type of pain before. Otherwise, it is recommended to consult a medical professional like a physical therapist or chiropractor. This is because shoulder pain can be caused by inflammation of the tendons and joints and/or the joint itself.
Pulled Muscle Shoulder Symptoms
A pulled muscle is characterized by:
Tenderness
Dull, sore, or aching pain.
Sometimes it can cause shooting pain between the shoulder blades in the front or back.
Pain when the shoulder is at rest.
Pain when the specific muscle is used.
Swelling of the area.
Shoulder instability.
The shoulder feels fragile.
Movement causes pain.
A bump may develop at the top of the shoulder near the end of the collarbone.
Inability to use the muscle at all.
If the pain is persistent, it could signify that there is something other than a pulled muscle like a pinched nerve or a joint issue.
Treatment and Recovery Options
Treatment and recovery vary and depend on the severity of the pull and the individual’s overall health. Many find that their pain is reduced with self-care in 2 or 3 weeks. Chiropractic treatment for a pulled shoulder muscle can provide relief within 1 or 2 weeks.
Self Care
Depending on the severity of the pull and how much pain is being experienced, individuals could be recommended to take an NSAID like Ibuprofen to reduce pain and swelling. Self-care can include:
Ice To Reduce Swelling
Applying ice or a cold pack to the area can help reduce swelling.
Place a cloth or towel between the skin and the cold pack.
Apply it for 20 minutes an hour.
The swelling should reduce in a day or two.
Rest
It is recommended to rest the shoulder for no more than 2 or 3 days.
This begins the healing process and prevents worsening the injury.
Wrap or Sling
During rest days, it can be hard to keep the shoulder from moving.
To avoid this, use a shoulder wrap or a sling to support the arm.
However, they should not be used for more than 2 or 3 days.
Gentle Stretching
It is essential to get the muscle working again after 2 or 3 days of rest.
Stretches will help the muscle group heal and gain strength.
Not stretching the muscle could prolong recovery and worsen the injury, and possibly cause new injuries.
Stretches For a Pulled Shoulder
Stretching a pulled shoulder muscle after a few days of rest is recommended because not working out the injured muscle can cause more problems. Not using the muscle can cause it to atrophy, which will take longer to heal, and the surrounding muscles become weak.
Pendulum Stretch
Slightly bent support the body by placing the unaffected arm on a table or chair.
Let the injured arm hang straight down.
Swing the arm in small circles clockwise as far as the pain or discomfort allows.
Perform for 1 minute.
Go counterclockwise for one minute.
Repeat 4 to 8 times throughout the day.
Chiropractic
If self-care is not providing sufficient relief, then chiropractic treatment is recommended. A doctor of chiropractic can advise on the best treatment options and get to the root of the issue. Chiropractors have a treatment arsenal of modalities and approaches to help treat pulled muscles. These include:
A somatotype is the overall shape and composition of the human body. Body types based on physique have three generalized divisions:
Endomorph
Mesomorph
Ectomorph
However, it is rare for someone to fall entirely into one somatotype. Individuals can have a combination of qualities from two somatotypes, like an ectomorph-endomorph hybrid or an endomorph-ectomorph, for example.
Ectomorphs
Naturally lean with long limbs, ectomorphs typically possess a slender look no matter what type of diet.
A lot of endurance runners and swimmers are ectomorphs.
Ectomorphs may have a decent amount of muscle but may appear to have less muscle development because of their long limb length.
Body fat also seems to get hidden by the long, slender figure, which means they can get away with a few extra pounds of fat.
However, if ectomorphs do not watch their health, they can become skinny fat.
Mesomorphs
Mesomorphs have a natural athletic look.
They can achieve a muscular physique without really trying.
The physiology tends to include:
Narrow hips
Wide back
A large frame contributes to a muscular appearance.
Many professional fighters, football, and basketball players are mesomorphs.
Endomorphs
Endomorphs have a larger structure with wide hips and shoulders.
Shorter arms and legs.
This type of body shape is excellent for activities that require a lot of strength.
