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Mobility & Flexibility

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 Benefits of Walking with a Cane After Injury or Surgery

The Benefits of Walking with a Cane After Injury or Surgery

Can using a cane help individuals after an injury, living with chronic pain or balance issues, or post-surgery?

The Benefits of Walking with a Cane After Injury or Surgery

Walking With A Cane

A cane is an assistive device that can help individuals walk after injury or surgery and aids with balance and stability. It can be used for:

Balance or Stability Issues

  • Canes can help with minor balance or stability issues, such as weakness in the leg or trunk, or after an injury.

Pain

  • Canes can help reduce stress on painful joints or limbs.

Independence

  • Canes can help people continue living independently, especially the elderly.

There are different types of canes, including single-point and quad canes. Single-point canes are generally the least expensive. Quad canes have four points and can provide more stability. It is important to use it correctly to prevent falls and injuries.

Post-surgery or Injury

A cane can help reduce pressure on the leg or back after surgery or injury. Healthcare providers may recommend a cane as a step-down device after using a walker or crutches. Before walking with the cane, ensure it is at the right height. Hold the cane in the hand on the opposite side of the injury. Hold the cane’s handle at the level of the bend in the wrist when standing with the elbow slightly bent. (American Academy of Orthopaedic Surgeons, 2020) If there are issues in both legs or a cane is used after back surgery, keep the cane in the hand with the most support.

Practicing Taking Steps

To practice taking steps with a cane, try the following (American Academy of Orthopaedic Surgeons, 2020)

  • Place the cane firmly on the ground.
  • Take a small step forward with the injured leg.
  • Step the opposite foot forward to meet the injured leg.
  • Continue this process until you can take multiple steps in a row with balance.

Progress to a step-to-walking pattern (Hirayama K. et al., 2022)

  • Step forward with the cane and injured leg at the same time.
  • Step the non-injured leg up with the cane firmly on the ground to meet the injured leg.
  • The feet should be side by side.

Walking Normally

Once comfortable taking practice steps, try walking normally with the cane. Step forward with the cane and injured leg simultaneously. The cane should be off the ground when the wounded leg is in the air. Firmly plant the cane when stepping onto the injured leg. Step forward with the cane and the injured leg first, then step past the injured leg with the good leg.

Using The Stairs

When walking up and down stairs, it’s important to use proper technique to prevent losing balance. (American Academy of Orthopaedic Surgeons, 2020)

Walking Up the Stairs

  • Step up with the good leg.
  • Bring the injured leg and cane up to the step.

Walking Down the Stairs

  • Step down with the injured leg while lowering the cane to the step below.
  • Make sure the cane is firmly on the stairs.
  • Bring the good leg down to the same step.

If a handrail is available, use it. Although doing so may require moving the cane to the other hand, even if it’s on the same side as the injured leg, it will improve stability and reduce the risk of falling. Once proficient on the stairs, individuals may alternate placing one foot on each step.

Walking With Chronic Pain

Walking with a cane with a chronic pain condition is similar to using it with an injury. The location of the pain will determine which hand the cane is held in. If the pain is on the right side of the body, keep the cane on the left side or vice versa. If chronic pain is not in the legs but, for example, back pain makes it difficult to walk, hold the cane on either side, whichever feels more supportive and comfortable. If there is weakness on one side of the body or decreased sensation/numbness in one of the legs or feet, hold the cane on the opposite side of the pain, weakness, or numbness. Walking with a cane can also benefit individuals with other medical conditions. For example, assistive devices may be recommended for those with balance issues. (National Library of Medicine, 2023)

Cane Types

There are two primary types of canes, characterized by their points, and choosing the right one depends on the reason it’s needed. (Arthritis Foundation, N.D.)

Single-point

  • Single-point canes have one tip at the end.
  • These are recommended for those who need to relieve some pressure off an injured leg or need support due to occasional difficulties with balance.

Quad

  • Quad canes have four tips or feet to provide more stability.
  • They provide more support and are recommended for those with significant weakness in one leg or difficulty maintaining their balance while walking.

The traditional cane has a rounded C handle. Other types have contoured handles for a more secure grip. Talk to a doctor, physical therapist, or other health care professional for suggestions on which cane is right for you.

Losing Balance

A potential risk of using a cane is losing balance. If unable to maintain balance with a cane, individuals may want to consider a different walking device, such as a walker or crutches. To reduce the risk of falls, consider the following tips (American Academy of Orthopaedic Surgeons, 2020)

  • Wear shoes with nonskid soles.
  • Add lighting so you can see where you are walking.
  • Remove throw rugs or objects that can cause tripping.
  • Arrange furniture to allow for wide walking paths throughout the home.
  • Carry objects in a backpack or fanny pack rather than holding them.

Injury Medical Chiropractic and Functional Medicine Clinic

Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other associated medical professionals to develop a personalized treatment plan to help relieve muscle pain, improve the body’s flexibility and mobility, resolve musculoskeletal issues, and prevent future pain symptoms from reoccurring.


Osteoporosis


References

American Academy of Orthopaedic Surgeons. (2020). How to use crutches, canes, and walkers. orthoinfo.aaos.org/en/recovery/how-to-use-crutches-canes-and-walkers/

Hirayama, K., Otaka, Y., Kurayama, T., Takahashi, T., Tomita, Y., Inoue, S., Honaga, K., Kondo, K., & Osu, R. (2022). Efficiency and Stability of Step-To Gait in Slow Walking. Frontiers in human neuroscience, 15, 779920. doi.org/10.3389/fnhum.2021.779920

National Library of Medicine. (2023). Using a cane. Retrieved from medlineplus.gov/ency/patientinstructions/000343.htm

Arthritis Foundation. (N.D.). How to choose the right cane. www.arthritis.org/health-wellness/healthy-living/managing-pain/joint-protection/how-to-choose-the-right-cane

Antalgic Gait: A Comprehensive Overview

Antalgic Gait: A Comprehensive Overview

Individuals walking with a limp that results in pain could have an antalgic gait, an abnormal walking pattern commonly seen in emergency clinics and primary care offices. Can recognizing the symptoms help healthcare providers develop an effective treatment for the underlying cause?

