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
Posterior tibial tendon dysfunction is a very common ankle and foot problem that occurs when there is a tear or inflammation in the posterior tibial tendon � the tendon that is at the back of the ankle and is the key player in stabilizing the foot. The inflammation or tear affects the integrity of the tendon, weakening it so that is no longer provides the support or stability of the arch of the foot. This results in what is commonly known as flatfoot.
While this condition rarely requires surgery, there is pain, sometimes severe, swelling, and impaired mobility associated with it. Chiropractic for flatfoot has been found to be very effective for most patients, helping them heal faster and manage their pain.
What Causes Posterior Tibial Tendon Dysfunction?
The most common causes of flatfoot are overuse and injury. Falls are common culprits, causing injury to the tendon so that it tears or becomes inflamed.
Overtraining, particularly in high impact exercise or sports like basketball, dancing, soccer, and high impact aerobics can get tears due to the repetitive motion and constant pressure on the foot. Once the tendon is torn or inflamed, the arch begins to collapse until eventually the foot is flat.
This condition occurs more often in women than men. Also, people over 40 seem to be more prone to posterior tibial tendon dysfunction, although it can occur in younger people who overtrain or have any of the other risk factors including diabetes, obesity, and hypertension.
What Are The Symptoms Of Posterior Tibial Tendon Dysfunction?
Pain is the first and most common indicator of flatfoot. It typically is located where the tendon lies; along the inner portion of the ankle and foot. Sometimes swelling may be present.
The patient will also notice that the pain increases with activity. High impact or high intensity activities can be excruciating and quite difficult. It can get to the point where standing or walking for extended periods of time are very painful.
In advanced stages, the pain may shift to the outer portion of the ankle. As the arch collapses, the movement may cause the heel bone to shift outward. This, in turn, puts pressure on the outer ankle bone.
How Is Posterior Tibial Tendon Dysfunction Treated?
The treatment for flatfoot depends on the severity of the condition. Most patients can avoid surgery, but it is still a long healing process.
Typically, the patient will be advised to rest and ice the area, switch to low impact exercise, and take nonsteroidal anti-inflammatory medication for the pain. In moderate to severe cases, the patient may be put in a walking boot or short leg cast for 6 to 8 weeks in order to immobilize the foot and ankle, letting the tendon rest and heal. The downside of this is that the other muscles around the ankle will also �rest� and atrophy as a result.
Shoe inserts, or orthotics, as well as braces are also common treatments for flatfoot. However, any type of immobilization of the ankle and foot is usually accompanied by physical therapy either while the brace is worn or after a cast has been removed.
In more severe cases, the doctor may recommend a steroid injection directly into the tendon although there is an increased risk of the tendon rupturing. Surgery is usually a last resort and it is much more complex. Patients who undergo surgery for flatfoot rarely regain all of the mobility they had prior to the operation.
Chiropractic For Posterior Tibial Tendon Dysfunction
There has been a great deal of success in using chiropractic to treat flatfoot. The chiropractor will typically recommend rest and ice as well as chiropractic manipulations to help bring the ankle, foot, and leg back into alignment to counteract the weakened tendon. Often the ankle will lose mobility as the arch collapses and the bones in the foot and ankle shift. This, in turn, causes the arch to collapse even more.
By using chiropractic techniques to bring the ankle back into alignment, thus restoring the forward glide of the joint, they can alleviate the pain and help heal the condition. They may also recommend an air brace to stabilize the ankle when the patient will be doing a lot of walking as well as advise on lifestyle changes such as weight loss and a healthy diet. Often patients who have tried working with medical doctors to cure their flatfoot but were unsuccessful, were finally able to gain relief and improvement when they started working with their chiropractor.
Injury Medical Clinic: Ankle Sprain Chiropractic Treatment
Vincent Garcia, an athlete training in mixed martial arts, or MMA, suffered a knee injury and developed turf toe, but that has not stopped him from engaging in his normal training regimen. In order to return to as well as enhance his first physical performance, Vincent Garcia found treatment with Dr. Alex Jimenez, doctor of sports chiropractic. Now recovering from his sports injuries, Vincent Garcia looks forward to regaining his strength, flexibility and freedom to go back to sport.
