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.
For individuals with a broken collarbone, can conservative treatment help in the rehabilitation process?
Broken Collarbone
Broken collarbones are very common orthopedic injuries that can occur in any age group. Also known as the clavicle, it is the bone over the top of the chest, between the breastbone/sternum and the shoulder blade/scapula. The clavicle can be easily seen because only skin covers a large part of the bone. Clavicle fractures are extremely common, and account for 2% – 5% of all fractures. (Radiopaedia. 2023) Broken collarbones occur in:
Babies – usually during birth.
Children and adolescents – because the clavicle does not fully develop until the late teens.
Athletes – because of the risks of being hit or falling.
Through various types of accidents and falls.
The majority of broken collarbones can be treated with nonsurgical treatments, usually, with a sling to let the bone heal and physical therapy and rehabilitation.
Sometimes, when clavicle fractures are significantly shifted out of alignment, surgical treatment may be recommended.
There are treatment options that should be discussed with an orthopedic surgeon, physical therapist, and/or a chiropractor.
A broken collarbone is not more serious than other broken bones.
Once the broken bone heals, most individuals have a full range of motion and can return to the activities before the fracture. (Johns Hopkins Medicine. 2023)
Types
Broken clavicle injuries are separated into three types depending on the location of the fracture. (Radiopaedia. 2023)
Mid-Shaft Clavicle Fractures
These occur in the central area which can be a simple crack, separation, and/or fractured into many pieces.
Multiple breaks – segmental fractures.
Significant displacement – separation.
Shortened length of the bone.
Distal Clavicle Fractures
These happen close to the end of the collarbone at the shoulder joint.
This part of the shoulder is called the acromioclavicular/AC joint.
Distal clavicle fractures can have similar treatment options as an AC joint injury.
Medial Clavicle Fractures
These are less common and often related to injury to the sternoclavicular joint.
The sternoclavicular joint supports the shoulder and is the only joint that connects the arm to the body.
Growth plate fractures of the clavicle can be seen into the late teens and early 20s.
The bruising can extend down to the chest and armpit.
Numbness and tingling down the arm.
Deformity of the collarbone.
In addition to swelling, some individuals may have a bump in the place where the fracture occurred.
It can take several months for this bump to fully heal, but this is normal.
If the bump appears inflamed or irritated, inform a healthcare provider.
Clavicular Swelling
When the sternoclavicular joint swells up or gets bigger, it is referred to as clavicular swelling.
It is commonly caused by trauma, disease, or an infection that affects the fluid found in the joints. (John Edwin, et al., 2018)
Diagnosis
At the healthcare clinic or emergency room, an X-ray will be obtained to assess for the specific type of fracture.
They will perform an examination to ensure the nerves and blood vessels surrounding the broken collarbone are unsevered.
The nerves and vessels are rarely injured, but in severe cases, these injuries can occur.
Treatment
Treatment is accomplished either by allowing the bone to heal or by surgical procedures to restore the proper alignment. Some common treatments for broken bones are not used for clavicle fractures.
For example, casting a broken collarbone is not done.
In addition, resetting the bone or a closed reduction is not done because there is no way to hold the broken bone in proper alignment without surgery.
If surgery is an option the healthcare provider looks at the following factors: (UpToDate. 2023)
Location of Fracture and Degree of Displacement
Nondisplaced or minimally displaced fractures are usually managed without surgery.
Age
Younger individuals have an increased ability to recover from fractures without surgery.
Shortening of the Fracture Fragment
Displaced fractures can heal, but when there is a pronounced shortening of the collarbone, surgery is probably necessary.
Other Injuries
Individuals with head injuries or multiple fractures can be treated without surgery.
Patient Expectations
When the injury involves an athlete, heavy job occupation, or the arm is the dominant extremity, there can be more reason for surgery.
Dominant Arm
When fractures occur in the dominant arm, the effects are more likely to be noticeable.
The majority of these fractures can be managed without surgery, but there are situations where surgery can produce better results.
Supports for Non-surgical Treatment
A sling or figure-8 clavicle brace.
The figure-8 brace has not been shown to affect fracture alignment, and many individuals generally find a sling more comfortable. (UpToDate. 2023)
Broken collarbones should heal within 6–12 weeks in adults
3–6 weeks in children
Younger patients are usually back to full activities before 12 weeks.
