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Personal Injury

Back Clinic Personal Injury Chiropractic Team. Injuries from an accident can not only cause physical harm to you or a loved one, being involved in a personal injury case can often be a complicated and stressful situation to handle. These types of circumstances are unfortunately fairly common and when the individual is faced with pain and discomfort as a result of trauma from an accident or an underlying condition that has been aggravated by the injury, finding the right treatment for their specific issue can be another challenge on its own.

Dr. Alex Jimenez’s compilation of personal injury articles highlights a variety of personal injury cases, including automobile accidents resulting in whiplash, while also summarizing various effective treatments, such as chiropractic care. For more information, please feel free to contact us at (915) 850-0900 or text to call Dr. Jimenez personally at (915) 540-8444.


Whiplash Rehabilitation: Road to Recovery and Pain Relief

Whiplash Rehabilitation: Road to Recovery and Pain Relief

Experiencing a whiplash injury can be disorienting and painful. Can recognizing the signs of more serious complications, seeking timely medical intervention, and following a structured whiplash rehabilitation plan help individuals find relief and restore function and quality of life?

Whiplash Rehabilitation: Road to Recovery and Pain Relief

Whiplash Rehabilitation

For individuals who have recently been in an automobile accident, once the initial neck pain and stiffness have passed, it’s crucial to recognize potential delayed symptoms, such as nerve damage. While many recover quickly, some may experience prolonged symptoms requiring more aggressive treatment and management.

Neck Injury

Whiplash injuries result from sudden, forceful whipping back and forth of the head, commonly occurring in rear-end vehicle collisions, and are one of the most common neck injuries. Other potential causes include: (Johns Hopkins Medicine, 2024)

Symptoms can include: (Johns Hopkins Medicine, 2024)

  • Pain that radiates to the shoulders and/or upper back
  • Neck stiffness
  • Headaches

Mobility, Flexibility, and Sensations

The symptoms of a neck injury can vary in severity but commonly include: (Johns Hopkins Medicine, 2024) (American Academy of Physical Medicine and Rehabilitation, 2024) (Medline Plus, 2024)

  • Neck pain and stiffness are often the most noticeable symptoms and can take several hours to appear and worsen the following day.
  • Decreased range of motion
  • Difficulty turning or tilting the head
  • Tenderness, pain, or stiffness in the shoulders, upper back, or arms – sometimes accompanied by numbness or tingling.
  • Having no energy
  • Fatigue
  • Headaches
  • Tiredness and irritability
  • Dizziness
  • Blurred vision
  • Unusual sensations around the face
  • Difficulty concentrating or remembering things

Individuals may not feel any symptoms directly following an accident, as it can sometimes take several hours or weeks to develop. (Medline Plus, 2024)

Immediate Medical Attention

Seek immediate medical attention from a healthcare provider or the emergency clinic for any of the following symptoms (NHS, 2023)

  • Injured neck and are experiencing severe pain that isn’t relieved by over-the-counter medication.
  • Feeling pins and needles or tingling in one or both sides of the body.
  • Have difficulty walking or sitting upright.
  • Experience a sudden shock sensation in the back or neck, extending into the arms and legs.
  • Arms or legs feel weak, as these symptoms may indicate nerve damage in the neck or back.

Temporary Pain Relief

Temporary treatment often involves medications to reduce pain, inflammation, and muscle spasms and include. (University of Rochester Medical Center, 2024)

  • Non-steroidal anti-inflammatory Drugs
  • Muscle relaxants
  • Topical gels
  • Injections
  • Anticonvulsants for individuals experiencing nerve-related pain or tingling sensations. (Medline Plus, 2020)

Other treatments may include: (University of Rochester Medical Center, 2024)

  • Ice usually for the first 24 hours
  • Neck brace
  • Physical therapy
  • Gentle neck exercises

Following a healthcare provider’s recommendations regarding medication use, including dosage and duration, is critical to managing symptoms while effectively minimizing potential side effects.

Rehabilitation Steps

To determine the appropriate treatment whiplash rehabilitation plan, a healthcare provider will assess how much the pain affects daily life, including mental health and the ability to do regular activities (American Academy of Physical Medicine and Rehabilitation, 2024). X-rays or other imaging tests will be done to determine how serious the damage to the neck or spine is. Resting and icing the injured area are recommended to relieve inflammation. A provider may recommend slowly increasing neck movements several times daily and continuing with normal daily activities, as exercise will help maintain flexibility. Not moving the neck may prolong pain, stiffness, and healing. Physical therapy may be recommended if symptoms continue for over one or two weeks. (American Academy of Physical Medicine and Rehabilitation, 2024)

How Soon Until Pain and Symptoms Resolve

Whiplash rehabilitation healing and restoration of function depend on the severity of the injury. Many recover quickly; however, in extreme cases, pain and other symptoms can last 12 months or longer. (American Academy of Physical Medicine and Rehabilitation, 2024) It is recommended to see a provider if: (Johns Hopkins Medicine, 2024)

  • Pain worsens
  • Symptoms last longer than the healthcare provider estimated
  • Other symptoms develop, like weakness, numbness, or a sensation of pins and needles.

