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.
by Dr Alex Jimenez | Diets, Fitness
The U.S. is one of the world’s laziest countries, according to a new Stanford University study that used smartphone measurements of the number of steps taken by people in 46 countries.
The study, published in the journal Nature, included 700,000 participants and was “1,000 times larger than any previous study on human movement,” co-leader and Stanford bioengineering professor Scott Delp said, the BBC reported.
Countries with the highest average number of steps walked included China, Ukraine, Japan, and No. 1 Hong Kong, with 6,880 steps walked per day on average, USA Today reported.
The U.S. ranked in the bottom half of countries represented, with 4,774 steps walked per day, just below the worldwide average of 4,961 steps. Indonesia had the least steps walked with 3,513 per day on average, USA Today reported.
The study found that countries where people walked a similar amount of steps each day had lower rates of obesity, whereas countries where some people walked a lot and others walked very little had higher rates of obesity. The U.S. falls into the latter category, with high levels of what the study called “activity inequality.”
The study analyzed a total of 68 million days’ worth of data and tracks people’s activity over longer periods of time than previous studies, the BBC said.
Women averaged about 1,000 fewer steps than men in the U.S., and suburban areas reported fewer steps on average than urban, city areas that are more pedestrian-friendly.
Researchers hope the data might help design towns, cities, and neighborhoods that encourage more physical activity.
by Dr Alex Jimenez | Diets, Fitness
Western diets, high in sugar and fat, cause liver inflammation, especially in males, according to a new animal study in The American Journal of Pathology. Inflammation was most pronounced in males that lacked farnesoid x receptor (FXR), a bile acid receptor.
The study also found that probiotics may prevent and treat the condition, keeping it from advancing to liver cancer.
“We know the transition from steatosis, or fatty liver, to steatohepatitis — inflammation in the fatty liver — plays a crucial role in liver injury and carcinogenesis,” said lead investigator Yu-Jui Yvonne Wan, Ph.D., Professor and Vice Chair of the Department of Pathology and Laboratory Medicine at UC Davis Health.
“Because the liver receives 70 percent of its blood supply from the intestine, it is important to understand how the gut contributes to liver disease development,” Wan said.
“Our data show that diet, gender, and different antibiotic treatments alter the gut microbiota as well as bile acid profile and have different effects on liver inflammation,” she said.
Wan used an FXR-deficient mouse model (FXR KO), which has become an important tool to better understand the role of diet and inflammation in the development of liver diseases, including cancer, because patients with cirrhosis or liver cancer also have low FXR levels.
Other studies have found that mice deficient in FXR spontaneously develop liver problems and tumors even when they are fed a normal diet.
In this study, FXR-deficient mice as well as wild mice were fed either a Western diet or a matching control diet for 10 months. Both Western diet-fed wild-type mice and control diet-fed FXR KO mice accumulated fat in the liver, which was more severe in males than females.
The study suggested that antibiotics might help block inflammation in control mice, but not in the FXR KO mice fed a Western diet. It also indicated that probiotics might also deter some of the inflammation.
“Our results suggest that probiotics and FXR agonists hold promise for the prevention and treatment of hepatic inflammation and progression into advanced liver diseases such as cancer,” Wan said.
A recent Australian study found that zinc may be a major key in fighting liver damage. An article published in Nature Communications found that zinc had the potential to be a simple and effective treatment against acute and chronic liver inflammation.
Other natural substances have been found to be effective against liver disease. A 2016 study conducted at the University of Southampton found that two cups of coffee a day reduced the risk of liver cirrhosis — scarring due to alcohol and viruses like hepatitis C — by 44 percent.
by Dr Alex Jimenez | Diets, Fitness
Australian researchers have found that exercising as a child could potentially counteract the damage of a high-fat diet later in life.
Carried out by a team from the Liggins Institute at the University of Auckland, the animal study looked at the effect of different diets and exercise programs on rats’ bone health and metabolism, focusing on the activity of the genes in bone marrow.
Rats were given either a high-fat diet and a wheel for extra exercise, a high-fat diet but no wheel, or a regular diet and no wheel.
High-fat diets in childhood are known to “turn up,” or increase, the activity of other genes that cause inflammation — the body’s natural self-protective response to acute infection or injury. Ongoing inflammation as a result of high-fat diets can damage cells and tissues, increasing the risk of obesity, heart disease, cancer among other conditions.
