Sports Spine Specialist Chiropractic Team: Athletes strive to achieve their body’s maximum performance by participating in numerous training regimens consisting of strenuous exercises and physical activity and ensuring they meet all of their body’s nutritional requirements. Through proper fitness and nutrition, many individuals can condition themselves to excel in their specific sport. Our training programs are designed for athletes that look to gain a competitive edge in their sport.
We provide sport-specific services to help increase an athlete’s performance through mobility, strength, and endurance. Occasionally, however, the excess workouts can lead many to suffer injuries or develop underlying conditions. Dr. Alex Jimenez’s chronicle of articles for athletes displays in detail the many forms of complications affecting these professionals while focusing on the possible solutions and treatments to follow to achieve overall well-being.
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
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.
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. https://doi.org/10.1007/s00508-016-1096-4
American Academy of Orthopaedic Surgeons. (2020). Sprains, strains, and other soft-tissue injuries. https://orthoinfo.aaos.org/en/diseases–conditions/sprains-strains-and-other-soft-tissue-injuries/
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. https://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. https://doi.org/10.1016/j.pmrj.2014.09.018
Can eating white rice as a primary carbohydrate source provide quick energy and glycogen replenishment for athletes and bodybuilders who require high volumes of carbohydrates for fuel and muscle recovery?
Sports Nutrition White Rice
Athletes and bodybuilders often eat white rice to restore mass amounts of glycogen after an intense workout, race, or game. Brown rice is nutritious and recommended for overall health, but athletes and bodybuilders incorporate further nutritional guidelines for added fuel and performance. White rice is a starchy grain used by more than half the world’s population because of its versatility, availability, and ability to adapt to various flavors and seasonings. Its chewiness and soft texture add substance to and complement many meals.
Bodybuilders
Athletes and bodybuilders need macronutrients to fuel extreme training and replenish depleted glycogen stores. Carbohydrate-rich foods like white rice are high on the glycemic index (a score for how foods affect blood sugar and insulin levels) and provide a readily available source of carbohydrates for muscle glycogen synthesis. (Thomas, D. E. et al., 1991) White rice is considered excellent sports nutrition for athletes. (Melin, A. et al., 2016) Although white rice is considered less nutritious than brown rice, athletes and weightlifters consume it as part of their specifically developed nutrition plans. One of the most popular meals is a bowl of white rice combined with grilled chicken breast, providing lean protein. Endurance runners often load up on carbohydrates like white rice before marathons. Strenuous workouts deplete sugar/glycogen in the muscles. Eating the right carbohydrates is important to replenish those stores. Knowing how to improve carbohydrate availability during prolonged exercise is essential for athletes. (Burke, L. M. et al., 2011)
Fuel and Muscle Recovery
The high glycemic value of white rice provides quick fuel for hard workouts and expedites muscle recovery. It does not have the negative effects of potential gastrointestinal issues, allergy symptoms, or blocking the ability to absorb micronutrients. Brown rice contains phytic acid(located in the grain’s bran), an antinutrient that binds to essential minerals like iron, zinc, calcium, and magnesium and prevents the body from absorbing them. The milling process to change brown rice to white removes the phytate. Research is ongoing on degrading phytic acid in brown rice and whole grains, and some studies have found antioxidant benefits in phytate. This could increase the amount of carbohydrates that are safe for athletes. (Liang, J. et al., 2008)
Safe Carbohydrate
Athletes and bodybuilders with food sensitivity may have issues eating whole grains, as brown rice has more fiber. Extreme exercise requires a surplus of carbohydrates. For prolonged exercise lasting more than two hours, athletes should consume 60 grams per hour of carbohydrates. White rice is considered safe to consume before exercise as it is easy on the stomach and has been shown to meet sports nutrition recommendations.
Workouts
Rice contains more carbohydrates than potatoes for the same serving size. Parboiled, converted, and instant white rice can be eaten pre- and post-workout meals, ensuring the body is thoroughly fueled for training, competition, and recovery. However, white rice may not be the best option for sedentary individuals.