Long-Term Injury Side Effects

Individuals in whiplash rehabilitation usually recover in a few weeks to months, but some may have longer-lasting pain as the injury can cause nerve damage. (Fundaun J. et al., 2022) Discuss any new or worsening symptoms with a healthcare provider for guidance. (Johns Hopkins Medicine, 2024)

Chronic Neck and Back Pain Management

Treatments for chronic neck and back pain include: (National Institute of Arthritis and Musculoskeletal and Skin Diseases, 2023)

  • Physical therapy to help strengthen muscles.
  • Acupuncture.
  • Non-surgical decompression.
  • Over-the-counter pain relievers, such as acetaminophen or NSAIDs.
  • Muscle relaxants for tightness and tension.
  • Prescription pain medications.

If pain becomes chronic, antidepressants such as serotonin and norepinephrine reuptake inhibitors may be prescribed. These medications can help manage pain and improve sleep quality. (Ferreira G. E. et al., 2023) For severe inflammation and pain, corticosteroid injections directly into the affected area can provide relief. Healthcare providers administer these injections, offering long-lasting effects. (Harvard Health Publishing, 2015)

Injury Medical Chiropractic and Functional Medicine Clinic

Navigating a whiplash injury can be challenging, but understanding the whiplash rehabilitation process can significantly aid in recovery. A healthcare provider can determine the most effective treatment strategies. It is important to talk with a healthcare provider to determine the cause and extent of the injury to provide individualized patient education regarding treatment. This can include physical therapy, rest, health coaching, medication, and surgery, which may be recommended in certain cases. Overcoming these limitations is possible. 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, prevent injury, and help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.


Personal Injury Rehabilitation


References

Johns Hopkins Medicine. (2024). Whiplash Injury. www.hopkinsmedicine.org/health/conditions-and-diseases/whiplash-injury

American Academy of Physical Medicine and Rehabilitation. (2024). Cervical whiplash. www.aapmr.org/about-physiatry/conditions-treatments/musculoskeletal-medicine/cervical-whiplash

Rush University Medical Center. (2014). 5 facts about whiplash. www.rush.edu/news/5-facts-about-whiplash

National Library of Medicine. MedlinePlus. (2024). Whiplash. Retrieved from medlineplus.gov/ency/imagepages/9853.htm

National Health Service NHS. (2023). Whiplash. www.nhs.uk/conditions/whiplash/

University of Rochester Medical Center. (2024). Whiplash injury. www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=85&contentid=p01388

National Library of Medicine. MedlinePlus. (2020). Pregabalin. Retrieved from medlineplus.gov/druginfo/meds/a605045.html

Fundaun, J., Kolski, M., Baskozos, G., Dilley, A., Sterling, M., & Schmid, A. B. (2022). Nerve pathology and neuropathic pain after whiplash injury: a systematic review and meta-analysis. Pain, 163(7), e789–e811. doi.org/10.1097/j.pain.0000000000002509

National Institute of Arthritis and Musculoskeletal and Skin Diseases. (2023). Back pain: diagnosis, treatment, and steps to take. Retrieved from www.niams.nih.gov/health-topics/back-pain/diagnosis-treatment-and-steps-to-take

Ferreira, G. E., Abdel-Shaheed, C., Underwood, M., Finnerup, N. B., Day, R. O., McLachlan, A., Eldabe, S., Zadro, J. R., & Maher, C. G. (2023). Efficacy, safety, and tolerability of antidepressants for pain in adults: overview of systematic reviews. BMJ (Clinical research ed.), 380, e072415. doi.org/10.1136/bmj-2022-072415

Harvard Health Publishing. (2015). New recommendations aim to improve safety of pain-relieving spinal steroid injections. Harvard Health Publishing
Harvard Medical School. www.health.harvard.edu/blog/new-recommendations-aim-to-improve-safety-of-pain-relieving-spinal-steroid-injections-201505077991

How to Maintain Fitness While Recovering from Injuries

How to Maintain Fitness While Recovering from Injuries

Can modified workouts and/or having a personal trainer design an alternate fitness routine while in injury recovery help injured individuals and athletes maintain fitness?

How to Maintain Fitness While Recovering from Injuries

Maintain Fitness During Injury Recovery

Individuals with personal, work, or sports injuries must take time off to rest, recover, and rebuild. However, there are ways to maintain fitness and endurance levels while unable to engage in full workouts and exercise.

