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Posture

Back Clinic Posture Team. Posture is the position in which an individual holds their body upright against gravity while standing, sitting, or lying down. A proper posture visually reflects an individual’s health, ensuring the joints and muscles, as well as other structures of the body, are working properly. Throughout a collection of articles, Dr. Alex Jimenez identifies the most common effects of improper posture as he specifies the recommended actions an individual should take to improve their stance as well as enhance their overall health and wellness. Sitting or standing incorrectly can happen unconsciously, but recognizing the issue and correcting it can ultimately help many individuals develop healthier lifestyles. For more information, please feel free to contact us at (915) 850-0900 or text to call Dr. Jimenez personally at (915) 850-0900.


Pectoralis Minor and Its Role in Posture Improvement

Pectoralis Minor and Its Role in Posture Improvement

For individuals dealing with posture problems causing neck, back, and shoulder pain, can pectoralis minor stretches designed to work these areas be a part of physical therapy or as regular exercises at home?

Pectoralis Minor and Its Role in Posture Improvement

Pectoralis Minor Muscle Stretches

The pectoralis minor is a small, triangular muscle situated deep to the pectoralis major in the anterior chest wall. It originates from the margins of the third to fifth ribs adjacent to the costochondral junction and connects to the coracoid process of the scapula. The pectoralis minor helps with posture, mobility, and shoulder stability and aids breathing. Muscle tightness can cause pain in the chest, shoulder, and neck and a restricted range of motion. Strain and injuries can occur during activities involving overhead movements or forceful pushing. Pectoralis minor stretches are designed to work these muscles that span the ribs and connect to the shoulder to help improve posture and relieve pain and chest weakness. They can help reduce muscle tightness and other conditions like thoracic outlet syndrome. (Kaur U. et al., 2023) (Wagner E. R. et al., 2023) Talk with a healthcare provider Before starting any exercise or stretching program.

Corner Pectoralis Stretch

A corner pec stretch is similar to a wall push-up, except the emphasis is on staying in a position that lengthens the chest muscles. It’s important to move the whole body as a unit and not bend.

  • Stand facing a corner with a relaxed, upright posture.
  • Place your feet so they are parallel, and bend your knees slightly.
  • Stay as relaxed as possible during the movement to protect your joints.
  • Keep your gaze forward.
  • Place your forearms and palms over the walls where two walls connect at a right angle.
  • With your elbows bent to 90 degrees, move forward into the corner of the wall until you feel a comfortable stretch in the pectorals.
  • Keep the hips straight.
  • Hold the position for up to 30 seconds.
  • Return to starting position.
  • If you need a deeper stretch, move the arm position up or down. (University of North Carolina School of Medicine, 2020)

Doorway Stretch

The doorway stretch is similar to the corner stretch. It works the pectoralis major and the minor muscles and helps with mobility. To perform: (Maryland Pain & Wellness Center, 2025)

  • Stand in a doorway with your feet placed together.
  • Place the palms and forearms on either side of the doorway.
  • Your elbows should be even with your shoulders and bend at a 90-degree angle.
  • Keep your back straight.
  • Take a step forward, leaning into the doorway.
  • You should feel the stretch in the muscle.
  • Repeat the stretch with the other foot.

Exercise and ergonomic changes to your chair or desk height can help improve posture and relieve muscle tightness. (Kaur U. et al., 2023)

T Stretch

The T stretch stretches the front of the chest and is done on the floor, typically with a foam roller placed directly under the spine. To perform: (OrthoCarolina, N.D.)

  • Lie down on your back with the foam roller aligned to the spine.
  • Make sure your head and tailbone are supported.
  • Open your arms straight out like a T.
  • Hold the position while stretching.

Y Stretch

The Y stretch is similar to the T stretch; both reduce chest muscle tightness and discomfort. To perform: (OrthoCarolina, N.D.)

  • Use the same foam roll position, lying on your back with the head and tailbone supported and aligned.
  • Stretch the arms out above your head, placing them into the shape of a Y.
  • Allow the chest muscles that connect to the arms to relax.

Studies have examined how quickly a prone scapular retraction can help stretch the back and shoulders. Results suggest the exercises must be performed longer before the pectoralis minor is lengthened to improve symptoms. (Dye J., Allyn M., & Frank C. 2024) However, further research is needed.

Health Conditions

Pectoralis minor stretches may be part of a personalized therapy program to improve mobility, posture, and/or breathing and sleep quality with health conditions that include:

Stretching and strengthening exercises can help improve their flexibility and function. Exercises can improve strength and function by standing or lying down, depending on the stretch.

Injury Medical Chiropractic and Functional Medicine Clinic

The pectoralis minor muscles are often overlooked in clinical examinations but can contribute to musculoskeletal pain and dysfunction. A healthcare provider can teach about stretches, how they can help, and whether they are safe for the individual’s injury and/or condition. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. The clinic can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.


Doorway Stretching Routine


References

Kaur, U., Shrestha, D., Hussain, M. A., Dalal, P., Kalita, M., Sharma, V., & Sharma, S. (2023). Prompt Impact of Muscle Energy Technique on Pectoralis Muscle Tightness in Computer Users: A Quasi-Experimental Study. Journal of Lifestyle Medicine, 13(2), 123–128. doi.org/10.15280/jlm.2023.13.2.123

Wagner, E. R., Gottschalk, M. B., Ahmed, A. S., Graf, A. R., & Karzon, A. L. (2023). Novel Diagnostic and Treatment Techniques for Neurogenic Thoracic Outlet Syndrome. Techniques in hand & upper extremity surgery, 27(2), 100–114. doi.org/10.1097/BTH.0000000000000419

University of North Carolina School of Medicine. (2020). Upper Body Stretching. www.med.unc.edu/htcenter/wp-content/uploads/sites/711/2020/04/Upper-Body-Stretching.pdf

Maryland Pain & Wellness Center. (2025). Stretches to Help with Strained Chest Muscles. Maryland Pain & Wellness Center Restoring Hope, Rebuilding Lives. www.marylandpainandwellnesscenter.com/blog/stretches-to-help-with-strained-chest muscles#:~:text=With%20your%20knees%20bent%20and,assist%20in%20deepening%20the%20stretch.