Brown Rice
Brown rice is healthier for bodybuilders who train less than four days per week or have a metabolic disease.
Brown rice is a nutrient-dense food recommended for everyday active individuals who can tolerate whole grains and is a rich source of fiber and nutrients essential for a well-balanced healthy diet.
Injury Medical Chiropractic and Functional Medicine Clinic
Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop personalized programs. We focus on what works for you to enhance fitness and improve the body through research methods and total wellness programs. These programs strive to achieve improvement goals, and athletes can condition themselves to excel through proper fitness and nutrition. Our providers use Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine principles. An integrated approach improves flexibility, mobility, and agility. If further training or treatments are needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, trainers, medical researchers, and rehabilitation providers.
Sports Nutrition and Dietitian
References
Thomas, D. E., Brotherhood, J. R., & Brand, J. C. (1991). Carbohydrate feeding before exercise: effect of glycemic index. International journal of sports medicine, 12(2), 180–186. https://doi.org/10.1055/s-2007-1024664
Melin, A., Tornberg, Å. B., Skouby, S., Møller, S. S., Faber, J., Sundgot-Borgen, J., & Sjödin, A. (2016). Low-energy density and high fiber intake are dietary concerns in female endurance athletes. Scandinavian journal of medicine & science in sports, 26(9), 1060–1071. https://doi.org/10.1111/sms.12516
Burke, L. M., Hawley, J. A., Wong, S. H., & Jeukendrup, A. E. (2011). Carbohydrates for training and competition. Journal of sports sciences, 29 Suppl 1, S17–S27. https://doi.org/10.1080/02640414.2011.585473
Liang, J., Han, B. Z., Nout, M. J., & Hamer, R. J. (2008). Effects of soaking, germination and fermentation on phytic acid, total and in vitro soluble zinc in brown rice. Food chemistry, 110(4), 821–828. https://doi.org/10.1016/j.foodchem.2008.02.064
Could stability running shoes help correct foot pronation for runners, athletes, and physically active individuals who tend to have foot pronation issues?
Stability Running Shoes
Stability is having firm, steady balance in the feet and ankles. Individuals with flat feet or feet that tend to pronate or turn inward can seriously compromise their running stability, potentially increasing their risk of injury and making running uncomfortable. Stability running shoes can help because they stabilize the feet and ankles that roll inward. They combine the right alignment, arch support, and cushioning, and this specialty footwear helps hold the feet and ankles steady and can help maintain a straight gait.
Pronation
Pronation occurs when the foot and/or ankle roll inward when running or walking. It’s a common issue, typically caused by pushing off the ground with a big toe and a second toe. Arches can be excessively strained when pronation or overpronation occurs, resulting in ankle or shin pain. Eventually, overpronation can even cause the feet to flatten. Many runners find that the instability of an inward-rolling foot makes them more prone to strained muscles or falls. However, a study determined that foot pronation was not associated with increased injury risk in novice runners wearing non-specialty shoes. (Nielsen R. O. et al., 2014) However, another study found that foot pronation contributed to joint loading or increased stress on the joints of the lower limbs after long-distance running. (Mei Q. et al., 2019) This extra stress could be a factor in the development of osteoarthritis.
Supination
In contrast to pronation, some runners experience the opposite problem of supination. Supination occurs when the ankle or foot rolls outward from the center, which can cause pain or injury as it increases the likelihood of ankle rolls or sprains.
Features
Stability running shoes with the right features can help stabilize the feet and ankles for safer, more efficient running. This could make a major difference in how individuals feel after a run. For example, those with weak ankles should look for ankle support shoes with motion control, arch support, and grippy traction. Stabilizing shoes offer the following structural supports.
Arch Support
The foot is less likely to turn inward with a firm, high arch support.
Midsole Cushioning
Like arch support, cushioning the entire mid-section of the foot helps hold it steady.
For example, in walking shoes for flat feet, extra supportive cushioning in the midfoot helps prevent further arch collapse.
Stability running shoes may advertise having bars, rails, or medial posts to help maintain balance and reduce pronation.
Heel Cups and Heel Counters
A deep heel cup sits under the heel, correctly aligning the foot and ankle.
