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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 Complete Guide to Ehlers-Danlos Syndrome

The Complete Guide to Ehlers-Danlos Syndrome

Can individuals with Ehlers-Danlos syndrome find relief through various non-surgical treatments to reduce joint instability?

Introduction

The joints and ligaments surrounding the musculoskeletal system allow the upper and lower extremities to stabilize the body and be mobile. The various muscles and soft connective tissues that surround the joints help protect them from injuries. When environmental factors or disorders start to affect the body, many people develop issues that cause overlapping risk profiles, which then affect the stability of the joints. One of the disorders that affect the joints and connective tissue is EDS or Ehlers-Danlos syndrome. This connective tissue disorder can cause the joints in the body to be hypermobile. It can cause joint instability in the upper and lower extremities, thus leaving the individual to be in constant pain. Today’s article focuses on Ehlers-Danlos syndrome and its symptoms and how there are non-surgical ways to manage this connective tissue disorder. We discuss with certified medical providers who consolidate our patients’ information to assess how Ehlers-Danlos syndrome can correlate with other musculoskeletal disorders. We also inform and guide patients on how various non-surgical treatments can help reduce pain-like symptoms and manage Ehlers-Danlos syndrome. We also encourage our patients to ask their associated medical providers many intricate and important questions about incorporating various non-surgical therapies as part of their daily routine to manage the effects of Ehlers-Danlos syndrome. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer.

 

What Is Ehlers-Danlos Syndrome?

 

Do you often feel extremely tired throughout the day, even after a full night of sleep? Do you bruise easily and wonder where these bruises are coming from? Or have you noticed that you have an increased range in your joints? Many of these issues are often correlated with a disorder known as Ehlers-Danlos syndrome or EDS that affects their joints and connective tissue. EDS affects the connective tissues in the body. The connective tissues in the body help provide strength and elasticity to the skin, joints, as well as blood vessel walls, so when a person is dealing with EDS, it can cause a significant disruption to the musculoskeletal system. EDS is largely diagnosed clinically, and many doctors have identified that the gene coding of the collagen and proteins that interact in the body can help determine what type of EDS affects the individual. (Miklovic & Sieg, 2024)

 

The Symptoms

When understanding EDS, it is essential to know the complexities of this connective tissue disorder. EDS is classified into numerous types with distinct features and challenges that vary depending on the severity. One of the most common types of EDS is hypermobile Ehlers-Danlos syndrome. This type of EDS is characterized by general joint hypermobility, joint instability, and pain. Some of the symptoms that are associated with hypermobile EDS include subluxation, dislocations, and soft tissue injuries that are common and may occur spontaneously or with minimal trauma. (Hakim, 1993) This can often cause acute pain to the joints in the upper and lower extremities. With its broad range of symptoms and the personal nature of the condition itself, many often don’t realize that joint hypermobility is common in the general population and may present no complications that indicate that it is a connective tissue disorder. (Gensemer et al., 2021) Additionally, hypermobile EDS can lead to spinal deformity due to the hyperextensibility of the skin, joints, and various tissue fragility. The pathophysiology of spinal deformity associated with hypermobile EDS is primarily due to muscle hypotonia and ligament laxity. (Uehara et al., 2023) This causes many people to reduce their quality of life and daily living activities significantly. However, there are ways to manage EDS and its correlating symptoms to reduce joint instability.

 


Movement Medicine: Chiropractic Care-Video


Ways To Manage EDS

When it comes to looking for ways to manage EDS to reduce pain and joint instability, non-surgical treatments can help address the physical and emotional aspects of the condition. Non-surgical treatments for individuals with EDS commonly focus on optimizing the body’s physical function while improving muscular strength and joint stabilization. (Buryk-Iggers et al., 2022) Many individuals with EDS will try to incorporate pain management techniques and physical therapy and use braces and assistive devices to reduce the effects of EDS and improve their quality of life.

