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Complex Injuries

Back Clinic Complex Injuries Chiropractic Team. Complex injuries happen when people experience severe or catastrophic injuries, or whose cases are more complex due to multiple trauma, psychological effects, and pre-existing medical histories. Complex injuries can be serial injuries of the upper extremity, severe soft tissue trauma, and concomitant (naturally accompanying or associated), injuries to vessels or nerves. These injuries go beyond the common sprain and strain and require a deeper level of assessment that may not be easily apparent.

El Paso, TX’s Injury specialist, chiropractor, Dr. Alexander Jimenez discusses treatment options, as well as rehabilitation, muscle/strength training, nutrition, and getting back to normal body functions. Our programs are natural and use the body’s ability to achieve specific measured goals, rather than introducing harmful chemicals, controversial hormone replacement, unwanted surgeries, or addictive drugs. We want you to live a functional life that is fulfilled with more energy, a positive attitude, better sleep, and less pain. Our goal is to ultimately empower our patients to maintain the healthiest way of living.


The Role of Acupuncture in Treating Muscle Pain

The Role of Acupuncture in Treating Muscle Pain

Can individuals dealing with muscle pain find relief from acupuncture therapy to get back to their daily activities and well-being?

Introduction

Many people worldwide have dealt with pain in their musculoskeletal system that has affected their daily routine. Some of the most common factors that people have experienced muscle pain include sedentary lifestyles from working at a desk job or physical demands from an active lifestyle. The muscles, tendons, ligaments, and soft tissues can become overstretched and overworked, causing the muscles to become weak. At the same time, visceral somatic issues in the neck, shoulders, and back can affect the upper and lower extremities, leading to a life of disability. Many factors that can contribute to the development of muscle pain can impact a person’s routine and cause them to find various techniques to reduce the muscle pain in their bodies. Since muscle pain can be in acute or chronic form, many individuals who are seeking treatment for their ailments can look into non-surgical therapies like acupuncture to not only reduce muscle pain but also find the relief they are looking for. Today’s article focuses on how muscle pain can affect a person’s well-being, how the essence of acupuncture can be beneficial for muscle pain, and how people can integrate acupuncture therapy as part of a wellness routine. We talk with certified medical providers who consolidate our patients’ information to assess how muscle pain can impact a person’s well-being. We also inform and guide patients on how acupuncture therapy can benefit the body by reducing the effects of muscle pain. We encourage our patients to ask their associated medical providers intricate and important questions about incorporating acupuncture therapy into a wellness routine to reduce muscle pain and its referred symptoms. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer.

 

How Muscle Pain Can Affect A Person’s Well-Being

Do you feel the effects of tiredness and weakness in your upper and lower extremity muscles? Have you experienced general soreness or aches in your neck, shoulders, or back? Or does twisting and turning your body cause temporary relief to your body, only for it to be worse throughout the day? When it comes to muscle pain can be a multi-factorial condition where that can involve complex interactions on a person’s structure, physical, social, lifestyle, and comorbid health factors that can come into play as contributing factors for people to experience long-term pain and disability. (Caneiro et al., 2021) As many individuals start to do repetitive motions or stay in sedentary positions, muscle pain can develop when they stretch or try to move their muscles while doing their routine. The burden of muscle pain often correlates with socioeconomic factors that can cause many people, both young and old, to substantially limit their mobility and engagement in their routine, which predisposes increased risk factors to other chronic conditions they may have. (Dzakpasu et al., 2021)

 

 

When many individuals are dealing with muscle pain in its acute or chronic form, many often don’t realize that when the affected muscles in the upper and lower body quadrants are coping with pain, there is associated pain and stiffness from how active or inactive the muscles are can affect the soft tissue causing high mechanical stress to the affect the skeletal joints. (Wilke & Behringer, 2021) When this happens, many people will start to experience referred muscle pain in their bodies, causing issues with their mobility, flexibility, and stability. Coincidentally, muscle pain can also be a symptom of many people who have various pains in their bodies that have impacted their lives prior; seeking treatment can reduce the effects of muscle pain and help them take back their routine to lead a healthier lifestyle.

