ClickCease
+1-915-850-0900 spinedoctors@gmail.com
Select Page

Chiropractic

Back Clinic Chiropractic. This is a form of alternative treatment that focuses on the diagnosis and treatment of various musculoskeletal injuries and conditions, especially those associated with the spine. Dr. Alex Jimenez discusses how spinal adjustments and manual manipulations regularly can greatly help both improve and eliminate many symptoms that could be causing discomfort to the individual. Chiropractors believe among the main reasons for pain and disease are the vertebrae’s misalignment in the spinal column (this is known as a chiropractic subluxation).

Through the usage of manual detection (or palpation), carefully applied pressure, massage, and manual manipulation of the vertebrae and joints (called adjustments), chiropractors can alleviate pressure and irritation on the nerves, restore joint mobility, and help return the body’s homeostasis. From subluxations, or spinal misalignments, to sciatica, a set of symptoms along the sciatic nerve caused by nerve impingement, chiropractic care can gradually restore the individual’s natural state of being. Dr. Jimenez compiles a group of concepts on chiropractic to best educate individuals on the variety of injuries and conditions affecting the human body.


Orthopedic Massage

Orthopedic Massage

Orthopedic massage is part of injury rehabilitation that focuses on the muscles and soft tissues surrounding the joints and ligaments. Pain could be caused post-surgery, an acute injury, or overuse/repetitive motion injury from work or sports. The objective is to:

  • Decrease pain
  • Release tension
  • Restore balance
  • Increase mobility and flexibility
  • Preparing the body to return to everyday routines and activities.

Whatever the cause of the muscle damage or injury, an orthopedic massage will lengthen and soften the muscles and ligaments, allowing for a better range of motion of the affected joints.

Orthopedic Massage

Orthopedic Massage

All massage techniques can improve joint movement and function. Orthopedic massage is specifically designed to return the joints to their normal position function and alleviate pain with movement.

  • Swedish massage focuses on overall relaxation.
  • Deep tissue massage reduces deep muscle pain and strain.

Orthopedic massage therapists have an extensive understanding of anatomy, soft tissues, and misalignment of the musculoskeletal system that can cause pain and injury. It is similar to sports massage targeting damaged areas for recovery and rehabilitation from conditions and injuries. Sports massage helps the individual strengthen and retrain the damaged areas back to optimal performance and prevent injury. Orthopedic massage utilizes:

  • Alignment techniques
  • Release techniques
  • Pin techniques
  • Stretch techniques
  • To expedite thorough body healing.

Massage benefits many symptoms and conditions. It has been shown to help with:

  • Sprains
  • Pulled muscles
  • Torn ligaments
  • Carpal-tunnel syndrome
  • Frozen shoulder
  • Tennis elbow
  • Tendinitis
  • Sciatica
  • Bulging discs
  • Post-surgery

Techniques

A therapist will look at the range of motion, flexibility, and rotation of the tissues. This will help determine what muscle groups and tendons are involved and which techniques to use. Massage therapists use an assortment of approaches to loosen muscles and tendons. These include:

Active Engagement

  • This is used to reach deep, hard-to-reach muscles by applying pressure and massaging lengthwise in a perpendicular motion.
  • It is beneficial for whiplash and/or back pain.

Positional Release

  • This is a gentle treatment for inflamed muscles and tissues highly sensitive to other techniques.
  • Soft tissues are manipulated into comfortable positions and held in place for a specific time.
  • This lengthens and softens tissues to bring pain relief.

Nerve Mobilization

Muscle Energy Release

  • The therapist provides resistance while the individual voluntarily contracts muscles.
  • Effective with low back pain.

Trigger Point Therapy

  • Pressure intervals are held on trigger areas to release lactic acid and promote circulation.

Myofascial Release

  • Gentle pressure is applied to stretch fascia tissues.

Body Composition


Brittle Bones

The reason bones become weaker is that bone tissue is living tissue that constantly forms new bone material and absorbs the old bone material. As the body ages, the rate at which bone is reabsorbed becomes faster than newly formed bone material. One reason for rapid bone loss is lack of exercise and physical activity. The Mayo Clinic has stated that individuals that spend a great deal of time sitting, whether at home or work, have an increased risk of osteoporosis than more active individuals. Sitting too much with little to no activity can lead to weakened bones. Just like the muscles, bones get stronger when they are in use. Walking, running, jumping, and getting the body moving along with using some resistance, can increase the strength and durability of the bones.

