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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.


Reflex Pain Chiropractic Clinic

Reflex Pain Chiropractic Clinic

Reflex pain is a complex condition that involves the body’s pain withdrawal reflex failing to turn off after the event that triggered the pain, so the pain sensations continue. This is a neurological condition known as the withdrawal reflex. It occurs when the body and brain undergo a chain of reactions to remove an affected body part from dangerous situations/stimuli. A typical example is a vehicle crash or accident. During the process, the body’s reflex muscle\s in the injured area tighten to protect the specific body part/s from further damage.

Reflex Pain Chiropractor

The reflex can feel like a muscle spasm that goes away over time. However, in the case of reflex pain, the signals keep firing. Reflex pain can occur all over the body as the muscles overcompensate to handle the prolonged pain; secondary injuries often develop. An example could be reflex pain in the ankle caused by injury or problems in the hips and back, where the individual tries to avoid moving the ankle in a specific way to prevent and avoid the pain symptoms. Individuals with reflex pain also experience headaches and referred spine and extremity pain. Reflex pain can become a cycle of symptoms that include:

  • Unusual tightness
  • Stiffness
  • Pain
  • Contracture – hardening or shortening of the affected muscles, tendons, or other tissues.
  • Decreased functional abilities.

Somatic Pain

Somatic pain causes receptors in tissues including the skin, muscles, connective tissues, joints, and skeleton to be activated. Stimuli like force trauma, vibration, extreme temperature, or inflammation/swelling activate these receptors. The pain is often described as:

  • Aching
  • Gnawing
  • Cramping
  • Sharp

Somatic pain is often localized to a particular area that is constant and stimulated by movement. There are two types.

  • Superficial pain occurs when everyday injuries activate pain receptors in the skin and mucous membranes.
  • Deep somatic pain occurs when stimuli activate pain receptors deeper in the body, including the tendons, joints, bones, and muscles. Deep body pain usually feels more like aching.
  • Pain can be confined to a local area or radiate to other areas of the body, depending on the extent of the injury.

Somatic pain can come from a variety of different potential causes that include:

  • Injury to joints or bones.
  • Trauma.
  • Fall or collision that damages connective tissues.
  • Strained muscles from overuse.
  • Bone fracture.
  • Arthritis that causes swelling in the joints.
  • Diseases that affect connective tissues.
  • Bone or skin cancers.

Sometimes these reflexes can stay in the on position and keep the body from achieving full relaxation.

In the nervous system, a body part is stimulated, and the message travels through the spinal cord and into the brain. The information is processed, then sent back through the spinal cord to the level that activates the specific body part. The reflexes transmit faster staying at the same spinal level without having to travel to the brain and back again.

During reflex pain, the body’s muscles are unable to relax, which is necessary for motion/movement. This prolonged contraction generates added pain and causes imbalances that can decrease excitability in the muscles. This can increase the activation of brain receptors that receive pain signals to respond by telling them to shorten and contract.

Therapy

Body misalignment can cause muscles to spasm, causing the nerves to stretch in an awkward way, compress, and get twisted and tangled around other nerves or other tissues. This disrupts communication resulting in pain, illness, and ailments that can lead to other health problems. Chiropractic care can address reflex pain by realigning the spine and improving joint motion and nerve conduction.

Chiropractic restores the body to its full and proper function by activating the natural healing abilities. Manual and mechanical spinal decompression realigns the vertebrae, reducing swelling, blockages, and nerve stress. A comprehensive examination will identify potential dysfunctional areas of the body using palpitations to identify which muscles are involved. Once identified, chiropractic, massage, and physical therapy options can be prescribed to rebalance the body’s muscles, and restore their ability to contract and relax normally.

  • Patient education will be provided concerning self-assessment techniques, instruction on how to treat pain, and an anti-inflammatory diet.
  • An exercise and stretching program will help maintain the adjustments, keep the body flexible, and strengthen the body.
  • Patients are helped to understand how to take control of their pain.

Spinal Decompression Testimonials


References

Biurrun-Manresa J, Neziry A, Curatolo M, Arendt-Nielson L, Anderson O. Test-retest reliability of the nociceptive withdrawal reflex and electrical pain thresholds after single and repeated stimulation in patients with chronic low back pain. Eur J Appl Physiol. 2011;111:83-92

Derderian C, Tadi P. Physiology, Withdrawal Response. [Updated 2021 Nov 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK544292/

Muir, J M, and H Vernon. “Complex regional pain syndrome and chiropractic.” Journal of manipulative and physiological therapeutics vol. 23,7 (2000): 490-7. doi:10.1067/mmt.2000.108816

Neziri A, Haesler S, Steen P, et al. Generalized expansion of nociceptive reflex receptive fields in chronic pain patients. Pain. 2010;151(3):798-805

Szynkowicz, Peter, and Anthony Petrucci 4th. “Chiropractic Care of a Patient With Complex Regional Pain Syndrome Type 1 (CRPS-1): A Case Report.” Journal of chiropractic medicine vol. 19,2 (2020): 145-151. doi:10.1016/j.jcm.2020.05.001

Yezierski R, Vierck C. Reflex and pain behaviors are not equivalent: Lessons from spinal cord injury. Pain. 2010;151(3):569-577

Forearm Pain Chiropractic Care

Forearm Pain Chiropractic Care

Forearm pain refers to soreness, aches, or discomfort between the wrist and the elbow. An injury or inflammation can affect any tissues, including muscles, bones, blood vessels, tendons, and the skin. The causes usually include overuse injuries, pinched nerves, accidents causing trauma, lifting or heaving heavy objects, sports injuries, and fractures. If left untreated, issues like chronic muscle pain and decreased and disrupted blood/nerve circulation can develop, leading to numbness and weakness. Chiropractic treatment can release tension, massage, reset, and stretch the muscles to expedite healing.

Forearm Pain Chiropractor

Anatomy

The forearm comprises the radius and ulna, which extend the forearm’s length and cross at the wrist.

The Radius

  • This bone starts at the elbow and connects to the wrist on the thumb side.

Ulna

  • This bone begins at the elbow and connects to the wrist on the side of the little finger.

Muscles

  • Several muscles operate to rotate the forearm up/supination and down/pronation and flex and extend the fingers.

Causes

Forearm pain can happen to anyone and is usually related to traumatic or repetitive use injury. In other cases, pain may be associated with a benign growth, like a cyst or possibly a malignant tumor. Common causes include:

  • Pulled and/or strained muscles
  • Muscle ruptures or small tears
  • A direct blow, fall, or any extreme twisting, bending or jamming action.
  • Tendonitis from tennis or golfers elbow.
  • Tennis elbow is caused by inflammation or tiny tears in the forearm muscles and tendons outside the elbow.
  • Golfers’ elbow is on the inside of the elbow.
  • Carpal Tunnel Syndrome is a repetitive stress disorder that affects the nerves and tendons of the wrist and forearm.

Musculoskeletal Causes

The musculoskeletal causes involve issues in how the forearm components operate together.

  • Repetitive actions like lifting, gripping, and typing can compress nerves and blood vessels throughout the forearm.
  • Repetitive positional injury can lead to swelling.
  • Forearm problems like dislocations or sprains can also lead to chronic inflammation and pain.

Traumatic Causes

Traumatic causes include those that result in injury to components of the forearm.

  • Anything that causes a direct injury to the forearm, including an automobile crash or accident, fall, or a direct hit, can fracture bones in the forearm.
  • A sprain can twist or stretch a ligament or tendon.
  • Activities that cause bending, twisting, quick sudden movement or direct impact can result in sprained multiple ligaments in the forearm.

Chiropractic Treatment

Healing forearm pain depends on the type of injury, location, and cause of the pain. Chiropractic addresses arm pain, tingling, and numbness in ways often overlooked by general physicians.

  • A chiropractor will perform a physical examination to determine if there are any underlying causes.
  • They may apply an ice pack to help control inflammation before the massage.
  • The chiropractor will perform gentle adjustments to the wrist, arm, and shoulder.
  • They may recommend a forearm brace to help retrain positioning and movement.
  • They will recommend exercises and stretches to strengthen and maintain the adjustments.

Carpal Tunnel Pain Treatment


References

Ellenbecker, Todd S et al. “Current concepts in examination and treatment of elbow tendon injury.” Sports health vol. 5,2 (2013): 186-94. doi:10.1177/1941738112464761

Shamsoddini, Alireza, and Mohammad Taghi Hollisaz. “Effects of taping on pain, grip strength and wrist extension force in patients with tennis elbow.” Trauma monthly vol. 18,2 (2013): 71-4. doi:10.5812/traumamon.12450

Suito, Motomu, et al. “Intertendinous epidermoid cyst of the forearm.” Case reports in plastic surgery & hand surgery vol. 6,1 25-28. 28 Jan. 2019, doi:10.1080/23320885.2018.1564314

Injury Medical Spinal Decompression

Injury Medical Spinal Decompression

Injury Medical Spinal Decompression: Spinal decompression therapy/treatment can be surgical or non-surgical, with differences in the procedure, recovery time, and results. Individuals who experience compression-related problems can have severe and prolonged spinal conditions that can lead to various health issues. Individuals experiencing persistent or chronic neck, back, or leg pain should know the differences between surgical and non-surgical spinal decompression. Spinal decompression aims to relieve pressure on the discs and reduce stress on the nerves to eliminate the pain associated with compression on the spine, restoring optimal circulation and improving spinal function.