Rugby players, strength athletes, and powerlifters are endomorphs.
This body type is considered to be a contributing performance factor in Ironman athletes.
References
Blache, Y et al. “Superficial shoulder muscle co-activations during lifting tasks: Influence of lifting height, weight, and phase.” Journal of electromyography and kinesiology: official journal of the International Society of Electrophysiological Kinesiology vol. 25,2 (2015): 355-62. doi:10.1016/j.jelekin.2014.11.004
Brantingham, James W et al. “Manipulative therapy for shoulder pain and disorders: expansion of a systematic review.” Journal of manipulative and physiological therapeutics vol. 34,5 (2011): 314-46. doi:10.1016/j.jmpt.2011.04.002
Kandel, Michel et al. “Somatotype, training and performance in Ironman athletes.” European journal of sports science vol. 14,4 (2014): 301-8. doi:10.1080/17461391.2013.813971
McFarland, Daniel C et al. “Spatial dependency of shoulder muscle demand during dynamic unimanual and bimanual pushing and pulling.” Applied ergonomics vol. 73 (2018): 199-205. doi:10.1016/j.apergo.2018.07.011
One of the most common tendons in the body that gets injured is the Achilles tendon, and this tendon tends to rupture when a person is doing recreational sports. Most people have opted for treatment for their Achilles tendon through surgery; however, low laser therapy can help the Achilles tendon recover a bit faster while providing beneficial properties during treatment. Low laser therapy has positive effects on the affected area where the pain resides and has helped progress the body’s natural healing process.
Achilles Tendon and Symptoms
The Achilles tendon is a strong fibrous cord connected at the back of the calf muscles to the heel bone. When a person does recreational sports, the Achilles tendon stretches during the activity. However, when the Achilles tendon is overly stretched during the exercise, it can rupture completely or partially depending on how strenuous the body is being put through.
Some of the symptoms of a ruptured Achilles include:
A feeling of being kicked in the calf
A popping or snapping sound where the injury occurred.
Pain and swelling near the heel.
The inability to bend the foot downwards
The inability to stand on the toes
When these symptoms occur in the Achilles tendon, it is due to the lack of blood flow that the body is not providing. Studies have found that when the Achilles tendon is ruptured, it is a severe injury due to the scarce blood supply, and it could take weeks or even months before it is completely healed.
Low Laser Treatments and Benefits
Patients with a ruptured Achilles heel can get low laser therapy to help relieve the pain from the ruptured tendon. Studies found that when patients are being treated with low laser therapy has shown beneficial results. The results showed how the application of low laser treatment is very effective. The therapy provides a consequent relief from the motor function pain to the heel while also providing anti-inflammatory properties to the affected area. What this does is that the low-intensity laser concentrates on the inflammatory markers of the affected area, thus providing an increased blood flow (angiogenesis) in the treated area and decreasing inflammation. Low laser therapy can even help accelerate and enhance the repair of the injured Achilles tendon with frequent treatment sessions.
Conclusion
Overall, the Achilles tendon is one of the most frequent tendons that gets ruptured when a person is doing recreational sports. The healing process can take to about a week to a month for the tendon to properly heal. But through low laser therapy, the Achilles tendon can be repaired while providing relief from inflammation and enhancing the injured tendon recovery process.
Jesus, Julio Fernandes de, et al. “Low-Level Laser Therapy on Tissue Repair of Partially Injured Achilles Tendon in Rats.” Photomedicine and Laser Surgery, U.S. National Library of Medicine, 15 May 2015, pubmed.ncbi.nlm.nih.gov/24831690/.
Nogueira, Adelmário Cavalcanti, and Manoel de Jesus Moura Júnior. “The Effects of Laser Treatment in Tendinopathy: A Systematic Review.” Acta Ortopedica Brasileira, Sociedade Brasileira De Ortopedia e Traumatologia, 2015, www.ncbi.nlm.nih.gov/pmc/articles/PMC4544521/.