References

Kim, Seung-Kook et al. “Clinical outcomes and cost-effectiveness of massage chair therapy versus basic physiotherapy in lower back pain patients: A randomized controlled trial.” Medicine vol. 99,12 (2020): e19514. doi:10.1097/MD.0000000000019514

Klein, Ifat et al. “Lymphatic treatments after orthopedic surgery or injury: A systematic review.” Journal of bodywork and movement therapies vol. 24,4 (2020): 109-117. doi:10.1016/j.jbmt.2020.06.034

Loew, Laurianne M et al. “Deep, transverse friction massage for treating lateral elbow or lateral knee tendinitis.” The Cochrane database of systematic reviews vol. 2014,11 CD003528. 8 Nov. 2014, doi:10.1002/14651858.CD003528.pub2

Majewski-Schrage, Tricia, and Kelli Snyder. “The Effectiveness of Manual Lymphatic Drainage in Patients With Orthopedic Injuries.” Journal of sport rehabilitation vol. 25,1 (2016): 91-7. doi:10.1123/jsr.2014-0222

Spinal Goals

Spinal Goals

Setting spinal goals is important for an individual’s treatment plan to ensure a thorough and successful recovery following:

  • Surgery
  • Trauma
  • Spinal condition

When developing goals with a surgeon or spine specialist, utilizing a well-known method known as SMART is recommended. Individuals are encouraged to set goals to accomplish personal growth and improvement. It is a model for forming goals and objectives that for medical purposes include:

  • Pain management
  • Physical Rehabilitation
  • Mental health
  • Exercises
  • Stretching
  • Anti-inflammatory diet

Spinal Goals

S.M.A.R.T Spinal Goals

The acronym stands for:

Specific

  • Target a specific area for improvement.

Measurable

  • Find ways to track progress.
  • This could be fitness trackers, daily journaling – writing, video, health coach, etc.

Attainable

  • Determine if the goal is achievable.
  • Figure out what tools or skill sets are needed to reach the goal.

Realistic

  • Results-oriented goals.
  • Measure results or output, including accomplishments.

Time Frame

  • Set goals within a doable time frame.

Goal setting helps individuals monitor their progress when recovering from injury, surgery, and/or spinal conditions. Making goals smaller makes it easier to achieve improvements. It’s recommended to have a partner assistant during the goal-setting because the pain can compromise decision-making. Pain affects the mind’s abilities to assess improvement and treatment response rationally. Taking the most important goals and focusing on small building blocks helps individuals maintain motivation during a long recovery process.

Difference Between Goal Setting and Treatment

A standard treatment plan is structured for a specific result and is not set up for adjusting the way goal setting does. A treatment plan is created and prescribed to a patient with little patient input. Goal setting is a collaboration between a patient and a doctor setting objectives as stepping-off points to achieve goals. Goal setting empowers patients with education, skillsets, and tools to succeed and continue that mindset as their lives move on. Achieving short-term goals helps individuals reflect positively on small gains that set a solid foundation for more challenging future goals.

Spinal Treatment Goals

Goals are personalized/custom-tailored to the individual’s case and condition. For example, a patient could set a goal of returning to weekend sports activities. Therefore, achieving the goal could require the individual to engage in exercise five days a week for the next two weeks that could include physical therapy rehabilitation:

These activities are small goals that help the body adapt to handling additional physical stress.

Goal Setting When In Recovery

Spinal issues are dealt with by creating reasonable small objectives to reach a goal. SMART goal setting is an instrumental framework for medical providers to help identify what is important to the patient. Modifications on SMART goals can be done to adjust to the individual’s needs. Spinal goals help patients accomplish what is necessary, keeping them empowered and motivated.


Body Composition


Too Comfortable With Goals

An individual may have a great deal of success doing the same workouts initially but then notice they’re getting easier and are not seeing the same rate of progression. That same workout routine, same weights, and equipment will only go so far in goal achievement. In recovery, as the body gets stronger and fitness levels improve, it is recommended to consistently challenge yourself to avoid falling into a rehabilitation fitness plateau. Part of the recovery process is to change up workouts to challenge the body to achieve optimal health and healing. Individuals are recommended to:

Increase weight and or reps

  • Increase the amount of weight or the number of reps in each set.