 


Movement Medicine- Video


The Essence Of Acupuncture For Muscle Pain

When many people are dealing with muscle pain, they are seeking treatments that are not only affordable but also can be effective in reducing the overlapping risk profiles that are affecting the body, causing muscle pain. Many treatments like chiropractic care, decompression, and massage therapy are non-surgical and are effective through consecutive sessions. One of the oldest and most effective treatments that can help reduce muscle pain in the body is acupuncture therapy. Acupuncture is a holistic treatment derived from Traditional Chinese Medicine that utilizes small, solid, thin needles inserted by professional acupuncturists to various acupoints. The main philosophy is that acupuncture provides relief to the body as it helps improve the body’s energy flow while maintaining a person’s overall health and vitality. (Zhang et al., 2022) When a person is dealing with muscle pain, the muscle fibers can develop tiny nodules known as trigger points that can induce pain in the affected muscle quadrants. With acupuncture needles placed in the affected area, local and referred pain is reduced, muscle blood flow and oxygen are returned to the body, and the muscle’s range of motion is improved. (Pourahmadi et al., 2019) Some of the benefits that acupuncture therapy provides include:

  • Increased circulation
  • Inflammation reduction
  • Endorphin release
  • Relaxing muscle tension

 

Integrating Acupuncture As Part Of A Wellness Routine

Many individuals who are seeking acupuncture therapy as part of their wellness journey can see the positive benefits of acupuncture and can combine it with other therapies to reduce the chances of muscle pain from returning. While acupuncture can help stimulate the nerves and restore motor function, treatments like joint mobilization can help stretch the affected muscles and joints to improve the body’s range of motion. (Lee et al., 2023) With many individuals seeking acupuncture treatment to reduce muscle pain, many can make small changes in their routine to prevent the pain from causing overlapping risk profiles to their bodies. When addressing the root causes of pain and promoting the body’s innate healing abilities, acupuncture can help restore balance, alleviate discomfort, and enhance overall well-being.

 


References

Caneiro, J. P., Bunzli, S., & O’Sullivan, P. (2021). Beliefs about the body and pain: the critical role in musculoskeletal pain management. Braz J Phys Ther, 25(1), 17-29. doi.org/10.1016/j.bjpt.2020.06.003

Dzakpasu, F. Q. S., Carver, A., Brakenridge, C. J., Cicuttini, F., Urquhart, D. M., Owen, N., & Dunstan, D. W. (2021). Musculoskeletal pain and sedentary behaviour in occupational and non-occupational settings: a systematic review with meta-analysis. Int J Behav Nutr Phys Act, 18(1), 159. doi.org/10.1186/s12966-021-01191-y

Lee, J. E., Akimoto, T., Chang, J., & Lee, H. S. (2023). Effects of joint mobilization combined with acupuncture on pain, physical function, and depression in stroke patients with chronic neuropathic pain: A randomized controlled trial. PLOS ONE, 18(8), e0281968. doi.org/10.1371/journal.pone.0281968

Pourahmadi, M., Mohseni-Bandpei, M. A., Keshtkar, A., Koes, B. W., Fernandez-de-Las-Penas, C., Dommerholt, J., & Bahramian, M. (2019). Effectiveness of dry needling for improving pain and disability in adults with tension-type, cervicogenic, or migraine headaches: protocol for a systematic review. Chiropr Man Therap, 27, 43. doi.org/10.1186/s12998-019-0266-7

Wilke, J., & Behringer, M. (2021). Is “Delayed Onset Muscle Soreness” a False Friend? The Potential Implication of the Fascial Connective Tissue in Post-Exercise Discomfort. Int J Mol Sci, 22(17). doi.org/10.3390/ijms22179482

Zhang, B., Shi, H., Cao, S., Xie, L., Ren, P., Wang, J., & Shi, B. (2022). Revealing the magic of acupuncture based on biological mechanisms: A literature review. Biosci Trends, 16(1), 73-90. doi.org/10.5582/bst.2022.01039

Disclaimer

Understanding Deep Buttock Pain: What You Need to Know

Understanding Deep Buttock Pain: What You Need to Know

Can physical therapy treatment protocols aimed at improving range of motion and flexibility around the hip and relieving inflammation around the sciatic nerve help individuals experiencing deep buttock pain or piriformis syndrome?

Understanding Deep Buttock Pain: What You Need to Know

Deep Buttock Pain

  • Piriformis syndrome, a.k .a. deep buttock pain, is described as sciatic nerve irritation from the piriformis muscle.
  • The piriformis is a small muscle behind the hip joint in the buttocks.
  • It is about one centimeter in diameter and functions in the hip joint’s external rotation or turning outward.
  • The piriformis muscle and tendon are close to the sciatic nerve, which supplies the lower extremities with motor and sensory functions.
  • Depending on an individual’s anatomic variation of the muscle and tendon:
  • The two cross over, under, or through each other behind the hip joint in the deep buttock.
  • This relationship is thought to irritate the nerve, leading to sciatica symptoms.

Piriformis Syndrome

  • When diagnosed with piriformis syndrome, it is thought that the muscle and tendon bind to and/or spasm around the nerve, causing irritation and pain symptoms.
  • The theory supported is that when the piriformis muscle and its tendon tighten, the sciatic nerve becomes compressed or pinched. This decreases blood circulation and irritates the nerve from the pressure. (Shane P. Cass 2015)

Symptoms

Common signs and symptoms include: (Shane P. Cass 2015)

  • Tenderness with pressure on the piriformis muscle.
  • Discomfort in the back of the thigh.
  • Deep buttock pain behind the hip.
  • Electric sensations, shocks, and pains travel down the back of the lower extremity.
  • Numbness in the lower extremity.
  • Some individuals develop symptoms abruptly, while others go through a gradual increase.

