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.
Muscle knots or trigger points are tissues/segments of muscle fibers stuck in a contracted state and balled up or become entangled. To the touch, they can feel like small bumps, nodules, or knots. They are primarily found in muscles, but they can also be found in tendons, fascia, periosteum, and ligaments. Tight muscles can limit flexibility, increase discomfort and pain symptoms, and cause further injury that can develop into chronic conditions. Trigger points can develop in all muscles and multiple muscles simultaneously. The Injury Medical Chiropractic and Functional Medicine Team can create a personalized treatment plan for trigger point alleviation.
Muscle Knots Trigger Points
When muscle fibers are stuck in contraction, blood circulation decreases in and around the affected area, and the necessary nutrients and oxygen cannot be delivered. The excessive accumulation of the chemicals – acetylcholine, and calcium leads to a lack of oxygen in the area, which causes muscle fiber contraction and spasms. As the muscle fibers overly contract, they form a knot. Waste materials build up in the fibers as the blocked circulation doesn’t allow removal. This irritates the trigger point, which reacts by sending out pain signals. The brain responds by telling the body not to use that muscle, causing the muscle to tighten, become weak, and lose range of motion. The other muscles have to work harder to compensate.
Trigger Point Types
Active and Latent
One type is an active trigger point.
The trigger point causes pain and discomfort even when the muscle or tissue rests.
The other type is latent, which means that the point does not cause pain or is sometimes even noticed until pressure is applied to the point or area.
Because key trigger point muscles are weakened, the muscles around that point need to work harder, causing multiple knots to form.
Referred pain happens when a satellite trigger point causes sensations in a different area from the point itself.
Causes
The main causes include the following:
Direct Trauma
Muscle trauma or injury can cause fibers not to heal properly, causing segments to stay deprived of oxygen and knotted.
Excessive and Extended Exercising
During exercise/physical activity, profound muscle strain and injury can occur from pushing too hard for too long without proper recovery and repair.
Maintaining Healthy Posture
Unhealthy postures can cause tension, stiffness, and aches and pains.
Stress and Fatigue
Emotional and physical stress takes a toll on the body, which can result in excessive muscle contraction.
Most of the time, it happens subconsciously without realizing that the body is tensing up.
This is why engaging in relaxation activities, including therapeutic massage, is important.
Inactivity
Lack of physical activity and a sedentary lifestyle can cause muscle spasms and over-contracting, leading to muscle knots.
Medical Conditions
Conditions that affect muscles, like arthritis and fibromyalgia or medications, can cause muscle spasms and the development of trigger points.
Chiropractic and Massage Therapy
Chiropractic and therapeutic massage is an effective treatment to relieve muscle knots and symptoms and restore the body to optimal function. Massage uses various techniques to increase blood circulation, break down inflexible scar tissue and stretch and loosen muscles. Pain and discomfort decrease by allowing the muscles to move and restoring blood flow.
Massage Therapy Chiropractic Care
References
Barbero, Marco, et al. “Myofascial pain syndrome and trigger points: evaluation and treatment in patients with musculoskeletal pain.” Current Opinion in Supportive and palliative care vol. 13,3 (2019): 270-276. doi:10.1097/SPC.0000000000000445
Cheung, Karoline, et al. “Delayed onset muscle soreness: treatment strategies and performance factors.” Sports medicine (Auckland, N.Z.) vol. 33,2 (2003): 145-64. doi:10.2165/00007256-200333020-00005
Money, Sarah. “Pathophysiology of Trigger Points in Myofascial Pain Syndrome.” Journal of Pain & palliative care pharmacotherapy vol. 31,2 (2017): 158-159. doi:10.1080/15360288.2017.1298688
Moraska, Albert F et al. “Responsiveness of Myofascial Trigger Points to Single and Multiple Trigger Point Release Massages: A Randomized, Placebo-Controlled Trial.” American Journal of physical medicine & Rehabilitation vol. 96,9 (2017): 639-645. doi:10.1097/PHM.0000000000000728
Weerapong, Pornratshanee, et al. “The mechanisms of massage and effects on performance, muscle recovery, and injury prevention.” Sports medicine (Auckland, N.Z.) vol. 35,3 (2005): 235-56. doi:10.2165/00007256-200535030-00004
The hamstring muscles attach, through a tendon called the proximal hamstring tendon, to the ischial tuberosity, the bones used to sit deep in the buttock muscles. When the tendon is subjected to overuse/repetitive stresses and strains, the internal structure can become compromised, leading to weakness and pain symptoms. This is known as proximal hamstring tendinopathy. Tendinopathy is an overuse injury where the tendon is repeatedly strained until microscopic tears form. It is common in athletes that do a lot of running but also in individuals that sit for prolonged periods. If left untreated, high hamstring tendinopathy can lead to progressive degeneration of the tissues, leading to chronic weakness, pain, and dysfunction.