Increase or decrease the tempo

  • Shorten the rest period between sets to keep the heart rate high or slow down to focus on muscle contraction.

Experiment with different types of workout sets

  • If you’ve been doing the same kinds of lifts, try drop sets, supersets, or AMRAP (as many reps as possible) to challenge your muscles differently.

Learn new exercises

  • Individuals doing a lot of weightlifting are recommended to engage in plyometric body exercises.
  • Individuals doing high-intensity interval training are recommended to incorporate a long run or bike ride.

Changing the workout routine will keep challenging the body, which is great for health progress.

References

Alexanders, Jenny et al. “Goal setting practices used within anterior cruciate ligament rehabilitation: An exploration of physiotherapists understanding, training, and experiences.” Musculoskeletal care vol. 19,3 (2021): 293-305. doi:10.1002/msc.1535

Bovend’Eerdt, Thamar J H et al. “Writing SMART rehabilitation goals and achieving goal attainment scaling: a practical guide.” Clinical rehabilitation vol. 23,4 (2009): 352-61. doi:10.1177/0269215508101741

Haas, B et al. “Rehabilitation goals of people with spinal cord injuries can be classified against the International Classification of Functioning, Disability and Health Core Set for spinal cord injuries.” Spinal cord vol. 54,4 (2016): 324-8. doi:10.1038/sc.2015.155

Chiropractic and Spinal Health

Chiropractic and Spinal Health

Chiropractic and spinal health. Most individuals seek out chiropractic care only after an injury and when pain presents. Because traditional medical care tends to focus on treating disorders and diseases, individuals are used to seeking care only when something is imbalanced. For many, chiropractic is known for its ability to resolve back and neck pain, correct postural misalignments, manage acute or chronic conditions and accelerate the healing of injuries. Chiropractic is different in that it is a tool for increasing overall wellness and vitality when no injury or imbalance is present.

Chiropractic and Spinal Health

Chiropractic and Spinal Health

Chiropractic is an invaluable treatment that raises the baseline of an individual’s health by:

  • Increasing performance
  • Extending lifespan and longevity
  • Improving overall comfort
  • Increasing agility in the body

Chiropractic helps to achieve these transformational results by improving the function of the:

  • Circulatory system
  • Immune system
  • Respiratory system
  • Muscular system
  • Nervous system
  • Skeletal system

Circulation Increased

The circulation system includes the heart and its chambers, arteries, veins, lungs, lobes, and capillaries. The structures within this system move blood, nutrients, and waste throughout the body. The quality of health and life depends on the level of functioning in this system. The better and more efficient the tissues receive clean blood, nutrients, and oxygen, the better the body is able to utilize these building blocks to achieve whatever function is required. The slower and more unclean these building blocks, the lower quality of function. The nervous system is the communication system that includes the brain, spinal cord, and nerves that run throughout the body. Everything in the body and the work functions as a result of this communication system.

The circulatory system relies on the communication that runs through the nervous system, which is housed in the spine. If the spine is misaligned, moving improperly, or sustaining an injury, it can interfere with the function of the communication. Regular chiropractic care increases the health levels of the nervous system by keeping the spine as healthy and flexible as possible. The muscles are kept loose, which promotes blood flow, and the flow and movement of waste in the lymphatic system. Individuals that receive regular adjustments report:

  • Enhanced perception of sensations in their extremities.
  • Warmer hands and feet.
  • Improved cognitive response and clarity.
  • Decrease or eliminate tingling and numbness.
  • Maintaining the proper range of motion of the spine also facilitates better function and movement of the whole body.

Immune Response Improvement

Regular chiropractic improves immune responses that leads to improved response against foreign invaders and disease, fewer instances of illness, exhaustion, fatigue, and inflammation. When expert chiropractic and spinal health intervention is delivered it helps to realign bones and joints, alleviate muscle tension, and restore nerve function. The body immediately experiences a decrease in stress, downregulation of stress hormones and chemicals in the body leads to a reduction in inflammation.

Increased Mobility & Flexibility

Chiropractic helps to improve physical mobility and flexibility in the muscular and skeletal systems. This is accomplished through manual manipulation to restore ideal posture and achieve a balanced skeletal structure. Manual manipulation is also used to soften and relax tense muscles which have developed abnormalities to compensate for incorrect posture. When skeletal structure, muscular imbalances, and strain are corrected, the result is improved mobility and flexibility.

