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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.


Understanding the Causes of Acute and Chronic Sports Injuries

Understanding the Causes of Acute and Chronic Sports Injuries

Acute and chronic sports injuries. Individuals who participate in sports or physical activities have an increased risk of experiencing an injury. These types of damages range from minor to severe and could require medical attention. Acute sports injuries happen suddenly and are usually the result of trauma to the area. A specific, identifiable incident is what causes an acute injury. Chronic sports injuries, also known as repetitive/overuse injuries, happen with time and are not caused by a single incident.

Understanding the Causes of Acute and Chronic Sports Injuries

Acute and Chronic Sports Injuries Identification

Acute injuries can be identified by their cause. This could be a falling down during a run, sharp pain that presents in the shoulder after a throw, or a sprained ankle. The ability to focus on one cause usually means it’s acute. Acute injuries are characterized by:

  • Sudden pain in an area where there was none.
  • Swelling
  • Redness
  • Tenderness
  • Limited range of motion.
  • The inability of the injured area to support its weight.
  • A broken bone.
  • Dizziness
  • Headache
  • Nausea
  • Vomiting

Chronic injuries are different but are usually easy to identify. The pain begins gradually, usually over weeks or months. Repetitive activities like running, throwing, and swinging can exacerbate the pain. However, it is difficult to point to a specific issue that first caused the discomfort or pain. Chronic sports injuries are characterized by:

  • Pain and tenderness in the area, especially during and immediately after activity.
  • Minor swelling and limited range of motion.
  • Dull pain when resting.

These two types of injuries have different causes – trauma for acute and wear-and-tear for chronic – but they can both result in similar issues. For example, shoulder rotator cuff injuries are common, especially those that repeatedly use their shoulder to swing, throw, swim, etc. The individual needs to undergo a rotator cuff injury test to diagnose the injury correctly, whether the damage is acute or chronic. Chronic injuries can cause acute injuries, and acute injuries can lead to chronic injuries if left untreated.

Examples of Acute and Chronic Sports Injuries

Chronic and acute injuries are common in every type of sport. There’s an opportunity for both types of injuries. The most common include:

Acute Injuries:

  • Sprain and Strains
  • Burners and Stingers
  • A.C.L. Tears
  • Rotator Cuff Tear
  • Dislocated Shoulder
  • Broken Bones or Fractures
  • Concussion
  • Whiplash

Chronic Injuries:

  • Runner’s Knee
  • Achilles Tendon Issues
  • Shin Splints
  • Swimmer’s Shoulder
  • Lateral epicondylitis tennis elbow
  • Stress Fractures

Other injuries from trauma, overuse, or both include:

  • Nonspecific Back Pain
  • Herniated Disc/s
  • Spondylolysis

Treatment

Minor acute injuries can be treated with rest, ice, compression, and elevation, aka R.I.C.E. Overuse injuries, are different as the injury has been gradually increasing in its severity, possibly causing scar tissue and ganglion cysts to develop. To prevent the injury from worsening, it’s recommended to see a sports injury chiropractor or physical therapist. These professionals can help heal the body and educate the individual on self-care and prevention.

Chiropractic

The musculoskeletal system takes a beating. Chronic injuries usually affect the bones, joints, muscles, or a combination. Chiropractic helps keep the musculoskeletal system limber and in proper alignment. Adjustments include:

  • Neck adjustments
  • Arm and hand adjustments
  • Shoulder adjustments
  • Knee adjustments
  • Hip adjustments
  • Foot adjustments

Physical Therapy

Physical therapy for a chronic injury can help prevent future injuries. A physical therapist helps:

  • Improve range of motion
  • Reduces pain and swelling
  • Increases strength

Whether an athlete or is just staying active and having some fun with sports, acute and chronic injuries can sneak up and worsen if they are not treated properly. Healing with the help of a professional can quicken recovery time and prevent future injuries.


Body Composition


Maintain Muscle Mass While Losing Fat

Individuals who want to lose weight should focus on losing excess fat tissue, not muscle mass. Studies have shown that diet and exercise are crucial to preserving Skeletal Muscle Mass while losing weight. Losing weight healthily includes:

  • A healthy balance of cardio and resistance training to burn calories and build muscle.
  • A caloric deficit diet to burn through extra fat stores.
  • Get enough protein to support and maintain healthy muscle mass.
References

Cava, Edda et al. “Preserving Healthy Muscle during Weight Loss.” Advances in nutrition (Bethesda, Md.) vol. 8,3 511-519. 15 May. 2017, doi:10.3945/an.116.014506

www.niams.nih.gov/health-topics/sports-injuries

link.springer.com/article/10.2165/00007256-199418030-00004

journals.lww.com/acsm-csmr/FullText/2010/09000/An_Overview_of_Strength_Training_Injuries__Acute.14.aspx?casa_token=8sCDJWxhcOMAAAAA:CDEFNkTlCxFkl-77MtALBQAkttW0PqWwCj4masQzEcYOJNuwFKyZgHZ9npQoHhWgMKOPSbnkLyfcQACYGpuu7gg

Wörtler, K, and C Schäffeler. “Akute Sportverletzungen und chronische Überlastungsschäden an Vor- und Mittelfuß” [Acute sports injuries and chronic overuse stress damage to the forefoot and midfoot]. Der Radiologe vol. 55,5 (2015): 417-32. doi:10.1007/s00117-015-2855-3

Yang, Jingzhen et al. “Epidemiology of overuse and acute injuries among competitive collegiate athletes.” Journal of athletic training vol. 47,2 (2012): 198-204. doi:10.4085/1062-6050-47.2.198

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