The pain usually subsides within a few weeks. (UpToDate. 2023)
Immobilization is rarely needed beyond a few weeks, and with a doctor’s clearance light activity and gentle motion rehabilitation usually begins.
Edwin, J., Ahmed, S., Verma, S., Tytherleigh-Strong, G., Karuppaiah, K., & Sinha, J. (2018). Swellings of the sternoclavicular joint: review of traumatic and non-traumatic pathologies. EFORT open reviews, 3(8), 471–484. doi.org/10.1302/2058-5241.3.170078
Tennis requires strength, power, and endurance. Can combining tennis weight training into a player’s fitness regimen that is broken up into phases achieve optimal results?
Tennis Weight Training
In professional sports that utilize weight lifting, the training is often broken up into seasonal phases. (Daniel S Lorenz, Michael P Reiman, John C Walker. 2010) Each phase consists of specific objectives that contribute to and build upon the previous phase. This is known as periodization. Tennis is played year-round indoors and outdoors. This is an example of a tennis weight training program to build up strength.
Pre-Season
In the early pre-season, players prepare to rebuild their strength after a break.
The emphasis is on building functional strength and some muscle.
Late Pre-Season
In late pre-season, players workout to get ready for the start of the season.
Here, the emphasis is on building maximum power.
In Season
In season, regular practice, play, and competition get underway and players are in top condition.
In this phase, strength and power maintenance is the focus.
Season Break
This is when players need to relax for a while.
However, players need to keep active if they want to maintain some level of fitness.
The emphasis is on rest and recovery with the maintenance of light activity, like cross-training and light gym workouts.
Research has shown that taking a break from serious strength training does help the body recover and rebuild. (Daniel Lorenz, Scot Morrison. 2015)
This is a three-phase all-around program.
The first phase concentrates on building basic strength and muscle
The second phase on power delivery.
Players who play year-round can continue with the power program once they build the basics.
Players who take a break for longer than six weeks should start again with the strength program.
Pre-Season – Phase One
Strength and Muscle
The focus is on lifting heavy weights, but not going full force to begin training the nervous system to work with the muscle fibers.
Some muscle building or hypertrophy/building muscle size will happen during strength development.
Strength is the foundation for the power development phase.
Exercises:
Duration: 6-8 weeks
Workout Days: 2-3, with at least one day, however, two are recommended between sessions.
Reps: 8-10
Sets: 2-4
Rest between sets: 1-2 minutes
Barbell squat, dumbbell squat, or sled hack squat
Romanian deadlift
Dumbbell bent-over row
Dumbbell triceps extension or machine pushdown
Cable wood chop
Lat pulldown to the front with a wide grip
Reverse crunch
Things to Remember
Use the Proper Weight
Adjust the weight so that the last reps are heavy but don’t cause a complete failure.
Balance the Lower Half
The posterior chain of the hips, the gluteals/buttocks, the upper legs, and the abdominals are of equal importance and require equal attention. (Eline Md De Ridder, et al., 2013)
Squats and deadlifts build strength and power in this region.
Follow Proper Form
For upper body exercises like the dumbbell press, lat pulldown, and wood chops the proper form needs to be followed.
Keep the forearms in a vertical plane with the upper arms.
Do not extend excessively at the bottom of the movement.
Remember to protect the vulnerable shoulder joint.
Listen to The Body
Strength training is physically and mentally challenging.
Individuals who are not able to recover from a session with only one rest day are recommended to move the program to two sessions per week.
Muscle soreness or delayed onset muscle soreness – DOMS – is normal, however, joint pain is not.
Monitor arm and shoulder reactions during this phase.
Stop if any joint pain or discomfort is felt.
Late Pre-Season – In-Season – Phase Two
Power
Power is the ability to move the heaviest loads in the shortest time and is the combination of strength and speed. In this phase, the player builds on the strength developed in phase one with tennis weight training that will increase the ability to move a load at high velocity.
Power training requires lifting weights at high velocity and with explosiveness.
The body needs to rest adequately between repetitions and sets so that each movement is done as fast as possible.
The number of sets can be less than phase one because there is no point in training at this level when the body is fatigued.
Exercises
Duration: Ongoing
Days per week: 2
Reps: 8 to 10
Sets: 2-4
Rest between repetitions: 10 to 15 seconds
Rest between sets: at least 1 minute or until recovered
Barbell or dumbbell hang clean
Cable push-pull
Cable wood chop
One arm cable raises
Medicine ball push press
Medicine ball standing twist with a partner or alone – 6×15 repetitions fast and recover between sets.