Fitness Base

Injured individuals and athletes will lose a certain amount of fitness during recovery. After all, the body is injured and needs to focus most of its attention on healing to get back to normal. Deconditioning is a fact of life when the body stops exercising, but there are ways to stay active to maintain a fitness base. Individuals can modify or scale back exercise. Before exercising after an injury, get a doctor’s approval. Then, follow their recommendations. (Garber C. E. et al., 2011)

Even if one body part or joint is immobilized, cross-training principles can help individuals discover new ways to stay fit while rehabilitating. The key is to have the right attitude and remain active within tolerance levels until the injury is healed. Trying new things may take some creativity and flexibility, but most find training through injury is possible and not difficult. Here are ways to continue working out while recovering.

Lower Back Injury Workout

Talk with a doctor or sports doctor to understand exercise limitations before modifying workouts. Walking, swimming, or recumbent cycling are generally safe for individuals with a lower back injury. These workouts can help maintain cardiovascular fitness. An example of a modified workout may consist of the following:

  • Warm up before exercising.
  • Perform the workout on Monday, Wednesday, and Friday.
  • Perform each exercise for 30 to 60 seconds with 15 seconds of rest between exercises.
  • Complete the entire circuit three to four times.
  • Complete 30 to 60 minutes of non-weight-bearing cardiovascular exercises on Tuesday, Thursday, and Saturday.
  1. Chest Press
  2. Lat Pulldown
  3. Overhead Press
  4. Leg Extension
  5. Wall Sit

Shoulder and Elbow Injury Workout

Shoulder or other upper body injuries often make it possible to continue traditional cardiovascular exercise because the lower body can be fully exercised. Walking, stair climbing, stationary cycling like an under-desk bike, and the elliptical trainer all work. Circuit training routines will maintain strength and power in the non-injured muscles and joints. The following example routine can be done four to five times weekly.

  • Warm-up.
  • Perform each exercise for 30 to 60 seconds, allowing 15 seconds of rest between exercises.
  • Complete the entire routine three to four times.
  1. Stationary cycling for two minutes at a moderate pace and two at a higher intensity.
  2. Leg Press
  3. Elliptical trainer for two minutes at a moderate pace and two at a higher intensity.
  4. Ab Crunches
  5. Walking Lunges
  6. Low Back Extensions
  7. Treadmill walking for two minutes at a moderate pace and two at a higher intensity or incline.
  8. Wall sits

Ankle and Foot Injury Workout

If the doctor approves, individuals can use a rowing machine or a stationary bike with one leg or swim a few laps. As a doctor or physical therapist recommends, individuals may also need an ankle brace or other support. A sports doctor or personal trainer can help recommend other non-weight-bearing cardiovascular exercises for 30 to 60 minutes three times weekly. Here is a sample workout to try:

  • Warm-up.
  • Perform the workout on Monday, Wednesday, and Friday.
  • Perform each exercise for 30 to 60 seconds with 15 seconds rest between exercises.
  • Complete the workout three to four times.
  1. Leg Extensions
  2. Chest Press
  3. Lat Pulldown
  4. Overhead Press
  5. Seated Cable Rows
  6. Incline Push-Up
  7. Bicycle Crunches
  8. Hanging Leg Raise

Leg and Knee Injury Workout

Leg and knee injuries can be limiting, as most endurance exercise requires flexion and knee joint extension. One-legged cycling or using an upper-body ergometer/handcycle are options. Swimming may be possible if the individual uses a pull buoy to keep them from kicking or using their legs. Here are two circuit workout examples:

Circuit 1

  • Warm-up.
  • Perform this on Monday, Wednesday, and Friday.
  • Perform each exercise for 30 to 60 seconds with 15 seconds of rest between exercises.
  • Complete the workout three to four times.
  1. Pull-Up or Assisted Pull-Up
  2. Chest Press
  3. Lat Pulldown
  4. Overhead Press

Circuit 2

  • Warm-up.
  • Perform the workout on Tuesday, Thursday, and Saturday.
  • Perform each exercise for 30 to 60 seconds with 15 seconds of rest between exercises.
  • Complete the workout three to four times.
  1. Seated Russian Twist
  2. Ab Crunch
  3. V-Sit ab exercise

Injury Medical Chiropractic and Functional Medicine Clinic

Individuals may need significant rest time to heal properly, so consult a doctor on the balance of rest and training. Doing the exercises prescribed by the physical therapist during rehabilitation is important. 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 medical professionals to integrate a treatment plan to resolve musculoskeletal issues.


