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 hamstring muscles attach, through a tendon called the proximal hamstring tendon, to the ischial tuberosity, the bones used to sit deep in the buttock muscles. When the tendon is subjected to overuse/repetitive stresses and strains, the internal structure can become compromised, leading to weakness and pain symptoms. This is known as proximal hamstring tendinopathy. Tendinopathy is an overuse injury where the tendon is repeatedly strained until microscopic tears form. It is common in athletes that do a lot of running but also in individuals that sit for prolonged periods. If left untreated, high hamstring tendinopathy can lead to progressive degeneration of the tissues, leading to chronic weakness, pain, and dysfunction.
High Hamstring Tendinopathy
The hamstrings are a powerful muscle group that extends the hip and flexes the knee. They experience stress and pressure during activity and inactivity/sitting and are susceptible to strain injuries. Tendons attach muscle to bone and are designed to take compressive and tensile weight/loads that stretch or flex. A tendon is made up of fibrous tissue containing organized type 1 collagen. Tendons receive blood; however, the supply is less where the tendon attaches to the bone and is commonly where tendinopathy occurs.
Injury
A hamstring injury involves the bruising, irritation, or tearing of the hamstring tendon or muscle tissue. Severity can range from:
Microtears that cause stiffness and pain symptoms but heal fast on their own.
Severe ruptures that cause debilitating pain, dysfunction and require medical intervention.
The tendon attaches to the ischial tuberosity or sitting buttock bone. Tendons can have a spasm-like reaction to sudden or quick shift changes. A sudden change can cause adverse changes to the tendon. Too much load on the tendon beyond its ability to recover can cause the structure to change and the collagen to break down/tear like a rope tearing and unraveling. High hamstring tendinopathy happens around the hip area and presents as buttock or upper thigh pain. Individuals report deep, dull, radiating buttock pain during walking, running, and prolonged sitting or driving. Sometimes the sciatic nerve can become irritated or entrapped by an affected tendon’s scar tissue, causing sciatica-like symptoms.
Stages of Tendon Pathology
Reactive Phase
Caused by an acute overload of physical activity or inactivity.
The tendon will thicken temporarily to decrease the stress; however, there may be no inflammation.
The tendon can return to normal if the load is reduced or sufficient time for recovery and repair is allowed.
Disrepair
Chronically overloaded.
Unsuccessful healing.
More negative tendon changes occur.
Reversibility is possible with load management and targeted exercises to stimulate the tendon and surrounding tissues.
Degenerative
Continual progression of adverse tendon changes.
More common in older individuals.
Continue load management and strength training to maximize the tendon’s tolerance.
Chiropractic Treatment
A chiropractic therapy team will develop a personalized treatment program to improve tendon structure and strengthen the hamstrings, gluteal, and side abdominal muscles. They will begin with tendon symptom-relieving massage to loosen the muscles and get the blood circulating, MET-targeted stretches to lengthen the muscles, and spinal and pelvic adjustments to realign the body.
Sciatica Explained
References
Buckley, Mark R et al. “Distributions of types I, II and III collagen by region in the human supraspinatus tendon.” Connective tissue research vol. 54,6 (2013): 374-9. doi:10.3109/03008207.2013.847096
Lempainen, Lasse, et al. “Expert opinion: diagnosis and treatment of proximal hamstring tendinopathy.” Muscles, ligaments, and tendons journal vol. 5,1 23-8. 27 Mar. 2015
Mattiussi, Gabriele, and Carlos Moreno. “Treatment of proximal hamstring tendinopathy-related sciatic nerve entrapment: presentation of an ultrasound-guided “Intratissue Percutaneous Electrolysis” application.” Muscles, ligaments, and tendons journal vol. 6,2 248-252. 17 Sep. 2016, doi:10.11138/mltj/2016.6.2.248
Ono, T et al. “Estimation of tensile force in the hamstring muscles during overground sprinting.” International Journal of sports medicine vol. 36,2 (2015): 163-8. doi:10.1055/s-0034-1385865
White, Kristin E. “High hamstring tendinopathy in 3 female long-distance runners.” Journal of chiropractic medicine vol. 10,2 (2011): 93-9. doi:10.1016/j.jcm.2010.10.005
Wilson, Thomas J et al. “Sciatic Nerve Injury After Proximal Hamstring Avulsion and Repair.” Orthopedic Journal of sports medicine vol. 5,7 2325967117713685. 3 Jul. 2017, doi:10.1177/2325967117713685
Automobile collisions, work, sports, and personal accidents can cause neck injuries that can affect other areas, leading to long-term health problems. Neck injuries involving soft tissue damage frequently persist after the incident. One of the injuries includes vocal cord damage caused by impact to the larynx. The larynx, or voicebox, is an organ that is behind the Adam’s apple. A neck injury impacting the larynx can affect the ability to speak and breathe and cause vocal cord paralysis. Treatment can involve surgery, voice therapy, physical therapy, and chiropractic.