High Hamstring Tendinopathy
The hamstrings are a powerful muscle group that extends the hip and flexes the knee. They experience stress and pressure during activity and inactivity/sitting and are susceptible to strain injuries. Tendons attach muscle to bone and are designed to take compressive and tensile weight/loads that stretch or flex. A tendon is made up of fibrous tissue containing organized type 1 collagen. Tendons receive blood; however, the supply is less where the tendon attaches to the bone and is commonly where tendinopathy occurs.
Injury
A hamstring injury involves the bruising, irritation, or tearing of the hamstring tendon or muscle tissue. Severity can range from:
Microtears that cause stiffness and pain symptoms but heal fast on their own.
Severe ruptures that cause debilitating pain, dysfunction and require medical intervention.
The tendon attaches to the ischial tuberosity or sitting buttock bone. Tendons can have a spasm-like reaction to sudden or quick shift changes. A sudden change can cause adverse changes to the tendon. Too much load on the tendon beyond its ability to recover can cause the structure to change and the collagen to break down/tear like a rope tearing and unraveling. High hamstring tendinopathy happens around the hip area and presents as buttock or upper thigh pain. Individuals report deep, dull, radiating buttock pain during walking, running, and prolonged sitting or driving. Sometimes the sciatic nerve can become irritated or entrapped by an affected tendon’s scar tissue, causing sciatica-like symptoms.
Stages of Tendon Pathology
Reactive Phase
Caused by an acute overload of physical activity or inactivity.
The tendon will thicken temporarily to decrease the stress; however, there may be no inflammation.
The tendon can return to normal if the load is reduced or sufficient time for recovery and repair is allowed.
Disrepair
Chronically overloaded.
Unsuccessful healing.
More negative tendon changes occur.
Reversibility is possible with load management and targeted exercises to stimulate the tendon and surrounding tissues.
Degenerative
Continual progression of adverse tendon changes.
More common in older individuals.
Continue load management and strength training to maximize the tendon’s tolerance.
Chiropractic Treatment
A chiropractic therapy team will develop a personalized treatment program to improve tendon structure and strengthen the hamstrings, gluteal, and side abdominal muscles. They will begin with tendon symptom-relieving massage to loosen the muscles and get the blood circulating, MET-targeted stretches to lengthen the muscles, and spinal and pelvic adjustments to realign the body.
Sciatica Explained
References
Buckley, Mark R et al. “Distributions of types I, II and III collagen by region in the human supraspinatus tendon.” Connective tissue research vol. 54,6 (2013): 374-9. doi:10.3109/03008207.2013.847096
Lempainen, Lasse, et al. “Expert opinion: diagnosis and treatment of proximal hamstring tendinopathy.” Muscles, ligaments, and tendons journal vol. 5,1 23-8. 27 Mar. 2015
Mattiussi, Gabriele, and Carlos Moreno. “Treatment of proximal hamstring tendinopathy-related sciatic nerve entrapment: presentation of an ultrasound-guided “Intratissue Percutaneous Electrolysis” application.” Muscles, ligaments, and tendons journal vol. 6,2 248-252. 17 Sep. 2016, doi:10.11138/mltj/2016.6.2.248
Ono, T et al. “Estimation of tensile force in the hamstring muscles during overground sprinting.” International Journal of sports medicine vol. 36,2 (2015): 163-8. doi:10.1055/s-0034-1385865
White, Kristin E. “High hamstring tendinopathy in 3 female long-distance runners.” Journal of chiropractic medicine vol. 10,2 (2011): 93-9. doi:10.1016/j.jcm.2010.10.005
Wilson, Thomas J et al. “Sciatic Nerve Injury After Proximal Hamstring Avulsion and Repair.” Orthopedic Journal of sports medicine vol. 5,7 2325967117713685. 3 Jul. 2017, doi:10.1177/2325967117713685
When it comes to the body, the lower portion has three compartments of muscles that work together to provide stability and mobility to the host when they are in motion. The anterior, posterior, and lateral compartments have numerous muscles, tissues, and ligaments that support the spine and allow the musculoskeletal system to do various movements without pain. When normal factors affect the body, it can cause symptoms of overlapping risk profiles that can lead to musculoskeletal pain disorders associated with pain-like symptoms in the joints and muscles. Today we will look at one of the muscle compartments known as the postural muscles, how postural pain affects the body, and how manual therapy combined with the MET technique can improve the postural muscles. We mention valuable information about our patients to certified medical providers who use methods like the MET combined with manual therapy to reduce pain-like symptoms associated with musculoskeletal disorders. We encourage patients by referring them to our associated medical providers based on their findings. We support that education is a marvelous way to ask our providers the most interesting questions at the patient’s acknowledgment. Dr. Alex Jimenez, D.C., incorporates this information as an educational service. Disclaimer
What Are The Postural Muscles?
