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Athletes

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.


Pain In Your Adductor Muscles? Could Be Myofascial Trigger Points

Pain In Your Adductor Muscles? Could Be Myofascial Trigger Points

Introduction

The hips and thighs have a working relationship as their jobs are to maintain stability for the legs and pelvis while supporting the upper body’s weight. These two body groups have various muscles, tendons, and nerves that have specific jobs that allow mobility to the lower body. Many athletes in multiple sports events use their thighs to exert a huge amount of power to be the best. This is due to the adductor muscles in the thighs that allow the athlete to win the event. These adductor muscles are voluminous in size and can become overstretched if the muscles have been worked out too much or injuries have caused dysfunction in the surrounding muscles, causing mobility issues. To that point, the adductor muscles will develop myofascial trigger points and cause hip and thigh pain. Today’s article looks at the two adductor muscles (Longus and Magnus), how myofascial trigger points affect the adductor muscles, and available treatments to manage hip adductor trigger points. We refer patients to certified providers who incorporate multiple methods in the lower body extremities, like thigh and hip pain treatments correlating to myofascial trigger point pain, to aid individuals dealing with pain symptoms along the adductor muscles. We encourage and appreciate patients by referring them to associated medical providers based on their diagnosis, especially when appropriate. We understand that education is an excellent solution to asking our providers complex questions at the patient’s request. Dr. Jimenez, D.C., utilizes this information as an educational service only. Disclaimer

Adductor Longus & Adductor Magnus

Have you been dealing with groin pain located near your thighs? Do you feel muscle tenderness or stiffness when stretching your inner thighs? Or have you been feeling unstable in your hips or thighs when walking? Many individuals, especially athletes and older adults, could be experiencing myofascial trigger points associated with groin pain along their adductor muscles. The thighs contain several muscles and functions that allow many people to bend and extend their knees and hips. The adductor muscles allow the legs to move inward toward one another. The adductor muscles have five muscles: magnus, brevi, longus, pectineus, and gracilis. These muscles enable functionality to the thighs and hips, and we will look at two adductor muscles in the inner thighs. The long adductor muscle is a large, fan-shaped muscle that starts from the superior aspect of the pubis bone and travels down to connect at the thigh bone. Studies reveal that the adductor longus is a long and thin muscle with many actions for the thighs, including external/lateral rotation and thigh flexion.

 

 

Now the adductor Magnus is a large triangular-shaped muscle of the inner thighs that are important for thigh and hip function and stabilizing the pelvis. Studies reveal that even though the adductor Magnus is a large muscle in the inner thighs, its primary function is to allow the thigh to move in a larger range of motion without any pain inflicted on the thigh muscles. However, the adductor muscle can succumb to various issues affecting the thighs and groin regions of the body that can be overstretched and strain the body.

 

Myofascial Trigger Points Affecting The Adductor Muscles

 

Groin pain is a multi-factorial pain issue that affects the lower limbs, and its often due to muscle strain in the inner thigh muscles. This pain increases during vigorous activities and when there is a sudden twist in the hips. When the adductor muscles suddenly change in motion when the body is active, they can be overstretched and correlate to myofascial trigger points that can affect the inner thigh and groin regions. According to “Myofascial Pain and Dysfunction,” by Dr. Travell, M.D., patients with active myofascial trigger points in the two adductor muscles (Longus and Magnus) would become frequently aware of the pain in their groin and medial thigh. When the adductor muscles have myofascial trigger points in the inner thigh, diagnosing is difficult since the individual thinks they are suffering from groin pain when the pain is in their inner thighs. To that point, studies reveal that many individuals participating in various sports would suffer from groin pain due to myofascial trigger points affecting the adductor muscles. Luckily, there are multiple treatments to reduce the pain in the adductor muscles.

 


Hip Adductors: Trigger Point Anatomy- Video

Have you been dealing with groin pain when you are walking? What about experiencing unquestionable thigh pain that affects your daily activities? Or does stretching your inner thigh muscles seem difficult, causing muscle tenderness? Many of these symptoms correlate with groin pain associated with myofascial trigger points affecting the adductor muscles in the inner thighs. The adductor muscles allow mobility function to the thighs and enable the hips to have a wide range of motion. When the adductor muscles are overstretched due to a sudden change of hip rotation or injury has occurred on the thighs can lead to referred pain in the groin and inner thighs and develop myofascial trigger points. The video above shows where the trigger points are located in the hip adductor muscles. The video also explains where the pain is localized in the adductor muscles and the symptoms it produces that can affect the lower body extremities. Fortunately, even though diagnosing myofascial trigger points are a bit challenging, available treatments can manage trigger points along the hip adductors.


Available Treatments To Manage Hip Adductor Trigger Points

When myofascial trigger points affect the hip adductor muscles, many individuals complain about stiffness in their inner thighs and how they feel miserable when they don’t have mobility from their thighs and hips. As stated earlier, trigger points are a bit challenging when diagnosed, but they are treatable when doctors examine patients dealing with myofascial pain in their hips and thigh muscles. Once the diagnosis is complete, doctors work with pain specialists who can locate the trigger points and devise a treatment plan to relieve the pain. Available treatments like trigger point injections can minimize the pain and reduce the chances of trigger points returning. Other available therapies like exercising or stretching, especially for the hips and thighs. Specific exercises for the hips and thigh muscles can help strengthen the adductor muscles from suffering pain and can help reduce the pain symptoms. Another treatment is applying moist heat on the hip adductor muscles to release the tension from the tight muscles and allow mobility back to the hip adductors.  

