Back Clinic Injury Care Chiropractic and Physical Therapy Team. There are two approaches to injury care. They are active and passive treatment. While both can help get patients on the road toward recovery, only active treatment has a long-term impact and keeps patients moving.
We focus on treating injuries sustained in auto accidents, personal injuries, work injuries, and sports injuries and provide complete interventional pain management services and therapeutic programs. Everything from bumps and bruises to torn ligaments and back pain.
Passive Injury Care
A doctor or a physical therapist usually gives passive injury care. It includes:
Acupuncture
Applying heat/ice to sore muscles
Pain medication
It’s a good starting point to help reduce pain, but passive injury care isn’t the most effective treatment. While it helps an injured person feel better in the moment, the relief doesn’t last. A patient won’t fully recover from injury unless they actively work to return to their normal life.
Active Injury Care
Active treatment also provided by a physician or physical therapist relies on the injured person’s commitment to work. When patients take ownership of their health, the active injury care process becomes more meaningful and productive. A modified activity plan will help an injured person transition to full function and improve their overall physical and emotional wellness.
Spine, neck, and back
Headaches
Knees, shoulders, and wrists
Torn ligaments
Soft tissue injuries (muscle strains and sprains)
What does active injury care involve?
An active treatment plan keeps the body as strong and flexible as possible through a personalized work/transitional plan, which limits long-term impact and helps injured patients work toward a faster recovery. For example, in injury Medical & Chiropractic clinic’s injury care, a clinician will work with the patient to understand the cause of injury, then create a rehabilitation plan that keeps the patient active and brings them back to proper health in no time.
For answers to any questions, you may have, please call Dr. Jimenez at 915-850-0900
Skateboarding is a popular activity among children, teenagers, and young adults. It is recreational, competitive, fun, and exciting but, like any sport, carries a risk of injury. There are around 70,000 skateboarding injuries requiring a visit to the emergency room every year. The most common injuries involve the shins, ankles, forearms, wrists, elbows, face, and skull, with many left untreated that worsen as they heal improperly, leading to further damages and complications. Chiropractic can treat the injuries, rehabilitate the muscles and joints, and strengthen the body to get the skater back on their board.
Skateboarding Injuries
Skateboarding injuries can range from scrapes, cuts, and bruises to sprains, strains, broken bones, and concussions.
Shin injuries often happen during flip/twist tricks where the board or axle hits the shin causing bruising and swelling.
Shoulder, wrist, and hand injuries are common when skaters lose their balance and fall with outstretched arms.
Ankle injuries include rolls/sprains, as well as dislocations and fractures.
Dislocations usually happen to the shoulders, wrists, and fingers.
Facial injuries include teeth knocked out, broken nose, or jaw are typically caused by fast forward hard falls.
Severe injuries include concussions and head injuries.
Injury causes
Skateboarding injuries typically occur from:
Skating on irregular surfaces locks up wheels and affects balance, causing falls.
Losing balance or losing control of the board and falling hard/slamming into the pavement.
Inexperience, slow reaction times, and less coordination lead to falls and slams.
Skating into another skater, a person walking or cycling, a car, or a road hazard.
Trying an advanced trick/maneuver too soon and beyond their skill level.
Help prevent further injuries and long-term effects.
Chiropractic Skateboarding Injury Treatment
References
Forsman, L, and A Eriksson. “Skateboarding injuries of today.” British journal of sports medicine vol. 35,5 (2001): 325-8. doi:10.1136/bjsm.35.5.325
Hunter, Jamie. “The epidemiology of injury in skateboarding.” Medicine and sport science vol. 58 (2012): 142-57. doi:10.1159/000338722
Partiali, Benjamin, et al. “Injuries to the Head and Face From Skateboarding: A 10-Year Analysis From National Electronic Injury Surveillance System Hospitals.” Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons vol. 78,9 (2020): 1590-1594. doi:10.1016/j.joms.2020.04.039
Shuman, Kristin M, and Michael C Meyers. “Skateboarding injuries: An updated review.” The Physician and sportsmedicine vol. 43,3 (2015): 317-23. doi:10.1080/00913847.2015.1050953
Many live with chronic discomfort and pain regularly in one or both knees. This could be from past injuries, being overweight, lack of physical conditioning, degeneration, or arthritis. Many take prescription or over-the-counter pain medication to deal with the discomfort. Pain medications only dull and mask the pain and discomfort associated with the symptoms. As a result, living with masked knee pain can worsen the condition, and the surrounding bones, joints, and tissues can begin to deteriorate. Chiropractic combined with massage, decompression, and traction therapy can significantly reduce or eliminate knee pain.
