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Work Related Injuries

Back Clinic Work-Related Injuries Chiropractic and Physical Therapy Team. Work injuries and conditions can occur from a variety of circumstances, altering an individual’s lifestyle, however, those that occur in the work field can often also be debilitating and impairing, affecting an individual’s work performance. Work-related injuries can include bone fractures and muscle strains/sprains to conditions causing degeneration of many structures of the body, such as arthritis.

Also referred to as occupational injury, repetitive and constant motions of the hands, arms, shoulders, neck and back, among others, can gradually wear out the tissues, increasing the risk of injury which could eventually lead to further complications. A collection of articles depicts the causes and effects of many work-related injuries, carefully describing each variety. For more information, please feel free to contact us at (915) 850-0900 or text to call Dr. Jimenez personally at (915) 540-8444.


Why Maintaining Correct Posture is Crucial for Pain Relief

Why Maintaining Correct Posture is Crucial for Pain Relief

For individuals who are feeling back pain, neck pain, or shoulder pain, can using postural techniques help decrease pain and develop strategies to maintain correct posture?

Why Maintaining Correct Posture is Crucial for Pain Relief

Maintaining Correct Posture

Exercise and postural correction are two of the most important strategies to manage pain. (Robin McKenzie, the great spine guru PT, (May S. and Donelson R. 2008) However, it is not easy to maintain correct posture as the day progresses. While working or driving, most of us forget to be mindful of our posture; we slip back into unhealthy habits of sitting slouched, to the side, forward, etc, which often leads to continued pain and movement limitations. Studies on postural correction and its effect on overall back or neck pain levels are limited. (Lederman E. 2011) However, some studies show that a forward-head posture increases stress and load on the neck. (Hansraj K. K. 2014) If an individual has pain that improves with sitting upright, perhaps checking posture as the day progresses could be beneficial. There are ways to start changing posture and maintain the change. First, visit a physical therapist, spine specialist, or chiropractor to learn how to sit or stand to manage posture problems. They can teach individuals how to attain healthy posture and manage their condition. These strategies can then be used to maintain correct posture.

Lumbar Support

A lumbar roll/support is one of the simplest ways to attain and maintain a healthy sitting posture. These specialized pillows can help maintain the forward curve in the lower back. Maintaining the lumbar lordosis curve is essential for keeping stress off the back muscles, joints, and discs. Lumbar support pillows can be found in various stores, office supply stores, or purchased online. A physical therapist PT can help train individuals to use a lumbar roll properly.

Utilize the Slouch Overcorrect Exercise

The slouch overcorrect exercise is a simple maneuver for training the body to find and maintain its neutral position. It involves slowly shifting from a slouched position to an overcorrected postural position. Once posture is overcorrected, a slight relaxation from a fully erect posture will return to sitting properly. Practicing this exercise daily can help train the body to feel the muscles, listen to the body, and maintain proper posture. The muscles have memory, and the more often the body is placed in optimal posture, the muscles memorize their healthy, pain-free positioning.

Kinesiology Tape

Kinesiology tape is a flexible cotton adhesive that facilitates muscle contractions and inhibits muscle spasms and pain. (Han J. T. et al., 2015) Using the tape is a simple way to help facilitate the postural support muscles. The tape can be applied to the middle trapezius and rhomboid muscles to help support the shoulder blades and spine. Kinesiology tape for postural control also gently pulls on the muscles when slouching to remind the individual to sit up or stand straight.

Scapular Stabilization Exercises

A physical therapist or chiropractor can help improve posture through targeted exercises. Strengthening the muscles attached to the shoulder blades can help individuals better control their posture. (Shiravi S. et al., 2019) Exercises like the prone T, I, or Y can help improve the muscles’ neuromuscular recruitment to maintain correct posture.

Use an Alarm

Setting an alarm while working can help train the body to maintain correct posture. Most of us sit at a computer, desk, or workstation with proper posture, but depending on what we’re working on, we eventually slouch, lean to the side, or have a forward head posture. Pretty much all computers and phones have an alarm setting or app. Use the alarm or timer to go off every 20 to 30 minutes. When the alarm rings, look at your posture to recognize what you’re doing, get up and move around to stretch the body, sit and readjust, reset the alarm, and continue working. As you get better at maintaining appropriate posture, you won’t need the alarm anymore, and readjusting will become automatic.

Chiropractic Team

Sitting and standing with unhealthy posture can significantly cause back, neck, and shoulder pain. By visiting a chiropractic and physical therapy team and learning to attain and maintain correct posture, you can quickly relieve pain, resolve musculoskeletal issues, and prevent future pain symptoms. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop a personalized care plan for each patient through an integrated approach to treating injuries and chronic pain syndromes, improving flexibility, mobility, and agility programs to relieve pain and help return to normal and optimal function. If other treatments are needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments.