However, the team found that in the rats given a high-fat diet and an exercise wheel, the early extra physical activity caused inflammation-linked genes to be turned down, not turned up.
It appeared that exercise altered the way the rats’ bones metabolized energy from food, disrupting the body’s response to a high-calorie diet.
“What was remarkable was that these changes lasted long after the rats stopped doing that extra exercise — into their mid-life,” commented Dr Justin O’Sullivan, a molecular geneticist at the Institute.
“The bone marrow carried a ‘memory’ of the effects of exercise. This is the first demonstration of a long-lasting effect of exercise past puberty.”
“The rats still got fat,” he pointed out, “but that early extra exercise basically set them up so that even though they put on weight they didn’t have the same profile of negative effects that is common with a high fat diet.”
Dr O’Sullivan says that the results may help explain why even though obesity and diabetes are often linked, not everyone who is obese develops diabetes.
“It also strongly emphasizes the health benefits of exercise for children.”
The team are now carrying out further research, varying the exercise and looking at the even longer-term effects into old age in the hope of recreating their results.
by Dr Alex Jimenez | Athletes, Complex Injuries, Physical Rehabilitation, PUSH-as-Rx
In the first part of the 2-part article on femoro-acetabular impingement (FAI), chiropractor, Dr. Alexander Jimenez discussed FAI and how it can lead to insidious onset abdominal pain and damage the hip joint labrum, leading to early arthritic changes. Given that conservative management generally fails in young athletes and needs operation, part two describes the post-operative rehabilitation period required to take an athlete back to full competition.
The post-operative rehabilitation period is highly dependent on the magnitude of pathology and the subsequent procedure; weight-bearing development is consequently variably reported in the literature.
If the labrum is surgically repaired, then protected weight bearing is encouraged to allow the repair site in order to be protected during the early healing phase. Also, avoiding extremes of flexion (beyond 60�) and also internal/external rotation for the initial 4 to 6 weeks is important to safeguard the repaired labrum. Any positions that possibly create an impingement and boost inflammation ought to be prevented. These include:
- Deep squatting
- Prolonged sitting
- Low couch sitting
- Lifting off the ground
- Pivoting on a fixed foot
These positions are more safely tolerated following the six week post-operative period. But on account of the selection of hip flexion limitations imposed in the initial six months, usual activities of daily living are rather restricted, making yield to work and daily chores challenging if not impossible from the first few weeks following surgery. Therefore, the post- surgical patient does have to make substantial lifestyle changes and they need assistance in the first six weeks following surgery.
Special precautions in certain types of FAI processes. Reshaping of the femoral head- neck junction can weaken the rectal neck so particular care must be taken in this post- operative period. Fracture of the femoral neck is an unlikely but potentially serious complication after a reshaping process. The athlete may be allowed to bear full weight, but crutches are needed to avoid twisting movements during the initial four weeks after surgery. High impact pursuits and high torsion moves should be prevented in the first 3 months, as bone grafting requires around three weeks to attain full structural integrity.
Furthermore, if microfracture of this femoral head is also done for femoral head cartilage defects, then the athlete ought to be restricted to partial weight- bearing for two weeks so as to optimize the premature maturation of the fibrocartilaginous healing response.
Key points
1. Weight bearing status is dependent on the kind of reshaping procedure, whether the labrum was repaired, and also what the surgeon favors
2. Steer clear of hip flexion beyond 60� in the first 4-6 Weeks
3. Avoid extremes of rotation
Post-Surgical Rehab
Rehabilitation protocols provided in the literature have a tendency to be quite generic in their own advice and at best explain broad transitional phases during the rehab process. They usually describe the transition in weight bearing status, the development of gait through walking into jogging, and give general guidelines as to how to and when to progress activity based on a time dependant strategy.
They then progress describing transitions into twisting and affect actions — usually explained as beginning at 3 weeks following surgery — and generally the guidance is that the speed with which the athlete progresses is variable and might need yet another 1 to 3 months to get full return based on the game. Trainers are usually advised that return to sports after surgical correction of FAI can require 4 to 6 weeks. However it’s critical that progression through rehabilitation phases is driven more by subjective and objective measures during the transition phases. This allows the athlete and therapist to track load (type and quantity) and ascertain whether the joint arrangements are able to withstand changes in load securely.
