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.
Can knowing about the health benefits of hot yoga help individuals decide if it is right for them?
Hot Yoga
The body has a system for ridding itself of what it can’t use or doesn’t need, called toxins. Individuals may have heard that they can sweat out toxins by doing various hot yoga styles. Hot yoga, practiced in a heated room, has become popular. The standard room temperature is around 105 degrees Fahrenheit with 40% humidity. (Mayo Clinic 2020) Because of the temperatures, hot yoga is not for everyone, and those with heart problems or dizziness are recommended to stick with regular classes. However, the detoxification medical benefits may not be there, or there is still insufficient research to confirm.
Body Detoxification
Broken down by the liver, the toxins in the blood or bile are filtered in the kidneys or intestines and removed in urine or stool. (Boyer J. L. 2013) Sweat is not part of the removal equation. The function of sweat is to cool the body down when it becomes overheated. This can happen during strenuous activity, when overdressed, or in summer. Sweat comprises primarily water with trace amounts of urea, lactic acid, and minerals. (Baker L. B. 2019) Except for water, none of the products in sweat are excreted in large enough quantities to alter or improve metabolic function. The sodium excreted in sweat is quickly re-absorbed through the skin’s epithelial sodium channels, which does little to alter the sodium levels in the blood. (Hanukoglu I. et al., 2017)
Environmental Toxins
The body is exposed to all sorts of toxins daily, including pollution and pesticides in the air, preservatives in our foods, and detergents and cosmetics on our skin. (Hunt P. 2011) Sweat-based exercise to remove these toxins is still unfounded.
Sweating In Hot Yoga
Many think that sweating in a hot yoga class will cleanse the alcohol or unhealthy foods. Yoga won’t help sweat these things out, but the practice still provides benefits that help burn some fat from the calories consumed. Exercising helps burn fat regardless of the temperature of the surroundings. (Swift, D. L. et al., 2014) The benefits include:
Increased circulation to deliver more oxygenated blood to the muscles.
Improved muscle tone and flexibility.
Stress relief.
Instead of sweating out the toxins, minimize exposure by eating a healthy, balanced diet, using natural products, and reading the labels of products placed on or in the body.
Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness program that fully benefits the individual to get back to normal. Using an integrated approach to treat injuries and chronic pain syndromes, the ability to relieve pain is improved through flexibility, mobility, and agility programs. Our providers create personalized care plans for each patient, including Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine. If other treatment is needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments.
Body Signals Decoded
References
Mayo Clinic. (2020). What is hot yoga? Mayo Clinic Orthopedics and Sports Medicine. https://sportsmedicine.mayoclinic.org/news/what-is-hot-yoga/
Boyer J. L. (2013). Bile formation and secretion. Comprehensive Physiology, 3(3), 1035–1078. https://doi.org/10.1002/cphy.c120027
Baker L. B. (2019). Physiology of sweat gland function: The roles of sweating and sweat composition in human health. Temperature (Austin, Tex.), 6(3), 211–259. https://doi.org/10.1080/23328940.2019.1632145
Hanukoglu, I., Boggula, V. R., Vaknine, H., Sharma, S., Kleyman, T., & Hanukoglu, A. (2017). Expression of epithelial sodium channel (ENaC) and CFTR in the human epidermis and epidermal appendages. Histochemistry and cell biology, 147(6), 733–748. https://doi.org/10.1007/s00418-016-1535-3
Hunt P. (2011). Toxins all around us. Exposure to the chemicals in everyday objects poses a hidden health threat. Scientific American, 305(4), 14.
Swift, D. L., Johannsen, N. M., Lavie, C. J., Earnest, C. P., & Church, T. S. (2014). The role of exercise and physical activity in weight loss and maintenance. Progress in cardiovascular diseases, 56(4), 441–447. https://doi.org/10.1016/j.pcad.2013.09.012
For individuals wanting to try Pilates for back pain and exercise, can learning how to find their neutral spine help improve flexibility and increase the range of motion in the joints?
Pilates Neutral Spine
Pilates is a functional exercise modality emphasizing core stability, which is fundamental to developing a balanced body. The exercises strengthen the muscles, improve flexibility, and increase the range of motion in the joints. (Kloubec J. 2011) It is considered a functional fitness method because its principles work to establish more graceful, efficient movements from everyday life, such as improving posture. Pilates has shown its effectiveness in that it is often used in physical therapy and rehabilitation settings. (Byrnes, K., Wu, P. J., and Whillier, S. 2018) However, knowing how to find the neutral spine is essential for performing various Pilates exercises correctly. (Barbosa, A. C. et al., 2018) This subtle adjustment during practice may help prevent injury and increase overall performance. A neutral spine is the natural position of the spine when all three curves:
Cervical (neck)
Thoracic (middle)
Lumbar (lower)
Are active and in healthy alignment.
