Back Clinic Sports Injuries Chiropractic and Physical Therapy Team. Athletes from all sports can benefit from chiropractic treatment. Adjustments can help treat injuries from high-impact sports i.e. wrestling, football, and hockey. Athletes that get routine adjustments may notice improved athletic performance, improved range of motion along with flexibility, and increased blood flow. Because spinal adjustments will reduce the irritation of the nerve roots between the vertebrae, the healing time from minor injuries can be shortened, which improves performance. Both high-impact and low-impact athletes can benefit from routine spinal adjustments.
For high-impact athletes, it increases performance and flexibility and lowers the risk for injury for low-impact athletes i.e. tennis players, bowlers, and golfers. Chiropractic is a natural way to treat and prevent different injuries and conditions that impact athletes. According to Dr. Jimenez, excessive training or improper gear, among other factors, are common causes of injury. Dr. Jimenez summarizes the various causes and effects of sports injuries on the athlete as well as explaining the types of treatments and rehabilitation methods that can help improve an athlete’s condition. For more information, please feel free to contact us at (915) 850-0900 or text to call Dr. Jimenez personally at (915) 540-8444.
Individuals who participate in physical and sports activities could suffer an Achilles tendon tear. Can understanding the symptoms and risks help in treatment and return the individual back to their sports activity sooner?
This is a common injury that occurs when the tendon attaching the calf muscle to the heel gets torn.
About the Tendon
The Achilles tendon is the largest tendon in the body.
In sports and physical activities, intense explosive movements like running, sprinting, quickly shifting positions, and jumping are exerted on the Achilles.
Fluoroquinolone antibiotics are commonly used for the treatment of respiratory infections, urinary tract infections, and bacterial infections. These antibiotics are associated with Achilles tendon rupture, but further research is needed to determine how they affect the Achilles tendon. Individuals taking these medications are advised to consider an alternative medication if Achilles tendon problems begin to develop. (Anne L. Stephenson et al., 2013)
Depending on the severity of the injury, treatment can consist of non-surgical techniques or surgery.
The benefit of surgery is there is usually less immobilization.
Individuals can often return to sports activities sooner, and there is less chance of re-rupturing the tendon.
Thevendran, G., Sarraf, K. M., Patel, N. K., Sadri, A., & Rosenfeld, P. (2013). The ruptured Achilles tendon: a current overview from biology of rupture to treatment. Musculoskeletal surgery, 97(1), 9–20. doi.org/10.1007/s12306-013-0251-6
Stephenson, A. L., Wu, W., Cortes, D., & Rochon, P. A. (2013). Tendon Injury and Fluoroquinolone Use: A Systematic Review. Drug safety, 36(9), 709–721. doi.org/10.1007/s40264-013-0089-8
Yasui, Y., Tonogai, I., Rosenbaum, A. J., Shimozono, Y., Kawano, H., & Kennedy, J. G. (2017). The Risk of Achilles Tendon Rupture in the Patients with Achilles Tendinopathy: Healthcare Database Analysis in the United States. BioMed research international, 2017, 7021862. doi.org/10.1155/2017/7021862
For individuals into sports, fitness enthusiasts, and those that engage in physical activities, musculoskeletal injuries are common. Can using ice tape help during the initial or acute phase of injury decrease inflammation and swelling to expedite recovery and return to activities sooner?
After a musculoskeletal injury, individuals are recommended to follow the R.I.C.E. method to help reduce swelling and inflammation. R.I.C.E. is the acronym for Rest, Ice, Compression, and Elevation. (Michigan Medicine. University of Michigan. 2023) The cold helps to decrease pain, lower tissue temperature, and decrease swelling around the site of the injury. By controlling the inflammation with ice and compression early after injury, individuals can maintain the appropriate range of motion and mobility around the injured body part. (Jon E. Block. 2010) There are different ways to apply ice to an injury.
Store-bought ice bags and cold packs.
Soaking the injured body part in a cold whirlpool or tub.
Making reusable ice packs.
A compression bandage can be used together with the ice.
Ice Tape is a compression bandage that provides cold therapy all at once. After an injury, applying it can help decrease the pain and swelling during the acute inflammatory phase of healing. (Matthew J. Kraeutler et al., 2015)
How The Tape Works
The tape is a flexible bandage that is infused with therapeutic cooling gel. When applied to an injured body part and exposed to air, the gel activates, generating a cold sensation around the area. The therapeutic medicinal effect can last five to six hours. Combined with a flexible bandage, it provides ice therapy and compression. The ice tape can be used straight out of the package but can also be stored in the refrigerator to increase the cold effect. Depending on the maker’s instructions, the tape should not be stored in the freezer as this can make it too hard to wrap around the injured area.