OrthoCarolina. (N.D.). Stretching Guide to Ease Tight Muscles. www.orthocarolina.com/storage/wysiwyg/stretching_guide_1.pdf

Dye, J., Allyn, M., & Frank, C. (2024). Is there an immediate effect on pectoralis minor length after performing a prone scapular retraction exercise using typical sets and repetitions in pain-free participants? Journal of bodywork and movement therapies, 40, 1014–1019. doi.org/10.1016/j.jbmt.2024.07.026

Chankavee, N., Amatachaya, S., Hunsawong, T., Thaweewannakij, T., & Mato, L. (2023). Effects of modified long stick exercise on hyperkyphosis, muscle imbalance, and balance control in elderly community-dwelling women with hyperkyphosis. Journal of back and musculoskeletal rehabilitation, 36(5), 1151–1162. doi.org/10.3233/BMR-220350

Liao, Y. X., Saiken, A., Chang, X., Guo, Y. F., Tan, Z., Deng, F., Meng, Q. L., Zhen, H., Li, Y. M., & Fang, B. M. (2025). Associations of fat, bone, and muscle indices with disease severity in patients with obstructive sleep apnea-hypopnea syndrome. Sleep & breathing = Schlaf & Atmung, 29(1), 82. doi.org/10.1007/s11325-024-03241-8

Thongchote, K., Chinwaro, U., & Lapmanee, S. (2024). Effects of scapulothoracic exercises on chest mobility, respiratory muscle strength, and pulmonary function in male COPD patients with forward shoulder posture: A randomized controlled trial. F1000Research, 11, 1284. doi.org/10.12688/f1000research.126832.2

Peroneal Tendon Damage: Causes and Treatment

Peroneal Tendon Damage: Causes and Treatment

Are individuals with high foot arches or participating in sports involving repetitive ankle motion at risk for developing peroneal tendon injuries?

Peroneal Tendon Damage: Causes and Treatment

Peroneal Tendon Injuries

The peroneal tendons connect the muscles of the outer side of the lower leg to the foot. They may be acute—occurring suddenly—or chronic—developing over time. The basic types of peroneal tendon injuries are tendonitis, tears, and subluxation.

Anatomy and Function

The two major peroneal muscles (peroneus longus and peroneus brevis) are outside the lower leg, next to the calf muscles. The peroneal tendons run along the outer side of the ankle and attach to the foot, connecting these muscles to bone. They help stabilize the ankle joint, point the foot downward (plantarflexion), and turn the foot outward (eversion). In normal gait, the motion of the peroneal muscles is balanced by the muscles that invert the foot or rock the foot inward from the ankle.​ The two peroneal tendons sit one on top of the other right behind the fibula (the smaller lower leg bone). This closeness can contribute to problems with the peroneal tendons, as they rub together behind the ankle.

Tendonitis

The most common problem is inflammation or tendonitis. The tendons are usually inflamed just behind the fibula bone at the ankle joint. This part of the fibula is the bump on the outside of the ankle, and the peroneal tendons are located just behind that bony prominence. Tendonitis can either result from repetitive overuse or an acute injury. Common symptoms of tendonitis include:

  • Pain behind the ankle
  • Swelling over the peroneal tendons
  • Tenderness of the tendons
  • Pain usually worsens if the foot is pulled down and inwards, stretching the peroneal tendons.
  • X-rays of the ankle are taken.
  • MRI may show inflammation and fluid around the tendons. (Walt J. & Massey P. 2023)

Typical treatment of peroneal tendonitis is accomplished by:

Ice application

  • Applying ice to the area can help reduce swelling and control pain.

Rest

  • Resting is important to allow the tendon to heal.
  • A supportive device (walking boot or ankle brace) or crutches can help in severe cases.
  • Braces and boots provide support, reduce tendons’ stress, and allow rest and inflammation to subside.

Anti-inflammatory Medications

  • Motrin or Aleve are anti-inflammatory and can reduce the swelling around the tendon.

Physical Therapy

  • Physical therapy can help restore normal ankle joint mechanics, help with swelling and pain relief, and correct strength imbalances.

Cortisone Injections

  • Cortisone injections are low-risk if administered to the area around the tendon and not more often than every three months.
  • Ultrasound guidance can help ensure the medication is injected into the correct area. (Walt J. & Massey P. 2023)

Tendon Tears

Tears can occur and are more likely to happen in the peroneus brevis tendon. Tears are believed to be the result of two issues with the tendon. One is the blood supply. Tears of the peroneus brevis tendon almost always occur in the area where the blood supply and nutrition of the tendon are the poorest.

The second issue is the closeness between the two tendons, causing the peroneus brevis tendon to be wedged between the peroneus longus tendon and the bone. (Saxena A., & Bareither D. 2001) Tears of the peroneus brevis tendon are often treated with the same treatments for tendonitis. About half of the tears diagnosed by imaging are found to be asymptomatic. For individuals who don’t find lasting relief from symptoms, surgery may be necessary. Surgical options for peroneal tendon tears (Dombek M. F. et al., 2001)

Tendon Debridement and Repair

  • During a tendon debridement, the damaged tendon and the surrounding inflammatory tissue are removed.
  • The tear can be repaired, and the tendon can be tubularized to restore its normal shape.