Pain Symptoms Are Decreased

Pain originates from the nervous, muscular, and skeletal systems. Chiropractic can help with back pain, neck pain, shoulder pain, migraines, nerve and sciatic pain, and other conditions and forms of discomfort. The origin of the pain can include:

  • Postural imbalance
  • Muscle tension
  • Damage from accident or injury
  • Spinal degeneration

Chiropractic and spinal health care helps soothe and de-inflame the comprised areas, allowing the natural healing systems to intervene and promote long-term reduction of discomfort and pain.

Bending, Standing, Sitting Activities Improve

For many individuals, bending, standing, and sitting are normal movements they engage in every day. This can be part of work occupation, school, house chores, etc, and for many these movements and positions can become painful over long durations of time and when it is repetitive. Regular chiropractic and spinal health treatment can restore optimal posture in the body, soothe strained and tense muscles, and resolve disrupted nerve energy flow which often leads to nerve pain like sciatica.


Body Composition


Pregnancy Hypertension

Hypertension in pregnancy falls into one of three categories. It can range from benign and easily controlled to serious with increased medical risks. This makes monitoring blood pressure important to individual health risks. The risks for hypertension in pregnancy include:

  • Early delivery
  • Decreased oxygen to the placenta
  • Potential heart disease

The main types of hypertension in pregnancy.

Chronic hypertension

Chronic hypertension is a pre-existing condition known prior to pregnancy.

  • Individuals that are aware of elevated blood pressure before becoming pregnant, a doctor will diagnose the individual with chronic hypertension.
  • A doctor will use diagnostic criteria to determine if chronic hypertension is present prior to getting pregnant.

Gestational hypertension

Gestational hypertension develops during pregnancy.

  • Gestational hypertension is not preventable and typically returns to normal levels postpartum.
  • However, risk increases for later developing chronic hypertension is higher if gestational hypertension presents.
  • According to Mayo Clinic, gestational hypertension is diagnosed by the following criteria:
  1. At least 20 weeks gestation
  2. Blood pressure is greater than 140/90 on two occasions
  3. Must be documented more than four hours apart
  4. No other organ damage is present

Preeclampsia

Preeclampsia is the most serious.

Preeclampsia develops after 20 weeks of pregnancy and is associated with a sharp spike in blood pressure levels. Notable symptoms include:

  • Sudden fluid swelling
  • Chronic headaches
  • Changes in vision
  • Nausea
  • Vomiting
  • Weight gain
References

Brown, Richard A. “Spinal Health: The Backbone of Chiropractic’s Identity.” Journal of chiropractic humanities vol. 23,1 22-28. 8 Sep. 2016, doi:10.1016/j.echu.2016.07.002

Bussières, André E et al. “Spinal Manipulative Therapy and Other Conservative Treatments for Low Back Pain: A Guideline From the Canadian Chiropractic Guideline Initiative.” Journal of manipulative and physiological therapeutics vol. 41,4 (2018): 265-293. doi:10.1016/j.jmpt.2017.12.004

Maher, Jennifer L et al. “Exercise and Health-Related Risks of Physical Deconditioning After Spinal Cord Injury.” Topics in spinal cord injury rehabilitation vol. 23,3 (2017): 175-187. doi:10.1310/sci2303-175

Meeker, William C, and Scott Haldeman. “Chiropractic: a profession at the crossroads of mainstream and alternative medicine.” Annals of internal medicine vol. 136,3 (2002): 216-27. doi:10.7326/0003-4819-136-3-200202050-00010

Nerve Injury

Nerve Injury

A nerve injury is often caused by a sudden traumatic event, like a slip and fall, personal or work injury, an automobile accident, or a sports injury. Overall stresses of the body from poor posture and being overweight can also lead to nerve pain over time, known as cumulative trauma. Where ligaments and bones are not aligned correctly, nerve pain and damage can occur. When nerve pain presents, there is pressure being placed on that nerve/s. Nerve pain symptoms include burning, tingling, or numbness-type sensations in the tissues controlled by that nerve. Orthopedic and neurologic testing will determine what specific nerve is affected. Chiropractic adjustments realign the spine and relieve the pressure on the nerve, thus eliminating the pain and correcting the problem.