Stretching out for everyday wear and tear. The body was designed for movement, mobility, and physicality. When discomfort, aches, and pain present in the neck, shoulders, back, and joints, it is often from a decrease of natural body movement. Many think that sitting still and resting is the best solution to alleviate the pain. While it is important to rest, it is the type of rest that helps the body. Sitting still with no movement is not recommended. The muscles, ligaments, and tendons need to flex and stretch out to help reduce pain and prevent injury. Safe, chiropractic-approved stretches can increase mobility and fluidity, helping the body stay flexible and loose.
Stretching Out For Everyday Wear and Tear Is Important
Whether experiencing pain or are getting ready for the day, there are many reasons why stretching is important. One, stretching is essential to optimal joint health. When muscles surrounding the joints become tight/tense, this significantly reduces mobility in the joint. Regular stretching lengthens the muscles, relaxing the joints to move without discomfort/awkwardness. Stretching optimizes blood circulation to flow smoothly through the body. Routine stretching helps reduce stress and improves energy. Other benefits include:
Post-workout/exercise/physical activity soreness and pain relief
Improves athletic performance
Prevents injury/s
Helps heal existing injuries
Improves posture
Stretching Safe at Home
Chiropractors often recommend stretches for patients to follow to help improve their progress between appointments. If persistent pain is presenting, consult with a qualified chiropractic doctor before performing any stretches. If done incorrectly, they can exacerbate pain and cause further damage. No matter an individual’s lifestyle, the wear and tear of everyday life can cause tightness, inflammation, or generalized pain. Developing a regular stretching routine can address any tense, tight, sore areas that will help keep the body pain-free.
Tailbone Stretch
Most individuals feel tailbone pain from sitting for long periods of time. Reasons for tailbone pain can result from:
Falling backward
Sitting in the wrong position
Childbirth
Hypermobility
All can injure the tailbone and/or the surrounding muscles and tissue.
Tailbone stretching improves movement and flexibility in these muscles and tissue, maintaining the tailbone’s health. One recommended stretch is the piriformis cross leg stretch.
Lie flat on the back.
Bring both knees toward the hips.
Rest the right ankle across the left knee.
Wrap both hands around the left thigh
Pull toward the chest.
Hold for 20-30 seconds.
Slowly bring down both legs and return to the starting position.
Repeat on the other side.
Wrist and Hand Stretch
For those that are constantly writing, typing, or lifting regularly, wrist and hand pain can begin to present. Stretches for the hands and wrists can:
Increase flexibility
Alleviate pain
Reduce the risk of injury
The prayer stretch for the wrists and hands is specifically designed to strengthen the muscles and tendons in the wrists.
Standing with the back straight and feet shoulder-width apart.
Place hands together in a prayer position.
Hands in front of the face.
Pressing both palms together, slowly spread the elbows apart.
Begin to lower the hands to waist height
Stop once the hands become level with the belly button or when the stretch is felt.
Hold the position for 10-30 seconds.
Return to the original position.
Repeat as needed.
Knee Stretch
When tightness or soreness presents in the knee, stretching the hamstrings can help. The hamstrings go through a great deal of wear and tear, supporting the hips and knees, maintaining mobility and flexibility.
Standing with the back straight.
Step forward with the left foot.
Flex the left foot and keep the right foot flat.
Loosen the hips and bend the right knee.
As the right leg is bent, keep the left leg completely straight with the heel pressing into the ground.
If maintaining balance is difficult, use a wall for support.
Hold the position for 10-15 seconds.
Return to starting position.
Repeat on the other side.
Body Composition Health
The Gut’s Hormones
When a meal enters the stomach and intestines, it triggers the digestive tract to release hormones that create the full feeling. These are the gut’s hormones, with each having a specific set of actions and effects. Examples include PYY, GLP-1, and GIP. Gut hormones are essential because they signal the body to slow down or stop eating. Therefore, the size of a meal influences the number of gut hormones that get released. The body releases larger quantities of gut hormones in response to meals with a higher caloric density. This is because larger meals usually contain more calories. This is one reason the body feels more satisfied after a large meal. Smaller meals are less satisfying, which means an individual will want to eat again after the meal.