This is the strongest position for the spine when standing or sitting, allowing the body to move more naturally.
Alignment
The following exercise can help find the Pilates neutral spine.
Basic Position
Lie on the back with knees bent and feet flat on the floor.
Ensure the legs are parallel to the hips, knees, heels, and toes.
Let the arms rest at your sides.
Relax
Relax the body, including the shoulders, neck, and jaw.
Allow the back to melt into the floor.
The rib cage will drop when the lower ribs are released to the floor.
Breathe Deep
Inhale all the way into the body, allowing it to move into the back and sides of the rib cage and all the way to the pelvis.
Pelvic Tilt
Exhale and use the abdominals to press the lower spine into the floor in a pelvic tuck. (Eickmeyer S. M. 2017)
Inhale to release.
Exhale and pull the lower spine off the floor, creating a pelvic tilt.
Inhale to release.
Pilates exercises don’t use excess energy or tension. Proper alignment and a neutral spine position can ensure that tension is released and excess energy is not exerted. (Byrnes, K., Wu, P. J., and Whillier, S. 2018) When performing the exercise, ensure that the shoulders, neck, and legs are relaxed and not involved in the movement.
When Exercising
Once a neutral spine is achieved, the goal is to maintain this spinal position during the exercises and when changing positions.
Start by lifting the right leg and placing it back down without letting the hips move.
Then, repeat the motion with the left leg.
Engage the abdominal muscles to help stabilize the pelvis, keeping it from moving and maintaining a neutral spine.
Repeat this process with each leg.
Once each leg can be lifted easily, test with both legs.
Exhale deeply and lift the legs while keeping the core and pelvis stable.
Then, lower them back down.
When performing this progression, there may be a want to release the abs and let the back arch.
This will cause a tuck and tilt position away from the neutral spine position.
If this progression is difficult, keep practicing until you can maintain a neutral spine.
Once this basic progression feels easy, try additional progressions and positioning.
Visualization Tips
Most people have their spines in one of two positions: tucked or tilted. A neutral spine requires individuals to be in between, with the lower abdominals flat and the lower spine’s natural curve slightly off the floor. The following visualization can help establish a neutral spine.
Balanced Pelvic Placement
Imagine a cup of water sitting on the lower abdomen, a couple of inches below the belly button.
Allow the abdominal muscles to drop toward the spine, flattening the belly.
You don’t want the water to spill, so the pelvis cannot be tipped forward or tucked under.
Body Scan Meditation
Once the body is relaxed with a balanced alignment on the floor.
Allow breathing to become deep and full and the abdominals to drop toward the floor.
The natural neck and lower spine curves should be off the floor.
Ensure the lower spine is not pressed into the floor, as this indicates a pelvic tilt.
If there is any discomfort or pain when working to increase endurance, seek advice from a healthcare professional. Injury Medical Chiropractic and Functional Medicine Clinic uses an integrated approach to treating injuries and chronic pain syndromes. It offers personalized care plans that improve ability through flexibility, mobility, and agility programs to relieve pain. Our providers use an integrated approach to create personalized care plans for each patient, including Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine principles. Our goal is to relieve pain naturally by restoring health and function to the body. If other treatment is needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments.
Is Motion Key to Healing?
References
Kloubec J. (2011). Pilates: how does it work and who needs it?. Muscles, ligaments and tendons journal, 1(2), 61–66.
Byrnes, K., Wu, P. J., & Whillier, S. (2018). Is Pilates an effective rehabilitation tool? A systematic review. Journal of bodywork and movement therapies, 22(1), 192–202. https://doi.org/10.1016/j.jbmt.2017.04.008
Barbosa, A. C., Vieira, E. R., Silva, A. F., Coelho, A. C., Martins, F. M., Fonseca, D. S., Barbosa, M. A., & Bordachar, D. (2018). Pilates experience vs. muscle activation during abdominal drawing-in maneuver. Journal of bodywork and movement therapies, 22(2), 467–470. https://doi.org/10.1016/j.jbmt.2017.05.002
Eickmeyer S. M. (2017). Anatomy and Physiology of the Pelvic Floor. Physical medicine and rehabilitation clinics of North America, 28(3), 455–460. https://doi.org/10.1016/j.pmr.2017.03.003
Can increasing endurance help individuals who want to improve their physical abilities or extend the time they perform these activities?
Endurance
Individuals tend to think of endurance in terms of exercise and fitness, such as running, biking, swimming, and strength training. While this is true, endurance is involved in nearly every task we perform. For example, an individual has to have enough endurance to complete a full day of activities. This includes:
Carpooling the kids
Professional responsibilities
Home chores
Preparing dinner
Helping out kids with homework, etc.