Antalgic Gait: A Comprehensive Overview

Antalgic Gait

Limping and having an antalgic gait usually indicate a larger issue within the leg or lower back. It is the most common type of abnormal gait. There are various causes of antalgic gait, including acute injuries and gradually progressing medical conditions. The most common causes include osteoarthritis in one of the leg’s joints, lumbar radiculopathy, or an injury to a ligament or tendon. Paying attention to when the limping occurs, and any accompanying symptoms can help determine its origins.

Walking

When limping, the stance phase during walking is shorter than the swing phase. Individuals may widen their legs apart to provide a support base to compensate for the imbalance. In severe cases, an individual may swing their leg irregularly or take several side steps.

Causes and Symptoms

Antalgic gait can be caused by pain in any part of the lower extremity. Limping when walking may be a primary concern but is rarely the only complaint. Other associated symptoms may also be present, depending on the cause. These include:

  • Limited range of motion
  • Joint stiffness
  • Muscular weakness
  • Numbness and tingling
  • Pain
  • Swelling
  • Leg instability or buckling
  • Clicking or popping

Common Causes include:

Hip, knee, and/or Foot problems

When the hip, knee, ankle, or foot joints are injured or have some issue, walking can be painful and lead to a limp.

Sprains, Strains, or Soft-tissue Injuries

Sprains, strains, and soft-tissue injuries can result from acute injury or chronic, repetitive activities over time. (Pirker W. and Katzenschlager R. 2017) Sprains affect the body’s ligaments, while strains impact muscle tendons. However, sprains and strains occur when the impacted structure is overstretched or partially torn. The damage can lead to pain and antalgic gait. An injury to several other soft-tissue structures, including a bursa or fluid-filled sacs that reduce friction, meniscus, or fat pad, can also lead to limping. Symptoms typically include swelling, pain, and limited range of motion. More severe injuries can also make the leg feel unstable and cause it to give way when walking. Sometimes, bruising can also occur in the area of the injury. (American Academy of Orthopaedic Surgeons, 2020)

Osteoarthritis

Osteoarthritis occurs when the smooth, articular cartilage that lines the ends of bones begins to thin and deteriorate. This can alter the normal movement of a joint and lead to pain. Osteoarthritis symptoms gradually progress, affect individuals over 50, and worsen after periods of sedentary activity (Arthritis Foundation, Osteoarthritis, N.D.) Typically, it results in pain, stiffness, clicking, and occasionally swelling in the affected joint. These symptoms are usually worse in the morning and at the end of a long activity day. Moving around and warming the joint improves osteoarthritis symptoms. (Arthritis Foundation, Osteoarthritis, N.D.)

Lower Back Radiculopathy

Lumbar radiculopathy is when the nerve roots branching off the spine’s lower region become compressed or inflamed. This can occur because of disc issues like bulging, degeneration, herniation, bone spurring, or, rarely, a growth or tumor. (Johns Hopkins Medicine, 2024) Because these nerves control movement, sensation, and strength in the legs and feet, irritation in one can lead to limping. (Yokogawa N. et al., 2015) The antalgic gait from this condition frequently comes on suddenly and is commonly accompanied by back pain symptoms. This can include shooting pain and paresthesia in the leg. Depending on which nerve is involved, individuals may also experience muscular weakness in certain areas of the lower extremity. Sometimes, the affected leg feels like it will buckle while standing or walking. (Johns Hopkins Medicine, 2024)

Other causes include:

  • Broken bones
  • Tumors
  • Infections
  • Blood clots
  • Vascular issues

Treatment

Treatment for antalgic gait depends on the underlying cause but can include:

  • Rest, ice, and elevation are important for injuries. Individuals can control their initial symptoms by icing, elevating the leg, and resting from irritating activities.
  • Activity modifications
  • Antibiotics for infections
  • Pain relievers
  • Anti-inflammatories
  • Physical therapy is also frequently initiated to strengthen the core and alleviate walking symptoms.
  • Chiropractic realignment
  • Non-surgical decompression
  • Acupuncture
  • A corticosteroid injection or joint replacement surgery may prove necessary in more advanced cases. (Arthritis Foundation, Osteoarthritis, N.D.)
  • A spinal injection or surgery can reduce the pressure on the nerve root if conservative interventions fail to improve antalgic gait patterns. (Johns Hopkins Medicine, 2024)
  • Crutches, canes, walkers, or assistive devices can reduce pressure traveling through an affected joint and improve overall walking quality. A study found that using a cane for two months helped reduce pain and improve function in individuals with knee osteoarthritis. (Fang M. A. et al., 2015)

Injury Medical Chiropractic and Functional Medicine Clinic

Though it can be tempting to ignore the limp and push through it, discussing the condition with a healthcare provider is important. A thorough medical exam and diagnostic tests, such as X-ray, MRI, or EMG, can help determine the underlying causes of a limp, help discover the cause of the problem, and help improve the quality of walking. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop personalized treatment programs. Using an integrated approach to treating injuries and chronic pain syndromes to improve flexibility, mobility, and agility and help individuals return to normal activities. Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers if other treatments are needed.