Sports Injury Chiropractic Treatment
Exercising is important for overall health and wellness, but occasionally, an individual can suffer an injury when playing sports or engaging in physical activities. Accidents, poor training methods, or improper equipment can cause them. Some people today get hurt because they aren’t in shape. Not warming up or stretching enough can also lead to injuries. Treatment often begins with the RICE (Rest, Ice, Compression, and Elevation) method to relieve pain, reduce swelling, and speed recovery. Other possible treatments include pain relievers, rehabilitation, and sometimes surgery, if needed.
We are blessed to present to you�El Paso�s Premier Wellness & Injury Care Clinic.
As El Paso�s Chiropractic Rehabilitation Clinic & Integrated Medicine Center,�we passionately are focused treating patients after frustrating 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 you have enjoyed this video and/or we have helped you in any way please feel free to subscribe and recommend�us.
Chiropractor Near Me: Due to his previous back injury history, George Lara suffered a recent back injury which he was unfortunately unable to recover from through traditional treatment. That’s when the VA recommended him to seek chiropractic care with Dr. Alex Jimenez, ultimately changing his quality of life. George Lara had degenerative disc disease, or DDD, and sciatic nerve pain before receiving treatment with Dr. Alex Jimenez. George Lara describes how much his life has improved with chiropractic care and he’s grateful of the services and care he received. George Lara recommends Dr. Alex Jimenez as the non-surgical choice for back pain, among other spine health issues.
Chiropractor Near Me
Chiropractic care is a means to diagnose and treat health problems that affect the nerves, muscles, bones, and joints of the body. A healthcare provider who supplies chiropractic care is known as a chiropractor. Adjustment of the spine, known as manipulation, is the basis of care. Chiropractors also use other kinds of treatments. Your physician will ask about your goals for your health history and therapy. It’s important to inform your physician about any physical problems you may have which make it difficult for you to do particular things.
We are blessed to present to you�El Paso�s Premier Wellness & Injury Care Clinic.
As El Paso�s Chiropractic Rehabilitation Clinic & Integrated Medicine Center,�we passionately are focused treating patients after frustrating 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 you have enjoyed this video and/or we have helped you in any way please feel free to subscribe and share us.
Why Chiropractic Combined With Glucosamine & Chondroitin Sulfates Are A Win-Win For Degenerative Disc Disease Sufferers.
The most effective treatments are often found in the natural ones. The human body has this incredible ability to provide its own healing. Often we can aid that process through nutrition, exercise, and lifestyle changes. While there are some people who do reach for medications and invasive means of pain control, the truth is the best cure is the natural one. This is also true of degenerative disc disease. There are several natural treatments that help relieve the pain and even stop the progression of the disease. Common treatments include chiropractic, glucosamine, and chondroitin sulfates.
What Is Degenerative Disc Disease (DDD)?
In a healthy spine the discs that lie between the vertebrae and cushion them are filled with fluid. They allow the spine to move, flex, bend, and twist. Over time they may lose some of their cushion as part of the aging process.
Degenerative disc disease occurs when the discs of the spine collapse and degrade. In extreme cases, the discs can completely collapse causing the vertebrae�s facet joints to rub against each other. This leads to osteoarthritis. The condition is accompanied by pain, inflammation, and loss of mobility.
How Do Glucosamine & Chondroitin Sulfates Help Degenerative Disc Disease?
Glucosamine and chondroitin sulfates are substances that occur naturally in the body. It is an essential element in cartilage maintenance and regeneration. They help to form new cartilage from within existing cartilage. They can actually help to rebuild the discs that have begun to degrade. Often they are taken as nutritional supplements.
