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Back Clinic Conditions Treated. Chronic Pain, Auto Accident Care, Back Pain, Low Back Pain, Back Injuries, Sciatica, Neck Pain, Work Injuries, Personal Injuries, Sports Injuries, Migraine Headaches, Scoliosis, Complex Herniated Discs, Fibromyalgia, Wellness & Nutrition, Stress Management, and Complex Injuries.

At El Paso’s Chiropractic Rehabilitation Clinic & Integrated Medicine Center, we are focused on treating patients after debilitating injuries and chronic pain syndromes. We focus on improving your ability through flexibility, mobility, and agility programs tailored for all age groups and disabilities.

If Dr. Alex Jimenez feels you need other treatment, then you will be referred to a clinic or Physician that is best suited for you. Dr. Jimenez has teamed with the top surgeons, clinical specialists, medical researchers, and premiere rehabilitation providers to bring El Paso the top clinical treatments to our community. Providing the top non-invasive protocols is our priority. Clinical insight is what our patients demand in order to give them the appropriate care required. For answers to any questions you may have please call Dr. Jimenez at 915-850-0900


A Clinical Approach of Identity Formation in Therapy Practices

A Clinical Approach of Identity Formation in Therapy Practices

Learn about the clinical approach of identity formation and its role in facilitating personal insight and emotional well-being.

Introduction

Many individuals deal with musculoskeletal, autoimmune, gut, or body issues that can affect their daily routine and how they perceive themselves when getting checked out by their doctors. Many healthcare professionals can help assess individuals with these pain-like symptoms causing overlapping risk profiles by creating a safe and positive experience with a clinical approach. By creating a secure environment, many individuals can have good experiences when pain-like issues are affecting their bodies. By delving into today’s article, we are going to look into identity formation, the four identity statuses, and the various areas of identity development.

 

Theories & Types of Identity Formation

A lot of individuals have an identity, but have they always had one? Everyone’s identity is a conglomeration of the characteristics, values, and attributes they consider significant and use to define themselves. People’s identities are developed as they mature and gain knowledge about the world; they are not forced upon them. Adolescence is the first period when individuals notice a significant change toward identity creation and self-exploration.

A major concern in theories of teenage development is identity building. Identity formation, for instance, was emphasized as the main sign of effective development throughout adolescence in Erikson’s 1968 classic theory of developmental phases. Teenagers who struggle to define their identities may have role confusion, which suggests that they need to do more self-discovery and are unclear of their place in the world.

 

The Four Identity Statuses

Many healthcare providers will hear their patients describe identity formation during adolescence as it involves decision points and commitments regarding belief systems (e.g., religion, politics) and occupations. The four modes of reacting to late identity crises during the adolescent phase were described, measured, and validated so that individuals could figure out their identity status. (Marcia, 1966)  The four described identity statuses are:

  • Foreclosure: An individual commits to an identity without exploring options.
  • Identity diffusion: When individuals neither explore nor commit to any identities.
  • Moratorium: A state in which individuals actively explore options but have not made commitments.
  • Identity achievement: When individuals have explored different options and made identity commitments.

For example, teens may commit to an identity without exploring if they are content with the values, culture, and religion they were raised in. Teens in foreclosure status may adopt large parts of their parents’ identities or the identity parents have put them on. However, when teens achieve identity, they can explore the world for themselves and decide how they identify due to those experiences. This causes them to relinquish their claims of infantile sources of gratification, thus renouncing lingering fantasies of competence. (Marcia, 1967) At the same time, many people have experienced things that led to a crisis. The thing is that a crisis doesn’t necessarily mean a negative event; it’s simply branching out from what’s comfortable to discover who they are.

 


Understanding The Effects Of Personal Injury- Video


Various Areas of Identity Development

As a stage in the adolescent life cycle, identity development happens to many people. For many, the search for identity begins in the teenage years. During these years, adolescents are more open to taking on different behaviors and appearances to discover who they are. In an attempt to find their own identity and discover who they are, adolescents tend to cycle through several identities to find one that suits them best. Multiple factors like family life, environment, and social status can make it difficult to develop and maintain an identity. Some studies suggest that this process might be more accurate to identity development rather than formation but confirm this is a typical change process in people’s thoughts about themselves.

 

Several different areas of identity development are described:

  • Religious identity: Teens’ religious views are similar to those of their families. Many may question specific customs, practices, or ideas in their parents’ faith, but a few may completely reject their families’ religion. This is due to the dynamic of the parent-adolescent relationship with religion, which exerts positive effects on adolescent adjustments. (Kim-Spoon et al., 2012)
  • Political identity: Adolescents’ political identity is influenced by their parents’ political beliefs. In the 21st century, a new trend shows decreased political affiliation among young adults. However, many adolescents tend to be more liberal than their elders on social issues. This is because many adolescents encounter events that trigger their civic interest and challenge their beliefs and moralities. (Stattin et al., 2017) Like in other aspects of identity formation, adolescent individuals are predicted by their parents’ involvement and current events when there is an interest in politics.
  • Vocational identity: Adolescents in earlier generations envisioned themselves working in a particular job and often worked as apprentices or part-time in such occupations. This is a rare case for many people in today’s world. Vocational identity is also related to ego identity by correlating with a successful transition from school to work, allowing individuals to be more confident in their decision-making ability, especially in environmental ambiguities. (Koo & Kim, 2016) Still, vocational identity takes a bit longer to develop since many workplaces require specific skills and knowledge that require additional education or are acquired on the job. Additionally, many job opportunities held by teens are not in occupations many will seek as adults.
  • Ethnic identity: Ethnic identity refers to how many individuals come to terms with who they are based on ethnicity or racial ancestry. According to the U.S. Census 2012, Americans under 18 are from historically marginalized ethnic groups. Many people who identify under BIPOC (Black, Indigenous, people of color) have discovered their ethnoracial identity as an important part of their identity formation as teens.
  • Gender identity: Gender identity involves an individual’s sense of gender and can be similar to or different from their biological sex regardless of age group. Gender identity greatly influences many adolescents during these years of self-discovery and can impact other areas of identity, like religion and politics.