Chiropractic and Integrative Healthcare


References

Pirker, W., & Katzenschlager, R. (2017). Gait disorders in adults and the elderly : A clinical guide. Wiener klinische Wochenschrift, 129(3-4), 81–95. doi.org/10.1007/s00508-016-1096-4

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

American Academy of Orthopaedic Surgeons. (2020). Sprains, strains, and other soft-tissue injuries. orthoinfo.aaos.org/en/diseases–conditions/sprains-strains-and-other-soft-tissue-injuries/

Johns Hopkins Medicine. (2024). Radiculopathy. www.hopkinsmedicine.org/health/conditions-and-diseases/radiculopathy

Yokogawa, N., Toribatake, Y., Murakami, H., Hayashi, H., Yoneyama, T., Watanabe, T., & Tsuchiya, H. (2015). Differences in Gait Characteristics of Patients with Lumbar Spinal Canal Stenosis (L4 Radiculopathy) and Those with Osteoarthritis of the Hip. PloS one, 10(4), e0124745. doi.org/10.1371/journal.pone.0124745

Fang, M. A., Heiney, C., Yentes, J. M., Harada, N. D., Masih, S., & Perell-Gerson, K. L. (2015). Effects of contralateral versus ipsilateral cane use on gait in people with knee osteoarthritis. PM & R : the journal of injury, function, and rehabilitation, 7(4), 400–406. doi.org/10.1016/j.pmrj.2014.09.018

Relieving Pain and Inflammation from Extensor Tendonitis

Relieving Pain and Inflammation from Extensor Tendonitis

Individuals with inflammation, pain, and swelling on the tops of their feet or hands could be experiencing extensor tendonitis. What treatment options are available?

Relieving Pain and Inflammation from Extensor Tendonitis

Extensor Tendonitis

These tendons attach to muscles that straighten the fingers and lift the toes and the top of the foot. Extensor tendonitis is a condition characterized by inflammation of the tendons on the tops of the hands and feet. It often results from overuse of the muscles and from wearing tight shoes. Symptoms tend to worsen with activity and improve with rest. The condition does not usually require surgery; treatments include medications, home remedies/activity modification, and physical therapy.

Types

Tendonitis can develop in any tendon of the extensor muscles. These tendons are long, thin bands of tissue that can be felt on the tops of the hands and feet. The structures attach to muscles on one end and bones of the fingers and toes on the other. The extensor tendons in the hands include: (American Society for Surgery of the Hand, 2024)

  • The extensor digitorum communis straightens the index, middle, ring, and small fingers.
  • The extensor digiti minimi straightens the small finger.
  • The extensor indicis proprius straightens the index finger.
  • The extensor pollicis longus and extensor pollicis brevis muscles move the thumb into the thumb-up position.

Extensor tendons on the top of the foot attach to: (American Society for Surgery of the Hand, 2024)

  • The extensor digitorum longus and extensor digitorum brevis muscles lift the second, third, fourth, and fifth toes.
  • The extensor hallucis longus lifts the big toe.

Tendonitis vs Tendinopathy

  • Chronic tendon pain can lead to a condition known as tendinopathy.
  • Tendonitis results from inflammation.
  • Tendinopathy is the degeneration/micro-tearing of a tendon that occurs with long-term overuse.
  • Knowing which condition you are dealing with is important because it requires different treatments.

Symptoms

The primary symptom is pain in the affected tendon/s. Individuals may also experience swelling, and the skin can become red or warm to the touch. Extensor tendonitis can cause pain when using the affected muscles, moving the hand or foot in the opposite direction, and stretching the tendons. Usually, the pain worsens when using the affected muscles and improves with rest.

Causes

Extensor tendonitis in the hands usually results from overuse, which causes inflammation. However, it can also result from trauma, such as falling on the hand or an injury during physical or sports activities. Common activities include: (Hanson Z. C., and Lourie G. M. 2022)

  • Manual labor work
  • Typing
  • Computer mouse use
  • Weightlifting
  • Gymnastics
  • Playing a musical instrument

Extensor tendonitis in the foot can also result from overuse activities like running, especially uphill. However, it can also occur from wearing overly tight or tightly laced shoes for physical activities like running or dancing. Less common causes include: (Arthritis Foundation, N.D.)

  • Medical conditions like diabetes or arthritis
  • Medication side effects
  • Infection
  • Joint deformities

Treatment

Extensor tendonitis usually improves with conservative treatment, which includes self-care, activity modification, physical therapy, and medication.

Medications

Individuals can treat inflammation with non-steroidal anti-inflammatory drugs NSAIDs like:

  • Ibuprofen
  • Naproxen
  • Aspirin
  • Acetaminophen can help reduce pain.
  • In some cases, individuals may need prescription anti-inflammatory medications like corticosteroids or pain relievers for short-term use.

Self-Care and Activity Adjustments

Self-care includes:

  • Rest and avoid any activities that increase pain symptoms. If you can’t avoid them completely, take frequent breaks to allow the muscles to relax.
  • Apply ice to the hand or foot several times daily for up to 20 minutes.
  • Compression wraps should be applied on the foot or hand using an elastic bandage or soft splint to help support the injured tendons and reduce swelling.
  • Elevate the hand or foot if swollen above the heart level when resting.

Activity Adjustments

  • Modifying activities can help address the underlying cause/s.
  • Hand extensor tendonitis can develop from poor positioning.
  • Setting up an ergonomic workstation can help.
  • Consult a coach or trainer if the tendonitis is related to sports or exercise.
  • Individuals might need to adjust their technique or training schedule to decrease pressure on the tendons.

Physical Therapy

Physical therapy is an effective treatment. A therapy team can help determine the condition’s underlying cause and provide a personalized treatment program. Interventions can include:

  • Pain-reducing treatments like ultrasound, electrical stimulation, electroacupuncture, and laser therapy.
  • Manual therapy
  • Massage therapies
  • Targeted exercise programs
  • Prescription of orthotics like a hand splint or shoe inserts.

Surgery

Surgery is not necessary unless the tendon is torn. (Bronner S., Ojofeitimi S., and Rose D. 2008) (American Society for Surgery of the Hand, 2014) Recovery after surgical repair requires physical therapy treatment following specific protocols based on the patient’s case.