Studies show that long term use of glucosamine and chondroitin sulfate do indeed not just help arrest the development of spinal disc degeneration, they can also help to reverse the symptoms, especially if begun in the early stages of the disease. Treatment that incorporates these supplements result in decreased pain and improved range of motion. Patients may also notice strengthening of the back and increased flexibility. This is true even in patients who are older, in their 50�s and 60�s.
Patients may start noticing a decrease in pain as early as six months after beginning to take the supplement. After taking it consistently, the other benefits present over time. What is also important to note is that neither glucosamine nor chondroitin sulfate cause any adverse side effects. These supplements are safe and effective.
Chiropractic For Degenerative Disc Disease
Chiropractic is a complementary treatment to combine with glucosamine and chondroitin sulfate for degenerative disc disease. Chiropractic alone is very effective for many spine and neck disorders, including degenerative disc disease. It is a natural, non-invasive treatment that does not use medications but instead incorporates lifestyle changes, diet, and exercise recommendations to provide whole body wellness. While chiropractic works very well to treat pain, improve mobility, and increase flexibility, it has actually been proven to stop the progression of degenerative disc disease and even reverse its effects.
Using chiropractic for degenerative disc disease and combining it with supplements that include glucosamine and chondroitin sulfate is a very effective system for relieving the pain and other symptoms. In several studies, many patients saw improvement and decrease in symptoms faster than patients who used the supplements alone. Combining these treatments is usually the best course of action to help patients suffering from this devastating disease.
When treating any condition, it is always best to go the most natural route possible. The fewer synthetic substances and manufactured toxins that are introduced into the body, the better chance the patient has of a more thorough and faster healing or at the very least a dramatic decrease in symptoms.
Injury Medical Clinic: Herniated Disc Treatment & Recovery
Three Steps: Your lower back needs protection, strength and nourishment to help prevent and reduce lower back pain.
Adding these 3 steps to one’s day can help take stress off your lower back:
Three Steps
1. Work On A Stand-Up Desk For Part Of The Day
Too much sitting is common in the cause of low back pain. Posture while sitting, forward leaning in order to look at a computer screen, affects the natural alignment of the lower spine by placing a heavy load on the lumbar discs and joints.
Many people are utilizing standup desks for part of their workday. Standup desks come in a variety of shapes, functionality, and price ranges. They can be inexpensive to fully adjustable, automatic models.
If lower back pain is already an issue, only stand for part of the day and gradually increase to longer standing times. Cushioned and standing mats add additional comfort, as well as, exercise benefits. Standing more, along with quick walks and/or quick stretches at the half hour can break up the extended sitting cycle.
2. Stretch Hamstrings On A Daily Basis
Hamstrings are the large muscles that run down the back of each thigh. They can quite easily become tight. If they become very tight then the hamstring/s will transfer stress across the lower back and can lead to back pain.
There are a variety of hamstring stretches that are gentle on the back and easy to do: pick one or two that work for you and are easy to incorporate it into a daily routine.
3. Sleep In A Reclined Position
People with lower back pain feel more support when the lower back is in a slightly reclined position, along with the knees supported and elevated. This is true for lower back diagnoses, such as osteoarthritis, spinal stenosis, and lumbar degeneration.
If it is difficult to sleep on your back, try resting in this position in a reclining chair or bed before going to sleep.
Sleeping the most comfortable in a supported, reclined position can come from switching to an adjustable bed, aka (adjustable base). Just like the stand-up desks, these models range from basic to sophisticated options.
A new development now is that online mattress companies now offer mattress bases that are fully adjustable, and some offer free delivery/setup. Consider a new mattress with an adjustable base that goes with the mattress. This combination may work to help your back.
We encourage back pain supplementation with chiropractic treatment and any type of steps one can take to help prevent and reduce lower back.
Injury Medical Clinic: Sciatica Treatments & Recoveries
Opioids and Prescription drug abuse and addiction is a significant problem in the United States. In fact, the U.S. Department of Health and Human Services (HHS) has declared it an epidemic.