Heel counters are hard plastic inserts that reinforce the back of a running shoe, increasing overall support and holding the foot in place.
Wider Base
A wider platform underneath the foot is another key to preventing the inward rolling of overpronation.
It’s a common feature of walking shoes for seniors that provide stability for balance issues.
Choose the Right Shoes
Selecting the best shoe for pronation issues does not have to be complex. At many athletic stores, customers start with an in-store gait, foot shape, and running style assessment. Overpronators should look for a shoe with at least some of the features listed, such as arch support, cushioning, heel cups, counters, or a wide base. For narrow or wide feet, seek out shoes made specifically for these issues. In any running shoe, comfort is the number one priority. The feet should feel firmly supported with no pinching, and the toe shoes should have plenty of wiggle room and be able to lace up without hassle.
Benefits
Stability running shoes may also improve performance. A well-cushioned, well-fitting stability shoe can enhance running comfort, making workouts more enjoyable. When running without pain, individuals are more likely to continue running long-term. A stability shoe that prevents overpronation can improve form, allowing faster and more efficient running. A study in the Journal of Orthopaedic and Sports Physical Therapy explored the potential of motion-control shoes, which are somewhat more stabilizing than stability shoes regarding running injuries. The authors concluded that these shoes may reduce the risk of injuries related to overpronation. (Willems T. M. et al., 2021) Another study compared stability shoes to neutral and motion-control shoes in female runners with various degrees of foot pronation. Those who ran in stability shoes missed the fewest days of training, an indicator that they experienced fewer injuries, but those who wore stability shoes reported more pain while running than those who wore neutral shoes. (Ryan M. B. et al., 2011)
Conclusion
Stability running shoes might be the solution for jogging pain and injuries. The only way to find out is to try them for yourself. Look for footwear with sturdy arch support, plenty of cushioning in the midsole, heel support, and a wide sole. At Injury Medical Chiropractic and Functional Medicine Clinic, we focus on what works for you and strive to create fitness and better the body through research methods and total wellness programs. These programs use the body’s ability to achieve improvement goals, and athletes can condition themselves to excel through proper fitness and nutrition. Our providers use an integrated approach to create personalized programs, including Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine principles.
Correct Foot Pronation
References
Nielsen, R. O., Buist, I., Parner, E. T., Nohr, E. A., Sørensen, H., Lind, M., & Rasmussen, S. (2014). Foot pronation is not associated with increased injury risk in novice runners wearing a neutral shoe: a 1-year prospective cohort study. British journal of sports medicine, 48(6), 440–447. https://doi.org/10.1136/bjsports-2013-092202
Mei, Q., Gu, Y., Xiang, L., Baker, J. S., & Fernandez, J. (2019). Foot Pronation Contributes to Altered Lower Extremity Loading After Long Distance Running. Frontiers in physiology, 10, 573. https://doi.org/10.3389/fphys.2019.00573
Willems, T. M., Ley, C., Goetghebeur, E., Theisen, D., & Malisoux, L. (2021). Motion-Control Shoes Reduce the Risk of Pronation-Related Pathologies in Recreational Runners: A Secondary Analysis of a Randomized Controlled Trial. The Journal of orthopaedic and sports physical therapy, 51(3), 135–143. https://doi.org/10.2519/jospt.2021.9710
Ryan, M. B., Valiant, G. A., McDonald, K., & Taunton, J. E. (2011). The effect of three different levels of footwear stability on pain outcomes in women runners: a randomised control trial. British journal of sports medicine, 45(9), 715–721. https://doi.org/10.1136/bjsm.2009.069849
Individuals with inflammation, pain, and swelling on the tops of their feet or hands could be experiencing extensor tendonitis. What treatment options are available?
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.
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.
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. https://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. https://doi.org/10.1177/23259671221088610
Arthritis Foundation. Foundation, A. (N.D.). Tendinitis. https://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. https://doi.org/10.2519/jospt.2008.2749
American Society for Surgery of the Hand. (2014). Extensor tendon injury. https://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.