Treating Ankle Sprains


References

Garber, C. E., Blissmer, B., Deschenes, M. R., Franklin, B. A., Lamonte, M. J., Lee, I. M., Nieman, D. C., Swain, D. P., & American College of Sports Medicine (2011). American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Medicine and science in sports and exercise, 43(7), 1334–1359. doi.org/10.1249/MSS.0b013e318213fefb

Isometric Exercise for Rehabilitation and Pain Relief

Isometric Exercise for Rehabilitation and Pain Relief

For individuals going through post surgery, injury rehabilitation, illness and/or chronic condition management, can physical therapy isometric exercises help?

Isometric Exercise for Rehabilitation and Pain Relief

Isometric Exercise

Isometric exercises are used in physical therapy to help build muscle endurance, improve range of motion, relieve pain, and reduce blood pressure more effectively than other types of exercise. Because they don’t involve joint movement, they are a solid starting point for rehabilitation and are suitable for individuals with a limited range of motion. They can be performed by pushing against an immovable object, like a wall, or by having a therapist provide resistance. Examples of isometric exercises include:

  • Planks
  • Glute bridges
  • Adductor isometrics

A physical therapist/PT may have a patient perform isometric exercises after injury or illness. During an isometric contraction, the muscle does not change in length, and there is no motion around the joint surrounding the muscle/s. (Rhyu H. S. et al., 2015)

When To Use

Isometric muscular contractions can be used at any time during physical rehabilitation and strengthening or a home exercise program and are regularly used with the following (Rhyu H. S. et al., 2015)

  • Post-surgery
  • When muscles cannot contract forcefully enough to move the joint it surrounds.
  • To help increase neuromuscular input to a specific muscle/s.
  • When injury or condition frailty makes other forms of exercise dangerous and not beneficial.

A healthcare provider or physical therapist should be consulted first if isometrics are used in a rehabilitation program.

Benefits

The benefits of using isometric exercise after injury or surgery may include the following:

  • No special equipment is necessary to perform isometric exercises.
  • The ability to safely contract a muscle while protecting a surgical incision or scar tissue.
  • The muscles can be strengthened in a specific range of motion around a joint. (NikolaidouO. et al., 2017)

A physical therapist can help determine whether isometric exercise benefits the specific condition.

Effectiveness

Isometric exercise is very effective after injury or surgery. However, when a muscle is contracted isometrically, it gains strength in a very small area and with a short range of motion. For example, an isometric shoulder external rotation performed with the arm at the side will only strengthen the rotator cuff muscles in the specific position that the arm is in. (NikolaidouO. et al., 2017).

  • Strength gains are specific to the joint’s position during the exercise.
  • Individuals who want to strengthen their gluteal muscles in their hip using isometrics would have to contract their glute muscles in one specific position for several reps.
  • Once several reps of the exercise in one position have been performed, the individual moves their hip joint into a new position and repeats the gluteal contractions in the new position.
  • This makes the exercise time-consuming, but it is perfect for injury rehabilitation, preventing and avoiding worsening or further injuries.

How to Perform

To perform isometric exercises, all that is needed is something stable to push against. (Rhyu H. S. et al., 2015) For example, to strengthen the shoulder muscles:

  • Stand next to a wall and try to lift an arm out to the side.
  • Allow the hand to press against the wall so no motion occurs at the shoulder joint.
  • Once pressed against the wall, hold the contraction for 5 to 6 seconds and slowly release it.
  • Perform 6 to 10 repetitions of the exercise.
  • This could be one set of completed isometric exercises for the shoulder muscles.

Elastic resistance bands or tubing can also be used to perform isometric exercises. Hold the tubing in a specific position and then move the body away from the anchor point instead of moving the joint. The muscles will contract against the increased resistance of the elastic tubing, and no motion will occur at the joint. A physical therapist can show and train on how to perform isometric exercises with the bands.

Neuromuscular Stimulation

Isometric exercise can strengthen muscles and help improve the neuromuscular recruitment of the muscles being trained. This enhances muscle contraction and expedites gains in muscle recruitment while protecting the joint. Isometric exercise can also be used during physical therapy using neuromuscular electrical stimulation (NMES). (Fouré A. et al., 2014) For example, a PT may use NMES to improve muscular function for individuals who have difficulty contracting their quadriceps after knee surgery and may be instructed to perform isometric quad-setting exercises during the session.

Injury Medical Chiropractic and Functional Medicine Clinic

A physical therapist can use isometric exercises to help individuals injured or have had surgery and are experiencing difficulty with normal functional mobility by improving their strength during recovery. The exercises can safely enhance the function and stability of the muscles and return individuals to the previous level of activity and function. 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 medical professionals to integrate a treatment plan to resolve musculoskeletal issues.