 

Conclusion

The adductor muscles work with the hips and thighs to allow a wide range of motions and extension to the knees and hips. The hips and the thighs allow stability to the lower body and support the weight to the upper body. When injuries or sudden changes start to affect the adductor muscles, it can lead to symptoms of groin pain associated with myofascial trigger points. Myofascial trigger points produce tiny nodules in the affected muscle that causes referred pain to the muscle group. When this happens, it causes the body to be dysfunctional and can affect a person’s mobility to function in the world. Luckily myofascial trigger points are treatable through various techniques and treatments that can reduce the chances of trigger points from re-occurring in the body.

 

References

Jeno, Susan H, and Gary S Schindler. “Anatomy, Bony Pelvis and Lower Limb, Thigh Adductor Magnus Muscle.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 1 Aug. 2022, www.ncbi.nlm.nih.gov/books/NBK534842/.

Sedaghati, Parisa, et al. “Review of Sport-Induced Groin Injuries.” Trauma Monthly, Kowsar, Dec. 2013, www.ncbi.nlm.nih.gov/pmc/articles/PMC3864393/.

Shahid, Shahab. “Adductor Longus Muscle.” Kenhub, Kenhub, 30 June 2022, www.kenhub.com/en/library/anatomy/adductor-longus-muscle.

Simons, D. G., and L. S. Simons. Myofascial Pain and Dysfunction: The Trigger Point Manual: Vol. 2:the Lower Extremities. Williams & Wilkins, 1999.

Takizawa, M, et al. “Why Adductor Magnus Muscle Is Large: The Function Based on Muscle Morphology in Cadavers.” Scandinavian Journal of Medicine & Science in Sports, U.S. National Library of Medicine, 27 Apr. 2012, pubmed.ncbi.nlm.nih.gov/22537037/.

van de Kimmenade, R J L L, et al. “A Rare Case of Adductor Longus Muscle Rupture.” Case Reports in Orthopedics, Hindawi Publishing Corporation, 2015, www.ncbi.nlm.nih.gov/pmc/articles/PMC4397006/.

Disclaimer

Baseball Training: Chiropractic Back Clinic

Baseball Training: Chiropractic Back Clinic

All sports differ in the relative importance of various physical skills contributing to the game and individual performance. Baseball is a precision sport with fast, explosive movements and full-body activity. The ability to repeatedly perform near maximum level with little rest is necessary for baseball players. Baseball training involves a multidimensional approach that focuses on speed, agility, and strength in a way that is relative to the motions and requirements of the sport.

Baseball Training: Injury Medical Chiropractic ClinicBaseball Training

Trainers have to assess the unique needs of the sport and determine the time needed to improve each quality within the athlete. They should focus on the following:

  • Improving core strength and trunk rotation.
  • Increasing shoulder stability and strength.
  • Improving quick reactive movements.
  • Increasing explosiveness.
  • Improving running, throwing, and bat speed.
  • Injury prevention.

Baseball training workouts are targeted at increasing running speed, bat speed, pitching, and throwing velocity that breaks down the muscle groups for improving performance while decreasing the risk of injury. Training consists of combined conditioning that includes:

  • Sprinting
  • Interval runs
  • Jump rope
  • High-intensity cardio
  • Strength training

Rotational Movements

  • Players often lack abdominal or core strength.
  • One of the main aspects of baseball is the hitting and throwing that is done in a rotational movement and are explosive.
  • Players are recommended to train rotationally with light weights and high speed.
  • Exercises emphasizing rotating the hips and torso with resistance, including cable and pulley machines, dumbbell workouts, and medicine ball workouts, are effective.
  • Abdominal crunches and various rotational twists with a medicine ball can develop a strong muscular base in this area.
  • This will improve strength and power in the core area, which is vital for swinging a bat and throwing.

Shoulder and Rotator Cuff Work

  • High stress is placed on the shoulder joint and the rotator cuff muscles.
  • Pitching happens at the shoulder joint and is one of the fastest human movements.
  • Repetitive stress increases the risk of injury.
  • Exercises that strengthen the anterior and posterior shoulder muscles in a balanced manner are recommended.
  • Shoulder flexibility is necessary to allow external rotation when throwing at high speeds.
  • Deceleration is the area of pitching where injuries happen most.
  • Plyometric shoulder and upper body exercises can help with the explosive pitching motion.

Explosive Speed

Bat Speed

  • Players need increased lower body and core strength to develop power in the swing.
  • The muscles require rotational training at a high velocity.
  • Strong hip and leg muscles initiate the swing.
  • The core area transfers the rotational speed to the torso.
  • The arms complete the swing.
  • The efficient transfer of force from the lower body to the upper body or the kinetic chain principle requires balance for optimal transfer.
  • Strong lats, triceps, and forearms facilitate optimal bat acceleration during ball contact.
  • Forearm and triceps exercises, squats, bench presses, and pull-ups are recommended.

Throwing Velocity

  • Throwing a baseball at high velocity is a full-body movement that requires total body development.
  • Strong leg, hip, and core muscles are necessary to transfer power from the ground, up through the lower body, to the torso, and then the arm and hand to generate a fast, whipping ball release.
  • Weighted or medicine ball exercises can improve velocity.
  • This will improve generating power in the throwing muscles.
  • The objective is to build power utilizing a heavy and then a light load to build arm speed, and using proper form will improve throwing velocity safely.
  • Proper trunk rotation during arm cocking and strength and flexibility training should involve trunk rotational exercises to develop the obliques so that maximum arm speed can be generated.