Tenodesis

  • A tenodesis is a procedure where the damaged area of the tendon is sewn to the normal tendon.
  • In this case, the damaged segment of the peroneal tendon is removed, and the ends left behind are sewn to the adjacent remaining peroneal tendon.
  • Tenodesis is often recommended for tears involving more than 50% of the tendon. (Castilho R. S. et al., 2024)

Depending on the surgical procedure, Recovery after surgery can take several weeks of restricted weight-bearing and immobilization. Following immobilization, therapy can begin. Recovery is usually six to 12 weeks, depending on the surgery, but a full return to sports and activities may take several months. Risks of surgery include infection, stiffness, skin numbness near the incision, persistent swelling, and persistent pain.

Injury Medical Chiropractic and Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.


The Difference of Using Custom Foot Orthotics


References

Walt, J., & Massey, P. (2025). Peroneal Tendon Syndromes. In StatPearls. www.ncbi.nlm.nih.gov/pubmed/31335074

Saxena, A., & Bareither, D. (2001). Magnetic resonance and cadaveric findings of the “watershed band” of the Achilles tendon. The Journal of foot and ankle surgery: official publication of the American College of Foot and Ankle Surgeons, 40(3), 132–136. doi.org/10.1016/s1067-2516(01)80078-8

Dombek, M. F., Orsini, R., Mendicino, R. W., & Saltrick, K. (2001). Peroneus brevis tendon tears. Clinics in podiatric medicine and surgery, 18(3), 409–427.

Castilho, R. S., Magalhães, J. M. B., Veríssimo, B. P. M., Perisano, C., Greco, T., & Zambelli, R. (2024). Minimally Invasive Peroneal Tenodesis Assisted by Peroneal Tendoscopy: Technique and Preliminary Results. Medicina (Kaunas, Lithuania), 60(1), 104. doi.org/10.3390/medicina60010104

Trapezius Self Massage: Relieve Neck and Shoulder Pain

Trapezius Self Massage: Relieve Neck and Shoulder Pain

Can individuals who sit for long hours daily prevent tight neck and shoulder muscles by improving their posture, regularly stretching, and massaging their trapezius muscles?

Trapezius Self Massage: Relieve Neck and Shoulder Pain

Trapezius Self Massage

The trapezius muscle is a triangle-shaped muscle in the upper back that starts at the base of the neck, spans the length of the upper shoulders, and extends into the middle back. This muscle’s main function is stabilizing and moving the scapula/shoulder blade. The trapezius also helps to move the head, neck, arms, shoulders, and torso, stabilizes the spine, and plays an important role in posture. Physical and mental stress can tighten the trapezius muscle, leading to neck and shoulder pain. Learning to perform a trapezius self-massage can ease tension and provide pain relief. (Domingo A. R. et al., 2017)

Anatomy

The trapezius consists of three parts in three different areas of the back. The bottom of the skull, across the shoulders, and down to the mid back. A trapezius self-massage focuses on the upper portion of the traps. This part is located at the top of the shoulders. To find the upper trapezius, cross one arm in front of your body so that you can place the palm on top of the other shoulder.

stock photo trapezius anatomy muscles isolated on white d illustration

For a trapezius self-massage, you need to know that there are two areas where your upper traps start and where the muscle connects to a bone. The first point is on the bottom of the skull, close to the center of the back of the skull. Start there with your fingers and trace the muscle down the back of the neck to where the shoulders widen. If you get lost, You can walk your fingers up or down the muscle on either side to relocate its origin at the base of the skull, the vertebra at the base of your neck that sticks out. This is C-7, another of the upper trapezius’s origin sites. (University of Washington Department of Radiology, 2025)

Massage Technique

Massage oil is optional but can hydrate the skin during a massage. You can perform the trapezius self-massage using your hands.

Start at the Base of The Neck

Choose one shoulder to work at a time.

  • Raise the arm on the opposite side of your body.
  • Reach this arm across your body and fold it around your neck so that your fingers rest at the back base of your neck.
  • Apply a decent amount of pressure to the muscle while moving your fingers in a circular motion.
  • The action is similar to kneading dough.
  • Massage this area at the base of your neck for about 30 seconds to start.
  • If this part of your muscle is sore, you can massage it longer.

Slowly Work Out Towards The End of The Shoulder

Once you have spent about 30 seconds massaging the muscle at the base of the neck, work your way out toward the end of your shoulder.

  • In close increments, in your fingers across the trapezius muscle, spending at least 30 seconds at each point.
  • Follow the muscle until you reach the end of the shoulder.
  • Apply enough pressure, and use slow, rhythmic movements so that you feel relief.
  • If the pressure is not relieving or makes you wince, it’s too much.

Repeat as Needed

Repeat each side two to three times before switching to the other shoulder. After massaging, you may notice a certain trapezius area is particularly sore or tense. Zero in on those areas a little longer. Remember to relax throughout the trapezius self-massage. This is an opportunity to learn where tension is in your neck and shoulders and how to apply pressure to relieve it. This knowledge can also help you be mindful throughout your day, whether sitting, doing chores, or other physical activities. If you notice scrunching or slouching, massage the trapezius and remind yourself to keep your shoulders relaxed.