Can incorporating explosive strength training help develop power for athletes and sports enthusiasts who need to generate maximum energy quickly?
Explosive Training
Explosive strength training exercises help develop power and athletic abilities by challenging the nervous and muscular systems. The focus is on the number of sets, repetitions, and rest periods to maximize gains. Explosive exercises typically use fewer repetitions 3–6 and more sets 3–5 to allow for maximum power output. Adequate rest periods, 2–3 minutes, are allotted between sets to prevent fatigue and reduce the risk of injury. Explosive training combines strength and speed to increase an individual’s power output and can be helpful for various sports, including track and field, court sports, cycling, and football.
Exercises
Explosive strength training uses large muscle movements that can include:
Squats
Power cleans
Weighted or unweighted vertical jumps
Heavy ball throws
Hill sprinting
Smaller muscle exercises can also build power, but results may be limited. These can include:
Bench presses
Pushups
Sample Exercises
Training exercises to develop power include:
Sprints
Agility drills
Weighted step ups
Overhead walking lunges
Plyometrics
Squats
Explosive training exercises should be selected to match individual fitness and sports goals. Exercise choices should simulate the movement patterns specific to the sport. Explosive training is unlikely to lead to injury if you train slowly, listen to your body for signs and symptoms of injury, and work with a qualified professional. Some evidence suggests that regularly engaging in explosive strength training can decrease the risk of injury.
Explosive strength exercises are movements that require an athlete to produce maximum or near-maximum output in a short time.
Explosive training aims to build enough power to ultimately move heavy weights quickly.
It is recommended to start with light weights and use slow, controlled movements.
The amount of weight used during a workout and the speed at which they are lifted should be increased over several weeks and training sessions.
Benefits
Research supports that explosive speed and strength exercise builds power but is more effective when combined with other training. For example, in a study, researchers showed that a mixed maximal and explosive strength training program was more effective than traditional approaches like circuit training in increasing overall fitness and adaptive processes that are helpful when increasing training loads, such as runners training for a marathon. (Taipale, R. S. et al., 2014) Other reports suggest that to maximize strength, power, and speed, a combination of heavy and light explosive exercise provides optimal results compared to training only in one style. (Baker D. 2003) The first training phase should focus on increasing maximum strength and building a solid foundation to maximize power output or movement speed. The second phase is devoted to power and speed training. (DeWeese B. H. et al., 2015)
Programs
The first five weeks of a 12-week training program to increase power and speed may consist primarily of heavy strength training. The next six weeks would consist of heavy and high-power explosive exercise training, and the final week would be high-power movements. Individuals are recommended to work with a coach or personal trainer specializing in this type of training when developing a program. A qualified professional can choose sport-specific exercises that will help improve performance. Correct form is essential for safety. A professional trainer can observe alignment throughout each exercise and provide adjustments and tips for safety and efficiency.
Injury Medical Chiropractic
At Injury Medical Chiropractic and Functional Medicine Clinic, we focus on what works for you and strive to create fitness and better the body through research methods and total wellness programs. These programs use the body’s ability to achieve improvement goals, and athletes can condition themselves to excel in their sport through proper fitness and nutrition. Our providers use an integrated approach to create personalized programs, often including Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine principles.
Chiropractic Sport Rehabilitation
References
Taipale, R. S., Mikkola, J., Salo, T., Hokka, L., Vesterinen, V., Kraemer, W. J., Nummela, A., & Häkkinen, K. (2014). Mixed maximal and explosive strength training in recreational endurance runners. Journal of strength and conditioning research, 28(3), 689–699. https://doi.org/10.1519/JSC.0b013e3182a16d73
Baker D. (2003). Acute effect of alternating heavy and light resistances on power output during upper-body complex power training. Journal of strength and conditioning research, 17(3), 493–497. https://doi.org/10.1519/1533-4287(2003)017<0493:aeoaha>2.0.co;2
DeWeese, B. H., Hornsby, G., Stone, M., & Stone, M. H. (2015). The training process: Planning for strength–power training in track and field. Part 2: Practical and applied aspects. Journal of Sport and Health Science, 4(4), 318–324. doi:10.1016/j.jshs.2015.07.002
Individuals who engage in sports and physical activities that involve lunging forward while running or jumping can sustain a plantaris muscle injury. Can understanding the anatomy of the back of the leg and the symptoms help diagnose and treat plantar muscle injuries?