 

Self-Concept

Self-concept and self-esteem are the two primary facets of identity formation. The capacity of an individual to have views and beliefs established with confidence, consistency, and stability throughout the course of their life is the central premise of self-concept. Cognitive growth in early adolescence leads to increased self-consciousness, awareness of others and their opinions, the ability to think about abstract future possibilities, and the ability to weigh many alternatives at once. As a consequence, many teenagers will stop using straightforward, global, and concrete self-descriptions when they are younger. As kids, they use physical characteristics like gender, hair color, or whether they’re quick to identify themselves.

Many teenagers have the ability to imagine many “possible selves” that they may become, and the decisions they make may have long-term effects or possibilities. Exploring these options may cause individuals to make sudden changes in how they show themselves when the teenager selects or rejects traits and actions. In addition, when combining their combinational operation with their degree of identification, both men and females exhibit strong positive connections. (Wagner, 1987) This in turn means directing the real self in the direction of the ideal self. The ideal self differs from person to person; many individuals aspire to be the person they want to be, while many others dread becoming the person they do not want to be. Many may find this unsettling, but it may also serve as motivation by demonstrating consistent conduct that aligns with the ideals and distinguishes the feared potential selves.

Our ideal and frightened selves may be simultaneously explored and discovered. In an effort to create their own identities, many young people may observe characteristics in their family members, friends, or other community members and begin to consider what they like and dislike at the same time. Teenagers learn to identify the factors that impact their conduct and how others see them, which leads to a further distinction in their self-concept known as differentiation. Differentiation seems to be completely established by mid-adolescence and peaks when students enter the seventh or ninth grade. Nowadays, identifying contradictory material in one’s self-concept is a frequent cause of anxiety. Nonetheless, by promoting their exploration and growth, it might help a lot of teenagers.

 

Self-Esteem

Self-esteem is the other component of identity building. By definition, one’s ideas and emotions about one’s identity and self-concept constitute one’s self-esteem. Many views contend that a strong desire to preserve, defend, and improve oneself is a component of self-esteem. Contrary to common opinion, little evidence supports these views, suggesting that teenage self-esteem has significantly declined. The two sexes have distinct levels of self-esteem; women have higher levels of self-esteem when they have supportive friendships. However, women have poor self-esteem when they are unable to meet someone with similar interests and hobbies or when they are unable to get the acceptance of their friends.

Males have varied levels of self-esteem. Males are more focused on defining authority and establishing and claiming their independence regarding self-esteem. This, in turn, enables men to effectively have high self-esteem via the influence of their peers and friends. However, a male’s poor self-esteem may be further exacerbated by a lack of romantic abilities or the inability to sustain another person’s attachment.

 

Conclusion

Numerous medical experts may use a clinical approach to identity development to provide a secure environment and a satisfying experience for people when evaluating the pain-like sensations impacting their bodies. Additionally, by offering a variety of alternatives in their individualized treatment plans to improve their health and well-being, a thorough awareness of the significance of identity development helps foster positive relationships with patients.

 


Injury Medical & Functional Medicine Clinic

We associate with certified medical providers who understand the importance of identity formation when assessing individuals dealing with various pain-like symptoms within their bodies. When asking important questions to our associated medical providers, we advise patients to implement small changes to their daily routine to reduce the pain-like symptoms associated with body pains. Dr. Alex Jimenez, D.C., utilizes this information as an academic service. Disclaimer.


References

Kim-Spoon, J., Longo, G. S., & McCullough, M. E. (2012). Parent-adolescent relationship quality as a moderator for the influences of parents’ religiousness on adolescents’ religiousness and adjustment. J Youth Adolesc, 41(12), 1576-1587. doi.org/10.1007/s10964-012-9796-1

Koo, H.-Y., & Kim, E.-J. (2016). Vocational Identity and Ego Identity Status in Korean Nursing Students. Asian Nursing Research, 10(1), 68-74. doi.org/10.1016/j.anr.2015.11.001

Marcia, J. E. (1966). Development and validation of ego-identity status. J Pers Soc Psychol, 3(5), 551-558. doi.org/10.1037/h0023281

Marcia, J. E. (1967). Ego identity status: relationship to change in self-esteem, “general maladjustment,” and authoritarianism. J Pers, 35(1), 118-133. doi.org/10.1111/j.1467-6494.1967.tb01419.x

Stattin, H., Hussein, O., Ozdemir, M., & Russo, S. (2017). Why do some adolescents encounter everyday events that increase their civic interest whereas others do not? Dev Psychol, 53(2), 306-318. doi.org/10.1037/dev0000192

Wagner, J. A. (1987). Formal operations and ego identity in adolescence. Adolescence, 22(85), 23-35. www.ncbi.nlm.nih.gov/pubmed/3591499

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Triceps Tendonitis: Causes, Symptoms, and Treatment

Triceps Tendonitis: Causes, Symptoms, and Treatment

Triceps tendonitis can be frustrating, especially when you need to rest from normal activities. Can knowing the causes, symptoms, and diagnosis help individuals understand the treatment and prevention of the condition?

Triceps Tendonitis: Causes, Symptoms, and Treatment

Triceps Tendonitis

Tendons are connective tissue that attach muscles to bones, enabling the joints to move. Triceps tendonitis is inflammation of the tendon at the back of the elbow. It is most often caused by overuse of the triceps muscles. The condition can cause pain, swelling, and loss of function. It’s common in jobs that require regular hammering, shoveling, and overhead reaching, as well as in weightlifters, gymnasts, and boxers.

Causes

The triceps muscle runs along the back of the upper arm and is attached to the point of the elbow by a tendon. This muscle straightens the elbow. Tendonitis develops from repeatedly straightening the elbow against resistance. This causes tiny tears in the tissue, which leads to inflammation. Triceps tendonitis commonly occurs from repetitive manual labor tasks or sports activities like throwing sports, gymnastics, or boxing. Exercises that target the triceps muscle can cause tendonitis to develop, including kickbacks, dips, push-ups, and bench presses. For this reason, triceps tendonitis is also known as weightlifter’s elbow. (Orthopedic & Spine Center, N.D.)