Benefits

Tension and tightness in the trapezius muscle are common, particularly among individuals who work in an office, do manual labor, or deal with a lot of stress. (Marker R. J. Campeau S., & Maluf K. S. 2017) Trapezius strains are a common overuse injury that is more likely to happen when the muscle is tight. (Salavati M. et al., 2017) The injury can cause unhealthy posture to avoid the pain. This poor posture will place more stress on the muscles, leading to a cycle of poor posture and chronic pain. A trapezius self-massage can benefit in many ways, including:

  • Improved blood circulation
  • Better quality of sleep
  • Improved posture
  • Improved range of motion
  • Decreased swelling
  • Faster recovery after workouts
  • Reduced risk of injury

Seeing a Healthcare Provider

Like any other muscle in the body, the trapezius can be injured and requires special treatment to recover. Sometimes, the neck or shoulder pain may not come from the trapezius muscle. Consider seeing a healthcare provider if you have pain in your neck or shoulder that doesn’t get better within a week or two, especially if it isn’t responding to at-home treatment. Regardless of how long you have been experiencing pain or stiffness, contact a healthcare provider if it prevents you from getting adequate sleep or interfering with daily activities. Reasons to see a healthcare provider immediately for neck or shoulder pain include: (Mount Sinai, 2025)

  • There is sudden pressure or pain in the left shoulder, which can sometimes signal a heart attack.
  • A fall or accident resulted in pain, swelling, or problems moving the neck or arm.
  • If there is shoulder pain, a fever, swelling, or redness.
  • The skin on the shoulder area appears discolored.

It’s important to take regular breaks to stretch and move your muscles. You can release tension in the trapezius by doing shoulder shrugs throughout the day and stretching regularly. When the trapezius feels tight or sore, give yourself a massage.

Injury Medical Chiropractic and Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.


Whiplash Chiropractic Massage Therapy


References

Domingo, A. R., Diek, M., Goble, K. M., Maluf, K. S., Goble, D. J., & Baweja, H. S. (2017). Short-duration therapeutic massage reduces postural upper trapezius muscle activity. Neuroreport, 28(2), 108–110. doi.org/10.1097/WNR.0000000000000718

University of Washington Department of Radiology. (2025). Trapezius. rad.washington.edu/muscle-atlas/trapezius/

Marker, R. J., Campeau, S., & Maluf, K. S. (2017). Psychosocial stress alters the strength of reticulospinal input to the human upper trapezius. Journal of Neurophysiology, 117(1), 457–466. doi.org/10.1152/jn.00448.2016

Salavati, M., Akhbari, B., Ebrahimi Takamjani, I., Ezzati, K., & Haghighatkhah, H. (2017). Reliability of the Upper Trapezius Muscle and Fascia Thickness and Strain Ratio Measures by Ultrasonography and Sonoelastography in Participants With Myofascial Pain Syndrome. Journal of Chiropractic Medicine, 16(4), 316–323. doi.org/10.1016/j.jcm.2017.06.003

Mount Sinai. (2025). Shoulder pain. www.mountsinai.org/health-library/symptoms/shoulder-pain

The Importance of Back Stretching for Pain Relief

The Importance of Back Stretching for Pain Relief

Can knowing how to stretch your back help reduce pain and improve your range of motion?

The Importance of Back Stretching for Pain Relief

Stretch Your Back

Over time, muscle tension can cause significant back pain and increase the risk of a back injury. Getting into a regular back stretching routine can help prevent back and spinal issues. These exercises can be performed when your back hurts to ease a backache or to avoid future problems. However, before beginning an exercise or stretch regimen, talk to your healthcare provider about any questions and what is safe for you. A few things to be mindful of are:

  • When stretching, don’t try to push past your pain limit.
  • Listen to your body, which leads to a calmer nervous system.
  • Take special care when stretching during pregnancy, as the hormones supporting your pregnancy could lead to overstretching or injury.

Warm Up

Stretching cold muscles can lead to injury. Always warm up first.

  • Do between five and 10 minutes of mild activity, such as walking.
  • Apply heat for 15 to 20 minutes before stretching.

Knees-to-Chest Back Stretch

To perform:

  • Lie on your back with your feet flat on the floor.
  • Bring your legs toward your chest With your knees bent.
  • Place your hands behind your thighs or on the shins, and pull the legs down toward your chest.
  • Pull until there is a gentle stretch.
  • Hold for 15 seconds.
  • Return to the starting position.
  • Do a total of 10 reps.

Supine Twist Back Stretch

To perform:

  • Lie on your back with your knees bent and feet flat on the floor.
  • Keep your back flat on the floor, rotate your hips to the left, and lower your legs until you feel the stretch.
  • Hold for 15 seconds.
  • Return to the starting position.
  • Next, rotate the hips to the right and lower your legs to the floor until you feel a gentle stretch.
  • Hold for 15 seconds.
  • Return to the starting position.
  • Repeat for nine reps.

Prone Bridging Back Stretch

To perform:

  • Lie on your stomach.
  • Prop yourself up on your elbows.
  • Extend your back.
  • Start straightening your elbows, further extending the back.
  • Continue straightening the elbows until the stretch is felt.
  • Hold for 15 seconds.
  • Return to the starting position.
  • Repeat for nine reps.

Supine Butt Lift Back Stretch

To perform:

  • Lie on your back with your knees bent and feet flat on the floor.
  • Push down through the feet as you slowly raise yourself off the floor.
  • Hold for 10 seconds.
  • Return to starting position.
  • Repeat for nine reps.

Seated Forward Curl Back Stretch

To perform:

  • Sit in a chair with your feet flat on the ground.
  • Bend forward until your chest is on your thighs, and you can touch the ground with your hands.
  • Hold for 10 seconds.
  • Return to the starting position.
  • Repeat for nine reps.