Injury Medical Spinal Decompression

Surgical Procedure

  • It is invasive, must be performed by a surgeon, and can have a recovery time of up to 6 weeks.
  • Surgery is usually suggested as a last resort after alternative therapies have not succeeded or when the compression is so severe that surgery is the only option.
  • Surgical spinal decompression is directed towards removal to reduce pressure instead of adjusting or stretching the discs.
  • In cases of severe nerve compression, surgery can be an effective option.
  • Risks include infection, damage to the spinal cord, and blood clots.

Types of Spinal Decompression Surgery

Types of surgeries; spinal fusion could be necessary to stabilize the spine. Common types of back surgery:

Discectomy

  • This procedure removes a portion of the disc to relieve pressure on nerves.

Laminotomy

  • The procedure removes a small portion of the bone or a section of the bony arch to increase the size of the spinal canal and relieve pressure.

Laminectomy

  • The procedure removes the entire bony arch or lamina to increase the size of the spinal canal and relieve pressure.

Foraminotomy

  • This procedure removes bone and other tissue to widen the openings for the nerve roots to pass through.

Osteophyte Removal

  • The procedure involves removing bony growths.

Corpectomy

  • The procedure removes a vertebral body along with discs.

Injury Medical Spinal Decompression

Surgery for a damaged/injured spine is not always necessary. Treatment regimes vary depending on each individual’s medical condition. Non-surgical motorized spinal decompression is a non-invasive back treatment that uses a mechanized decompression table to slowly and gently stretch the spine. The therapy gradually relieves the pressure on the compressed nerve root/s resulting in reduced or complete alleviation of pain.

Non-Surgical Spinal Decompression Treats

  • Neck pain
  • Back pain
  • Sciatica
  • Injured, damaged, or diseased nerve roots
  • Damaged discs
  • Deteriorated discs
  • Bulging or Herniated discs
  • Osteoarthritis
  • Facet Joint Syndrome

Benefits

  • Painless
  • Non-invasive
  • Sessions only take 30-45 minutes
  • Feel immediate results

Decompression Program

An Injury Medical Spinal Decompression program incorporates:

Injury Medical Spinal Decompression Sessions

  • Decompression treatment sessions last about 30-45 minutes for 4-6 weeks.
  • The sessions are conducted in the chiropractor’s office.

Post Decompression Treatment

  • This is necessary to ensure that the injured areas are fully relaxed and conditioned for chiropractic manual adjustments.
  • Massage therapy
  • Percussive massage
  • Cold laser
  • Heat and/or ice
  • These treatments facilitate blood and nerve circulation.

Chiropractic Adjustments

  • Chiropractic adjustments enhance decompression by fine-tuning mechanical and structural misalignments.

Health Coaching

Supplements and essential vitamins:

  • Support, repair, and restore the discs
  • Decrease inflammation
  • Increase healing

Core Strengthening/Postural Rehabilitation

  • Core exercises are recommended to strengthen the muscles and soft tissues.
  • Posture exercises

Oxygen, water, and nutrients circulate abundantly, promoting healing as the discs re-hydrate, and are re-nourished, improving and enhancing spine function. Individuals can enjoy increased levels of mobility, strength in the spine and muscles, and more flexibility.


Descompresión Espinal Con La DRX9000


 

References

American Spinal Decompression Association: “Spinal Decompression Therapy.”

Daniel, D.M. Chiropractic and Osteopathy, 2007.

Macario, Alex, and Joseph V Pergolizzi. “Systematic literature review of spinal decompression via motorized traction for chronic discogenic low back pain.” Pain practice: the official journal of World Institute of Pain vol. 6,3 (2006): 171-8. doi:10.1111/j.1533-2500.2006.00082.x

O’Hara K, editor. Decompression: a treatment for back pain. Vol. 11. National Association of Healthcare Professionals; 2004. pp. 1-2.www.naohp.com/menu/publications/mccu/bibliography.htm#10 [Google Scholar]

Sacral Fracture

Sacral Fracture

For older individuals, experiencing frequent low back pain could turn out to be a sacral fracture. They tend to occur in individuals over the age of 60 often because there has been a degree of bone loss. Sacral fractures tend not to be the first thing doctors think of when low back pain symptoms are presenting. They are often not picked up on X-rays and are either not diagnosed early enough to take steps or not diagnosed at all. However, they are common.

Sacral Fracture

Sacrum

The sacrum is shaped like a triangle and comprises five segments fused into one large bone. It sits at the base of the spine,  between the two halves of the pelvis, connecting the spine to the lower half of the body. It stabilizes the body when walking, sitting, or standing. The nerves in the lower spine control the bowels bladder and provide sensation to the region.

  • The two dimples that can be seen on individuals’ backs are where the sacrum joins the hipbones or the sacroiliac joint.
  • The point where the low back joins the sacrum can develop discomfort, soreness, and pain.
  • This area experiences stress from bending, twisting, reaching, lifting, carrying during physical activities or sitting for long periods.

Sacral Fracture

Most sacral fractures result from trauma, like slips, falls, and automobile accidents. Stress fractures that happen without a specific injury are also called insufficiency fractures.

Types of Sacral Fractures

  • Low-energy fractures usually happen to older individuals with weak bones due to osteoporosis.
  • An individual trips on something, lands hard on their butt, lifts a heavy object awkwardly, or over-exerts themselves from some physical activity.
  • Then persistent back or buttock pain begins to present.
  • The pain is often centered in the lower back, the hips, and butt.
  • It is more than just back achiness.
  • The individual goes to the doctor, and X-rays are ordered.
  • A lot of the time, these fractures are missed on X-rays.
  • The doctor may diagnose a sprain, but the pain symptoms do not improve.
  • Sometimes there is no apparent cause for the pain.
  • It can be misdiagnosed as a lower back compression fracture or urinary tract infection.

 

  • High-energy fractures are due to trauma and are more common among the young.
  • The individual sustains injuries from an auto accident, has fallen from a significant height, or suffers a sports injury.
  • It results in severe pain.
  • A woman who has just had a baby and gone through some bone loss because of the pregnancy can experience a sacral stress fracture.

Diagnosis

The most common causes for low back pain include:

  • Frequent improper posture.
  • Muscle weakness or tightness.
  • Ligament strain.
  • Joint inflammation.
  • A pilonidal cyst or an anal fissure can also cause pain.

For individuals that have been to a doctor and had an X-ray that reveals no fracture, and there is no improvement after 5 to 7 days, it is recommended to schedule another appointment and ask for a CAT scan or MRI, which is highly effective at finding a sacral fracture.

Treatment

Treatment consists of resting the bone but still being safely active in most cases.

  • Medication is prescribed for pain relief.
  • Many individuals have been found to do well with anti-inflammatory medications, topical medications, and lidocaine patches.
  • Older individuals may be recommended to use a walker during the treatment/healing process.
  • Depending on the severity, crutches may be recommended.
  • Engaging in regular exercise is not recommended, but too much bed rest is also not recommended.
  • Too much rest may not allow the injury to heal correctly, worsen the injury, and/or cause new injuries.
  • Chiropractic and physical therapy are not recommended to let the sacrum naturally heal.
  • After the pain subsides, chiropractic and physical therapy can be implemented to maintain agility and flexibility and strengthen the pelvic and core muscles.

In some cases, if the bone does not heal correctly or some other issue, sacroplasty could be recommended. This is a minimally invasive procedure that injects bone cement into the fracture. It offers quick and long-lasting pain relief with a low percentage of complications. It is considered low risk and can be done by an interventional radiologist or spine surgeon.

Prevention

To minimize the risk of a sacral fracture, it is highly recommended to maintain bone strength. This consists of:


Body Composition


Sitting Posture Adjustments

Adjust Sitting

Change Chair

  • Try a solid wooden chair if unable to use a ball or sit-stand desk.
  • It will make the body sit up straight and increase proper posture.

Move Around Alarm

References

Gibbs, Wende Nocton, and Amish Doshi. “Sacral Fractures and Sacroplasty.” Neuroimaging clinics of North America vol. 29,4 (2019): 515-527. doi:10.1016/j.nic.2019.07.003

Holmes, Michael W R, et al. “Evaluating Abdominal and Lower-Back Muscle Activity While Performing Core Exercises on a Stability Ball and a Dynamic Office Chair.” Human factors vol. 57,7 (2015): 1149-61. doi:10.1177/0018720815593184

Santolini, Emmanuele et al. “Sacral fractures: issues, challenges, solutions.” EFORT open reviews vol. 5,5 299-311. 5 May. 2020, doi:10.1302/2058-5241.5.190064

TMJ: Jaw Disorders

TMJ: Jaw Disorders

The temporomandibular (tem-puh-roe-man-dib-u-lur) joint TMJ acts as a sliding hinge that connects the jawbone to the skull. There is one joint on each side of the jaw. TMJ jaw disorders are also known as temporomandibular disorders – TMD. These disorders affect the connecting point between the jaw and the skull that causes swelling and pain in the joint and the muscles that control movement. The disorder can be caused by a combination of factors, like stress, genetics, arthritis, or injury. The symptoms, pain, and discomfort are often temporary and can be relieved with self-care and nonsurgical treatment like chiropractic.

TMJ: Jaw Disorders

Jaw Disorders

If the jaw is not moving correctly or becomes imbalanced, it can stress the temporomandibular joint. If this happens, the jaw muscles and the neck and shoulder muscles can tense up and over time become fatigued as they overwork to compensate and keep the jaw balanced. The bones that interact in the joint are covered with cartilage and are separated by a small shock-absorbing disc to maintain smooth movement. Jaw disorders can happen if:

  • The disc erodes or moves out of alignment.
  • The joint’s cartilage is damaged by arthritis.
  • The joint is damaged by impact trauma like hitting the head from a fall or sports accident.
  • Individuals that have been in an automobile accident.