Nerve Injury

Nerve Injury

Too much pressure from surrounding tissues compresses and irritates the nerve and interrupts its ability to function correctly. Pinched nerves are most vulnerable at points in the body where they pass through narrow spaces and have little to no soft tissue protection. Symptoms include:

  • Pins and Needles Sensation
  • Numbness
  • Pain
  • Weakness

A pinched nerve can decrease the range of motion and cause muscle spasms. If left untreated, a nerve injury can leave an individual with chronic pain and lead to permanent nerve damage.

Tingling and Numbness

Tingling and numbness are unusual or unpleasant physical sensations, most commonly experienced in the arms, hands, fingers, legs, feet, and toes. Tingling and numbness come in two forms:

Paresthesia

  • A feeling of pins and needles on the skin or the sensation of the hand or arm having fallen asleep.
  • Paresthesia can be a result of reduced blood flow to the region. This can be caused by external pressure that constricts the blood vessels.

Dysesthesia

  • This is a more persistent sensation resembling itching, burning, electric shock, or tightening pain.

 Injuries to the nervous system can also produce numbness and tingling, even in areas nowhere near the actual injury. Examples include:

  • Neck pain from a neck injury can cause numbness or tingling in the hand or arm.
  • A low back injury can result in tingling in the back of the leg.

Other possible causes include:

  • Inflammation that puts pressure on nerves
  • Trigger points in the muscles
  • Enlarged blood vessels
  • Tumors
  • Myofascial adhesions
  • Scar tissue
  • Infection
  • Lesions on the spinal disc/s
  • Diabetes
  • Calcium deficiency
  • Vitamin B12 deficiency
  • Liver disease
  • Kidney disease
  • Alcoholism
  • Drug abuse

Chiropractic Treatment

To determine the appropriate course of treatment, a doctor of chiropractic must diagnose the cause of the nerve injury. Depending on the nature or severity of the sensation, the examination will include:

  • Muscle tests
  • Range-of-motion tests
  • Neurological tests
  • Orthopedic tests

The chiropractor will palpate the effective areas and order imaging tests like X-rays if necessary. If further testing is needed to diagnose the source of the nerve injury, the doctor may order an MRI or CT scan. Once the underlying condition is diagnosed, a chiropractor will develop a treatment plan to eliminate irritation, correct misalignments causing pressure, and restore proper nerve function. Treatment plans vary from case to case but can include:

  • Therapeutic Massage
  • Body adjustments
  • Spinal manipulation
  • Heat and Ice

The objective is to relieve/release the pressure on the nerves. Chiropractic adjustments help reposition the muscles and nerves. Deep-tissue massage helps to release tension and eliminate toxins that worsen the sensations. Treatment improves circulation and relieves pressure on the neural pathways necessary to restore normal neural signaling between the body and the brain.


Body Composition


Why The Brain Needs Sugar

The brain needs half of all the body’s energy supply because of its complex nerve cell system. The brain requires glucose for brain cell energy. Because neurons can’t store energy, they need a continuous fuel supply to function correctly from the bloodstream. The ability to think, learn and recall information is closely associated with glucose levels. When blood glucose levels are low, the ability to think is inhibited as the production of chemical messengers/neurotransmitters, are reduced, disrupting communication between the neurons. Natural sugar can boost brain health because it requires glucose for functioning. Sugar is released slowly into the bloodstream when taken naturally from sources like apples and bananas, keeping the energy levels steady, without craving more sugar.

References

Ameh, Victor, and Steve Crane. “Nerve injury following shoulder dislocation: the emergency physician’s perspective.” European journal of emergency medicine: official journal of the European Society for Emergency Medicine vol. 13,4 (2006): 233-5. doi:10.1097/01.mej.0000206190.62201.ad

Nichols, J S, and K O Lillehei. “Nerve injury associated with acute vascular trauma.” The Surgical clinics of North America vol. 68,4 (1988): 837-52. doi:10.1016/s0039-6109(16)44589-5

Ruggiero, S L. “Trigeminal nerve injury and repair.” The New York state dental journal vol. 62,8 (1996): 36-40.