Scapular Winging In-Depth


References

May, S., & Donelson, R. (2008). Evidence-informed management of chronic low back pain with the McKenzie method. The spine journal : official journal of the North American Spine Society, 8(1), 134–141. doi.org/10.1016/j.spinee.2007.10.017

Lederman E. (2011). The fall of the postural-structural-biomechanical model in manual and physical therapies: exemplified by lower back pain. Journal of bodywork and movement therapies, 15(2), 131–138. doi.org/10.1016/j.jbmt.2011.01.011

Hansraj K. K. (2014). Assessment of stresses in the cervical spine caused by posture and position of the head. Surgical technology international, 25, 277–279.

Han, J. T., Lee, J. H., & Yoon, C. H. (2015). The mechanical effect of kinesiology tape on rounded shoulder posture in seated male workers: a single-blinded randomized controlled pilot study. Physiotherapy theory and practice, 31(2), 120–125. doi.org/10.3109/09593985.2014.960054

Shiravi, S., Letafatkar, A., Bertozzi, L., Pillastrini, P., & Khaleghi Tazji, M. (2019). Efficacy of Abdominal Control Feedback and Scapula Stabilization Exercises in Participants With Forward Head, Round Shoulder Postures and Neck Movement Impairment. Sports health, 11(3), 272–279. doi.org/10.1177/1941738119835223

Comminuted Fractures: Surgery, Casts, and Physical Therapy

Comminuted Fractures: Surgery, Casts, and Physical Therapy

Can learning about comminuted fracture symptoms and repair help individuals and healthcare providers develop effective treatment and rehabilitation programs?

Comminuted Fractures: Surgery, Casts, and Physical Therapy

Comminuted Fractures

A comminuted fracture is a severe break in which the bone splits into at least three pieces. Comminuted fractures typically happen in the long bones like those in the arms and legs. But they can also happen in other places, including the ribs. (Corinne Tarantino, 2022) They are usually caused by intense impact, like an automobile collision/accident or a severe fall. Depending on the location of the fracture, recovery from a comminuted fracture can take months and often involves:

  • Surgery – A surgeon will place screws and rods to hold the pieces of the bone in position. Sometimes, the hardware is left in permanently. (American Academy of Orthopaedic Surgeons, 2021)
  • Wearing a cast for several months.
  • Physical therapy.

Types

In these types of fractures, the bone is completely broken, not just cracked. The break is a highly comminuted fracture if the bone is broken into four or more pieces. (Corinne Tarantino, 2022)

Symptoms

The symptoms are the same as those of other broken bones, but they can be more intense because the bone is broken in multiple areas, which means there may also be more soft tissue injuries than with a simple fracture. Broken bone symptoms include: (MedlinePlus, 2024)

  • Persistent pain
  • Swelling
  • Bruising
  • Deformity – the bone looks out of place or is at an odd angle.
  • Tingling
  • Numbness
  • Difficulty moving the limb.

Causes

An intense force causes a comminuted fracture, often a car accident or a hard fall, but it can also result from sports injuries. (Corinne Tarantino, 2022)

Diagnosis

A comminuted fracture is diagnosed by X-ray, which shows where the bone has broken and how many pieces it has split into (MedlinePlus, 2024). Healthcare providers will diagnose any broken bones but also look for other injuries.

Treatment

Typically, broken bones can be treated with casts, braces, or a boot to keep them immobilized. (MedlinePlus, 2024) Because comminuted fractures are more severe, they often need other treatments, including surgery. Sometimes, the bone can be reset instead of surgery using a closed reduction technique, where the healthcare provider resets the bone manually. Surgery may be recommended if that’s not possible or doesn’t work.

Types of Surgery

Surgery allows the healthcare provider to correctly position all the pieces of the bone to heal in a strong, stable formation. The two types commonly used to treat comminuted fractures are: (American Academy of Orthopaedic Surgeons, 2021)

External Fixation

  • This surgery uses rods and screws outside the body to stabilize the bone.
  • This external frame is placed during surgery and later removed.

Open Reduction Internal Fixation – ORIF

  • During this surgery, the bone is stabilized with metal plates, screws, rods, and/or wires placed inside your body.
  • Sometimes, these are permanent, but in other cases, they are removed later.
  • An orthopedic surgeon performs these surgeries.

Casting

After surgery, a cast is usually needed to prevent the bone from moving and allow healing. Typically, the cast is worn for six to eight weeks, but it may need to be worn longer with comminuted fractures. Some need a cast for several months (American Academy of Orthopaedic Surgeons, 2021). Sometimes, those with an external fixation must continue wearing a cast after removing the pins and rods, giving the bone more time to stabilize. The healthcare provider will inform the patient how long the cast will need to be worn and which sports activities should be avoided even after the cast comes off.