Plantaris Muscle
The plantaris muscle is a long, narrow muscle in the calf that runs along the back of the leg. It’s part of the Triceps Surae, a group of muscles in the calf that, along with the gastrocnemius and soleus muscles, makes up the bulk of the back of the leg. It is located in the superficial posterior compartment of the leg. Strains or tears of the plantaris muscle at the back of the leg can cause pain and swelling, similar to a calf strain or Achilles tendon tear. Individuals may feel immediate pain, cramping, and other symptoms.
Anatomy
The gastrocnemius and soleus muscles are the major muscles, with the soleus located deeper in the leg. Together, they form the Achilles tendon, which blends into a tendon in the back of the heel and attaches to the heel bone/calcaneus. When the calf muscles contract, they point the foot downward, propelling the body forward when walking, running, and sprinting. The plantaris muscle and tendon sit more or less in the center of the calf, between the two heads of the gastrocnemius. Around 7% to 20% of the population are born without plantaris muscles. There are variations, such as having a double- or triple-headed plantaris muscle. (Olewnik Ł. et al., 2020) However, individuals that do not have the muscle or have a variation have not been shown to affect long-term or short-term mobility.
Symptoms
Plantaris muscle ruptures are the most common injury and occur often during running or jumping. (Spang C. et al., 2016) Many who sustain this injury are athletes who have to lunge forward. Common symptoms include:
Swelling and bruising in the back of the calf area.
Cramping in the calf muscle.
Spasm sensations of the calf muscle.
Symptoms of a plantaris muscle strain are less severe, with the common signs being tightness and pain during and after physical activity.
Diagnosis
Plantaris muscle tears differ from Achilles tendon tears because the foot can be pointed downward following the rupture, whereas an Achilles tear cannot. Plantaris ruptures can also be confused with a blood clot in the large veins of the calf, called deep vein thrombosis/DVT. (Rohilla S. et al., 2013) Tests like MRI or ultrasound can be performed to confirm or exclude a plantaris rupture. Both can be useful for verifying whether the injury is a strain or tear and identifying other possible causes of calf pain.
Treatment
Treatment is typically non-surgical. While the injuries can cause pain and disability, the symptoms almost always resolve with conservative treatments and therapies. Rest, ice, compression, and elevation are the first line used and may be all that is needed for a muscle strain. Short-term use of NSAIDs may be recommended for a strain or tear to reduce pain and inflammation. (Morelli K. M. et al., 2018) If the pain is profound or there is a tear, patients may require short-term immobilization or the use of a crutch for the pain to subside. With the assistance of a physical therapist, sports chiropractor, and athletic trainer, gradual increases in mobility and strength can be obtained. Symptoms usually gradually resolve over several weeks. Full recovery may take up to eight weeks, depending on the severity of the injury.
Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop customized 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. 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.
Control Foot Motion with Custom Orthotics
References
Olewnik, Ł., Zielinska, N., Karauda, P., Tubbs, R. S., & Polguj, M. (2020). A three-headed plantaris muscle: evidence that the plantaris is not a vestigial muscle?. Surgical and radiologic anatomy : SRA, 42(10), 1189–1193. https://doi.org/10.1007/s00276-020-02478-8
Spang, C., Alfredson, H., Docking, S. I., Masci, L., & Andersson, G. (2016). The plantaris tendon: a narrative review focusing on anatomical features and clinical importance. The bone & joint journal, 98-B(10), 1312–1319. https://doi.org/10.1302/0301-620X.98B10.37939
Rohilla, S., Jain, N., & Yadav, R. (2013). Plantaris rupture: why is it important?. BMJ case reports, 2013, bcr2012007840. https://doi.org/10.1136/bcr-2012-007840
Morelli, K. M., Brown, L. B., & Warren, G. L. (2018). Effect of NSAIDs on Recovery From Acute Skeletal Muscle Injury: A Systematic Review and Meta-analysis. The American journal of sports medicine, 46(1), 224–233. https://doi.org/10.1177/0363546517697957
Can incorporating walking help accomplish health goals for individuals trying to burn fat?
