Sports Spine Specialist Chiropractic Team: Athletes strive to achieve their body’s maximum performance by participating in numerous training regimens consisting of strenuous exercises and physical activity and ensuring they meet all of their body’s nutritional requirements. Through proper fitness and nutrition, many individuals can condition themselves to excel in their specific sport. Our training programs are designed for athletes that look to gain a competitive edge in their sport.
We provide sport-specific services to help increase an athlete’s performance through mobility, strength, and endurance. Occasionally, however, the excess workouts can lead many to suffer injuries or develop underlying conditions. Dr. Alex Jimenez’s chronicle of articles for athletes displays in detail the many forms of complications affecting these professionals while focusing on the possible solutions and treatments to follow to achieve overall well-being.
Can individuals with joint hypermobility find relief through nonsurgical treatments in reducing pain and restoring body mobility?
Introduction
When a person moves their body, the surrounding muscles, joints, and ligaments are incorporated into various tasks that allow them to stretch and be flexible without pain or discomfort. Many repetitive motions enable the individual to continue their routine. However, when the joints, muscles, and ligaments are stretched farther than normal in the upper and lower extremities without pain, it is known as joint hypermobility. This connective tissue disorder can correlate with other symptoms that affect the body and cause many people to seek treatment to manage joint hypermobility symptoms. In today’s article, we will look at joint hypermobility and how various non-surgical treatments can help reduce pain caused by joint hypermobility and restore body mobility. We talk with certified medical providers who consolidate our patients’ information to assess how their pain may be associated with joint hypermobility. We also inform and guide patients on how integrating various non-surgical treatments can help improve joint function while managing the associated symptoms. We encourage our patients to ask their associated medical providers intricate and insightful questions about incorporating non-surgical therapies as part of their routine to reduce pain and discomfort from joint hypermobility. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer.
What Is Joint Hypermobility?
Do you often feel your joints locked up in your hands, wrists, knees, and elbows? Do you experience pain and fatigue in your joints when your body feels constantly tired? Or when you stretch your extremities, do they extend farther than usual to feel the relief? Many of these various scenarios are often correlated with individuals experiencing joint hypermobility. Joint hypermobility is an inherited disorder with autosomal dominant patterns that characterize joint hyperlaxity and musculoskeletal pain within the body extremities. (Carbonell-Bobadilla et al., 2020) This connective tissue condition is often related to the flexibility of the connected tissues like ligaments and tendons in the body. An example would be if a person’s thumb is touching their inner forearm without feeling pain or discomfort, they have joint hypermobility. Additionally, many individuals dealing with joint hypermobility will often have a difficult diagnosis as they will develop skin and tissue fragility over time, causing musculoskeletal complications. (Tofts et al., 2023)
When individuals deal with joint hypermobility over time, many often have symptomatic joint hypermobility. They will present with musculoskeletal and systemic symptoms that lead to displaying skeletal deformities, tissue and skin fragility, and structural differences in the body’s system. (Nicholson et al., 2022) Some of the symptoms that joint hypermobility are shown in a diagnosis include:
Muscle pain and joint stiffness
Clicking joints
Fatigue
Digestive issues
Balance issues
Luckily, there are various treatments that many people can use to help restrengthen the surrounding muscles around the joints and reduce the correlating symptoms caused by joint hypermobility.
Movement As Medicine-Video
Nonsurgical Treatments For Joint Hypermobility
When dealing with joint hypermobility, many individuals need to seek treatments to reduce the correlating pain-like symptoms of joint hypermobility and help relieve the body’s extremities while restoring mobility. Some excellent treatments for joint hypermobility are non-surgical therapies that are non-invasive, gentle on the joints and muscles, and cost-effective. Various non-surgical treatments can be customized for the individual depending on how severe their joint hypermobility and comorbidities affect the person’s body. Non-surgical treatments can relieve the body from joint hypermobility by treating the causes of the pain through reduction and maximizing functional capacity and restoring a person’s quality of life. (Atwell et al., 2021) The three non-surgical treatments that are excellent for reducing pain from joint hypermobility and helping strengthen the surrounding muscles are below.
Chiropractic Care
Chiropractic care utilizes spinal manipulation and helps restore joint mobility in the body to reduce the effects of joint hypermobility by stabilizing the affected joints from the hypermobile extremities. (Boudreau et al., 2020) Chiropractors incorporate mechanical and manual manipulation and various techniques to help many individuals improve their posture by being more mindful of their bodies and work with multiple other therapies to emphasize controlled movements. With other comorbidities associated with joint hypermobility, like back and neck pain, chiropractic care can reduce these comorbidity symptoms and allow the individual to regain their quality of life.
Acupuncture
Another non-surgical treatment that many individuals can incorporate to reduce joint hypermobility and its comorbidities is acupuncture. Acupuncture utilizes small, thin, solid needles that acupuncturists use to block pain receptors and restore the body’s energy flow. When many individuals are dealing with joint hypermobility, their extremities in the legs, hands, and feet are in pain over time, which can cause the body to be unstable. What acupuncture does is help reduce the pain caused by joint hypermobility associated with the extremities and restore balance and functionality to the body (Luan et al., 2023). This means that if a person is dealing with stiffness and muscle pain from joint hypermobility, acupuncture can help rewire the pain by placing the needles in the body’s acupoints to provide relief.