Prognosis

Extensor tendonitis can take weeks or even months to fully heal. Early diagnosis and determining the condition’s underlying cause rather than just treating symptoms are recommended for a faster and optimal recovery. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop personalized treatment programs through an integrated approach to treating injuries and chronic pain syndromes, improving flexibility, mobility, and agility, relieving pain, and helping individuals return to normal activities. Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers if other treatments are needed.


Move Better, Live Better, with Chiropractic


References

American Society for Surgery of the Hand. (2024). Tendons. www.assh.org/handcare/safety/tendons#Finger%20Extensor

Hanson, Z. C., & Lourie, G. M. (2022). Middorsal Wrist Pain in the High-Level Athlete: Causes, Treatment, and Early Return to Play. Orthopaedic journal of sports medicine, 10(4), 23259671221088610. doi.org/10.1177/23259671221088610

Arthritis Foundation. Foundation, A. (N.D.). Tendinitis. www.arthritis.org/diseases/tendinitis

Bronner, S., Ojofeitimi, S., & Rose, D. (2008). Repair and rehabilitation of extensor hallucis longus and brevis tendon lacerations in a professional dancer. The Journal of orthopaedic and sports physical therapy, 38(6), 362–370. doi.org/10.2519/jospt.2008.2749

American Society for Surgery of the Hand. (2014). Extensor tendon injury. www.assh.org/handcare/condition/extensor-tendon-injury#:~:text=The%20tendon%20may%20take%20eight%20to%20twelve%20weeks,may%20include%20stitches%20%28for%20cuts%20in%20the%20tendon%29.

Exploring the Role of Voluntary Muscles in Body Control

Exploring the Role of Voluntary Muscles in Body Control

Skeletal muscles attached to the arms, legs, neck, back, and trunk bones are voluntary and consciously controlled. Weakness or inability to control these muscles can signal a health issue like a neuromuscular disorder or electrolyte imbalance. Can recognizing the symptoms can help healthcare providers develop effective treatment programs?

Exploring the Role of Voluntary Muscles in Body Control

Voluntary Muscles

Voluntary muscles are the skeletal muscles that attach to bones and control movement of the limbs, head, neck, and body under an individual’s conscious control. Skeletal muscles are controlled by neuromuscular signals from the brain that communicate with individual muscle fibers and cause them to contract.

Difference

  • Voluntary muscles are skeletal muscles that contract and relax under conscious control.
  • These muscles attach to bones and regulate movement of the body.
  • Involuntary muscles are not under conscious control.
  • Involuntary muscles involve automatic internal processes needed for survival, like controlling blood vessels and organs like the heart, lungs, and digestive system.
  • They contract and relax automatically and receive signals from the autonomic nervous system, which regulates internal bodily functions.

Voluntary

Voluntary muscles are skeletal muscles that comprise 40% of the body’s weight and 50% to 75% of the body’s proteins. These muscles can convert chemical and mechanical energy to cause voluntary muscle contraction and movement. (Trovato F.M. et al., 2016) Skeletal muscle comprises fascicles or bundled units of multiple muscle fibers or muscle cells. Each muscle fiber consists of a cross-banded structure further divided into myofibrils containing thick myosin and thin actin myofilaments, which give the muscle its stripe appearance, and the structure gives the characteristic striated structure. (Trovato F.M. et al., 2016) Muscle contraction occurs when these myofilaments move closer together, stimulated by the release of the neurotransmitter acetylcholine from nerve cells that communicate with the muscle fiber.

Involuntary

The autonomic nervous system controls involuntary muscles, regulating their contraction and relaxation. This system also controls the activity of organs and blood vessels for essential daily functions, including breathing, circulation, digestion, heartbeat regulation, and urination. Most involuntary muscles are composed of smooth muscles. Smooth muscles do not have the striated structure of skeletal muscles and consist of sheets or layers of smooth muscle cells. When the autonomic nervous system stimulates these muscle cells to contract by releasing hormones or other chemical signals, smooth muscle cells shorten through the movement of actin and myosin myofilaments. Involuntary smooth muscles include the blood vessel walls, diaphragm, intestines, and bladder. (Webb R. C. 2003) One exception of an involuntary muscle is the myocardium, or heart muscle. The myocardium comprises a specialized cardiac muscle cell found only in the heart. Cardiac muscle is striated like skeletal muscle but is controlled by the autonomic nervous system and pacemaker cells, causing it to contract automatically and rhythmically.

Weakened Voluntary Muscles

Skeletal muscle diseases, neuromuscular disorders, and other causes can weaken muscles. Neuromuscular or skeletal muscle disorders affect the nerves that send electrical signals to voluntary skeletal muscles to control movement. When the nerves are damaged, communication between the nerves and muscles becomes disrupted. This can result in significant muscle weakness, atrophy, and loss of function. Most neuromuscular disorders are genetic or caused by issues with the immune system. Nerves communicate with muscles through the release of neurotransmitters at the neuromuscular junction, which is the space between a nerve cell and muscle fiber. Neuromuscular disorders can damage the nerve or the neuromuscular junction. Neuromuscular disorder symptoms can include: (Cleveland Clinic, 2023)

  • Numbness and tingling
  • Muscle weakness
  • Muscle twitches, cramps, or spasms
  • Muscle pain
  • Muscle atrophy
  • Decreased coordination
  • Balance problems
  • Drooping eyelids and double vision from eye muscle weakness.
  • Difficulty swallowing due to weakness of the pharynx.
  • Difficulty breathing due to weakness of the diaphragm.

Common Neuromuscular Disorders

Amyotrophic Lateral Sclerosis – ALS

  • More commonly known as Lou Gehrig’s disease, it is a genetic disorder that results from hardening of the spinal cord.
  • It causes damage to the nerves that control muscles and voluntary movement.

Charcot-Marie-Tooth Disease

  • This is a class of peripheral nerve disorders that cause muscle weakness, atrophy, and loss of sensation, most commonly in the legs and feet.
  • It is a genetic disorder caused by a gene mutation that damages myelin, or the insulating sheath that surrounds all nerves and supports the conduction of electrical signals.