Welch, J A. “Peripheral nerve injury.” Seminars in veterinary medicine and surgery (small animal) vol. 11,4 (1996): 273-84. doi:10.1016/s1096-2867(96)80020-x

WOODHALL, B. “Peripheral nerve injury.” The Surgical clinics of North America (1954): 1147-65. doi:10.1016/s0039-6109(16)34299-2

Flat Back Syndrome

Flat Back Syndrome

Individuals believe that maintaining a straight/flat back is healthy. However, the back is made up of natural curves that allow flexibility and optimal movement. If there is a lack of these curves, it can lead to spine issues, discomfort, and pain. A common problem to develop from a spine lacking natural curvature is abnormal kyphosis. This is when the natural curve in the thoracic spine – mid-back or lumbar spine – low back disappears, which results in a flat back. Restoring the curvature can be challenging, as flatback syndrome requires chiropractic adjustments to gently shift and realign the spine back into a healthy curve and re-train the spine to maintain the curve.

Flat Back Syndrome

Causes of Flat Back Syndrome

Flatback syndrome is usually a result of muscle tightness in the lower back muscles, specifically in the psoas muscle. Or it could be degenerative disc disease, where the cartilage supporting the spine begins to weaken. Other causes include arthritis and osteoporosis. Practicing unhealthy posture habits can worsen these conditions, speeding up the loss of the spine’s curvature. Loss of spinal curvature does not occur rapidly, as the body will begin to present with symptoms. The following symptoms could be an indication:

  • Fatigue when trying to stand upright
  • Balance problems
  • Restricted mobility
  • Muscle spasms
  • Chronic low back pain
  • Thigh pain
  • Groin pain
  • Disc herniation

Back pain and problems with balance are the earliest warning signs of flatback syndrome.

Symptoms

Flatback symptoms usually get worse as the day progresses, with a sense of fatigue and increasing difficulty to stand upright. Individuals tend to flex or bend their hips and knees to get into an upright position. This can become an exhausting process as the day progresses. Individuals can also have symptoms of sciatica and/or spinal stenosis with leg pain and weakness that gets worse when walking. Neck and upper back pain can begin to present while straining to align themselves. The symptoms become disabling, often requiring pain medications that limit the individual’s ability to perform daily activities.

Realignment Treatment

A chiropractor must determine the severity of the deviation through a thorough assessment and examination. This shows the loss of curvature to help a chiropractor plan a realignment/remodeling adjustment schedule. Restoring a natural kyphosis is done through a combination of adjustments and bracing. Scheduled spinal adjustments will realign and shift the vertebrae back to neutral, while a back brace supports to prevent any deviation. Stretching and exercising relevant muscle groups is also part of a chiropractic treatment plan. An example is core exercises for strengthening the muscles supporting the spine.


Body Composition


Personalized Nutrition

Because the body is so complex and dynamic, there is no perfect fit when it comes to diet, exercise, or a combination. Fad diets typically recommend that individuals adhere to the same eating guidelines, indicating they will reach an expected result like fat loss. These diets work because they focus on a simple reduction in calorie intake, especially processed and fast foods. The problem is that some of these fad diets can restrict critical nutrients that negatively affect an individual’s health. More information about an individual’s body and how it works is an excellent resource in improving body composition and overall health. Personalized nutrition is an innovative and favorable approach to preventing and treating obesity and related conditions. This approach identifies:

  • Genetic markers
  • Dietary patterns
  • Environment
  • Metabolism

Educated recommendations can be made based on these factors.

References

Drabsch, Theresa, and Christina Holzapfel. “A Scientific Perspective of Personalised Gene-Based Dietary Recommendations for Weight Management.” Nutrients vol. 11,3 617. 14 Mar. 2019, doi:10.3390/nu11030617

Farcy, J P, and F J Schwab. “Management of flatback and related kyphotic decompensation syndromes.” Spine vol. 22,20 (1997): 2452-7. doi:10.1097/00007632-199710150-00025

Lee, Chang-Hyun, et al. “‘Lumbar Degenerative Kyphosis’ Is Not Byword for Degenerative Sagittal Imbalance: Time to Replace a Misconception.” Journal of Korean Neurosurgical Society vol. 60,2 (2017): 125-129. doi:10.3340/jkns.2016.0607.001

Lu, Daniel C, and Dean Chou. “Flatback syndrome.” Neurosurgery clinics of North America vol. 18,2 (2007): 289-94. doi:10.1016/j.nec.2007.01.007

Wiggins, Gregory C et al. “Management of iatrogenic flat-back syndrome.” Neurosurgical focus vol. 15,3 E8. 15 Sep. 2003, doi:10.3171/foc.2003.15.3.8