Diagnosis

  • Doctors will order X-rays, MRIs, and nerve conduction studies, which is normal.
  • Because piriformis syndrome can be challenging to diagnose, some individuals with minor hip pain may receive a piriformis syndrome diagnosis even if they don’t have the condition. (Shane P. Cass 2015)
  • It is sometimes referred to as deep buttock pain. Other causes of this type of pain include back and spinal problems like:
  1. Herniated discs
  2. Spinal stenosis
  3. Radiculopathy – sciatica
  4. Hip bursitis
  5. A piriformis syndrome diagnosis is usually given when these other causes are eliminated.
  • When the diagnosis is uncertain, an injection is administered in the area of the piriformis muscle. (Danilo Jankovic et al., 2013)
  • Different medications can be used, but the injection itself is used to help determine the specific location of the discomfort.
  • When an injection is given into the piriformis muscle or tendon, it is often administered by ultrasound guidance to ensure the needle delivers the medication to the correct location. (Elizabeth A. Bardowski, J. W. Thomas Byrd 2019)

Treatment

Common treatments include the following. (Danilo Jankovic et al., 2013)

Rest

  • Avoiding activities that cause symptoms for at least a few weeks.

Physical Therapy

  • Emphasize stretching and strengthening the hip rotator muscles.

Non-Surgical Decompression

  • Gently pulls the spine to release any compression, allowing optimal rehydration and circulation and taking the pressure off the sciatic nerve.

Therapeutic Massage Techniques

  • To relax and release muscle tension and increase circulation.

Acupuncture

  • To help relax the piriformis muscle, sciatic nerve, and surrounding area.
  • Relieve pain.

Chiropractic Adjustments

  • Realignment rebalances the spine and musculoskeletal system to alleviate pain.

Anti-Inflammatory Medication

  • To decrease inflammation around the tendon.

Cortisone Injections

  • Injections are used to decrease inflammation and swelling.

Botulinum Toxin Injection

  • Injections of botulinum toxin paralyze the muscle to relieve pain.

Surgery

  • Surgery can be performed in rare cases to loosen the piriformis tendon, known as a piriformis release. (Shane P. Cass 2015)
  • Surgery is a last resort when conservative treatments have been tried for at least 6 months with little to no relief.
  • Recovery can take several months.

Sciatica Causes and Treatment


References

Cass S. P. (2015). Piriformis syndrome: a cause of nondiscogenic sciatica. Current sports medicine reports, 14(1), 41–44. doi.org/10.1249/JSR.0000000000000110

Jankovic, D., Peng, P., & van Zundert, A. (2013). Brief review: piriformis syndrome: etiology, diagnosis, and management. Canadian journal of anaesthesia = Journal canadien d’anesthesie, 60(10), 1003–1012. doi.org/10.1007/s12630-013-0009-5

Bardowski, E. A., & Byrd, J. W. T. (2019). Piriformis Injection: An Ultrasound-Guided Technique. Arthroscopy techniques, 8(12), e1457–e1461. doi.org/10.1016/j.eats.2019.07.033

Expert Tips to Avoid Weightlifting Knee Injuries

Expert Tips to Avoid Weightlifting Knee Injuries

Knee injuries can present in physically active individuals that lift weights. Can understanding the types of weightlifting knee injuries help in prevention?

Expert Tips to Avoid Weightlifting Knee Injuries

Weightlifting Knee Injuries

Weight training is very safe for the knees as regular weight training can improve knee strength and prevent injury as long as the correct form is followed. For Individuals with knee injuries from other activities, incorrect weight-training exercises could worsen the injury. (Ulrika Aasa et al., 2017) As well as, sudden twisting movements, poor alignment, and pre-existing injuries can increase the risk of worsening or creating further injuries. (Hagen Hartmann et al, 2013) The body and the knees are designed to support vertical forces on the joints.

Common Injuries

Weightlifting knee injuries occur as the knee joints endure a wide range of stresses and strains. In weight training, the ligaments that attach to the complex bone system of the knee joint can be damaged by incorrect movements, overloading the weight, and increasing the weight too soon. These injuries can result in pain, swelling, and immobility that can range from minor to severe, from a sprain or a slight tear to a complete tear in serious cases.

Anterior Cruciate Ligament – ACL – Injury

This ligament attaches the thigh’s femur bone to the lower leg’s shin bone/tibia and controls excessive rotation or extension of the knee joint. (American Academy of Family Physicians. 2024)

  • Anterior means front.
  • ACL injuries are seen mostly in athletes but can happen to anybody.
  • Severe damage to the ACL usually means surgical reconstruction and up to 12 months of rehabilitation.
  • When weightlifting, try to avoid twisting knee movements, intentionally or accidentally, under excessive load.