Are you experiencing muscle stiffness in your lower back? What about aches and pain in your shoulders and neck? Or have you noticed your legs feel heavy after sitting down for a long time? Many of these issues are associated with the postural muscles that are causing pain to the musculoskeletal system. So what are the postural muscles in the musculoskeletal system? Well, they are the core muscles that are deep within the abdomen, pelvis, and back. Research studies reveal that the curvature of the spine (cervical, thoracic, and lumbar regions) communicates and works with the central nervous system and musculoskeletal system to provide balance, support, and resistance against pressure on the body. The postural muscles are important in the body as they ensure the host has perfect posture when walking, sitting, or standing. Additional studies mentioned that good postural and stability control are the fundamentals for motor skills. When a person has good postural control, it can help give them a stable gait when walking. However, as the body ages, the postural muscles can become weak and lead to muscle strain while affecting the joints and tendon structures.
The Effects Of Postural Pain In The Body
So what happens to the body when dealing with pain in the postural muscles, and how does it affect one’s posture? Research studies reveal that reducing back muscle endurance from prolonged sitting, slouching, or constantly looking down can cause muscle strain symptoms in the postural muscles. To that point, it can lead to increased development of low back pain and lumbar discomfort in the joints. As stated earlier, other factors like slouching, prolonged sitting, and constantly looking down can affect the lower back, shoulders, and neck. The various muscles that make up the shoulders and neck would become strained and tensed, leading to shoulder and neck pain that can cause discomfort. When these overlapping symptoms affect the body, it can cause many overlapping symptoms that can overlap and cause the individual to be miserable.
How Neck Injuries Affect The Body- Video
Have you been experiencing any muscle strain in your neck, shoulders, or lower back? Does stretching bring temporary relief? Or have you been dealing with heaviness in your legs? Many of these factors are associated with weak postural muscles that can contribute to poor posture, low back and neck pain, and other musculoskeletal issues. The video above explores the common causes and symptoms of neck injuries and how treatments like chiropractic care can help alleviate the symptoms. Treatments like chiropractic care utilize manual manipulation and various techniques to help realign the body and reduce any musculoskeletal disorders associated with pain. Chiropractic care is non-invasive and works with other medical professionals to restore the body naturally.
Manual Therapy & MET On Postural Muscles
So what can one do when dealing with postural pain and trying to find relief? Many individuals go to treatments like chiropractic care, which can allow the body to be realigned and restored naturally. Treatments like chiropractic care can help restore good posture in the spine while relieving and reducing excess pain and strain on the various muscles, tendons, and joints. Additionally, chiropractors use techniques like the MET technique to reduce stress on the soft tissues and restore the joint’s range of motion. According to the book, “Clinical Applications of Neuromuscular Techniques,” Leon Chaitow N.D., D.O., and Judith Walker DeLany L.M.T., stated that muscle restoration is accompanied by biomechanical solutions and strategies that are introduced to the body and become a key focus on the muscles that required strengthening, enhancing, and improve breathing and posture function. When therapists like chiropractors and massage therapists use the MET technique, the affected muscles can be stretched and strengthened while restoring the structural and functional imbalances the body has endured. This can help improve postural muscles while allowing the body to heal naturally. This allows the individual to be mindful of how they present themselves with good posture.
Conclusion
Overall, the body requires the postural muscles to help stabilize and keep the body mobile. When musculoskeletal disorders associated with pain started to affect the muscles through bad posture or other normal factors, it can cause these muscles to be weak and develop musculoskeletal conditions that can lead many individuals to constant pain. Luckily therapies like chiropractic care combined with the MET technique allow the affected muscles to be stretched and strengthened. This allows the body to be realigned and restored naturally. Incorporating stretching combined with chiropractic care can help many individuals be mindful of their posture and enable them to continue their health and wellness journey without pain.