Vocal Cord Injury
The vocal cords are two flexible bands of muscle tissue at the entrance of the trachea. The vocal cords are normally in a relaxed open position to allow breathing. When talking, the bands combine and vibrate to make a sound. Surgery, viral infections, certain cancers, and neck trauma can cause vocal cord paralysis. In this condition, nerve damage blocks or inhibits impulses from transmitting to the voice box. The muscles, usually one of them, become paralyzed, preventing swallowing and ingesting saliva through the windpipe/trachea. In rare cases, both muscles are unable to move.
Trauma to the neck or chest can injure the voice box nerves.
Infections
Infections like Lyme disease, Epstein-Barr virus, and herpes can cause inflammation and nerve damage.
Tumors
Tumors, cancerous and noncancerous, can grow inside or around the muscles, cartilage, and nerves.
Neurological
Neurological conditions like multiple sclerosis or Parkinson’s disease can lead to vocal cord paralysis.
Surgical Injury
Surgical procedure mistakes or complications on or near the neck or upper chest can result in damage to the voice box nerves.
Surgeries to the thyroid or parathyroid glands, esophagus, neck, and chest have an increased risk.
Stroke
A stroke chokes blood flow to the brain and can damage the region of the brain that transmits messages to the voice box.
Treatment
Treatment is determined by a doctor based on the individual medical condition and diagnostic tests. Treatment can involve:
Speech Therapy
Speech therapy is recommended as the laryngeal muscles are strengthened through various exercises, improving breathing function. A speech therapist will begin working with the individual on exercises targeting the weakened vocal folds by enhancing airflow and blood circulation.
Physical Therapy and Chiropractic
Treatment involves performing gentle exercises that work on the vocal cords gradually and progressively but does not stress them. Chiropractors work with the physical therapist performing high-velocity, low-amplitude manipulation targeted at the lower neck and upper thoracic area, the C3/T1 vertebrae. A treatment plan will also use massage, non-surgical decompression, instrument/tool-assisted soft-tissue mobilization, low laser or ultrasound, and at-home stretches and exercises.
Surgery
Surgery could be necessary for individuals experiencing no improvement despite doing the prescribed speech and physical therapy exercises. Different types of procedures are based on the degree and extent of the paralysis:
Injections – Collagen and fillers are injected into the vocal cords to reposition the affected muscles closer to the larynx.
Phonosurgery – The vocal cords are repositioned through restructuring.
Tracheotomy – If the vocal folds are closing, a surgeon may make an incision in the neck at the opening of the windpipe and insert a breathing tube. This bypasses the air blockage caused by the vocal folds and promotes proper air circulation.
Cervical Spine Instability
References
Chen, Ching-Chang, et al. “Long-term result of vocal cord paralysis after anterior cervical discectomy.” The European spine journal: official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society vol. 23,3 (2014): 622-6. doi:10.1007/s00586-013-3084-y
Dankbaar JW, et al. Vocal cord paralysis: Anatomy, imaging, and pathology. Insights in Imaging. 2014; doi:10.1007/s13244-014-0364-y.
Fitzpatrick, P C, and R H Miller. “Vocal cord paralysis.” The Journal of the Louisiana State Medical Society: official organ of the Louisiana State Medical Society vol. 150,8 (1998): 340-3.
Kriskovich, M D et al. “Vocal fold paralysis after anterior cervical spine surgery: incidence, mechanism, and prevention of injury.” The Laryngoscope vol. 110,9 (2000): 1467-73. doi:10.1097/00005537-200009000-00011
Waddell, Roger K. “Chiropractic care for a patient with spasmodic dysphonia associated with cervical spine trauma.” Journal of chiropractic medicine vol. 4,1 (2005): 19-24. doi:10.1016/S0899-3467(07)60108-6
The body has around 1,000 ligaments that connect bones and joints. Ligaments are strong bands of tissue that support joint mobility and stabilize the muscles and bones. An injury to one or more ligaments can cause inflammation, swelling, discomfort, and instability. The PCL refers to the posterior cruciate ligament that runs along the back of the knee joint. This ligament connects the femur/thigh bone to the tibia/shinbone. Anyone can suffer from an injury to the posterior cruciate ligament. It can be caused by the knee hitting a dashboard in an automobile collision, a worker twisting or falling on a bent knee or a sports contact injury. The Injury Medical Chiropractic and Functional Medicine Clinic Team provide soft tissue work, trigger point therapy, and targeted non-surgical treatment through advanced therapy methods and technologies.