Symptoms

Inflammation leads to a series of chemical reactions in the area of the injury. There are five main symptoms of inflammation:

  • Redness
  • Warmth
  • Swelling
  • Pain
  • Loss of function

With triceps tendonitis, the pain and stiffness are felt at the back of the elbow. Weakness may also present when using the affected arm. Tendonitis usually causes more pain with movement than when resting. Pain can occur when straightening the elbow, which puts tension on the triceps, or bending the elbow, which stretches the tendon.

Diagnosis

A healthcare provider will ask questions and perform a physical exam to diagnose tendonitis. (Harvard Health Publishing, 2014) A healthcare provider will ask you to describe the pain and the activities that make it better or worse. The elbow will be assessed for movement issues, swelling, or deformities that could indicate a worse injury, like a tendon tear. A healthcare provider will order X-rays or other imaging, such as MRI, to assess for a bone fracture or more extensive damage to the tendon.

Treatment

Several types of treatments include self-care, physical therapy, and medications.

Self Care

Triceps tendonitis can be treated at home if symptoms are addressed early. These include:

Rest

  • Rest the triceps tendon by avoiding activities that cause pain for a few days.

Ice

  • Apply ice to the triceps tendon for 15 to 20 minutes, two to three times daily.
  • Massage the area with an ice cube for several minutes.

Range of Motion Exercises

  • Decrease stiffness in the elbow with gentle range of motion exercises.
  • Slowly bend and straighten the elbow in a pain-free range, 10 times.
  • Repeat several times per day.

Physical Therapy

Physical therapists use various therapies and tools when treating tendonitis, including (Prall J. & Ross M. 2019)

PT Modalities

  • Physical therapy modalities are used to decrease pain, inflammation, and stiffness.
  • Examples include ultrasound, electrical stimulation, and light therapy.

Manual Therapy

  • Manual techniques for tendonitis include soft tissue massage, friction massage, stretching, and joint mobilization.

Exercise

  • Stretching and strengthening exercises that target the triceps muscle and any other muscle weakness that might have contributed to the condition.

Activity Modification

  • A therapist will look at the activities that led to the tendonitis and ensure you use the correct form and proper body mechanics.
  • Sometimes, a physical therapist can make on-site changes in the work environment to help prevent further injury.

Medications

Medications that are used to treat the condition (Aurora Health Care, 2025)

NSAIDs

  • Nonsteroidal anti-inflammatory medications are often used to treat tendonitis.
  • Many are available over-the-counter, including Aleve, Bayer, and Advil.
  • These medications can also be prescribed in higher doses by a healthcare provider.

Pain-Relievers

  • Additional over-the-counter medications such as Tylenol can help decrease pain.

Oral Steroids

  • These medications might be prescribed for short-term use to decrease inflammation if over-the-counter medications are ineffective in treating symptoms.
  • Long-term use of oral steroids can cause more damage to the tendons. (Spoendlin J., Meier C., Jick S. S., & Meier C. R. 2015)

Corticosteroid Injections

  • Tendonitis is frequently treated with an injection of steroid medication to decrease inflammation.
  • However, having multiple injections in the same area can eventually cause tendons to weaken more. (NYU Langone Health, 2024)

Platelet-Rich Plasma

  • PRP is made by taking a small amount of blood and separating the platelets or cells that release growth factors to promote healing.
  • The liquid is then injected into the tendon.
  • PRP is controversial; some studies support its use, while others do not.
  • While PRP may show some promise, insurance may not cover PRP treatments because of the ambiguity in the clinical data.

Injury Medical Chiropractic and Functional Medicine Clinic

Prevention is key. Warming up before a workout, stretching, and using the proper form can help prevent triceps tendonitis. Temporarily halting activities to address symptoms can prevent more serious injury. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.


From Inflammation to Healing


References

Orthopedic & Spine Center. (N.D.). Triceps Tendonitis or Weightlifter’s Elbow. www.osc-ortho.com/resources/elbow-pain/triceps-tendonitis-or-weightlifters-elbow/

Harvard Health Publishing. (2014). Tendonitis. www.health.harvard.edu/diseases-and-conditions/tendonitis

Prall, J., & Ross, M. (2019). The management of work-related musculoskeletal injuries in an occupational health setting: the role of the physical therapist. Journal of Exercise Rehabilitation, 15(2), 193–199. doi.org/10.12965/jer.1836636.318

Aurora Health Care. (2025). Tendonitis symptoms & treatment. www.aurorahealthcare.org/services/orthopedics/conditions/tendonitis

Spoendlin, J., Meier, C., Jick, S. S., & Meier, C. R. (2015). Oral and inhaled glucocorticoid use and risk of Achilles or biceps tendon rupture: a population-based case-control study. Annals of Medicine, 47(6), 492–498. doi.org/10.3109/07853890.2015.1074272

NYU Langone Health. (2024). Therapeutic injections for bursitis & tendinitis in adults. nyulangone.org/conditions/bursitis-tendinitis/treatments/therapeutic-injections-for-bursitis-tendinitis

Managing Myofascial Pain Syndrome Spasm Cycles

Managing Myofascial Pain Syndrome Spasm Cycles

For individuals who have to be in one position for long periods, have poor postural alignment, and perform repetitive motions, what are myofascial pain syndrome spasm cycles?

Managing Myofascial Pain Syndrome Spasm Cycles

Myofascial Pain Syndrome Spasm Cycles

Myofascial pain syndrome is a common condition that causes pain symptoms in a particular body area (Jafri M. S. 2014). A myofascial pain syndrome spasm cycle is a recurring pattern in which muscle tension and spasms in affected regions, caused by myofascial pain syndrome, lead to pain, triggering more muscle spasms. This creates a vicious cycle of discomfort and tightness that can be difficult to break without treatment; the pain perpetuates muscle spasms and vice versa.