Physical Therapy
Physical therapy is the last non-surgical treatment many people can incorporate into their daily routine. Physical therapy can help manage joint hypermobility that are tailored to help strengthen weak muscles that are surrounding the affected joints, improving a person’s stability and helping reduce the risk of dislocation. Additionally, many individuals can use low-impact exercise to ensure optimal motor control when doing regular exercises without putting excessive strain on the joints. (Russek et al., 2022)
By incorporating these three non-surgical treatments as part of a customized treatment for joint hypermobility, many individuals will begin to feel a difference in their balance. They will not experience joint pain by being more mindful of the body and incorporating small changes in their routine. Even though living with joint hypermobility can be a challenge for many individuals, by integrating and utilizing the right combination of non-surgical treatments, many can begin to lead active and fulfilling lives.
References
Atwell, K., Michael, W., Dubey, J., James, S., Martonffy, A., Anderson, S., Rudin, N., & Schrager, S. (2021). Diagnosis and Management of Hypermobility Spectrum Disorders in Primary Care. J Am Board Fam Med, 34(4), 838-848. doi.org/10.3122/jabfm.2021.04.200374
Boudreau, P. A., Steiman, I., & Mior, S. (2020). Clinical management of benign joint hypermobility syndrome: a case series. J Can Chiropr Assoc, 64(1), 43-54. www.ncbi.nlm.nih.gov/pubmed/32476667
Carbonell-Bobadilla, N., Rodriguez-Alvarez, A. A., Rojas-Garcia, G., Barragan-Garfias, J. A., Orrantia-Vertiz, M., & Rodriguez-Romo, R. (2020). [Joint hypermobility syndrome]. Acta Ortop Mex, 34(6), 441-449. www.ncbi.nlm.nih.gov/pubmed/34020527 (Sindrome de hipermovilidad articular.)
Luan, L., Zhu, M., Adams, R., Witchalls, J., Pranata, A., & Han, J. (2023). Effects of acupuncture or similar needling therapy on pain, proprioception, balance, and self-reported function in individuals with chronic ankle instability: A systematic review and meta-analysis. Complement Ther Med, 77, 102983. doi.org/10.1016/j.ctim.2023.102983
Nicholson, L. L., Simmonds, J., Pacey, V., De Wandele, I., Rombaut, L., Williams, C. M., & Chan, C. (2022). International Perspectives on Joint Hypermobility: A Synthesis of Current Science to Guide Clinical and Research Directions. J Clin Rheumatol, 28(6), 314-320. doi.org/10.1097/RHU.0000000000001864
Russek, L. N., Block, N. P., Byrne, E., Chalela, S., Chan, C., Comerford, M., Frost, N., Hennessey, S., McCarthy, A., Nicholson, L. L., Parry, J., Simmonds, J., Stott, P. J., Thomas, L., Treleaven, J., Wagner, W., & Hakim, A. (2022). Presentation and physical therapy management of upper cervical instability in patients with symptomatic generalized joint hypermobility: International expert consensus recommendations. Front Med (Lausanne), 9, 1072764. doi.org/10.3389/fmed.2022.1072764
Tofts, L. J., Simmonds, J., Schwartz, S. B., Richheimer, R. M., O’Connor, C., Elias, E., Engelbert, R., Cleary, K., Tinkle, B. T., Kline, A. D., Hakim, A. J., van Rossum, M. A. J., & Pacey, V. (2023). Pediatric joint hypermobility: a diagnostic framework and narrative review. Orphanet J Rare Dis, 18(1), 104. doi.org/10.1186/s13023-023-02717-2
Can individuals with spinal pain in their necks and back utilize decompression therapy to restore spinal disc height and find relief?
Introduction
Many people don’t realize that as the body gets older, so does the spine. The spine is part of the musculoskeletal system that provides structural support to the body by keeping it upright. The surrounding muscles, ligaments, and tissues surrounding the spine help with stability and mobility, while the spinal disc and joints provide shock absorption from the sheer vertical weight. When a person is on the move with their daily activities, the spine can allow the individual to be mobile without pain or discomfort. However, as time passes, the spine goes through degenerative changes that can cause pain and discomfort to the body, thus leaving the individual to deal with overlapping risk profiles that can affect their neck and back. To that point, many people seek out treatments to reduce the pain affecting their spine and restore the disc height in their bodies. Today’s article looks at how spinal pain affects a person’s neck and back and how treatments like spinal decompression can reduce spinal pain and restore disc height. We talk with certified medical providers who consolidate our patients’ information to assess how spinal pain can significantly impact a person’s well-being and quality of life in their bodies. We also inform and guide patients on how integrating spinal decompression can help reduce spinal pain and restore spinal disc height. We encourage our patients to ask their associated medical providers intricate and important questions about incorporating non-surgical treatments into a health and wellness routine to relieve spinal pain and regain their quality of life. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer.
How Spinal Pain Affects A Person’s Neck & Back
Do you feel constant muscle aches and pains in your neck and back? Have you experienced stiffness and limited mobility when you are twisting and turning? Or do heavy objects cause muscle strain when moving from one location to another? Many individuals will be on the move and be in weird positions without feeling pain and discomfort when it comes to the spine. This is due to the surrounding muscles and tissues being stretched and the spinal discs taking on the vertical pressure on the spine. However, when environmental factors, traumatic injuries, or natural aging start to affect the spine, it can lead to the development of spinal pain. This is because the outer portion of the spinal disc is intact, and the inner portion of the disc is being affected. When abnormal stresses start to reduce the water intake within the disc, it can internally stimulate the pain receptors without nerve root symptoms inside the disc. (Zhang et al., 2009) This causes many individuals to deal with neck and back pain in their bodies and reduces their quality of life.