Personal Injury Rehabilitation


References

Rhyu, H. S., Park, H. K., Park, J. S., & Park, H. S. (2015). The effects of isometric exercise types on pain and muscle activity in patients with low back pain. Journal of Exercise Rehabilitation, 11(4), 211–214. doi.org/10.12965/jer.150224

Nikolaidou, O., Migkou, S., & Karampalis, C. (2017). Rehabilitation after Rotator Cuff Repair. The Open Orthopaedics Journal, 11, 154–162. doi.org/10.2174/1874325001711010154

Fouré, A., Nosaka, K., Wegrzyk, J., Duhamel, G., Le Troter, A., Boudinet, H., Mattei, J. P., Vilmen, C., Jubeau, M., Bendahan, D., & Gondin, J. (2014). Time course of central and peripheral alterations after isometric neuromuscular electrical stimulation-induced muscle damage. PloS one, 9(9), e107298. doi.org/10.1371/journal.pone.0107298

Improving Mobility and Emotional Health with Recreation Therapy

Improving Mobility and Emotional Health with Recreation Therapy

Individuals who have been injured or ill or have a chronic disability may be having difficulty performing everyday activities. Can recreation therapy help rehabilitate injuries and manage chronic conditions?

Improving Mobility and Emotional Health with Recreation Therapy

Recreation Therapy

Living with a chronic disability or functional limitation due to an illness or injury can significantly impact an individual’s quality of life. Working with a team of rehabilitation professionals can help improve mobility and the ability to complete everyday tasks comfortably. A recreational therapist is one professional who helps regain emotional and functional well-being. A recreational therapist is a healthcare professional who helps individuals maximize physical and emotional health through recreational activities. Also known as therapeutic recreation, the therapist will use activities to help move and feel better. A physical or occupational therapist uses exercises to improve functional mobility, and a recreational therapist uses recreational activities to help regain mobility and improve well-being. Activities can include:

  • Playing games
  • Outdoor activities
  • Hiking
  • Puzzles
  • Horseback riding
  • Cooking

Therapy

A healthcare specialist uses activity-based interventions to help individuals move and feel better after injury or illness or if they have a chronic disability. The interventions and therapies are based on recreational activities the individual likes and are designed to help recover physical, functional, and emotional health. Recreational therapists are trained to evaluate an individual’s condition and intervene in ways that help maximize social, mental, and physical health. The main goal is to reduce depression and anxiety and to help individuals socialize comfortably. (American Therapeutic Recreation Association, 2024)

Activities

Therapeutic recreation involves engaging in specific activities to help individuals regain their confidence and independence. Examples of activities can include: (American Therapeutic Recreation Association, 2024)

  • Painting or drawing
  • Dancing
  • Sports programs
  • Cooking
  • Community outings
  • Group exercise classes

The key to a positive experience is that the activity should be specific to the individual’s emotional and physical needs and capabilities and something the individual would want to do as an activity.

Other Types of Therapy

Individuals may be familiar with other types of therapists, like physical and occupational therapists. These professionals help individuals regain pain-free functional mobility after injury or illness. For individuals who cannot move their upper extremities after falling, the physical therapist can measure their shoulder range of motion and strength and develop a personalized treatment program. Recreation therapists are similar; they meet with patients regularly to help them recover from injuries or positively socialize with their community. During the initial meeting, they will evaluate the individual’s condition and learn how their emotional and physical needs prevent them from achieving maximal potential. (American Therapeutic Recreation Association, 2024) The patient and therapist will engage in activities to help move and feel better during therapy. During the activity, the therapist may suggest adjustments or ideas that improve movement and ability to interact with the environment.

Who Can Benefit?

Individuals of all ages and abilities with physical and psychological conditions can benefit from working with a recreational therapist. Children, teenagers, adults, and older individuals who have a disability, either temporary or permanent, can engage in recreation therapy as part of a rehabilitation and recovery program. (American Therapeutic Recreation Association, 2024)

Benefits

Whenever engaging in any healthcare activity or treatment, ask if that treatment can help your specific condition. A review of the use of recreational dance in children and young people ages 5 to 21 found evidence of the benefits of the therapy, which included: (Burkhardt J, Brennan C. 2012)

  • Decreased anxiety
  • Improve self-image
  • Improved cardiovascular fitness
  • Decreased obesity
  • Improved bone health

Another study examined health improvements in individuals injured in military service after a week-long recreational therapy wellness retreat. The participating service members’ results showed significant improvement in outcome measures for post-traumatic stress disorder, stress, anxiety, and depression. The health improvements remained three and six months after completing the recreation therapy. This shows that therapeutic recreation may offer significant emotional and psychological benefits to injured military service members’ long-term health and an effective treatment to improve the well-being of injured or disabled individuals with limited negative side effects. (Townsend J, Hawkins BL, Bennett JL, et al., 2018)

Professional Background

Most therapists have a bachelor’s degree in recreational or leisure studies, focusing on art, psychology, and music classes. Upon graduation, students can take a national exam and become Certified Therapeutic Recreation Specialists/CTRS. (Hoss M.A.K, 2019) Once certified, therapists must regularly take continuing education classes and undergo a recertification process every five years.