Posterior Cruciate Ligament
The posterior cruciate ligament – PCL is located inside the knee, just behind the anterior cruciate ligament – ACL. It is one of several ligaments that connect the femur/thighbone to the tibia/shinbone. The posterior cruciate ligament keeps the tibia from moving backward.
Injury
Posterior cruciate ligament injuries are far less common than ACL – anterior cruciate tears. PCL injuries make up less than 20% of all knee ligament injuries. It is more common for PCL tears to occur with other ligament injuries. A PCL injury can cause mild, moderate, or severe damage and is rated into four different categories:
Grade I
A partial tear is present in the ligament.
Grade II
There is a partial tear.
The ligament can feel loose.
Grade III
The ligament is completely torn.
The knee is unstable.
Grade IV
The PCL is injured.
Other knee ligaments are damaged.
Individuals with posterior cruciate ligament injuries can have short or long-term symptoms. Typically, long-term symptoms occur when an injury slowly develops over time. In mild cases, individuals may still be able to walk, and their symptoms may be less noticeable. Common symptoms associated with PCL injuries include:
Difficulty placing weight on the injured knee.
Stiffness.
Walking difficulties.
Difficulty descending stairs.
A wobbly sensation inside the knee.
Inflammation and swelling can be mild to severe.
Knee pain.
Pain that worsens over time.
Over time, tears could lead to the development of osteoarthritis.
There is an increased risk of extensive damage and chronic pain conditions if left untreated.
Chiropractic Care
The continued participation in work or activity following a mild injury is the primary reason individuals undergo therapy, injections, or surgical repairs. Knee injuries need immediate attention to prevent worsening or further damage. A chiropractor will examine the knee, check the range of motion and ask about symptoms. They may request imaging tests to determine the extent of the damage. These tests may include the following:
X-rays.
Magnetic resonance imaging.
CT scan.
During the physical examination, they will check all the structures of the injured knee and compare them to the non-injured knee. The wounded knee may appear to sag backward when bent or could slide back too far, specifically when beyond a 90-degree angle. Treatment depends on the severity of the injury. Common treatments include:
Crutches
Crutches may be recommended to limit the weight placed on the knee.
Knee Brace
A special brace can address instability and help prevent the tibia bone from sagging backward.
Gravity tends to pull the bone backward when lying down.
Chiropractic and Physical Therapy
As the swelling goes down, a carefully personalized rehabilitation program can begin.
This procedure is less invasive compared to traditional surgical methods.
Recovery time varies from person to person. If the injury is mild, it may only take around ten days to heal. If surgery was needed, recovery could take about six to nine months. Full recovery typically requires 6 to 12 months.
Bedi A, Musahl V, Cowan JB. Management of Posterior Cruciate Ligament Injuries: An Evidence-Based Review. Journal of the American Academy of Orthopedic Surgery. 2016 May;24(5):277-89. Accessed 7/26/21.
Lu, Cheng-Chang, et al. “Twelve Weeks of a Staged Balance and Strength Training Program Improves Muscle Strength, Proprioception, and Clinical Function in Patients with Isolated Posterior Cruciate Ligament Injuries.” International journal of environmental research and public health vol. 18,23 12849. 6 Dec. 2021, doi:10.3390/ijerph182312849
Pierce, Casey M et al. “Posterior cruciate ligament tears: functional and postoperative rehabilitation.” Knee surgery, sports traumatology, arthroscopy: official journal of the ESSKA vol. 21,5 (2013): 1071-84. doi:10.1007/s00167-012-1970-1
Schüttler, K F et al. “Verletzungen des hinteren Kreuzbands” [Posterior cruciate ligament injuries]. Der Unfallchirurg vol. 120,1 (2017): 55-68. doi:10.1007/s00113-016-0292-z
Zsidai, Bálint, et al. “Different injury patterns exist among patients undergoing operative treatment of isolated PCL, combined PCL/ACL, and isolated ACL injuries: a study from the Swedish National Knee Ligament Registry.” Knee surgery, sports traumatology, arthroscopy: official journal of the ESSKA vol. 30,10 (2022): 3451-3460. doi:10.1007/s00167-022-06948-x
Hamstring syndrome is a condition where the sciatic nerve gets pinched between the hamstring muscles and the pelvic bone or by the tissue bands that connect the hamstring muscles causing compression on and around the nerve. It is seen in individuals that play sports that involve running, kicking, or jumping, in middle-aged individuals engaged in daily activities that have suffered falls, and in individuals that sit for many hours. Chiropractic care, massage, and decompression therapy can relieve the symptoms, release the trapped nerve, relax and stretch the muscles, and restore function.