After eating comes the digestion and absorption of macronutrients. This is known as the postprandial state. The body is in storage mode during the postprandial state. Even though the metabolic rate increases after a meal, the contents of that meal get broken down and stored for fuel. Four hours after a meal, the body goes back to its baseline state, which primarily burns through the stored fuel. Eating frequent, small meals throughout the day means the body spends more of the day in the postprandial storage state.
References
Bandy, WD et al. “The effect of time and frequency of static stretching on flexibility of the hamstring muscles.” Physical therapy vol. 77,10 (1997): 1090-6. doi:10.1093/ptj/77.10.1090
Freitas, SR et al. “Stretching Effects: High-intensity & Moderate-duration vs. Low-intensity & Long-duration.” International journal of sports medicine vol. 37,3 (2016): 239-44. doi:10.1055/s-0035-1548946
Hotta, Kazuki et al. “Daily muscle stretching enhance blood flow, endothelial function, capillarity, vascular volume and connectivity in aged skeletal muscle.” The Journal of physiology vol. 596,10 (2018): 1903-1917. doi:10.1113/JP275459
le Roux, C W et al. “Attenuated peptide YY release in obese subjects is associated with reduced satiety.” Endocrinology vol. 147,1 (2006): 3-8. doi:10.1210/en.2005-0972
Although it is not officially summer, the past few weeks sure feels like it. Especially for those with joint discomfort and pain. As the body ages, individuals may notice their joints have some mobility/flexibility issues in the summer heat. Again, the heat and humidity are the culprits. The hotter it is, the more the body is susceptible to inflammation and swelling. The more prone an individual’s body is to swelling, the more pain can present. Barometric pressure can also have some form of impact on joint health. The pressure changes can cause the joints to become more sensitive. When the pressure changes, individuals often speak of their joints feeling tighter combined with stiffness, leading to a cycle of swelling and pain.
Joint Anatomy
Whether it’s the hip, knee, elbow, or hand, all of the body’s joints have fluid in them. It is a gel-like substance known as synovial fluid. This is what lubricates the joints and keeps them functioning smoothly. However, the temperature and humidity levels can change the thickness of the fluid in the joints. This means that the synovial fluid can become inflamed with the weather changes. This is a symptom when the joints begin to feel like they cannot move and/or are becoming stiff. Joint inflammation can become more common and chronic as the body gets older.
Weather and the joints
The summer heat and humidity can affect the joint because:
The tendons, ligaments, and muscles expand in this type of weather
The heat can restrict individuals from moving around. Non-use stiffens the joints
Joints that have worn down cartilage could have exposed nerves that are reacting to the temperature changes
Humidity causes the body to lose water by sweating. This can reduce the fluid around the joints leading to stiffness, immobility, and pain.
However, not everyone has joint problems in the summer heat. Many have joint issues when it’s cold, damp, or raining. Other’s are at their best in cool, dry weather. It depends on an individual’s body and how their joints react when the temperature changes.
Maintaining joint health for the summer heat
When joint discomfort or pain presents in the summer, there are a few easy ways to gain relief.
Properly Hydrate the Body
Water and sports drinks maintain the fluid levels in the body, specifically, it keeps the joints moving. One way to hydrate the body can be achieved by eating healthy fruits and vegetables. Water-rich fruits and vegetables include:
Watermelon
Oranges
Strawberries
Tomatoes
Cucumbers
Spinach
Celery
Over-The-Counter pain ointments and creams
Arthritis and anti-inflammatory creams/ointments can ease joint pain by allowing more blood circulation in the affected areas.
Dressing for the heat
Wear loose, natural fiber, breathable clothing that allows the body to move freely while maintaining a cool temperature.
Relax in the air conditioning
Get into the air conditioning. The cool air can help reduce joint inflammation.