Knee Discomfort and Pain
The knee’s joint and ligaments need to be strong and healthy to support activities. The most common issues that individuals develop include:
Acute Injuries
Knee injuries can be caused by auto accidents, physical strain, playing sports, work accidents, workplace ergonomics, and walking up and down stairs.
Chronic or inflammatory medical conditions can wear down the cartilage cushion between the upper and lower leg bones.
Most common include gout, septic arthritis, osteoarthritis, and rheumatoid arthritis.
Unhealthy postures and obesity can also contribute to the chronic degradation of the knee joint.
Knee discomfort and pain can present in various ways. Some might hear an acute popping in the knee followed by swelling. Others might notice the gradual development of stiffness and weakness over time. When injured or compromised, localized pain is one of the first indicators. Chronic knee and joint pain can lead to weakness, nerve damage, or create new injuries/problems. Not all knee pain is caused by injury; in many cases, a triggering incident, like an awkward step or misstep, a stretch that went too far, or a walk, can create an injury. Even a sedentary lifestyle can contribute to knee degeneration as the surrounding muscles can lose strength, placing unnecessary strain on the joints when movement is necessary.
Chiropractic
A chiropractor will examine the knee through a series of analyses, including x-rays, digital imaging, and a physical exam. The chiropractor will develop a personalized treatment plan to treat, rehabilitate, and strengthen the knee. The treatment can include:
Posture correction to distribute body weight evenly, lessening the stress on an affected knee.
Targeted exercises and nutritional recommendations will ensure long-term healing.
Q Angle of the Knee
References
Cimino, Francesca, et al. “Anterior cruciate ligament injury: diagnosis, management, and prevention.” American family physician vol. 82,8 (2010): 917-22.
Donnell-Fink, Laurel A et al. “Effectiveness of Knee Injury and Anterior Cruciate Ligament Tear Prevention Programs: A Meta-Analysis.” PloS one vol. 10,12 e0144063. 4 Dec. 2015, doi:10.1371/journal.pone.0144063
Hoskins, Wayne, et al. “Chiropractic treatment of lower extremity conditions: a literature review.” Journal of manipulative and physiological therapeutics vol. 29,8 (2006): 658-71. doi:10.1016/j.jmpt.2006.08.004
Neogi, Tuhina, et al. “Sensitivity and sensitization in relation to pain severity in knee osteoarthritis: trait or state?.” Annals of the rheumatic diseases vol. 74,4 (2015): 682-8. doi:10.1136/annrheumdis-2013-204191
The ribs are designed to protect the lungs and heart and assist breathing. Twenty-four ribs start at the shoulders in the thoracic spine region and run down the mid-back covering the front, back, and side of the chest. Almost all ribs are attached in two places, including the spine in the back and the sternum in the front of the chest, by cartilage joints. Trauma, poor posture, intense coughing, sneezing, and heaving are a few factors that can cause mechanical rib dysfunction or rib misalignment.
Rib dysfunction and misalignment are typically caused by unhealthy postures like slumped back and rounded shoulders, weakened posterior muscles, and repetitive stress from work, sports, and intense physical activity. Any ribs can become misaligned, causing dysfunction and stress on the body. A chiropractor can adjust and reset the rib as they do for misaligned and compressed spinal joints.
Rib Cage Design
The ribcage is flexible and expands when inhaling. Each rib is attached to the spine by three joints in the back and the breastbone in the front. Breathing is an involuntary reflex that is impossible to avoid movement in these joints. The joints are small but allow flexing, so the ribs rise and fall with each breath. These rib joints can become inflamed from rib misalignment causing movement problems that can restrict breathing.