Side Stretch

To perform:

  • Stand up straight with your arms at your sides and feet shoulder-width apart.
  • Bend sideways to the left while sliding your left hand down your thigh and reaching your right arm over your head.
  • Hold for 10 seconds.
  • Return to the starting position.
  • Now, bend to the right while sliding your right hand down your thigh and reaching your left arm over your head.
  • Hold for 10 seconds.
  • Repeat for nine reps.

Other Treatments to Loosen a Tight Back

Many healthcare providers recommend other treatments for back pain before using medication. Recommended treatments that can help loosen the back include: (Sudhakaran P. 2021)

Acupuncture

  • Acupuncture needles are inserted in release points to unblock stagnated blood and energy circulation.
  • They have an analgesic, pain-relieving effect. (Foley C., & Litscher G. 2024)

Massage Therapy

  • Various massages involve kneading soft tissue in the back with hands, fingers, elbows, or instruments/tools/devices to relieve stress or pain.

Spinal Manipulation

  • Practiced by chiropractors, this therapy involves using the hands or instruments/tools/devices to manipulate the joints in the spine to relieve pain.

Tai Chi

  • Based on martial arts, slow movements, and deep breaths help to work muscle groups in flowing motions, supporting back strength and overall health.

Yoga

  • Yoga combines physical poses, breathwork, and meditation to help build strength, be restorative, and relax the body.

Anti-inflammatory Diet

  • An anti-inflammatory diet can also benefit tight muscles. (U.S. Department of Defense, 2012)
  • Incorporating foods like those on the Mediterranean diet, which emphasizes fish, vegetables, and olive oil, can help reduce chronic inflammation and help with back pain.

Injury Medical Chiropractic and Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. We build optimal health and wellness solutions with primary healthcare providers and specialists to integrate a treatment plan to resolve musculoskeletal problems.


Stretching Benefits


References

Sudhakaran P. (2021). Acupuncture for Low-Back Pain. Medical acupuncture, 33(3), 219–225. doi.org/10.1089/acu.2020.1499

Foley, C., & Litscher, G. (2024). The Biggest Obstacle to the Integration of Acupuncture: The Meaning of Qi from the Ancients to Einstein. Medical acupuncture, 36(1), 5–11. doi.org/10.1089/acu.2023.0054

U.S. Department of Defense. (2012). Complementary Alternative Medicine for Low Back Pain. Retrieved from media.defense.gov/2019/Oct/22/2002198454/-1/-1/0/CAM%20FOR%20LOW%20BACK%20PAIN.PDF

Understanding Planes of Motion: A Comprehensive Guide

Understanding Planes of Motion: A Comprehensive Guide

Can understanding the planes of motion help individuals adjust fitness training to maximize fitness for physical and sports performance and reduce the risk of injury?

Understanding Planes of Motion: A Comprehensive Guide

Planes of Motion

The body’s planes of motion are the sagittal, frontal, and transverse planes, which divide it into left and right, front and back, and top and bottom halves. The body moves in different dimensions during daily work, house chores, and physical activity/exercises. The movements in each plane correspond to forward/backward, side-to-side, and rotational motions. Think of each plane as an imaginary line or a pane of glass that divides the body into opposing segments when standing in the anatomical position. (National Academy of Sports Medicine, 2024)

  • Sagittal plane -Divides the body into right and left sides.
  • Frontal plane – Divides the body into front and back.
  • Transverse plane – Divides the body into top and bottom sections.

To determine the plane of motion of a particular movement, consider how the movement would interact with the imaginary lines or plates. When a movement runs parallel to the imaginary line, the movement is occurring in that plane of motion. For example, when going upstairs, the forward and upward movement at the hip, knee, and ankle occurs primarily in the sagittal plane because that movement runs parallel to the imaginary line that divides the body into right and left sides. Frontal plane movements occur while you walk up the stairs and reach for the handrail. The movement is in the frontal plane because the lateral hand reach runs parallel to the line, dissecting the body into front and back sections. If you turn around to look behind, the rotational movement occurs in the transverse plane because your upper torso runs parallel to the line, dissecting the body into an upper and lower section. Individual movements at any joint in the body can occur in a single plane or multiple planes. Complex movements usually happen in several planes of motion concurrently.

Sagittal Plane

Movement in the sagittal plane generally happens in front or behind. This is the most familiar plane of motion because many typical day-to-day activities happen within arm’s reach in front. Walking, texting, or computer work involves movement primarily in the sagittal plane. Several eating mechanics occur in the sagittal plane. Movements include:

  • Flexion – A bending movement that decreases the angle at a joint.
  • Extension – An extending movement that increases the angle at a joint.
  • Hyperextension – Extending the angle at a joint beyond neutral.
  • Dorsiflexion – Bending at the ankle so the top of the foot moves toward the shin.
  • Plantarflexion – Pushing the foot down and away from the body.

Many strength-training exercises in the sagittal plane include biceps curls, forward or reverse lunges, squats, vertical jumping, running, downward dog, and yoga chair poses.

Frontal Plane

The frontal plane divides the body into front/anterior and back/posterior sections. Frontal plane movements are lateral or side-to-side and include:

  • Abduction – Moving the body or a limb laterally and away from the body’s midline.
  • Adduction – Moving the body or a limb towards the body’s midline.
  • Elevation – Moving the shoulder blades up.
  • Depression – Moving the shoulder blades down.
  • Eversion – Rolling the foot towards the inside/medial side.
  • Inversion – Rolling the foot towards the outside/lateral side.

Frontal plane movements are less common than sagittal movements. For example, individuals walk forward more than side to side or reach for something in front rather than directly to the side. Frontal plane movements in fitness include side lunges, lateral shoulder raises, and side shuffles, and in yoga poses, standing side bends and the triangle.