Get in the Water
Swimming or just wading through doing some light exercise in the water cools the body’s core. In addition, the buoyancy of the water relieves pressure on the joints.
Body Composition Testing
Body Water
The body is made up of as much as 2/3’s water. Even though much of the body is made up of water, the percentage of body composition changes based on functional needs. Essential functions of water include:
Water is the building block to almost every cell in the body
It regulates the body’s temperature through sweating and respiration
Carbohydrates and proteins for energy are transported via the water in the blood
Water assists in the removal of metabolic waste through urination
It is part of the shock-absorbing system that protects the brain and spinal cord
Water is part of the saliva and fluid that lubricates the joints
The amount of water in the body depends on various factors. This includes:
Age
Gender
Physical activity
It is referred to as Total Body Water or TBW.
TBW is constantly changing with gains and losses of fluid in healthy adults. The body can detect irregularities and compensate for losses and/or gains to make sure that the systems are balanced.
The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. In addition, we provide copies of supporting research studies available to regulatory boards and the public upon request.
We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.
Morton, Darren, and Robin Callister. “Exercise-related transient abdominal pain (ETAP).” Sports medicine (Auckland, N.Z.) vol. 45,1 (2015): 23-35. doi:10.1007/s40279-014-0245-z
Peeler, Jason et al. “Managing Knee Osteoarthritis: The Effects of Body Weight Supported Physical Activity on Joint Pain, Function, and Thigh Muscle Strength.” Clinical journal of sports medicine: official journal of the Canadian Academy of Sports Medicine vol. 25,6 (2015): 518-23. doi:10.1097/JSM.0000000000000173
Quick, D C. “Joint pain and weather. A critical review of the literature.” Minnesota medicine vol. 80,3 (1997): 25-9.
Timmermans, Erik J et al. “The Influence of Weather Conditions on Joint Pain in Older People with Osteoarthritis: Results from the European Project on OSteoArthritis.” The Journal of rheumatology vol. 42,10 (2015): 1885-92. doi:10.3899/jrheum.141594
Here are a few recommended stretches and exercises for relieving herniated disc symptoms. The vertebrae are the small bones that make up the spine. They have cushion discs between each one. These are the intervertebral discs and are the body’s shock absorbers. The discs can be thought of as small balloons that are filled with an elastic gel-type material. There are twenty-three of these cushions.
Functioning as the body’s shock absorbers transferring various forces, weight, and stress from vertebra to vertebra, so that no one is overburdened taking on all the impact the body goes through. But like any machine, the discs can wear down over time, and sustain injury. When this happens the cushioning gel can leak out and press on the nerve roots emerging from the spine. This type of injury is a herniated disc.
Herniated Disc Treatment
A herniated disc can lose its height because of fluid and water loss.
This loss affects the bone structures bringing them closer together affecting the ligaments that connect each segment. The ligaments become loose and do not provide the same stability. Ligaments cannot be strengthened with exercise making it more important to strengthen the muscles around the spine to make up for this stability loss. Depending on the severity of the injury, the displaced disc can cause pressure to build upon the nerves, resulting in pain and other discomforts. This comes from the loss of the disc’s cushion causing the vertebrae to rub against each other. Stretches and exercises designed for herniated discs can work in conjunction with conservative treatment to relieve the pain and discomfort.
Stretches and Exercises for Pain Relief
Consult a medical spine specialist/chiropractor before beginning a stretch and exercise regimen. This is because the herniation can become worse or additional injury/s can occur without proper instruction. Once the injury and clinical considerations have been addressed, gentle stretches and exercises can help reduce the pain and other symptoms. Strengthening the back and hamstring muscles reduces pressure on the spinal column helping to prevent pain and promotes healing by:
Increasing blood flow to the spine
Building strength to support the spinal muscles
Decreases stress on the spine
Helps relieve the pain
Improves abnormal postures and awkward body positions
Equipment is not necessary but there are few items that can help the process.
A herniated disc in the neck is usually caused by a forward head posture and a swayback or excessive curvature of the spine.