 

Non-surgical Treatments For EDS

Various non-surgical treatments like MET (muscle energy technique), electrotherapy, light physical therapy, chiropractic care, and massages can help strengthen while toning the surrounding muscles around the joints, provide sufficient pain relief, and limit long-term dependence on medications. (Broida et al., 2021) Additionally, individuals dealing with EDS aim to strengthen the affected muscles, stabilize the joints, and improve proprioception. Non-surgical treatments allow the individual to have a customized treatment plan for the severity of EDS symptoms and help reduce the pain associated with the condition. Many individuals, when going through their treatment plan consecutively to manage their EDS and reduce the pain-like symptoms, will notice improvement in symptomatic discomfort. (Khokhar et al., 2023) This means that non-surgical treatments allow individuals to be more mindful of their bodies and reduce the pain-like effects of EDS, thus allowing many individuals with EDS to lead fuller, more comfortable lives without feeling pain and discomfort.

 


References

Broida, S. E., Sweeney, A. P., Gottschalk, M. B., & Wagner, E. R. (2021). Management of shoulder instability in hypermobility-type Ehlers-Danlos syndrome. JSES Rev Rep Tech, 1(3), 155-164. doi.org/10.1016/j.xrrt.2021.03.002

Buryk-Iggers, S., Mittal, N., Santa Mina, D., Adams, S. C., Englesakis, M., Rachinsky, M., Lopez-Hernandez, L., Hussey, L., McGillis, L., McLean, L., Laflamme, C., Rozenberg, D., & Clarke, H. (2022). Exercise and Rehabilitation in People With Ehlers-Danlos Syndrome: A Systematic Review. Arch Rehabil Res Clin Transl, 4(2), 100189. doi.org/10.1016/j.arrct.2022.100189

Gensemer, C., Burks, R., Kautz, S., Judge, D. P., Lavallee, M., & Norris, R. A. (2021). Hypermobile Ehlers-Danlos syndromes: Complex phenotypes, challenging diagnoses, and poorly understood causes. Dev Dyn, 250(3), 318-344. doi.org/10.1002/dvdy.220

Hakim, A. (1993). Hypermobile Ehlers-Danlos Syndrome. In M. P. Adam, J. Feldman, G. M. Mirzaa, R. A. Pagon, S. E. Wallace, L. J. H. Bean, K. W. Gripp, & A. Amemiya (Eds.), GeneReviews((R)). www.ncbi.nlm.nih.gov/pubmed/20301456

Khokhar, D., Powers, B., Yamani, M., & Edwards, M. A. (2023). The Benefits of Osteopathic Manipulative Treatment on a Patient With Ehlers-Danlos Syndrome. Cureus, 15(5), e38698. doi.org/10.7759/cureus.38698

Miklovic, T., & Sieg, V. C. (2024). Ehlers-Danlos Syndrome. In StatPearls. www.ncbi.nlm.nih.gov/pubmed/31747221

Uehara, M., Takahashi, J., & Kosho, T. (2023). Spinal Deformity in Ehlers-Danlos Syndrome: Focus on Musculocontractural Type. Genes (Basel), 14(6). doi.org/10.3390/genes14061173

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Managing Hinge Joint Pain and Conditions

Managing Hinge Joint Pain and Conditions

 Can understanding the body’s hinge joints and how they operate help with mobility and flexibility problems and manage conditions for individuals with difficulty fully bending or extending their fingers, toes, elbows, ankles, or knees?

Managing Hinge Joint Pain and Conditions

Hinge Joints

A joint forms where one bone connects to another, allowing motion. Different types of joints differ in structure and movement depending on their location. These include hinge, ball and socket, planar, pivot, saddle, and ellipsoid joints. (Boundless. General Biology, N.D.) Hinge joints are synovial joints that move through one plane of motion: flexion and extension. Hinge joints are found in the fingers, elbows, knees, ankles, and toes and control movement for various functions. Injuries, osteoarthritis, and autoimmune conditions can affect hinge joints. Rest, medication, ice, and physical therapy can help alleviate pain, improve strength and range of motion, and help manage conditions.

Anatomy

A joint is formed by the joining of two or more bones. The human body has three main classifications of joints, categorized by the degree to which they can move. These include: (Boundless. General Biology, N.D.)

Synarthroses

  • These are fixed, immovable joints.
  • Formed by two or more bones.

Amphiarthroses

  • Also known as cartilaginous joints.
  • A fibrocartilage disc separates the bones that form the joints.
  • These movable joints allow for a slight degree of movement.