Biomechanical Analysis

Video analysis of a player includes:

  • Pitching mechanics
  • Hitting mechanics
  • Fault correction
  • Feedback
  • Assessing progress

Mental and Emotional Skills

  • Mental and emotional skills training helps players deal with success, failure, and game pressure.
  • Players have to deal with consistent failure and remain confident.

Hitting Mistakes


References

Ellenbecker, Todd S, and Ryoki Aoki. “Step-by-Step Guide to Understanding the Kinetic Chain Concept in the Overhead Athlete.” Current reviews in musculoskeletal medicine vol. 13,2 (2020): 155-163. doi:10.1007/s12178-020-09615-1

Fleisig, Glenn S et al. “Biomechanical Analysis of Weighted-Ball Exercises for Baseball Pitchers.” Sports health vol. 9,3 (2017): 210-215. doi:10.1177/1941738116679816

Rhea, Matthew R, and Derek Bunker. “Baseball-specific conditioning.” International journal of sports physiology and performance vol. 4,3 (2009): 402-7. doi:10.1123/ijspp.4.3.402

Seroyer, Shane T et al. “The kinetic chain in overhand pitching: its potential role for performance enhancement and injury prevention.” Sports health vol. 2,2 (2010): 135-46. doi:10.1177/1941738110362656

Muscle Recovery Supplements: Chiropractic Back Clinic

Muscle Recovery Supplements: Chiropractic Back Clinic

Workout recovery is as important as working out. Pushing muscle past its normal levels creates tiny tears in the muscle tissue. It is the repairing process that generates muscle growth. Muscles that aren’t allowed to recover will not grow or gain muscle mass, and muscle strength could be reduced, making working out a struggle and hindering health goal progress. The body needs time to repair the muscles to reduce the risk of injury. Allowing enough time for recovery reduces overuse-related muscle breakdown and injuries. Muscle recovery supplements can expedite the healing process.Muscle Recovery Supplements Chiropractic Clinic

Muscle Recovery Supplements

Reasons for taking supplements include their ability to heal damaged muscles faster, aid in injury recovery, reduce muscle soreness, reduce muscle fatigue, and provide the muscle cells with energy during recovery.

  • Certain supplements work by supporting or enhancing muscle protein synthesis.
  • Protein synthesis is the muscle cells’ process to make more protein.
  • Protein is the building block for muscle.
  • Increasing protein synthesis gives the body more blocks to use.
  • Other supplements help to reduce muscle soreness.
  • Sore muscles are common.
  • Soreness that occurs soon after working out is usually from lactic acid buildup.
  • There are supplements to help the body get rid of lactic acid faster.
  • There is delayed onset muscle soreness, or DOMS, which lasts longer.
  • Some supplements work on both types of sore muscles.

Supplement Types

The type of recovery supplements depends on the individual and their goals. Here are a few to consider.

Protein Supplement

  • Protein is the most useful supplement for muscle recovery.
  • It helps the muscle repair faster and more effectively after an intense workout.
  • It is important if there is a lack of protein in an individual’s diet.
  • Whey protein is the most popular because it includes essential amino acids.
  • Other options include soy, egg, rice, hemp, and pea.

Branched-Chain Amino Acid – BCAA

  • The body makes certain amino acids; there are a few it cannot make.
  • A BCAA supplement provides these essential amino acids that aid in recovery.
  • This supplement promotes muscle growth, helps ease sore muscles, and reduces muscle fatigue.

Fatty Acid

  • Fatty acids supply energy but also reduce inflammation.
  • A medium-chain triglyceride – MCT fatty acid helps reduce lactic acid buildup.
  • Omega-3 fatty acid reduces muscle fatigue and muscle soreness and provides injury protection.
  • Fatty acid supplements should be stored in a dark, cool place to maintain quality.

Creatine

  • Creatine turns into creatine phosphate, which the body uses for energy.
  • Some studies have found that taking a creatine supplement may aid muscle recovery and greater muscle strength during recovery.

Citrulline Malate

  • Citrulline is a non-essential amino acid found in watermelon that converts into nitric oxide.
  • Nitric oxide helps open blood vessels and improve blood circulation.
  • This allows oxygen and nutrients to reach the muscle faster, speeding the recovery process.
  • Citrulline also improves the bioavailability of L-arginine, another amino acid that aids protein synthesis.

Magnesium

  • Magnesium assists with muscle recovery by helping the muscles relax.
  • When the body doesn’t have enough magnesium, there is a greater chance of muscle cramps.
  • Magnesium helps support healthy muscle contraction.

Tart Cherry Juice Extract

  • This extract works by reducing inflammation in the muscle.
  • Inflammation is normal, but too much can increase muscle soreness and the risk of injury.
  • One study found that cherry juice helps minimize post-exercise muscle pain.

Supplement Plan

After selecting a supplement plan that is the most beneficial for the individual, the next step is to devise a schedule for taking them.

  • When using a muscle recovery supplement can either be a pre-workout supplement or a post-workout supplement.
  • The recommended time to take a specific supplement is based on the type.
  • Individuals should talk with their doctor and a nutritionist before starting any new supplement regimen.
  • This helps ensure the supplements are safe and minimize negative side effects given health and medical conditions.