Spasm Pain Cycle

Left untreated, myofascial pain is often experienced as a recurring cycle of spasm, pain, and spasm. (Kojidi M. M. et al., O2016) The exact cause of the spasm is not known. It may be related to excessive accumulation and release of acetylcholine, which causes sustained muscle contraction. (Nicol A, Crooks M, Hsu E, Ferrante M. 2018) Another theory is that repetitive small muscle trauma helps create a trigger point or knot in the muscle. (Thorne. 2021)

Active trigger points in muscles characterize myofascial pain syndrome. (Shah J. P. et al., 2015) These trigger points cause pain in the area where they are located and sometimes in other places, known as referred pain. Each muscle has a particular referral pattern of pain that goes from a trigger point in that muscle to another place in the body. (Shah J. P. et al., 2015) Medical providers and massage therapists trained in this area can identify trigger points by their pain patterns. With myofascial pain syndrome, muscles tense, and joint range of motion may decrease. (Jafri M. S. 2014)

Trigger Points

  • Myofascial pain syndrome is characterized by trigger points and sensitive knots within muscles that can cause referred pain when pressed, contributing to the spasm cycle.

Muscle Tension

  • A repeatedly tense or injured muscle can develop trigger points, which can lead tocle tightness and potential spasms.

Pain-Spasm-Pain Cycle

  • The pain from a trigger point can cause the muscle to further contract and spasm, leading to even more pain and perpetuating the cycle.

How Spasms and Pain Present

Myofascial pain is often caused by long periods of poor postural alignment, muscle injury, and repetitive motions. (Cleveland Clinic, 2023) For example, the upper body slumps forward when sitting at a desk workstation all day. The upper section of the trapezius muscle is located on the back of the neck and the top of the shoulder. The upper trapezius muscle works to raise the head. (Yoo W. G. 2015) The trapezius muscle now has to work more than it is used to. This overuse may cause microscopic muscle injury, leading to muscle spasms and pain. (Bron C., & Dommerholt J. D. 2012) (Nicol A, Crooks M, Hsu E, Ferrante M. 2018) Without treatment, the muscle spasms, pain, and microscopic muscle injury may persist or worsen, leading to trigger points and chronic pain. (Jafri M. S. 2014)

Causes

Repetitive Motions

  • Repeating the same movement, like typing on a computer, can trigger muscle tension and points.

Poor Posture

  • Maintaining incorrect posture for extended periods can strain muscles and contribute to trigger point development.

Muscle Injury

  • Past injuries can leave muscles susceptible to developing trigger points and pain cycles.

Stress

  • Psychological stress can lead to muscle tension and exacerbate existing trigger points.

Break the Cycle

Physical Therapy

  • A physical therapist can use stretching, massage, and trigger point therapy to release muscle tension and address trigger points.

Exercise

  • Regular exercise, including gentle stretching, can help improve muscle flexibility and reduce tension.

Heat Therapy

  • Applying heat to affected areas can help relax muscles and alleviate pain.

Ergonomics

  • Modifying work habits and posture to reduce strain on muscles.

Stress Management

  • Techniques like deep breathing and meditation can help reduce stress-related muscle tension.

Injury Medical Chiropractic and Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.


Personal Injury Rehabilitation


References

Jafri M. S. (2014). Mechanisms of Myofascial Pain. International scholarly research notices, 2014, 523924. doi.org/10.1155/2014/523924

Kojidi, M. M., Okhovatian, F., Rahimi, A., Baghban, A. A., & Azimi, H. (2016). Comparison Between the Effects of Passive and Active Soft Tissue Therapies on Latent Trigger Points of Upper Trapezius Muscle in Women: Single-Blind, Randomized Clinical Trial. Journal of Chiropractic Medicine, 15(4), 235–242. doi.org/10.1016/j.jcm.2016.08.010

Nicol A, C. M., Hsu E, Ferrante M. (2018). Myofascial Pain Syndrome. Science Direct, 207-212. doi.org/https://doi.org/10.1016/B978-0-323-40196-8.00025-5

THORNE. (2021). Understanding Muscle Pain, Fascia, and Myofascial Release. www.thorne.com/take-5-daily/article/understand-muscle-pain-fascia-and-myofascial-release?srsltid=AfmBOop3Pp0wWEeiQEqpfPgAaTOpLvU7lOAGUv5VRYQdoH8OBcW4D_wk

Shah, J. P., Thaker, N., Heimur, J., Aredo, J. V., Sikdar, S., & Gerber, L. (2015). Myofascial Trigger Points Then and Now: A Historical and Scientific Perspective. PM & R: the journal of injury, function, and rehabilitation, 7(7), 746–761. doi.org/10.1016/j.pmrj.2015.01.024

Cleveland Clinic. (2023). Chronic myofascial pain (CMP). my.clevelandclinic.org/health/diseases/12054-myofascial-pain-syndrome

Yoo W. G. (2015). Comparison of activation and change in the upper trapezius muscle during painful and non-painful computer work. Journal of Physical Therapy Science, 27(10), 3283–3284. doi.org/10.1589/jpts.27.3283

Bron, C., & Dommerholt, J. D. (2012). Etiology of myofascial trigger points. Current pain and headache reports, 16(5), 439–444. doi.org/10.1007/s11916-012-0289-4

Choosing the Right Knee Brace for Pain Relief and Recovery

Choosing the Right Knee Brace for Pain Relief and Recovery

Can a knee brace relieve discomfort, provide support, and expedite recovery for individuals recovering from an injury or surgery?

Choosing the Right Knee Brace for Pain Relief and Recovery

Knee Brace

A knee brace is a medical device that supports and stabilizes the knee joint to help with pain and recovery after an injury or surgery. Many knee braces are made of various materials and offer a range of support levels. A healthcare provider or physical therapist can recommend the appropriate one for your condition and suggest the best one. Ask a healthcare provider if you’re unsure, as wearing a knee brace correctly and for the recommended time is important for healing. They are generally safe. However, individuals with health conditions such as poor circulation should be cautious when using them and consult their healthcare provider.