Gentle Yoga Poses After Spinal Fusion Surgery

Gentle Yoga Poses After Spinal Fusion Surgery

Recovery and rehabilitation after spinal fusion surgery take time. Gentle yoga poses can help expedite recovery from spinal fusion surgery and are recommended in a rehabilitation program. The spine is the body’s central support structure that allows the body to stand upright, bend, and stay balanced. However, an individual may need to have vertebrae fused to repair painful back problems. Spinal fusion is a surgical procedure that permanently connects/fuses two or more vertebrae into a single bone. The procedure is done to help:

  • Correct a deformity
  • Improve stability
  • Reduce pain

At the beginning of the recovery process, the doctor may recommend light physical activity like walking. As the spine continues to heal, moderate exercise is essential for optimal recovery. Doctors are recommending gentle yoga to increase mobility, flexibility and regain strength.

Gentle Yoga Poses After Spinal Fusion Surgery

Gentle Yoga and Spine Surgery Recovery

Yoga has become a way to stretch the body, exercise, promote physical and mental well-being. There are different styles of yoga, ranging from gentle stretching to advanced poses. Yoga focuses on stretching, coordination, and balance. When stretching the body, the range of motion is improved. Yoga also helps improve balance and increases strength to reduce the risk of falls and injuries. Gentle yoga after spinal fusion benefits include:

  • Pain relief
  • Stress reduction
  • Improved mental health
  • Increased flexibility and strength
  • Improved balance
  • Increase in energy levels

Gentle yoga after surgery focuses on an improved range of motion/coordination of the arms and legs with the torso. This allows the spine to safely flex, not become stiff, and avoid strain, leading to fuller activity.

When To Begin Yoga After Spinal Fusion?

A reduced range of motion and loss of muscle mass is expected in the weeks and months following surgery. The healthcare/rehabilitation team will address this through exercise and physical therapy once the doctor clears the individual to begin rehabilitation training. The doctor will use some form of diagnostic imaging to determine if the vertebrae have fully fused before giving the ok for exercise. Most individuals can begin light physical activity four to six weeks after the procedure. If the fusion surgery was fused in only one place, individuals could start gentle yoga poses within two to three months. For a multi-level fusion surgery, individuals may need to wait four to six months after the procedure before they can safely begin.

Yoga Recovery Program

It’s essential to take it slow and steady when first beginning yoga after spinal fusion. As the body continues to heal, gradually add more challenging poses and stretches to the routine. This is a graduated recovery program separated into stages to help the individual build back strength and flexibility. In the first stages of recovery, gentle poses that have minimal effects on the spine are recommended. These include:

A few weeks to a month later, with the doctor’s clearance, the individual can advance to poses that stretch/flex the spine a little more, including:

Eventually, individuals can slowly increase the challenge further, with poses like:

Garudasana – Eagle pose
Gomukhasana – Cow Face pose
Vasisthasana – Side plank pose

It’s crucial to listen to the body as a guide when moving through the poses, no matter what stage of recovery. The fusion needs time to heal and stabilize, so any poses that involve twisting movements and flexing should be avoided. Seek advice if there is confusion about how or whether or not to proceed. It is recommended to work with an experienced yoga teacher after spinal fusion. A knowledgeable instructor can guide with the poses, inform which poses to avoid and make modifications to get the most out of the gentle poses.


Body Composition


How Heat Affects Basal Metabolic Rate

Gender, height, and age influence Basal Metabolic Rate. These are factors individuals cannot control or change. However, individuals can increase the calories the body burns by regulating body temperature. Both the internal and external temperatures influence metabolic rate. The chemical reactions that contribute to metabolism happen more quickly if the temperature is higher, as the body works harder to restore normal temperature balance. For example, when a fever is present, the Basal Metabolic Rate will jump up to a much higher rate than usual to increase the speed of cellular metabolic reactions to combat the fever and get the body back to a healthy state. When it comes to external temperature, it’s only prolonged exposure to heat that raises the Basal Metabolic Rate.