References
Carini, Francesco, et al. “Posture and Posturology, Anatomical and Physiological Profiles: Overview and Current State of Art.” Acta Bio-Medica : Atenei Parmensis, U.S. National Library of Medicine, 28 Apr. 2017, www.ncbi.nlm.nih.gov/pmc/articles/PMC6166197/.
Chaitow, Leon, and Judith Walker DeLany. Clinical Applications of Neuromuscular Techniques. Churchill Livingstone, 2003.
Jung, Kyoung-Sim, et al. “Effects of Prolonged Sitting with Slumped Posture on Trunk Muscular Fatigue in Adolescents with and without Chronic Lower Back Pain.” Medicina (Kaunas, Lithuania), U.S. National Library of Medicine, 23 Dec. 2020, www.ncbi.nlm.nih.gov/pmc/articles/PMC7822118/.
Ludwig, Oliver, et al. “Neuromuscular Performance of Balance and Posture Control in Childhood and Adolescence.” Heliyon, U.S. National Library of Medicine, 31 July 2020, www.ncbi.nlm.nih.gov/pmc/articles/PMC7398941/.
Healthy posture and movement are essential for everyone, but especially for mothers-to-be. Practicing healthy posture is one of the most important contributions to a healthy pregnancy. Proper body alignment decreases low back and neck discomfort symptoms and muscle fatigue. A chiropractic therapy team can educate on maintaining a healthy posture when standing, sitting, and lying down throughout pregnancy, alleviate any subluxations, maintain optimal alignment, and keep the muscles relaxed through massage techniques.
Pregnancy Posture
Many changes occur in the musculoskeletal system during pregnancy for the growing fetus. This impacts posture, balance, and gait. Pregnancy posture can significantly influence the comfort and/or pain levels in the pregnant and postnatal body. This includes:
Sleeping in the best position while pregnant.
Sitting in the best position during pregnancy.
These little changes and adjustments impact the health of the mother and baby.
Postural Changes During Pregnancy
During pregnancy, several factors work against maintaining correct and healthy alignment. For one, the baby’s weight causes the lower back to sway as the center of gravity shifts forward.
Increased Lumbar Lordosis
The concave curvature in the spine can become more pronounced because of the forward pull of the growing fetus.
The normal slight forward curvature of the spine in the neck or cervical area is called cervical lordosis.
The growing fetus aggravates the forward pull on the neck.
During pregnancy, the breasts grow, adding more weight to the thoracic or mid back, causing the neck curvature to get pulled forward and down.
Both shoulders also move forward and inward.
These changes can lead to back problem symptoms/pain, sciatica, and other musculoskeletal disorders and conditions if left untreated.
Unhealthy Posture Happens Naturally
The abdominal muscles become stretched as the baby grows.
Hormone levels increase and cause joints and ligaments to loosen.
The muscles cannot contract fully and keep the lower back in alignment.
Healthy Posture Requires Practice
Standing
Proper posture when standing. From top to bottom:
Maintain a neutral gaze that looks straight ahead.
Don’t bend the head too much forward or backward.
Avoid twisting/bending movements whenever possible, or keep them to a minimum.
The chest should be up, the core braced, and the shoulders back.
The body weight is distributed evenly along the lower extremities.
Contract abdominal and pelvic floor muscles during movements, as they support the stability of the pelvis and the trunk.
When standing and having to hold the position for an extended period, use a box or stool to prop up one foot.
For example, when washing dishes, the cabinet under the sink can rest the foot on the ledge.
Switch position every 20 to 30 minutes.
Chiropractic
Whether in the planning stages or the second or third trimester, it’s essential to keep postural health in mind. A chiropractor trained in the needs of pregnant women will use tables that adjust for a pregnant woman’s body, and they will use techniques that avoid unneeded pressure on the abdomen and provide safe exercises and stretches. Benefits of chiropractic include:
Helps maintain a healthier pregnancy.
Helps regulate symptoms of nausea.
Relieves back, neck, discomfort symptoms, and pain.
Relieves and reduces excess strain on muscles, ligaments, and joints.
Spinal curvature exaggeration is corrected.
The normal spine curvatures are restored and maintained.
As more women seek the benefits of chiropractic for pregnancy, more healthcare providers seek trained doctors of chiropractic to refer their pregnant patients. Discuss these options with your healthcare provider, and schedule a visit to Injury Medical Chiropractic and Functional Medicine Clinic to check posture and biomechanics.