Wahoff et al (2014) have provided some standards which may be utilized to guide the transition from one point to the next(1). They describe their rationale and supply a complete description of all of the cited tests in their printed clinical comment. Essentially, the exit criteria they offer in each phase are as follows;
So as to advance through the six clarified stages, the athlete may undergo extensive physiotherapy, focusing on hip range of movement exercises, manual therapy and trigger point releases, active stretching, potentially deloaded activities like hydrotherapy or Alta G walking/ running and strong hip rotator and gluteal strengthening exercises. Much of this will be ‘controlled’ and led by the wishes of the surgeon as they will provide the framework on if and what happens concerning loading.
But more direct physiotherapy Interventions have been devised to direct the physiotherapist through the rehabilitation protocol. The Takla-O�Donnell Protocol (TOP) is a validated physiotherapy intervention program which may be utilized to induce the arthroscopically handled FAI patient (Bennel et al)(2).)�This protocol is shown in box 2.
Hip Muscle Control
The focus of the rest of this article Will be to summarize some common yet powerful hip strengthening exercises which may be used to progress the hip muscle control throughout the rehabilitation phases.
Regaining hip muscle power, particularly in the heavy hip external rotator group, is imperative from the FAI recovering athlete. Good muscle endurance and strength in those muscle groups will ensure adequate hip joint compression happens with motion to reduce any shearing effect between the head of femur and acetabulum(3). The muscle groups needing focus are (see figure 5):
- Posterior fibres Gluteus Medius (PGMed)
- Gluteus minimus
- Superior and Inferior Gemellus
- Internal and External Obturator
- Quadratus Femoris
- Piriformis
There’s plenty of exercises that can be utilized to fortify the hip joint musculature. The chosen ones below are a sample of some effective exercises that can be used throughout the rehabilitation phases. However, the key requirements of the contained exercises include:
1. Performed in neutral stylish places to no more than 60 degrees hip flexion. This range of movement protects the hip joint from any possibly damaging impingement.
2. Minimal rotation of the hip, letting them be used in most stages of the rehabilitation process.
3. Performed isometrically or utilizing little oscillating concentric/eccentric contractions — to contract and hold to maintain the hip joint compacted and stable. This represents how these muscles work in individual function.
Summary
In many ways. hip joint labral tears, capsule sprains, cartilage and muscle accidents and bony architectural issues like FAI can all lead to debilitating hip pain. FAI is a real concern for the athlete as the existence of a bone abnormality may lead to a painful hip impingement, damage to the acetabular labrum and premature onset degeneration. FAI’s don’t respond to conservative management. If the athlete suffers debilitating pain that affects competition then the options are either to cease competition all together or have the FAI surgically corrected. Once corrected by the surgeon, regaining complete motion and muscle strength and ultimate game related functional skills will require some time. Hip rotator muscle strengthening must shape the foundation of all handling post-surgical FAI issues.
References
1. International Journal of Sports Physical Therapy. 9(6); pp 813-826
2. Arthroscopy. 2006;22(12):1304-1311
3. Int J Sports Phys Ther. 2012;7(1):20-30.
by Dr Alex Jimenez | Diets, Fitness
While too much fat, especially of the “bad” variety, can lead to weight gain and health problems, a moderate amount of fat is essential to a healthy lifestyle.
Adding a little fat to your food, either through cooking or drizzling over salads, can help to fill you up and feel more satisfied after a meal, as well as boost health by helping the body absorb several fat-soluble vitamins.
However, with the recent news that coconut oil, long believed to be a “healthy” fat, should actually be avoided, many of us may be wondering once again which fats are the good ones.
Here we round up some advice from the University of Kentucky on which oils to keep on hand in the kitchen, and which to avoid.
Canola oil
This oil is the lowest in saturated fat, just 7 percent, while also containing high levels of monounsaturated fatty acids, which lower LDL and in recent years have been studied for potentially helping control blood glucose.
This oil is great for stir-frying, grilling, and replacing many solid fats — the ones to avoid — in recipes.
Olive oil
An important ingredient in the popular and healthy Mediterranean diet, olive oil is well-known for its many health benefits, including lower risk of death from cardiovascular disease and a reduced level of inflammation in the body.