Multiple Sclerosis – MS

  • MS causes degeneration of the myelin sheath surrounding nerves, decreasing the impulses along the nerves to muscles.
  • It can result in muscle weakness, which is often more severe on the dominant side of the body.
  • There are different forms of MS, but the condition is often progressive and gets worse over time if left untreated.

Muscular Dystrophies

  • These are genetic diseases characterized by gradual loss of motor function, muscle weakness and atrophy, walking gait problems, progressive respiratory failure, and cardiomyopathy.
  • There are nine types of muscular dystrophy, all caused by genetic mutations.

Myasthenia Gravis

  • This is an autoimmune disease that causes inflammation throughout the body.
  • An autoimmune disease occurs when the immune system attacks healthy cells by mistake.
  • With myasthenia gravis, the body produces antibodies that attack the receptors for acetylcholine, reducing the body’s ability to contract muscles.
  • This leads to muscle weakness, atrophy, and fatigue.

Myopathies

  • These are diseases of muscles that cause muscle weakness and atrophy.
  • Depending on the type, they may progress and get worse over time.

Electrolyte Imbalances

  • Muscle weakness can result from altered sodium, potassium, calcium, or magnesium levels.

Always seek immediate medical attention for any sudden, unexplained muscle weakness. Individuals who experience skeletal muscle weakness should discuss the type and duration of symptoms with their doctor, specialist, physical therapist, or chiropractor, as this might be a sign of a medical condition such as a neuromuscular disorder. Working with a chiropractic team can help expedite healing. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop a personalized treatment program through an integrated approach to treat injuries and chronic pain syndromes, improving flexibility, mobility, and agility, relieving pain, and helping individuals return to normal activities. If other treatments are needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments.


Chiropractic Massage Therapy


References

Trovato FM, I. M., Conway N, Castrogiovanni P. (2016). Morphological and functional aspects of human skeletal muscle. J Funct Morphol Kinesiol., 1(3), 289-302. doi.org/https://doi.org/10.3390/jfmk1030289

Webb R. C. (2003). Smooth muscle contraction and relaxation. Advances in physiology education, 27(1-4), 201–206. doi.org/10.1152/advan.00025.2003

Cleveland Clinic. (2023). Mitochondrial diseases. my.clevelandclinic.org/health/diseases/15612-mitochondrial-diseases

Boost Your Health with Cycling and Osteoarthritis

Boost Your Health with Cycling and Osteoarthritis

Can individuals with osteoarthritis can incorporate cycling to reduce joint pain and regain their joint mobility?

Introduction

The joints in the musculoskeletal system allow the individual to be mobile while allowing the extremities to do their jobs. Just like the muscles and ligaments of the body, the joints can also wear and tear through repetitive motions, leading to joint pain in the extremities. Over time, the wear and tear from the joints can lead to the potential development of osteoarthritis, which then can affect joint mobility and lead to a life of pain and misery for individuals. However, numerous ways exist to reduce osteoarthritis’s pain-like symptoms and help restore joint mobility through cycling. Today’s article looks at how osteoarthritis affects the joints, how cycling is incorporated for osteoarthritis, and how it can reduce joint pain. We discuss with certified associated medical providers who consolidate our patients’ information to assess osteoarthritis and its associated pain symptoms affecting the joints in the extremities. We also inform and guide patients while asking their associated medical provider intricate questions to integrate cycling into their personalized treatment plan to manage the pain correlated with osteoarthritis affecting their joints. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer.

 

Osteoarthritis Affecting Joint Mobility

Do you feel pain and stiffness every morning in your joints only for it to feel better throughout the day? Do you experience pain in your knees, hips, and hands? Or have you noticed that your range of motion has decreased drastically? Many individuals, both young and old, can be affected by these pain-like issues and could be at risk of developing osteoarthritis in their joints. Osteoarthritis is the largest and most common musculoskeletal condition that causes a disturbance of the inflammatory cytokine balance, damaging the cartilage and other intra-articular structures surrounding the joints. (Molnar et al., 2021) This is because osteoarthritis develops over time, causing the cartilage to wear away and causing the connecting bones to rub against each other. This, in turn, can affect the extremity’s joint mobility, causing symptoms of stiffness, pain, swelling, and reduced range of motion to the joints.

 

 

Additionally, osteoarthritis is multifactorial as it can cause an imbalance in the joints due to genetics, environmental, metabolic, and traumatic factors that can contribute to its development. (Noriega-Gonzalez et al., 2023) This is because repetitive motions and environmental factors can impact the body and cause overlapping risk profiles to correlate with osteoarthritis. Some overlapping risk profiles associated with osteoarthritis are pathological changes in the joint structure that cause abnormal loading on the joints, which causes joint malalignment and muscle weakness. (Nedunchezhiyan et al., 2022) This causes many people to be in constant pain and trying to find relief from joint pain associated with osteoarthritis.

 


Chiropractic Solutions For Osteoarthritis-Video


Cycling For Osteoarthritis

Engaging in physical activities may seem daunting when managing osteoarthritis symptoms, but it can help restore joint mobility while reducing the pain associated with osteoarthritis. One of the physical activities that has little impact and does not impact the joints is cycling. Cycling for osteoarthritis has many beneficial properties as it can:

  • Strengthen surrounding muscles
  • Retain joint mobility
  • Improve range of motion
  • Weight management
  • Enhancing cardiovascular health

Cycling can help the individual focus on strengthening the lower extremity muscles surrounding the joints, which can help improve pain and functionality. (Katz et al., 2021) This, in turn, helps provide better support and stability to the joints, thus reducing overload on the body while minimizing the risk of injuries. Additionally, cycling can help improve many individuals looking for a healthier change and increase bone mineral density in the joints, thus decreasing the risk of fractures. (Chavarrias et al., 2019)

 

Cycling Reducing Joint Pain

Cycling is a safe and effective exercise for anyone, whether they’re just starting or haven’t been active for a while. The key to optimal recovery and joint functionality is to consult a doctor. This ensures that cycling is a safe option for you, helps you choose the right bike, and provides guidance on how to start slowly, warm up and stretch, maintain proper form, and stay consistent with the cycling sessions. This professional guidance is crucial, as it allows many individuals with joint pain to achieve complete functional recovery to their joints. (Papalia et al., 2020) Cycling is an excellent way to manage osteoarthritis and its associated symptoms. For many individuals with osteoarthritis, this low-impact exercise can be a game-changer, promoting muscle strengthening, improving joint range of motion, and helping alleviate osteoarthritis symptoms.