Reminders When Preparing For the Season
Recovery Time
In power training, it’s important that the body has relatively recovered for each repetition and set so that the individual can maximize the movement.
The weights should not be as heavy and the rest periods sufficient.
Push When Possible
Rest is important, at the same time, the player needs to push through reasonably heavy loads to develop power against significant resistance.
When doing medicine ball twists, do a full set at maximum, then sufficiently rest before the next one.
If doing the medicine ball exercises alone, use a lighter ball and keep the ball in your hands while twisting.
In Season – Phase Three
When the season begins training does not stop in order to help maintain strength and power.
Strength and Power Maintenance
Alternate phase one and phase two for a total of two sessions each week.
Every fifth week, skip weight training to achieve optimal recovery.
Key Points
Things to keep in mind during the season.
Avoid Overscheduling
Avoid strength training on the same day when practicing on the court.
If the weight training has to be both on the same day, try to separate the workouts into morning and afternoon sessions.
Plan Time
Rest completely from strength training one week out of every six.
Light gym work is fine.
During the season, use intuition when it comes to working out at the gym.
Individuals with limited time, stick to court skills training instead of tennis weight training.
Off Season
If there is an off-season, this is the time for emotional and physical decompression and full-body recovery.
For several weeks, forget about weight training and do other things.
Stay fit and active with cross-training or other physical activities but keep it light to prevent injuries.
It is recommended to consult a coach, trainer, sports chiropractor, and/or physical therapist to develop a program specific to an individual’s needs, fitness goals, and access to resources.
Spine Injuries In Sports
References
Lorenz, D. S., Reiman, M. P., & Walker, J. C. (2010). Periodization: current review and suggested implementation for athletic rehabilitation. Sports health, 2(6), 509–518. doi.org/10.1177/1941738110375910
Lorenz, D., & Morrison, S. (2015). CURRENT CONCEPTS IN PERIODIZATION OF STRENGTH AND CONDITIONING FOR THE SPORTS PHYSICAL THERAPIST. International journal of sports physical therapy, 10(6), 734–747.
De Ridder, E. M., Van Oosterwijck, J. O., Vleeming, A., Vanderstraeten, G. G., & Danneels, L. A. (2013). Posterior muscle chain activity during various extension exercises: an observational study. BMC musculoskeletal disorders, 14, 204. doi.org/10.1186/1471-2474-14-204
The Q or quadriceps angle is a measurement of pelvic width that is believed to contribute to the risk of sports injuries in women athletes. Can non-surgical therapies and exercises help rehabilitate injuries?
Quadriceps Q – Angle Injuries
The Q angle is the angle where the femur/upper leg bone meets the tibia/lower leg bone. It is measured by two intersecting lines:
One from the center of the patella/kneecap to the anterior superior iliac spine of the pelvis.
The other is from the patella to the tibial tubercle.
On average the angle is three degrees higher in women than men.
Women have biomechanical differences that include a wider pelvis, making it easier to give birth. However, this difference can contribute to knee injuries when playing sports, as an increased Q angle generates more stress on the knee joint, as well as leading to increased foot pronation.
Injuries
Various factors can increase the risk of injury, but a wider Q angle has been linked to the following conditions.
Patellofemoral Pain Syndrome
An increased Q angle can cause the quadriceps to pull on the kneecap, shifting it out of place and causing dysfunctional patellar tracking.
With time, this can cause knee pain (under and around the kneecap), and muscle imbalance.
Foot orthotics and arch supports could be recommended.
Some researchers have found a link, while others have not found the same association. (Wolf Petersen, et al., 2014)
Chondromalacia of the Knee
This is the wearing down of the cartilage on the underside of the kneecap.
An increased Q angle can be a factor that increases stress and causes the knee to lose its stability.
However, this remains controversial, as some studies have found no association between the Q angle and knee injuries.
Chiropractic Treatment
Strengthening Exercises
ACL injury prevention programs designed for women have resulted in reduced injuries. (Trent Nessler, et al., 2017)
The vastus medialis obliquus or VMO is a teardrop-shaped muscle that helps move the knee joint and stabilize the kneecap.
Strengthening the muscle can increase the stability of the knee joint.
Strengthening may require a specific focus on muscle contraction timing.
Closed-chain exercises like wall squats are recommended.
Glute strengthening will improve stability.
Stretching Exercises
Stretching tight muscles will help relax the injured area, increase circulation, and restore range of motion and function.