Transverse Plane

The transverse plane divides the body into upper/superior and lower/inferior sections. Transverse plane movements generally involve rotation. Movement in this plane is less common. Exercise injuries most often occur during transverse/rotational movements. (National Academy of Sports Medicine, 2024) Movements include:

  • Rotation – Moving the torso or a limb around its vertical axis.
  • Pronation – Rotating the forearm or foot to a palm-side or foot-side down position.
  • Supination – Rotating the forearm or foot to a palm-side or foot-side-up position.
  • Horizontal Abduction – Moving the upper arm away from the body’s midline when elevated to 90 degrees.
  • Horizontal Adduction – Moving the upper arm towards the body’s midline when elevated to 90 degrees.

Typical everyday activities in the frontal plane include turning the head to look behind or turning a doorknob. Exercises in the transverse plane include hitting a golf ball, swinging a baseball bat, or performing a seated twist.

Training Within the Planes of Motion Benefits

Training in all three planes can help with movement in several ways, providing greater ease in life and sports.

Prepares Body for Daily Tasks

Many traditional strength-training programs focus on training one muscle at a time, often in a single plane of motion. For example, weight lifters might do bicep curls to primarily work the biceps in the sagittal plane, a chest fly exercise to primarily work the pectoral muscles in the transverse plane, or lateral raises to work the shoulders in the frontal plane. However, compound exercises have recently become much more common. Compound movements allow individuals to train several muscle groups simultaneously and in different planes of motion.

In this way, training activities mimic daily living activities. For example, individuals often lift several heavy bags of groceries and turn to open the car or trunk, involving both sagittal and transverse movement. Preparing the body for complex activities with compound exercises allows individuals to perform them more easily throughout the day.

Prepares Body for Sports and Physical Activities

Complex multi-planar movements help prepare for safe and effective physical activity and sports performance (National Academy of Sports Medicine, 2024). Researchers and experts understand that many physical and athletic activities require the body to move in different directions, often quickly and under high stress. Several studies have found that anterior cruciate ligament/ACL injuries are more likely to occur during multi-planar rather than single-planar movements. (Quatman C. E., Quatman-Yates C. C., & Hewett T. E. 2010) Training the body to perform multi-planar movements safely and effectively through exercise can help reduce the risk of injury during daily activities or stressful athletic competitions.

Encourages Variation For Full Body Strengthening

Individuals tend to fall into certain movement patterns, such as repeatedly performing the same fitness activity or exercises. This can cause them to have a favorite plane of motion. One way to break away from the same routine is to include movement from all planes of motion. For example, many abdominal workout machines help train in multiple planes of motion, challenging your body to move in different ways. Dumbbells, kettlebells, TRX straps, and bands allow individuals to move joints freely in various planes of motion and work several muscles.

Runners train primarily in the sagittal plane, even if they cross-train by swimming, cycling, or using cardio machines. For this reason, trainers and coaches often recommend doing some form of yoga or weight training that allows them to move their joints in different ways, including lateral movements or rotation. Even flexibility training should incorporate all three planes of motion. For example, walkers might choose to do a simple calf or hamstring stretch at the end of their workout but may also benefit from a seated spine rotation or a lying hip stretch.

Injury Medical Chiropractic and Functional Medicine Clinic

Understanding the concept and importance of training in the three planes of motion can help improve sports and physical performance and prevent musculoskeletal injuries. Chiropractic care aims to help individuals enhance movement with less pain due to condition, after injury, or surgery. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.


The Difference of Using Custom Foot Orthotics


References

National Academy of Sports Medicine. (2024). Sagittal, Frontal and Transverse Body Planes: Exercises & Movements. NASM. blog.nasm.org/exercise-programming/sagittal-frontal-traverse-planes-explained-with-exercises?utm_source=blog&utm_medium=referral&utm_campaign=organic&utm_content=ReasonsToBecomeCES

Quatman, C. E., Quatman-Yates, C. C., & Hewett, T. E. (2010). A ‘plane’ explanation of anterior cruciate ligament injury mechanisms: a systematic review. Sports medicine (Auckland, N.Z.), 40(9), 729–746. doi.org/10.2165/11534950-000000000-00000

Improving Sleep Posture for Better Sleep: The Ultimate Guide

Improving Sleep Posture for Better Sleep: The Ultimate Guide

Can individuals have a full night of sleep by making small changes to their sleep posture to reduce general aches and pains?

Introduction

Many individuals know that after a long, hard day of working or running errands, getting much rest is necessary to reduce tension in the body and put it in a relaxed state. Getting a quick nap to a full night of sleep is important not only for the body but also for the posture. However, many people get a bad night’s rest from various environmental factors that can keep them from getting the full benefits of eight hours of sleep. It can range from stressful events impacting a person’s life to overlapping risk profiles correlated with chronic conditions. Today’s article focuses on how poor posture can affect sleep and how there are different ways for a person to get a good night’s rest, improve sleep posture, and find the right mattress and pillows to allow the individual to stay asleep. We discuss with certified medical providers who inform our patients how various environmental factors can cause overlapping risk profiles and not getting a full night of rest. While asking informed questions to our associated medical providers, we advise patients to incorporate various techniques to improve sleep posture when getting a full night of quality sleep. Dr. Alex Jimenez, D.C., encompasses this information as an academic service. Disclaimer.