Receiving Therapy Services

To start working with a recreational therapist, visit your healthcare provider and request a referral. They can ensure the treatment is appropriate for the specific injury and/or condition and should be able to help find a therapist. (American Therapeutic Recreation Association, 2024) Individuals in an inpatient hospital will likely spend time with a recreational therapist at some point. Just like working with a physical or occupational therapist to help individuals move better, working with a recreation therapist while in rehabilitation may be an everyday occurrence to help reintegrate into the community after discharge.

Insurance Coverage

One question regarding recreational therapy is, will my insurance cover the services of a recreational therapist?

  • For individuals with Medicare insurance, recreational therapy is a covered service for individuals with certain diagnoses and settings.
  • Therapeutic recreation is a covered rehabilitation service for individuals in an inpatient rehabilitation facility.
  • Individuals who receive outpatient recreational therapy should ensure they have a prescription and letter of medical necessity from a physician to qualify for Medicare reimbursement. (American Therapeutic Recreation Association, 2024)
  • Individuals with private insurance should call their insurance provider and inquire about coverage for recreation therapy.
  • Individuals who do not have insurance can expect to pay $100-$150 per session.
  • Each session lasts around one to two hours. (De Vries D. 2014)

Injury Medical Chiropractic and Functional Medicine Clinic

Working in therapeutic recreation may help decrease anxiety and depression, improve the sense of well-being, and improve function in daily tasks. (Townsend J, Hawkins BL, Bennett JL, et al., 2018) Always consult your healthcare provider before beginning new treatment methods. 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 medical professionals to integrate a treatment plan to resolve musculoskeletal issues.


Integrative Healthcare


References

American Therapeutic Recreation Association. Association, A. T. R. (2024). What is Recreational Therapy? www.atra-online.com/about-rt

American Therapeutic Recreation Association. Association, A. T. R. (2024). Who We Are. www.atra-online.com/who-we-are

Burkhardt, J., & Brennan, C. (2012). The effects of recreational dance interventions on the health and well-being of children and young people: A systematic review. Arts & Health, 4(2), 148–161. doi.org/10.1080/17533015.2012.665810

Townsend, J., Hawkins, B. L., Bennett, J. L., Hoffman, J., Martin, T., Sotherden, E., … Duregger, C. (2018). Preliminary long-term health outcomes associated with recreation-based health and wellness programs for injured service members. Cogent Psychology, 5(1). doi.org/10.1080/23311908.2018.1444330

Hoss, PhD, CTRS, FACHE, FDRT, M. A. K. (2019). Recreational therapy workforce: An update. American Journal of Recreation Therapy, 18(3), 9–15. doi.org/10.5055/ajrt.2019.0191

De Vries, DHA, MPA, CTRS, D. (2014). Regulatory requirements for recreational therapy in nursing homes. American Journal of Recreation Therapy, 13(1), 25–30. doi.org/10.5055/ajrt.2014.0063

Protect Your Back: Correct Manual Lifting Technique

Protect Your Back: Correct Manual Lifting Technique

Incorrect manual handling and lifting is a leading cause of workplace injuries. Can health and safety training help reduce injuries and lost workdays?

Protect Your Back: Correct Manual Lifting Technique

Correct Manual Lifting Technique

Manually lifting objects using incorrect techniques can lead to acute back injuries, herniated discs, sciatica, and long-term issues like increased risk of reinjury, body misalignment, and chronic back pain. Individuals can prevent spinal disc compression and/or lower back muscle strain by learning to use correct manual lifting techniques. (CDC. The National Institute for Occupational Safety and Health (NIOSH). 2007)

Lifting Guide

Individuals can protect their backs and prevent injury by following simple steps when lifting objects.

Support Base

  • Ensure there is a healthy support base from which to lift.
  • Keep feet shoulder-width apart with one foot slightly in front of the other.

Ask For Help

  • If coworkers or colleagues are available, ask for assistance.
  • If the load is too heavy, ask for help lifting and moving the object/s.

Use Mechanical Assistant Devices

  • Use hand trucks, dollies, or pushcarts whenever possible for uneven and heavy loads.

Squat To Lift Object

  • Bend at the hips and knees only, not the back.
  • Put one knee on the ground to ensure stability before lifting.

Check Posture

  • Looking straight ahead, maintain posture upright with the chest out, shoulders back, and lower back slightly arched.

Lift Slowly

  • Lift with the knees and hips only, gradually straightening the lower back.

Load Positioning

  • Once upright, hold the load close to the body around the stomach.