Spinal pain can lead to overlapping risk profiles that cause many individuals to deal with severe low back pain and neck pain, which then causes the surrounding muscles to become weak, tight, and overstretched. At the same time, the surrounding nerve roots are also affected as the nerve fibers surround the outer and inner parts of the spinal disc, which causes nociceptive pain properties to the neck and back region and leads to discogenic pain. (Coppes et al., 1997) When many individuals are dealing with muscle pain correlated with the spinal discs, it causes a pain-spasm-pain cycle that can affect their bodies due to not moving enough and causing painful muscular activities when trying to be mobile. (Roland, 1986) When a person has limited mobility cause they are experiencing spinal pain, their natural disc height slowly degenerates, causing more issues to their bodies and socioeconomic burdens. Fortunately, when many individuals are dealing with spinal pain, numerous treatments can reduce spinal pain and restore their disc height.
Movement Medicine- Video
How Spinal Decompression Reduces Spinal Pain
When people are seeking treatments for their spinal pain, many will seek surgical treatments to reduce their pain, but it will be a bit pricey. However, many individuals will opt for non-surgical treatments due to their affordability. Non-surgical treatments are cost-effective and customizable to a person’s pain and discomfort. From chiropractic care to acupuncture, depending on the severity of the person’s pain, many will find the relief they seek. One of the most innovative treatments for reducing spinal pain is spinal decompression. Spinal decompression allows the individual to be strapped into a traction table. This is because it gently pulls on the spine to realign the spinal disc by reducing the pressure on the spine to invoke the body’s natural healing process to relieve pain. (Ramos & Martin, 1994) Additionally, when many individuals are using spinal decompression, the gentle traction provides a motorized distraction to the spine that may induce physical changes to the spinal disc and help restore a person’s range of motion, flexibility, and mobility. (Amjad et al., 2022)
Spinal Decompression Restoring Spinal Disc Height
When a person is being strapped into the spinal decompression machine, the gentle traction helps the spinal disc return to the spine, allowing the fluids and nutrients to rehydrate the spine, increasing the spine’s disc height. This is because spinal decompression creates negative pressure on the spine, allowing the spinal disc to return to its original height and providing relief. Plus, the amazing thing that spinal decompression does is that it can be combined with physical therapy to help stretch and strengthen the surrounding muscles near the spine to provide more stability and flexibility. (Vanti et al., 2023) This allows the individual to be more mindful of their bodies and start incorporating small habit changes to reduce the pain from returning. When many people begin to think about their health and wellness by going to treatment, they will regain their quality of life and get back to their daily routine without the issues affecting their spine.
References
Amjad, F., Mohseni-Bandpei, M. A., Gilani, S. A., Ahmad, A., & Hanif, A. (2022). Effects of non-surgical decompression therapy in addition to routine physical therapy on pain, range of motion, endurance, functional disability and quality of life versus routine physical therapy alone in patients with lumbar radiculopathy; a randomized controlled trial. BMC Musculoskelet Disord, 23(1), 255. doi.org/10.1186/s12891-022-05196-x
Coppes, M. H., Marani, E., Thomeer, R. T., & Groen, G. J. (1997). Innervation of “painful” lumbar discs. Spine (Phila Pa 1976), 22(20), 2342-2349; discussion 2349-2350. doi.org/10.1097/00007632-199710150-00005
Ramos, G., & Martin, W. (1994). Effects of vertebral axial decompression on intradiscal pressure. J Neurosurg, 81(3), 350-353. doi.org/10.3171/jns.1994.81.3.0350
Roland, M. O. (1986). A critical review of the evidence for a pain-spasm-pain cycle in spinal disorders. Clin Biomech (Bristol, Avon), 1(2), 102-109. doi.org/10.1016/0268-0033(86)90085-9
Vanti, C., Saccardo, K., Panizzolo, A., Turone, L., Guccione, A. A., & Pillastrini, P. (2023). The effects of the addition of mechanical traction to physical therapy on low back pain? A systematic review with meta-analysis. Acta Orthop Traumatol Turc, 57(1), 3-16. doi.org/10.5152/j.aott.2023.21323
Zhang, Y. G., Guo, T. M., Guo, X., & Wu, S. X. (2009). Clinical diagnosis for discogenic low back pain. Int J Biol Sci, 5(7), 647-658. doi.org/10.7150/ijbs.5.647
Can participating in a favorite sport several days a week help individuals trying to get fit or maintain a certain level of health?
Sports For Fitness
Spending hours in the gym can sometimes feel like a chore, especially for individuals who prefer competitive or recreational sports over traditional cardiovascular and resistance training. Various sports activities require only time, energy, sufficient apparel, and the willingness to play. Here are a few sports for fitness that can help improve overall health and wellness.
Cycling and Mountain Biking
Cycling is one of the best sports for fitness. Whether on roads or trails, fast or slow, it is a fantastic aerobic workout and benefits the leg muscles, specifically the quads, glutes, and hamstrings. Research has shown that, especially for those with diabetes, cycling can lower the risk of premature mortality. (Mathias Ried-Larsen et al., 2021)
There are appropriate bikes for all ages and stages.