Other factors include:

Symptoms

Symptoms of TMJ vary from case to case. These symptoms might include:

  • Problems with opening or closing the mouth
  • Difficulty or pain while chewing
  • Pain or tenderness of the jaw
  • Pain in one or both of the temporomandibular joints
  • Aching facial pain
  • Neck and shoulder pain
  • Headaches
  • Aching pain in and around the ear
  • Dizziness
  • Locking of the joint
  • Clicking sound
  • Grating sensation

Chiropractic Relief

Chiropractors can help with TMJ by alleviating tension and dysfunction in the shoulder, neck, and jaw. Once the dysfunction is relieved, it reduces the pressure on various nerves. Treatment includes:


Body Composition


The Glycemic Index

Not all carbs are equal, with some having a more significant effect on insulin levels than others. For individuals with diabetes or insulin resistance, this is important. A food’s Glycemic Index – ranging from 0 to 100 – indicates how a particular carbohydrate will affect blood sugar and insulin levels.

  • Foods that digest quickly are high on the index.
  • Foods that digest slowly are lower on the index.

Foods high on the GI scale, include potatoes and white bread, are quickly broken down. This is what happens when going through a sugar rush that comes crashing down minutes later. Foods low on the GI scale, include sweet potatoes and whole oats, are digested gradually. This results in a steady rise in blood sugar levels. The following factors may influence the GI scale:

Food processing

  • The more processed the food, the higher the GI.

Fat and acid content

  • Foods high in fat, acid, or carbs eaten with fat or acid tend to have a lower GI.

Fiber content

  • Fiber slows down the rate of digestion, leading to a gradual, healthy rise in blood sugar levels.

Ripeness

  • Ripened fruits tend to have a higher GI than unripened fruit.
References

Alcantara, Joel et al. “Chiropractic care of a patient with temporomandibular disorder and atlas subluxation.” Journal of manipulative and physiological therapeutics vol. 25,1 (2002): 63-70. doi:10.1067/mmt.2002.120415

DeVocht, James W et al. “A pilot study of a chiropractic intervention for management of chronic myofascial temporomandibular disorder.” Journal of the American Dental Association (1939) vol. 144,10 (2013): 1154-63. doi:10.14219/jada.archive.2013.0034

Pavia, Steven et al. “Chiropractic Treatment of Temporomandibular Dysfunction: A Retrospective Case Series.” Journal of chiropractic medicine vol. 14,4 (2015): 279-84. doi:10.1016/j.jcm.2015.08.005

Rubis, Lisa M et al. “A collaborative approach between chiropractic and dentistry to address temporomandibular dysfunction: a case report.” Journal of chiropractic medicine vol. 13,1 (2014): 55-61. doi:10.1016/j.jcm.2013.10.003

Thoracic Back Pain

Thoracic Back Pain

The thoracic spine, also known as the upper or middle back, is designed for stability to anchor the rib cage and protect the organs in the chest. It is highly resistant to injury and pain. However, when thoracic back pain does present, it is usually from long-term posture problems or an injury. Thoracic back pain is less common than lower back and neck pain, but it does affect up to 20% of the population, particularly women. Treatment options include chiropractic for quick and long-term pain relief.

Thoracic Back Pain

Thoracic Back Pain and Soreness

The thoracic area is vital for various functions related to:

Common reasons for experiencing thoracic back pain include:

  • A direct hit or high-impact injury from a fall.
  • Sports injury.
  • Automobile accident.
  • Unhealthy postures that put the spine in chronic misalignment, causing strain.
  • Repetitive overuse injury from bending, reaching, lifting, twisting.
  • Poor core or shoulder mechanics, causing muscle imbalance.
  • Muscular irritation, the large upper back muscles are prone to developing strains or tightness that can be painful and difficult to alleviate.
  • De-conditioning or lack of strength.
  • Joint dysfunction can come from a sudden injury or natural degeneration from aging. Examples include facet joint cartilage tear or joint capsule tear.

Upper back pain usually feels like a sharp, burning pain localized to one spot or a general achiness that can flare up and spread out to the shoulder, neck, and arms.

Types of Upper Back Pain

These include:

  • Myofascial pain
  • Spine degeneration
  • Joint dysfunction
  • Nerve dysfunction
  • General spinal misalignments

Depending on what specific tissues are affected, pain can occur with breathing or arm use. It is recommended to have a healthcare professional perform an examination and get an accurate diagnosis. A chiropractor understands the delicate balance and functions that the thoracic spine provides and can develop a proper treatment plan.

Chiropractic

Treatment options will depend on the symptoms, underlying dysfunctions, and individual preferences. ​Recommendations for treatment often include:

  • Spine adjustments to improve alignment and nerve integrity.
  • Posture training to maintain spinal alignment.
  • Therapeutic massage.
  • Exercise training to restore muscular balance.
  • Non-invasive pain-relieving techniques.
  • Health coaching.

Body Composition


Plant-Based Diets for Weight Loss

Individuals who follow vegan, vegetarian, and semivegetarian diets have reported and shown they are less likely to be overweight or obese. This can indicate that reducing intake of meat and animal products is beneficial for weight loss. Studies have found that individuals who follow a vegan diet may lose more weight than individuals on a more conventional weight loss diet, even with similar calories consumed, and often have significant improvements in blood sugar and inflammation markers.

Plant-Based Protein and Muscle Gain

Some plant-based proteins are just as effective as animal protein at promoting muscle gain. A study found that supplementing rice protein following resistance training had similar benefits to whey protein supplementation. Both groups had:

References

Briggs AM, Smith AJ, Straker LM, Bragge P. Thoracic spine pain in the general population: prevalence, incidence and associated factors in children, adolescents and adults. A systematic review. BMC Musculoskelet Disord. 2009;10:77.

Cichoń, Dorota et al. “Efficacy of Physiotherapy in Reducing Back Pain and Improve Joint Mobility in Older Women.” Ortopedia, traumatologia, rehabilitacja vol. 21,1 (2019): 45-55. doi:10.5604/01.3001.0013.1115

Fouquet N, Bodin J, Descatha A, et al. Prevalence of thoracic spine pain in a surveillance network. Occup Med (Lond). 2015;65(2):122-5.

Jäger, Ralf et al. “Comparison of rice and whey protein isolate digestion rate and amino acid absorption.” Journal of the International Society of Sports Nutrition vol. 10,Suppl 1 P12. 6 Dec. 2013, doi:10.1186/1550-2783-10-S1-P12

Joy, Jordan M et al. “The effects of 8 weeks of whey or rice protein supplementation on body composition and exercise performance.” Nutrition journal vol. 12 86. 20 Jun. 2013, doi:10.1186/1475-2891-12-86

Medawar, Evelyn et al. “The effects of plant-based diets on the body and the brain: a systematic review.” Translational psychiatry vol. 9,1 226. 12 Sep. 2019, doi:10.1038/s41398-019-0552-0

Newby, PK et al. “Risk of overweight and obesity among semivegetarian, lactovegetarian, and vegan women.” The American journal of clinical nutrition vol. 81,6 (2005): 1267-74. doi:10.1093/ajcn/81.6.1267

Pope, Malcolm H et al. “Spine ergonomics.” Annual review of biomedical engineering vol. 4 (2002): 49-68. doi:10.1146/annurev.bioeng.4.092101.122107

Musculoskeletal Disorders

Musculoskeletal Disorders

Musculoskeletal Disorders, or MSDs, are injuries, conditions, and disorders that affect the body’s musculoskeletal system. It includes the muscles, tendons, ligaments, nerves, discs, blood vessels, bones, and joints. MSDs are common, and the risk of developing them increases with age. The severity of an MSD can vary. They cause discomfort, recurrent pain, stiffness, swelling, and aching that interfere with everyday activities. Early diagnosis and treatment can alleviate symptoms and improve long-term health. Common disorders include:

  • Tendonitis
  • Tendon Strain
  • Epicondylitis
  • Carpal Tunnel Syndrome
  • Trigger Finger
  • Radial Tunnel Syndrome
  • DeQuervain’s Syndrome
  • Rotator Cuff Tendonitis
  • Muscle strain
  • Ligament Sprain
  • Rheumatoid arthritis – RA
  • Osteoarthritis
  • Tension Neck Syndrome
  • Thoracic Outlet Compression
  • Mechanical Back Syndrome
  • Degenerative Disc Disease
  • Ruptured Disc
  • Herniated Disc
  • Fibromyalgia
  • Digital Neuritis
  • Bone Fractures

Musculoskeletal Disorders

Musculoskeletal Disorders Discomfort and Pain

The term musculoskeletal disorder is used as it accurately describes the injury or condition. Other terms used are repetitive motion injury, repetitive stress injury, and overuse injury. When individuals are exposed to MSD risk factors, they begin to fatigue. This can start a musculoskeletal imbalance. With time, fatigue completely overtakes recovery/healing, and the musculoskeletal imbalance continues, a musculoskeletal disorder develops. The risk factors are broken into two categories: work-related/ergonomic risk factors and individual-related risk factors.