Researchers estimate that as many as 36 million people worldwide abuse opioids. Estimates in the U.S. alone reached 2.1 million people in 2012. In 2014, six out of ten drug overdose deaths involved an opioid � including prescription opioids for pain relief.
Every day, 78 Americans die from an opioid overdose. As the Opioid drug problem continues to spiral further out of control, claiming more lives, people are looking for safer, drug free ways to relieve their pain. Chiropractic offers such an option.
What Are Opioids?
Opioids are prescription medications that are intended for pain relief. They work by diminishing the intensity level of pain signals as they reach the brain. They also affect the areas of the brain that control emotion thereby weakening the perception of the pain as well. There are several very popular medications that are classified as opioids:
Hydrocodone (Vicodin)
Oxycodone (Percocet, OxyContin)
Morphine (Avinza, Kadian)
Codeine
The most commonly prescribed opioids are hydrocodone products. They are used to treat pain from injuries, dental work, and typically moderate pain. Milder pain is often treated with codeine but it is also used to treat coughing as well as severe diarrhea. Overall, opioids are used to treat everything from cancer pain to post-op pain to osteoarthritis.
What Are The Dangers Of Opioids?
Opioids have a serious risk of abuse, addiction, and overdose. Even then they are taken as prescribed, opioids can have the following side effects:
Excessive sleepiness
Nausea
Dry mouth
Vomiting
Confusion
Dizziness
Depression
Constipation
Low energy
Sweating
Low testosterone levels that result in a diminished sex drive
Itching
Decreased strength
Increased pain sensitivity
Over time, the body can build up a tolerance to the drug which means that in order to achieve the same relief from pain they must take more of it. Physical dependence is also a concern, usually going hand in hand with tolerance. Once that point is reached the patient will experience symptoms of withdrawal if they stop taking the medication.
If Doctors Are Prescribing Opioids, How Are People becoming Addicted?
In 2013, doctors wrote almost a quarter of a billion prescriptions for opioids. To put that into perspective, that is enough for every adult in the U.S. to have their own bottle of the drug. Doctors prescribe opioids to their patients in an effort to treat pain, but most of the time it is just a band aid. Instead of seeking out the root of the problem and educating their patients on whole body wellness, they prescribe pills that numb the senses, cause unpleasant or even dangerous side effects, and create addictions.
As the patient develops a tolerance for the drug, the doctor increases the prescription. This cycle continues as the patient become more and more dependent upon the drug. They may even experience more pain as the drug increases their pain sensitivity. As patients become addicted, the number of prescription opioid overdose deaths is steadily increasing. The most common drugs involved in these overdose deaths include:
Hydrocodone (Vicodin)
Oxycodone (OxyContin)
Methadone
States are putting measures in place to monitor and regulate how doctors prescribe opiates, but when desperate, addicted patients will go to great lengths to obtain the drugs they are addicted to. They will go to different doctors to get additional prescriptions or even find ways to obtain the drug illegally. It is a heartbreaking problem that is completely preventable.
How Is Chiropractic A Safer Alternative To Opioids?
Chiropractic is a proven method for managing pain relief that is not only effective but safe and drug free. Numerous chiropractic studies confirm what chiropractic patients have been saying for decades: chiropractic care is an excellent pain management method. The spinal adjustments bring the body into balance but that is only the beginning of the benefits. Chiropractic focuses on whole body wellness so patients learn how to take proactive steps to treat their condition.
It also seeks to find the root of the problem and begin healing by treating the cause. Through exercise, diet, and lifestyle recommendations in addition to the chiropractic adjustments, patients can get relief from pain caused by injury, surgery, arthritis, and many other conditions. Chiropractic is so much more than a back pain treatment; it is a whole body, whole patient treatment.
Concussions are traumatic brain injuries that affect brain function. Effects from these injuries are often temporary but can include headaches, problems with concentration, memory, balance and coordination. Concussions are usually caused by a blow to the head or violent shaking of the head and upper body. Some concussions cause loss of consciousness, but most do not. And it is possible to have a concussion and not realize it. Concussions are common in contact sports, such as football. However, most people gain a full recovery after a concussion.