Nearly every activity requires some level of endurance, which means the ability to maintain activity for an extended period of time. When endurance begins to wane, it usually results from not performing certain activities regularly. The body gets used to daily routines and activities. When it stops engaging in certain activities, like walking and exercising regularly, endurance slowly declines, and the ability to perform at the same caliber.
What Is It?
Endurance is an ability that is acquired after extensive physical and mental training. Physiological and psychological factors reinvigorate individuals to continue doing what they are doing longer. Factors include:
Fatigue
Individuals who didn’t sleep well the night before or are worn out may have difficulty following through with certain activities that require extensive output or stamina.
Fitness Levels
Current fitness levels are also a predictor of endurance.
How physically fit an individual is, coupled with their level of training, will impact endurance abilities.
Genetics is another factor, as everybody has different muscle fibers that can influence physical capabilities. While research shows that individuals can gradually alter the amount of these fibers, it also emphasizes the role of genetics in determining one’s muscle makeup. (de Souza, E. O. et al., 2014)
Individuals who constantly challenge themselves mentally and physically are continually building endurance.
Endurance and Stamina Difference
Endurance is often used interchangeably with stamina. However, the two are very different.
Stamina refers to how long an individual can perform a certain activity at maximum capacity or without getting tired.
Endurance revolves around an individual’s ability to perform a certain activity without performing at maximum capacity.
Types
Endurance can be divided into classifications defined by type. Here are the main types of endurance in physical fitness and what they mean.
Cardiovascular
Cardiovascular endurance is the stress an individual’s heart can take during physical activity.
When building cardiovascular endurance, the body becomes more efficient at pumping blood while performing a specific activity.
Individuals with more cardiovascular endurance can sustain longer and more intense overall training.
Muscular
Muscular endurance is the length of time muscles can continue to contract enough to allow the body to finish a certain activity.
An individual lacking in muscular endurance will succumb faster to excess lactic acid build-up, causing cramps.
An individual with significant muscular endurance can lift a weight for more repetitions before failure.
Anaerobic
Anaerobic means without oxygen, so anaerobic endurance refers to how long a muscle can continue working at a certain physical level without much or any oxygen.
Weightlifting is a great example of this.
Anaerobic exercise tends to be shorter in duration but more intense than aerobic exercise, like swimming or cycling.
Improvement
Through endurance training, individuals can improve their ability to carry out certain activities longer. Recommendations for how to improve include.
Interval Training
Interval training, or high-intensity interval training, involves increasing the intensity of the workout for a short period of time.
If running, intentionally push the pace harder than normal for 20-second intervals.
Followed by a slower recovery pace for about a minute.
This increases endurance and improves insulin sensitivity.
Pedaling on an air bike is another recommended activity to build strength and endurance.
Rest Less Between Sets
Resting in between certain types of physical activity is beneficial, it can also lower heart rate and endurance threshold.
Taking less rest between workout sets so that the heart rate stays elevated increases endurance with each workout.
Perform a Few More Reps On Each Set
Whatever the type of exercise being done, one way to enhance endurance is to add one more rep, one more mile, or a few more minutes to the fitness schedule.
The body will slowly adapt to that level, making it the new norm.
Increase Core Strength
No matter the workout—running, swimming, cycling, or weight lifting—it’s important to focus on strengthening the core. This will help improve endurance in any activity and prevent injuries.
Individuals having trouble taking their workouts to the next level and feeling that their endurance has flattened should consider enlisting the help of a certified personal trainer. If there is any discomfort or pain when working to increase endurance, seek advice from a healthcare professional. Injury Medical Chiropractic and Functional Medicine Clinic uses an integrated approach to treating injuries and chronic pain syndromes. It offers personalized care plans that improve ability through flexibility, mobility, and agility programs to relieve pain. Our providers use an integrated approach to create personalized care plans for each patient, including Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine principles. Our goal is to relieve pain naturally by restoring health and function to the body. If other treatment is needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments.
Unlocking Athletic Potential
References
de Souza, E. O., Tricoli, V., Aoki, M. S., Roschel, H., Brum, P. C., Bacurau, A. V., Silva-Batista, C., Wilson, J. M., Neves, M., Jr, Soares, A. G., & Ugrinowitsch, C. (2014). Effects of concurrent strength and endurance training on genes related to myostatin signaling pathway and muscle fiber responses. Journal of strength and conditioning research, 28(11), 3215–3223. https://doi.org/10.1519/JSC.0000000000000525
Can physical therapies help relieve muscle contractures in individuals who have endured prolonged bed rest, inactivity, or lack of use of certain muscle groups?