Chiropractic Pregnancy Treatment
References
Bauer, A W. “NEUE GESICHTSPUNKTE UEBER HALTUNG UND ERNAEHRUNG WAEHREND DER SCHWANGERSCHAFT” [NEW VIEWPOINTS ON POSTURE AND NUTRITION DURING PREGNANCY]. Wiener medizinische Wochenschrift (1946) vol. 113 (1963): 875-6.
Fitzhugh, M L, and M NEWTON. “Posture in pregnancy.” American Journal of Obstetrics and Gynecology vol. 85 (1963): 1091-5. doi:10.1016/s0002-9378(16)35644-7
Gutke A, Ostgaard HC, Oberg B Spine (Phila Pa 1976). 2006 Mar 1; 31(5):E149-55. Pelvic girdle pain and lumbar pain in pregnancy: a cohort study of the consequences in terms of health and functioning.
Schröder, Guido et al. “Impact of pregnancy on back pain and body posture in women.” Journal of physical therapy science vol. 28,4 (2016): 1199-207. doi:10.1589/jpts.28.1199
Yoo, Hyunju, et al. “Changes in the spinal curvature, degree of pain, balance ability, and gait ability according to pregnancy period in pregnant and nonpregnant women.” Journal of physical therapy science vol. 27,1 (2015): 279-84. doi:10.1589/jpts.27.279
The various muscle groups in the body allow the host to move around and function through many actions without feeling any discomfort or pain. The body has two sections: upper and lower portions that have different functions, from turning the neck from side to side to allowing the legs to enable the body to move around. When various issues or factors begin to affect the body over time, like muscle injuries or normal factors like poor posture and prolonged sitting, it causes overlapping risk profiles that can lead to chronic musculoskeletal conditions. When musculoskeletal disorders affect the body, it can lead to muscle and joint pain that can cause misalignment in the spine and cause the muscle fibers to become short and tense. Luckily there are available treatments that allow the body to realign itself and stretch those short muscles. Today’s article looks at how muscle pain affects the body and how different variations of the MET technique are used to reduce and stretch muscle pain. We mention and provide valuable information about our patients to certified medical providers who use techniques like the MET and therapy for individuals with muscle strain associated with body pain. We give encouragement to patients by referring them to associated medical providers based on their diagnostic findings. We support that education is a marvelous way to ask our providers the most interesting questions at the patient’s acknowledgment. Dr. Alex Jimenez, D.C., incorporates this information as an educational service. Disclaimer
How Does Muscle Pain Affect The Body?
Have you been dealing with muscle strain or pain in different body areas? Are you experiencing any referred pain in other body locations? Or are your muscles feeling extremely tight that it is causing you pain? When the body is dealing with various issues that are causing the muscle fibers to be tensed, it can lead to muscle pain and cause many people to suffer. Studies reveal that muscle pain is caused when painful conditions like mechanical forces, ischemia, and inflammation stimulate the body’s free nerve endings. Many of these factors also correlate with musculoskeletal disorders like fibromyalgia and myofascial pain that can develop trigger points (palpable, small nodules) in the muscle fibers to cause the muscles to become stiff and contract. Additional studies also reveal that when the muscles begin to cramp up, especially the calves, it can become extremely painful and involuntary as it affects the entire muscle group, the muscle itself, or any selected muscle fibers. This causes the individual to be in pain in an acute setting as the muscle relaxes; however, if the muscle fibers are still in constant contraction, it can lead to chronic issues that affect the muscle group.
Overcoming Pain With Chiropractic Care-Video
Regarding muscle pain in the body, studies reveal that the nociceptive nerve endings in the muscles and tissue fibers can cause the neuron signals from the central nervous system to become hyperexcitable, and hyperactivity can lead to muscle pain. This causes the muscle group and the surrounding muscles to tense and invokes pain when in motion. To that point, it can cause the individual dealing with muscle pain to try and find various treatments to alleviate the pain and continue their lives. When it comes to pain can be relieved through treatments like chiropractic care and massage therapy to reduce the effects of the muscle pain associated with musculoskeletal disorders. The video above explains how treatments like chiropractic care incorporate different techniques to realign the body from subluxation and help stretch the tight, short muscles using manual manipulation and the MET technique.
Variations Of The MET Technique
When the muscles in the musculoskeletal system are dealing with pain in different locations or one location in the body, it can cause the individual to be in constant pain. Luckily treatments like chiropractic care are non-invasive and therapeutic as they utilize different techniques to realign the spine and stretch the tight muscle groups. In “Clinical Applications of Neuromuscular Techniques,” written by, Leon Chaitow, N.D., D.O., and Judith Walker DeLany, L.M.T., stated that when muscle pain affects tone muscle or causes structural changes to the joint’s ROM (range of motion) can lead to shortness and stress to the muscle group. Studies reveal that MET is a stretching technique therapists use to contract the affected muscle in a precisely controlled direction voluntarily. Many stretch variations of the MET technique allow the muscles to be stretched, strengthening and improving local circulation while mobilizing joint restriction. Down below are some of the variations of stretching techniques with MET.