Muscles commonly found to be tight include the quadriceps, hamstrings, iliotibial band, and gastrocnemius.
Foot Orthotics
Custom-made, flexible orthotics decrease the Q angle and reduce pronation, relieving the added stress on the knee.
A custom orthotic ensures that the foot and leg dynamics are accounted for and corrected.
Motion-control shoes can also help correct overpronation.
Knee Rehabilitation
References
Khasawneh, R. R., Allouh, M. Z., & Abu-El-Rub, E. (2019). Measurement of the quadriceps (Q) angle with respect to various body parameters in young Arab population. PloS one, 14(6), e0218387. doi.org/10.1371/journal.pone.0218387
Petersen, W., Ellermann, A., Gösele-Koppenburg, A., Best, R., Rembitzki, I. V., Brüggemann, G. P., & Liebau, C. (2014). Patellofemoral pain syndrome. Knee surgery, sports traumatology, arthroscopy: Official journal of the ESSKA, 22(10), 2264–2274. doi.org/10.1007/s00167-013-2759-6
Vaienti, E., Scita, G., Ceccarelli, F., & Pogliacomi, F. (2017). Understanding the human knee and its relationship to total knee replacement. Acta bio-medica : Atenei Parmensis, 88(2S), 6–16. doi.org/10.23750/abm.v88i2-S.6507
Mitani Y. (2017). Gender-related differences in lower limb alignment, range of joint motion, and the incidence of sports injuries in Japanese university athletes. Journal of Physical Therapy Science, 29(1), 12–15. doi.org/10.1589/jpts.29.12
Nessler, T., Denney, L., & Sampley, J. (2017). ACL Injury Prevention: What Does Research Tell Us? Current reviews in musculoskeletal medicine, 10(3), 281–288. doi.org/10.1007/s12178-017-9416-5
Can weight and strength training increase speed and power in athletes that participate in throwing sports?
Throwing Sports
Top-throwing athletes have amazing arm speed. To succeed in throwing sports athletes need to be able to generate quick explosive power. This means the ability to propel the arm forward with substantial velocity for maximum object delivery like a baseball, javelin, hammer throw, shot put, discus, etc. Combined with sports technique training, throwing strength and power can be increased by training with weights. Here is a three-phase training plan to improve throwing performance.
Full Body
The arm provides only one part of the delivery process.
The legs, core, shoulders, and general flexibility need to work cooperatively to exert maximum thrust and achieve maximum object speed.
The natural ability to throw fast with power is largely determined by an individual’s muscle type, joint structure, and biomechanics. (Alexander E Weber, et al., 2014)
Preparation
Preparation should provide all-around muscle and strength conditioning for early pre-season conditioning.
Athletes will be doing throwing training as well, so fieldwork will need to be able to fit in.
It is recommended not to do weight training prior to throwing practice.
This leads to the start of competition and tournament play.
Frequency
2 to 3 sessions per week
Type
Strength and power – 60% to 70% for one-rep max/1RM
The one-repetition maximum test, known as a one-rep max or 1RM, is used to find out the heaviest weight you can lift once.
When designing a resistance training program, individuals use different percentages of their 1RM, depending on whether they’re lifting to improve muscular strength, endurance, hypertrophy, or power. (Dong-Il Seo, et al., 2012)
Throwing practice and competition are the priorities.
Before competition begins, take a 7- to 10-day break from heavyweight sessions while maintaining throwing workouts.
Weight training during competition should provide maintenance.
Frequency
1 to 2 sessions per week
Type
Power – lighter loads and faster execution than in the preparation stage.
Exercises
3 sets of 10
Rapid movement, 40% to 60% of 1RM.
Squats
Power hang clean and press
Romanian deadlift
Lat pulldown
Incline bench press
Crunches
Rest
Between sets 1 to 2 minutes.
Training Tips
Athletes have individual needs, so a general program like this needs modification based on age, sex, goals, skills, competitions, etc.
A certified strength and conditioning coach or trainer could help develop a fitness plan that can be adjusted as the athlete progresses.
Be sure to warm up prior to weight training and cool down afterward.
Don’t try to train through injuries or try to progress too fast – it is recommended not to throw or do weights when treating or recovering from an injury. (Terrance A Sgroi, John M Zajac. 2018)
Focus on the fundamentals and practice proper form.
Take a few weeks off at the end of the season to recover after hard training and competition.