Ergonomic Factors:

  • Force
  • Repetition
  • Posture

High Task Repetition

  • Many work tasks and cycles are repetitive and are typically controlled by hourly or daily production targets and work processes.
  • High task repetition combined with other risks factors like high force and/or awkward postures can contribute to the formation of MSD.
  • A job is considered highly repetitive if the cycle time is 30 seconds or less.

Forceful Exertions

  • Many job tasks require high force loads on the body.
  • Muscle effort increases in response to high force requirements. This increases associated fatigue.

Repetitive or Sustained Awkward Postures

  • Awkward postures place excessive force on joints, overload the muscles and tendons around affected joints.
  • The joints of the body are most efficient when they operate close to the mid-range motion of the joint.
  • The risk of MSD is increased when the joints are worked outside of this mid-range repetitively for sustained periods without a proper amount of recovery time.

Individual Factors

  • Unhealthy work practices
  • Lack of physical activity/fitness
  • Unhealthy habits
  • Poor diet

Unhealthy Work Practices

  • Individuals that engage in poor work practices, body mechanics, and lifting techniques are introducing unnecessary risk factors.
  • These poor practices create unnecessary stress on the body that increases fatigue and decreases the body’s ability to recover properly.

Poor Health Habits

  • Individuals who smoke, drink excessively, are obese, or exhibit numerous other poor health habits put themselves at risk for musculoskeletal disorders and other chronic diseases.

Insufficient Rest and Recovery

  • Individuals that do not get adequate rest and recovery put themselves at higher risk.
  • MSDs develop when fatigue outruns the individual’s recovery system, causing a musculoskeletal imbalance.

Poor Diet, Fitness, and Hydration

  • Individuals who eat unhealthily are dehydrated, at a poor level of physical fitness, and do not take care of their bodies are putting themselves at a higher risk of developing musculoskeletal and chronic health problems.

Causes

The causes of musculoskeletal disorders are varied. Muscle tissue can be damaged with the wear and tear of daily work, school, and physical activities. Trauma to the body can come from:

  • Postural strain
  • Repetitive movements
  • Overuse
  • Prolonged immobilization
  • Jerking movements
  • Sprains
  • Dislocations
  • Falling injuries
  • Auto accident injuries
  • Fractures
  • Direct trauma to the muscle/s

Poor body mechanics can cause spinal alignment problems and muscle shortening, causing other muscles to be strained, causing problems and pain.

Treatment Rehabilitation

A doctor will recommend a treatment plan based on the diagnosis and severity of the symptoms. They may recommend moderate exercise and over-the-counter medications like ibuprofen or acetaminophen to address occasional discomfort or pain. They often recommend chiropractic and physical therapy rehabilitation to learn how to manage pain and discomfort, maintain strength, range of motion, and adjust everyday activities. Different types of manual therapy, or mobilization, can treat body alignment problems. A doctor may prescribe medications like nonsteroidal anti-inflammatories NSAIDs to reduce inflammation and pain for more severe symptoms. For individuals with musculoskeletal disorders like fibromyalgia, medications to increase the body’s level of serotonin and norepinephrine may be prescribed in low doses to modulate sleep, pain, and immune system function.


Body Composition


Types of Pain

Pain can be grouped into three categories:

Early Warning Pain

  • This is most recognizable after having just touched a pan, and the hand jerks away before realizing how hot the pan is, also known as the withdrawal reflex.
  • This is a protective mechanism that helps avoid danger and is vital for survival.

Inflammatory Pain

  • This type of pain happens after an injury or surgery while the body is healing and recovering.
  • Inflammation prevents the body from performing movements to prevent and avoid re-injury.

Pathological Pain

  • This type of pain can happen after the body has healed, but the nervous system has been damaged.
  • This is often the case with individuals who sustain an injury and inform doctors that the injured area is never the same.
  • If the rehabilitation does not correctly heal the nervous system, protective pain measures can generate a false alarm causing pain signals to fire off.
References

Asada, Fuminari, and Kenichiro Takano. Nihon eiseigaku zasshi. Japanese journal of hygiene vol. 71,2 (2016): 111-8. doi:10.1265/jjh.71.111

da Costa, Bruno R, and Edgar Ramos Vieira. “Risk factors for work-related musculoskeletal disorders: A systematic review of recent longitudinal studies.” American journal of industrial medicine vol. 53,3 (2010): 285-323. doi:10.1002/ajim.20750

Malińska, Marzena. “Dolegliwości układu mięśniowo-szkieletowego u operatorów komputerowych” [Musculoskeletal disorders among computer operators]. Medycyna pracy vol. 70,4 (2019): 511-521. doi:10.13075/mp.5893.00810

Musculoskeletal system diseases. (n.d.). dmu.edu/medterms/musculoskeletal-system/musculoskeletal-system-diseases/

Roquelaure, Yves et al. “Troubles musculo-squelettiques liés au travail” [Work-related musculoskeletal disorders]. La Revue du praticien vol. 68,1 (2018): 84-90.

Villa-Forte A. (n.d.). Diagnosis of musculoskeletal disorders. merckmanuals.com/home/bone,-joint,-and-muscle-disorders/diagnosis-of-musculoskeletal-disorders/introduction

Work-related musculoskeletal disorders (WMSDs). (2014). ccohs.ca/oshanswers/diseases/rmirsi.html

Cold Weather Muscle Spasms, Cramps

Cold Weather Muscle Spasms, Cramps

Muscle spasms also referred to as muscle cramps, are painful contractions and tightening of the muscles. They are common, involuntary, and unpredictable. Temperature drops and cold weather can cause the muscles and joints to contract and tighten, leading to spasms and pain. Chiropractic, physical therapy massage, exercises, stretching, and an anti-inflammatory diet can bring relief and help strengthen the muscles to prevent future episodes.

Cold Weather Muscle Spasms, Cramps

Muscle Spasms

Spasms are common and can affect any of the muscles. They can involve part of a muscle, all of a muscle, or several muscles in a group. Spasms occur when the muscle/s involuntary and forcibly contract uncontrollably and are unable to relax. The most common sites for muscle spasms include:

  • Hands
  • Arms
  • Abdomen
  • Back
  • Legs
  • Thighs
  • Calves
  • Thighs
  • Feet

How Cold Affects the Muscles

As the weather gets colder, this causes the muscles in the body to lose heat, causing them to contract. As a result, the muscles and joints become tighter, stiffer, and decrease mobility and range of motion. This forces the muscles to work harder than usual to compensate. This can increase the fatigue of the muscles, leading to more prolonged bouts of pain and discomfort after physical activity, movement, exercise, etc.

Symptoms and Causes

A cramp can last a few seconds or last up to 15 minutes. During a muscle spasm, the following may be experienced:

  • Twitching in the muscle.
  • Pain in the muscle.
  • Throbbing.
  • Hardness and/or stiffness.
  • The muscles appear physically distorted.

Because the muscles have to work harder, the cold weather can increase muscle spasms. One of the most common causes of muscle spasms is overuse and fatigue. However, exact causes vary from person to person. Some experts believe that one or more of the following contribute to the spasms/cramps, and they include:

  • Dehydration.
  • Stress.
  • Not stretching the body regularly.
  • Muscle fatigue.
  • Restricted blood circulation.
  • Involuntary nerve discharge/s.
  • Over-exercising.
  • Exercising in the heat.
  • Exhaustion of salts and minerals:
  • Potassium
  • Magnesium
  • Calcium

Possible causes for leg cramps at night or nocturnal leg cramps specifically include:

  • Sitting for too long without moving around to keep circulation healthy.
  • Sitting with unhealthy posture.
  • Overusing the muscles.
  • Standing or working on hard floors.

Dealing With The Cold

One way to deal with the cold is to warm up before any physical activity. Taking a few minutes to get the heart rate up can increase the blood flow and flexibility of the muscles. This will ensure the muscles are functioning correctly and avoid the need to work harder to stop spasms. When a cramp strikes, there are a few steps to try to alleviate the spasm:

  • Stretching the affected area.
  • Massaging the affected area manually with a massage roller, percussive massager.
  • Stand up.
  • Move around.
  • Apply heat or ice.
  • A warm bath, shower with massage setting if possible.
  • Ibuprofen and acetaminophen.
  • Vitamin B12 complex can help prevent cramps.

Body Composition


Getting Back To Fitness

Get back into regular exercising with a few tips for making the transition as smooth as possible.

Start Slow

  • Don’t try to jump back into exercise in attempting to crush out a challenging workout.
  • Commit to a few light workouts a week that integrate stretching pre and post-exercise.
  • Over-exerting the body increases the risk of injuries, motivation loss, and prolonged exhaustion.

Create a Workout Schedule That Works For You

  • Routines and habits can help stay on track.
  • Build a sustainable exercise routine to stay focused and committed.
  • Find times that work.
References

American Academy of Orthopaedic Surgeons. Muscle Cramp. (orthoinfo.aaos.org/topic.cfm?topic=A00200) Accessed 3/1/2021.

American Association of Osteopathy. Muscle Cramp—A Common Pain. (www.osteopathic.org/osteopathic-health/about-your-health/health-conditions-library/general-health/Pages/muscle-cramp.aspx) Accessed 3/1/2021.

Herzberg J. Stevermer J. Treatments for Nocturnal Leg Cramps. (www.aafp.org/afp/2017/1001/od3.pdf) Am Fam Physician 2017;96(7):468-469. Accessed 3/1/2021.

Young G. Leg Cramps. (www.ncbi.nlm.nih.gov/pmc/articles/PMC4429847/) BMJ Clin Evid 2015; May 13;1113. Accessed 3/1/2021.