Physical Therapy

The healthcare provider may recommend physical therapy to help treat the fracture. Usually, when the cast is removed, physical therapy is activated to help rebuild strength and range of motion. (Corinne Tarantino, 2022)

Prognosis

Although these fractures are severe, they are treatable. The prognosis is good for individuals who follow their healthcare provider’s treatment plan. Most don’t have lingering pain after the initial injury and can eventually return to regular activities. (American Academy of Orthopaedic Surgeons, 2021)

Recovery

Healing a comminuted fracture can take months. During that time, it’s helpful to focus on tasks that can be accomplished, like new hobbies that don’t involve physical injury. Talk to the healthcare provider about any problems with the cast or ongoing pain and what to expect during recovery.

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution through an integrated approach to treating injuries and chronic pain syndromes, improving flexibility, mobility, and agility programs to relieve pain and help individuals return to normal. Our providers create personalized care plans for each patient. If other treatments are needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments.


The Path to Healing Personal Injury


References

Corinne Tarantino, MPH. Osmosis. (2022). Comminuted Fracture: What is it, Examples and More. www.osmosis.org/answers/comminuted-fracture

Throckmorton T.W. American Academy of Orthopaedic Surgeons. (2021). Fractures (broken bones). orthoinfo.aaos.org/en/diseases–conditions/fractures-broken-bones/

MedlinePlus. National Library of Medicine. (2024). Fractures Also called: Broken bone. Retrieved from medlineplus.gov/fractures.html

FOOSH Injury Treatment: What to Know

FOOSH Injury Treatment: What to Know

During a fall individuals tend to automatically outstretch their hands to help break a fall, which can slam onto the ground causing a falling onto an outstretched hand or FOOSH injury. Should individuals get checked by a healthcare provider if they believe there is no injury?

FOOSH Injury Treatment: What to Know

FOOSH Injuries

Falling down usually results in minor injuries. A FOOSH injury occurs when falling down and trying to break the fall by reaching out with the hand/s. This can result in an upper extremity injury like a sprain or a fracture. But sometimes, falling on one’s hands can lead to serious injuries and/or create future musculoskeletal issues. Individuals who have fallen or suffered a FOOSH injury should consult their healthcare provider and then a physical therapist or chiropractor to safely develop a treatment plan to rehabilitate, strengthen, and expedite recovery.

After The Injury

For individuals who have fallen down and landed on their hand, wrist, or arm, here are a few things to ensure the proper care for the injury, including:

  • Follow the R.I.C.E. protocol for acute injuries
  • Visit a healthcare provider or local emergency clinic
  • Contact a physical therapist

A FOOSH injury could be or become serious, so to avoid letting small issues become big problems, get examined by a musculoskeletal specialist. The healthcare provider will obtain an imaging scan of the injured and surrounding areas. They will perform a physical examination to determine the type of injury, like a sprain or muscle strain. Not getting appropriate medical treatment after a fall can result in chronic pain and loss of function. (J. Chiu, S. N. Robinovitch. 1998)

Common Injuries

A FOOSH injury can injure different areas. These usually involve the wrist and hand, but the elbow or shoulder can also be injured. Common injuries include:

Colles’ fracture

  • A wrist fracture where the end of the arm bone is displaced backward.

Smith’s fracture

  • A wrist fracture, similar to a Colles’ fracture, is where the end of the arm bone is displaced towards the front of the wrist.

Boxer’s fracture

  • A fracture of the small bones in the hand.
  • Typically, it occurs after punching something, but it can happen from falling on an outstretched fist.

Elbow dislocation or fracture

  • The elbow can pop out of the joint or can break a bone in the elbow.

Collarbone fracture

  • The force from falling with the hands and arms outstretched can travel up to the collarbone, causing a fracture.

Proximal humeral fracture

  • Falling onto an outstretched hand injury can cause the arm bone to get jammed into the shoulder, causing a proximal humeral fracture.

Shoulder dislocation

  • The shoulder can pop out of the joint.
  • This can cause a rotator cuff tear or labrum injury.

Regardless of the injury, individuals should visit a healthcare provider to evaluate the damage. If the injury is serious, the practitioner can make an accurate or differential diagnosis and develop a treatment plan. (William R. VanWye et al., 2016)

Physical Therapy

Individuals can benefit from physical therapy to help recover and return to their previous level of function. Physical therapy varies depending on the specific injury, but generally, a physical therapist can help individuals return to function after a fall on an outstretched hand. (William R. VanWye et al., 2016) Common treatments can include:

  • Treatments and modalities to decrease pain, inflammation, and swelling.
  • Instruction on how to wear an arm sling properly.
  • Exercises and stretches to improve the range of motion, strength, and functional mobility.
  • Balance exercises.
  • Scar tissue management if surgery was necessary.

The therapy team will ensure the proper treatment is utilized to quickly and safely return to normal activities.