Muscle Contracture
A muscle contracture, or contracture deformity, is caused when a muscle loses elasticity. This causes permanent shortening and tightening of muscle fibers, which reduces flexibility and makes movement difficult. Muscles that cannot move and stretch cause the surrounding joints to lose mobility and develop pain symptoms. When trying to stretch the contracted muscle, the individual will feel the muscle become very rigid, which can increase pain. (Lieber, R. L., and Fridén, J. 2019) Delaying treatment can potentially cause irreversible and chronic symptoms.
Commonly Affected Muscles
Flexor muscles bend the joints and are those most affected by contractures. The stiffening and tightening prevent the body parts from moving out and away. The most common include:
Wrist and Finger Flexors
Muscle groups that bend the wrist and fingers.
Biceps
The primary elbow flexor that bends the arm.
Gastrocnemius and Soleus
The calf muscles which allow the ankle to point the foot/plantarflexion.
Hamstrings
A group of three muscles behind the thigh that bend the knee.
Causes
The permanent shortening of muscle fibers and changes in muscle structure cause muscle contractures or stiffer-than-normal tissue that is difficult to stretch. Sarcomeres are structural units of muscles that cause fibers to contract.
With contractures, the sarcomeres overly lengthen when the muscle fibers tighten. This increase in sarcomere length prevents the muscle from contracting normally, resulting in weakness. Muscle fibers are encased in an extracellular matrix, a mesh composed of collagen and other proteins that help transmit force and provide muscle contraction. Muscle contractures cause the amount of collagen within the extracellular matrix to increase, causing a stiffening of fibers that restricts movement. (Lieber, R. L., and Fridén, J. 2019)
Muscle contractures also form from decreased satellite cells. Satellite cells are specialized stem cells that can rebuild muscle and are necessary for muscle regeneration and repair. Without the proper amount of satellite cells, other cells like fibroblasts significantly increase in the muscle tissue, causing the fibers to become stiff and fibrotic or more fibrous. These changes to the sarcomeres, collagen within the extracellular matrix, and decreased satellite cells all result from conditions in which neurological input to the brain and spinal cord muscles becomes reduced. This is caused by lack of use, injury, or neurological and neuromuscular conditions. (Lieber, R. L., and Fridén, J. 2019)
Cerebral Palsy
Contractures often occur from upper motor neuron lesions, which prevent signals from the brain and spinal cord from reaching the motor neurons that control muscle contraction. When these signals are weakened or blocked, muscles become stiff and weak from lack of stimulation. (Lieber, R. L., and Fridén, J. 2019)
Cerebral palsy is a group of disorders affecting mobility caused by an upper motor neuron lesion that is present at birth and is the most common motor disability in children. It causes:
Cognitive impairment
Decreased muscle strength
Problems with movement, coordination, and functional motions.
Because cerebral palsy prevents the muscles of the legs from being sufficiently stimulated, contractures commonly develop in the hips, knees, and ankles. Individuals can have a 75% decrease in satellite cells to repair muscle tissue and prevent muscle fibrosis or stiffening. Specific genes linked to collagen production are also altered, causing irregular changes to the extracellular matrix of muscles. (Lieber, R. L., and Fridén, J. 2019)
Muscular Dystrophy
Muscular dystrophy is a group of inherited neuromuscular disorders characterized by muscle weakness and wasting. Deficient nerve supply to muscles causes them to become stiff and tight, inhibiting the functional range of motion needed to move joints and activate muscles to move. Clinical research suggests that individuals with muscular dystrophy have decreased levels of satellite cells to repair, increasing the risk of developing muscle contracture. (Lieber, R. L., and Fridén, J. 2019)
Disuse-induced Muscle Wasting or Disuse Atrophy
When muscles are not used for some time because of hospitalization, prolonged bed rest, or immobilization from wearing braces, splints, or casts after injuries, the blood circulation and electrical signaling from nerves to muscles decreases. This results in weakness, increased muscle tightness and stiffness, and muscle wasting/atrophy. Over time, stiff and tight muscles can progress to contractures that become extremely difficult to stretch.
Trauma or Injury
Muscle or tendon injuries can cause contractures as scar tissue develops, joining muscle fibers and joints together. This can significantly restrict movement. Large burns can also cause skin, muscles, and joint contractures. The range of motion can become significantly limited, and the changes can become irreversible if not aggressively treated.
Other Causes
Other forms of upper motor neuron lesions that can cause contractures because of weak or blocked electrical input to muscles as a result of brain or spinal cord damage include:
Neuromuscular disorders like spinal muscular atrophy – SMA.
Conditions that cause inflammation and joint stiffening, like juvenile rheumatoid arthritis.
A history of diabetes also increases the risk of developing contractures affecting finger flexors, like Dupuytren’s contractures and stenosing tenosynovitis
or trigger finger. (Lieber, R. L., and Fridén, J. 2019)
Symptoms
Symptoms include:
Extremely stiff and tight muscles resistant to stretching.