Posterior Cruciate Ligament – PCL – Injury

  • The PCL connects the femur and tibia at different points to the ACL.
  • It controls any backward motion of the tibia at the joint.
  • Injuries occur most with high-impact forces as a result of accidents and sometimes in activities where forceful trauma to the knee occurs.

Medial Collateral Ligament – MCL – Injury

  • This ligament maintains the knee from bending too far to the inside/medially.
  • Injuries mostly occur from impact to the outside of the knee or from accidental bodyweight force on the leg that bends at an unusual angle.

Lateral Collateral Ligament – LCL – Injury

  • This ligament connects the smaller bone of the lower leg/fibula to the femur.
  • It is opposite to the MCL.
  • It maintains excessive outward movement.
  • LCL injuries occur when a force pushes the knee out.

Cartilage Injury

  • Cartilage prevents bones from rubbing together and cushions impact forces.
  • Knee menisci are cartilage that cushions the knee joints inside and outside.
  • Other types of cartilage protect the thigh and shin bones.
  • When cartilage gets torn or damaged, surgery may be required.

Tendonitis

  • Aggravated and overused knee tendons can lead to weightlifting knee injuries.
  • A related injury known as iliotibial band syndrome/ITB causes pain to the outside of the knee, usually in runners, but it can occur from overuse.
  • Rest, stretching, physical therapy, and anti-inflammatory medication are a common treatment plan.
  • Individuals should consult a physical therapist for pain lasting longer than two weeks. (Simeon Mellinger, Grace Anne Neurohr 2019)

Osteoarthritis

  • As the body ages, normal wear and tear can cause the development of osteoarthritis of the knee joints. (Jeffrey B. Driban et al., 2017)
  • The condition causes the cartilage to deteriorate and bones to rub together, resulting in pain and stiffness.

Prevention

  • Individuals can minimize their risk of weightlifting knee injuries and pain by following their doctor’s and personal trainers’ recommendations.
  • Individuals with an existing knee injury should follow their doctor’s or physical therapist’s recommendations.
  • A knee sleeve can keep the muscles and joints secure, providing protection and support.
  • Stretching the leg and knee muscles can maintain joint flexibility.
  • Avoid sudden lateral movements.
  • Possible recommendations can include:

Avoiding Certain Exercises

  • Isolation exercises like leg curls, standing, or on a bench, as well as using the leg extension machine, can stress the knee.

Deep Squat Training

Research shows that the deep squat can protect against lower leg injury if the knee is healthy. However, this is when done with proper technique, under expert supervision, and with a gradual progressive load. (Hagen Hartmann et al, 2013)

Individuals should talk to their doctor before beginning a new exercise routine. A personal trainer can provide training in learning the proper technique and weightlifting form.


How I Tore my ACL Part 2


References

Aasa, U., Svartholm, I., Andersson, F., & Berglund, L. (2017). Injuries among weightlifters and powerlifters: a systematic review. British journal of sports medicine, 51(4), 211–219. doi.org/10.1136/bjsports-2016-096037

Hartmann, H., Wirth, K., & Klusemann, M. (2013). Analysis of the load on the knee joint and vertebral column with changes in squatting depth and weight load. Sports medicine (Auckland, N.Z.), 43(10), 993–1008. doi.org/10.1007/s40279-013-0073-6

American Academy of Family Physicians. ACL injury. (2024). ACL injury (Diseases and Conditions, Issue. familydoctor.org/condition/acl-injuries/

Mellinger, S., & Neurohr, G. A. (2019). Evidence based treatment options for common knee injuries in runners. Annals of translational medicine, 7(Suppl 7), S249. doi.org/10.21037/atm.2019.04.08

Driban, J. B., Hootman, J. M., Sitler, M. R., Harris, K. P., & Cattano, N. M. (2017). Is Participation in Certain Sports Associated With Knee Osteoarthritis? A Systematic Review. Journal of athletic training, 52(6), 497–506. doi.org/10.4085/1062-6050-50.2.08

Symptoms of Heat Cramps: Causes & Treatment

Symptoms of Heat Cramps: Causes & Treatment

Individuals that engage in heavy exercise can develop heat cramps from overexertion. Can knowing the causes and symptoms help prevent future episodes from happening?

Symptoms of Heat Cramps: Causes & Treatment

Heat Cramps

Heat cramps can develop during exercise from overexertion or prolonged exposure to high temperatures. The muscle cramps, spasms, and pain can range from mild to severe.