Beginners start with paved trails.
Intermediate to advanced levels can engage in road cycling and mountain biking.
Road or mountain bike races for individuals looking to compete.
Racket Sports
Racket sports players range from all ages and fitness levels, entry-level to highly competitive, and all provide intense workouts.
Racket sports target the muscles in the back, shoulders, arms, chest, quads, glutes, hamstrings, and core.
Racquet sports have also been shown to lower the risk of cardiovascular disease mortality. (Pekka Oja et al., 2017)
Combine that with the endurance, speed, balance, and agility required to compete, and individuals will quickly see how these two sports can give a phenomenal workout while also burning a ton of calories.
Golf
For golf to be a fitness sport, individuals must walk all the holes while carrying or pushing the clubs.
What is needed is a supportive pair of shoes.
Walking the course can have multiple health benefits, including cardiovascular and respiratory health. (A. D. Murray et al., 2017)
Golf is a sport individuals can participate in at any life stage.
Water Sports
Paddleboarding, rowing, kayaking, and canoeing can provide a fitness solution for individuals who enjoy the outdoors. These sports increase heart rate, improve muscular endurance and strength, and burn serious calories. (Thomas Ian Gee et al., 2016)
Swimming
Activities that require upper and lower body muscles to work together rank high in sports for fitness. Swimming is the perfect full-body workout for anyone looking for an intense and competitive outlet that requires strength and endurance.
Swimming can be a year-round sport with various levels of competition.
Triathlon Training
Triathlon training is for lifelong athletes looking to improve endurance and strength and exercise beginners who need a goal; it is the ultimate sport for fitness.
Running, biking, and swimming together challenges every muscle and significantly increases aerobic and anaerobic fitness. (Naroa Etxebarria et al., 2019)
There’s something for every fitness level, from short sprint competitions to full Ironman events.
Basketball and Volleyball
Basketball and volleyball offer the physical benefits of a hard workout. These sports require sprinting, pivoting, and jumping, which engages the cardiovascular system and strengthens every muscle. Playing volleyball in the sand makes the muscles work harder.
Both sports are appropriate for most levels of fitness.
Beginners are recommended to learn the basic skills and go through drills before moving to games or matches.
Both sports require constant movement, increasing the risk of injury, so it is important to learn the fundamentals.
Talk to a healthcare provider before starting a new exercise routine or adding a new activity to an exercise regimen.
Lumbar Sports Injuries
References
Ried-Larsen, M., Rasmussen, M. G., Blond, K., Overvad, T. F., Overvad, K., Steindorf, K., Katzke, V., Andersen, J. L. M., Petersen, K. E. N., Aune, D., Tsilidis, K. K., Heath, A. K., Papier, K., Panico, S., Masala, G., Pala, V., Weiderpass, E., Freisling, H., Bergmann, M. M., Verschuren, W. M. M., … Grøntved, A. (2021). Association of Cycling With All-Cause and Cardiovascular Disease Mortality Among Persons With Diabetes: The European Prospective Investigation Into Cancer and Nutrition (EPIC) Study. JAMA internal medicine, 181(9), 1196–1205. doi.org/10.1001/jamainternmed.2021.3836
Oja, P., Kelly, P., Pedisic, Z., Titze, S., Bauman, A., Foster, C., Hamer, M., Hillsdon, M., & Stamatakis, E. (2017). Associations of specific types of sports and exercise with all-cause and cardiovascular-disease mortality: a cohort study of 80 306 British adults. British journal of sports medicine, 51(10), 812–817. doi.org/10.1136/bjsports-2016-096822
Murray, A. D., Daines, L., Archibald, D., Hawkes, R. A., Schiphorst, C., Kelly, P., Grant, L., & Mutrie, N. (2017). The relationships between golf and health: a scoping review. British journal of sports medicine, 51(1), 12–19. doi.org/10.1136/bjsports-2016-096625
Ian Gee, T., Caplan, N., Christian Gibbon, K., Howatson, G., & Grant Thompson, K. (2016). Investigating the Effects of Typical Rowing Strength Training Practices on Strength and Power Development and 2,000 m Rowing Performance. Journal of human kinetics, 50, 167–177. doi.org/10.1515/hukin-2015-0153
Lo, G. H., Ikpeama, U. E., Driban, J. B., Kriska, A. M., McAlindon, T. E., Petersen, N. J., Storti, K. L., Eaton, C. B., Hochberg, M. C., Jackson, R. D., Kwoh, C. K., Nevitt, M. C., & Suarez-Almazor, M. E. (2020). Evidence that Swimming May Be Protective of Knee Osteoarthritis: Data from the Osteoarthritis Initiative. PM & R : the journal of injury, function, and rehabilitation, 12(6), 529–537. doi.org/10.1002/pmrj.12267
Etxebarria, N., Mujika, I., & Pyne, D. B. (2019). Training and Competition Readiness in Triathlon. Sports (Basel, Switzerland), 7(5), 101. doi.org/10.3390/sports7050101
“Can understanding moderate exercise and how to measure the amount of exercise help expedite individuals’ health goals and well-being?”
Moderate Exercise
Various physical activity guidelines recommend regular, moderate exercise for achieving and maintaining health and wellness. Getting the minimum, moderate weekly physical activity can help prevent disease, increase mental well-being, support weight loss and maintenance, and improve quality of life.