Pain from the inability to stretch.
Loss of range of motion.
Impaired joint mobility.
Severe contractures can interfere with the functional range of motion needed to move joints to complete normal tasks and movements, such as standing up from a chair and walking.
Treatment
Physical Therapy
Physical therapies can help reduce the severity through stretching and soft tissue mobilization to decrease tightness. (Lieber, R. L., and Fridén, J. 2019)
Specialized braces or splints can be custom-made to fit different body parts.
These provide a prolonged low-intensity stretch over a period of time to increase muscle length.
Once the muscle has stretched, a new brace or splint may be needed to adjust to the increased range of motion. (Lieber, R. L., and Fridén, J. 2019)
Surgery
In severe cases where muscle contractures limit the functional range of motion needed for activities of daily living or ADLs, surgical release of the contracted tissue may be recommended. This surgery can improve functional movements like walking, getting in and out of bed, and standing up from chairs. The tight muscles can be surgically cut, and the tendons can be lengthened to allow more mobility. (Lieber, R. L., and Fridén, J. 2019)
The causes of muscle contracture are not always avoidable, but various treatment options are available to help loosen up tight muscles and preserve or restore the range of motion. It’s important to move daily and stretch common areas like the fingers, arms, and legs to reduce the risk of muscle tightness and prevent contractures from developing. It is imperative to seek medical treatment for severe contractures resulting from neuromuscular disorders, including physical and occupational therapy, to prevent contractures from worsening and regaining as much functional range as possible.
Injury Medical Chiropractic and Functional Medicine Clinic uses an integrated approach personalized to the individual that focuses on what works for them and treats injuries and chronic pain syndromes through personalized care plans that improve ability through flexibility, mobility, and agility programs to relieve pain. Our providers use an integrated approach to create personalized care plans for each patient, including Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine principles. Our goal is to relieve pain naturally by restoring health and function to the body. If other treatment is needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments.
Chiropractic Treatment for Cerebral Palsy
References
Lieber, R. L., & Fridén, J. (2019). Muscle contracture and passive mechanics in cerebral palsy. Journal of applied physiology (Bethesda, Md. : 1985), 126(5), 1492–1501. https://doi.org/10.1152/japplphysiol.00278.2018
For wrestling athletes or those thinking about getting into the sport, can knowing about common injuries help in rehabilitation and prevention?
Wrestling Injuries
Wrestling is an intense and demanding sport. Studies have found that football and wrestling are the two high school sports with the highest risk of serious injury to athletes (Center for Injury Research and Policy, 2009). The injury rate for college wrestlers is 9 injuries per 1,000 athlete exposures. (Kroshus, E. et al., 2018) While most wrestling injuries include strains and sprains, there can also be serious traumatic and unusual injuries. Using proper safety gear and learning correct techniques can significantly reduce the risk of injuries. The majority occur during competition.
Common
The most common wrestling injuries are similar to those in other sports and include:
Muscle Soreness
Muscle soreness that is experienced 12 to 48 hours after an intense workout or competition.
Resting is often all that is needed to recover.
Bruises and Contusions
Sparring, take-downs, and hard landings can result in various bruises and contusions.
Sprains and Strains
Rest, ice, compression, and elevation are recommended to treat sprains and strains immediately.
Ankle Sprains
Ankle sprains occur when surrounding ligaments stretch and tear around the joint.
Wrist Sprains
Typically, it occurs when stretching or tearing the ligaments.
Falling or landing on the hands is a common cause.
Overtraining Syndrome
Frequently occurs in athletes who train beyond the body’s ability to recover.
Dehydration
When trying to make weight, dehydration can be a serious health problem that many wrestlers experience.
Other Injuries
Other injuries common in wrestling:
Wrist tendinitis
Finger fractures
Iliotibial band syndrome
Meniscus tears
Groin pull
Hamstring pull or tear
Pulled calf muscle
Achilles tendonitis
Achilles tendon rupture
Clavicle/Collarbone fracture
Concussion
Serious
The forcing of a joint beyond its normal range of motion is the most common cause of serious injuries. The most serious wrestling injuries affect the neck, shoulder, elbow, and knee and include:
Neck
The cervical vertebrae are often forced into vulnerable positions during various techniques and movements, which can result in a neck injury. Common types include:
Neck Strain
Whiplash
Cervical Fracture
Shoulder
A combination of leverage and twisting causes most upper body and shoulder injuries during competition. Types of shoulder injuries include:
Rotator cuff injury
Shoulder separation
Shoulder dislocation
Elbow Dislocation
Elbows are under tremendous strain when maneuvering.
Dislocations of the radial head are often related to the athlete bracing for a fall on an outstretched arm during take-downs.