Isometric Contraction: Reciprocal Inhibition In Acute Setting
The isometric contraction technique is used for reciprocal inhibition in an acute setting where the affected muscles are dealing with symptoms of muscle spasms. The isometric contraction allows the therapist to help relax acute muscular spasms and mobilize restricted joints while preparing the joints for manipulation.
Starting point: When acute muscles or joint problems affect the body’s functionality, therapists must commence an easy restriction barrier.
Modus Operandi: The affected muscles are used in an isometric contraction, allowing the short muscle to relax.
Forces: The therapist and individual forces are matched and involve 20% of the individual’s strength to increase no more than 50%.
Duration: Initially7-10 seconds while increasing up to 20 seconds.
Action following contraction: The area of the muscle and joint are taken to a new restricted barrier without stretching after complete relaxation. Therapists should perform the movement to a new restricted barrier on exhalation.
Repetitions: Repeat three to five times until no further gain in the range of motion is possible.
Isometric Contraction: Post-isometric Relaxation In Chronic Setting
The isometric contraction technique is used for post-isometric relaxation in a chronic setting where the muscles are severely contracted. The isometric contraction technique is known as post-facilitation stretching, where therapists stretch chronic or subacute restricted, fibrotic, contracted soft tissues or muscle tissues affected by myofascial trigger point pain.
Starting point: Short of resistance barrier
Modus Operandi: The affected muscles are used in the isometric contraction that allows the shortened muscles to relax and let an easier stretch.
Forces: Both the therapist and individual forces match and increase about 30% of the patient’s strength and increase to 50% of contractions up to 20 seconds.
Duration: Initially 7-10 seconds and increasing up to 20 seconds.
Action following contraction: The rest period is 5 seconds so the body can relax completely before being stretched, and during exhalation, the muscle goes through a painless, new restriction barrier position that is held for at least 10-60 seconds.
Repetitions: Repeat three to five times.
Isotonic Eccentric Contraction
The isotonic eccentric contraction is an isolytic technique to strengthen weak postural muscles that are tensed or tight from prolonged sitting or poor posture.
Starting point: At the restriction barrier
Modus Operandi: When the muscle is contracted and prevented, the therapist uses this technique to slowly overcome and reverse the contracting muscle so it can be stretched to full resting length.
Forces: Therapists use greater forces on the individual and build up subsequent contractions for the affected muscle (*Utilize this stretch on individuals who are not dealing with osteoporotic issues in their muscles and joints)
Duration: Five to seven seconds
Repetitions: Repeat three to five times if discomfort is not excessive.
Isokinetic
The isokinetic technique is a combination of isotonic and isometric contractions that many pain specialists like chiropractors and massage therapists use to tone weakened musculature, build strength in all the surrounding muscles that are involved in a particular joint function, and help train and balance the effects on the body’s muscle fibers.
Starting point: Easy mid-range position
Modus Operandi: The individual uses moderate resistance as the therapist puts the joint through a rapidly full range of movement as this technique is different than simple isotonic exercises, and resistance varies from each person. This technique progressively increases as the procedure progress.
Forces: The therapist uses moderate forces to prevent movement from the individual and then progresses to full forces.
Duration of contraction: Up to four seconds.
Conclusion
Different stretching techniques in MET therapy allow the affected muscles to be stretched and lengthened while reducing muscle pain affecting a body’s location. It is important to be mindful of the movements that can cause the muscles to be overstretched or cramped up, which can cause pain. Treatments incorporating these various stretching techniques allow the affected muscles to relax and restore naturally.
Chaitow, Leon, and Judith Walker DeLany. Clinical Applications of Neuromuscular Techniques. Churchill Livingstone, 2003.
Faqih, Anood I, et al. “Effects of Muscle Energy Technique on Pain, Range of Motion and Function in Patients with Post-Surgical Elbow Stiffness: A Randomized Controlled Trial.” Hong Kong Physiotherapy Journal : Official Publication of the Hong Kong Physiotherapy Association Limited = Wu Li Chih Liao, U.S. National Library of Medicine, June 2019, www.ncbi.nlm.nih.gov/pmc/articles/PMC6467834/.