Hamstring Muscles Trapped Sciatic Nerve
Three muscles make up the hamstrings in the back of the thigh. The sciatic nerve runs from the low back down the leg into the foot. A trapped sciatic nerve can cause various symptoms and sensations in the back of the leg, hip, buttock, and foot. It may hurt to sit down or stretch the legs out, and there is usually tightness in and/or around the buttock and back of the leg. The symptoms typically recede when lying on your back.
Cause
Regular wear and tear on the back muscles and hamstrings can contribute to the condition.
Often the sciatic nerve and/or the sheath surrounding the sciatic nerve gets trapped and irritated as it travels around the ischial tuberosity. The ischial tuberosities are known as the sit bones.
The area where the sciatic nerve runs down the back of the leg can become narrowed, leading to nerve irritation and stinging, numbing, and tingling sensations.
The injury often happens during sudden, quick, forceful movements that overstretch the tendons and/or muscles but can also happen during slow movements.
Movement agitates the pulling and rubbing of the nerve on the muscles.
A non-painful pull or pop of the hamstrings can cause the muscles to spasm and wrap around the nerve.
Symptoms
Symptoms usually include the following:
Leg pain that worsens when sitting.
Intense electrical shooting pain that makes it hard to stand or move.
Difficulties moving the leg or foot.
Numbness and weakness in and around the leg.
Tingling or burning sensations running down the leg.
Persistent pain on one side of the lower back.
Chiropractic Care
Chiropractic treatment can relieve the symptoms and release the trapped nerve. Treatment includes:
Accurate Diagnosis – A chiropractor will examine and review physical activity, work, and medical history.
Ice and Heat therapies will stop the swelling and increase blood flow.
Massage therapy relaxes the muscles and increases circulation.
Decompression therapy incrementally and gently stretches the body.
Chiropractic adjustments realign and reset the body.
Targeted stretches and exercises will keep the muscles loose and increase strength.
Nutritional recommendations will help reduce inflammation and prevent flare-ups.
Hamstrings and Sciatic Nerve Relationship
References
Lohrer, Heinz, et al. “Nerve entrapment after a hamstring injury.” Clinical journal of sports medicine: official journal of the Canadian Academy of Sports Medicine vol. 22,5 (2012): 443-5. doi:10.1097/JSM.0b013e318257d76c
Mattiussi, Gabriele, and Carlos Moreno. “Treatment of proximal hamstring tendinopathy-related sciatic nerve entrapment: presentation of an ultrasound-guided “Intratissue Percutaneous Electrolysis” application.” Muscles, ligaments and tendons journal vol. 6,2 248-252. 17 Sep. 2016, doi:10.11138/mltj/2016.6.2.248
McGregor, Catriona, et al. “Traumatic and overuse injuries of the ischial origin of the hamstrings.” Disability and rehabilitation vol. 30,20-22 (2008): 1597-601. doi:10.1080/09638280701786138
Saikku, Kari, et al. “Entrapment of the proximal sciatic nerve by the hamstring tendons.” Acta orthopaedica Belgica vol. 76,3 (2010): 321-4.