Chiropractic Care For Healing After Trauma


References

Chiu, J., & Robinovitch, S. N. (1998). Prediction of upper extremity impact forces during falls on the outstretched hand. Journal of biomechanics, 31(12), 1169–1176. doi.org/10.1016/s0021-9290(98)00137-7

VanWye, W. R., Hoover, D. L., & Willgruber, S. (2016). Physical therapist screening and differential diagnosis for traumatic-onset elbow pain: A case report. Physiotherapy theory and practice, 32(7), 556–565. doi.org/10.1080/09593985.2016.1219798

Cracked Rib: A Complete Guide on Causes and How to Treat It

Cracked Rib: A Complete Guide on Causes and How to Treat It

Individuals may not realize they have a cracked rib until symptoms like pain when taking in a deep breath begin to present. Can knowing the symptoms and causes of cracked or broken ribs help in diagnosis and treatment?

Cracked Rib: A Complete Guide on Causes and How to Treat It

Cracked Rib

A broken/fractured rib describes any break in the bone. A cracked rib is a type of rib fracture and is more a description than a medical diagnosis of a rib that has been partially fractured. Any blunt impact to the chest or back can cause a cracked rib, including:

  • Falling
  • Vehicle collision
  • Sports injury
  • Violent coughing
  1. The main symptom is pain when inhaling.
  2. The injury typically heals within six weeks.

Symptoms

Cracked ribs are usually caused by a fall, trauma to the chest, or intense violent coughing. Symptoms include:

  • Swelling or tenderness around the injured area.
  • Chest pain when breathing/inhaling, sneezing, laughing, or coughing.
  • Chest pain with movement or when lying down in certain positions.
  • Possible bruising.
  • Although rare, a cracked rib can cause complications like pneumonia.
  • See a healthcare provider immediately if experiencing difficulty breathing, severe chest pain, or a persistent cough with mucus, high fever, and/or chills.

Types

In most cases, a rib usually gets broken in one area, causing an incomplete fracture, which means a crack or break that does not go through the bone. Other types of rib fractures include:

Displaced and Nondisplaced Fractures

  • Completely broken ribs may or may not shift out of place.
  • If the rib does move, this is known as a displaced rib fracture and is more likely to puncture lungs or damage other tissues and organs. (Yale Medicine. 2024)
  • A rib that stays in place usually means the rib is not completely broken in half and is known as a nondisplaced rib fracture.

Flail Chest

  • A section of the ribcage can break away from the surrounding bone and muscle, although this is rare.
  • If this happens, the ribcage will lose stability, and the bone will move freely as the individual inhales or exhales.
  • This broken ribcage section is called a flail segment.
  • This is dangerous as it can puncture the lungs and cause other serious complications, like pneumonia.

Causes

Common causes of cracked ribs include:

  • Vehicle collisions
  • Pedestrian accidents
  • Falls
  • Impact injuries from sports
  • Overuse/Repetitive stress brought on by work or sports
  • Severe coughing
  • Older individuals can experience a fracture from a minor injury due to the progressive loss of bone minerals. (Christian Liebsch et al., 2019)

The Commonality of Rib Fractures

  • Rib fractures are the most common type of bone fracture.
  • They account for 10% to 20% of all blunt trauma injuries seen in emergency rooms.
  • In cases where an individual seeks care for a blunt injury to the chest, 60% to 80% involve a broken rib. (Christian Liebsch et al., 2019)

Diagnosis

A cracked rib is diagnosed with a physical exam and imaging tests. During the examination, a healthcare provider will listen to the lungs, press gently on the ribs, and watch as the rib cage moves. The imaging test options include: (Sarah Majercik, Fredric M. Pieracci 2017)

  • X-rays – These are for detecting recently cracked or broken ribs.
  • CT Scan – This imaging test comprises multiple X-rays and can detect smaller cracks.
  • MRI – This imaging test is for soft tissues and can often detect smaller breaks or cartilage damage.
  • Bone Scan – This imaging test uses a radioactive tracer to visualize the structure of bones and can show smaller stress fractures.

Treatment

In the past, treatment used to involve wrapping the chest with a band known as a rib belt. These are rarely used today as they can restrict breathing, increasing the risk of pneumonia or even a partial lung collapse. (L. May, C. Hillermann, S. Patil 2016). A cracked rib is a simple fracture that requires the following:

  • Rest
  • Over-the-counter or prescription medications can help manage pain symptoms.
  • Nonsteroidal anti-inflammatory drugs – NSAIDs like ibuprofen or naproxen are recommended.
  • If the break is extensive, individuals may be prescribed stronger pain medication depending on the severity and underlying conditions.
  • Physical therapy can expedite the healing process and help maintain the range of motion of the chest wall.
  • For patients who are frail and elderly individuals, physical therapy can help the patient walk and normalize certain functions.
  • A physical therapist can train the individual to transfer between bed and chairs safely while maintaining awareness of any movements or positioning that make the pain worse.
  • A physical therapist will prescribe exercises to keep the body as strong and limber as possible.
  • For example, lateral twists can help improve the range of motion in the thoracic spine.
  1. During the early stages of recovery, it is recommended to sleep in an upright position.
  2. Lying down can add pressure, causing pain and possibly worsen the injury.
  3. Use pillows and bolsters to help support sitting up in bed.
  4. An alternative is to sleep in a reclining chair.
  5. Healing takes at least six weeks. (L. May, C. Hillermann, S. Patil 2016)