Rib Misalignment
Rib misalignment symptoms can include:
Difficulty breathing.
Difficulty when trying to sit up.
Dull, achy, deep pain next to the spine or under the shoulder blade.
Unexplained back pain.
Pain when moving or walking.
Painful sneezing and/or coughing.
Tenderness and pain in the front of the chest.
The formation of a lump over the affected rib.
Swelling and/or bruising in the region.
Numbness in nearby or surrounding ribs.
Radiating pain from the back to the front and vice versa.
Improvement when pressure is applied to the affected rib.
Rib Dysfunction
Up to 50% of emergency room visits for chest pain symptoms result from non-cardiac factors, with the majority being rib misalignment and the muscles and joints around the rib cage becoming irritated/inflamed.
Causes
There can be several reasons for a misaligned rib. The more common causes include:
Unhealthy Postures
Unhealthy postures stress the body that can place pressure on the posterior portion of the ribcage.
With time, the ribs can start to shift out of alignment.
Physical Activity, Exercise, and Sports
Working out intensely can cause the ribs to shift out of position.
Weight lifting improperly can cause the body to shift along with the muscles involved not being strong enough to handle the added weight and movement, causing rib misalignment.
Pregnancy
As a woman’s body changes, the weight shifts to the front.
This can create a downward pull on the rib cage, increasing misalignment risk.
Intense Coughing or Sneezing
Excessive or severe coughing, associated with asthma, bronchitis, or pneumonia, can significantly strain the ribcage.
Coughing from a common cold can generate stress to cause a rib to dislocate.
Sneezing hard can also cause a rib to shift out of place.
Illnesses associated with constant coughing and sneezing can increase an individual’s susceptibility to rib misalignment because of the weakened state of the muscles.
Intense Vomiting
Vomiting intensely or heaving can cause the condition.
Vomiting does not necessarily involve the lungs, but the convulsive action can cause a rib shift/pop out.
Chiropractic Treatment
Chiropractic can diagnose and treat rib misalignment/dysfunction by using various stretching or massage techniques to loosen the area, making the muscles more flexible, then applying firm pressure to realign the rib back. The treatment plan will include specific stretches, postural exercises, diet, and other recommendations to prevent rib problems.
Spinal Decompression In 90 Seconds
References
Flodine TE, Thomas M. Osteopathic Manipulative Treatment: Inhaled Rib Dysfunction. [Updated 2021 Aug 15]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK560751/
Jawed, Muzamil. and Bruno Bordoni. “Osteopathic Manipulative Treatment: Muscle Energy Procedure – Exhaled Ribs.” StatPearls, StatPearls Publishing, 19 February 2022.
Claudication is muscle pain that presents when the body is active and stops when the body is at rest, also known as intermittent claudication. Individuals typically report dull aching, cramping, tingling, and/or numbness. Vascular claudication is caused by circulatory problems like poor blood circulation and peripheral artery disease. Still, spinal conditions can also cause neurogenic claudication caused by problems with the spine and nervous system.
Neurogenic Claudication
Sciatica is the usual suspect when thigh, hip, buttock, calf, or total leg pain or other sensations are present; however, it could be spinal stenosis with neurogenic claudication. Spinal stenosis is sometimes called pseudo claudication, a narrowing of the space around the low back, which can put pressure on the spinal cord directly and compress the blood vessels around the spine, cutting off oxygen-carrying blood. Pain can start in the lower back and circulate down the legs and cause weakness, tingling, or numbness in the legs and feet. The most common areas of spinal compression include:
The foramen are the openings on the sides of the spine where nerves exit and connect to the peripheral nervous system.
The narrowing can occur in any of these areas, with the most common cause being lumbar spinal stenosis brought on by lumbar degenerative disease.
Symptoms
The most common symptoms of neurogenic claudication include:
Pain in the lower extremities, including the buttocks, thighs, and calf, only manifests with activities like walking or standing around.
Pain that shows up equally on both sides.