The various muscles and ligaments that encompass the back help protect the spine’s thoracic region. The spine has three sections: cervical, thoracic, and lumbar, which assist the body with bending, turning, and twisting. For the thoracic spine, various muscles like the rhomboid, trapezoid, and other superficial muscles provide functionality to the scapula or shoulder blades to stabilize the ribcage. When the body succumbs to injuries or traumatic forces, it can develop myofascial pain syndrome associated with upper back pain. Upper back pain can lead to unwanted symptoms affecting their quality of life. Fortunately, various exercises target the upper portion of the back and can strengthen multiple muscles from injuries. Today’s article looks at the effects of upper back pain in the body and shows a few stretches and exercises that can support the various muscle groups in the upper back region. We refer our patients to certified providers that incorporate techniques and multiple therapies for many individuals suffering from upper back pain and its correlating symptoms that can affect the musculoskeletal system in the neck, shoulders, and thoracic region of the spine. We encourage and appreciate each patient by referring them to associated medical providers based on their diagnosis when it is appropriate. We understand that education is a fantastic way when asking our providers intricated questions at the patient’s request and understanding. Dr. Jimenez, D.C., only utilizes this information as an educational service. Disclaimer
The Effects Of Upper Back Pain In The Body
Have you been experiencing stiffness around or near your shoulder blades? Do you feel muscle strain when you are rotating your shoulders? Or does it hurt when you stretch your upper back in the morning? Many of these issues are signs and symptoms of upper back pain. Studies reveal that back pain is one of the most common complaints many individuals would go for emergency care. Back pain can affect the different regions in the back and cause unwanted symptoms in various areas in the upper back. Additional studies mentioned that persistent pain in the thoracic region could cause hyper-sensitization of the intercoastal nerves that mimic other conditions affecting the back. Some of the causes and effects that can lead to the development of upper back pain include:
When this happens, it can lead to overlapping conditions that mimic other issues and, if not treated right away, leave individuals with chronic disabling symptoms that correlate with upper back pain.
Upper Back Pain Relief-Video
Have you been experiencing stiffness in your shoulders or neck? Do you feel aches and pains when stretching your arms? Or what about feeling muscle strain when lifting a heavy object? Many of these factors correlate with upper back pain affecting the thoracic spine region. When this happens, it can lead to overlapping risk profiles that can develop into different issues that can cause even more pain to the body. There are various ways to prevent upper back pain from causing further issues to the individual and can relieve the pain associated with it. Many people would go to chiropractic therapy to have their spine re-aligned to bring adequate relief or incorporate upper back exercises and stretches to relieve tension accumulated in the neck and shoulder regions. The video above explains how stretches work for different muscle regions in the upper back and provide relief to the thoracic spine.
Exercises For Upper Back Pain
Regarding the upper back, it is important to understand that incorporating various exercises that target the thoracic region can cause prolonged injuries. Studies reveal that different back exercises focus not only on the back but the shoulders, arms, chest, core, and hips providing stability, balance, and coordination to the individual. This allows the muscles in the back region to improve strength and endurance over time when a person continues to work out. More studies reveal that protocols like the McKenzie back exercise are effective programs to treat various musculoskeletal conditions that can cause pain in the back. Many physical therapists use this protocol on their patients to relieve back pain and help improve their muscular structure to have better posture.
Warm Up
Just like any individual that is starting to get back to their health and wellness through exercise, the most important step that anyone has to do is warming up their muscles before getting into a workout. Warming up each muscle group can prevent future injuries and increase blood flow before starting the exercise. Many individuals would incorporate stretches and foam rolling for 5-10 minutes to ensure that each muscle is ready to perform with maximum effort.
Exercises
After the body is warmed up, it is time to begin the exercise regime. Many different exercise movements target each muscle group and help build muscle mass and improve functionality. It is important to build up momentum when it comes to working out. Starting slowly with minimum reps and sets is important to ensure the exercise is done correctly. Afterward, the individual can increase the workout reps and go with a heavier weight. Below are some of the exercise routines that are suited for the upper back.
Superman
Lie on your stomach and extend your arms above the head
Keep neck in a neutral position and lift legs and arms off the floor at the same time
Make sure to use the back and glutes to lift
Briefly pause at the top, then return to starting position
Complete three sets of 10 reps
This exercise helps strengthen the spine and surrounding muscles to support the spine and reduce any future injuries from upper back pain.
Reverse Dumbbell Flies
Grab light weighted dumbbells
Hinge at the waist at 45 degrees while standing
Make sure the arms are hanging down with the weights
Keep the neck in a neutral position while gazing down
Lift the arms (with the dumbbells) out to the side and upwards
Squeeze the shoulders together at the top during this movement
Complete three sets of 8-12 reps
This exercise is excellent for strengthening the muscles that surround the shoulder and upper back.
Rows
Use a resistance band or a light weighted dumbbell.
