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
Forklifts, also known as lift trucks, are used for loading, unloading, and transporting various goods and materials in construction, shipping, and retail industries. They are heavy-duty equipment and require extensive training to operate safely. Forklifts are involved in many serious workplace accidents causing thousands of injuries annually. Chiropractors specialize in injury care and rehabilitation from vehicle accidents and collisions. They can help restore optimal musculoskeletal function and health through adjustments, massage, decompression, and traction therapies.
Forklift Operation
The forklift is one of the most widely used pieces of equipment to raise, lower, or remove pallets, boxes, crates, or other containers and transport and stock goods and materials. There are a variety of lift trucks that include:
The weight, speed, and operation difficulty increase the risk of an accident, increasing the risk of injuries. Other factors include:
They can reach up to 20 miles per hour or more.
They have front braking systems making it harder to stop.
The weight distribution is in the back.
The rear wheels turn instead of the front, causing tip-overs.
Most carry their loads in front and can obstruct an operator’s view.
Lifting too heavy a load can destabilize a forklift and cause it to turn over.
Accident and Injury Causes
Federal work safety regulations require individuals to complete a training program to operate a forklift safely. The most common causes of accidents include:
Lack of training and experience.
Lack of safety equipment – helmets, seatbelts, grab handles, roll cages, cage guards, warning lights, and sirens.
Lack of maintenance – bent forks, no load backrest, unbalanced wheels, etc.
Improper loading – off center, damaged goods, loose loads.
Lifting, moving or tilting the mast too fast.
Riding with a raised load.
Speeding.
Improper backing-up techniques.
Poor communication.
Horseplay.
Giving rides.
Failing to immobilize the machine when the operator leaves.
Failing to pay attention to the position of the forks.
Failing to yield to pedestrians.
Traveling up or down unsafe inclines.
Driving off the side of a ramp.
Design or manufacturing defects.
Common Accidents
The most common type of accidents involve:
Tip-overs and Rollovers.
Falling off the lift.
Getting struck by falling materials or objects.
Pedestrian injuries like getting hit by the vehicle or tripping over the forks.
Getting caught in or compressed/crushed by the vehicle or objects.
Injuries
The most common injuries that result from lift accidents include:
Chiropractic therapy can help heal and rehabilitate musculoskeletal injuries. A chiropractic team will relieve pain symptoms and restore the body’s alignment and function. Treatment includes:
Adjustments
To gently realign joints.
Decrease pain.
Increase range of motion.
Improves posture.
Soft-tissue massage
To relax tight muscles.
Relieve spasms.
Release tension in the connective tissue surrounding the muscles.
Reduces pain.
Improves the range of motion of the spine and joints.
Exercises and stretches
To restore and maintain flexibility, joint stability, and mobility.
Joint bracing and taping
To support sprained joints or muscles during healing.
Health Coaching
Guides diet and nutrition to reduce inflammation and promote healthy eating to manage weight.
Forklift Fails
References
Bage, T et al. “Forklift-related lower limb injuries: a retrospective case series study with patient-reported outcome measures (PROMs).” Annals of the Royal College of Surgeons of England vol. 103,10 (2021): 730-733. doi:10.1308/rcsann.2020.7124
Born, C T et al. “Patterns of injury and disability caused by forklift trucks.” The Journal of trauma vol. 40,4 (1996): 636-9. doi:10.1097/00005373-199604000-00020
Hong, Choon Chiet, et al. “Forklift-Related Crush Injuries of the Foot and Ankle.” Foot & ankle international vol. 36,7 (2015): 806-11. doi:10.1177/1071100715576486
Ull, Christopher et al. “Injuries after Forklift Trucks Accidents – Injury Patterns, Therapy and Outcome in the Context of the Statutory Accident Insurance.” “Gabelstaplerunfälle – Verletzungsmuster, Therapie und Outcome im berufsgenossenschaftlichen Kontext.” Zeitschrift fur Orthopadie und Unfallchirurgie, 10.1055/a-1402-1649. 19 Apr. 2021, doi:10.1055/a-1402-1649
Waters, Thomas et al. “Lower back disorders among forklift operators: an emerging occupational health problem?.” American journal of industrial medicine vol. 47,4 (2005): 333-40. doi:10.1002/ajim.20146
Individuals that have experienced a muscle strain, pull, spasm, etc., that has healed can begin to behave overly cautious, avoiding putting full weight on the area or using full motion out of fear of re-injuring it. This can and does strain other body areas because of the imbalance and awkward positioning. It also leads to anxiety, emotional distress, and decreased self-confidence in everyday movement. Adjustments, massage, and decompression therapy can maintain musculoskeletal health, and a chiropractor can help retrain individuals on healthy posture and confident movement.
Muscle Guarding
Muscles can be held in a position of readiness to act, like the stress response of fight or flight. When this happens, the muscles are partially contracted in preparation for action and is a form of muscle-guarding. But once the fight or flight passes, the muscles relax into their normal position. With injury muscle guarding, the fears and stresses after recovering from an injury can cause the injured and non-injured muscles to stay in the guarded/semi-contracted position. The longer the muscle guarding continues, fatigue begins to set in, decreasing function, restricting mobility, and making the body more vulnerable to damage and injury.
The Brain
The discomfort, pain, or just the thought reinforces the need to guard the area. The brain will find a way to move without causing pain and create compensating but unhealthy movement patterns that strain the other areas of the body. The body adapts to not using the formerly injured muscles and now relies on the other muscles to perform the functions in a non-relaxed state that can become normal, causing stiffness, soreness, tenderness, tendon tension, and pain.