Moderate-intensity cardiovascular exercise includes – brisk walking, yard work, mopping, vacuuming, and playing various sports that require consistent movement.
When engaged in moderate exercise, individuals should breathe harder but still be able to carry a conversation. (American Heart Association, 2024)
The talk test is a way to monitor whether the exercise is at moderate intensity.
A heart rate chart or calculator can determine an individual’s maximum heart rate.
To measure heart rate mid-exercise, individuals can take their pulse or use a heart rate monitor, app, fitness tracker, or smartwatch to ensure they stay at a moderate intensity.
MET
M.E.T. stands for Metabolic Equivalent for Task and refers to the amount of oxygen the body uses during physical activity.
Assigning METs to an activity allows individuals to compare the amount of exertion an activity takes.
This works for individuals with different weights.
During moderate physical activity, breathing and heart rate increase, and the body burns around 3.5 to 7 calories a minute.
The actual number burned depends on your weight and fitness level.
The body uses 1 MET for basic functions like breathing.
Grades of activity:
1 MET – Body at rest
2 METs – Light activity
3-6 METs – Moderate activity
7 or more METs – Vigorous activity
Perceived Exertion Scale
Individuals can also check their activity level using the Borg Rating of Perceived Exertion scale/RPE. (Centers for Disease Control and Prevention, 2022) Using this scale involves monitoring how an individual feels about how hard their body is working during physical activity. The scale starts at 6 and ends at 20. A perceived exertion between 11 and 14 is considered moderate physical activity.
6 – No exertion – sitting still or sleeping
7-8 – Extremely light exertion
9-10 – Very light exertion
11-12 – Light exertion
13-14 – Somewhat hard exertion
15-16 – Heavy exertion
17-18 – Very heavy exertion
20 – Maximum exertion
Examples
Many activities are counted as moderate-intensity exercise. Choose some appealing and learn to add them to a weekly routine.
Ballroom dancing
Line dancing
Gardening
House chores that get the heart pumping.
Softball
Baseball
Volleyball
Doubles tennis
Brisk walking
Light jogging
Walking or jogging on a treadmill
Using an elliptical trainer
Bicycling under 10 miles an hour on ground level
Leisurely swim
Water aerobics
Mobility Challenges
Individuals with mobility issues can achieve moderate intensity using a manual wheelchair or a handcycle and swimming or water aerobics.
Individuals who can use their legs but can’t tolerate walking or jogging can try bicycling or swimming.
Getting More Exercise
There are different ways to incorporate and increase moderate physical activities. These include:
10-minute Activity Bursts
Walk briskly for at least 10 minutes at a time.
Walk at an easy pace for a couple of minutes.
Pick up the pace for 10 minutes.
Try to walk during work breaks or lunch and/or before or after work.
Walking Workouts
Individuals can walk indoors, outdoors, or on a treadmill.
Proper posture and walking techniques make it easier to achieve a brisk pace.
Once comfortable walking briskly for 10 minutes, begin to extend walking time.
Try different walking workouts that offer fast walks, jogging intervals, and/or adding hills or treadmill inclines.
New Activities
Individuals are recommended to experiment with various exercises to find what works for them.
Consider roller skating, blading, or skateboarding to increase heart rate.
Moderate physical activity will get and keep the body in shape. Individuals should not become distressed if they can only do a little at first. Allow time to build endurance and gradually make time each day for enjoyable physical activities.
For individuals training for long distance walking marathons and/or events, can focusing on building a walking foundation, then increasing mileage progressively help condition the body for overall readiness?
Long Distance Walking Training
Training helps individuals be comfortable and safe for long-distance walking and events.
Training should focus on building a walking pace and increasing mileage gradually.
Individuals need endurance, not speed, and want to build mental stamina for walking for hours at a steady pace.
To reduce the risk of training injuries, increasing the total mileage per week/the distance of the longest walk per week to no more than 10% is recommended.
Individuals should also train to wear the gear worn during long-distance walks.
Training could last a few months.
Being methodical allows the body time to repair and build new muscle, blood supplies, and endurance.
Example Training Plans
Following a marathon training plan for mileage building and determining the proper hydration, nutrition, and gear for multi-day walks and treks is recommended. However, individuals must build back-to-back long days into their training sessions to assess any issues or problems resulting from walking long distances on back-to-back days.
Example Walking Training Plans
Multi-Day Walks/Treks Training Schedule
13 miles per day/21 kilometers
Use this plan for marathons or other multi-day walks with hills and natural surfaces requiring a backpack.
Training to Walk a Marathon
26.2 miles/42 kilometers
This will condition the body to go longer distances.
When training for distances of 31 to 100 miles/50 to 161 kilometers, the longest distance to train should not need to exceed 20 to 25 miles,
These should be performed at least twice two months before the marathon or event.
Taper down the month before the event to a 12.4-mile/20-kilometer distance.
Gear
All clothing, shoes, sunscreen, backpacks, etc., must be tested on the longer training days before the event.
Given the climate and terrain, plan for what will be needed and removed.
Try things out, as individuals don’t want to be surprised with something unfamiliar at the event. From head to toe, test the gear, including:
Shoes/boots, socks, underwear, bra, shirt, pants, hat, jacket, and rain gear.