Pain Running Down The Leg

Pain Running Down The Leg

A common symptom of sciatica is radiating/spreading pain running down the leg. However, the leg pain could be something to do with the blood vessels. If the pain travels from the low back to the hip, through the buttocks, down the leg, and into the foot, then more than likely it is sciatica. However, sciatica is just one condition that causes leg pain; other causes of leg pain include:

  • Bone spurs
  • Herniated disc
  • Arthritis
  • All can irritate the sciatic nerve causing sciatica.

The vascular system, also called the circulatory system, comprises the vessels that circulate blood and lymph throughout the body. Problems with the vascular system are a less common cause of leg pain but can be severe. Therefore, it is vital to learn to tell the difference.

Pain Running Down The Leg

Deep Vein Thrombosis

Deep vein thrombosis – DVT happens when a blood clot forms in a deep vein in the body and not the superficial veins just under the skin. The legs’ deep veins are susceptible to clotting. The formation of a clot can happen:

  • After surgery
  • From an accident
  • When recovering, bed resting and not moving.
  • When the body is in the same position for a long time with little to no movement, like a long plane ride.
  • On long plane rides, try to get up and walk around every hour. If unable to walk, do three sets of 20 reps of heel-to-toe exercises every hour.

Deep vein thrombosis can cause leg pain or swelling but can also present without causing any symptoms. Other risk factors include:

Blood Clots

Three main factors place individuals at risk for blood clots. They are:

Hypercoagulability

  • This is when the blood is more prone to clotting. This can occur through:
  • Genetics
  • Medications
  • Pregnancy
  • Kidney disease
  • Trauma

Venous stasis

  • This is when blood flow circulation is slower than it should be. This usually happens from:
  • Sedentary lifestyle
  • Heart conditions
  • Obesity
  • Smoking
  • Clotting disorders

Vascular Trauma

  • Blunt or penetrating injury to the blood vessel and/or its walls.

Pain running down the leg from a blood clot feels like:

  • Tightness
  • Cramping soreness
  • Throbbing
  • Possible warmth
  • Swelling.

Blood clots and sciatica are reported to feel relatively different. The pain from a blood clot does not spread out and does not extend from or to the back. Sciatica does not cause swelling, redness, and warmth. If a doctor suspects a blood clot is causing the pain, they will order an ultrasound to confirm the diagnosis. If it is deep vein thrombosis, blood thinners could be recommended for three to six months.

  • A doctor may recommend aspirin, which can help in the prevention of blood clots.
  • Compression stockings/socks could also be recommended.
  • In some cases, the clot may have to be surgically removed.

Vascular Conditions and Pain Running Down The Leg

Other blood vessel conditions that can cause individuals to believe they have sciatica include:

Peripheral artery disease – PAD

This often presents in individuals with diabetes or who smoke. It causes pain in the calf area but does not radiate throughout the leg. The pain usually presents with physical effort movement. If the pain occurs when at rest, this could be a serious medical emergency. Peripheral artery disease is a chronic condition that can worsen if lifestyle changes are not made to reduce risk factors.

Acute limb ischemia

This condition can cause leg pain, but not the same as sciatica. What happens is the leg is not receiving blood, causing:

  • Intense pain in the extremity
  • Change in the color of the skin
  • Numbness
  • Weakness
  • Loss of a pulse

This vascular condition is a medical emergency and requires immediate treatment.

Acute compartment syndrome

This can happen after some kind of trauma to the leg.

  • The pain is acute, with the leg swelling up and a building up of tight pressure.
  • It usually affects the lower part of the leg.
  • This condition can also cause:
  • Numbness
  • Tingling
  • Visible swelling
  • Bruising

It is considered a medical emergency and needs to be treated quickly to avoid complications.

Varicose veins

Varicose veins can cause some pain running down the leg and/or aching, but the discomfort is not as intense. Treatment has come a long way, is less invasive, and includes:

  • Compression stockings, including prescription socks/stockings
  • Laser treatments
  • Minimally invasive procedures
  • Not staying on the feet too much
  • Elevating the legs
  • Maintaining an ideal weight can help

Vascular Disorder Prevention

Healthy lifestyle habits are recommended to keep the vascular system operating correctly. This includes:

Sciatica Treatment

If it is sciatica, fortunately, most cases go away on their own, but if treatment is needed, it is recommended to start with conservative treatments such as:

  • Chiropractic
  • Physical therapy
  • Anti-inflammatory medication
  • Muscle relaxants
  • Corticosteroid injections
  • In severe cases, surgery like a microdiscectomy or laminectomy will be performed to relieve pressure on the sciatic nerve.

Body Composition


Why might blood pressure be different when measuring on each arm?

The heart sits just to the left of the midline in the chest cavity. The aorta is the largest blood vessel in the body. It leaves through the left side of the heart and transports blood to a network of blood vessels that branch out, supplying the body with oxygen and nutrients. The arteries that branch off the aorta and go to the left and right sides of the body are different.

On the right, the brachiocephalic trunk comes off the aorta and splits into the right common carotid artery and right subclavian artery. The left common carotid and left subclavian arteries branch directly off the aorta. The differences mean that the risk for arterial thrombosis is not the same for the right and left subclavian arteries. Arterial thrombosis causes the blood vessels to become stiff, causing obstruction over time and is more likely to happen in the left subclavian than in the right. The difference in arterial branching affects blood pressure measurements on the left and right arms. The blood vessels are surrounded by:

  • Muscle
  • Fat
  • Connective tissue

When muscles place pressure on the blood vessels around the heart, it can cause short-term turbulence changes that can affect blood pressure.

References

American Heart Association. Atherosclerosis and cholesterol. www.heart.org/en/health-topics/cholesterol/about-cholesterol/atherosclerosis

American Heart Association. What is excessive blood clotting (Hypercoagulation?) www.heart.org/en/health-topics/venous-thromboembolism/what-is-excessive-blood-clotting-hypercoagulation

Centers for Disease Control and Prevention. What is venous thromboembolism? www.cdc.gov/ncbddd/dvt/facts.html

Cleveland Clinic. Compartment syndrome. my.clevelandclinic.org/health/diseases/15315-compartment-syndrome

Mayo Clinic. Deep vein thrombosis overview. www.mayoclinic.org/diseases-conditions/deep-vein-thrombosis/symptoms-causes/syc-20352557

Mayo Clinic. Sciatica. www.mayoclinic.org/diseases-conditions/sciatica/diagnosis-treatment/drc-20377441

Mayo Clinic. Sciatica overview. www.mayoclinic.org/diseases-conditions/sciatica/symptoms-causes/syc-20377435

Mayo Clinic. Varicose veins. www.mayoclinic.org/diseases-conditions/varicose-veins/diagnosis-treatment/drc-20350649

Obara, Hideaki et al. “Acute Limb Ischemia.” Annals of vascular diseases vol. 11,4 (2018): 443-448. doi:10.3400/avd.ra.18-00074

ScienceDirect. (n.d.) “Virchow’s Triad.” www.sciencedirect.com/topics/medicine-and-dentistry/virchows-triad

Polymyositis: Inflammatory Myopathy

Polymyositis: Inflammatory Myopathy

Polymyositis is a disease that causes the body’s muscles to become irritated and inflamed. It can affect the muscles all over the body. The muscles gradually begin to break down and weaken, making everyday movements difficult. This disease falls into a category known as inflammatory myopathies.

Polymyositis: Inflammatory Myopathy

Polymyositis Unknown Causation

The causes of polymyositis are currently unknown. However, experts believe it could be associated with or triggered by a virus or an autoimmune reaction. An autoimmune response is when the body attacks itself along with the body’s tissues. It’s seen in individuals ages 31 to 60 and is rarely seen in individuals younger than 18. In some instances, medication can lead to an allergic reaction/response that causes muscle irritation and damage. But in most cases, healthcare experts are not able to find the exact cause.

Symptoms

The condition can affect the muscles all over the body. Physical activities like walking, getting up from a chair, or lifting objects can become difficult to perform. It can also affect the muscles that allow for eating and breathing. The muscles at the center of the body tend to be affected the most. Common symptoms include:

  • Muscle pain.
  • Muscle stiffness.
  • Muscle weakness, specifically in the abdomen, shoulders, upper arms, and hips.
  • Joint pain and stiffness.
  • Breathing problems.
  • Problems swallowing.
  • Abnormal weight loss can become an issue if there are problems with swallowing.
  • Irregular heart rhythms if the heart muscle/myocardium becomes inflamed.
  • Individuals may notice they have trouble climbing stairs or lifting their arms.
  • The inflammation can worsen, causing pain and weakness that affects the wrists, lower arms, and ankles.

Diagnosis

Diagnosis begins with the individual’s medical history, family medical history if necessary, and a physical examination. The examination includes seeing and feeling the strength of the muscles. Tests will be required that include:

Blood Tests

  • Blood tests allow the doctor to see if there are signs of muscle inflammation.
  • They also show if there are abnormal proteins that form in autoimmune diseases.

Electromyogram EMG

  • This test can be used to find abnormal electrical activity in the affected muscles.

MRI

  • Magnets and computer graphic imagery are used to help the doctor inspect for inflammation in the body.

Muscle Biopsy

  • A small piece of muscle tissue is removed to be analyzed with a microscope.