What They Do

The knee joint comprises bones, cartilage, ligaments, tendons, and muscles. A knee brace stabilizes these structures, preventing them from moving too much or too fast. Some braces redistribute the knee joint’s weight, decreasing the force the knee absorbs. (American Academy of Family Physicians, 2020)

Conditions

A knee brace is used after surgery to aid in healing and following an injury. This can be:

  • Sprain
  • Ligament injury
  • Patellar/kneecap dislocation

They are also used to support the knee and relieve pain from some chronic conditions including: (Sprouse R. A., McLaughlin A. M., & Harris G. D. 2018)

  • Tendonitis
  • Patellar tendinopathy
  • Chondromalacia patellae
  • Patellofemoral stress syndrome
  • Medial knee osteoarthritis

Types

Knee braces differ in function and support level. Some stabilize the knee, while others completely immobilize the joint. A healthcare provider and/or physical therapist will explain what support is needed and how to use it. They can also check the brace’s fit and determine if adjustments or a different size are required.

Most Commonly Used

Prophylactic Brace

Unloader

  • This brace helps rebalance the weight and shift the pressure on the knee joint to other parts of the leg, reducing pain. (American Academy of Family Physicians, 2020)
  • A knee unloader is typically used to control discomfort due to inflammatory conditions like tendonitis and osteoarthritis.

Functional

  • This brace limits motion in the joint after an injury or prevents dislocation.

Bledsoe Brace

  • This brace has straps to wrap around the thigh and shin and support brackets on the inside and outside of the knee joint.
  • A small mechanism locks the knee into full extension or allows the knee to bend a specific amount.

Knee Immobilizer

  • A knee immobilizer keeps the knee in one position.
  • It is a long cloth brace that runs the length of the shin and thigh.

Knee Brace vs Knee Support

A knee support or sleeve is usually a tight-fitting fabric garment. It provides compression to help reduce swelling and discomfort. A knee brace offers more support and can also be set to limit mobility.

Wearing The Brace

Individuals may need to wear a knee brace all day or only when performing specific tasks and operations. It depends on the individual and the condition the brace is being used for. Some may only need to wear a knee brace during certain activities or a flare-up of pain. (Mayo Clinic, 2022) Wearing a brace for unnecessarily long periods can cause skin abrasion, joint stiffness, and muscle atrophy. (American Academy of Family Physicians, 2020) Conversely, neglecting to wear it can cause more susceptibility to injury or extend and or impair healing time. Ask a healthcare provider when you should and should not wear the brace. This could be when:

  • Sitting
  • Walking
  • Driving
  • Sleeping
  • Stretching

Contraindications

Some medical conditions can make an individual susceptible to injury and adverse effects from wearing a knee brace. These include: (Holden, M. A. et al., 2021)

  • Poor circulation
  • Superficial wounds on the knee
  • Psoriasis
  • Eczema
  • Arterial insufficiency
  • Severe varicose veins
  • A history of thrombophlebitis

Injury Medical Chiropractic and Functional Medicine Clinic

If you have one of these conditions, a healthcare provider will decide if a knee brace is safe. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.


Best Knee Injury Chiropractor


References

American Academy of Family Physicians. (2020). Knee Bracing: What Works? familydoctor.org/knee-bracing-what-works/

Sprouse, R. A., McLaughlin, A. M., & Harris, G. D. (2018). Braces and Splints for Common Musculoskeletal Conditions. American family physician, 98(10), 570–576.

American Academy of Pediatrics. (2019). Knee pain: how to choose the right knee brace for your child. www.healthychildren.org/English/health-issues/injuries-emergencies/sports-injuries/Pages/Knee-Pain-and-braces.aspx

Mayo Clinic. (2022). To brace or not to brace: What’s the best answer? www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/to-brace-or-not-to-brace#:~:text=If%20you%20have%20early%20onset%2C%20mild%20arthritis,below%20the%20knee%20for%20compression%20and%20comfort.

Holden, M. A., Callaghan, M., Felson, D., Birrell, F., Nicholls, E., Jowett, S., Kigozi, J., McBeth, J., Borrelli, B., Jinks, C., Foster, N. E., Dziedzic, K., Mallen, C., Ingram, C., Sutton, A., Lawton, S., Halliday, N., Hartshorne, L., Williams, H., Browell, R., … Peat, G. (2021). Clinical and cost-effectiveness of bracing in symptomatic knee osteoarthritis management: protocol for a multicentre, primary care, randomised, parallel-group, superiority trial. BMJ open, 11(3), e048196. doi.org/10.1136/bmjopen-2020-048196

Try This Exercise Protocol to Relieve Achilles Tendonitis

Try This Exercise Protocol to Relieve Achilles Tendonitis

Can incorporating an exercise program like the Alfredson Protocol help athletes and individuals who have hurt their Achilles tendon find pain relief and healing so they can return to regular physical activities?

Try This Exercise Protocol to Relieve Achilles Tendonitis

Exercise Protocol Achilles Tendonitis

Achilles tendonitis occurs when the tendon at the back of the ankle gets injured. It is common in runners. For individuals who have Achilles tendonitis, walking and running can be painful. You might have to stop engaging in exercise and physical activities like sports. Depending on your job, having the condition may make working harder. Here are a few of the signs and symptoms of the condition:

  • Pain in the back of the lower leg, just above the heel.
  • Pain with running, jumping, or pointing the toes.
  • A small lump on the Achilles tendon just above the heel.