Choose shoes or walking boots and wear them on long training days to break them in and ensure they perform.
Backpacks should be tested on longer training days to ensure they can be carried comfortably over long distances and have the necessary capacity.
Choose wicking fabrics that allow the skin to breathe and cool, especially under layers. (Justin De Sousa et al., 2014)
Individuals will want to wear gear similar to marathon walkers if the walk will mostly be on pavement or asphalt.
Individuals can modify their gear if the route is off-road or during different seasons. Find out what other long-distance walkers have worn on the same route or event.
Individuals can connect with fellow walkers via social media or find answers to frequently asked questions on the event’s or destination’s website.
Individuals can also contact the event director via the website or social media.
Nutrition
Proper sports nutrition will prepare the body for endurance activity.
For example, individuals are recommended to follow a diet comprising 70% carbohydrates, 20% protein, and 10% fat.
Avoid high-protein diets, as they can cause hydration problems and strain your kidneys under endurance walking conditions. (Marta Cuenca-Sánchez et al., 2015)
Train with the water, sports drinks, food, and snacks taken to the event, and do not deviate from them during the event.
Water is needed for 20 kilometers and under events, but an electrolyte replacement sports drink may be better for longer walks.
Diluting or leaving out some sugar can be easier on the stomach.
Have snacks pre-packaged and labeled for the times to be eaten.
Individuals need to eat fat and protein for ultramarathon distances – this can come from trail mix, peanut butter sandwiches, and chocolate bars with nuts.
Carbohydrates can be provided by sports gels or energy bars.
It is recommended to avoid products made for short distances and power sports as they can cause digestive problems when walking longer distances.
Planning a Walk
Planning begins by setting goals. Considerations include:
Time of year
Distance
Transportation to the event
Event pace requirements
Altitude and hill profile
Climate
Individuals are recommended to:
Prepare by researching routes and trails.
Study the course maps to know what services are provided along the way and what individuals must bring.
Walk a long distance without a supporting event.
Contact individuals who have walked the course.
Know the terrain and areas of total sun, hills, pavement, natural trails, and shade.
If possible, drive the course to become familiar with it.
Individuals may be able to find apps designed for their route.
Taking Breaks and Resting
Regular breaks should be short – using the bathroom, eating a snack, rehydrating, tying shoes, or bandaging blisters.
The body can stiffen up quickly during breaks and take several minutes to regain walking pace after a long break.
Recommendations could be taking a walking break instead, which means continuing to walk but at a very slow pace.
Foot Care
Individuals will have found what works for them concerning shoes, boots, socks, etc., on the long training days to prevent blisters and injuries. It is recommended to try different strategies, which include:
Sports tape
Blister block pads
Sprays
Lubricants
Wicking and/or double-layered socks
Moleskin
Stop at the first sign of irritation along the walk and doctor the foot with tape, blister bandages, or whatever method works best.
The body was built for walking. Planning and training properly before taking a long-distance or multi-day walk will ensure a safe and enjoyable marathon.
Move Better, Live Better
References
De Sousa, J., Cheatham, C., & Wittbrodt, M. (2014). The effects of a moisture-wicking fabric shirt on the physiological and perceptual responses during acute exercise in the heat. Applied ergonomics, 45(6), 1447–1453. doi.org/10.1016/j.apergo.2014.04.006
Cuenca-Sánchez, M., Navas-Carrillo, D., & Orenes-Piñero, E. (2015). Controversies surrounding high-protein diet intake: satiating effect and kidney and bone health. Advances in nutrition (Bethesda, Md.), 6(3), 260–266. doi.org/10.3945/an.114.007716
Can individuals dealing with joint pain incorporate acupuncture therapy to manage lupus symptoms and restore body mobility?
Introduction
The immune system is highly important to the body as its main job is to protect vital structures from foreign invaders that can cause pain-like issues and discomfort. The immune system has a healthy relationship with the different body systems, including the musculoskeletal system, as the inflammatory cytokines help heal muscle and tissue damage when the body is injured. Over time, however, when normal environmental and genetic factors start to develop in the body, the immune system will begin to send out these cytokines to healthy, normal cells. To that point, the body starts at risk of developing autoimmune diseases. Now, autoimmune diseases in the body can cause havoc over time when they are not managed, leading to chronic disorders that can cause overlapping symptoms in the musculoskeletal system. One of the most common autoimmune diseases is systemic lupus erythematosus or lupus, and it can cause a person to be in consistent pain and discomfort while correlating with muscle and joint pain. Today’s article looks at the factors and effects of lupus, the burden of joint pain in lupus, and how holistic approaches like acupuncture can help manage lupus while restoring body mobility. We talk with certified medical providers who consolidate our patients’ information to assess how to minimize the pain effects caused by lupus on the joints. We also inform and guide patients on how acupuncture can help manage lupus and combine other therapies to reduce its pain-like symptoms affecting the musculoskeletal system. We encourage our patients to ask their associated medical providers intricate and important questions about incorporating acupuncture therapy to relieve the inflammatory effects of lupus while finding natural ways to restore mobility. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer.