Treatment

Treatment depends on how severe the condition is, individual symptoms, age, and overall health. Currently, there is no cure for polymyositis, but symptoms can be managed. Individuals are recommended to utilize more than one type of treatment because the treatment plan may also need to be changed as treatment progresses. Treatments include:

Anti-inflammatory Medication

Steroid medication can help manage the disease and reduce symptoms, and corticosteroids can help ease inflammation in the body. The symptoms improve within 4 to 6 weeks, and a healthcare provider can lower the dosage after the symptoms decrease to reduce and ease any side effects.

Immunosuppressive Medication

  • These medications block or slow down the body’s immune system responses.
  • Talk with a doctor about the risks, benefits, and side effects of all medications.

Chiropractic and Physical therapy

  • Chiropractic treatment and physical therapy can help:
  • Aligning the spine to provide optimal nerve energy and blood circulation.
  • Therapeutic massage to stimulate and keep the muscles loose.
  • Specific exercises to help stretch and strengthen the muscles.
  • These can help keep the muscles from shrinking.

Heat therapy and Rest

  • Heat therapy and allowing the body to rest thoroughly can help decrease pain symptoms.

Special Braces

  • Body, hip, and leg braces can help support the muscles and help with mobility.

Complications

Polymyositis left untreated can lead to severe complications. The muscles become weaker, increasing the risk of falling and limiting daily activities.

  • If the chest muscles are affected, there could be problems with breathing that can lead to respiratory failure.
  • If the digestive tract is affected, malnutrition and unintentional weight loss can result.
  • Polymyositis poorly managed well can cause severe disability.

Body Composition


Nutrition and Muscle Growth

Protein

  • Protein is the foundation for gaining muscle.
  • This essential component is for all of the body’s daily functions.
  • It is essential to balance protein increase with overall diet.

Complex Carbs

  • Carbs are the body’s fuel source.
  • Carbs should be a daily element of nutritional intake because they are the primary component.
  • Acquiring energy
  • Preventing muscle weakness and degradation

Consuming Carbs

  • Understanding how accurate results only happen when both sides work together.
  • Healthy consumption of protein and carbohydrates can help muscle growth and sustain optimal health for all body types.
References

Corrado, Bruno et al. “Supervised Physical Therapy and Polymyositis/Dermatomyositis-A Systematic Review of the Literature.” Neurology international vol. 12,3 77-88. 24 Nov. 2020, doi:10.3390/neurolint12030015

Findlay, Andrew R et al. “An overview of polymyositis and dermatomyositis.” Muscle & nerve vol. 51,5 (2015): 638-56. doi:10.1002/mus.24566

Sasaki, Hirokazu, and Hitoshi Kohsaka. “Current diagnosis and treatment of polymyositis and dermatomyositis.” Modern rheumatology vol. 28,6 (2018): 913-921. doi:10.1080/14397595.2018.1467257

Van Thillo, Anna et al. “Physical therapy in adult inflammatory myopathy patients: a systematic review.” Clinical rheumatology vol. 38,8 (2019): 2039-2051. doi:10.1007/s10067-019-04571-9

Calf Soreness, Pain and Chiropractic Treatment

Calf Soreness, Pain and Chiropractic Treatment

Calf pain is common in individuals that are on their feet for long periods. This could be standing, walking, as part of a job or jogging, and running. In most cases, calf soreness and/or pain result from repetitive/overuse strain/injury/tear of the calf muscles. Pain along with stiffness presents with physical activity, exercise, movement. Chiropractic treatment and Active Release can help alleviate and eliminate calf pain.

Calf Soreness, Pain and Chiropractic Treatment

Calf  Muscles

The calf muscle is in the back of the lower leg, behind the shin bone, and consists of three muscles. The calf muscle supports the body when standing and enables movement of the foot and lower leg. The calf muscles support the body when:

  • Walking
  • Running
  • Jumping
  • Standing on the toes.
  • Flexing the foot – lifting the toes toward the knee.
  • It helps push the body forward and allows jumping, ankle rotation, and flexing of the foot.

Causes, Conditions, and Disorders

The overuse of the calf muscles usually causes calf soreness, discomfort, and pain. Over time, tiny tears develop in the muscles of the lower legs and calves. Repeated use can lead to more severe injury or condition without proper treatment. Conditions include:

Strain

The most common injury is a strain. Strains happen when the muscle fibers are overused and get stretched too far and/or tear. However, the fibers may not tear in that instance, and so the tear could occur at a later time while doing a basic movement like slightly bending or kneeling to tie a shoe. This is when individuals wonder how a tear happened with a simple action. But the tear was already present, just not fully torn.

Cramps

Muscle cramps and muscle spasms in the calves can be excruciating limiting mobility. Calf cramps can happen during the day or at night. They can result from several factors that include:

Tennis leg

Healthcare providers call this strain tennis leg because it happens when the leg extends and the foot flexes. Tennis players are in this position when they serve and push themselves off into motion; however, it can happen in any sport, job, chore that involves the same movement. This type of muscle strain injury affects the gastrocnemius muscle.

Compartment syndrome

Compartment syndrome happens when pressure builds up inside a muscle. The pressure significantly reduces the flow of blood and oxygen. It can result from trauma like a fracture or strenuous exercise/activity.

Symptoms

Calf muscle issues can cause calf muscle:

  • Pain
  • Tightness
  • Stiffness
  • Pain may be sharp or dull
  • Pain can start as mild pain and progressively worsen.
  • Limited mobility
  • Limited range of motion
  • Muscle weakness
  • A bump, bulge, or lump in the back of the lower leg.
  • Tenderness
  • Bruising
  • General leg cramps are common and are more likely to happen as the body ages.
  • Healthcare professionals estimate around 75% of individuals over 50 have had leg cramps and pain.

Calf Health

To prevent and avoid problems with the calf muscles, individuals are recommended to:

Maintain a healthy diet and weight

  • Individuals that are overweight are more likely to pull or strain a muscle.
  • Excess pounds add pressure on the legs placing individuals at a higher risk of an injury.
  • If obese or overweight, talk to a healthcare professional about healthy weight.

Stay hydrated

  • Drink the proper amount of water and other fluids
  • This decreases the chance of causing a cramp.

Stretch and warm-up

  • Warmed-up calf muscles are less likely to stretch too far or tear.
  • Before engaging in physical activity at work or school, do a few warm-up stretches to increase flexibility.
  • When exercising, gradually increase the intensity.

Stay aware of medications.


Body Composition


Nutrients of Protein

Protein is necessary for all of the body’s physiological functions. Protein and amino acids are the building blocks of the muscle tissue in the body. The body’s muscles are a house, protein is the bricks, and the amino acids that form protein are the building blocks of muscle. The body manufactures various amino acids, but nine are essential amino acids – EAA because they are not made in the body. Individuals have to consume EAAs from food sources like:

  • Meat
  • Beans
  • Nuts
  • Soy

A diet that consists of mixed amino acids can help maximize muscle protein synthesis. Protein is essential in building muscle because amino acids help repair and maintain muscle tissue. After a strenuous activity or a workout, protein helps the body repair muscles that are slightly torn. To build a healthy body, the body needs to have the right amount of protein. Protein is an essential component of:

  • Muscle development
  • Bone density
  • Muscle mass
  • Lean tissue
References

Binstead JT, Munjal A, Varacallo M. Anatomy, Bony Pelvis, and Lower Limb, Calf. [Updated 2020 Aug 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. . Accessed 6/4/2021.www.ncbi.nlm.nih.gov/books/NBK459362/ (www.ncbi.nlm.nih.gov/books/NBK459362/)

Bright JM, Fields KB, Draper R. Ultrasound Diagnosis of Calf Injuries. Sports Health. 2017 Jul-Aug;9(4):352-355. . Accessed
6/4/2021.www.ncbi.nlm.nih.gov/pmc/articles/PMC5496702/ (www.ncbi.nlm.nih.gov/pmc/articles/PMC5496702/)

Young G. Leg cramps. BMJ Clinical Evidence. 2015 May 13;2015:1113. . Accessed 6/4/2021.www.ncbi.nlm.nih.gov/pmc/articles/PMC4429847/ (www.ncbi.nlm.nih.gov/pmc/articles/PMC4429847/)

The Hands: Injuries, Symptoms, Causes, Medical Care

The Hands: Injuries, Symptoms, Causes, Medical Care

The hands are a magnificent piece of work. Its intricate design and functional form follow the hand. However, any injury to the underlying structures of the hand can overlap with other injuries/conditions. Even the smallest hand injuries require a proper medical examination. The objective is a quick and accurate initial evaluation along with treatment. Early treatment is done quickly to minimize short and long-term effects.

The Hands: Injuries, Symptoms, Causes, Medical Care

Anatomy

The hand consists of 27 bones that include 8 bones in the wrist. If the associated structures:

  • Nerves
  • Arteries
  • Veins
  • Muscles
  • Tendons
  • Ligaments
  • Joint cartilage
  • Fingernails
  • Get injured or damaged in some way; there is increased potential for various injuries.