Body Transformation
References
Weber, A. E., Kontaxis, A., O’Brien, S. J., & Bedi, A. (2014). The biomechanics of throwing: simplified and cogent. Sports medicine and arthroscopy review, 22(2), 72–79. doi.org/10.1097/JSA.0000000000000019
American College of Sports Medicine (2009). American College of Sports Medicine position stand. Progression models in resistance training for healthy adults. Medicine and science in sports and exercise, 41(3), 687–708. doi.org/10.1249/MSS.0b013e3181915670
Zaras, N., Spengos, K., Methenitis, S., Papadopoulos, C., Karampatsos, G., Georgiadis, G., Stasinaki, A., Manta, P., & Terzis, G. (2013). Effects of Strength vs. Ballistic-Power Training on Throwing Performance. Journal of sports science & medicine, 12(1), 130–137.
Seo, D. I., Kim, E., Fahs, C. A., Rossow, L., Young, K., Ferguson, S. L., Thiebaud, R., Sherk, V. D., Loenneke, J. P., Kim, D., Lee, M. K., Choi, K. H., Bemben, D. A., Bemben, M. G., & So, W. Y. (2012). Reliability of the one-repetition maximum test based on muscle group and gender. Journal of sports science & medicine, 11(2), 221–225.
Sakamoto, A., Kuroda, A., Sinclair, P. J., Naito, H., & Sakuma, K. (2018). The effectiveness of bench press training with or without throws on strength and shot put distance of competitive university athletes. European journal of applied physiology, 118(9), 1821–1830. doi.org/10.1007/s00421-018-3917-9
Sgroi, T. A., & Zajac, J. M. (2018). Return to Throwing after Shoulder or Elbow Injury. Current reviews in musculoskeletal medicine, 11(1), 12–18. doi.org/10.1007/s12178-018-9454-7
Can adding calisthenics resistance training to a fitness routine provide health benefits like flexibility, balance, and coordination?
Calisthenics Resistance Training
Calisthenics resistance training requires no equipment, they can be done with minimal space, and are a great way to get a quick burn.
They are a form of resistance training using your own body weight that is low-impact, which makes it accessible to individuals of all ages and fitness levels.
They effectively help build agility, and cardiovascular health, and improve balance, coordination, and flexibility.
Benefits
Muscle Strength
Because calisthenics are easily adaptable to any fitness level, require minimal or no equipment, and are great for beginners and experienced exercise enthusiasts it is a fantastic full-body workout and an excellent way to build strength and muscle. Research supports that calisthenics resistance training can improve muscle strength in various ways.
One study found that eight weeks of calisthenics not only improved posture and body mass index/BMI but can impact strength, even with exercises not routinely performed. (Thomas E, et al., 2017)
During the study, one group did calisthenics and the other maintained regular training routines.
The researchers discovered that the group that did calisthenics increased their repetitions of exercises that were not included.
The group who continued with their regular training routines did not improve on what they could do before the eight-week study. (Thomas E, et al., 2017)
Cardiovascular Fitness
Regular participation in calisthenic resistance training can lead to improved cardiovascular health, including increased endurance and a healthier heart.
Certain calisthenic exercises, like burpees and mountain climbers, are high-intensity movements that can increase heart rate and blood circulation just from the movements.
Gradually performing these exercises at a faster pace, research indicates could potentially experience the same cardiovascular benefits from interval or treadmill running. (Bellissimo GF, et al., 2022) – (Lavie CJ, et al., 2015)
Balance, Coordination, and Flexibility
The movements require a full range of motion that stretches and strengthens the muscles, tendons, and ligaments.
These exercises can help decrease the risk of injury and make daily physical activities easier to perform without over-exertion.
Incorporating calisthenics resistance training on a regular basis can help improve posture, balance, and flexibility, depending on which exercises are recommended.
Exercises like stretches, lunges, and squats help to improve flexibility and mobility.
Exercises like single-leg squats and one-arm push-ups can work the balance, coordination, and proprioception of the body.
Mental Health
Exercise, in general, is known to improve mood, reduce stress, and improve overall well-being.
Calisthenic resistance training can have additional impacts on mental well-being.
For example, the discipline and focus required to perform the movements can help concentration and mental clarity.