 

Poor Posture Affecting Sleep

Do you feel extremely tired throughout the day, even after a full night? Do you experience stiffness in the morning that gets better throughout the day? Or how often do you wake up constantly at night and have trouble staying asleep? Many individuals who have experienced these scenarios are frequently correlated with bad sleeping habits. Many individuals have dealt with poor sleeping habits throughout the day due to environmental factors that can impact their sleep. Some environmental factors, like poor posture, can affect how people sleep at night. Poor posture has always been associated with musculoskeletal disorders. When musculoskeletal disorders have overlapping risk profiles from physical workload and psychological stress, it can become a predictor or even correlate with sleep disorders. (Hammig, 2020) This is because having habitual in-bed behaviors like movement and posture could cause health complications and prevent people from getting a good night’s rest. (Elnaggar et al., 2023)

 

 

This is due to how individuals’ posture can affect their sleep quality and overall health. For instance, individuals dealing with chronic spinal pain will begin to develop poor posture over time. When this happens, it can coexist with other comorbidities like insomnia, which can lead to a larger negative effect on a person’s physical and mental functioning while preventing them from being less productive and having poor quality of sleep. (Bilterys et al., 2021) When people experience spinal pain, causing them to develop poor posture, it can lead to sleep disturbances. The correlation between sleep disturbances and poor posture can cause impairment of the physiological process that can contribute to maintaining chronic pain. (Skillgate et al., 2021) However, there are numerous ways for people to get a good night’s rest while improving their posture.

 


The Benefits Of Stretching-Video


Ways To Get a Good Night Rest

When it comes to finding ways to get a good night’s rest, many people will try to devise solutions to establish a routine for their bedtime. Some of the ways people can utilize for a good night’s rest include:

  • Lowering room temperature
  • Keeping a sleep diary
  • Limit caffeinated drinks in the evening
  • Limit electronics before bed
  • Stick and create a sleep schedule

By creating some of these habits and sticking with them, many people can get much-needed rest and more energy when they wake up. At the same time, proper sleeping habits can help improve sleeping posture.

 

Improving Sleep Posture

There is no right way to do it regarding proper sleeping habits and improving sleep posture. Everyone has a position they favor more to be comfortable. For instance, a person who sleeps on the back is more relaxed than sleeping on their sides. Since sleep posture is associated with sleep quality, poor posture may provoke increased wake time and affect a person’s ability to maintain an asleep state. (Cary et al., 2021) So, by listening to the body and following its natural sleep flow, a person can stay asleep longer and be comfortable.

 

Finding The Right Mattress & Pillow

 

 

At the same time, improving one’s sleeping posture is not the only way to get a good night’s rest. Finding the right mattress and pillows is important, too. When people seek mattresses and pillows to improve their sleep quality, many often seek out tempur-pedic mattresses to support their body and have the best sleep. Many tempur-pedic mattresses can help reduce pressure from the body, making a person comfortable and minimizing movement. Additionally, new pillows supporting the neck and lower back can reduce somatic symptoms and provide neutral spinal alignment for the body. (Yamada et al., 2023) When it comes to having the best quality of sleep, it can be achievable with proper sleep habits, a new set of pillows and mattresses, and a comfortable position that will allow people to feel refreshed and re-energized.


References

Bilterys, T., Siffain, C., De Maeyer, I., Van Looveren, E., Mairesse, O., Nijs, J., Meeus, M., Ickmans, K., Cagnie, B., Goubert, D., Danneels, L., Moens, M., & Malfliet, A. (2021). Associates of Insomnia in People with Chronic Spinal Pain: A Systematic Review and Meta-Analysis. J Clin Med, 10(14). doi.org/10.3390/jcm10143175

Cary, D., Jacques, A., & Briffa, K. (2021). Examining relationships between sleep posture, waking spinal symptoms and quality of sleep: A cross sectional study. PLOS ONE, 16(11), e0260582. doi.org/10.1371/journal.pone.0260582

Elnaggar, O., Arelhi, R., Coenen, F., Hopkinson, A., Mason, L., & Paoletti, P. (2023). An interpretable framework for sleep posture change detection and postural inactivity segmentation using wrist kinematics. Sci Rep, 13(1), 18027. doi.org/10.1038/s41598-023-44567-9

Hammig, O. (2020). Work- and stress-related musculoskeletal and sleep disorders among health professionals: a cross-sectional study in a hospital setting in Switzerland. BMC Musculoskelet Disord, 21(1), 319. doi.org/10.1186/s12891-020-03327-w

Skillgate, E., Isacson Hjortzberg, M., Stromwall, P., Hallqvist, J., Onell, C., Holm, L. W., & Bohman, T. (2021). Non-Preferred Work and the Incidence of Spinal Pain and Psychological Distress-A Prospective Cohort Study. Int J Environ Res Public Health, 18(19). doi.org/10.3390/ijerph181910051

Yamada, S., Hoshi, T., Toda, M., Tsuge, T., Matsudaira, K., & Oka, H. (2023). Changes in neck pain and somatic symptoms before and after the adjustment of the pillow height. Journal of Physical Therapy Science, 35(2), 106-113. doi.org/10.1589/jpts.35.106

Disclaimer

Understanding Overpronation and its Effects on the Body

Understanding Overpronation and its Effects on the Body

What are the treatment options for individuals dealing with foot overpronation when the foot and ankle move too much downward and inward?