Knee
Most knee injuries occur to the ligaments of the knee joint.
These include anterior and posterior cruciate ligament or ACL/PCL injuries.
Safety
Wrestling requires flexibility, strength, and proper technique to prevent injury, combined with thorough instruction and coaching and following basic safety precautions. Some tips include.
Safety Gear
Wear appropriate headgear and mouthguards during practices, meets, and tournaments.
Improving Joint Flexibility
Wrestlers with a high degree of shoulder flexibility have fewer injuries.
The flexibility of the lower back, hamstrings, elbows, and cervical spine should also be worked on.
Gain or Lose Weight Safely
Avoid dramatic weight loss and weight-gaining strategies by maintaining healthy nutrition and hydration during the season.
Avoiding Dangerous Holds and Slam Moves
Safe wrestling techniques need to be followed as these can generate severe injuries.
Regardless of how common or seemingly not serious an injury or medical condition is, it’s important to rest and recover and tell a coach and health care professional, as some injuries and conditions can become serious if left untreated. Injury Medical Chiropractic and Functional Medicine Clinic focuses on and treats injuries and chronic pain syndromes through personalized care plans that improve ability through flexibility, mobility, and agility programs to relieve pain. Our providers use an integrated approach to create personalized care plans for each patient, including Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine principles. Our goal is to relieve pain naturally by restoring health and function to the body. If other treatment is needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments.
Perseverance and Power
References
Nationwide Children’s Hospital. (2024). Center for Injury Research and Policy. https://www.nationwidechildrens.org/research/areas-of-research/center-for-injury-research-and-policy
Kroshus, E., Utter, A. C., Pierpoint, L. A., Currie, D. W., Knowles, S. B., Wasserman, E. B., Dompier, T. P., Marshall, S. W., Comstock, R. D., & Kerr, Z. Y. (2018). The First Decade of Web-Based Sports Injury Surveillance: Descriptive Epidemiology of Injuries in US High School Boys’ Wrestling (2005-2006 Through 2013-2014) and National Collegiate Athletic Association Men’s Wrestling (2004-2005 Through 2013-2014). Journal of athletic training, 53(12), 1143–1155. https://doi.org/10.4085/1062-6050-154-17
Can physical therapies help treat a high steppage gait from injury or medical conditions and restore normal gait patterns for individuals who have or are developing one?
Walking or gait anthropometric analysis on a treadmill
Neuropathic Gait
Neuropathic gait, aka equine or high steppage gait, is a type of walking abnormality that causes individuals to raise their hips to lift their legs higher than normal. It occurs when individuals have a foot drop or ankle equinus due to loss of dorsiflexion. As a result, the foot hangs with the toes pointing down, causing the toes to drag while walking. The foot may appear floppy when it drops. Foot drop is caused by weakness or paralysis of the anterior tibialis muscle in front of the shin bone. The anterior tibialis muscle contracts to help flex the foot and ankle while walking, ensuring the foot clears the floor and doesn’t drag. Individuals with anterior tibialis weakness or paralysis may have a neuropathic gait and excessively bend the hip and knee while stepping forward, lifting their leg high off the floor to clear the foot to avoid tripping. A physical therapy team can help with a high steppage gait pattern after illness or injury.
Causes
Conditions that can cause anterior tibialis weakness or paralysis and a high steppage gait pattern include:
Sciatica
Pain caused by compression or irritation of the sciatic nerve starts in the lower back and travels down the back of the leg. (McCabe, F. J., McCabe, J. P. 2016)
Peroneal Nerve Injury
Damage to the peroneal nerve branches from the sciatic nerve that help move the lower leg and foot. (Johns Hopkins Medicine. 2024)
Multiple Sclerosis
An autoimmune disease that damages nerve cells in the brain and spinal cord. (Taylor, P. N. et al., 2016)
Balance exercises will help improve overall proprioception, or the sense of the body’s position and movement.
Neuromuscular electrical stimulation, or NMES, can help improve the function of the muscle. (Hollis, S., McClure, P. 2017)
The electrical stimulation artificially contracts the muscle to restore proper function.
For anterior tibialis weakness caused by sciatica, back decompression exercises may be prescribed to relieve pressure off the sciatic nerve.
The exercises release the nerve to restore normal signal transmission up and down the nerve in the lower back.
Neuromuscular electrical stimulation may also be used to help improve muscle function.
Assistive Walking Devices
A therapist may suggest using an assistive device to help the patient walk properly. This could include a wheeled walker or a quad cane. A temporary solution to anterior tibialis weakness is to elevate the foot while walking with an elastic band. Tie a band around the leg below the knee and secure it around the ball of the foot. When swinging the leg forward, the band pulls the foot up. Using it as a temporary solution may help maintain safe mobility. Sometimes, paralysis of the anterior tibialis muscle can become permanent. In this case, individuals may benefit from a special brace called an ankle-foot orthosis. The brace helps to lift the foot and toes off the ground.