References

American Academy of Orthopedic Surgeons. (June 2018). “Spinal Fusion.” orthoinfo.aaos.org/en/treatment/spinal-fusion/

Gillooly, James F, and Andrew P Allen. “Changes in body temperature influence the scaling of VO2max and aerobic scope in mammals.” Biology letters vol. 3,1 (2007): 99-102. doi:10.1098/rsbl.2006.0576

National Center for Complementary and Integrative Health. (February 2020) “Yoga for Health: What the Science Says.” www.nccih.nih.gov/health/providers/digest/yoga-for-health-science

National Center for Complementary and Integrative Health. (April 2021) “Yoga: What You Need to Know.” www.nccih.nih.gov/health/yoga-what-you-need-to-know

Pelvic Floor Pain and Back Pain

Pelvic Floor Pain and Back Pain

The pelvic floor is essentially the spine, and when pain presents, it can be mistaken for back pain. However, these two conditions are frequently linked. The National Institutes of Health- NIH reported that a quarter of women are impacted by pelvic floor disorders and up to 16% of men. The pelvic floor is made up of muscles. If the muscles begin to spasm, they can spread pain upwards and even downwards. This is where the misdiagnosis of lower back pain comes in.

Pelvic Floor Pain and Back Pain

The Pelvic Floor

The pelvic floor is comprised of muscles and connective tissue, known as fascia. The muscles and fascia intertwine, creating a support system for the pelvic organs. The pelvic floor muscles act as a spring system that supports the organs. When downward pressure is applied, and the spring system is working correctly, they push back up to support the muscles. These muscles create the base known as the core. The core muscles support the abdomen, diaphragm, and back muscles, supporting the spine. This is why back, pelvic pain is prevalent as these muscles are interconnected.

Pelvic Floor Dysfunction and Back Pain

If there is pelvic floor dysfunction, there is an inability to control the muscles. There can be too much or insufficient tension, resulting in urinary incontinence or inability to complete bowel movements. It can also be mistaken for back pain or contributes to pelvic and low back pain. The core muscles support the torso and promote stabilization during movement. If they are not working correctly, the torso and pelvis become unstable. The SI – sacroiliac joints linked with the pelvis and the lower spine can begin to present with posterior pelvic and back pain.

Symptoms

Dysfunction can present in several ways, including:

Causes of Dysfunction

Causes of dysfunction include:

  • Weakness of the muscles or tight muscles.
  • Vaginal dryness by a lack of estrogen during menopause.
  • Tight inner thigh muscles.
  • Back pain itself can cause dysfunction.

Women make up the majority of cases that result from:

  • Pregnancy
  • Childbirth
  • Endometriosis – a condition in which uterine tissue grows outside the uterus.

Men can also develop problems. As a man’s body ages, prostate problems can cause urinary leakage and frequency problems. It can develop from activities like bicycling. The seat can compress the pudendal nerve, causing pain and dysfunction.

Retraining the Muscles

The dysfunction can be helped by reactivating and strengthening the pelvic and core muscles. Training the pelvic floor and the core muscles will help boost support for the spine and alleviate discomfort and pain. First, it is recommended to get a physical evaluation by a chiropractor or physical therapist to determine if the pelvic floor muscles are too tight or weak. The objective is to improve the strength of the pelvic floor muscles or relax them if they are too tight. A chiropractor and physical therapist can work on the muscles, educate on stretches, exercises, nutrition, and offer additional help and support.


Body Composition


Muscle Adaptation

The point of resistance training is to get the muscles to function more effectively. It begins with the contractile proteins that control muscle shortening and lengthening. Resistance exercise can cause some of the proteins to get pulled apart. The stress the muscles experience is the stimulus for the muscles to rebuild bigger, stronger, or more powerful. After resistance exercise, the muscle synthesizes proteins helped by nutritional stimuli and protein consumption. Satellite cells also activate to help build up the broken-down muscle. Resistance exercise causes activation.

References

Cleveland Clinic. (2020). “Pelvic Floor Dysfunction.” my.clevelandclinic.org/health/diseases/14459-pelvic-floor-dysfunction

National Institutes of Health. (September 2008) “Roughly One-Quarter of U.S. Women Affected by Pelvic Floor Disorders” www.nih.gov/news-events/news-releases/roughly-one-quarter-us-women-affected-pelvic-floor-disorders

Smith, Christopher P. “Male chronic pelvic pain: An update.” Indian journal of urology: IJU: journal of the Urological Society of India vol. 32,1 (2016): 34-9. doi:10.4103/0970-1591.173105

World Health Organization. (2013) “Low back pain” www.who.int/medicines/areas/priority_medicines/Ch6_24LBP.pdf