Nutrition In Recovery


References

Cooke, M.B., Rybalka, E., Williams, A.D. et al. Creatine supplementation enhances muscle force recovery after eccentrically-induced muscle damage in healthy individuals. J Int Soc Sports Nutr 6, 13 (2009). doi.org/10.1186/1550-2783-6-13

DiNicolantonio, James J et al. “Subclinical magnesium deficiency: a principal driver of cardiovascular disease and a public health crisis.” Open heart vol. 5,1 e000668. 13 Jan. 2018, doi:10.1136/openhrt-2017-000668

Gough, Lewis A et al. “A critical review of citrulline malate supplementation and exercise performance.” European journal of applied physiology vol. 121,12 (2021): 3283-3295. doi:10.1007/s00421-021-04774-6

Kuehl, Kerry S et al. “Efficacy of tart cherry juice in reducing muscle pain during running: a randomized controlled trial.” Journal of the International Society of Sports Nutrition vol. 7 17. 7 May. 2010, doi:10.1186/1550-2783-7-17

Vitale, Kenneth C et al. “Tart Cherry Juice in Athletes: A Literature Review and Commentary.” Current sports medicine reports vol. 16,4 (2017): 230-239. doi:10.1249/JSR.0000000000000385

Weinert, Dan J. “Nutrition and muscle protein synthesis: a descriptive review.” The Journal of the Canadian Chiropractic Association vol. 53,3 (2009): 186-93.

Wolfe, Robert R. “Branched-chain amino acids and muscle protein synthesis in humans: myth or reality?.” Journal of the International Society of Sports Nutrition vol. 14 30. 22 Aug. 2017, doi:10.1186/s12970-017-0184-9

Zhang, Shihai, et al. “Novel metabolic and physiological functions of branched-chain amino acids: a review.” Journal of animal science and biotechnology vol. 8 10. 23 Jan. 2017, doi:10.1186/s40104-016-0139-z

The Pectoralis Minor Being Affected By Myofascial Pain

The Pectoralis Minor Being Affected By Myofascial Pain

Introduction

The chest has the pectoralis major muscle that works with the upper half of the body that provides mobility and power. The pectoralis major also surrounds the clavicle skeletal structure and works with the thoracic spine. The chest allows mobility to the arms and stability to the shoulders while working together with the shoulder and arm muscles. Many individuals utilize the upper body more when working out, lifting, or carrying objects from one place to another. This causes the muscle to become overused and succumb to injuries that can affect the functionality of the chest and invoke pain-like symptoms in the body. One of the chest muscles affected by pain is the pectoralis muscles, especially the pectoralis minor muscle. Today’s article looks at the pectoralis minor muscle, how myofascial pain affects the pectoralis minor, and how to manage myofascial pain associated with the pectoralis minor. We refer patients to certified providers specializing in chest pain therapies to aid many people suffering from trigger point pain affecting the minor muscles of the pectoralis. We brief patients by referring them to our associated medical providers based on their examination when appropriate. We indicate that education is a great solution to asking our providers profound and complex questions at the patient’s request. Dr. Alex Jimenez, D.C., notes this information as an educational service only. Disclaimer

The Pectoralis Minor Muscle

 

Have you been experiencing pain in your upper-mid back? Do you feel like your chest is feeling compressed constantly? Do you feel the tension in your shoulders that makes it difficult to reach behind your back? Most of these symptoms are signs that many individuals are developing myofascial pain along the pectoralis muscles, especially the pectoralis minor. The pectoralis minor muscle is a thin triangular-shaped muscle below the pectoralis major. It has a crucial part of the chest as it helps stabilize the scapula (the shoulder blades) and is in front of the thoracic wall of the spine. The pectoralis minor is also part of the respiratory muscle group that works with the lungs. The pectoralis minor muscle has many functions for the shoulder blades, which include:

  • Stabilization
  • Depression
  • Abduction or Protraction
  • Internal Rotation
  • Downwards Rotation

When environmental factors begin to affect the lungs and cause respiratory issues in the body, the surrounding respiratory muscle group also gets involved, causing the body to be hunched over.

 

Myofascial Pain Affecting The Pectoralis Minor

 

When environmental factors begin to affect the lungs, it causes the respiratory muscles to contract and become compressed. This is just one of the many factors that can affect the pectoralis minor muscle. The other factor is that the pectoralis minor muscle may be short in the chest and when individuals try to reach behind their backs. This causes the pectoralis minor muscle to to be overstretched and develop myofascial pain or trigger points along the muscle fibers. The book, “Myofascial Pain and Dysfunction,” written by Dr. Travell, M.D., described the pain from myofascial pain associated with the pectoralis minor to be similar to cardiac pain. This is known as referred pain caused by myofascial pain syndrome and it can be a bit difficult to diagnose since it can mimic other chronic issues. Studies reveal that shortening or any sort of tightness of the pectoralis minor is one of the potential biomechanical mechanisms that is associated with an altered scapular alignment which causes pain and shoulder movement impairments. Overusing the pectoralis minor muscles creates tiny nodules that can affect the stability of the shoulders and causes upper-mid back problems in the thoracic region of the spine.