For the resistance band, affix the band to a stable surface above eye level. For the light weighted dumbbells, extend the arms in front of the body above eye level.
Use an overhead grip when holding the resistance band handles and the light weighted dumbbells.
Pull resistance bands or dumbbells toward the face.
Flare out the upper arms to the sides
Squeeze the shoulders together
Pause for a bit and then return to starting position
Complete three sets of 12 reps
This exercise helps strengthen the shoulder muscles and prevent future injuries from occurring in the upper back.
Conclusion
Some various muscles and ligaments encompass the back and help protect the spine’s thoracic region. These muscles help with the stabilization of the ribcage and help provide the functionality to the upper back. When multiple factors cause traumatic injuries to the upper back, it can lead to pain-like symptoms that can cause overlapping features and affect a person’s quality of life. Luckily, various exercises target the upper back and surrounding muscle groups. Each activity targets all the muscles in the upper back and allows a person to regain health and wellness without constant pain.
References
Atalay, Erdem, et al. “Effect of Upper-Extremity Strengthening Exercises on the Lumbar Strength, Disability and Pain of Patients with Chronic Low Back Pain: A Randomized Controlled Study.” Journal of Sports Science & Medicine, U.S. National Library of Medicine, 1 Dec. 2017, www.ncbi.nlm.nih.gov/pmc/articles/PMC5721192/.
Casiano, Vincent E, et al. “Back Pain – Statpearls – NCBI Bookshelf.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 4 Sept. 2022, www.ncbi.nlm.nih.gov/books/NBK538173/.
Louw, Adriaan, and Stephen G Schmidt. “Chronic Pain and the Thoracic Spine.” The Journal of Manual & Manipulative Therapy, U.S. National Library of Medicine, July 2015, www.ncbi.nlm.nih.gov/pmc/articles/PMC4534852/.
Mann, Steven J, et al. “McKenzie Back Exercises – Statpearls – NCBI Bookshelf.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 4 July 2022, www.ncbi.nlm.nih.gov/books/NBK539720/.
Sciatica From Working Out: There are benefits from strenuous exercise and a level of acceptance of the discomfort that goes with exertion. While this is true to a certain degree, when individuals feel the pump and are in the workout zone, it can be very easy to take off and overdo it. This is when the body and the back become susceptible to injuries. Sciatica from working out occurs when added pressure on the sciatic nerve results in a compressed/pinched nerve. Left untreated can lead to further back problems and other health issues. The Injury Medical Chiropractic and Functional Medicine Team can relieve the compression, release the nerve, relax the muscles, and restore function.
Sciatica From Working Out
Microtrauma
Building muscle and increasing strength require a certain amount of physical damage to the muscles for successful progress. Intense and heavy exercise tear the muscle tissues causing microtrauma that triggers a healing response that creates muscle mass. These micro-injuries can cause the back muscles to tighten up, shifting the spine out of alignment, causing the discs to slip and compress nerves, or by tight leg muscles like the piriformis swelling and squeezing the sciatic nerve.
Causes
Rest and Recovery
It’s important to understand that proper recovery is essential to an exercise program.
It can take up to 72 hours to recover from the microtears.
Individuals that go right back for a similar workout can aggravate existing micro tears while creating more, resulting in a downward cycle of symptoms that can lead to other problems or become a chronic condition.
Rotating to exercises that go easy on the back and leg muscles assists in the normal healing and development of muscle tissue.
Not Warming up Before Workout
Not warming up before exercising can cause injuries.
When muscles are cold and not warmed up properly, they can become stiff and inflexible, causing them to strain and tear when exposed to sudden, intense exertion.
Before performing any exercise, always start with a low-impact, gentle warm-up.
Not Stretching Properly or at All
Full-body stretching is necessary as the torn, tight muscles need to be relaxed and kept loose.
Make sure to stretch the hamstrings and hips thoroughly.
After each workout, take 10 minutes and stretch.
Not Stretching After
Always do some stretching after a workout.
Stretching after can help prevent muscle fatigue and soreness from a lactic acid buildup.
Starting With Heavy Weights
Many injuries happen because individuals start too heavy.
Challenging the body’s performance is part of the process but should be done in small steps.
Start with lighter weights and add more gradually.
Improper Posture and Form
A leading cause of back problems is poor posture and form.
Curving the back while lifting weights is the most error.
Overarching can also cause injury.
When performing push-ups or planks, avoid sinking the hips.