 


References

Chavarrias, M., Carlos-Vivas, J., Collado-Mateo, D., & Perez-Gomez, J. (2019). Health Benefits of Indoor Cycling: A Systematic Review. Medicina (Kaunas, Lithuania), 55(8). doi.org/10.3390/medicina55080452

Katz, J. N., Arant, K. R., & Loeser, R. F. (2021). Diagnosis and Treatment of Hip and Knee Osteoarthritis: A Review. JAMA, 325(6), 568-578. doi.org/10.1001/jama.2020.22171

Molnar, V., Matisic, V., Kodvanj, I., Bjelica, R., Jelec, Z., Hudetz, D., Rod, E., Cukelj, F., Vrdoljak, T., Vidovic, D., Staresinic, M., Sabalic, S., Dobricic, B., Petrovic, T., Anticevic, D., Boric, I., Kosir, R., Zmrzljak, U. P., & Primorac, D. (2021). Cytokines and Chemokines Involved in Osteoarthritis Pathogenesis. Int J Mol Sci, 22(17). doi.org/10.3390/ijms22179208

Nedunchezhiyan, U., Varughese, I., Sun, A. R., Wu, X., Crawford, R., & Prasadam, I. (2022). Obesity, Inflammation, and Immune System in Osteoarthritis. Front Immunol, 13, 907750. doi.org/10.3389/fimmu.2022.907750

Noriega-Gonzalez, D., Caballero-Garcia, A., Roche, E., Alvarez-Mon, M., & Cordova, A. (2023). Inflammatory Process on Knee Osteoarthritis in Cyclists. J Clin Med, 12(11). doi.org/10.3390/jcm12113703

Papalia, R., Campi, S., Vorini, F., Zampogna, B., Vasta, S., Papalia, G., Fossati, C., Torre, G., & Denaro, V. (2020). The Role of Physical Activity and Rehabilitation Following Hip and Knee Arthroplasty in the Elderly. J Clin Med, 9(5). doi.org/10.3390/jcm9051401

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Managing Rheumatoid Arthritis with Various Exercises: Find Relief and Move with Ease

Managing Rheumatoid Arthritis with Various Exercises: Find Relief and Move with Ease

Can individuals with rheumatoid arthritis incorporate various exercises to reduce joint pain and inflammation in their hands and feet?

Introduction

The joints in the human help provide function, mobility, and flexibility to the upper and lower extremities. The joints are part of the musculoskeletal system and have an outstanding relationship with the muscles, ligaments, and soft tissues that give the body structure and support that lets the individual move around and protects the important organs to function normally. However, when a person is dealing with injuries or illnesses that affect the body’s musculoskeletal function, it can cause pain to the individual. One of the symptoms that often correlate in the joints is chronic inflammation, leading to the development of an autoimmune disease known as rheumatoid arthritis. Today’s article looks at how rheumatoid arthritis affects the joints in the musculoskeletal system and how various exercises can help manage and reduce the symptoms associated with rheumatoid arthritis. We discuss with certified associated medical providers who consolidate our patients’ information to assess rheumatoid arthritis and its associated pain symptoms affecting the joints. We also inform and guide patients while asking their associated medical provider intricate questions to integrate various exercises into their personalized treatment plan to manage the pain correlated with rheumatoid arthritis. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer.

 

How RA Affects The Joints

Do you feel pain and tenderness in your joints affecting your daily routine? Do you experience stiffness first thing in the morning, and it goes away throughout the day? Or do you feel fatigued throughout the day, even after a good night’s sleep? Many individuals with these symptoms could be dealing with early development of rheumatoid arthritis in their joints. Now, rheumatoid arthritis is a chronic inflammatory autoimmune disorder that affects the body’s joints but is more prominent on the hands, wrists, and feet. The symptoms of rheumatoid arthritis can develop early or slowly depending on the environmental factors contributing to the development. Since rheumatoid arthritis is categorized as a systemic autoimmune disease, genetic and environmental risk factors that can contribute to rheumatoid arthritis development can trigger overlapping risk profiles on the joints. (Jang et al., 2022) When a person is dealing with the symptoms of rheumatoid arthritis, one of the key pain symptoms that can affect the joints drastically is inflammation. Inflammation is associated with rheumatoid arthritis; it is reflected by joint pain, leading to swelling and subsequent destruction of the cartilage and bone. (Scherer et al., 2020) This causes many individuals to be in constant pain and prevents them from doing any activities.

 

 

Additionally, when a few joints are being affected by rheumatoid arthritis in the early stages, some of the symptoms include:

  • Fatigue
  • Flu-like symptoms
  • Swollen & tender joints
  • Stiffness

However, when rheumatoid arthritis reaches the later stages in the joints, the autoantigens that are specific to rheumatoid arthritis can lead to a self-perpetuating chronic inflammatory state on the joints, thus causing an expansion on the periarticular bone at the cartilage-bone junction, leading to bone erosion and cartilage degradation. (Lin et al., 2020) Luckily, there are therapeutic options to reduce the pain and inflammatory effects of rheumatoid arthritis and help manage the symptoms that are affecting the joints.