There is no pain when sitting or not walking around.
Radiculopathy or nerve pain that radiates down an affected limb. Sciatica is a typical example.
However, the symptoms of claudication and radiculopathy are different.
Claudication will be felt all along the length of the nerve.
Radiculopathy pain is more localized to the buttock, thighs, and calves and can get worse with activity and is generally present even when at rest.
Treatment
Non-surgical treatment of neurogenic claudication includes medication to help control pain, chiropractic manual therapy, non-surgical spinal decompression, physical rehabilitation therapy, and steroid shots to reduce inflammation. A doctor will recommend stretching, strengthening exercises, and types of activities to help improve the body’s ability to support itself. This could include swimming, walking, and stationary cycling. However, conservative treatment might not be an option for individuals with more severe cases. If conservative treatment options don’t work, surgery could be recommended. A healthcare provider can help explain treatment options. Successful outcomes have been seen in cases that are diagnosed and treated early.
Non-Surgical Spinal Decompression Chiropractor
References
Colak, Ahmet, et al. “A less invasive surgical approach in the lumbar lateral recess stenosis: a direct approach to the medial wall of the pedicle.” 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. 17,12 (2008): 1745-51. doi:10.1007/s00586-008-0801-z
Munakomi S, Foris LA, Varacallo M. Spinal Stenosis And Neurogenic Claudication. [Updated 2022 Feb 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK430872/
Many complex spinal surgeries take place in a hospital environment. The individual spends a night or two in the hospital, so medical staff can monitor them if any complications arise. However, outpatient surgeries have increased with new developments in minimally invasive procedures, pain management, and home rehabilitation. The improvements compared to traditional spinal surgical procedures are significant. These advancements have made it possible to perform more complex surgeries outside of a hospital. Outpatient surgeries have:
Accelerated recovery times
Decreased complications
Decreased infections
Healthier overall outcomes
Outpatient Surgery Candidates
Determining if outpatient surgery can be performed effectively depends on the injury/s and/or conditions that the individual is going through. An individual who is debilitated or has underlying medical conditions that increase their risk for complications or do not have support at home to assist with recovery and rehabilitation is recommended to have the surgery done in a hospital. To be considered for outpatient spine surgery, a surgeon looks at:
Standalone ambulatory surgery centers offer same-day surgical procedures for individuals that meet specific criteria. Medical staff assess the patient’s condition and determine recovery at home. If issues arise, the individual can be transferred to a hospital. Some facilities are single-specialty facilities, focusing on one medical specialty, and others are multi-specialty, meaning they offer a range of medical services from:
Orthopedic
Podiatry
Pain management services
Procedures
Anterior Cervical Discectomy and Fusion – ACDF
ACDF is a two-part surgery. First, the surgeon removes part of an intervertebral disc with bulged and compressed nerves from the spinal cord. Because there is less cushion, the vertebrae above and below are fused to prevent and eliminate painful movement. The discectomy:
Provides more accessible access to the vertebrae
Reduces healing time
Causes less pain
ACDF outpatient procedure treats several neck conditions that include:
Cervical spinal stenosis
Cervical radiculopathy
Neck-related degenerative disc disease
Herniated disc
Cervical spinal fracture
Individuals recover in the surgical center for one to several hours following the surgery before returning home. Traditional ACDF procedure takes three weeks to three months to recover.
Lumbar Discectomy
A lumbar discectomy is a minimally invasiveprocedure that repairs a lower back herniated disc compressing the surrounding nerves. This procedure provides compression relief and allows the nerve to heal. A traditional lumbar discectomy takes four to six weeks to recover.
Lumbar Laminectomy
This minimally invasive procedure removes thickened ligaments and lamina from the lower back. This opens the spinal canal space, relieving pressure and bringing pain relief. The surgery commonly treats lower-back spinal stenosis. A traditional laminectomy takes four to six weeks to recover.