Muscle Cramps and Dehydration

Heat cramps often develop because of dehydration and electrolyte loss. (Robert Gauer, Bryce K. Meyers 2019) Symptoms include:

Electrolytes like sodium, calcium, and magnesium are important for properly functioning muscles, including the heart. The primary role of sweating is to regulate the body’s temperature. (MedlinePlus. 2015) Sweat is mostly water, electrolytes, and sodium. Excessive sweating from physical activity and exertion or a hot environment can cause electrolyte imbalances that lead to cramps, spasms, and other symptoms.

Causes and Activities

Heat cramps most commonly affect individuals who sweat excessively during strenuous activity or are exposed to hot temperatures for prolonged periods. The body and organs need to cool down, which causes sweat production. However, too much sweating can lead to dehydration and electrolyte depletion. (Centers for Disease Control and Prevention. 2022)

Risk Factors

Factors that can increase the risk of developing heat cramps include: (Robert Gauer, Bryce K. Meyers 2019)

  • Age – Children and adults 65 years and older have the highest risk.
  • Excessive sweating.
  • Low sodium diet.
  • Preexisting Medical Conditions – heart disease, diabetes mellitus, and obesity are conditions that can increase the risk of muscle cramping.
  • Medications – blood pressure, diuretics, and antidepressants can affect electrolyte balance and hydration.
  • Alcohol consumption.

Self-Care

If heat cramps begin, immediately stop the activity and look for a cool environment. Rehydrate the body to replenish the fluid loss. Staying hydrated and drinking fluids regularly during intense activity or in a hot environment can help prevent the body from cramping. examples of beverages that increase electrolytes include:

Gently applying pressure and massaging affected muscles can help reduce pain and spasms. As symptoms resolve, it is recommended to not return to strenuous activity too soon because additional exertion can progressively lead to heatstroke or heat exhaustion. (Centers for Disease Control and Prevention. 2021) Heatstroke and heat exhaustion are two heat-related illnesses. (Centers for Disease Control and Prevention. 2022)

  • Heatstroke is when the body loses the ability to regulate temperature and can cause dangerously high temperatures.
  • Heat exhaustion is the body’s response to excessive fluid and electrolyte loss.

Symptom Timing

The timing and length of heat cramps can determine whether medical attention is necessary. (Centers for Disease Control and Prevention. 2022)

During or After Activities

  • The majority of heat cramps develop during activities because of the exertion and sweating, causing more electrolytes to be lost and the body to become more dehydrated.
  • Symptoms can also develop minutes to hours after activity has ceased.

Duration

  • Most heat-related muscle cramps will resolve with rest and hydration within 30–60 minutes.
  • If muscle cramping or spasms do not subside within one hour, seek professional medical attention.
  • For individuals with heart conditions or on a low-sodium diet who develop heat cramps, regardless of duration, medical help is necessary to ensure there are no complications.

Prevention

Tips for preventing heat cramps include: (Centers for Disease Control and Prevention. 2022)

  • Drink plenty of fluids before and during physical activities.
  • Avoid alcohol and caffeinated beverages.
  • Avoid exercising or exposure to extreme heat during peak sunlight hours.
  • Avoid tight and dark-colored clothing.

Assessing Patients In A Chiropractic Setting


References

Gauer, R., & Meyers, B. K. (2019). Heat-Related Illnesses. American family physician, 99(8), 482–489.

Centers for Disease Control and Prevention. (2022). Heat stress — heat related illness. The National Institute for Occupational Safety and Health (NIOSH) Retrieved from www.cdc.gov/niosh/topics/heatstress/heatrelillness.html#cramps

MedlinePlus. (2015). Sweat. Retrieved from medlineplus.gov/sweat.html#cat_47

FoodData Central. (2019). Nuts, coconut water (liquid from coconuts). Retrieved from fdc.nal.usda.gov/fdc-app.html#/food-details/170174/nutrients

FoodData Central. (2019). Milk, nonfat, fluid, with added vitamin A and vitamin D (fat free or skim). Retrieved from fdc.nal.usda.gov/fdc-app.html#/food-details/746776/nutrients

Centers for Disease Control and Prevention. (2012). Frequently asked questions (FAQ) about extreme heat. Retrieved from www.cdc.gov/disasters/extremeheat/faq.html

How to Identify and Treat Finger Sprains and Dislocations

How to Identify and Treat Finger Sprains and Dislocations

Finger sprains and dislocations are common hand injuries that can happen during work, physical/sports activities, or in automobile collisions and accidents. Can recognizing the symptoms help in developing an effective treatment strategy?

How to Identify and Treat Finger Sprains and Dislocations

Finger Sprains and Dislocations

Finger sprains and dislocations are common injuries of the hand that cause pain and swelling.

  • A sprain happens when the finger tissue that supports a joint gets stretched beyond its limits in a way that stresses the ligaments and tendons.
  • The ligament tissue can be partially or completely torn. If the damage is bad enough, the joint comes apart.
  • This is a dislocation – A dislocation happens when the joint in the finger gets shifted out of its normal position.
  • Both injuries can cause pain and stiffness in the finger and hand.