The first line of treatment is to rest and ice the tendon. Anti-inflammatory medications can help reduce pain. (American Academy of Orthopaedic Surgeons, 2022) Physical therapy can include strengthening exercises, ultrasound heat therapy, and deep massage. Exercises stretching the nearby muscles will help gradually increase the stress the tendon can handle, eventually reducing inflammation and swelling. Stretching and flexibility exercises will help an Achilles tendon heal. (University of Michigan, 2023)

The only way to determine if an individual has injured their Achilles tendon is to see a doctor. If the injury is Achilles tendonitis, a physical therapist may be recommended. A physical therapist can train individuals on the Alfredson protocol, an exercise protocol program for those with Achilles tendonitis (tendinopathy) that research has shown is helpful for those with the condition. The therapist will train on how to exercise to strengthen the tendon. The exercises stretch the Achilles tendon to help it handle forces and stress, known as eccentric loading. (Stevens M., & Tan C. W. 2014)

Inflammation

Tendonitis is inflammation of a tendon. However, studies have shown that the tendon might not be inflamed in those with the condition. When an area of the body is inflamed, inflammatory cells are present. Individuals usually feel pain in the inflamed area. For those with Achilles tendonitis, the tendon will present with pain, but not necessarily because the tendon is inflamed. Under a microscope, researchers examined tissue from the tendons of those with Achilles tendonitis. They did not find inflammatory cells in the tissue. (Stevens M., & Tan C. W. 2014) This means that although individuals felt pain, they were not inflamed. If there are no inflammatory cells in the tendon, this could explain why those with Achilles tendonitis often do not find relief from the anti-inflammatory treatment of non-steroidal anti-inflammatory drugs (NSAIDs). Studies have shown that gentle exercise protocols for the tendon are more helpful. However, researchers are not sure why these exercises are so beneficial. (O’Neill S., Watson P. J., & Barry S. 2015)

Eccentric Exercise

A chiropractic physical therapy team can help individuals heal the injury with eccentric loading exercises. Eccentric loading exercises work the muscles and tendons to help them get stronger. Once healing has begun, they can help strengthen the tendon. Individuals start slowly with easy exercises and then work up to harder ones. They will have the patient lengthen or stretch out the muscle. As the patient moves, the muscles and tendons contract or shorten. The Alfredson protocol consists of eccentric loading exercises for the Achilles and the muscles that support it.

Alfredson Protocol

Before exercising, talk to a doctor or physical therapist to know if it’s safe. How to do the Alfredson protocol:

  1. First, stand on a small step or curb.
  2. Stand with the balls of your feet on the edge.
  3. Your heels should hang over the edge.
  4. Hold onto something for balance.
  5. Keep the knees straight.
  6. This will load a muscle part of the Achilles tendon called the gastrocnemius.
  7. Using both feet, lift the heels and rise onto the balls of the feet.
  8. Keep the foot with the painful Achilles tendon on the step.
  9. Lift the non-injured foot off the step.
  10. Slowly lower down using the injured ankle.
  11. The heel should move towards the floor.
  12. The ball of the foot should remain in contact with the edge of the step.
  13. Return the non-injured foot to the step.
  14. Repeat the exercise.

Do three sets of 15 reps with the knees straight. Then, do the Alfredson protocol again with the knees slightly bent. This will work a muscle called the soleus, which connects to the gastrocnemius. Perform three sets of 15 repetitions. Perform both exercises twice a day. This could be in the morning and the evening. The Alfredson protocol is most beneficial when done for about 12 weeks. (Stevens M., & Tan C. W. 2014)

Injury Medical Chiropractic and Functional Medicine Clinic

The Alfredson exercise protocol can be done at home with a step or raised platform to put the feet on safely. Individuals should consider working with a personal trainer to ensure safety and get the most out of the workouts. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.


Functional Foot Orthotics Achieve Optimal Performance


References

American Academy of Orthopaedic Surgeons. OrthoInfo. (2022). Achilles Tendinitis. orthoinfo.aaos.org/en/diseases–conditions/achilles-tendinitis/

University of Michigan. (2023). Achilles Tendon Injury: Physical Therapy and Rehab. www.uofmhealth.org/health-library/tr2261

Stevens, M., & Tan, C. W. (2014). Effectiveness of the Alfredson protocol compared with a lower repetition-volume protocol for midportion Achilles tendinopathy: a randomized controlled trial. The Journal of orthopaedic and sports physical therapy, 44(2), 59–67. doi.org/10.2519/jospt.2014.4720

O’Neill, S., Watson, P. J., & Barry, S. (2015). WHY ARE ECCENTRIC EXERCISES EFFECTIVE FOR ACHILLES TENDINOPATHY?. International journal of sports physical therapy, 10(4), 552–562.

Understanding the Vastus Lateralis Muscle: Anatomy and Function

Understanding the Vastus Lateralis Muscle: Anatomy and Function

The vastus lateralis is a muscle on the outside part of the thigh. Injuries to the muscle include strains, tendinitis, femoral nerve compression, and others. Can rehabilitation like heat and ice, massage, and strength and mobility exercises help individuals return to normal activities and function?

Understanding the Vastus Lateralis Muscle: Anatomy and Function

Vastus Lateralis Muscle

The vastus lateralis is the largest of the four quadriceps muscles on the thigh’s outer portion. The vastus lateralis helps extend the knee joint and maintain the knee position when walking or running. The vastus lateralis functions to work with the other quad muscles to help extend the knee joint.

Anatomy

Most muscles are attached to bone points of attachment, called the origin and insertion points. The vastus lateralis origin and insertion points are as follows (Vieira, EPL. 2017)

Origin

  • The origin is on the upper inter-trochanteric line of the femur or thigh bone.
  • It also arises from the base of the greater trochanter and the linea aspera, the supracondylar ridge, and the lateral intermuscular septum.

Insertion

  • From its origin, the muscle courses down the lateral thigh and inserts as part of the lateral quadriceps tendon on the tibial tubercle, an elevated portion of the upper shin.
  • The muscle is a large, flat structure with different attachments and a flat aponeurosis or sheath of connective tissue on the outer thigh.
  1. The femoral nerve from lower back levels two, three, and four controls or innervates the muscle.
  2. Blood supply to the muscle goes through the lateral circumflex femoral artery of the upper thigh.