For individuals concerned about losing their balance and falling, there are ways to improve walking patterns to stay safe. A healthcare provider may recommend physical therapy to correct gait, strengthen the anterior tibialis muscle, improve balance, and educate on injury prevention. Individuals should discuss symptoms and conditions with a primary physician, healthcare provider, or specialist to guide them in the right direction and determine the best treatment.
Injury Medical Chiropractic and Functional Medicine Clinic uses an integrated approach personalized to the individual that focuses on what works for them and treats injuries and chronic pain syndromes through personalized care plans that improve ability through flexibility, mobility, and agility programs to relieve pain. If other treatment is 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 and Posture
References
McCabe, F. J., & McCabe, J. P. (2016). An Unusual Presentation of Right-Sided Sciatica with Foot Drop. Case reports in orthopedics, 2016, 9024368. https://doi.org/10.1155/2016/9024368
Kaykisiz, E. K., & Unluer, E. E. (2017). An Unexpected Reason for Isolated Foot Drop: Acute Stroke. Pakistan journal of medical sciences, 33(5), 1288–1290. https://doi.org/10.12669/pjms.335.13593
Taylor, P. N., Wilkinson Hart, I. A., Khan, M. S., & Slade-Sharman, D. E. (2016). Correction of Footdrop Due to Multiple Sclerosis Using the STIMuSTEP Implanted Dropped Foot Stimulator. International journal of MS care, 18(5), 239–247. https://doi.org/10.7224/1537-2073.2015-038
Hollis, S., & McClure, P. (2017). Intramuscular Electrical Stimulation for Muscle Activation of the Tibialis Anterior After Surgical Repair: A Case Report. The Journal of orthopaedic and sports physical therapy, 47(12), 965–969. https://doi.org/10.2519/jospt.2017.7368
Can various stretches provide beneficial results for individuals experiencing TMJ pain by providing relief to the jaw?
Introduction
Many individuals use their jaws to communicate with one another, eat delicious food, and express themselves. The jaw is part of the upper extremities as it has five muscles that allow it to function when the mouth is opening or closing, chewing, and moving from side to side. When common motor functions like yawning, chewing, or speaking produce loud pops or clicks, it can become very painful and more often lead to temporomandibular joint dysfunction or TMJ. TMJ is a joint disorder that can affect a person’s ability to use their jaws properly and can lead to visceral-somatic disorders that can affect the upper extremities, causing them to be miserable. Luckily, many individuals can incorporate various stretches to reduce the impact of TMJ and help relax the stiff muscles around the jaw. Today’s article looks at the effects of TMJ, how various stretches can effectively reduce TMJ, and how additional non-surgical treatments can relieve TMJ pain. We discuss with certified associated medical providers who consolidate our patients’ information to assess pain-like issues associated with TMJ. We also inform and guide patients on various stretches for TMJ and ask their associated medical providers intricate questions to integrate a customized treatment plan to reduce the pain-like issues affecting their jaws. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer.
The Effects of TMJ
Do you feel stiffness in your jaw after clenching for an extended period? Do you hear excessive loud clicks when opening or closing your jaw? Or do you think your jaw is locking up constantly, making it difficult to open or close your mouth? When many individuals start to feel pain around their jaws excessively, many would often think that it could be tooth pain, but in actuality, it is the temporomandibular joint that is causing the issues. Temporomandibular joint disorder, or TMJ, can be developed through various causes that can impact a person’s jaw and can lead to pain and discomfort. Mechanical factors like jaw injuries, arthritis, teeth clenching, and grinding can cause excessive or unbalanced joint loading to the jaw, which can progress the development of TMJ. (Cardoneanu et al., 2022) When dealing with TMJ, pain can lead to symptoms of tenderness around the joint area of the jaw, difficulty chewing, ear pain, and stiffness.
At the same time, the effects of TMJ pain are often characterized by localized discomfort, as TMJ is a multifactorial musculoskeletal and neuromuscular disorder that can be difficult to diagnose. (Alolayan et al., 2022) This is because of how many individuals chew their foods on one side, which can lead to its development. When the masseter muscles of the jaw begin to overload on the TMJ, it can initiate remodeling on the non-working side of the jaw and cause the pain to flourish over time. (Santana-Mora et al., 2013) However, when dealing with TMJ pain, many individuals can seek out various treatment options that can reduce muscular impairment and disc displacement from the jaw and help improve the mandibular range of motion. (Brighenti et al., 2023)
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Why Stretching Helps With TMJ
When it comes to reducing TMJ pain, many individuals can seek out non-surgical treatments to reduce the overlapping pain symptoms and restore jaw function. Some of the main objectives that many pain specialists can take into account when dealing with TMJ pain are reducing reflex masticatory muscle pain and helping increase TMJ function through various treatments that can have a positive impact on the jaw. (Ferrillo et al., 2022) Some non-surgical treatments include multiple stretches to help relax the surrounding muscles and jaw and alleviate the tension and discomfort associated with TMJ.