The Factors & Effects Of Lupus
Have you been experiencing joint pain in your upper or lower extremities, making it difficult to function throughout the day? Have you been feeling the constant effects of fatigue? Many individuals experiencing these pain-like issues could risk developing systemic lupus erythematosus. In this autoimmune disease, the body’s own immune system mistakenly starts to attack its tissues, thus leading to inflammation and a range of pain-like symptoms. Lupis is tricky to diagnose because of its complex immune dysregulation that can lead to an overproduction of cytokines that can affect the body. (Lazar & Kahlenberg, 2023) At the same time, lupus can affect a diverse population, with symptoms and severity varying depending on how mild or severe the factors affect the body. Lupus can impact various body parts, including the joints, skin, kidneys, blood cells, and other vital body parts and organs, as environmental and hormonal factors can influence its development. (Tsang & Bultink, 2021) Additionally, lupus can be closely associated with other comorbidities that are causing overlapping risk profiles with inflammation that can affect the joints in the musculoskeletal system.
The Burden of Joint Pain In Lupus
Lupus is tricky to diagnose since it often mimics other ailments; the most common pain symptom that lupus affects is the joints. Individuals with lupus experience joint pain, which can cause inflammatory effects and structural damage to the joints, tendons, muscles, and bones, causing pathological abnormalities. (Di Matteo et al., 2021) Since lupus causes inflammatory effects in the joints, many individuals will think that they are experiencing inflammatory arthritis, and it can cause overlapping risk profiles as it is accompanied by lupus, thus causing localized pain in the joints regardless of its origin. (Senthelal et al., 2024) Joint pain in lupus individuals can significantly hinder daily activities, reducing mobility and overall quality of life as they are trying to find relief.
Unlocking The Secrets of Inflammation-Video
A Holistic Approach to Managing Lupus
While standard treatments for lupus involve medication and immunosuppressants to reduce the inflammation caused by lupus, many people want to seek out holistic approaches to manage lupus and reduce the inflammatory effects from affecting their joints by making small changes in their lives. Many people incorporate anti-inflammatory foods rich in antioxidants to dampen the inflammatory effects. Various supplements, like vitamin D, calcium, zinc, etc., can help reduce inflammation caused by lupus and strengthen bone health. Additionally, non-surgical treatments can even improve cardiorespiratory capacity and decrease fatigue while improving psychological function, which can help improve a person’s quality of life by managing the symptoms caused by lupus. (Fangtham et al., 2019)
How Acupuncture Could Help Lupus & Restore Mobility
One of the oldest forms of non-surgical and holistic approaches to reducing inflammation and managing lupus is acupuncture. Acupuncture involves solid, thin needles used by highly trained professionals to be inserted into specific body points to balance the body’s qi (energy) by stimulating the nervous system and releasing beneficial chemicals into the affected muscles, spinal cord, and brain. Additionally, acupuncture, with its minimal side effects and holistic approach, can help manage lupus. This is because when acupuncture needles are placed at the acupoints of the body, it can disrupt the pain signals that are causing pain in the affected area and regulate the inflammatory cytokines from lupus to provide relief. (Wang et al., 2023) This is due to its philosophy of addressing not only the physical pain but also the emotional and psychological symptoms of living with a chronic condition like lupus.
Additionally, acupuncture can help restore joint mobility while managing lupus through consecutive treatments, as many people notice that their joint mobility is improved and their pain is diminished. This is because the insertion and manipulation of the needles in the body’s acupoints cause alterations in afferent sensory input to the central nervous system, which increases alpha motoneuron excitability and reduces inflammation. (Kim et al., 2020) When individuals are dealing with lupus and are trying to find alternative holistic methods to relieve inflammation and joint pain caused by lupus, acupuncture, and non-surgical treatments can offer a ray of hope in managing the daily challenges of lupus.
References
Di Matteo, A., Smerilli, G., Cipolletta, E., Salaffi, F., De Angelis, R., Di Carlo, M., Filippucci, E., & Grassi, W. (2021). Imaging of Joint and Soft Tissue Involvement in Systemic Lupus Erythematosus. Curr Rheumatol Rep, 23(9), 73. doi.org/10.1007/s11926-021-01040-8
Fangtham, M., Kasturi, S., Bannuru, R. R., Nash, J. L., & Wang, C. (2019). Non-pharmacologic therapies for systemic lupus erythematosus. Lupus, 28(6), 703-712. doi.org/10.1177/0961203319841435
Kim, D., Jang, S., & Park, J. (2020). Electroacupuncture and Manual Acupuncture Increase Joint Flexibility but Reduce Muscle Strength. Healthcare (Basel), 8(4). doi.org/10.3390/healthcare8040414
Lazar, S., & Kahlenberg, J. M. (2023). Systemic Lupus Erythematosus: New Diagnostic and Therapeutic Approaches. Annu Rev Med, 74, 339-352. doi.org/10.1146/annurev-med-043021-032611
Tsang, A. S. M. W. P., & Bultink, I. E. M. (2021). New developments in systemic lupus erythematosus. Rheumatology (Oxford), 60(Suppl 6), vi21-vi28. doi.org/10.1093/rheumatology/keab498
Wang, H., Wang, B., Huang, J., Yang, Z., Song, Z., Zhu, Q., Xie, Z., Sun, Q., & Zhao, T. (2023). Efficacy and safety of acupuncture therapy combined with conventional pharmacotherapy in the treatment of systemic lupus erythematosus: A systematic review and meta-analysis. Medicine (Baltimore), 102(40), e35418. doi.org/10.1097/MD.0000000000035418
For individuals experiencing musculoskeletal issues and pain symptoms, can learning about biomechanics and how it applies to movement, physical training, and performance, help in injury treatment and prevention?