Function

The muscle works with the other quadriceps muscles to extend or straighten the knee. The quads are responsible for functional activities like walking, running, climbing stairs, and getting up from a seated position. The vastus lateralis and the iliotibial band, which courses down the lateral thigh next to this muscle, form the lateral wall of the thigh. The vastus lateralis is on the opposite side of the vastus medialis muscle on the inner portion of the thigh. These muscles work together to maintain the appropriate position of the patella/kneecap in the femoral groove of the thigh bone. Malfunctioning these muscles properly can lead to knee pain from patellofemoral stress syndrome. (American Academy of Orthopaedic Surgeons, 2024)

Conditions

Many different injuries and conditions can affect the vastus lateralis and quad muscles, especially in athletes or active individuals. These injuries can cause vastus lateralis pain and other problems. (Timothy J. Von Fange, 2024) Some of the injuries and conditions include:

Patellofemoral Stress Syndrome – PFSS

  • This occurs when the kneecap tracks improperly in the femoral groove of the knee joint.
  • This leads to pain and difficulty when walking and running.

Vastus Lateralis Strain

  • A sudden force on the thigh can cause the quad muscle to be strained.
  • If the vastus lateralis suffers a pull injury, individuals may have pain, muscle swelling, thigh bruising, and walking difficulties.

Patellar Tendinitis

  • Irritation of the quad tendon that courses over the kneecap can cause patellar tendinitis.

Femoral Nerve Compression Weakness

  • The femoral nerve may become pinched or irritated from a herniated disc, lumbar stenosis, or arthritis.
  • Pain, numbness, tingling, or weakness in the thigh may result.

Iliotibial Band Friction Syndrome

  • Tight or weak muscles can irritate the IT band, and the vastus lateralis muscle can be affected.

Injury Rehabilitation

Injury to the vastus lateralis or quad muscles can cause pain, swelling of the thigh, or limited walking ability. Various treatments are available to help expedite recovery. A primary healthcare provider may recommend working with a physical therapy team. Self-care techniques can include:

Heat and Ice

  • Ice may be applied to the lateral thigh the first few days after injury to control pain and decrease swelling and inflammation.
  • Ice should be applied for 10 to 15 minutes.
  • Individuals may switch to heat two to three days after to promote circulation and improve tissue mobility.
  • Heat should be applied for 10 to 15 minutes.

Massage

  • Massage can help decrease pain and promote circulation.
  • Massage techniques can improve tissue mobility before stretching to help improve quadriceps motion.

Exercises and Stretching

A physical therapy team will prescribe certain exercises and stretches to help regain strength and range of motion. After an injury, quad stretching can improve the mobility and function of the muscle group.

Prone Towel Quad Stretch

  • Lie on your stomach and place a towel or strap around the ankle.
  • Bend the knee up, and gently pull on the towel to bend the knee fully.
  • A pulling sensation should be felt in the front of the thigh.
  • Hold the stretch for 30 seconds and release.
  • Repeat three times.

Half-kneeling Quad and Hip Flexor Stretch

  • Kneel on one knee.
  • Slowly move forward until a stretch is felt in the front of the hip and thigh.
  • Hold this position for 30 seconds.
  • Relax back to the starting position.
  • Repeat three times.

Back Exercises

If femoral nerve irritation coming from the lower back is causing thigh pain or weakness, exercises to release the nerve may be helpful and can include:

  • Prone press-ups
  • Supine lumbar flexion
  • Lumbar side glides

The exercises are designed to relieve pressure on the lumbar nerve, and postural correction exercises may be performed to maintain decompression.

Strengthening

Weakness to the vastus laterals and quads may be causing injury, and strengthening exercises may be prescribed during rehabilitation and can include:

  • Hip-strengthening exercises
  • Straight leg raises
  • Leg extension exercises
  • Lunges
  • Squats

Strengthening exercises should be done two to four times weekly with appropriate rest between sessions.

Functional Training

A physical therapist may recommend functional training to restore normal function. (Ramírez-delaCruz, M. et al., 2022)

  • Balance exercises and sport-specific plyometric training may be recommended to ensure the quad functions normally.
  • Most quadriceps and vastus lateralis muscle injuries heal within six to eight weeks.
  • Recovery may be shorter or longer depending on the nature of the injury.

Injury Medical Chiropractic and Functional Medicine Clinic

By understanding the anatomy and function of the vastus lateralis muscle, a healthcare provider can help individuals understand their specific injury and develop a treatment program to rehabilitate the muscle properly. At Injury Medical Chiropractic and Functional Medicine Clinic, we focus on what works for you and strive to develop fitness and better the body through research methods and total wellness programs. These natural programs use the body’s ability to achieve improvement goals, and athletes can condition themselves to excel in their sport through proper fitness and nutrition. Our providers use an integrated approach to create personalized programs, often including Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine principles.


Knee Injury Chiropractor


References

Vieira EPL. (2017). Anatomic study of the portions long and oblique of the vastus lateralis and vastus medialis muscles. J Morphol Sci., 28(4), 0-. www.jms.periodikos.com.br/article/587cb49f7f8c9d0d058b47a1/pdf/jms-28-4-587cb49f7f8c9d0d058b47a1.pdf

American Academy of Orthopaedic Surgeons. (2024). Patellofemoral pain syndrome. orthoinfo.aaos.org/en/diseases–conditions/patellofemoral-pain-syndrome/

Timothy J Von Fange. (2024). Quadriceps muscle and tendon injuries. UpToDate. www.uptodate.com/contents/quadriceps-muscle-and-tendon-injuries/print

Ramírez-delaCruz, M., Bravo-Sánchez, A., Esteban-García, P., Jiménez, F., & Abián-Vicén, J. (2022). Effects of Plyometric Training on Lower Body Muscle Architecture, Tendon Structure, Stiffness, and Physical Performance: A Systematic Review and Meta-analysis. Sports medicine – open, 8(1), 40. doi.org/10.1186/s40798-022-00431-0

Lifting-Related Elbow Pain: Causes and Treatment Options

Lifting-Related Elbow Pain: Causes and Treatment Options

Elbow pain from lifting is a common symptom among individuals who lift weights, heavy objects, children, grocery bags, etc. Depending on the underlying cause, can conservative treatments relieve and heal elbow pain?