Lumbar Spinal Fusion
Outpatient lumbar spinal fusion permanently connects two or more vertebrae in the lower back. The surgery helps stabilize the spine from severe arthritis or herniated disc removal. Spinal fusion has been found to be effective for correcting certain spinal deformities. The surgery involves a short recovery time at the outpatient center, after which the individual can return home the same day. A traditional or open spinal fusion requires a two-to-three-day hospital stay. After four to six weeks and with a doctor’s clearance, individuals can return to light activities, with full recovery requiring six months.
Chiropractic Spinal Decompression
References
International Journal of Spine Surgery. (April 16, 2021) “The expanding frontier of outpatient spine surgery.” pubmed.ncbi.nlm.nih.gov/33900984/
Any vehicle crash, collision, or accident can cause various injuries, with back pain issues as a primary injury or a side effect from other injuries. Usually, injury symptoms begin right after the collision, but in other cases, individuals may not start experiencing symptoms until hours, days, or even weeks later. This is from the adrenaline that rushes throughout the body during the collision/fight or flight response delaying the injury symptoms. There are reports of individuals who walk away from an accident unscathed but require urgent medical treatment a short while later. Chiropractic care can provide manual and spinal motorized decompression benefits.
Decompression Benefits
Head Injuries
Head injuries occur when drivers and/or passengers hit their heads on the steering wheel, windows, dashboard, metal frame, and sometimes each other.
A head injury is considered a severe condition that can cause concussions, skull fractures, comas, hearing loss, cognitive and memory issues, and vision problems.
A significant head injury can cause extensive and costly medical treatment with the possibility of long-term medical care.
Neck Injuries
Neck injuries are common in vehicle collisions.
The most common is whiplash, with the head and neck-snapping from indirect blunt force, like being rear-ended.
Whiplash can cause significant damage to the ligaments and muscles, like swelling and neck pain, and temporary paralysis of the vocal cords.
Injury patterns of whiplash can differ depending on the speed, force, and overall health of the individual involved.
Back Injuries
Back injuries can range in severity from sprains to significant damage involving the nerves and/or the spinal cord.
If the damage is severe, it can lead to loss of sensation in the body, loss of limb control, or permanent paralysis.
Disc herniation/s can lead to disability, muscle weakness, tingling and numbness in the limbs, and radiating body pain.
Chest and Torso Injuries
Vehicle collision forces can result in severe chest injuries that include broken ribs.
Broken ribs might not sound dangerous by themselves; they can puncture the lungs leading to other injuries and internal bleeding.
The legs, feet, arms, and hands are frequently injured, broken, and sometimes dislocated.
Motorcyclists are also at a higher risk for significant injury that includes:
Multiple fractures, internal injury, head injuries, and severe ligament damage.
Pedestrians struck by a vehicle have an increased risk for a combination of all injuries at once.
Non-Surgical Decompression Benefits
Chiropractors are trained to identify and treat injuries from vehicle collisions.
Non-surgical spinal decompression gently stretches the spine using a motorized traction device to help reposition the spine and remove the pressure.
As the pressure is taken off, the spinal discs regain their natural height, relieving the pressure on the nerves and other spinal structures.
Optimal healing is promoted by an improved circulation of nutrients, water, and oxygen to the injury site.
Decompression helps to strengthen the muscles in the affected area.
It provides positive spinal structural changes.
Improves nervous system function.
Non-surgical decompression is a tool for correcting injuries and relieving pain, allowing optimal health for the individual.
DOC Decompression Table
References
Apfel, Christian C et al. “Restoration of disk height through non-surgical spinal decompression is associated with decreased discogenic low back pain: a retrospective cohort study.” BMC musculoskeletal disorders vol. 11 155. 8 Jul. 2010, doi:10.1186/1471-2474-11-155
Koçak, Fatmanur Aybala et al. “Comparison of the short-term effects of the conventional motorized traction with non-surgical spinal decompression performed with a DRX9000 device on pain, functionality, depression, and quality of life in patients with low back pain associated with lumbar disc herniation: A single-blind randomized controlled trial.” Turkish Journal of physical medicine and rehabilitation vol. 64,1 17-27. 16 Feb. 2017, doi:10.5606/tftrd.2017.154
Macario, Alex, and Joseph V Pergolizzi. “Systematic literature review of spinal decompression via motorized traction for chronic discogenic low back pain.” Pain practice: the Official Journal of World Institute of Pain vol. 6,3 (2006): 171-8. doi:10.1111/j.1533-2500.2006.00082.x
As the body gets older, slouching, little to no physical activity, and regular stretching cause muscle fatigue, weakness, tension, leading to poor posture complications. The complications include:
Posture can be improved along with overall spinal health and a better quality of life through chiropractic treatment. Chiropractic will improve posture through adjustments, postural exercise training and stretching, education on ergonomics, and nutrition to strengthen the body.