The benefits include the following:
Easy to Use
The product is easy to use.
Take out the tape, and start wrapping it around the injured body part.
Fasteners Not Required
The wrap sticks to itself, so the tape stays in place without using clips or fasteners.
Easy to Cut
The standard roll is 48 inches long by 2 inches wide.
Most injuries require enough to wrap around the injured area.
Scissors cut the exact amount needed, and store the rest in the resealable bag.
After 15 to 20 minutes of application, the product can be easily removed, rolled up, stored in the bag, and used again.
The tape can be used multiple times.
The tape begins to lose its cooling quality after several uses.
The tape does not need to be placed in a cooler when traveling.
It is easily portable and perfect for a quick ice and compression application immediately after an injury.
It can decrease pain and inflammation and kept at the workplace.
A few disadvantages include the following:
The gel on the flexible wrap can have a medicine odor.
It is not quite as powerful smelling as pain creams, but the chemical odor could bother some individuals.
Might Not Be Cold Enough
The tape works for immediate pain relief and inflammation, but it may not get cold enough for the user when applied right from the package at room temperature.
However, it can be placed in a refrigerator to increase the coldness and may provide a more therapeutic cooling effect, especially for those dealing with tendinitis or bursitis.
Stickiness Could Be Distracting
The tape could be a bit sticky for some.
This sticky factor can be a minor annoyance.
However, it just feels sticky when being applied.
A couple of flecks of the gel may get left behind when removed.
The ice tape can also stick to clothing.
For individuals looking for a quick, on-the-go cooling therapy for injured or aching body parts, ice tape may be an option. It could be good to have on hand to provide cooling compression if a minor injury occurs while participating in athletics or physical activities and relief for overuse or repetitive strain injuries.
Block J. E. (2010). Cold and compression in the management of musculoskeletal injuries and orthopedic operative procedures: a narrative review. Open access journal of sports medicine, 1, 105–113. doi.org/10.2147/oajsm.s11102
Kraeutler, M. J., Reynolds, K. A., Long, C., & McCarty, E. C. (2015). Compressive cryotherapy versus ice-a prospective, randomized study on postoperative pain in patients undergoing arthroscopic rotator cuff repair or subacromial decompression. Journal of shoulder and elbow surgery, 24(6), 854–859. doi.org/10.1016/j.jse.2015.02.004
For individuals experiencing a turf toe injury, can knowing the symptoms help athletes and non-athletes with treatment, recovery time, and returning to activities?
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.
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.
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.
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
American Academy of Orthopaedic Surgeons. (2021). Turf toe.
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
Athletes and physically active individuals who participate in activities, exercises, and sports that involve kicking, pivoting, and/or shifting directions can develop pelvis overuse injury of the pubic symphysis/joint at the front of the pelvis known as osteitis pubis. Can recognizing the symptoms and causes help in treatment and prevention?
Osteitis Pubis Injury
Osteitis pubis is the inflammation of the joint that connects the pelvic bones, called the pelvic symphysis, and the structures around it. The pubic symphysis is a joint in front of and below the bladder. It holds the two sides of the pelvis together in the front. The pubis symphysis has very little motion, but when abnormal or continued stress is placed on the joint, groin and pelvic pain can present. An osteitis pubis injury is a common overuse injury in physically active individuals and athletes but can also occur as the result of physical trauma, pregnancy, and/or childbirth.
The most common symptom is pain over the front of the pelvis. The pain is most often felt in the center, but one side may be more painful than the other. The pain typically radiates/spreads outward. Other signs and symptoms include: (Patrick Gomella, Patrick Mufarrij. 2017)
Lower abdominal pain in the center of the pelvis
Hip and/or leg weakness
Difficulty climbing stairs
Pain when walking, running, and/or shifting directions
Clicking or popping sounds with movement or when shifting directions
Pain when lying down on the side
Pain when sneezing or coughing
Osteitis pubis can be confused with other injuries, including a groin strain/groin pull, a direct inguinal hernia, ilioinguinal neuralgia, or a pelvic stress fracture.
An osteitis pubis injury usually occurs when the symphysis joint is exposed to excessive, continued, directional stress and overuse of the hip and leg muscles. Causes include: (Patrick Gomella, Patrick Mufarrij. 2017)
Pregnancy and childbirth
Pelvic injury like a severe fall
The injury is diagnosed based on a physical examination and imaging tests. Other tests may be used to rule out other possible causes.
The physical exam will involve manipulation of the hip to place tension on the rectus abdominis trunk muscle and adductor thigh muscle groups.