Lifting-Related Elbow Pain: Causes and Treatment Options

Elbow Pain Caused By Lifting

Elbow pain from lifting can result from weight training, repetitive daily tasks, or job duties like lifting small children or heavy objects. Pain can manifest at the sides or the front of the elbow. Most minor injury cases can be treated with ice, rest, and medications at home. However, pain after lifting can also be a sign of a serious injury, such as a tendon rupture/tear.

Minor Pain From Lifting

Lifting puts pressure on the tendons connecting the wrist and upper arm to the bones in the elbow joint. Minor elbow pain can occur from temporary inflammation in any of these structures after lifting an object. Tendonitis occurs when a tendon becomes inflamed, often from overuse or lifting something too heavy, and ranges from mild to severe. Mild tendonitis typically causes pain during the activity and improves with rest. (American Academy of Orthopaedic Surgeons, 2020) Common forms of tendonitis include:

  • Tennis elbow – tendonitis on the outside of the elbow
  • Golfer’s elbow – tendonitis on the inside of the elbow.
  • Biceps tendonitis – at the front of the elbow. (Kheiran A. Pandey, A. & Pandey R. 2021)

Self-Care

Self-care can help reduce elbow pain after lifting and include: (American Academy of Orthopaedic Surgeons, 2020)

Ice

  • Add ice to the affected area for up to 20 minutes daily to decrease elbow pain.

Rest

  • Avoid lifting heavy objects as much as possible when pain is present.

Wearing A Brace

  • If the pain is at the tendons on the inside or outside of your elbow, try wearing a wrist brace to limit the use of your wrist muscles that connect to this area.

Stretching

Gently stretching the wrist flexors and extensors can help reduce elbow pain after lifting. Stretches can be performed several times daily, even after symptoms have resolved. (American Academy of Orthopaedic Surgeons, 2024)

  • Hold the arm out in front with the palm down. Keep the elbow straight.
  • Bend the wrist down so that the fingers are pointing toward the ground.
  • With the other hand, gently pull the wrist further down until a stretch is felt along the back of the forearm.
  • Hold this position for 15 seconds.
  • Repeat five times.
  • Next, bend the wrist upward so the fingers point toward the ceiling.
  • Using the other hand, gently pull the hand backward until the stretch is felt along the front of the forearm.
  • Hold for 15 seconds.
  • Repeat five times.

Medication

Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) can help manage elbow pain caused from lifting and include: (American Academy of Orthopaedic Surgeons, 2023)

  • Advil/Motrin – ibuprofen
  • Aleve – naproxen
  • Bayer – aspirin
  • Tylenol – acetaminophen

Healing

Mild cases can improve after a few days of self-care, whereas more pronounced elbow symptoms can take several weeks, months, or even a year. (Kheiran A. Pandey, A. & Pandey R. 2021) If self-care doesn’t work, physical therapy may be recommended. A physical therapy team can use various modalities and treatments to help reduce pain and inflammation from elbow injuries. The therapy can include targeted exercises to strengthen weak muscles and stretch tight muscles that might contribute to the condition. In addition, the therapy team will help individuals modify their lifting technique to help prevent further injury.

Moderate to Severe Elbow Pain

In addition to sharp, severe pain, serious elbow pain caused from lifting have distinct symptoms, including: (American Academy of Orthopaedic Surgeons, 2022)

  • Bruising
  • Swelling
  • Elbow weakness that suddenly happens.

A biceps tendon rupture is a rare but serious injury usually caused from lifting. In addition to other visible signs of the injury, there will be a bulge at the top of the upper arm because the muscle bunches up as it is no longer attached to the elbow. (American Academy of Orthopaedic Surgeons, 2022) Individuals may hear an audible popping sound if an elbow ligament or tendon gets torn while lifting. (Johns Hopkins Medicine, 2024)

Treatment

Treatment depends on the severity of the injury, but most cases resolve on their own with rest and, if necessary, physical therapy. Conditions that cause severe pain require orthopedic surgeon expertise. These physicians specialize in treating musculoskeletal system injuries. Imaging such as X-rays, MRIs, or CT scans are often used to determine the extent of damage. Individuals with tendon or ligament tears in the elbow may need surgery to regain full range of motion and strength in their arm. After surgery, physical therapy will help restore function.

Injury Medical Chiropractic and Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other associated medical professionals to integrate a treatment plan to improve the body’s flexibility and mobility and resolve musculoskeletal issues.


Shoulder Pain Chiropractic Treatment


References

American Academy of Orthopaedic Surgeons. (2020). Sprains, strains, and other soft-tissue injuries. orthoinfo.aaos.org/en/diseases–conditions/sprains-strains-and-other-soft-tissue-injuries/

Kheiran, A., Pandey, A., & Pandey, R. (2021). Common tendinopathies around the elbow; what does current evidence say?. Journal of clinical orthopaedics and trauma, 19, 216–223. doi.org/10.1016/j.jcot.2021.05.021

American Academy of Orthopaedic Surgeons. (2024). Therapeutic exercise program for epicondylitis (tennis elbow/golfer’s elbow). orthoinfo.aaos.org/globalassets/pdfs/2024-therapeutic-exercise-program-for-lateral-and-medial-epicondylitis.pdf

American Academy of Orthopaedic Surgeons. (2023). What are NSAIDs? orthoinfo.aaos.org/en/treatment/what-are-nsaids/

American Academy of Orthopaedic Surgeons. (2022). Biceps tendon tear at the elbow. orthoinfo.aaos.org/en/diseases–conditions/biceps-tendon-tear-at-the-elbow

Johns Hopkins Medicine. (2024). Ulnar collateral ligament. www.hopkinsmedicine.org/health/conditions-and-diseases/ulnar-collateral-ligament-ucl-injuries-of-the-elbow