Walking To Burn Calories and Fat
Walking has many wonderful benefits that include:
Improving fitness
Strengthening bones
Easing joint pain
Improving mental health
What to know
Taking it easy at first and steadily working on the basics can help individuals reach their health goals. Two keys to burning more fat when walking are:
Walk with enough speed and intensity to burn fat for energy.
The longer you walk, the more stored fat is burned instead of the sugars for quick bursts of exercise.
While any exercise can burn calories, brisk walking and other aerobic exercises are especially recommended for burning internal abdominal visceral fat. This fat contributes to the waistline and increases the risk of diabetes and heart disease. (Bairapareddy, K. C. et al., 2018)
Fat-Burning Zone
The American Heart Association categorizes brisk walking at a pace of 2.5 miles per hour as a moderate-intensity aerobic activity. (American Heart Association, 2024) The target heart rate for exercising at this level of intensity should be 50% to 70% of an individual’s maximum heart rate. For more vigorous activities, the heart rate should be about 70% to 85% of an individual’s maximum heart rate. (American Heart Association, 2021) Working out at a low to moderate intensity can help burn fat because the body uses stored fat as fuel compared with workouts of higher intensity that depend on carbohydrates. (Carey D. G. 2009)
The heart rate range for this zone varies by age. An age heart rate zone chart can help individuals find the right numbers. While exercising, take your pulse to check your heart rate. Heart rate apps and pulse monitors have been built into activity monitors and smartwatches. While exercising in this zone, breathing is heavier, and there is a feeling of increased exertion and sweating, but individuals should be able to carry on a conversation. (Centers for Disease Control and Prevention, 2022)
Beginners should gradually build up walking time and speed.
A beginner’s walking plan starts with 15 minutes daily, five days a week, and continued improvement in walking technique.
Increase walking time by 5 minutes per session each week.
Increasing Walking Intensity
If the heart rate is still below 60% of the maximum heart rate, individuals need to intensify the workout to burn fat. Ways to do this include:
Adding Distance and Time
Make the walk longer to keep the body working harder and maintain a brisk pace. Adding additional minutes will burn additional stored fat. However, since not everyone has the time there are other options.
Picking Up The Pace
Even for a short walk, make a goal to perform faster than normal, walking faster using correct posture, arm motion, and a powerful stride. It can help to time the walking route and challenge yourself to complete it faster each time. One study looked at individuals walking 3.6 miles per hour, 4.1 mph, and 4.6 mph. Accelerating to 4.6 mph burned more than 50% more calories than going from 3.6 mph to 4.1 mph. (Schwarz, M. et al., 2006)
Adding Intervals
Intervals add intensity and also help increase the overall pace. The aforementioned strategies to walk faster incorporate intervals, where individuals increase their speed for a set distance or time, alternating with a slower pace. Research on individuals with diabetes found that those who did interval walking for four months lost six times as much weight as those who walked steadily. (Karstoft K. et al., 2013)
Adding Hills and/or Stairs
Incorporating hills or stair-climbing into some walking sessions helps you stay challenged and makes workouts more intense. If there is no access to outdoor hills or stairs, use a treadmill – start with a slight incline and work up to a steeper one, or get on a stair-stepping machine at the gym. There is no need to walk briskly on hills, as one study showed that walking slowly on an incline was an effective workout that didn’t cause knee joint stress, especially for obese individuals. (Haight, D. J. et al., 2014)
Switch Up Workouts
Mix up different walking workouts like intervals, short and fast walks, and long and moderate walks. Meditative, mindful walks also have stress-reducing benefits that help lower cortisol, which can contribute to weight gain. Individuals who can’t spend 45 continuous minutes walking make the most of the available time. Try and fit in two to four 15-minute walks at a brisk pace. It’s also recommended to include other types of moderate-intensity exercise and activities that include:
Bicycle riding on level terrain
Water aerobics
Using an elliptical trainer
Ballroom dancing
Gardening
Doubles tennis or pickleball
Challenge the body in new ways to burn fat, build muscle, and raise basal metabolic rate. With a boosted metabolism, the body burns more calories all day.