Sprains

Finger sprains can happen any time the finger bends in an awkward or unusual way. This can happen from falling on the hand or getting hurt when engaged in physical activities like sports or household chores. Sprains can occur in any of the knuckle joints in the finger. However, most commonly, the joint in the middle of the finger gets sprained. It’s known as the proximal interphalangeal or PIP joint. (John Elfar, Tobias Mann. 2013) Symptoms of a finger sprain can include:

  • Pain when you move your finger
  • Swelling around the knuckle
  • Tenderness in the finger and around the joint
  • For a sprain, individuals may need to have imaging done to see if any of the bones in the hand are broken or fractured. (OrthoInfo. American Academy of Orthopaedic Surgeons. 2022)

Treatment

Individuals are encouraged not to move the injured finger while in recovery and healing. It can be hard to do, but wearing a splint can help.

  • Splints are supports that are usually made from foam and pliable metal.
  • A sprained finger can also be taped to one of the fingers next to it while in recovery, known as buddy-taping.
  • Splinting a sprained finger while engaged in activities can protect the hand from worsening or further injury.
  • However, splinting the finger when it is not needed can cause the joint to become stiff. (OrthoInfo. American Academy of Orthopaedic Surgeons. 2022)
  1. An injury known as “gamekeeper’s thumb” is a more serious type of sprain.
  2. Injury to the ligaments at the thumb joint can cause difficulty in pinching and gripping.
  3. This injury must often be taped up or splinted for a significant amount of time for full recovery and could require surgery. (Chen-Yu Hung, Matthew Varacallo, Ke-Vin Chang. 2023)

Other treatments to help a sprained finger include:

  • Elevate the hand if swelling and inflamed.
  • Gentle finger exercises/movements to prevent stiffness.
  • Icing the injured finger.
  • Take an anti-inflammatory medication.

Individuals who have not broken bones or dislocated the joint will probably be able to move their finger in about a week. A doctor will set a timeline for when to start using the finger normally.

  1. Individuals who sprain their finger that feels swollen and stiff for longer than a few weeks are recommended to consult a doctor or specialist.
  2. They will need to check the hand to make ensure there aren’t any breaks or fractures. (OrthoInfo. American Academy of Orthopaedic Surgeons. 2022)
  3. Thumb sprains and finger sprains in children may need to be splinted or taped for longer periods, as the ligament is not fully developed or as strong, which could lead to a tear.

Dislocations

A finger dislocation is a more severe injury involving the ligament, joint capsule, cartilage, and other tissues that causes misalignment of the finger. The ligaments and the joint capsule get torn when a joint is dislocated. The joint needs to be reset, which can be a simple process, or in severe cases, patients may need to be placed under anesthesia or undergo surgery to reset the joint properly.

  • In these cases, tendons or other tissues might be preventing the joint from getting into position.
  • Putting the finger back into the right position is known as”reduction.” Once reduced, the finger needs to be splinted.
  • Individuals also need an X-ray to ensure the joint is lined up correctly and that any bones were not broken or fractured when they sustained the injury. (James R. Borchers, Thomas M. Best. 2012)
  • Once reset, caring for a dislocated finger is basically the same as a sprained finger. Using ice on the finger, keeping the hand elevated to reduce swelling.
  • Individuals need to check with their doctor to find out when to start moving the finger. (James R. Borchers, Thomas M. Best. 2012)

The Chiropractic Approach To Improving Health


References

Elfar, J., & Mann, T. (2013). Fracture-dislocations of the proximal interphalangeal joint. The Journal of the American Academy of Orthopaedic Surgeons, 21(2), 88–98. doi.org/10.5435/JAAOS-21-02-88

OrthoInfo from the American Academy of Orthopaedic Surgeons. (2022) Hand fractures.

Hung, C. Y., Varacallo, M., & Chang, K. V. (2023). Gamekeeper’s Thumb. In StatPearls. StatPearls Publishing.

OrthoInfo from the American Academy of Orthopaedic Surgeons. (2022) Finger fractures.

Borchers, J. R., & Best, T. M. (2012). Common finger fractures and dislocations. American family physician, 85(8), 805–810.

Understanding Iliopsoas Syndrome: Symptoms & Causes

Understanding Iliopsoas Syndrome: Symptoms & Causes

Individuals suffering from hip, thigh, and/or groin pain could be experiencing iliopsoas syndrome. Could knowing the symptoms and causes help in diagnosis and treatment?

Understanding Iliopsoas Syndrome: Symptoms & Causes

Iliopsoas Syndrome

Iliopsoas syndrome encompasses several conditions that affect the inner hip muscle and can cause hip and thigh pain. The muscle helps to bend the leg toward the body.