Effective Stretches For TMJ Relief
Stretching can be part of a person’s personalized treatment plan to reduce TMJ pain and its associated comorbidities. Stretching and strengthening exercises can positively affect pain while improving the range of TMJ movement and helping many individuals restore their jaw motor function (Byra et al., 2020). Below are some of the stretches that can help reduce TMJ pain and relax the jaw muscles.
Relaxed Jaw Exercise
How to Do It: Place the tongue gently on the roof of the mouth behind the upper front teeth. This allows the teeth to come apart while relaxing the jaw muscles.
Benefits: This exercise helps relax the jaw and ease muscle tension.
Partial Goldfish Exercises
How to Do It: Place the tongue gently on the roof of the mouth and one finger in front of the ear where the TMJ is located. Place your middle finger on your chin. Drop your lower jaw halfway and close. Perform this exercise six times in one set.
Benefits: This stretch helps target the jaw’s range of motion and reduce joint stiffness.
Full Goldfish Exercises
How to Do It: Similar to the partial opening, but open your mouth fully this time.
Benefits: This stretch helps enhance the full range of motion and reduce joint stiffness.
Chin Tucks
How to Do It: Sitting upright in a chair, pulling your chin straight back, creating a “double chin.” Hold for three seconds, and then release.
Benefits: This exercise helps strengthen the neck muscles, improves posture, and reduces strain on the jaw.
Additional Tips To Reduce TMJ
Along with these stretches, additional tips for managing and reducing TMJ by avoiding excessive jaw movements and applying hot/cold packs to reduce any residual inflammation correlating with TMJ. When people with TMJ start incorporating non-surgical treatments and stretches to relieve the pain, it can help increase the mandibular active range of motion and provide beneficial relief. (Urbanski et al., 2021) This, in turn, allows many people with TMJ pain to be more mindful of the body and make small changes in their health and well-being.
References
Alolayan, A., Alsayed, S. S., Salamah, R. M., Ali, K. M., Alsousi, M., & Elsayed, S. (2022). Temporomandibular joint (TMJ) disorders prevalence and awareness of appropriate clinical practices, among Al-Madinah community in Saudi Arabia. F1000Res, 11, 395. https://doi.org/10.12688/f1000research.104272.2
Brighenti, N., Battaglino, A., Sinatti, P., Abuin-Porras, V., Sanchez Romero, E. A., Pedersini, P., & Villafane, J. H. (2023). Effects of an Interdisciplinary Approach in the Management of Temporomandibular Disorders: A Scoping Review. Int J Environ Res Public Health, 20(4). https://doi.org/10.3390/ijerph20042777
Byra, J., Kulesa-Mrowiecka, M., & Pihut, M. (2020). Physiotherapy in hypomobility of temporomandibular joints. Folia Med Cracov, 60(2), 123-134. https://www.ncbi.nlm.nih.gov/pubmed/33252600
Cardoneanu, A., Macovei, L. A., Burlui, A. M., Mihai, I. R., Bratoiu, I., Rezus, II, Richter, P., Tamba, B. I., & Rezus, E. (2022). Temporomandibular Joint Osteoarthritis: Pathogenic Mechanisms Involving the Cartilage and Subchondral Bone, and Potential Therapeutic Strategies for Joint Regeneration. Int J Mol Sci, 24(1). https://doi.org/10.3390/ijms24010171
Ferrillo, M., Giudice, A., Marotta, N., Fortunato, F., Di Venere, D., Ammendolia, A., Fiore, P., & de Sire, A. (2022). Pain Management and Rehabilitation for Central Sensitization in Temporomandibular Disorders: A Comprehensive Review. Int J Mol Sci, 23(20). https://doi.org/10.3390/ijms232012164
Santana-Mora, U., Lopez-Cedrun, J., Mora, M. J., Otero, X. L., & Santana-Penin, U. (2013). Temporomandibular disorders: the habitual chewing side syndrome. PLOS ONE, 8(4), e59980. https://doi.org/10.1371/journal.pone.0059980
Urbanski, P., Trybulec, B., & Pihut, M. (2021). The Application of Manual Techniques in Masticatory Muscles Relaxation as Adjunctive Therapy in the Treatment of Temporomandibular Joint Disorders. Int J Environ Res Public Health, 18(24). https://doi.org/10.3390/ijerph182412970
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