 


 An Overview Of Trigger Points On The Pectoralis Minor- Video

Have you been experiencing difficulty inreaching behind your back? Do you feeling your body becoming more hunched over than usual? Or have you been experiencing chest pain constantly? These pain-like symptoms are caused by myofascial pain associated with the pectoralis minor muscle. The pectoralis minor muscle helps with the stability of the shoulders and studies reveal that when the presense of myofascial trigger points are linked to shoulder and upper body disorders, it can increase the risk of overlapping conditions that trigger points can mimic. Myofascial trigger points are a common complaint as it can significantly impact a person’s daily activites by causing the taut muscle band to be tender or hypersenitive. When this happens, it can lead to issues of muscle imbalance, weakness and impaired motor function. Thankfully, there are various techniques that can help reduce the pain symptoms and issues in the pectoralis minor muscle, while mananging the trigger points. The video above explainshow to tell when your chest muscles are tight and various tests to know when the pectoralis muscles (both the minor and major) are being affected by trigger points.


Managing Myofacial Pain Associated With Pectoralis Minor

 

When dealing with chest pains associated with myofascial pain along the pectoralis minor, there are many techniques they can incorporate to prevent myofascial pain from causing further damage to the muscle itself and the surrounding muscles. Various chest stretches can help gently loosen the stiff muscles, warm the pectoralis minor, and improve mobility to the chest and shoulders. Correct posture can help prevent the body from being hunched over constantly and let the surrounding muscles and the pectoralis minor relax. If the pain is unbearable, studies reveal that treatments like dry needling and palpations on the pectoralis minor muscles can help manage the pain caused by trigger points. This kind of treatment allows the muscle to release the trigger point and, combined with a hot or cold pack, can reduce the chances of myofascial pain from forming again in the muscle.

 

Conclusion

Underneath the pectoralis major muscle, the pectoralis minor is a thin triangular-shaped muscle that helps stabilize the shoulder blades and is located in the front of the thoracic wall of the spine. This tiny muscle is part of the respiratory muscles that have a causal relationship with the lungs and can succumb to environmental factors that can lead to the development of myofascial pain or trigger points on the pectoralis minor. Myofascial pain associated with the pectoralis minor muscle can mimic cardiovascular issues and invoke pain in the muscle. Fortunately, various treatments can help relieve and manage myofascial pain from re-occurring in the pectoralis minor.

 

References

Bagcier, Fatih, et al. “Three Simple Rules in Pectoral Muscle’s Trigger Point Treatment, Which May Be a Cause of Chest Pain: Position, Palpation, and Perpendicular Needling.” American Board of Family Medicine, American Board of Family Medicine, 1 Nov. 2020, www.jabfm.org/content/33/6/1031.long.

Baig, Mirza A, and Bruno Bordoni. “Anatomy, Shoulder and Upper Limb, Pectoral Muscles.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 11 Aug. 2021, www.ncbi.nlm.nih.gov/books/NBK545241/.

Morais, Nuno, and Joana Cruz. “The Pectoralis Minor Muscle and Shoulder Movement-Related Impairments and Pain: Rationale, Assessment and Management.” Physical Therapy in Sport : Official Journal of the Association of Chartered Physiotherapists in Sports Medicine, U.S. National Library of Medicine, Jan. 2016, pubmed.ncbi.nlm.nih.gov/26530726/.

Ribeiro, Daniel Cury, et al. “The Prevalence of Myofascial Trigger Points in Neck and Shoulder-Related Disorders: A Systematic Review of the Literature.” BMC Musculoskeletal Disorders, BioMed Central, 25 July 2018, www.ncbi.nlm.nih.gov/pmc/articles/PMC6060458/.

Travell, J. G., et al. Myofascial Pain and Dysfunction: The Trigger Point Manual: Vol. 1:Upper Half of Body. Williams & Wilkins, 1999.

Disclaimer

Myofascial Trigger Pain Affecting The Thumb Muscles

Myofascial Trigger Pain Affecting The Thumb Muscles

Introduction

Many people use their hands when going to work or doing normal things in their daily lives. The hands correlate with the five finger digits that provide grip strength when holding onto items in various sizes and weights that the hand muscles can handle. The hands have multiple muscles, tendons, and ligaments that travel past the wrist and forearms. These three components in the upper body have a casual relationship with the shoulders to provide stability and mobilization to the upper extremities. When the various muscles, tendons, and ligaments succumb to traumatic forces or injuries that cause pain to the forearms, wrists, and hands, it can develop myofascial pain syndrome or trigger points to generate overlapping risk profiles that mask other symptoms. Today’s article looks at the thumb muscles, how myofascial trigger pain affects the thumb, and how to prevent and manage the trigger thumb from occurring further in the hands. We refer patients to certified providers specializing in hand and wrist pain therapies to aid many people suffering from trigger thumb and fingers affecting their hands. We also guide and inform our patients by referring them to our associated medical providers based on their examination when appropriate. We established that education is a great solution to asking our providers profound questions the patient requests. Dr. Jimenez DC takes note of this information as an educational service only. Disclaimer

A Look At The Thumb Muscles

Have you been experiencing a strong decrease in your grip when holding something? What about hearing popping or snapping sounds when moving your fingers or thumb? Or have you experienced pain near your wrist or at the palm of your hands? When people are experiencing pain along their fingers, especially thumbs, it can develop into myofascial trigger pain along the thumb. As part of the hand, the thumb has muscles that provide movement and motor skills to make the thumb mobile. The two muscles: the adductor pollicis and the opponens pollicis, allow the thumb to move and touch each of the other finger digits. The adductor pollicis in the hand has deep, intricate, superimposed layers of muscles, tendons, and fascial compartments that work together to be versatile to the thumb. This muscle is triangular-shaped with a two-headed structure, and its main function is to adduct the thumb. This means that the adductor pollicis allows the thumb to move, touch the palm, and be close to the index finger. To that point, this muscle provides the thumb pinching and gripping movements.