Diarthroses

  • Also known as synovial joints.
  • These are the most common freely mobile joints that allow movement in multiple directions.
  • The bones that form the joints are lined with articular cartilage and enclosed in a joint capsule filled with synovial fluid that allows for smooth motion.

Synovial joints are classified into different types depending on differences in structure and the number of motion planes they allow. A hinge joint is a synovial joint that allows movement in one plane of motion, similar to a door hinge that moves forward and backward. Within the joint, the end of one bone is typically convex/pointed outward, with the other concave/rounded inward to allow the ends to fit smoothly. Because hinge joints only move through one plane of movement, they tend to be more stable than other synovial joints. (Boundless. General Biology, N.D.) Hinge joints include:

  • The finger and toe joints – allow the fingers and toes to bend and extend.
  • The elbow joint – allows the elbow to bend and extend.
  • The knee joint – allows the knee to bend and extend.
  • The talocrural joint of the ankle – allows the ankle to move up/dorsiflexion and down/plantarflexion.

Hinge joints allow the limbs, fingers, and toes to extend away and bend toward the body. This movement is essential for activities of daily living, such as showering, getting dressed, eating, walking, standing up, and sitting down.

Conditions

Osteoarthritis and inflammatory forms of arthritis can affect any joint (Arthritis Foundation. N.D.) Autoimmune inflammatory forms of arthritis, including rheumatoid and psoriatic arthritis, can cause the body to attack its own joints. These commonly affect the knees and fingers, resulting in swelling, stiffness, and pain. (Kamata, M., Tada, Y. 2020) Gout is an inflammatory form of arthritis that develops from elevated levels of uric acid in the blood and most commonly affects the hinge joint of the big toe. Other conditions that affect hinge joints include:

  • Injuries to the cartilage within the joints or ligaments that stabilize the outside of the joints.
  • Ligament sprains or tears can result from jammed fingers or toes, rolled ankles, twisting injuries, and direct impact on the knee.
  • These injuries can also affect the meniscus, the tough cartilage within the knee joint that helps cushion and absorb shock.

Rehabilitation

Conditions that affect hinge joints often cause inflammation and swelling, resulting in pain and limited mobility.

  • After an injury or during an inflammatory condition flare-up, limiting active movement and resting the affected joint can reduce increased stress and pain.
  • Applying ice can decrease inflammation and swelling.
  • Pain-relieving medications like NSAIDs can also help reduce pain. (Arthritis Foundation. N.D.)
  • Once the pain and swelling start to subside, physical and/or occupational therapy can help rehabilitate the affected areas.
  • A therapist will provide stretches and exercises to help improve the joint range of motion and strengthen the supporting muscles.
  • For individuals experiencing hinge joint pain from an autoimmune condition, biologic medications to decrease the body’s autoimmune activity are administered through infusions delivered every several weeks or months. (Kamata, M., Tada, Y. 2020)
  • Cortisone injections may also be used to decrease inflammation.

At Injury Medical Chiropractic and Functional Medicine Clinic, we passionately focus on treating patients’ injuries and chronic pain syndromes and improving ability through flexibility, mobility, and agility programs tailored to the individual. Our providers use an integrated approach to create personalized care plans that include Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine protocols. Our goal is to relieve pain naturally by restoring health and function to the body. If the individual needs other treatment, they will be referred to a clinic or physician best suited for them. Dr. Jimenez has teamed up with the top surgeons, clinical specialists, medical researchers, and premier rehabilitation providers to provide the most effective clinical treatments.


Chiropractic Solutions


References

Boundless. General Biology. (N.D.). 38.12: Joints and Skeletal Movement – Types of Synovial Joints. In. LibreTexts Biology. bio.libretexts.org/Bookshelves/Introductory_and_General_Biology/Book%3A_General_Biology_%28Boundless%29/38%3A_The_Musculoskeletal_System/38.12%3A_Joints_and_Skeletal_Movement_-_Types_of_Synovial_Joints

Arthritis Foundation. (N.D.). Osteoarthritis. Arthritis Foundation. www.arthritis.org/diseases/osteoarthritis

Kamata, M., & Tada, Y. (2020). Efficacy and Safety of Biologics for Psoriasis and Psoriatic Arthritis and Their Impact on Comorbidities: A Literature Review. International journal of molecular sciences, 21(5), 1690. doi.org/10.3390/ijms21051690

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

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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.