Isometric hold
Sit straight
Relax the shoulders
Place one hand on the forehead
Push head into the hand without moving the head
Hold for 5 to 15 seconds.
Repeat 15 times
Chin tuck
Lie on your back on a flat surface
Place arms at sides
Tuck the chin in and down toward the chest until a stretch is felt
Hold for 5 to 10 seconds
Repeat 15 to 20 times
Lumbar/Low Back Stretches and Exercises
Back flexion stretch
This stretch extends the back muscles to relieve low back pain.
Lie flat on your back
Pull the knees toward the chest and wrap your arms around the knees
Lift head straight up off the floor until there is a stretch across the mid and low back
Hold for 10 seconds
Repeat 5 to 10 times
Piriformis stretch
This stretches the small muscle in the buttocks helping to relieve low back pain and helps with sciatica.
Lie flat on your back on the floor or yoga mat
Bend the knees
Plant feet on the floor
Pick up one leg and rest the ankle on the other leg’s bent knee
Reach one arm through the leg and use both hands to grasp the bent leg
Pull the leg toward the chest until there is a stretch in the buttock
Hold for 30 seconds
Repeat on the other leg
Prone extension stretch
This stretch helps reposition the disc back to its proper position, expediting the healing process. Start slowly and if pain presents, stop immediately.
Lie face down on the floor or yoga mat
Place the forearms on the floor next to the body
The elbows should be at a 45- degree angle
Slowly prop the body up, being sure to keep the hips on the floor
Keep pressing upward until the elbows are at a 90-degree angle
Hold the position for 10-15 seconds
Return to starting position
Repeat the stretch 10 times
Gradually increase the upward position hold time until it can be maintained for 30 seconds
Performing these stretches and exercises or similar types will help with herniated injury recovery and prevent worsening or creating new injuries.
Body Composition
Benefits of yoga
Yoga benefits mental and physical health. Yoga helps improve individual physical health. Specific poses can help:
Improve balance
Flexibility
Build/Tone muscle
Prevent injury
Improve sense of well-being
Yoga stretches the muscles while relieving physical and emotional stress. Practicing yoga regularly can prevent obesity, and reduce the risk of developing metabolic syndrome. Yoga can help decrease leptin which is a hormone that helps control appetite. This is important for individuals going through chronic stress who are twice as likely to develop metabolic syndrome.
Disclaimer
The information herein is not intended to replace a one-on-one relationship with a qualified health care professional, licensed physician, and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the musculoskeletal system’s injuries or disorders. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request. We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.
Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, CTG*
email: coach@elpasofunctionalmedicine.com
phone: 915-850-0900
Licensed in Texas & New Mexico
References
Court C, Mansour E, Bouthors C. Thoracic disc herniation: Surgical treatment, Orthopaedics & Traumatology: Surgery & Research, 104(1)S31-@40, 2018, https://www.sciencedirect.com/science/article/pii/S1877056817303419.
Individuals with ankylosing spondylitis have a new treatment option that was previously used for rheumatoid arthritis. It is a medication that belongs to a class known as JAK inhibitors. Ankylosing spondylitis combines joint pain with reduced mobility. Ankylosing spondylitis is different because in severe cases, the bones in the spine can fuse together, literally reducing mobility.
The disease typically begins with pain and stiffness in the back. This is usually after some time of inactivity. Symptoms start before the age of 45 and develop gradually. There is no cure for ankylosing spondylitis but there are treatments that can improve symptoms and put the condition into remission. Ankylosing spondylitis treatment is the most successful when addressed early before irreversible damage to the joints begins.