Other Conditions

What may feel like a cracked rib may be a similar condition, which is why it’s important to get checked out. Other possible symptom causes can include:

Emergency

The most common complication is being unable to take a deep breath because of the pain. When the lungs cannot breathe deeply enough, mucous and moisture can build up and lead to an infection like pneumonia. (L. May, C. Hillermann, S. Patil 2016). Displaced rib fractures can also damage other tissues or organs, increasing the risk of a collapsed lung/pneumothorax or internal bleeding. It is recommended to seek immediate medical attention if symptoms develop like:

  • Shortness of breath
  • Difficulty breathing
  • A bluish color of the skin caused by lack of oxygen
  • A persistent cough with mucus
  • Chest pain when breathing in and out
  • Fever, sweating, and chills
  • Rapid heart rate

The Power of Chiropractic Care In Injury Rehabilitation


References

Yale Medicine. (2024). Rib fracture (broken rib).

Liebsch, C., Seiffert, T., Vlcek, M., Beer, M., Huber-Lang, M., & Wilke, H. J. (2019). Patterns of serial rib fractures after blunt chest trauma: An analysis of 380 cases. PloS one, 14(12), e0224105. doi.org/10.1371/journal.pone.0224105

May L, Hillermann C, Patil S. (2016). Rib fracture management. BJA Education. Volume 16, Issue 1. Pages 26-32, ISSN 2058-5349. doi:10.1093/bjaceaccp/mkv011

Majercik, S., & Pieracci, F. M. (2017). Chest Wall Trauma. Thoracic surgery clinics, 27(2), 113–121. doi.org/10.1016/j.thorsurg.2017.01.004

Dislocated Elbow: Causes and Treatment Options

Dislocated Elbow: Causes and Treatment Options

A dislocated elbow is a common injury in adults and children and often happens in tandem with bone fractures and nerve and tissue damage. Can physical therapy help to support recovery and ensure range of motion?

Dislocated Elbow: Causes and Treatment Options

Dislocated Elbow Injury

Elbow dislocations are generally caused by trauma when the elbow bones no longer connect. Individuals falling onto an outstretched hand is the most common cause of the injury. (James Layson, Ben J. Best 2023) Healthcare providers will try to relocate the elbow using a closed reduction. Individuals may require surgery if they cannot relocate the elbow using closed reduction.

Resetting The Elbow

The elbow is made up of a hinge and ball-and-socket joint, enabling unique motions: (American Society for Surgery of the Hand. 2021)

Hinge joint

  • The hinge function allows the bending and straightening of the arm.

Ball-and-socket joint

  • The ball-and-socket function allows you to rotate the palm of your hand to face up or face down.

A dislocated elbow injury can damage bones, muscles, ligaments, and tissues. (American Academy of Orthopaedic Surgeons. 2021) The longer the elbow remains out of the joint, the more damage can occur. Elbow dislocations rarely reset into their joints on their own and are recommended to be evaluated by a qualified healthcare provider to prevent permanent damage to nerves or function.

  • It is not recommended to try to reset the elbow on your own.
  • A healthcare provider will work to restore the joint and ensure proper alignment.
  • Before the reset, they will perform a physical examination to assess blood circulation and any nerve damage.
  • Providers will order an imaging scan to examine the dislocation and identify broken bones. (American Academy of Orthopaedic Surgeons. 2021)

Type of Dislocation

The two types of elbow dislocations are: (James Layson, Ben J. Best 2023)

Posterior Dislocation

  • Occurs when there is a significant force on the palm that spreads toward the elbow.
  • Falling with the hands stretched out to catch yourself, and the elbow joint pushes backward/posterior.

Anterior Dislocation

  • This is less common and results from applied force on a flexed elbow.
  • Falling to the ground when the hand is up near the shoulder.
  • In this case, the elbow joint pushes forward/anterior.
  • X-rays are used to determine the type of dislocation and to identify any broken bones. (American Society for Surgery of the Hand. 2021)
  • Depending on the injury, the provider may order a CT scan or MRI to ensure no damage has occurred to nerves or ligaments. (Radiopaedia. 2023)

Signs and Symptoms

A dislocated elbow injury is often caused by trauma. (American Academy of Orthopaedic Surgeons. 2021) General signs and symptoms include: (American Society for Surgery of the Hand. 2021)

  • Inability to move the elbow.
  • Bruising and swelling around the area.
  • Intense pain in the elbow and surrounding area.
  • Deformity around the elbow joint.
  • Numbness, tingling, or weakness in the arm or hand can indicate nerve damage.