Biomechanics
Biomechanics studies all life forms and their mechanical workings. Many think of biomechanics in sports and athletic performance, but biomechanics helps create and improve technologies, equipment, and injury rehabilitation techniques. (Tung-Wu Lu, Chu-Fen Chang 2012) Scientists, sports medicine doctors, physiotherapists, chiropractors, and conditioning specialists utilize biomechanics to help develop training protocols and techniques to improve therapy outcomes.
Body Movement
Biomechanics studies the movement of the body, including how muscles, bones, tendons, and ligaments work together, especially when movement is not optimal or correct. It is part of the larger field of kinesiology, specifically focusing on motion mechanics and analysis of how all the individual parts of the body work together to make up athletic and normal movements. (José M Vilar et al., 2013) Biomechanics includes:
Structure of bones and muscles.
Movement ability.
Mechanics of blood circulation, renal function, and other functions.
The study of forces and the effects of these forces on the tissues, fluid, or materials used for diagnosis, treatment, or research. (Jose I. Priego-Quesada 2021)
Sports
Sports biomechanics studies motion in exercising, training, and sports, which incorporates physics and the laws of mechanics. For example, the biomechanics of a specific exercise looks at:
Body position.
Movement of the feet, hips, knees, back, shoulders, and arms.
Knowing the correct movement patterns helps make the most of the exercise while preventing injuries, correcting form mistakes, informing training protocols, and increasing positive results. Understanding how the body moves and why it moves the way it does helps medical professionals prevent and treat injuries, alleviate pain symptoms, and improve performance.
Equipment
Biomechanics is used in the development of physical and sports equipment to improve performance. For example, a shoe can be designed for optimal performance for a skateboarder, long-distance runner, or soccer player. Playing surfaces are also studied for this purpose, such as how the surface stiffness of artificial turf affects athletic performance. (Jose I. Priego-Quesada 2021)
Individuals
Biomechanics can analyze an individual’s movements for more effective movement during training and games.
For example, an individual’s running gait or swing can be filmed with recommendations on what to change to improve.
Injuries
The science studies the causes, treatment, and prevention of neuromusculoskeletal injuries.
The research can analyze the forces that cause injuries and provide information for medical professionals on how to reduce the risk of injury.
Training
Biomechanics studies sports techniques and training systems to develop ways to improve efficiency.
This can include research on positioning, release, follow-through, etc.
It can analyze and help design new training techniques based on the mechanical demands of the sport, aimed at resulting in better performance.
For example, muscle activation is measured in cycling using electromyography and kinematics, which helps researchers analyze factors like posture, components, or exercise intensity that affect activation. (Jose I. Priego-Quesada 2021)
Motions
In biomechanics, the body’s motions are referred to from anatomical positioning:
Standing upright, with the gaze straight ahead
Arms at the sides
Palms facing forward
Feet spaced slightly apart, toes forward.
The three anatomical planes include:
Sagittal – median – Dividing the body into right and left halves is the sagittal/median plane. Flexion and extension occur in the sagittal plane.
Frontal – The frontal plane divides the body into front and back sides but also includes abduction, or moving a limb away from the center, and adduction, or moving a limb towards the center in the frontal plane.
Transverse – horizontal. – The upper and lower parts of the body are divided by the transverse/horizontal plane. Rotating movements occur here. (American Council on Exercise 2017)
Moving the body in all three planes occurs with daily activity. This is why performing exercises in each plane of motion to build strength, function, and stability is recommended.
Tools
Various tools are used to study biomechanics. Studies are usually performed using a device known as electromyography or EMG sensors. Sensors are placed on the skin and measure the amount and degree of muscle fiber activation in certain muscles during test exercises. EMGs can help:
Researchers understand which exercises are more effective than others.
Therapists know whether patients’ muscles are properly operating and functioning.
Dynamometers are another tool that helps measure muscle strength.
They measure the force output generated during muscle contractions to see if the muscles are sufficiently strong.
They are used to measure grip strength, which can be an indicator of overall strength, health, and longevity. (Li Huang et al., 2022)
Beyond Adjustments: Chiropractic and Integrative Healthcare
References
Lu, T. W., & Chang, C. F. (2012). Biomechanics of human movement and its clinical applications. The Kaohsiung journal of medical sciences, 28(2 Suppl), S13–S25. doi.org/10.1016/j.kjms.2011.08.004
Vilar, J. M., Miró, F., Rivero, M. A., & Spinella, G. (2013). Biomechanics. BioMed research international, 2013, 271543. doi.org/10.1155/2013/271543
Priego-Quesada J. I. (2021). Exercise Biomechanics and Physiology. Life (Basel, Switzerland), 11(2), 159. doi.org/10.3390/life11020159
Huang, L., Liu, Y., Lin, T., Hou, L., Song, Q., Ge, N., & Yue, J. (2022). Reliability and validity of two hand dynamometers when used by community-dwelling adults aged over 50 years. BMC geriatrics, 22(1), 580. doi.org/10.1186/s12877-022-03270-6
IFM's Find A Practitioner tool is the largest referral network in Functional Medicine, created to help patients locate Functional Medicine practitioners anywhere in the world. IFM Certified Practitioners are listed first in the search results, given their extensive education in Functional Medicine