Move and Maintain Alertness

  • Always take small steps.
  • Maintain alertness as to where you are going.
  • Keep the shoulders square with the hips when changing directions to avoid twisting and losing or shifting balance.

Rest

  • If you are fatigued, set the load/object down and rest for a few minutes until you can fully engage in the task.

Squat To Set Object Down

  • Squat with the knees and hips and set the load down slowly.
  • Avoid quickly rising and jerking movements, and allow the legs, hips, and back muscles to reset.

Planning and Tips

Lifting anything heavy takes planning to prevent muscle spasms, back strain, and other musculoskeletal injuries. Considerations to keep in mind:

Make a Plan Before Lifting

  • Knowing what object/s are being lifted and where they are going will prevent individuals from making awkward movements while holding and carrying something heavy.
  • Set and clear a path.
  • If lifting something with another person, ensure both agree and understand the plan.

Lift Close to The Body

  • Individuals are stronger and more stable lifters if the object is held close to their body rather than at the end of their reach.
  • Make sure there is a firm hold on the object.
  • It is easier to maintain balance close to the body.

Maintain Feet Shoulder-Width Apart

  • Keep the feet about shoulder-width apart.
  • Having a solid base of support is important while lifting.
  • Placing the feet too close together will cause instability while placing them too far apart will hinder movement.
  • Take short steps.

Visualize The Motions Involved and Practice The Motions Before Lifting

  • Think about the motion before lifting.
  • Practice the lifting motion before lifting the object.
  • Focus on keeping the spine straight.
  • Raise and lower to the ground by bending the knees.
  • Avoid bending at the waist or hips.

Tighten the Stomach Muscles

  • Tightening the abdominal muscles will hold the back in a healthy lifting position and help prevent excessive force on the spine.

Lift With the Legs

  • The legs are stronger than the back muscles, so let the leg strength do the work.
  • Lower yourself to the ground by bending the knees, not the back.

Keep Eyes Up

  • Looking slightly upwards will help maintain a better spine position and help keep the back straight.

Avoid Twisting or Bending

  • Face in the direction you are walking.
  • Stop, take small steps, and continue walking if turning is required.

Back Belts

It has become common for many who work in jobs requiring manual lifting to wear back belts or support. However, research does not show that they decrease the risk of a lifting injury. (CDC and The National Institute for Occupational Safety and Health, 2023) Instead, it is recommended that the belt be thought of as a reminder of where the back muscles are positioned to keep the individual aligned, combined with the correct lifting techniques.

Injury Medical Chiropractic and Functional Medicine Clinic

Training the body and maintaining its optimal health for correct manual lifting techniques requires daily efforts through practice, conscious position corrections, and ergonomics. 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 medical professionals to integrate a treatment plan to resolve musculoskeletal issues.


Chiropractic Care For Injury Recovery


References

CDC. The National Institute for Occupational Safety and Health (NIOSH). (2007). Ergonomic Guidelines for Manual Material Handling. (No. 2007-131). Retrieved from www.cdc.gov/niosh/docs/2007-131/pdfs/2007-131.pdf

CDC. The National Institute for Occupational Safety and Health (NIOSH) (2023). Back Belts – Do They Prevent Injury? (No. 94-127). Retrieved from www.cdc.gov/niosh/docs/94-127/

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

Adjusting Your Work Office Chair for Improved Back Health

Adjusting Your Work Office Chair for Improved Back Health

Individuals who sit in an office chair for a long period naturally tend to slouch over or slouch down into the chair. This posture can overstretch the spinal ligaments, strain the discs and surrounding structures in the spine, and contribute to or worsen back pain. Can the right office chair settings help relieve and prevent future injuries?

Adjusting Your Work Office Chair for Improved Back Health

Work Office Chair

Sitting in an office chair for prolonged periods can cause lower back pain or worsen an existing back problem. The main reason behind this is that sitting is a static posture that increases stress in the back, shoulders, arms, and legs, putting pressure on the back muscles and spinal discs. Over time, incorrect sitting posture can damage the spinal structures. Most office chair customers base their decisions on availability, color, style, and price. However, it’s recommended that individuals learn about fitting seating equipment to their height, frame, or any condition, such as back or hip pain. The controls on or under the armrests and at the bottom of the chair seat, including the levers, paddles, and knobs, are there for a reason. Here are some recommendations for adjusting their work office chair to decrease back and hip pain.

Height Adjustment

The chair’s height affects the quadriceps, psoas, and hamstring muscles, which are important in posture-related back pain. Height adjustment is the primary way to change the angle of the hip joint while sitting. This angle affects the position of the pelvis and the degree of curve in the lower back, which can alter the spine’s normal alignment. (De Carvalho D. et al., 2017) Adjusting the chair’s height can provide a reference for other chair and workstation adjustments.