Gregory, Nicholas S, and Kathleen A Sluka. “Anatomical and Physiological Factors Contributing to Chronic Muscle Pain.” Current Topics in Behavioral Neurosciences, U.S. National Library of Medicine, 2014, www.ncbi.nlm.nih.gov/pmc/articles/PMC4294469/.
Mense, Siegfried. “The Pathogenesis of Muscle Pain.” Current Pain and Headache Reports, U.S. National Library of Medicine, Dec. 2003, pubmed.ncbi.nlm.nih.gov/14604500/.
An acute injury or changes to the upper body over time can cause a compressed/pinched nerve in the shoulder. A pinched nerve in the shoulder happens when a muscle, ligament, tendon, or bone irritates or presses on a nerve exiting the neck. Shoulder nerve pain can develop from various sources, such as overuse work injuries, sports injuries, household chores, tendinitis, arthritis, torn cartilage, and other medical conditions, and injuries can contribute to symptoms. Chiropractors are highly qualified to treat pinched nerves. They are trained in whole-body realignment and rehabilitation techniques that find the root source and relieve pressure on compressed nerves.
Shoulder Nerve Pain
The shoulder joint is one of the most complex joints because of its wide range of motion. It is used so frequently that repetitive motion strain is common, often leading to injury. It is usually because of the continued use combined with an unhealed strain/injury that leads to shoulder nerve injury or when surrounding tissues like cartilage or tendons irritate or compress the nerves.
Pinched nerves also occur when a nerve root in the neck is damaged through wear and tear or an acute injury.
Individuals 50 years and older are likely to experience pinched nerves because of degeneration in the cervical spine and/or arthritis.
A nerve can become pinched when bone spurs form around the spinal discs.
Bone spurs are formations of bone that grow when discs weaken with age.
Bone spurs grow around the discs putting pressure on the nerve root.
Symptoms
Compressed Pinched Nerve/Cervical Radiculopathy
Pain sensations in the shoulder.
Tingling and/or pins and needles in fingers or hand.
Weakness in shoulder and arm muscles.
Symptoms have been known to overlap with shoulder arthritis, frozen shoulder, swimmer’s shoulder, or rotator cuff tears, so it’s always best to consult a chiropractor to understand possible causes. Other conditions with symptoms to compare:
Shoulder Arthritis
Stiffness in the joint.
Aching inside the shoulder.
Grinding when moving the joint.
Frozen Shoulder/Adhesive Capsulitis
Stiffness in the joint.
Pain in one shoulder.
Decreased range of motion and movement.
Swimmer’s Shoulder/Impingement
Pain and discomfort in the shoulder.
Weakness in the surrounding area.
Stiffness or tightness in the joint.
Impeded range of motion.
Rotator Cuff Tears
Pain and discomfort symptoms when moving the shoulder.
Weakness in the arm.
Deep aching sensations along the top and side of the joint.
Chiropractic Treatment
Chiropractors are experts on the neuromusculoskeletal system. First, a thorough medical examination will be conducted, including health history and regular activities, to understand the nature of the symptoms. Depending on the type of injury, tests, and exams may be needed to help diagnose and pinpoint the cause. Then the chiropractor will develop a personalized treatment plan. The objective is to relieve pressure and tension on the nerves and relax the muscles. In addition to adjusting the joint or other impacted areas, the therapy team will provide at-home exercises and stretches to maintain the adjustments and expedite healing.
Chiropractic Rehab
References
Kokkalis, Zinon T et al. “Nerve Injuries around the Shoulder.” Journal of long-term effects of medical implants vol. 27,1 (2017): 13-20. doi:10.1615/JLongTermEffMedImplants.2017019545
Leider, Joseph D et al. “Treatment of suprascapular nerve entrapment syndrome.” Orthopedic reviews vol. 13,2 25554. 11 Jul. 2021, doi:10.52965/001c.25554
Matzkin, Elizabeth, et al. “Swimmer’s Shoulder: Painful Shoulder in the Competitive Swimmer.” The Journal of the American Academy of Orthopaedic Surgeons vol. 24,8 (2016): 527-36. doi:10.5435/JAAOS-D-15-00313
Neviaser, Andrew S, and Jo A Hannafin. “Adhesive capsulitis: a review of current treatment.” The American Journal of sports medicine vol. 38,11 (2010): 2346-56. doi:10.1177/0363546509348048
Safran, Marc R. “Nerve injury about the shoulder in athletes, part 1: suprascapular nerve and axillary nerve.” The American Journal of sports medicine vol. 32,3 (2004): 803-19. doi:10.1177/0363546504264582
Strakowski, Jeffrey A, and Christopher J Visco. “Diagnostic and therapeutic musculoskeletal ultrasound applications of the shoulder.” Muscle & Nerve vol. 60,1 (2019): 1-6. doi:10.1002/mus.26505
Shoulder and neck discomfort, pain, and headaches could be caused by vision problems and eye strain that require corrective glasses, contact lenses, or an updated prescription. Spending long periods of activity involving eye usage, like driving, reading/writing reports, studying plans, instructions, reviewing charts, orders, etc., on mobile devices and computer screens fatigues the eyes. Individuals with tired eyes try to reduce eye strain by tilting their head or neck and hunching forward, which results in an unhealthy posture. And for individuals that need glasses squinting and straining the eyes also leads to unhealthy postures, directly contributing to neck and shoulder pain and headaches. Injury Medical Chiropractic and Functional Medicine Clinic can repair and heal musculoskeletal injuries and refer patients to the proper specialist, in this case, an eye care professional.