Causes

The most common cause of injury/s is blunt trauma, followed by injury from a sharp object. Hand injuries are divided into categories:

Other hand injuries include:

  • Finger injuries
  • Wrist injuries
  • Broken hand
  • Nail injuries
  • Finger infection

Symptoms

Symptoms vary depending on the type of injury, how the injury occurred/mechanism, the depth, severity, and location. Common symptoms:

Lacerations

  • Tenderness
  • Pain
  • Bleeding
  • Numbness
  • Decreased range of motion
  • Difficulty moving
  • Weakness
  • Pale appearance

Fractures and Dislocations

  • Swelling
  • Discoloration
  • Tenderness
  • Deformity
  • Reduced range of motion
  • Numbness
  • Weakness
  • Bleeding

Soft Tissue Injuries and Amputations

  • Swelling
  • Discoloration
  • Tenderness
  • Deformity with or without tissue loss/bone loss
  • Bleeding
  • Weakness
  • Numbness

Infection

  • Tenderness
  • Swelling
  • Warmth/Heat around the area
  • Redness
  • Deformity
  • Reduced range of motion
  • Fever is rare in hand infections

Burns

  • Redness
  • Tenderness
  • Blistering
  • Complete numbness
  • Discoloration
  • Loss of tissue
  • The texture of the skin change
  • Areas of tissue blackened
  • Deformity

High-pressure Injection Injury

  • Pain
  • Swelling
  • Bleeding
  • Skin discoloration
  • Muscle, tendon, ligament tears
  • Cracked/Broken bones

Medical Care

Anyone with a hand injury is recommended to call a doctor or seek medical attention. When medical attention is delayed, the possibility of worsening or creating further injuries increases. Even the smallest cut or what looks like a minor injury could require advanced treatment to prevent infection or loss of function. Any cut or laceration that requires stitches to repair should also have a medical evaluation to make sure the musculoskeletal system of the hands is functioning properly. Injuries causing the following symptoms require emergency medical attention at an emergency clinic.

  • Severe bleeding
  • Severe pain
  • Numbness
  • Loss of motion
  • Loss of strength
  • Deformity
  • Signs of infection – tenderness, warmth/heat, redness, swelling, pus, or fever
  • Exposure of structures – tendons, bones, joints, arteries, veins, or nerves

Diagnosis

A medical examination can include a medical history and physical examination.

Medical History

  • Past medical history
  • Does the patient have diabetes or arthritis?
  • Is the patient right or left-handed?
  • Occupation
  • Extracurricular activities and hobbies
  • How does the patient use their hands?
  • How did the injury occur, mechanism of injury?
  • Does the patient smoke?

Physical Exam

  • Visual inspection look at the injury
  • Sensory nerve exam feeling
  • Vascular exam circulation of blood supply
  • Muscular and tendon exam movement and strength
  • Bone exam broken bones or dislocated joints

Tests

A doctor will order X-rays after the history and physical exam if necessary. Certain injuries will require imaging to identify fractures/dislocations or to rule out foreign bodies. Many types of injuries can lead to compartment syndrome. Compartment syndrome is a condition in which there is swelling and an increase in pressure within a limited space or a compartment that presses on and compromises blood vessels, nerves, and/or tendons that run through that particular area. Once the immediate injury is addressed, a personalized treatment plan can be developed .to rehabilitate the hand/s to optimal function quickly


Body Composition


Artificial Sweeteners And Muscle Gain

Artificial sweeteners don’t individuals that are trying to build lean body mass. The body needs carbs after a workout for replenishing the depleted glycogen stores. Many commercially prepared protein supplements are made with artificial sweeteners that don’t provide an adequate source of carbohydrates. If an individual consumes only protein made with sugar substitutes after a workout, they are missing essential components of post-workout recovery. A study found that supplementing with carbohydrates before and during strength training can increase performance, compared to participants that were taking the artificial sweeteners saccharin and aspartame. To properly refuel after a workout, remove the artificially sweetened protein powders and replace them with a snack packed with protein and high-quality carbohydrates. These include:

  • Greek yogurt
  • Fruit with nuts or nut butter
  • Hummus with whole-grain crackers
  • Tuna
  • Hard-boiled eggs
References

Banting, Joshua, and Tony Meriano. “Hand Injuries.” Journal of special operations medicine: a peer-reviewed journal for SOF medical professionals vol. 17,4 (2017): 93-96.

Fuhrer, Reto et al. “Tipps und Tricks in der Behandlung offener Handverletzungen in der Notfallpraxis” [Treatment of acute injuries of the hand]. Therapeutische Umschau. Revue therapeutique vol. 77,5 (2020): 199-206. doi:10.1024/0040-5930/a001177

Harrison, BP, and M W Hilliard. “Emergency department evaluation and treatment of hand injuries.” Emergency medicine clinics of North America vol. 17,4 (1999): 793-822, v. doi:10.1016/s0733-8627(05)70098-5

MedscapeReference.com. High-Pressure Hand Injury.

MedscapeReference.com. Soft Tissue Hand Injury Differential Diagnoses.

Siotos, C et al. “Hand injuries in low- and middle-income countries: a systematic review of existing literature and call for greater attention.” Public health vol. 162 (2018): 135-146. doi:10.1016/j.puhe.2018.05.016

WebMD.com. Finger, Hand, and Wrist Injuries.

Quadriceps Thigh Strain: Chiropractic

Quadriceps Thigh Strain: Chiropractic

The quadriceps muscle consists of four muscles in front of the thigh that connects to the knee right below the knee cap. These muscles straighten the knee for walking, running, and jumping. They also help bend the knee for squatting. They move the leg forward when running and fire/transmit electrical impulses when the foot hits the ground to absorb shock. When jumping, the muscles provide stability coming down as well as when standing on one leg.

Quadriceps Thigh Strain: Chiropractic

Quadriceps Strain

Thigh strains are common in sports. Most players are sidelined because of this injury when compared to strains in the hamstrings or groin. Factors that can increase the risk of injury include:

  • Exhaustion
  • Muscle weakness
  • The strength of the quadriceps to the hamstrings is uneven, causing one set to get overused.
  • Consistent sprinting and/or kicking
  • Previous strain and/or injury

The quadriceps is made up of four muscles.  One is the rectus femoris, which gets injured the most. It’s the only muscle that crosses two joints – the hip joint and the knee joint.

Symptoms and Injury Grades

Individuals commonly report a pulling/stretching sensation in the front of the thigh. Common symptoms include:

  • Pain
  • Swelling
  • Bruising
  • Muscle tenderness
  • For minor quadriceps strains or tears, moderate to dull pain presents along with stiff movement.

Grades categorize the severity of the strain:

  • Grade 1 presents with mild discomfort in the thigh with no loss of strength.
  • Grade 2 presents with moderate pain, swelling, and some loss of strength.
  • Grade 3 is a complete rupture of the fibers. Individuals are in severe pain and unable to walk.
  • Grade 3 is where surgery is required.

Symptoms can vary depending on the type of injury that has been sustained and the severity. There is pain and localized swelling for both strains and contusions. If a muscle rupture has happened, there could be a bump/lump within the muscle or a gap in the muscle. If rupture of the Quadriceps Tendon has occurred, individuals often report hearing a pop when the injury happens. The swelling often makes straightening the leg difficult or impossible.

Injury causes

Thigh strains usually happen when slowing down/decelerating after a sprint. This can be because the individual takes too small or too large steps causing the muscles to overstretch, much like a rubber band that, if overstretched, tears, and if under stretched, it bunches up, which can cause spasms and tears.

Treatment

In the initial stages after a quadriceps strain, it is recommended to follow the RICE Procedure for 24 hours: This includes:

  • Rest
  • Ice
  • Compression
  • Elevate
  • The leg needs to be rested every 2-3 hours in 20-minute sessions.
  • A bandage can provide added support.
  • For slight tears and strains, it is recommended to stretch the quadriceps gently.
  • This helps prevent the muscles from experiencing shortening. This happens by the formation of scar tissue that pulls the muscle/s, making them shorter.
  • Gentle stretches allow the muscles to heal with minimal shortening. This helps prevent further and/or re-injury.

Chiropractic Physical Therapy Rehabilitation

After the acute stage of the injury, receiving regular chiropractic sports adjustments, physical therapy massage, coupled with strength training exercises will speed up recovery.

  • Physical therapy massage will remove scar tissue and keep the muscle/s loose and flexible.
  • Exercises for strengthening the muscles after injury will be recommended according to the individual’s condition/case.
  • Following correct post-injury-care, exercises, and physical therapy.
  • Healing time can be 4- 6 weeks.

Body Composition


Strength Training: The Inverted Row

This workout targets the back muscles, spine and scapular stabilizers, deep abdominals, and arms. Everyday activities that require various types of pulling motion, lifting, etc., become easier. To perform:

  • Lie flat on your back.
  • Grab a stable barbell or set of straps that are above you.
  • Pull your upper body up as high as possible while keeping the back straight.
  • Squeeze the shoulder blades together at the top.
  • Complete as many reps as possible.
  • Once enough strength and endurance have been built, try a pullup.
References

Kary, Joel M. “Diagnosis and management of quadriceps strains and contusions.” Current reviews in musculoskeletal medicine vol. 3,1-4 26-31. 30 Jul. 2010, doi:10.1007/s12178-010-9064-5

Hillermann, Bernd, et al. “A pilot study comparing the effects of spinal manipulative therapy with those of extra-spinal manipulative therapy on quadriceps muscle strength.” Journal of manipulative and physiological therapeutics vol. 29,2 (2006): 145-9. doi:10.1016/j.jmpt.2005.12.003

Wenban, Adrian B. “Influence of active release technique on quadriceps inhibition and strength: a pilot study.” Journal of manipulative and physiological therapeutics vol. 28,1 (2005): 73. doi:10.1016/j.jmpt.2004.12.015

Bursitis Types

Bursitis Types

Bursitis types: This is a condition that affects the bursae, which are the small, fluid-filled sacs that provide cushion for the:

  • Muscles
  • Tendons
  • Bones near joints

The bursae make it easier for tissues to slide over each other. The body has around one hundred and sixty bursae. However, only a few become clinically affected. These include the:

  • Wrist
  • Elbow
  • Shoulder
  • Hips
  • Knees
  • The base of the big toe and heel

The condition typically presents near joints constantly being used repetitively, like a job, sports, house/yard chores, etc. What happens is one or more of the bursae sacs become inflamed, resulting in pain.