Can also happen due to excessive shaking of the head or acceleration/deceleration
Mild injuries (mTBI/concussions) are the most common type of brain injury
Glasgow Coma Scale
Common Causes Of Concussion
Motor vehicle collisions
Falls
Sports injuries
Assault
Accidental or intentional discharge of weapons
Impact with objects
Prevention
Prevention of concussive injuries can be paramount
Encourage Patients To Wear Helmets
Competitive sports, especially boxing, hokey, football and baseball
Horseback riding
Riding bicycles, motorcycles, ATVs, etc.
High elevation activates such as rock climbing, zip lining
Skiing, snowboarding
Encourage Patients To Wear Seatbelts
Discuss the importance of wearing seatbelts at all times in vehicles with all of your patients
Also encourage use of appropriate booster or car seats for children to ensure adequate fit and function of seat belts.
Driving Safely
Patients should never drive while under the influence of drugs, including certain medications or alcohol
Never text and drive
Make Spaces Safer For Children
Install baby gates and window latches in the home
May in areas with shock-absorbing material, such as hardwood mulch or sand
Supervise children carefully, especially when they�re near water
Prevent Falls
Clearing tripping hazards such as loose rugs, uneven flooring or walkway clutter
Using nonslip mats in the bathtub and on shower floors, and installing grab bars next to the toilet, tub and shower
Ensure appropriate footwear
Installing handrails on both sides of stairways
Improving lighting throughout the home
Balance training exercises
Balance Training
Single leg balance
Bosu ball training
Core strengthening
Brain balancing exercises
Concussion Verbiage
Concussion vs. mTBI (mild traumatic brain injury)
mTBI is the term being used more commonly in medical settings, but concussion is a more largely recognized term in the community by sports coaches, etc.
The two terms describe the same basic thing, mTBI is a better term to use in your charting
Evaluating Concussion
Remember that there does not always have to be loss of consciousness for there to be a concussion
Post-Concussion Syndrome can occur without LOC as well
Symptoms of concussion may not be immediate and could take days to develop
Monitor for 48 post head injury watching for red flags
Blurred eyesight or other vision problems, such as dilated or uneven pupils
Confusion
Dizziness
Ringing in the ears
Nausea or vomiting
Slurred speech
Delayed response to questions
Memory loss
Fatigue
Trouble concentrating
Continued or persistent memory loss
Irritability and other personality changes
Sensitivity to light and noise
Sleep problems
Mood swings, stress, anxiety or depression
Disorders of taste and smell
Mental/Behavioral Changes
Verbal outbursts
Physical outbursts
Poor judgment
Impulsive behavior
Negativity
Intolerance
Apathy
Egocentricity
Rigidity and inflexibility
Risky behavior
Lack of empathy
Lack of motivation or initiative
Depression or anxiety
Symptoms In Children
Concussions can present differently in children
Excessive crying
Loss of appetite
Loss of interest in favorite toys or activities
Sleep issues
Vomiting
Irritability
Unsteadiness while standing
Amnesia
Memory loss and failure to form new memories
Retrograde Amnesia
Inability to remember things that happened before the injury
Due to failure in recall
Anterograde Amnesia
Inability to remember things that happened after the injury
Due to failure to formulate new memories
Even short memory losses can be predictive of outcome
Amnesia may be up to 4-10 times more predictive of symptoms and cognitive deficits following concussion than is LOC (less than 1 minute)
Return To Play Progression
Baseline: No Symptoms
As the baseline step of the Return to Play Progression, the athlete needs to have completed physical and cognitive rest and not be experiencing concussion symptoms for a minimum of 48 hours. Keep in mind, the younger the athlete, the more conservative the treatment.
Step 1: Light Aerobic Activity
The Goal: Only to increase an athlete�s heart rate.
The Time: 5 to 10 minutes.
The Activities: Exercise bike, walking, or light jogging.