  • The condition is usually caused by overuse injuries and commonly affects individuals who perform repeated hip flexion movements, like cyclists, gymnasts, dancers, runners, and soccer players. (Liran Lifshitz, et al., 2020)
  • The term is often used interchangeably with psoas syndrome, iliopsoas tendonitis, snapping hip syndrome, and iliopsoas bursitis. However, there are clinical differences.

Symptoms

Symptoms include: (American Association of Hip and Knee Surgeons. 2020)

  • Tenderness in the hip and groin area.
  • Hip or groin clicking or snapping that can be heard and/or felt during movement.
  • Pain and/or stiffness in the hip and thigh area.
  • Pain that worsens when bending the hip – walking, climbing stairs, squatting, sitting.
  • Movements that involve bringing the knee toward the chest can worsen the pain.

Causes

The iliopsoas muscles are hip muscles on the front of the hip. They are made up of the psoas major, the psoas minor, and the iliacus. Small, fluid-filled sacs/bursae are within the hip joint between bones and soft tissues. The bursae reduce friction and provide cushioning to help the tendons, muscles, and other structures move smoothly over the bony prominences.

  1. Iliopsoas bursitis happens when the bursa, which is located between the iliopsoas tendon and the inside of the hip joint, becomes inflamed and irritated.
  2. Iliopsoas tendonitis/hip tendonitis happens when the tendon that attaches the thigh bone to the iliopsoas muscle becomes inflamed and irritated.
  3. Iliopsoas bursitis and tendonitis are commonly caused by overuse injuries and intense activities like cycling, running, rowing, or strength training.

Diagnosis

  • Healthcare providers can diagnose iliopsoas syndrome based on symptom history and a hip examination.
  • Imaging tests – MRI and X-rays may be used to rule out other injuries or conditions like muscle tears. (Paul Walker, et al., 2021)

Treatment

Most mild cases of hip bursitis and hip tendonitis can be managed using the RICE method (American Association of Orthopedic Surgeons. 2020)

Rest

  • Avoid putting weight on the hip for a few days after the injury.

Ice

  • Apply ice immediately after the injury to bring the swelling down.
  • Use a cold pack for 20 minutes at a time, several times a day.
  • Do not apply ice directly on the skin.

Compression

  • Wrap the area in a soft bandage or use compression shorts to prevent further swelling.

Elevation

  • Rest as often as possible with the leg raised higher than the heart.

Medical Treatment

  • Non-steroidal anti-inflammatory drugs like ibuprofen and naproxen sodium can alleviate pain and reduce inflammation. (Paul Walker, et al., 2021)
  • Steroid injections can be used if symptoms continue or come back with additional injections administered as necessary. (Paul Walker, et al., 2021)
  • After pain and swelling subside, physical therapy may be recommended, as well as mild exercises to gradually improve hip strength and flexibility. (Paul Walker, et al., 2021)
  • A healthcare provider may recommend surgery in severe cases where pain persists, and conservative treatments don’t provide enough relief.
  • However, this is rare due to muscle weakness and nerve damage risks. (Paul Walker, et al., 2021)

Hip Labral Tear – Chiropractic Treatment


References

Lifshitz, L., Bar Sela, S., Gal, N., Martin, R., & Fleitman Klar, M. (2020). Iliopsoas the Hidden Muscle: Anatomy, Diagnosis, and Treatment. Current sports medicine reports, 19(6), 235–243. doi.org/10.1249/JSR.0000000000000723

American Association of Hip and Knee Surgeons. Iliopsoas tendonitis/bursitis.

Walker, P., Ellis, E., Scofield, J., Kongchum, T., Sherman, W. F., & Kaye, A. D. (2021). Snapping Hip Syndrome: A Comprehensive Update. Orthopedic reviews, 13(2), 25088. doi.org/10.52965/001c.25088

American Association of Orthopedic Surgeons. OrthoInfo. Hip strains.

A Guide to Complete Hamstring Muscle Injury Recovery

A Guide to Complete Hamstring Muscle Injury Recovery

Hamstring muscle injuries are common, especially in athletes and individuals with physically demanding jobs. Is there a better chance of full recovery with surgical repair and post-op rehabilitation?