Vision Problems
Like any muscle, the eyes can be overworked, causing unconscious tensing of the neck, upper back, and shoulder muscles, leading to muscle tension in the back of the skull. The tense muscles can cause blood flow and circulation restriction. Individuals compensate by tilting the head towards one shoulder, craning the neck, or leaning/hunching. This can help for a little while but does not relieve muscle soreness, headaches, or migraines, as well as the throbbing around the temples or the fact that it will keep happening. Individuals learn to live with the pain and push through it. This is unhealthy and can lead to serious, chronic musculoskeletal conditions that can cascade into other health problems. For individuals, the symptoms they are experiencing are common in conditions they may have been previously or currently diagnosed with, including:
Neck Strain
The risk of neck strain or injury comes with the overuse of the neck muscles and tendons.
This results in neck pain, tenderness, and a decreased range of motion.
With vision problems, individuals have additional stress on their neck muscles as they tilt their heads to relieve the discomfort.
Neck Muscle Spasms
When the muscles in the neck involuntarily tighten, it can cause sharp or sudden pain; this is referred to as a muscle spasm.
Individuals can experience muscle spasms for minutes, hours, or even days.
Constantly tilting the head to one side to realign vision can cause overuse and strain on the neck muscles, resulting in muscle spasms.
Torticollis/Wry Neck
With torticollis, individuals will likely have a head tilt and experience neck muscle tenderness, stiffness, and pain.
Chiropractic Treatment
Chiropractors are experts in relieving discomfort symptoms and restoring the neuromusculoskeletal system to optimal function. They help reduce inflammation and muscle spasms through heat, cold, stretches and exercises, and electrical stimulation to expedite healing. They also retrain individuals on posture training eliminating the need to tilt the head and being more aware of body positioning.
As primary care doctors, chiropractors can refer their patients to specialists.
Chiropractors work with a wide range of medical professionals, depending on the needs of their patients.
When neck and shoulder discomfort and headaches become chronic and do not heal or improve, they could be vision problems.
By treating the vision misalignment, pressure can be relieved in the neck and shoulders, reducing and eliminating spasms.
Beyond Medicine
References
Bryans, Roland, et al. “Evidence-based guidelines for the chiropractic treatment of adults with headache.” Journal of manipulative and physiological therapeutics vol. 34,5 (2011): 274-89. doi:10.1016/j.jmpt.2011.04.008
Gowrisankaran, Sowjanya, and James E Sheedy. “Computer vision syndrome: A review.” Work (Reading, Mass.) vol. 52,2 (2015): 303-14. doi:10.3233/WOR-152162
Kaur, Kirandeep, et al. “Digital Eye Strain- A Comprehensive Review.” Ophthalmology and therapy vol. 11,5 (2022): 1655-1680. doi:10.1007/s40123-022-00540-9
Lodin, Camilla, et al. “Eye- and neck/shoulder-discomfort during visually demanding experimental near work.” Work (Reading, Mass.) vol. 41 Suppl 1 (2012): 3388-92. doi:10.3233/WOR-2012-0613-3388
Richter, Hans O. “Neck pain brought into focus.” Work (Reading, Mass.) vol. 47,3 (2014): 413-8. doi:10.3233/WOR-131776
Zetterberg, Camilla et al. “Neck/shoulder discomfort due to visually demanding experimental near work is influenced by previous neck pain, task duration, astigmatism, internal eye discomfort, and accommodation.” PloS one vol. 12,8 e0182439. 23 Aug. 2017, doi:10.1371/journal.pone.0182439
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