Use extra-virgin and virgin olive oils for uncooked dishes, like salads, and choose refined olive oils for cooking as they are better at higher temperatures.
Peanut oil
High in monounsaturated (good) fat, peanut oil also contains vitamin E, an antioxidant that helps maintain a strong immune system, healthy skin and eyes, and helps with the formation of red blood cells.
Thanks to a high smoke point, this oil is ideal for frying, roasting and grilling.
Avocado oil
This oil is also high in monounsaturated fats and vitamin E, and also has a tasty but mild flavor, making it great to add cold onto salads.
It also has a high smoke point for those who prefer to cook with it. However, if avocado oil is too expensive or difficult to find, canola oil makes a good budget-friendly alternative.
And the oils to avoid
Saturated or “solid fats” should be consumed sparingly — these are the oils that are solid at room temperature such as coconut oil, butter, palm oil, beef tallow, and lard.
Because saturated fat contributes to a rise in the level of LDL cholesterol, also known as “bad” cholesterol, the AHA recommends that saturated fat should make up a maximum of 10 percent of total caloric intake for healthy Americans, and a maximum of 6 percent for those who need to lower cholesterol levels.
by Dr Alex Jimenez | Diets, Fitness
Coffee addicts and aficionados often say drinking the bitter liquid makes life worth living, but the habit may also help them live longer, according to two major international studies Monday.
Experts cautioned, however, that the US and European reports, published in the Annals of Internal Medicine, failed to show that coffee was truly the reason that many drinkers appeared to have longer lives.
Rather, the studies were observational in nature, meaning they showed an association between coffee-drinking and a propensity toward longevity, but stopped short of proving cause and effect.
The first study, led by the International Agency for Research on Cancer (IARC) and Imperial College London, examined more than half a million people across 10 countries in Europe.
Those who drank about three cups a day tended to live longer than non-coffee drinkers, said the study, which researchers described as the largest analysis of the effects of coffee-drinking in a European population.
“We found that higher coffee consumption was associated with a lower risk of death from any cause, and specifically for circulatory diseases, and digestive diseases,” said lead author Marc Gunter of the IARC, formerly at Imperial’s School of Public Health.
“Importantly, these results were similar across all of the 10 European countries, with variable coffee drinking habits and customs.”
The second study included more than 180,000 participants of various ethnic backgrounds in the United States.
It found benefits to longevity whether the coffee was caffeinated or decaffeinated.
Coffee drinkers had a lower risk of death due to heart disease, cancer, stroke, diabetes, and respiratory and kidney disease.
Those who drank one cup a day were 12 percent less likely to die compared to those who didn’t drink coffee.
Those who drank two or three cups per day saw an even higher 18 percent reduced risk of death.
“We cannot say drinking coffee will prolong your life, but we see an association,” said lead author Veronica Setiawan, an associate professor of preventive medicine at the Keck School of Medicine of University of Southern California.
“If you like to drink coffee, drink up! If you’re not a coffee drinker, then you need to consider if you should start.”
Coffee is one of the most popular drinks in the world. Some 2.25 billion cups are consumed every day.
Many prior studies have hailed the benefits of coffee-drinking, saying the beverage imparts anti-oxidants, may improve liver function and reduce inflammation.
But coffee may carry risks for some people, and pregnant woman and children are urged to avoid caffeine, which can be fatal in high doses.
A report from the IARC last year that said drinking very hot beverages — coffee, tea or otherwise — is one probable cause of cancer of the esophagus, the tube that runs from the throat to the stomach.
Experts who were not involved in the latest studies urged caution in interpreting the results.
For instance, the European study excluded people who had cancer, heart disease or diabetes, meaning it took a measure of people over 35 who were already generally healthy.
It also asked about coffee consumption just once, at the beginning, and did not update this figure over the span of the study, which included an average follow-up time of 16 years.
Finally, it found signs of a link between women who drank large amounts of coffee and a higher risk of cancer death, but downplayed this finding, saying it “may be spurious.”
The “conclusions will not lead me to start drinking coffee or to recommend people drink more coffee as a way to lessen their risks for heart disease,” said Naveed Sattar, professor of metabolic medicine at the University of Glasgow.