 


Arthritis Explained- Video


How Various Exercises Can Help With RA

When it comes to reducing the inflammatory effects of rheumatoid arthritis, many individuals can seek out therapeutic options to restore mobility, function, and flexibility. Many individuals can incorporate various physical activities to relieve stress on the inflamed tissues while slowing the progression of rheumatoid arthritis. (Radu & Bungau, 2021) When people with rheumatoid arthritis incorporate various physical activities, they can include a healthy diet and nutrition to suppress pro-inflammatory effects associated with rheumatoid arthritis, help provide symptomatic improvement, and restore bodily function to the joints. (Gioia et al., 2020)

 

When people with rheumatoid arthritis start exercising as part of their personalized treatment, it can have beneficial properties as they can help with the following:

  • Reduce joint pain & stiffness
  • Improve muscle strength around the joints
  • Enhance physical function
  • Boost mental health
  • Reduces inflammation
  • Increase energy levels

The main priority of incorporating exercises to reduce rheumatoid arthritis is choosing gentle exercises on the person’s joints while providing enough movement to keep the body flexible and strong. Below are some exercises to reduce rheumatoid arthritis.

 

Range of Motion Exercises

Range of motion exercises can help maintain normal joint function by improving flexibility and reducing stiffness for individuals with rheumatoid arthritis. Some examples include:

  • Finger Bends: Gently bend your fingers into a fist and straighten them. Repeat several times.
  • Wrist Stretch: Extend your arm with the palm facing down. Gently use your other hand to press the extended hand down and back for a stretch.
  • Shoulder Rolls: Roll the shoulders in a forward circular motion, then reverse the direction.

 

Strength Training Exercises

Strength training can help build the surrounding muscles around the joints. This allows many individuals with rheumatoid arthritis to provide better support and reduce stress on the joints. Some examples include:

  • Resistance Bands: Use resistance bands to perform bicep curls, leg extensions, and chest presses.
  • Light Weights: Incorporate light dumbbells to perform exercises like shoulder presses, tricep extensions, and squats.
  • Bodyweight Exercises: Engage in wall push-ups, seated leg lifts, and modified planks.

 

Water-Based Exercises

Water-based exercises provide resistance without impact on the joints, making it ideal for those with rheumatoid arthritis. The water helps cushion the joints by easing the stiffness, building strength, and helping relax sore muscles. Some examples of water-based exercises include:

  • Water Aerobics: Join a water aerobics class that offers structured routines in a supportive environment.
  • Aqua Jogging: Use a buoyancy belt to jog in the pool’s deep end.
  • Swimming: Perform laps or engage in gentle exercises like the backstroke or breaststroke.

 

Tips For Exercising With RA

It is important to remember that when exercising with rheumatoid arthritis, it is important to always start with a gentle warm-up and always end with a cool down to prepare the muscles and joints when beginning to exercise. Another thing to remember is to stay consistent and modify when needed. This allows many individuals to listen to their bodies and modify exercises to avoid pain and discomfort. Incorporating exercises is highly effective in reducing rheumatoid arthritis activity as it can help enhance the body’s immune function and help manage the inflammatory response associated with rheumatoid arthritis. (Li & Wang, 2022)

 


References

Gioia, C., Lucchino, B., Tarsitano, M. G., Iannuccelli, C., & Di Franco, M. (2020). Dietary Habits and Nutrition in Rheumatoid Arthritis: Can Diet Influence Disease Development and Clinical Manifestations? Nutrients, 12(5). doi.org/10.3390/nu12051456

Jang, S., Kwon, E. J., & Lee, J. J. (2022). Rheumatoid Arthritis: Pathogenic Roles of Diverse Immune Cells. Int J Mol Sci, 23(2). doi.org/10.3390/ijms23020905

Li, Z., & Wang, X. Q. (2022). Clinical effect and biological mechanism of exercise for rheumatoid arthritis: A mini review. Front Immunol, 13, 1089621. doi.org/10.3389/fimmu.2022.1089621

Lin, Y. J., Anzaghe, M., & Schulke, S. (2020). Update on the Pathomechanism, Diagnosis, and Treatment Options for Rheumatoid Arthritis. Cells, 9(4). doi.org/10.3390/cells9040880

Radu, A. F., & Bungau, S. G. (2021). Management of Rheumatoid Arthritis: An Overview. Cells, 10(11). doi.org/10.3390/cells10112857

Scherer, H. U., Haupl, T., & Burmester, G. R. (2020). The etiology of rheumatoid arthritis. J Autoimmun, 110, 102400. doi.org/10.1016/j.jaut.2019.102400

Disclaimer

Water Aerobics for Strength and Cardiovascular Health

Water Aerobics for Strength and Cardiovascular Health

For individuals living with chronic pain and various diseases like Parkinson’s, arthritis, and diabetes, can water aerobics be beneficial?

Water Aerobics for Strength and Cardiovascular Health

Water Aerobics

Water aerobics are low-impact exercises performed commonly in swimming pools. It is a great way to exercise for a full-body, low-impact workout without overworking the body’s joints and muscles. Other names used include:

  • Aquafitness
  • Aqua aerobics
  • Aquarobics

Many types can be tailored to individual needs, injuries, and/or conditions. The exercises have various health benefits, especially for those who cannot perform higher-impact movements.

How It Works

Water aerobics involves performing certain controlled movements as a form of exercise. Different types focus on various areas of health, including (Harvard Health Publishing Harvard Medical School, 2023)

  • Strength training
  • Cardiovascular
  • Interval training

Individuals can also perform water aerobics if they know the movements involved. (Harvard Health Publishing Harvard Medical School, 2023)

Benefits of Pool Exercises

There are many benefits associated with water aerobics.

Because of the low-impact and full-body nature of the exercises, people can expect to see improvements (Pereira Neiva, H. et al., 2018) (Harvard Health Publishing Harvard Medical School, 2023)

Joint health

  • Water aerobics is gentle on the joints with minimal strain.