Understanding Overpronation and its Effects on the Body

Overpronation

Pronation is the normal foot and ankle movement when taking a step and is usually associated with flat feet. Overpronation is a movement pattern in which the ankle rolls inward and downward, causing the foot’s arch to collapse with each stride. Overpronation can strain the muscles and ligaments in the feet and legs, leading to heel pain, ankle pain, shin splints, and low-back pain. (Pedorthic Association of Canada, 2023) Orthotic inserts for shoes, prescribed stretches, ankle braces, physical therapy, and surgery can all help alleviate the impact of overpronation. (Sánchez-Rodríguez, R. et al., 2020)

Signs and Symptoms

Some individuals with overpronation can have no symptoms at all. (Pedorthic Association of Canada, 2023) while others experience pain or other symptoms in their legs and feet. Overpronation is not a medical condition but a movement pattern that, if left untreated, can increase the risk for certain medical conditions because it strains the feet and leg muscles, joints, and ligaments. (Sánchez-Rodríguez, R. et al., 2020) Certain medical conditions can be a sign of overpronation and include: (Pedorthic Association of Canada, 2023)

  • Bunions
  • Heel pain
  • Plantar fasciitis
  • Achilles tendon pain
  • Posterior tibial tendonitis
  • Shin splints
  • Knee pain, including patellofemoral pain syndrome
  • Pain in the iliotibial or IT band
  • Lower back pain
  • Arthritis in foot and ankle joints
  • Stress fractures

Individuals may also experience pain in the midfoot or hips, which can be a symptom of flat feet.

Underpronation

Pronation refers to the normal movement of the foot and ankle while walking. Overpronation and underpronation are both abnormal movement patterns.

  • Overpronation – when the ankle rolls too much inward and downward.
  • Underpronation – occurs when an individual’s foot lacks flexibility and moves too little. This condition is called supination and is often associated with a high-arch foot type.
  • This often places added pressure on the outside of the foot, leading to other ankle and foot problems. (Pedorthic Association of Canada, 2023)

Causes

Overpronation can be caused or worsened by flatfeet. However, some individuals have overpronation because their feet and ankles are very flexible, so they tend to move more. Risk factors for flatfeet can also increase the chances of developing overpronation and include:

  • Age, especially individuals over 40.
  • Wearing shoes like high heels and shoes with a narrow-toe box.
  • Women are more prone to overpronate because of the various shoes and high heels worn.
  • Being overweight
  • Doing repetitive, impactful movements like running.

Correction and Treatment

Treating overpronation focuses on alleviating strain on muscles in the foot, ankle, and leg to relieve symptoms in the heel, ankle, knees, hips, or back. Common treatments are wearing supportive shoes and/or using foot orthotics. Exercises and stretches are also recommended to maintain flexibility and strength. Surgery is rare, but correcting flat feet that can cause overpronation may be recommended. (Sánchez-Rodríguez, R. et al., 2020) Individuals with overpronation are advised to see a podiatrist who can explain the best treatment options.

Supportive Shoes

The first course of treatment is to wear added supportive footwear. This can include specialized shoes or inserts that support the foot and reduce ankle movement. Individuals are advised to use shoes with firm heel and midfoot support to help prevent disproportionate movement. (Pedorthic Association of Canada, 2023)

Orthotics

A healthcare provider can recommend orthotics for individuals with moderate overpronation. These are meant to support the foot, especially the arch, and reduce overpronation. (Naderi A. Degens H. and Sakinepoor A. 2019) Individuals can purchase orthotics from shoe stores and elsewhere, but those with severe overpronation may need custom orthotics molded to the foot to provide individualized support.

Exercises and Stretches

Exercises and stretches can also help. A study found that exercises targeting the feet, core, and hips helped correct pronation over nine weeks. The exercises included: (Sánchez-Rodríguez, R. et al., 2020)

  • Toe pickups in which the individuals grab small objects with their toes and move them from one position to another.
  • Flexing and pointing the toes using a resistance band placed around the toes.
  • Hip abduction exercises to target the hip and glutes.
  • Abdominal and oblique muscle exercises to stabilize the torso.
  • Short-foot exercise raises the foot arch off the ground, drawing the toes toward the heel. (Sulowska I. et al., 2016)

Surgery

Rarely will surgery be needed to treat flat feet and severe overpronation. But if necessary, reconstruction realigns the bones to support the arch better and reduce overpronation. A metal implant is used for flatfeet to stabilize the area. Surgery can also repair torn tendons or other damage contributing to overpronation. (Healthline, 2020)

Injury Medical Chiropractic and Functional Medicine Clinic

Individuals with overpronation but no symptoms don’t necessarily have to see a healthcare provider since this may be the body’s natural movement pattern. But if the feet, legs, hips, or back begin to present with pain and other symptoms, see a healthcare provider who can evaluate gait and recommend treatment options. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.


Enhance Performance with Functional Foot Orthotics


References

Pedorthic Association of Canada. (2023). Overpronation and Underpronation Correction. pedorthic.ca/services/foot-health/pronation/

Sánchez-Rodríguez, R., Valle-Estévez, S., Fraile-García, P. A., Martínez-Nova, A., Gómez-Martín, B., & Escamilla-Martínez, E. (2020). Modification of Pronated Foot Posture after a Program of Therapeutic Exercises. International journal of environmental research and public health, 17(22), 8406. doi.org/10.3390/ijerph17228406

Naderi, A., Degens, H., & Sakinepoor, A. (2019). Arch-support foot orthoses normalize dynamic in-shoe foot pressure distribution in medial tibial stress syndrome. European journal of sport science, 19(2), 247–257. doi.org/10.1080/17461391.2018.1503337

Sulowska, I., Oleksy, Ł., Mika, A., Bylina, D., & Sołtan, J. (2016). The Influence of Plantar Short Foot Muscle Exercises on Foot Posture and Fundamental Movement Patterns in Long-Distance Runners, a Non-Randomized, Non-Blinded Clinical Trial. PloS one, 11(6), e0157917. doi.org/10.1371/journal.pone.0157917

Healthline. (2020). All About Surgery for Flat Feet: Pros and Cons. www.healthline.com/health/flat-feet-surgery