An example is a hip strain, pull or spasm that has been treated and has healed, but the individual is fearful of another injury or going through the painful experience again and begins walking by shifting all their weight to the other side and steps with a limp or some abnormal motion that strains and/or injures the rest of the body.
Chiropractic Treatment and Retraining
Individuals experiencing muscle guarding can find help through chiropractic to retrain their muscles to return to their normal position and regain confidence in their movements. The body will be rebalanced by releasing and relaxing the tight muscles. Then therapeutic repetitive movements, specialized exercises, stretches, and relaxation techniques will help the individual relearn to use the muscles without fear.
Protective Muscle Guarding
References
Hanlon, Shawn et al. “Examining Ankle-Joint Laxity Using 2 Knee Positions and With Simulated Muscle Guarding.” Journal of athletic training vol. 51,2 (2016): 111-7. doi:10.4085/1062-6050-51.3.06
Olugbade, Temitayo et al. “The relationship between guarding, pain, and emotion.” Pain reports vol. 4,4 e770. 22 Jul. 2019, doi:10.1097/PR9.0000000000000770
Prkachin, Kenneth M et al. “Pain behavior and the development of pain-related disability: the importance of guarding.” The Clinical journal of pain vol. 23,3 (2007): 270-7. doi:10.1097/AJP.0b013e3180308d28
The body’s nerves are the communication system that carries messages between the brain and the rest of the body. Some nerves transmit messages from the brain to muscles to make the body move, while others relay pain, pressure, or temperature signals. Tiny fibers bundled inside each nerve carry the messages with an outer layer/sheathing that insulates and protects the nerves. The brachial plexus is a network of nerves that send signals from the spinal cord to the shoulders, arms, and hands. A brachial plexus nerve injury occurs when the nerves are over-stretched, compressed, torn, cut, or ripped from the spinal cord.
Brachial Plexus Nerve Injury
The injury involves the head or neck hitting or getting hit and shifting to one side while the shoulder is stretched/pulled in the opposite direction.
Minor brachial plexus injuries are commonly known as stingers or burners and are common in sports like football, wrestling, hockey, soccer, and basketball.
Severe brachial plexus injuries can cause arm paralysis and usually result from vehicle or motorcycle accidents.
Other conditions like inflammation or tumors can affect the brachial plexus.
Sometimes babies can sustain brachial plexus injuries during birth.
Pressure and stretching injuries do not physically sever the nerve but can disrupt communication.
Cutting injuries vary depending on the severity of the cut and because the nerves are in a protective canal that can also be fractured or broken. If the canal remains intact, the nerve fibers could grow back with time.
However, surgery is necessary to repair the damage if the canal is broken.
Signs and symptoms of a brachial plexus nerve injury can vary, depending on the severity and location of the injury. Usually, only one arm is affected.
Minor Injuries
Minor damage comes from over-stretching or mild compression.
An electric or burning sensation shoots down the arm.
Numbness and weakness in the arm.
Neck pain.
These symptoms usually last for a few seconds or minutes but can linger for days or longer.
Severe Injuries
More-severe symptoms result from injuries that impact, tear, or rupture the nerves.
The most severe injury occurs when the nerve root is torn from the spinal cord.
Symptoms include:
Intense pain.
Writhing neck pain.
Weakness or inability to use specific shoulder, arm, and/or hand muscles.
Complete lack of movement and feeling in the shoulder, arm, and/or hand.
Symptoms in both arms.
Complications
With time, most brachial plexus injuries in children and adults heal with minimal long-term damage. But some injuries can cause long-lasting problems that include:
Joint Stiffness
The joints can stiffen, making movement difficult.
Healthcare providers often recommend ongoing chiropractic and physical rehabilitation during recovery.
Atrophy
Nerves regrow slowly and can take some time to completely heal after the injury.
During that time, lack of use can cause the muscles to break down.
Chronic Pain
Nerve damage can cause pain signals to be constantly firing.
Numbness
It can occur in the arm or hand, increasing the risk of worsening the injury or causing new injuries.
Disability
Recovery from a severe brachial plexus injury depends on age, damage, location, and severity.
Even with surgery, individuals can experience long-term muscle weakness or paralysis.
Chiropractic Treatment and Rehabilitation
Treatment depends on the severity of the damage. Chiropractic can help realign, rehabilitate, stretch, and strengthen the muscles, nerves, tendons, joints, and ligaments to expedite recovery. For less severe injuries:
Muscle strengthening and posture exercises help maintain motion.
Therapeutic massage will stimulate circulation and keep the muscles loose.
For severe injuries:
Surgery
Continued chiropractic and physical rehabilitation to maintain thorough circulation, range of motion, and relaxed muscles.
The Brachial Plexus
References
Brucker, J et al. “Brachial plexus birth injury.” The Journal of neuroscience nursing: Journal of the American Association of Neuroscience Nurses vol. 23,6 (1991): 374-80. doi:10.1097/01376517-199112000-00006
Gutkowska, Olga, et al. “Brachial plexus injury after shoulder dislocation: a literature review.” Neurosurgical review vol. 43,2 (2020): 407-423. doi:10.1007/s10143-018-1001-x
Joyner, Benny, et al. “Brachial plexus injury.” Pediatrics in review vol. 27,6 (2006): 238-9. doi:10.1542/pir.27-6-238
Noland, Shelley S et al. “Adult Traumatic Brachial Plexus Injuries.” The Journal of the American Academy of Orthopaedic Surgeons vol. 27,19 (2019): 705-716. doi:10.5435/JAAOS-D-18-00433
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/
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