Treatment Without Surgery

  • Healthcare providers initially try to treat a dislocated elbow using a closed reduction technique. (American Society for Surgery of the Hand. 2021)
  • A closed reduction means that the elbow can be relocated without surgery.
  • Before the closed reduction, a healthcare provider will administer medications to help relax the individual and address the pain. (Medline Plus. 2022)
  • Once relocated into the correct position, a healthcare provider applies a splint (usually at a 90-degree angle of flexion) to keep the elbow in place. (James Layson, Ben J. Best 2023)
  • The objective is to prevent elbow extension, which can cause re-dislocation.
  • The splint remains in place for one to three weeks. (American Academy of Orthopaedic Surgeons. 2021)
  • A physical therapist will assess motion and prescribe exercises to prevent elbow range of motion loss.

Treatment With Surgery

  1. The elbow remains unstable with a slight extension.
  2. The bones are not correctly aligning.
  3. The ligaments need further repair after a closed reduction.
  • Complex elbow dislocations can make it difficult to maintain joint alignment.
  • An assistive device, like an external hinge, may be recommended to help prevent re-dislocating the elbow.
  • The surgeon will recommend physical therapy after surgery to assist with range-of-motion exercises to optimize and expedite recovery.

Recovery

  • Recovery times can vary as every injury is different. (American Society for Surgery of the Hand. 2021)
  • The recovery time depends on the elbow’s stability after closed reduction or surgery.
  • Healthcare providers will initiate active motion exercises. (American Society for Surgery of the Hand. 2021)
  • Limiting how long the joint is immobilized will prevent stiffness, scarring, and inhibited movement.
  • Healthcare providers don’t recommend immobilization for more than a few weeks.

Resuming Normal Activities

Resuming regular activity often depends on the type of treatment for the elbow dislocation: (Ortho Bullets. 2023)

Closed Reduction

  • The elbow is splinted for five to ten days.
  • Individuals may engage in physical therapy early motion activity to help prevent loss of range of motion.
  • Individuals are recommended to do light exercises within two weeks after the injury.

Surgical Reduction

  • The elbow may be placed in a brace that allows for a gradual increase in motion.
  • It is essential to maintain controlled movement to prevent motion loss.
  • The elbow can extend fully within six to eight weeks, although it could take up to five months for complete restoration.
  • The healthcare provider will determine when it’s safe to resume normal activity.

The Path to Healing Personal Injury


References

Layson J, Best BJ. Elbow Dislocation. [Updated 2023 Jul 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK549817/

American Society for Surgery of the Hand. (2021). Elbow dislocation.

American Academy of Orthopaedic Surgeons. (2023). Elbow dislocation.

Jones J, Carroll D, El-Feky M, et al. (2023). Elbow dislocation. Reference article, Radiopaedia.org  doi.org/10.53347/rID-10501

Medline Plus. (2022). Closed reduction of a fractured bone.

Ortho Bullets. (2023). Elbow dislocation.

Understand Turf Toe Injury: Symptoms, Treatment, and Recovery

Understand Turf Toe Injury: Symptoms, Treatment, and Recovery

For individuals experiencing a turf toe injury, can knowing the symptoms help athletes and non-athletes with treatment, recovery time, and returning to activities?

Understand Turf Toe Injury: Symptoms, Treatment, and Recovery

Turf Toe Injury

A turf toe injury affects the soft tissue ligaments and tendons at the base of the big toe under the foot. This condition usually occurs when the toe is hyperextended/forced upward, such as when the ball of the foot is on the ground and the heel is lifted. (American Academy of Orthopaedic Surgeons. 2021) The injury is common among athletes who play sports on artificial turf, which is how the injury got its name. However, it can also affect non-athletes, like individuals working on their feet all day.

  • Recovery time after turf toe injury depends on the severity and the type of activities the individual plans to return to.
  • Returning to high-level sports activities after a severe injury can take six months.
  • These injuries vary in severity but usually improve with conservative treatment. In severe cases, surgery could be required.
  • Pain is the primary issue that stops physical activities after a grade 1 injury, while grades 2 and 3 can take weeks to months to heal completely.

Meaning

A turf toe injury refers to a metatarsophalangeal joint strain. This joint comprises ligaments that connect the bone on the sole of the foot, below the big toe/proximal phalanx, to the bones that connect the toes to the larger bones in the feet/metatarsals. The injury is usually caused by hyperextension that often results from a pushing-off motion, like running or jumping.

Grading

Turf toe injuries can range from mild to severe and are graded as follows: (American Academy of Orthopaedic Surgeons. 2021)

  • Grade 1 – The soft tissue is stretched, causing pain and swelling.
  • Grade 2 – The soft tissue is partially torn. Pain is more pronounced, with significant swelling and bruising, and it is difficult to move the toe.
  • Grade 3 – Soft tissue is completely torn, and symptoms are severe.