One study found that calisthenics can reduce cognitive decline and may be useful for dementia prevention. (Osuka Y, et al., 2020)
Another study found that calisthenics helped mental well-being in individuals with diseases like ankylosing spondylitis and multiple sclerosis. (Taspinar O, et al., 2015)
Types
Bodyweight exercises that use an individual’s own body weight as resistance are the foundation. Common examples include push-ups, squats, and lunges. An overview of some of the types of exercises.
Pulling
These exercises focus on training the muscles for pulling movements, which include the back, shoulders, and arms.
Examples include pull-ups, chin-ups, and rows.
Pushing
These exercises focus on training the muscles for pushing movements, like the chest, shoulders, and triceps.
Examples include dips, push-ups, and handstand push-ups.
Core
Core exercises focus on training the abdominal and lower back muscles, which are responsible for maintaining stability and balance.
Examples of core exercises include planks, sit-ups, and leg raises.
Single-Leg
Single-leg exercises focus on training one leg at a time.
These target the muscles of the legs, hips, and core.
Examples of single-leg exercises include single-leg squats, lunges, and step-ups.
Plyometric
Calisthenics resistance training focuses on powerful explosive movements.
Plyometric exercises challenge the muscles to work quickly and forcefully.
Examples include jump squats, clap push-ups, and box jumps.
Getting Started
Start by making sure calisthenics is an appropriate workout option, especially if you are a beginner or have pre-existing medical conditions.
Once cleared to exercise start with familiar movements that can be done with the correct form.
Pushups, bodyweight squats, planks, lunges, and other basic movements are a good place to start.
Make sure to warm up with light and easy motions that mimic the workout movements.
Aim to work each body part during the workout.
Try for at least two workouts a week.
It is recommended to split the movement patterns.
Reps can be counted or set a timer to switch exercises every minute. This is called EMOM-style or every minute on the minute.
Pick four to five exercises that target various areas.
For example, sit-ups can be done for the core, lunges for the glutes and thighs, planks can be done for the shoulders and core, and jumping jacks or jumping rope for cardiovascular.
Calisthenic resistance training is easily modifiable and can be adjusted to individual needs.
Core Strength
References
Thomas, E., Bianco, A., Mancuso, E. P., Patti, A., Tabacchi, G., Paoli, A., … & Palma, A. (2017). The effects of a calisthenics training intervention on posture, strength, and body composition. Isokinetics and exercise science, 25(3), 215-222.
Bellissimo, G. F., Ducharme, J., Mang, Z., Millender, D., Smith, J., Stork, M. J., Little, J. P., Deyhle, M. R., Gibson, A. L., de Castro Magalhaes, F., & Amorim, F. (2022). The Acute Physiological and Perceptual Responses Between Bodyweight and Treadmill Running High-Intensity Interval Exercises. Frontiers in physiology, 13, 824154. doi.org/10.3389/fphys.2022.824154
Osuka, Y., Kojima, N., Sasai, H., Ohara, Y., Watanabe, Y., Hirano, H., & Kim, H. (2020). Exercise Types and the Risk of Developing Cognitive Decline in Older Women: A Prospective Study. Journal of Alzheimer’s disease: JAD, 77(4), 1733–1742. doi.org/10.3233/JAD-200867
Taspinar, O., Aydın, T., Celebi, A., Keskin, Y., Yavuz, S., Guneser, M., Camli, A., Tosun, M., Canbaz, N., & Gok, M. (2015). Psychological effects of calisthenic exercises on neuroinflammatory and rheumatic diseases. Zeitschrift fur Rheumatologie, 74(8), 722–727. doi.org/10.1007/s00393-015-1570-9
Lavie, C. J., Lee, D. C., Sui, X., Arena, R., O’Keefe, J. H., Church, T. S., Milani, R. V., & Blair, S. N. (2015). Effects of Running on Chronic Diseases and Cardiovascular and All-Cause Mortality. Mayo Clinic Proceedings, 90(11), 1541–1552. doi.org/10.1016/j.mayocp.2015.08.001
Golfing wrist injuries are common with treatment requiring 1-3 months of rest and immobilization and if tears are present surgery. Can chiropractic treatment help avoid surgery, expedite recovery, and rehabilitation?
Golfing Wrist Injuries
Golfing Wrist Injuries: According to a study, there are over 30,000 golf-related injuries treated in American emergency rooms every year. (Walsh, B. A. et al, 2017) Nearly a third are related to a strain, sprain, or stress fracture.
This causes pain and inflammation and is usually accompanied by a grinding sensation when moving the thumb and wrist.