Janus Kinase Inhibitors
Janus kinase inhibitors have traditionally been used to treat:
Rheumatoid arthritis
Psoriatic arthritis
Ulcerative colitis
The medication works by decreasing the immune system�s activity. Janus kinase inhibitor drugs affect several cellular compounds that are important in the development and progression of ankylosing spondylitis. Currently, there are only three Janus kinase inhibitor medications available in the United States and FDA-approved to treat rheumatoid arthritis:
Xeljanz
Rinvoq
Olumiant
Each of the approved inhibitors targets specific enzymes
Current Ankylosing Spondylitis Treatments
Janus kinase inhibitors are not given to individuals right away. However, it could be an option if first and second-line treatments are not working. Treatments usually consist of:
First-Line Treatments
NSAIDs
Nonsteroidal anti-inflammatory medications are the most commonly used to treat ankylosing inflammation, pain, and stiffness.
Chiropractic
Chiropractic physical therapy is a major part of ankylosing spondylitis treatment keeping the spine flexible and as healthy as possible. A chiropractic/physical therapy team design and develop specific exercises to fit individual needs, which include:
Stretching and Range-of-motion exercises help maintain flexibility in the joints
Sleeping and walking posture adjustment exercises
Abdominal and spinal exercises to maintain a healthy posture
If nonsteroidal anti-inflammatory medications do not relieve symptoms, then biological medications could be prescribed. This class of medications includes:
Tumor necrosis factor blockers work by targeting cell protein that is part of the immune system, known as tumor necrosis alpha. This protein causes inflammation in the body, and the blockers suppress it.
Interleukin 17 Inhibitors
Interleukin 17 in the body’s immune system defends against infection. It uses an inflammatory response to fight infections. The IL-17 inhibitors suppress the inflammatory response and help reduce symptoms.
Other Treatment Options
Lifestyle Adjustments
Following a medical treatment plan is often combined with diet and lifestyle adjustments that are recommended to help with the condition, these include:
Most individuals with ankylosing spondylitis do not require surgery. However, a doctor could recommend surgery if there is joint damage, the hip-joint needs to be replaced, or if the pain is severe.
Inhibitor Potential
Studies are ongoing in the treatment of ankylosing spondylitis. The drug is currently in Phase 3 trials for the treatment of adults. The trial results have shown patients with active ankylosing spondylitis showed improvement in:
Fatigue
Inflammation
Back pain
The study enrolled adults with active ankylosing spondylitis who took at least two NSAIDs that were ineffective at treating symptoms. Most of the participants were men, average age of 41, and no prior usage of biologic disease-modifying antirheumatic drugs.
Janus kinase could become a standard treatment
There is still not enough research to make a prediction, but the data is promising. The inhibitors seem to be a safe option when used in a properly screened, well-matched setting that includes regular monitoring. The inhibitors appear to be effective and have the advantages of being taken orally and working fast.
Body Composition
Osteoarthritis and weight loss
Being obese has shown to be a high-risk factor for the development of osteoarthritis. This is not only from the effects of extra weight on the body’s joints but also as a result of the inflammatory effects of adipose tissue. The lower back, hips, and knees, bear the majority of the body’s weight.
An excess amount of adipose tissue on the body’s midsection and legs has been shown to negatively impact the weight-bearing joints. Promoting Lean Body Mass and encouraging weight loss lowers the risk of osteoarthritis and improves an individual’s quality of life. Exercise is regarded safe for individuals with osteoarthritis and should be incorporated to improve body composition, reduce Body Fat Mass, improve Lean Body Mass and maintain a healthy weight.
Dr. Alex Jimenez�s Blog Post Disclaimer
The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.*
Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*
References
Hammitzsch A, Lorenz G, Moog P. Impact of Janus Kinase Inhibition on the Treatment of Axial Spondyloarthropathies. Frontiers in Immunology 11:2488, Oct 2020; doi 10.3389/fimmu.2020.591176.�www.frontiersin.org/article/10.3389/fimmu.2020.591176, accessed Jan 21, 2021.
van der Heijde D, Baraliakos X, Gensler LS, et al. Efficacy and safety of filgotinib, a selective Janus kinase 1 inhibitor, in patients with active ankylosing spondylitis (TORTUGA): results from a randomized, placebo-controlled, phase 2 trial.�Lancet.�2018 Dec 1;392(10162):2378-2387. doi: 10.1016/S0140-6736(18)32463-2. Epub 2018 Oct 22. PMID: 30360970.�pubmed.ncbi.nlm.nih.gov/30360970/�accessed Jan 19, 2021.