Is This What’s Causing My Foot Pain?

Turf toe can be an:

  • Overuse injury – caused by repeating the same motion repeatedly for an extended period, that causes symptoms to worsen.
  • Acute injury – that occurs suddenly, causing immediate pain.

Symptoms can include the following: (Mass General Brigham. 2023)

  • Limited range-of-motion.
  • Tenderness in the big toe and surrounding area.
  • Swelling.
  • Pain in the big toe and surrounding area.
  • Bruising.
  • Loose joints can indicate there is a dislocation.

Diagnosis

If experiencing turf toe symptoms, see a healthcare provider for a proper diagnosis so they can develop a personalized treatment plan. They will perform a physical exam to assess pain, swelling, and range of motion. (American Academy of Orthopaedic Surgeons. 2021) If the healthcare provider suspects tissue damage, they may recommend imaging with X-rays and (MRI) to grade the injury and determine the proper course of action.

Treatment

A healthcare provider will determine the best treatment based on the severity of the injury. All turf toe injuries can benefit from the RICE protocol: (American College of Foot and Ankle Surgeons. Foot Health Facts. 2023)

  1. Rest – Avoid activities that worsen symptoms. This can include using an assistive device like a walking boot or crutches to reduce pressure.
  2. Ice – Apply ice for 20 minutes, then wait 40 minutes before reapplying.
  3. Compression – Wrap the toe and foot with an elastic bandage to support and reduce swelling.
  4. Elevation – Prop the foot above the level of the heart to help decrease swelling.

Grade 1

Grade 1 turf toe is classified by stretched soft tissue, pain, and swelling. Treatments can include: (Ali-Asgar Najefi et al., 2018)

  • Taping to support the toe.
  • Wearing shoes with a rigid sole.
  • Orthotic support, like a turf toe plate.

Grades 2 and 3

Grades 2 and 3 come with partial or complete tissue tearing, severe pain, and swelling. Treatments for more severe turf toe can include: (Ali-Asgar Najefi et al., 2018)

  • Limited weight bearing
  • Using assistive devices like crutches, a walking boot, or a cast.

Other Treatment

  • Less than 2% of these injuries require surgery. It is usually recommended if there is instability in the joint or when conservative treatments are unsuccessful. (Ali-Asgar Najefi et al., 2018) (Zachariah W. Pinter et al., 2020)
  • Physical therapy is beneficial for decreasing pain and improving the range of motion and strength after injury. (American Academy of Orthopaedic Surgeons. 2021)
  • Physical therapy also includes proprioception and agility training exercises, orthotics, and wearing recommended shoes for specific physical activities. (Lisa Chinn, Jay Hertel. 2010)
  • A physical therapist can also help ensure that the individual does not return to physical activities before the injury is fully healed and prevent the risk of re-injury.

Recovery Time

Recovery depends on injury severity. (Ali-Asgar Najefi et al., 2018)

  • Grade 1 – Subjective as it varies depending on the individual’s pain tolerance.
  • Grade 2 – Four to six weeks of immobilization.
  • Grade 3 – Eight weeks minimum of immobilization.
  • It can take up to six months to return to normal function.

Returning To Normal Activities

After a grade 1 turf toe injury, individuals can return to normal activities once the pain is under control. Grades 2 and 3 take longer to heal. Returning to sports activities after a grade 2 injury can take around two or three months, while grade 3 injuries and cases that require surgery can take up to six months. (Ali-Asgar Najefi et al., 2018)


Sports Chiropractic Treatment


References

American Academy of Orthopaedic Surgeons. (2021). Turf toe.

Mass General Brigham. (2023). Turf toe.

American College of Foot and Ankle Surgeons. Foot Health Facts. (2023). RICE protocol.

Najefi, A. A., Jeyaseelan, L., & Welck, M. (2018). Turf toe: A clinical update. EFORT open reviews, 3(9), 501–506. doi.org/10.1302/2058-5241.3.180012

Pinter, Z. W., Farnell, C. G., Huntley, S., Patel, H. A., Peng, J., McMurtrie, J., Ray, J. L., Naranje, S., & Shah, A. B. (2020). Outcomes of Chronic Turf Toe Repair in Non-athlete Population: A Retrospective Study. Indian journal of orthopaedics, 54(1), 43–48. doi.org/10.1007/s43465-019-00010-8

Chinn, L., & Hertel, J. (2010). Rehabilitation of ankle and foot injuries in athletes. Clinics in sports medicine, 29(1), 157–167. doi.org/10.1016/j.csm.2009.09.006

Massage Gun Head Attachments

Massage Gun Head Attachments

Massage guns can help relieve aching muscles and prevent soreness when used before and after physical activity, work, school, and exercise. They provide massage therapy benefits by targeting muscles with rapid burst pulses. Massage guns can be percussive or vibration-based. Percussive therapy helps increase blood flow to a targeted area, which reduces inflammation and muscle tension, and breaks up knots/trigger points that may have formed in the tissues from added stress or intense physical activity. One of the benefits is that they come with interchangeable massage gun head attachments that target different muscle groups and provide different types of massage. There are many types of interchangeable massage heads, we go over the most common to give a general idea of how they work. If experiencing joint pain, injury, acute muscle pain, or other musculoskeletal disorders, make sure to get clearance from a doctor before using a massage gun.