 

The other muscle is known as the opponens pollicis, and this muscle helps provides small hand movements for the thumb by allowing it to touch the tips of each of the digits. The opponens pollicis muscle works together with the adductor pollicis muscle as it allows the hand to cup objects while also making the pinching grip possible for the hand. The oppponens pollicis muscle also works with the various muscles, nerves, and bones to be in sync in providing movement to the hands and provide mobility strength.

 

How Myofascial Trigger Pain Affects The Thumb

 

The adductor and oppenens pollicis muscles can provide gripping and pinching motions to the hands without causing pain; however, when the thumb muscle ligaments have been overused or been through trauma, they can develop into myofascial trigger pain along the thumb muscles, causing trigger thumb. Studies reveal that causes for the trigger thumb to form are repetitive gripping motions and overusing of the thumb muscle. This causes the flexor tendon sheath to narrow along the thumb joint and causes clicking or popping sensations when the thumb is trying to extend, thus leading to the development of myofascial trigger pain. According to the book, “Myofascial Pain and Dysfunction: The Trigger Point Manual,” written by Dr. Janet G. Travell, M.D., when myofascial trigger pain begins to affect the hand’s functionality, it can make many individuals lose the pinching motion in their hands as they aren’t able to hold the object they are using. Even simple actions like pulling weeds in the garden can cause stress on the thumb and cause tenderness to the affected muscle. 

 


An Overview Of Trigger Finger & Trigger Thumb-Video

Are you having difficulty holding items in your hands? Do you feel like your fingers are locking up constantly? Or does it hurt when you extend your thumb or fingers? If you have been experiencing these pain symptoms in your hands and fingers, it could be due to myofascial trigger pain associated with the thumb and fingers along the hands. Trigger fingers or trigger thumbs is a common ailment that affects the mobility function of the hands and can invoke pain in the affected joints causing them to lock up. The video above explains what trigger fingers and trigger thumbs, the symptoms and causes, and how to treat and manage the pain. When pain is associated with the hands and fingers, causing trigger points to form along the affected muscle, many individuals begin to feel hopeless when they aren’t able to hold items. Thankfully, there are various ways to manage trigger thumb and prevent pain from causing further damage.


How To Manage & Prevent Trigger Thumb

 

When trigger thumb begins to affect a person’s ability to grasp objects, it can cause them to feel miserable and can greatly affect their quality of life. All is not lost, as there are various ways to manage trigger thumbs and prevent future pain symptoms from continuously affecting a person’s mobility in their hands. Studies show that multiple treatments like splinting can help gain mobility back to the thumb and prevent the joint from locking up, causing pain. Other therapies like hand and wrist stretches can help loosen up the stiff tendons and muscles and even bring back mobility strength to the hands. Many doctors advise their patients to start using different hand and wrist exercises to relax the aching muscles and get circulation back to the hands. Another way to prevent the trigger thumb from affecting the hands is to do stretch exercises for the adductor and opponens pollicis muscles with heat to relax and loosen the stiff muscles while also restoring flexion and extension to the thumb.

 

Conclusion

The thumbs provide the functionality to the hands by allowing gripping and pinching motions when people pick up objects. The two muscles that provide this motion are the adductor and oppnens pollicis muscles. When traumatic forces begin to affect these two muscles in the thumb, it can develop a trigger thumb associated with pain. This causes the thumb to lock up and invoke pain when someone tries to extend their thumbs. Trigger thumbs occur when individuals overuse the thumb muscles and causes the grip strength to weaken. Luckily, available treatments can help restore mobility to the thumb and prevent it from locking up.

 

Reference

Acosta, Jonathan R, et al. “Anatomy, Shoulder and Upper Limb, Hand Adductor Pollicis.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 11 Aug. 2021, www.ncbi.nlm.nih.gov/books/NBK526059/.

Akhtar, Sohail, et al. “Management and Referral for Trigger Finger/Thumb.” BMJ (Clinical Research Ed.), BMJ Publishing Group Ltd., 2 July 2005, www.ncbi.nlm.nih.gov/pmc/articles/PMC558536/.

Nguyen, John D, and Hieu Duong. “Anatomy, Shoulder and Upper Limb, Hand Opponens Pollicis Muscle.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 11 Aug. 2021, www.ncbi.nlm.nih.gov/books/NBK546603/.

Pencle, Fabio J, et al. “Trigger Thumb.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 20 July 2022, www.ncbi.nlm.nih.gov/books/NBK441854/.

Travell, J. G., et al. Myofascial Pain and Dysfunction: The Trigger Point Manual: Vol. 1:Upper Half of Body. Williams & Wilkins, 1999.

Disclaimer

Trigger Fingers & Lightning Pain On Hand

Trigger Fingers & Lightning Pain On Hand

Introduction

When it comes to the body, the hands and fingers correlate with each other by giving the host the grip strength to carry and hold items. The items can range from the smallest to the largest, depending on the item’s weight that a person can physically hold. When the weight becomes overbearingly heavy that a person can not lift or hold, it can lead to unwanted symptoms that overlap with other chronic conditions. To that point, when the hand muscles begin to lose their grip strength, it can lead to the development of trigger points in the affected muscles connected to the hand muscles and tendons. Today’s article looks at a chronic condition associated with trigger points known as trigger fingers, what the symptoms are, and how to treat trigger fingers in the hands. We refer patients to certified providers specializing in hand and wrist pain therapies to aid many people suffering from trigger fingers affecting their hands. We also guide and inform our patients by referring them to our associated medical providers based on their examination when appropriate. We established that education is a great solution to asking our providers profound questions the patient requests. Dr. Jimenez DC takes note of this information as an educational service only. Disclaimer

What Is Trigger Fingers?