Sample Walking Workout
You can use a treadmill or walk outside. Make sure you have athletic shoes that are flat and flexible and have the proper support and cushioning for a long walk. Wear breathable clothing, which allows freedom of movement and wicks away sweat.
Warmup
Start with 5 to 10 minutes of easy walking, increasing speed gradually.
The warmup is important to burn stored blood sugar and deplete the ready energy stored in the muscles.
This signals the body that a longer exercise session is underway.
As a result, the body prepares to burn stored fat.
Pick Up The Speed
To burn fat, the body needs to be in the fitness zone, with a heart rate of 60% to 70% of the maximum heart rate.
Check heart rate every 10 minutes to stay in the zone.
Stay In The Fitness Zone
For 30 to 50 minutes or more.
If your heart rate dips, pick up the speed.
Cool Down
End with 5 to 10 minutes at an easier pace to cool down.
Injury Medical Chiropractic and Functional Medicine Clinic
Using an integrated approach to treat and prevent injuries and chronic pain syndromes, improve flexibility, mobility, and agility, and help individuals return to normal activities, Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers, trainers, and specialists to develop a personalized fitness program. Each case is different and requires reviewing individual medical history and physical examination to determine the proper training plan. Dr. Jimenez has partnered with top trainers, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments and fitness training plans.
Weight Loss Techniques
References
Bairapareddy, K. C., Maiya, A. G., Kumar, P., Nayak, K., Guddattu, V., & Nayak, V. (2018). Effect of aerobic exercise on echocardiographic epicardial adipose tissue thickness in overweight individuals. Diabetes, metabolic syndrome and obesity : targets and therapy, 11, 303–312. https://doi.org/10.2147/DMSO.S145862
American Heart Association. (2024). American Heart Association Recommendations for Physical Activity in Adults and Kids. https://www.heart.org/en/healthy-living/fitness/fitness-basics/aha-recs-for-physical-activity-in-adults
American Heart Association. (2021). Target Heart Rates Chart. https://www.heart.org/en/healthy-living/fitness/fitness-basics/target-heart-rates
Carey D. G. (2009). Quantifying differences in the “fat burning” zone and the aerobic zone: implications for training. Journal of strength and conditioning research, 23(7), 2090–2095. https://doi.org/10.1519/JSC.0b013e3181bac5c5
Centers for Disease Control and Prevention. (2022). Measuring Physical Activity Intensity. Retrieved from https://www.cdc.gov/physicalactivity/basics/measuring/index.html
Schwarz, M., Urhausen, A., Schwarz, L., Meyer, T., & Kindermann, W. (2006). Cardiocirculatory and metabolic responses at different walking intensities. British journal of sports medicine, 40(1), 64–67. https://doi.org/10.1136/bjsm.2005.020198
Karstoft, K., Winding, K., Knudsen, S. H., Nielsen, J. S., Thomsen, C., Pedersen, B. K., & Solomon, T. P. (2013). The effects of free-living interval-walking training on glycemic control, body composition, and physical fitness in type 2 diabetic patients: a randomized, controlled trial. Diabetes care, 36(2), 228–236. https://doi.org/10.2337/dc12-0658
Haight, D. J., Lerner, Z. F., Board, W. J., & Browning, R. C. (2014). A comparison of slow, uphill and fast, level walking on lower extremity biomechanics and tibiofemoral joint loading in obese and nonobese adults. Journal of orthopaedic research : official publication of the Orthopaedic Research Society, 32(2), 324–330. https://doi.org/10.1002/jor.22497
IFM's Find A Practitioner tool is the largest referral network in Functional Medicine, created to help patients locate Functional Medicine practitioners anywhere in the world. IFM Certified Practitioners are listed first in the search results, given their extensive education in Functional Medicine
Extensor Tendonitis