Hard Surfaces
For runners, hard surfaces like concrete or asphalt force the body and back to absorb most of the impact.
This compresses the vertebrae, which can irritate the sciatic nerve.
Rotate by using running trails or a treadmill.
Work on running with a shorter stride to reduce bounce and impact.
Incorporate cross-training.
Rotate upper body strength training to give the legs, gluteals, and back muscles a rest.
Chiropractic Rehabilitation
Chiropractic care, massage, and decompression therapy can relieve sciatica pain. Using spinal manipulation techniques and other therapies, chiropractors can alleviate the pressure on the nerve. Treatment involves:
X-rays are taken so that the chiropractor can understand the cause.
Massaging the muscles to relax and release them and increase circulation.
Stretching and applying controlled pressure to the joints.
Specific exercises and stretches will be recommended to do at home.
Health coaching and nutrition and wellness recommendations.
Personalized Sciatica Treatment
References
Bonasia DE, Rosso F, Cottino U, Rossi R. Exercise-induced leg pain. Asia Pac J Sports Med Arthrosc Rehabil Technol. 2015;2(3):73-84. doi:10.1016/j.asmart.2015.03.003
Cook CE, Taylor J, Wright A, Milosavljevic S, Goode A, Whitford M. Risk factors for first-time incidence sciatica: a systematic review. Physiother Res Int. 2014 Jun;18:65-78. doi:doi:10.1002/pri.1572
Koes BW, van Tulder MW, Peul WC. Diagnosis and treatment of sciatica. BMJ. 2007;334(7607):1313‐1317. doi:10.1136/bmj.39223.428495.BE
Lewis RA, Williams NH, Sutton AJ, et al. Comparative clinical effectiveness of management strategies for sciatica: a systematic review and network meta-analyses. (PDF). Spine J. 2015;15(6):1461-77. doi:10.1016/j.spinee.2013.08.049
Salehi, Alireza, et al. “Chiropractic: Is it Efficient in Treatment of Diseases? Review of Systematic Reviews.” International Journal of community-based nursing and midwifery vol. 3,4 (2015): 244-54.
The body is a complex machine with various muscles, tendons, ligaments, and vital organs that each play a specific role in maintaining functionality and stability to the host. The body allows movement and mobility from the neck down to the feet. When the body suffers from pain or has been affected by various issues that correlate with pain, two things can occur, one, where acute pain can affect the body and cause the individual to be sore for a few days or two, where the body suffers from chronic pain that leads to the development of myofascial pain syndrome that can lead to referred pain in different muscle groups and cause the body to dysfunction. Today’s article examines how to diagnose myofascial pain syndrome, how the body reacts to this condition, and how various treatments can reduce myofascial pain syndrome in the body. We refer patients to certified providers incorporating techniques and therapies for individuals dealing with myofascial pain syndrome affecting different body areas and causing functionality. By locating where the trigger points are coming from, many pain specialists utilize a treatment plan to reduce the effects that trigger points are causing on the body while coming up with a diagnosis to minimize the referred pain impacting the body. We encourage and appreciate each patient by referring them to associated medical providers based on their diagnosis when it is appropriate. We understand that education is a terrific way when asking our providers intricated questions at the patient’s request and understanding. Dr. Jimenez, D.C., only utilizes this information as an educational service. Disclaimer
How To Diagnose Myofascial Pain Syndrome
Have you been experiencing pain in different locations in your body? Do you have any areas of complaint that affect your daily lifestyle? Or do you have issues of stability and mobility when you are out and about? More often than not, approximately 25% of Americans are in some pain that can impact their lives and, if not treated right away, can cause the body to be dysfunctional. When there is constant pain in the body, it can cause overlapping risk profiles, known as myofascial pain syndrome. Myofascial pain syndrome is often defined as pain that originates along the musculoskeletal muscle groups and causes hyperirritable spots within the muscle fibers’ taut band, causing trigger points to develop. This means repetitive motions cause muscle strain and tightness along the muscle fibers when the body goes through repetitive movements daily.
When many people are dealing with myofascial pain syndrome, they would go to their primary doctor and explain that they are dealing with pain in different areas of their bodies, including their head, neck, shoulders, back, hips, etc. Afterward, their doctors conduct an examination to see where the issue is occurring. Many doctors often ask numerous questions to their patients about their daily activities before coming up with a diagnosis that myofascial pain syndrome is affecting their bodies. Studies reveal that the etiology of myofascial pain syndrome is not fully understood. Still, when the muscles, ligaments, and tissues are inflamed or undergo repetitive trauma, it can be accompanied by correlating conditions and disorders. To that point, doctors will work with their associated medical providers to develop a personalized treatment plan to diagnose and reduce myofascial pain syndrome associated with chronic conditions affecting the body.