Absolutely no weight lifting, jumping or hard running.
Step 2: Moderate activity
The Goal: Limited body and head movement.
The Time: Reduced from typical routine.
The Activities: Moderate jogging, brief running, moderate-intensity stationary biking, and moderate-intensity weightlifting
Step 3: Heavy, non-contact activity
The Goal: More intense but non-contact
The Time: Close to typical routine
The Activities: Running, high-intensity stationary biking, the player�s regular weightlifting routine, and non- contact sport-specific drills. This stage may add some cognitive component to practice in addition to the aerobic and movement components introduced in Steps 1 and 2.
Step 4: Practice & full contact
The Goal: Reintegrate in full contact practice.
Step 5: Competition
The Goal: Return to competition.
Microglial Priming
After head trauma microglial cells are primed and can become over active
To combat this, you must mediate the inflammation cascade
Prevent repeated head trauma
Due to priming of the foam cells, response to follow-up trauma may be far more severe and damaging
What Is Post-Concussion Syndrome (PCS)?
Symptoms following head trauma or mild traumatic brain injury, that can last weeks, months or years after injury
Symptoms persist longer than expected after initial concussion
More common in women and persons of advanced age who suffer head trauma
Severity of PCS often does not correlate to severity of head injury
PCS Symptoms
Headaches
Dizziness
Fatigue
Irritability
Anxiety
Insomnia
Loss of concentration and memory
Ringing in the ears
Blurry vision
Noise and light sensitivity
Rarely, decreases in taste and smell
Concussion Associated Risk Factors
Early symptoms of headache after injury
Mental changes such as amnesia or fogginess
Fatigue
Prior history of headaches
Evaluation Of PCS
PCS is a diagnosis of exclusion
If patient presents with symptoms after head injury, and other possible causes have been ruled out => PCS
Use appropriate testing and imaging studies to rule out other causes of symptoms
Headaches In PCS
Often �tension� type headache
Treat as you would for tension headache
Reduce stress
Improve stress coping skills
MSK treatment of the cervical and thoracic regions
Constitutional hydrotherapy
Adrenal supportive/adaptogenic herbs
Can be migraine, especially in people who had pre-existing migraine conditions prior to injury
Reduce inflammatory load
Consider management with supplements and or medications
Reduce light and sound exposure if there is sensitivity
Dizziness In PCS
After head trauma, always assess for BPPV, as this is the most common type of vertigo after trauma
Dix-Hallpike maneuver to diagnose
Epley�s maneuver for treatment
Light & Sound Sensitivity
Hypersensitivity to light and sound is common in PCS and typically exacerbates other symptoms such as headache and anxiety
Management of excess mesencephalon stimulation is crucial in such cases
Sunglasses
Other light blocking glasses
Earplugs
Cotton in ears
Treatment Of PCS
Manage each symptom individually as you otherwise would
Manage CNS inflammation
Curcumin
Boswelia
Fish oil/Omega-3s � (***after r/o bleed)
Cognitive behavioral therapy
Mindfulness & relaxation training
Acupuncture
Brain balancing physical therapy exercises
Refer for psychological evaluation/treatment
Refer to mTBI specialist
mTBI Specialists
mTBI is difficult to treat and is an entire specialty both in the allopathic and complementary medicine
Primary objective is to recognize and refer for appropriate care
Pursue training in mTBI or plan to refer to TBI specialists
Sources
�A Head for the Future.� DVBIC, 4 Apr. 2017, dvbic.dcoe.mil/aheadforthefuture.
Alexander G. Reeves, A. & Swenson, R. Disorders of the Nervous System. Dartmouth, 2004.
�Heads Up to Health Care Providers.� Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 16 Feb. 2015, www.cdc.gov/headsup/providers/.
�Post-Concussion Syndrome.� Mayo Clinic, Mayo Foundation for Medical Education and Research, 28 July 2017, www.mayoclinic.org/diseases-conditions/post- concussion-syndrome/symptoms-causes/syc-20353352.
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