Cardiovascular

  • Water resistance during exercises can improve cardiovascular health without pushing it.
  • Studies have shown that it can also help control blood pressure.

Strength

  • Because of the resistance from the water, the muscles work harder.

Weight Loss

  • The water resistance exercises burn more calories than those outside the water, which could lead to more weight loss over time.

Health Conditions That Can Benefit

Some of the health conditions that can benefit from water aerobics include (Harvard Health Publishing Harvard Medical School, 2023)

  • Chronic pain
  • Arthritis
  • Obesity
  • Heart health
  • Blood pressure
  • Stress and Anxiety

Equipment

Individuals participating in water aerobics will need a bathing suit, towel, goggles, and a swim cap to protect their eyes or hair from chlorinated water. Individuals do not need other special equipment while exercising as the water acts as extra resistance. Foam dumbbells or paddles can be used to increase resistance. Other optional equipment includes: (Plunge San Diego, 2024) (Harvard Health Publishing Harvard Medical School, 2023)

  • Kickboards
  • Wrist and ankle weights
  • Water-jogging belts
  • Swim bar

Pool Exercises

There are many types of pool exercises to help reach health and fitness goals. They include:

Water Walking

  • The basic act of walking in water is a great way to get a full-body workout.
  • Start by standing in waist-deep water with the feet planted on the bottom of the pool.
  • Lengthen the spine by bringing the shoulders up and back and aligning the shoulders with the hips and knees.
  • Once in a good starting position, walk through the water, putting pressure on the heel first and then the toes, just like walking out of the water, while swinging the arms back and forth through the water.
  • This exercise can be done for five to 10 minutes.
  • The muscles that will get the most attention are the arms, core, and the lower body.

Arm Lifts

  • Stand up to the shoulders in water.
  • With the palms facing up, draw the elbows into the torso while lifting the forearms in front of the body up to the water’s surface.
  • Once at the surface, rotate the palms to face down and slowly move the forearms back down to the sides.
  • For more resistance, this exercise can also be done using foam dumbbells.
  • Repeat the action 10–15 times for one to three sets.
  • The muscles targeted are the core and the arm muscles.

Jumping Jacks

  • Water resistance makes jumping jacks in the water much more difficult than on land.
  • To perform, start by standing in chest-level water with your feet together and your arms straight down the sides.
  • Once in position, begin by simultaneously swinging the legs out to the side and arms over the head before returning to the starting position.
  • Muscles targeted include the entire body and cardiovascular system.
  • Add wrist or ankle weights for more resistance and to make the exercise more challenging.

High-Knee-Lift Extensions

  • High-knee-lift extensions are performed while standing in water that is waist deep.
  • To do the exercise, engage the core and lift one leg in a bent position until it is level with the water’s surface.
  • Hold the position for a few seconds, then extend the leg out in front and hold again.
  • After the hold period, move the leg back down through the water to the starting position while keeping it straight and flexing the foot.
  • Repeat on both legs for two to three sets of 15 reps per leg.
  • Use weights on the ankles to increase resistance.
  • The muscles targeted include the core, glutes, and lower body.

Risks

While exercising in water, individuals may not notice how much they sweat. This can make it seem like the workout is not as hard and can lead to dehydration. Individuals should always hydrate before and after a pool workout. Individuals who cannot swim well should avoid exercises that do not require a flotation device. Sometimes pools are heated, so choosing one 90 degrees F or below is recommended so the body doesn’t get overheated while exercising.

Stop Pool Exercises Immediately

Performing pool exercises can often seem easier than they are, leading to overworking. Stop exercising immediately if you feel:

  • Pain in any area of the body
  • Shortness of breath
  • Nauseated
  • Faint
  • Dizzy
  • Pressure in the upper body or chest

Other Health Conditions That Benefit

Water aerobics is recommended for most individuals, completely healthy or with a chronic disease. Those with chronic disease have been shown to benefit from the low-impact exercise. (Faíl, L. B. et al., 2022) One study looked at individuals with various health conditions, with the results showing that the following conditions saw improvements after 12 weeks of regular water exercise (Faíl, L. B. et al., 2022)

  • Diabetes
  • Arthritis
  • Fibromyalgia
  • Bone diseases
  • High blood pressure
  • Coronary artery disease
  • Stroke
  • Multiple sclerosis (MS)
  • Parkinson’s disease

While the benefits of water aerobics have been studied and proven effective, individuals should be cleared by a medical professional before starting any new exercise regimen. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution through an integrated approach to treating injuries and chronic pain syndromes, improving flexibility, mobility, and agility programs to relieve pain and help individuals return to normal. Our providers create personalized care plans for each patient. If other treatments are needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments.


Chiropractic and Integrative Healthcare


References

Harvard Health Publishing Harvard Medical School. (2023). Basic types of water-based exercises. HealthBeat. www.health.harvard.edu/healthbeat/basic-types-of-water-based-exercise

Pereira Neiva, H., Brandão Faíl, L., Izquierdo, M., Marques, M. C., & Marinho, D. A. (2018). The effect of 12 weeks of water-aerobics on health status and physical fitness: An ecological approach. PloS one, 13(5), e0198319. doi.org/10.1371/journal.pone.0198319

Harvard Health Publishing Harvard Medical School. (2024). Advantages of water-based exercise. HealthBeat. www.health.harvard.edu/healthbeat/advantages-of-water-based-exercise

Plunge San Diego. (2024). 5 must-have pieces of aquatic exercise equipment for water aerobics. Plunge San Diego. plungesandiego.com/what-equipment-needed-water-aerobics-shoes/

Faíl, L. B., Marinho, D. A., Marques, E. A., Costa, M. J., Santos, C. C., Marques, M. C., Izquierdo, M., & Neiva, H. P. (2022). Benefits of aquatic exercise in adults with and without chronic disease-A systematic review with meta-analysis. Scandinavian journal of medicine & science in sports, 32(3), 465–486. doi.org/10.1111/sms.14112