“I remain unconvinced that the link between coffee and heart disease represents a true cause and effect relationship and that coffee is truly protective, regardless of how large a study suggests this.”
Sattar said that one downside to the research is the fact that many people stop drinking coffee — or drink less of it — when they are ill, a “bias is very hard to fully overcome.”
David Spiegelhalter, a professor at the University of Cambridge, described the research as “huge in size and carefully done,” but nevertheless unable to prove cause and effect.
“If these estimated reductions in all-cause mortality really are causal, then an extra cup of coffee every day would on average extend the life of a man by around three months, and a woman by around a month,” he added.
“So perhaps we should relax and enjoy it.”
by Dr Alex Jimenez | Diets, Fitness
Americans love dining out al fresco when the summer weather is so perfect. But don’t let restaurant food throw a monkey wrench into your healthy eating plan. Dining establishments can be ticking time bombs when it comes to sabotaging your nutrition.
In fact, government surveys say that that the food you typically eat when you are not at home is nutritionally worse in every way than your own kitchen fare.
“Eating out can be challenging, but shouldn’t limit your social life,” Dr. Craig Title, a top New York City weight loss specialist tells Newsmax Health. “Here are some tips I share with my clients.”
Be prepared. Like a good scout, select your meal options before you get to the restaurant by checking the menu online. “You’ll make a more level-headed, healthier choice,” says Title.
Eat a little beforehand. Don’t arrive at the restaurant famished. Make sure you have eaten a small meal or two earlier in the day.
Nix the bread. Instruct the wait staff NOT to bring out the bread and butter basket. “Out of sight, out of mind,” says Title. “Ask for celery and carrots sticks instead.”
Drink water. Down one full glass of water as soon as you are seated to help you feel fuller sooner, which will make you eat less.
Ask for it your way. Dining out is not the time to be a meek consumer, notes Dr. Michael F. Jacobson, Ph.D., executive director of the Center for Science in the Public Interest (CSPI) and coauthor of the book, “Restaurant Confidential.” His advice: “You need to be assertive and asked for your food to be prepared they way you’d like it and very often the restaurant will comply.” For example, choose grilled fish over fried and extra veggies instead of French fries.
Go for healthier fare. Order from the “light” or “low fat” section of the menu. Many chains, even Chinese restaurants, offer lighter fare with nutritional info on the menu.
Make salad more than a side. Order a salad with lemon juice or balsamic vinegar and treat it as a first course, before you eat anything else. Scientists at Pennsylvania State University found that people who ate a big green or veggie salad before their entree consumed fewer calories.
Order double appetizers. This is especially rewarding when you’re dining at a seafood restaurant with sumptuous starters. An appetizer order of oysters on the half shell and another of steamed shrimp makes a complete and low-calorie meal along with your salad.
Avoid high-calorie dressings. Keep your salads tasty but healthy by shunning anything in a creamy high-calorie sauce and using raw or marinated vegetables, like artichoke hearts and mushrooms, for extra flavor. Skip the cheese and bacon bits, too.
Do the fork dip. Keep your salad dressing on the side and dip your fork into the dressing before skewering a forkful of salad. This makes the lettuce taste great and you won’t soak the greens in dressing.
Have the fish. When CPSI evaluated food served at seafood chains and independent restaurants they found many low-fat and low-sodium options on the menu. Just don’t order it fried. Stick to steamed, baked, broiled and blackened or grilled.
Read the fine print. Pay attention to words like “breaded, crisp, sauced or stuffed” as these indicate loads of hidden calories, much of it saturated or even trans-fats. Other words of caution are, “butter, pan-fried, Newburg, Thermidor, and cheese sauce.”
Limit alcohol. Instead drink soda or seltzer water. Enjoy one glass of wine or beer with your meal and order coffee or tea for dessert.
Skip the fancy drinks. Pass over the umbrella specials such as margaritas and Mai Tais and other exotic mixed drinks as they are chock full of sugar. Opt instead for a glass of vodka, wine, a light beer or a simple martini if you must imbibe.
Choose fruit for dessert. Title suggests sharing the finale with your date. Fresh fruit, like strawberries or blueberries, during the hot summer months makes an excellent dessert without any guilt.
“Most importantly, enjoy your food,” says Title. “Chew slowly and take time between bites. Focus on the occasion and the people you are dining with, rather than just the meal.”