Massage Gun Head Attachments

Massage Gun Head Attachments

The variations of attachments/heads are designed and shaped differently to effectively apply the right amount of pressure to rejuvenate the body’s pressure points, soothe tissues, and release tight and sore muscles. The different heads are designed with a distinctive purpose based on the muscle groups targeted. This maximizes effectiveness and ensures maximum comfort and safety.

Ball Head

  • The ball attachment is for overall muscle recovery.
  • It provides a broad surface area and mimics the hands of a skilled massage therapist, delivering a soothing kneading sensation.
  • Made of durable material, the ball massage head can reach deep into the muscles.
  • Its round shape makes it more flexible to use anywhere, especially the large muscle groups like the quads and glutes.

U/Fork Shaped Head

  • A plastic, dual-pronged head also known as a fork head.
  • The attachment provides relief to areas like the shoulders, spine, neck, calves, and Achilles tendon.

Bullet Head

  • The plastic head is named as such because of its pointed shape.
  • This is recommended for tightness and discomfort in the joints, deep tissues, trigger points, and/or small muscle areas like the feet and wrist.

Flat Head

  • The multipurpose flat head is for full-body general massage.
  • It helps relieve stiffness and pain for total body muscle relaxation, including muscle groups closer to bone joints.

Shovel-Shaped Head

  • The shovel-shaped head is for the abdominal muscles and lower back.
  • The attachment provides stimulation to release stiff muscles.

Using The Right Head

Which head to use depends on the individual’s specific needs and preferences. Consider the following factors when selecting a massage gun head:

Targeted Areas

  • Identify the body areas requiring the most attention.
  • If muscle tightness or soreness is occurring in larger muscle groups, like the back or legs, the ball attachment is recommended.
  • For more precise areas like trigger points, the bullet head is recommended.
  • Heads can be used in conjunction – for example, a large surface area head is used to relax and loosen and relax a general area, then a more precise head is used to focus the massage on the actual tight spot or trigger point.

Massage Intensity

  • Massage intensity levels can be varied from a light massage to full force.
  • For a softer touch on sensitive muscles, flat head or forkhead attachments are recommended.
  • For deep muscle penetration and consistent pressure, the bullet head or shovel head attachments are recommended.

Specific Conditions

  • Consider any specific conditions or injuries previous and current.
  • For individuals recovering from an injury or with sensitive areas, it’s important to choose a massage gun head that provides the necessary relief without causing discomfort or worsening an injury.

Try Out Different Heads and Settings

  • Experiment with different massage head attachments and speeds to find the one that works best for the intended purpose.
  • Explore each to discover personal preferences.
  • Start with the lowest setting and gradually increase, based on comfort level.
  • Always consult with a qualified healthcare provider regarding any medical concerns before using a massage gun.

Choosing The Right Massage Head Attachment


References

Bergh, Anna, et al. “A Systematic Review of Complementary and Alternative Veterinary Medicine in Sport and Companion Animals: Soft Tissue Mobilization.” Animals: an open access journal from MDPI vol. 12,11 1440. 2 Jun. 2022, doi:10.3390/ani12111440

Imtiyaz, Shagufta, et al. “To Compare the Effect of Vibration Therapy and Massage in Prevention of Delayed Onset Muscle Soreness (DOMS).” Journal of Clinical and diagnostic research: JCDR vol. 8,1 (2014): 133-6. doi:10.7860/JCDR/2014/7294.3971

Konrad, Andreas, et al. “The Acute Effects of a Percussive Massage Treatment with a Hypervolt Device on Plantar Flexor Muscles’ Range of Motion and Performance.” Journal of sports science & medicine vol. 19,4 690-694. 19 Nov. 2020

Leabeater, Alana et al. “Under the Gun: The effect of percussive massage therapy on physical and perceptual recovery in active adults.” Journal of athletic training, 10.4085/1062-6050-0041.23. 26 May. 2023, doi:10.4085/1062-6050-0041.23

Lupowitz, Lewis. “Vibration Therapy – A Clinical Commentary.” International journal of sports physical therapy vol. 17,6 984-987. 1 Aug. 2022, doi:10.26603/001c.36964

Yin, Yikun, et al. “The effect of vibration training on delayed muscle soreness: A meta-analysis.” Medicine vol. 101,42 (2022): e31259. doi:10.1097/MD.0000000000031259