A Guide to Complete Hamstring Muscle Injury Recovery

Hamstring Muscle Tear

Most often, hamstring muscle injuries are partial tears of the muscle. These types of injuries are muscle strains that occur when the muscle fibers are stretched beyond their normal limits. Complete tears of the hamstring muscle are unusual, but they do occur in both athletes and non-athletes. Determining the optimal treatment plan depends on:

  • The severity of the tendon tear
  • The expectations of the injured individual.
  1. Incomplete tears are when the hamstring muscle is stretched too far, but not completely detached.
  2. If the tear completes, the injury is more significant, as the ends are no longer connected. (American Academy of Orthopaedic Surgeons. 2021)
  3. Complete tears usually occur at the top of the muscle where the tendon tears away from the pelvis.
  4. A complete tear usually occurs when there is a sudden flexion of the hip and extension of the knee joint – when the muscle contracts in this position, it gets stretched beyond its limits.
  5. Complete tears are recognized as different injuries and may require more invasive treatments. (American Academy of Orthopaedic Surgeons. 2021)
  6. Individuals who sustain this type of injury describe a sharp stabbing in the back of the thigh.
  7. The injury may occur in athletes or middle-aged individuals. (American Academy of Orthopaedic Surgeons. 2021)

Basic hamstring strains can be treated with simple steps – rest, ice, anti-inflammatory medications, and conservative therapies.

Symptoms

Symptoms of a hamstring muscle strain can include pain, bruising, swelling, and movement difficulty. (American Academy of Orthopaedic Surgeons. 2021) Individuals who sustain this injury typically experience sudden sharp pain. Signs of a tear can include:

  • Sharp pain where the buttock and thigh meet.
  • Difficulty walking.
  • Sitting can be difficult as the edge of a chair can place pressure directly on the injury.
  • Spasms and cramping sensations in the back of the thigh.
  • Weakness in the leg, specifically when bending the knee or lifting the leg behind the body.
  • Numbness or burning sensations as a result of sciatic nerve irritation.
  • Swelling and bruising in the back of the thigh – over time it can travel down to the back of the knee and calf and possibly into the foot.
  • With a complete hamstring tear, there is usually significant swelling and bruising that develops in the back of the thigh.

Diagnosis

The symptoms can be difficult to spot in the early stages which is why X-rays of the hip or thigh are usually obtained.

In some situations, a fragment of bone can get pulled off the pelvis along with the hamstring muscle attachment. MRI testing can be performed to evaluate the attachment and can define critical features of a complete hamstring muscle tear, including: (American Academy of Orthopaedic Surgeons. 2021)

  • The number of tendons involved.
  • Complete versus incomplete tearing.
  • The amount of retraction – the amount the tendons have pulled back.
  • This will guide the development of treatment.

Treatment

The treatment of a complete tear will depend on different factors. The other variable is the patient and their expectations.

  • Treatment is more aggressive in younger individuals like high-level athletes.
  • Treatment is less aggressive in middle-aged individuals.
  • Often a single tendon tear can be treated non-surgically.
  • When one tendon is involved, it is typically not pulled very far from its normal attachment and will develop scar tissue in a positive position.
  • Conversely, when three tendons have been torn, they usually pull more than a few centimeters away from the bone. These cases have better results with surgical repair. (UW Health. 2017)
  • Surgeons will use patient characteristics – high-level athletes or less physically active individuals – to guide treatment recommendations.

Rehabilitation

  • Rehabilitation following surgery can take 3-6 months or longer.
  • The first six weeks limit weight-bearing with the use of crutches.
  • Patients may be recommended to wear a brace to reduce tension on the repaired hamstring tendons.
  • Strengthening does not begin until three months post-op, and even light activities are usually delayed. (UW Health. 2017)
  • Because this injury can have a long recovery time, some individuals may choose nonsurgical treatment.
  • Sometimes these individuals experience symptoms of discomfort from sitting and may exhibit long-term weakness of the hamstring muscle.

Full recovery from a complete hamstring muscle injury takes time. Studies have shown high-level athletes are able to resume competitive sports after the repair and rehabilitation of an acute hamstring muscle injury. (Samuel K. Chu, Monica E. Rho. 2016)

  • Delaying surgical treatment may not always lead to optimal results.
  • When the tendon is torn away from its normal attachment, it begins to scar around the surrounding soft tissues.
  • When there is a delay of more than a few weeks following the initial injury, regaining the full length of the tendon and muscle can be challenging.
  • This could delay the rehabilitation process and may limit the potential for full recovery. (Ho Yoon Kwak, et al., 2011)

With severe injuries, there is a better chance of full recovery with surgical repair but could involve a long recovery and commitment to a post-op rehabilitation plan.



References

American Academy of Orthopaedic Surgeons. (2021) Hamstring muscle injuries.

UW Health. (2017) Rehabilitation guidelines following proximal hamstring primary repair.

Chu, S. K., & Rho, M. E. (2016). Hamstring Injuries in the Athlete: Diagnosis, Treatment, and Return to Play. Current sports medicine reports, 15(3), 184–190. doi.org/10.1249/JSR.0000000000000264

Kwak, H. Y., Bae, S. W., Choi, Y. S., & Jang, M. S. (2011). Early surgical repair of acute complete rupture of the proximal hamstring tendons. Clinics in orthopedic surgery, 3(3), 249–253. doi.org/10.4055/cios.2011.3.3.249