Bursitis Types

Causes

  • Inflamed or irritated bursae typically cause it from overuse or intense/vigorous activity.
  • It can also be caused by bacterial infection.
  • Arthritis and gout can also cause bursitis.
  • Another cause is age.
  • As tendons age, they can tear easily, lose their elasticity, and can’t take too much stress.

Intense physical activities can lead to bursitis. These include:

  • Gardening
  • Typing
  • Working with a computer mouse
  • Throwing
  • Golf
  • Tennis
  • Manual tasks
  • Carpentry

These types of activities can lead to incorrect posture, overuse, and injury/damage.

Symptoms

The main symptom is pain in and around the affected area that worsens with movement. Depending on the severity of the strain and the length of time it has been going on, the pain can be intense with active and passive movements. Other symptoms include:

  • Tenderness
  • Stiffness
  • For some individuals, it can present as acute, with the intensity increasing.
  • This happens when movement aggravates the condition.

Bursitis Types

Four major types include:

  • Prepatellar
  • Trochanteric
  • Olecranon
  • Retrocalcaneal

Prepatellar Bursitis

Prepatellar is an inflammation of the sac situated between the skin and the patella/kneecap. The most common causes are trauma from a fall and direct pressure/friction from repetitive kneeling. This is one of the bursitis types that can get infected. Overproduction of liquid places pressure on the other areas of the knee, causing swelling. Most individuals report swelling and knee pain just over the front of the knee.

Trochanteric Bursitis

This bursitis type goes over the lateral area of the hip. There is a distinctive tenderness and aching pain. This type is more common for individuals with arthritis conditions and fibromyalgia. This condition is also seen after surgery, mainly osteotomies. The bursa can become inflamed in case of injury or overuse. It tends to affect middle-aged or older folks. Common causes include:

  • Muscle tears
  • Hip injuries
  • Tight hip or leg muscles
  • Disc disease of the low back
  • Leg-length inequality
  • Improper walking technique from a minor injury or strain
  • Overuse of the gluteal muscles
  • Flat feet
  • Improper footwear

Olecranon Bursitis

Olecranon is a common bursitis type. It is diagnosed by the appearance of swelling over the elbow. The swelling happens just behind the olecranon process of the ulna. The bursa can become infected. This bursitis does cause blood to rupture out, and fluid could be present. Individuals are advised to avoid leaning or resting on the elbows.

Retrocalcaneal Bursitis

This is characterized by pain in the Achilles tendon. Chronic inflammation of the bursa is brought on by friction, supination, and overpronation.  The flexibility of the calf muscles can be significantly reduced. Severe pain and swelling of the posterior soft tissue in front of the Achilles tendon are common symptoms. This bursitis type is often accompanied by mid-portion insertional tendinosis.

Risk Of Getting Bursitis

Anybody at any age can develop bursitis, but older individuals, specifically those in their forties and beyond, are more susceptible. This comes from all the wear and tear of the muscles and bones.

Risk Factors

  • Overpronation of the foot
  • Leg length deviation
  • Osteoarthritis
  • Obesity
  • Tight hamstring muscles
  • Incorrect physical training
  • Not stretching properly

Body Composition


When Inflammation Becomes Permanent

When white blood cells cause inflammation, it’s signaling that the body’s immune system works properly. The process works like this:

  • Inflammation activates
  • White blood cells attack the foreign invader
  • The invader is neutralized
  • The inflammation deactivates

This is how the body’s defense system naturally works. But, white blood cells are not the only type of cell that emit cytokines. Adipocytes or fat cells are another type of cell that can emit cytokines and cause inflammation. Scientists have learned that fat is an active endocrine organ that secretes various proteins and chemicals, including inflammatory cytokines. The body stores excess calories as fat to be used later for energy. When the body keeps adding more adipose tissue, cytokines are released by the fat cells, triggering inflammation. Obesity is characterized as a state of low-grade, chronic inflammation. Increased fat cells place the body in a constant state of stress activating immune responses. This means the body is in a constant state of inflammation with the immune system switch permanently on.

References

Aaron, Daniel L et al. “Four common types of bursitis: diagnosis and management.” The Journal of the American Academy of Orthopaedic Surgeons vol. 19,6 (2011): 359-67. doi:10.5435/00124635-201106000-00006

Coelho, Marisa et al. “Biochemistry of adipose tissue: an endocrine organ.” Archives of medical science: AMS vol. 9,2 (2013): 191-200. doi:10.5114/aoms.2013.33181

Khodaee, Morteza. “Common Superficial Bursitis.” American family physician vol. 95,4 (2017): 224-231.

Summer Heat Can Affect Joints and Movement

Summer Heat Can Affect Joints and Movement

Although it is not officially summer, the past few weeks sure feels like it. Especially for those with joint discomfort and pain. As the body ages, individuals may notice their joints have some mobility/flexibility issues in the summer heat. Again, the heat and humidity are the culprits. The hotter it is, the more the body is susceptible to inflammation and swelling. The more prone an individual’s body is to swelling, the more pain can present. Barometric pressure can also have some form of impact on joint health. The pressure changes can cause the joints to become more sensitive. When the pressure changes, individuals often speak of their joints feeling tighter combined with stiffness, leading to a cycle of swelling and pain.

Summer Heat Can Affect Joints and Movement

Joint Anatomy

Whether it’s the hip, knee, elbow, or hand, all of the body’s joints have fluid in them. It is a gel-like substance known as synovial fluid. This is what lubricates the joints and keeps them functioning smoothly. However, the temperature and humidity levels can change the thickness of the fluid in the joints. This means that the synovial fluid can become inflamed with the weather changes. This is a symptom when the joints begin to feel like they cannot move and/or are becoming stiff. Joint inflammation can become more common and chronic as the body gets older.

Weather and the joints

The summer heat and humidity can affect the joint because:

  • The tendons, ligaments, and muscles expand in this type of weather
  • The heat can restrict individuals from moving around. Non-use stiffens the joints
  • Joints that have worn down cartilage could have exposed nerves that are reacting to the temperature changes
  • Humidity causes the body to lose water by sweating. This can reduce the fluid around the joints leading to stiffness, immobility, and pain.

 

However, not everyone has joint problems in the summer heat. Many have joint issues when it’s cold, damp, or raining. Other’s are at their best in cool, dry weather. It depends on an individual’s body and how their joints react when the temperature changes.

Maintaining joint health for the summer heat

When joint discomfort or pain presents in the summer, there are a few easy ways to gain relief.

Properly Hydrate the Body

Water and sports drinks maintain the fluid levels in the body, specifically, it keeps the joints moving. One way to hydrate the body can be achieved by eating healthy fruits and vegetables. Water-rich fruits and vegetables include:

  • Watermelon
  • Oranges
  • Strawberries
  • Tomatoes
  • Cucumbers
  • Spinach
  • Celery

Over-The-Counter pain ointments and creams

Arthritis and anti-inflammatory creams/ointments can ease joint pain by allowing more blood circulation in the affected areas.

Dressing for the heat

Wear loose, natural fiber, breathable clothing that allows the body to move freely while maintaining a cool temperature.

Relax in the air conditioning

Get into the air conditioning. The cool air can help reduce joint inflammation.

Get in the Water

Swimming or just wading through doing some light exercise in the water cools the body’s core. In addition, the buoyancy of the water relieves pressure on the joints.


Body Composition Testing


Body Water

The body is made up of as much as 2/3’s water. Even though much of the body is made up of water, the percentage of body composition changes based on functional needs. Essential functions of water include:

  • Water is the building block to almost every cell in the body
  • It regulates the body’s temperature through sweating and respiration
  • Carbohydrates and proteins for energy are transported via the water in the blood
  • Water assists in the removal of metabolic waste through urination
  • It is part of the shock-absorbing system that protects the brain and spinal cord
  • Water is part of the saliva and fluid that lubricates the joints

The amount of water in the body depends on various factors. This includes:

  • Age
  • Gender
  • Physical activity
  • It is referred to as Total Body Water or TBW.

TBW is constantly changing with gains and losses of fluid in healthy adults. The body can detect irregularities and compensate for losses and/or gains to make sure that the systems are balanced.

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. In addition, we provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Morton, Darren, and Robin Callister. “Exercise-related transient abdominal pain (ETAP).” Sports medicine (Auckland, N.Z.) vol. 45,1 (2015): 23-35. doi:10.1007/s40279-014-0245-z

Peeler, Jason et al. “Managing Knee Osteoarthritis: The Effects of Body Weight Supported Physical Activity on Joint Pain, Function, and Thigh Muscle Strength.” Clinical journal of sports medicine: official journal of the Canadian Academy of Sports Medicine vol. 25,6 (2015): 518-23. doi:10.1097/JSM.0000000000000173

Quick, D C. “Joint pain and weather. A critical review of the literature.” Minnesota medicine vol. 80,3 (1997): 25-9.

Timmermans, Erik J et al. “The Influence of Weather Conditions on Joint Pain in Older People with Osteoarthritis: Results from the European Project on OSteoArthritis.” The Journal of rheumatology vol. 42,10 (2015): 1885-92. doi:10.3899/jrheum.141594