Complications Poor Posture
Symptoms
Symptoms vary as they depend on the severity of the case and condition.
Skeletal muscle comprises two types of muscle fiber. They are static or slow-twitch muscles and phasic or fast-twitch muscles. Static muscle fibers are found in the deeper muscle layers. Static fibers burn energy slowly and keep working without tiring. They help the body maintain posture without effort and contribute to balance by sensing the body’s position and transmitting the information to the brain. Phasic muscle fibers are used for movement and activity but can quickly run out of energy. Poor posture causes muscle fatigue because the phasic fibers are used rather than the static fibers to maintain the body’s proper position.
Muscle Strength and Length
Over time, the body constantly needs support from the phasic muscle fibers. This causes the deeper supporting muscles to waste away because they are not being used. Weak, unused muscles begin to tighten, causing a shortening of muscle length that can compact the spine’s bones and cause back complications.
Nervous System Feedback
The deeper layers of muscle sense the body’s position in space and relay this information to the brain. The brain does not receive complete transmission if the phasic muscle fibers take over this function. The brain assumes that the body needs to be propped up/corrected to counteract the poor posture effects, triggering further muscle contraction, adding to the fatigue and pain.
Listening To The Body
The objective is to form a habit of regularly listening to what the body is saying. Make minor adjustments while standing and sitting throughout the day/night. Often what happens is individuals become so immersed in their work, school tasks that they ignore any physical discomfort and push through and forget to change positions/move around to get the muscles moving and the blood pumping. If there is muscle tension or fatigue, don’t just work through the pain; move into another healthy position.
Posture Improvement
Suggestions include:
Try to avoid sitting in soft chairs.
Switch to ergonomic chairs for any activity that requires sitting for long periods.
Use a lumbar roll to support the lower back when sitting in regular chairs or driving.
Remember to reverse the curve; an example could be if leaning over a desk/workstation, stretch the back in the other direction.
As the body ages, it loses muscle mass, known as sarcopenia. Between the ages of 30 and 80, both men and women can lose 30-50 percent of their muscle strength. Decreasing strength can make it a challenge to lead an active lifestyle or have energy levels to complete the daily errands. Individuals can be reluctant to improve fitness levels through resistance workouts believing there is nothing left after years of inactivity. This is not true as anybody can strength train. With the right mindset, and health coaching team, goals can be set to:
Improve body composition
Improve energy levels
Maintain an active lifestyle
References
Creze, Maud et al. “Posture-related stiffness mapping of paraspinal muscles.” Journal of anatomy vol. 234,6 (2019): 787-799. doi:10.1111/joa.12978
Deliagina, Tatiana G et al. “Physiological and circuit mechanisms of postural control.” Current opinion in neurobiology vol. 22,4 (2012): 646-52. doi:10.1016/j.conb.2012.03.002
Korakakis, Vasileios et al. “Physiotherapist perceptions of optimal sitting and standing posture.” Musculoskeletal Science & practice vol. 39 (2019): 24-31. doi:10.1016/j.msksp.2018.11.004
Pollock, A S et al. “What is balance?.” Clinical rehabilitation vol. 14,4 (2000): 402-6. doi:10.1191/0269215500cr342oa
Waters, Thomas R, and Robert B Dick. “Evidence of health risks associated with prolonged standing at work and intervention effectiveness.” Rehabilitation nursing: the official journal of the Association of Rehabilitation Nurses vol. 40,3 (2015): 148-65. doi:10.1002/rnj.166
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