Chiropractic Treatment
Given the nature of these injuries, medical attention should be sought out for image scans to look at any damage and properly immobilize the wrist. Once a fracture has been ruled out or healed, golfing wrist injuries can benefit from chiropractic and physical therapy. (Hulbert, J. R. et al, 2005) A typical treatment may involve a multifaceted approach involving various therapies including:
Active release therapy, myofascial release, athletic taping, corrective exercise, and stretching.
A chiropractor will examine the wrist and its functioning to determine the nature of the injury.
A chiropractor may recommend using a splint to immobilize the wrist, particularly in cases of overuse.
They will relieve pain and swelling first, then focus on strengthening the joint.
They may recommend a regimen of icing the hand.
Adjustments and manipulations will relieve pressure on the nerves to reduce swelling and restore mobility.
Peripheral Neuropathy Successful Recovery
References
Walsh, B. A., Chounthirath, T., Friedenberg, L., & Smith, G. A. (2017). Golf-related injuries treated in United States emergency departments. The American journal of emergency medicine, 35(11), 1666–1671. doi.org/10.1016/j.ajem.2017.05.035
Moon, H. W., & Kim, J. S. (2023). Golf-related sports injuries of the musculoskeletal system. Journal of exercise rehabilitation, 19(2), 134–138. doi.org/10.12965/jer.2346128.064
Ray, G., Sandean, D. P., & Tall, M. A. (2023). Tenosynovitis. In StatPearls. StatPearls Publishing.
Zouzias, I. C., Hendra, J., Stodelle, J., & Limpisvasti, O. (2018). Golf Injuries: Epidemiology, Pathophysiology, and Treatment. The Journal of the American Academy of Orthopaedic Surgeons, 26(4), 116–123. doi.org/10.5435/JAAOS-D-15-00433
Tan, H. K., Chew, N., Chew, K. T., & Peh, W. C. (2014). Clinics in diagnostic imaging (156). Golf-induced hamate hook fracture. Singapore medical journal, 55(10), 517–521. doi.org/10.11622/smedj.2014133
Hulbert, J. R., Printon, R., Osterbauer, P., Davis, P. T., & Lamaack, R. (2005). Chiropractic treatment of hand and wrist pain in older people: systematic protocol development. Part 1: informant interviews. Journal of chiropractic medicine, 4(3), 144–151. doi.org/10.1016/S0899-3467(07)60123-2
Individuals at work, school, etc, perform all kinds of repetitive physical tasks that put their bodies through a great deal of musculoskeletal stress, what are the effects and benefits of joint manipulation therapy for pain relief?
Joint Manipulation Health Benefits
Joint manipulation is a form of manual therapy that involves applying force to the spinal or peripheral joints to:
Relieve pain symptoms.
Realign the joints to their proper position.
Restore flexibility.
Improve mobility.
Increase range of motion.
Chiropractors, massage, and physical therapists use various manipulation techniques to help move and feel better after an injury or illness that causes loss of functional mobility. Here we explain joint manipulation, its applications, and if the technique is safe for you and your condition.
Joint Popping
The joints in the body are places where two or more bones come together to allow movement.
The cartilage allows the joint surfaces to glide/slide smoothly.
If the cartilage is injured or damaged, pain and limited motion can present.
When a joint doesn’t move properly, the muscles surrounding that joint don’t contract properly.
If a joint is dysfunctional for some time, significant muscle wasting and atrophy can occur around the joint, leading to difficulty with mobility like standing, walking, or reaching. (Hurley MV.1997)
The body is made up of cells that breathe by converting energy and releasing waste materials. One type of waste material from cell respiration is carbon dioxide. The gas is transported through the blood and delivered out of the body while breathing. Small pockets of gas can get trapped in the joints that expand and contract as pressure around the joint changes during movement, known as cavitation. When the gas is released through joint manipulation, there can be a popping or snapping sound as the joint is moved. Once the gas is released, joint pressure is decreased and mobility is increased. (Kawchuk, et al., 2015)
Causes
Non-medical
There are non-medical and medical causes of joint dysfunction and derangement that include:
Overuse and repetitive strain.
Unhealthy sitting and/or standing posture.
Lack of physical activity.
Over-stretching or stretching incorrectly.
In these situations, the joints can be temporarily placed in a dysfunctional/compromised position. When moving to the correct position, a popping sound can present as built-up pressure is released.
Medical
Joint problems can occur from medical conditions that can include:
Herniated cervical or lumbar discs.