 

Have you encountered stiffness in your fingers? Do you feel pain radiating from your forearms to the palm of your hands? Does it seem difficult to carry or hold items for an extended period? Many people who have dealt with these symptoms believe it is something arthritic or just normal signs of age; however, it could correlate with triggering fingers affecting the hands. Trigger fingers or stenosing tenosynovitis happens when the flexor sheaths in the wrist become overused due to repetitive motions that cause the flexor tendon muscles in the forearm to be inflamed and development issues in the finger joints. This can be very problematic for many individuals who work with their hands as it can cause significant functional impairment to the hands and the fingers. Trigger fingers also commonly affect the individual’s dominant hand and involve the most common digit, the thumb. 

 

The Symptoms

 

When many individuals are dealing with trigger fingers in their hands, they often complain about their fingers locking up in flexion or extension. When this happens, it can become problematic, as trigger fingers can affect the mobility of the fingers. Some of the symptoms that trigger fingers cause in the digits include:

  • Stiffness in the fingers
  • Popping or clicking sensations 
  • Bumps at the base of the finger joint
  • Finger catching in a bent position and pops straight
  • Finger locking

What is the correlation between diabetes and trigger fingers? Studies reveal that trigger fingers are a multifactorial chronic condition that can occur in anyone, especially those with diabetes. Trigger fingers are diagnosed by palpating a thickened tendon. Other issues cause trigger fingers to form due to active trigger points affecting the flexor muscles in the forearms. According to Dr. Travell, M.D.’s book, “Myofascial Pain and Dysfunction: The Trigger Point Manual,” individuals with active trigger points along their forearm muscles tend to experience difficulty in utilizing mobility strength with their hands. To that point, many individuals may not be able to cup and supinate their hands, extend or flex their fingers, or be able to grip items they are reaching. 


An Overview Of Trigger Fingers- Video

Are you dealing with joint stiffness along your fingers? What about feeling pain from flexing or extending their fingers? Or do you feel pain and tenderness in your forearm muscles? Many individuals with these symptoms could be dealing with the pain associated with trigger fingers. Trigger fingers occur when the finger digits suffer from microtrauma by repetitive use or compression forces that invokes pain and inflammation along the tendons of the fingers. The video above overviews trigger fingers, their symptoms, and how to diagnose and treat trigger fingers in the hands. Many associated factors can lead to the development of trigger fingers, and one related factor is diabetes overlapping trigger points along the forearms. Studies reveal that trigger fingers are a complication affecting the upper extremities in diabetic individuals. Individuals with trigger fingers associated with diabetes can also cause overlapping risk profiles for cardiovascular diseases. This relationship is known as somato-visceral pain, where the damaged muscle affects the corresponding organ. In this case, the tendons for the fingers cause referred pain to the heart, thus potentially involving the cardiovascular system. Luckily there are various ways to treat trigger fingers and prevent pain from occurring in the hands in the future.


How To Treat Trigger Fingers

 

Since trigger fingers are a common source of pain and disability in the hands, many individuals seek pain specialists to manage and relieve pain associated with trigger fingers. Studies reveal that various methods are used to reduce the pain along the affected finger digits and bring back mobility to the finger joints. Doing gentle finger stretches, not gripping items so tightly, or applying heat to loosen up the locked joints, can help manage trigger fingers while preventing the pain-like symptoms from coming back. Incorporating these treatments can help bring mobility strength back to the hands and prevent the fingers from locking up. However, treatment alone can not be the only solution; after the individuals get treatment for trigger fingers, they have to do their part to prevent future issues from reoccurring again in their fingers.

 

Conclusion

The hands and fingers have a casual relationship, providing mobility and grip strength for the host to hold and carry items. However, when traumatic factors or normal activities begin to overuse the joints and muscles in their hands, it can lead to trigger fingers. Trigger fingers can cause the finger joints to lock up and invoke pain-like symptoms in the hands. This can make many individuals lose their mobility function in their hands and can make them miserable. Luckily, various treatments can help manage trigger fingers and help bring mobility back to the individual’s hands.

 

References

Akhtar, Sohail, et al. “Management and Referral for Trigger Finger/Thumb.” BMJ (Clinical Research Ed.), BMJ Publishing Group Ltd., 2 July 2005, www.ncbi.nlm.nih.gov/pmc/articles/PMC558536/.

Jeanmonod, Rebecca, et al. “Trigger Finger – Statpearls – NCBI Bookshelf.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 20 July 2022, www.ncbi.nlm.nih.gov/books/NBK459310/.

Makkouk, Al Hasan, et al. “Trigger Finger: Etiology, Evaluation, and Treatment.” Current Reviews in Musculoskeletal Medicine, Humana Press Inc, June 2008, www.ncbi.nlm.nih.gov/pmc/articles/PMC2684207/.

Mineoka, Yusuke, et al. “Trigger Finger Is Associated with Risk of Incident Cardiovascular Disease in Individuals with Type 2 Diabetes: A Retrospective Cohort Study.” BMJ Open Diabetes Research & Care, BMJ Publishing Group, Apr. 2021, www.ncbi.nlm.nih.gov/pmc/articles/PMC8039242/.