When lower back pain presents many want to retreat to the couch, bed and just lay down, but doctors, chiropractors, physical therapists, and spine specialists do not recommend this course of action. What they do recommend, other than treatment, is to engage in the easiest forms of exercise on the spine and back muscles. �
Staying sedentary is one of the worst things an individual can do to their back. When the back is aching exercise can usually help. This is because the muscles, ligaments, tendons are being stretched and not just staying still, which lets inflammation build up and swell. Moving keeps the blood flowing, allowing for broader healing and recovery.
However, back pain relief can be a challenge. Various treatment options exist because there are a variety of causes. The key is figuring out which type is best for each individual and their specific condition. An individual needs to know the cause of their type of back pain, as this determines which exercises should or should not be doing. The Pain and Therapy journal evaluated some of the best exercises for lower back pain. �
Physical Therapy Exercises
The McKenzie method can be very effective for acute disc herniation pain and sciatica. This type of exercise is to figure out if there is a specific position that helps the pain become centralized, correct any motion restrictions, and take the pressure off the region that is compressed or inflamed. Physical therapists incorporate McKenzie exercises as part of regular treatment. The strength-building moves are designed to help support the spine and consist of range-of-movement work and sustained positions. �
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Home and Studio Workouts
Pilates is one of the easiest exercises for individuals with chronic low-back pain. Like McKenzie exercises, it utilizes sustained positions that strengthen the trunk/core muscles. The muscles are strengthened using small movements. Using the machine called a reformer, has built-in support for the spine. This is considered a low-key, muscle-toning workout that can ease chronic back pain. �
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Water Exercise
Water exercises lessen the body’s weight, taking pressure/stress off the spine. Deep-water running with the water at shoulder-height can significantly improve low-back pain. In a study, a group of overweight/obese women worked out twice a week for an hour-long exercise session. After 12 weeks, improvements in pain intensity, personal care, sitting, standing, and sleeping were reported. �
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Easiest Office Exercise
One of the easiest exercises is walking. It is great for the body. But the key is to walk more than usual around the office, or wherever work is. This is not about getting the heart rate up. It is about not staying in the same position for too long. When sitting and focused, an individual can stay in an uncomfortable position for some time and just push through it in an attempt to finish up the work.
Using a timer or an application that alerts every hour to get up and stretch is highly beneficial. Walk correctly to the bathroom, or just get up and walk around for a bit gets the blood pumping through the body and the muscles in motion stretching and contracting. �
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Stabilization Exercise
Strengthening workouts can be done at home.
Stretch while standing against the wall bringing the arms up and down.
Pull the elbows down into the back, which stops the hyperactive trapezius from tensing up.
Knee to the chest motion while lying on the back
Abdominal crunches while balance on an exercise ball
Push the head back into the headrest while driving. This helps avoid the forward head posture.
Contact a doctor, chiropractor, or physical therapist that can recommend the best stabilization exercises for the specific pain/condition. �
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Tai Chi and Qigong
Tai Chi and Qigong are gentle exercises where an individual performs slow, controlled movements emphasizing balance and focus. Both can reduce pain, disability, and other symptoms associated with lower back pain. �
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Body Composition Testimonial
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Exercise After Childbirth
Physical activity for pregnant and post-birth, the American Congress of Obstetricians and Gynecologists recommends the following. The easiest exercise routines can be resumed gradually after pregnancy, once a doctor confirms it is medically safe, depending on the delivery, and the presence or absence of medical complications.
Regular aerobic exercise in lactating women has been shown to improve cardiovascular fitness without affecting milk production, composition, or infant growth.
Nursing women should consider feeding their infants before exercising in order to avoid exercise discomfort.
Nursing women also should ensure proper hydration before engaging in physical activity.
Take it slow.
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Dr. Alex Jimenez�s Blog Post Disclaimer
The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.*
Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*
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