Spinal arthritis.
Rheumatoid arthritis.
Osteoarthritis.
Joint contracture after being immobilized for some time.
In these cases, a medical problem can be causing a limitation in the joint’s position and movement. (Gessl, et al., 20220)
Benefits
If a chiropractic practitioner determines there is joint dysfunction then manipulation may be a treatment option. The benefits include:
Pain Relief
When a chiropractor or therapist gets an injured joint moving properly, the receptors in and around the area get reset allowing for pain relief.
Improved Muscle Activation
As a chiropractor manipulates a joint into its correct anatomical position, the surrounding muscles can flex and contract properly.
Improved Range of Motion
The joint is repositioned for proper movement.
This improves the range of motion and relieves tightness and stiffness.
Improved Functional Mobility
Once a joint is manipulated, the improved range of motion and muscle activation around the joint can lead to improved overall functional mobility. (Puentedura, et al., 2012)
Candidates
Joint manipulation is a safe manual therapy technique for certain individuals. (Puentedura, et al., 2016) This includes:
Individuals with acute neck, back, or peripheral joint pain.
Adults aged 25 to 65 with no serious medical conditions.
Athletes who have been injured from their sport.
Individuals who have been immobilized after injury or surgery.
Joint manipulation is not recommended for everyone and can be dangerous or lead to injury in individuals with certain conditions. (Puentedura, et al., 2016) These include individuals with:
Osteoporosis
Weakened bones may fracture if a high-velocity force is applied to a joint via manipulation
Joint fractures
Individuals with a joint fracture, should not have that specific joint manipulated.
Post Spinal Fusion Surgery
Individuals that have had spinal fusion in the neck or lower back should avoid spinal joint manipulations or adjustments for at least one year after the procedure.
The bones need time to heal thoroughly.
Manipulation can cause a failure of the fusion.
Individuals with Arterial Insufficiency In Their Neck
A rare but dangerous side effect of a neck adjustment is the risk of tearing an artery in the neck known as the vertebrobasilar artery. (Moser, et al., 2019)
If there is pain, loss of movement, or decreased mobility after an injury or surgery, a chiropractic adjustment with joint manipulation can be beneficial to help regain movement. Manual techniques can help improve joint mobility, alleviate pain, and increase strength and stability around the joints. Joint manipulation isn’t for everyone and is recommended to consult with a healthcare professional to see if it is safe for your specific condition.
Gessl, I., Popescu, M., Schimpl, V., Supp, G., Deimel, T., Durechova, M., Hucke, M., Loiskandl, M., Studenic, P., Zauner, M., Smolen, J. S., Aletaha, D., & Mandl, P. (2021). Role of joint damage, malalignment, and inflammation in articular tenderness in rheumatoid arthritis, psoriatic arthritis, and osteoarthritis. Annals of the rheumatic diseases, 80(7), 884–890. doi.org/10.1136/annrheumdis-2020-218744
Hurley M. V. (1997). The effects of joint damage on muscle function, proprioception, and rehabilitation. Manual therapy, 2(1), 11–17. doi.org/10.1054/math.1997.0281
Kawchuk, G. N., Fryer, J., Jaremko, J. L., Zeng, H., Rowe, L., & Thompson, R. (2015). Real-time visualization of joint cavitation. PloS one, 10(4), e0119470. doi.org/10.1371/journal.pone.0119470
Moser, N., Mior, S., Noseworthy, M., Côté, P., Wells, G., Behr, M., & Triano, J. (2019). Effect of cervical manipulation on the vertebral artery and cerebral hemodynamics in patients with chronic neck pain: a crossover randomized controlled trial. BMJ open, 9(5), e025219. doi.org/10.1136/bmjopen-2018-025219
Puentedura, E. J., Cleland, J. A., Landers, M. R., Mintken, P. E., Louw, A., & Fernández-de-Las-Peñas, C. (2012). Development of a clinical prediction rule to identify patients with neck pain likely to benefit from thrust joint manipulation to the cervical spine. The Journal of orthopedic and sports physical therapy, 42(7), 577–592. doi.org/10.2519/jospt.2012.4243
Puentedura, E. J., Slaughter, R., Reilly, S., Ventura, E., & Young, D. (2017). Thrust joint manipulation utilization by U.S. physical therapists. The Journal of manual & manipulative therapy, 25(2), 74–82. doi.org/10.1080/10669817.2016.1187902
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