How Does The Body React To Myofascial Pain Syndrome
Now when the body is dealing with myofascial pain syndrome, studies reveal that it can be a major health problem when it is not treated right away; it can cause the following:
Impaired mobility
Pain
Muscle hypersensitivity
Sleep issues
Neurological issues
According to “Myofascial Pain and Dysfunction: The Trigger Point Manual,” by Dr. Janet G. Travell, M.D., the book mentioned that when myofascial pain syndrome becomes aberrant, it can lead to a disorder known as myofascial pain modulation disorder. This means that when a person is dealing with trigger points in their bodies, it can distort their referred pain patterns when being diagnosed. Active trigger points normally project pain in different body locations, known as referred pain. However, with myofascial pain modulation disorder, the pain is not localized but aberrant, which causes distortion to the central nervous system and sends pain signals to cause structural damage to the affected muscles in the body.
An Overview Of Referred Pain- Video
Have you been experiencing pain in different locations in your body? Do you have mobility issues when turning your neck or hips? Do you feel like you are losing your quality of life? If you have been dealing with pain-like problems in your body, it could be due to myofascial pain syndrome causing these issues. Myofascial pain syndrome is when the body goes through repetitive motions or trauma that causes symptoms of muscle strain and stiffness that are correlated with referred pain. The video above explains what referred pain does to the body and how it can affect the muscles and the corresponding organs. This is known as somato-visceral dysfunction, where the muscles and the related vital organs are affected, causing pain. An example would be chest pain associated with cardiovascular issues that mimic a heart attack. Various treatments can now treat myofascial pain syndrome associated with trigger points that can reduce the localized pain affecting the body.
Various Treatments To Reduce Myofascial Pain Syndrome
Several available treatments can help the body and bring back a person’s quality of life when it comes to reducing pain-like symptoms associated with myofascial pain syndrome. As stated earlier, when a person is diagnosed with myofascial pain syndrome by their primary doctors, their doctors will work with other pain specialists, like physical therapists, massage therapists, and chiropractors, that can locate where the referred pain is in the body and alleviate the symptoms. This allows the treatment plan to be personalized and catered to the individual. When myofascial pain syndrome causes the muscles to become tight and stiff due to repetitive factors, the pain specialists work with the body to restore functionality and help loosen the muscles. Not only that, but many individuals would take up meditative practices to allow their bodies to relax and reduce future trigger points from developing. This will enable them to have a clear mind and be pain-free.
Conclusion
Myofascial pain syndrome is when the body has pain-like symptoms affecting different muscle groups. It can cause numerous symptoms associated with pain that can cause mobility and dysfunction in the individual. Since the body is a complex machine that incorporates various muscles, tendons, ligaments, and vital organs to maintain functionality, myofascial pain can cause referred pain to a different location of the body and can be a major health problem. However, available treatments can reduce the pain-like symptoms caused by myofascial pain syndrome. When doctors work with associated medical providers specializing in myofascial pain syndrome, they can develop a personalized treatment plan to reduce future pain-like symptoms associated with myofascial pain syndrome from causing more issues to the body and even reduce correlating conditions that overlap that trigger myofascial pain.
References
Cao, Qi-Wang, et al. “Expert Consensus on the Diagnosis and Treatment of Myofascial Pain Syndrome.” World Journal of Clinical Cases, U.S. National Library of Medicine, 26 Mar. 2021, www.ncbi.nlm.nih.gov/pmc/articles/PMC8017503/.
Desai, Mehul J, et al. “Myofascial Pain Syndrome: A Treatment Review.” Pain and Therapy, U.S. National Library of Medicine, June 2013, www.ncbi.nlm.nih.gov/pmc/articles/PMC4107879/.
Niddam, D M, et al. “Brain Structural Changes in Patients with Chronic Myofascial Pain.” European Journal of Pain (London, England), U.S. National Library of Medicine, Jan. 2017, pubmed.ncbi.nlm.nih.gov/27352085/.
Travell, J. G., et al. Myofascial Pain and Dysfunction: The Trigger Point Manual: Vol. 2:the Lower Extremities. Williams & Wilkins, 1999.
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