Travell, J. G., et al. Myofascial Pain and Dysfunction: The Trigger Point Manual: Vol. 1:Upper Half of Body. Williams & Wilkins, 1999.

Disclaimer

Long Distance Running: Back Clinic

Long Distance Running: Back Clinic

Long-distance running, also known as endurance running, is a great way to improve fitness and relieve stress. Health experts say long-distance runners’ benefits include strong cardiovascular health, low cholesterol, healthy blood pressure levels, and improved metabolism. However, it is not easy and requires specific training, but it is not impossible even for beginners. Here is a beginner long-distance running training guide that goes over the fundamental areas needed to develop.Long Distance Running

Long Distance Running Training

Running is a great form of cardio that offers several health benefits that, includes:

  • Weight loss
  • Stronger muscles
  • Stronger bones
  • Improved cardiovascular functionality

One of the main prerequisites is building up the body’s ability to handle the exercise. To reach the full potential as a distance runner, key areas that need developing include:

  • Using proper footwear
  • Endurance
  • Lactate threshold
  • Aerobic capacity
  • Basic speed
  • Running technique

Running Shoes

  • It’s essential to wear comfortable running shoes that can handle the terrain and the distance.
  • Improper support can lead to injury and long-term damage.
  • Wearing good athletic socks is also recommended.
  • Stopping a run halfway because blisters form stops the flow of the workout and impacts stamina and momentum.
  • It is important to find the correct size, weight, and comfort.
  • Ask the experts for help from local sports or running shoe stores who will look at how you move and recommend a running shoe.

Endurance Base

  • Endurance base refers to how long an individual can run at a comfortable pace before having to stop.
  • Once an individual finds their endurance base, which for beginners could be around five minutes at a time, this can be a starting point to build off.
  • On light days, a run could last for 10 minutes before walking.
  • On harder days, a run could go for 20 minutes before walking.
  • Incremental increases build up an individual’s endurance base.

Lactate Threshold

  • The lactate threshold is similar to the endurance base in that it refers to how long an individual can run before feeling a buildup in lactate.
  • Lactate is what makes the muscles cramp and become sore the following days.
  • Understanding how much the individual’s body can take before this buildup becomes too much is their lactate threshold.
  • The threshold will gradually increase with training.

Aerobic Capacity

  • Maximum aerobic capacity measures the heart and lungs’ ability to send oxygen to the muscles.
  • Understanding individual maximum cardio capacity will help identify the starting point to slowly and steadily increase running distances.

Basic Speed

  • Basic speed is how fast individuals can run while holding a conversation.
  • Knowing the basic running speed can help determine the starting point.
  • As stamina increases, basic speed increases.

Running Technique

Running technique is essential for gaining the most speed and endurance. Using the correct form, the body is not expending unnecessary energy. The proper running form includes:

  • Maintaining an upright spine with the head, shoulders, and hips aligned.
  • Focus on maintaining a steady breathing rhythm.
  • Follow through on strides.
  • Do not cut the movements short.
  • Find your natural stride, which could be leading with the heel or running toe to heel.
  • Consult an experienced running coach or exercise physiologist for assistance in finding your running form.

Long-Term Goal

  • The body adapts to the stress of training slowly and over time.
  • Physiological adaptations cannot be rushed; however, the training program can be optimized to individual needs.
  • The minimum time before seeing an improvement from training is around six weeks.

Gradual Increase

  • Training load is a combination of distance, intensity, and the number of runs each week.
  • The body can only develop with moderate increases over a short time.
  • Increasing the load too much and too fast leads to injury, illness, and exhaustion.
  • Limiting distance, intensity, or frequency changes is recommended no more than once a week.

Recovery

  • Training provides the stimulus to improved fitness, but the body needs recovery time to grow and adapt.
  • Often beginners want to train hard every day, trying to cover all the elements at once.
  • This common mistake slows progress and can cause various injuries, fatigue, and loss of motivation.
  • Rest days are essential to allow the body to recover, develop, adapt, and continue to progress healthily.
  • The classic training program alternates a hard training day with an easy day or a rest day.
  • Two consecutive hard training days can be done as long as they are followed by two full recovery days.

Beginner Tips


References

Berryman, Nicolas, et al. “Strength Training for Middle- and Long-Distance Performance: A Meta-Analysis.” International journal of sports physiology and performance vol. 13,1 (2018): 57-63. doi:10.1123/ijspp.2017-0032

Blagrove, Richard C et al. “Effects of Strength Training on the Physiological Determinants of Middle- and Long-Distance Running Performance: A Systematic Review.” Sports medicine (Auckland, N.Z.) vol. 48,5 (2018): 1117-1149. doi:10.1007/s40279-017-0835-7

Kenneally, Mark, et al. “The Effect of Periodization and Training Intensity Distribution on Middle- and Long-Distance Running Performance: A Systematic Review.” International journal of sports physiology and performance vol. 13,9 (2018): 1114-1121. doi:10.1123/ijspp.2017-0327

Tschopp, M, and F Brunner. “Erkrankungen und Überlastungsschäden an der unteren Extremität bei Langstreckenläufern” [Diseases and overuse injuries of the lower extremities in long distance runners]. Zeitschrift fur Rheumatologie vol. 76,5 (2017): 443-450. doi:10.1007/s00393-017-0276-6

van Poppel, Dennis, et al. “Risk factors for overuse injuries in short- and long-distance running: A systematic review.” Journal of sport and health science vol. 10,1 (2021): 14-28. doi:10.1016/j.jshs.2020.06.006