Back Angle

The hip angle is how close (increased hip flexion) or how far away (less hip flexion) the trunk is to the top of the thigh when sitting. Adjusting chair height can control the angle of the hip joint. When adjusting the height, adjust the degree of flexion at the hip joint to ensure ideal alignment for the individual body frame. A recent study measured the load that sitting has on simulated spinal discs. Researchers concluded that pressure on the spine can be relieved with a more open angle between the trunk and the thigh, that is, the hip joint angle. (Rohlmann A. et al., 2011) The backrest, seat tilt, and lumbar support features help maintain a pain-free back and relieve pressure and tension in the lower back and should be utilized.

Seat Depth

A kitchen chair, for example, may have no back supports or armrests to assist with posture and angle. (Holzgreve F. et al., 2022) When sitting, the individual’s back should be against the back of the work office chair for the best support and a healthy posture. Individuals will want to check and see how concave the seat surface is. If there is a prominent curve, this will cause the back to be rounded when sitting, which can become uncomfortable and lead to back pain. A chair with built-in support or a pillow can help adjust the depth. This means that chair size matters, as different people will need seats of varying depths to match their musculoskeletal structure.

Seat Height

Another way to understand the hip joint angle is to compare the height of the knees to the height of the hips. This is usually the easiest way to assess whether the chair height is right while adjusting. When the seat is right, the feet will be flat on the floor. The feet should reach the floor without causing pressure on the back of the thighs. Individuals with dangling feet, which may be because of their height, should place a footrest or thick book under them. The knees should be approximately level with or lower than the hips. In this case, the level is a 90-degree angle between the hip and trunk, which is stress-free on the hips and back.

Risks

Chair Too High

For individuals who can’t reach their feet to the floor, the chair is probably too high. The Occupational Safety and Health Administration (OSHA) says this is potentially hazardous because it can lead to scooting forward and forgoing the backrest’s support (United States Department of Labor, N.D.) Sitting like this is considered an awkward posture and a risk factor for work-related musculoskeletal disorders (MSD). Musculoskeletal disorders and symptoms caused by awkward sitting posture include muscle fatigue, swelling, pain, numbness, or decreased circulation. (Ng, P. K., Jee, K. S. and Lim, S. Y. 2016)

Chair Too Low

If the knees are higher than the hips, the chair is probably too low, causing extreme flexion in the hip joints. Most individuals’ backs can’t handle this well because their hip muscles are not flexible enough. If sitting with knees higher than hips, the position can cause lower back pain.

Taking Breaks

No matter how comfortable a work office chair is, prolonged static posture is unhealthy for the spine and is a common contributor to back problems and muscle strain. Remember to stand, stretch, and walk for at least a minute or two every half hour to prevent the back from staying in one position for a long period. A quick stretch or minimal movement, like a quick walk, will help. A longer walk will help even more, promoting blood circulation to supply nutrients to all the spinal structures.
Moving and stretching regularly throughout the day will help keep the joints, ligaments, muscles, and tendons loose and promote comfort, relaxation, and the ability to focus productively.

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop personalized treatment programs. An integrated approach to treating injuries and chronic pain syndromes improves flexibility, mobility, and agility, relieving pain and helping individuals return to normal activities. If other treatments are needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers.


Low Back Pain: Impact and Chiropractic Solutions


References

De Carvalho, D., Grondin, D., & Callaghan, J. (2017). The impact of office chair features on lumbar lordosis, intervertebral joint and sacral tilt angles: a radiographic assessment. Ergonomics, 60(10), 1393–1404. doi.org/10.1080/00140139.2016.1265670

Rohlmann, A., Zander, T., Graichen, F., Dreischarf, M., & Bergmann, G. (2011). Measured loads on a vertebral body replacement during sitting. The spine journal : official journal of the North American Spine Society, 11(9), 870–875. doi.org/10.1016/j.spinee.2011.06.017

Holzgreve, F., Maurer-Grubinger, C., Fraeulin, L., Bausch, J., Groneberg, D. A., & Ohlendorf, D. (2022). Home office versus ergonomic workstation – is the ergonomic risk increased when working at the dining table? An inertial motion capture based pilot study. BMC musculoskeletal disorders, 23(1), 745. doi.org/10.1186/s12891-022-05704-z

United States Department of Labor. (N.D.). Computer workstations eTool. Retrieved from www.osha.gov/etools/computer-workstations

Ng, P. K., Jee, K. S. & Lim, S. Y. (2016). Development of Ergonomics Guidelines for Improved Sitting Postures in the Classroom among Malaysian University Students. American Journal of Applied Sciences, 13(8), 907-912. doi.org/10.3844/ajassp.2016.907.912