Pain during the manipulation is a common sign of the condition.
Individuals may be asked to walk to look for irregularities in gait patterns or to see if symptoms occur with certain movements.
X-rays will typically reveal joint irregularities as well as sclerosis/thickening of the pubic symphysis.
Magnetic resonance imaging – MRI may reveal joint and surrounding bone inflammation.
Some cases will show no signs of injury on an X-ray or MRI.
Effective treatment can take several months or longer. Because inflammation is the underlying cause of symptoms, the treatment will often involve: (Tricia Beatty. 2012)
Allows the acute inflammation to subside.
During recovery, sleeping flat on the back may be recommended to reduce pain.
Ice and Heat Applications
Ice packs help reduce inflammation.
The heat helps ease pain after the initial swelling has gone down.
Over-the-counter nonsteroidal anti-inflammatory medications – NSAIDs like ibuprofen and naproxen can reduce pain and inflammation.
Assistive Walking Devices
If the symptoms are severe, crutches or a cane may be recommended to reduce stress on the pelvis.
There have been attempts to treat the condition with cortisone injections, but the evidence supporting its use is limited and needs further research. (Alessio Giai Via, et al., 2019)
Once diagnosed, the prognosis for full recovery is optimal but can take time. It can take some individuals six months or more to return to pre-injury level of function, but most return by around three months. If conservative treatment fails to provide relief after six months, surgery could be recommended. (Michael Dirkx, Christopher Vitale. 2023)
Sports Injuries Rehabilitation
Gomella, P., & Mufarrij, P. (2017). Osteitis pubis: A rare cause of suprapubic pain. Reviews in urology, 19(3), 156–163. doi.org/10.3909/riu0767
Via, A. G., Frizziero, A., Finotti, P., Oliva, F., Randelli, F., & Maffulli, N. (2018). Management of osteitis pubis in athletes: rehabilitation and return to training – a review of the most recent literature. Open access journal of sports medicine, 10, 1–10. doi.org/10.2147/OAJSM.S155077
Dirkx M, Vitale C. Osteitis Pubis. [Updated 2022 Dec 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK556168/
The Q or quadriceps angle is a measurement of pelvic width that is believed to contribute to the risk of sports injuries in women athletes. Can non-surgical therapies and exercises help rehabilitate injuries?
Quadriceps Q – Angle Injuries
The Q angle is the angle where the femur/upper leg bone meets the tibia/lower leg bone. It is measured by two intersecting lines:
One from the center of the patella/kneecap to the anterior superior iliac spine of the pelvis.
The other is from the patella to the tibial tubercle.
On average the angle is three degrees higher in women than men.
Women have biomechanical differences that include a wider pelvis, making it easier to give birth. However, this difference can contribute to knee injuries when playing sports, as an increased Q angle generates more stress on the knee joint, as well as leading to increased foot pronation.
Various factors can increase the risk of injury, but a wider Q angle has been linked to the following conditions.
Patellofemoral Pain Syndrome
An increased Q angle can cause the quadriceps to pull on the kneecap, shifting it out of place and causing dysfunctional patellar tracking.
With time, this can cause knee pain (under and around the kneecap), and muscle imbalance.
Foot orthotics and arch supports could be recommended.
The vastus medialis obliquus or VMO is a teardrop-shaped muscle that helps move the knee joint and stabilize the kneecap.
Strengthening the muscle can increase the stability of the knee joint.
Strengthening may require a specific focus on muscle contraction timing.
Closed-chain exercises like wall squats are recommended.
Glute strengthening will improve stability.
Stretching tight muscles will help relax the injured area, increase circulation, and restore range of motion and function.
Muscles commonly found to be tight include the quadriceps, hamstrings, iliotibial band, and gastrocnemius.
Custom-made, flexible orthotics decrease the Q angle and reduce pronation, relieving the added stress on the knee.
A custom orthotic ensures that the foot and leg dynamics are accounted for and corrected.
Motion-control shoes can also help correct overpronation.
Khasawneh, R. R., Allouh, M. Z., & Abu-El-Rub, E. (2019). Measurement of the quadriceps (Q) angle with respect to various body parameters in young Arab population. PloS one, 14(6), e0218387. doi.org/10.1371/journal.pone.0218387
Petersen, W., Ellermann, A., Gösele-Koppenburg, A., Best, R., Rembitzki, I. V., Brüggemann, G. P., & Liebau, C. (2014). Patellofemoral pain syndrome. Knee surgery, sports traumatology, arthroscopy: Official journal of the ESSKA, 22(10), 2264–2274. doi.org/10.1007/s00167-013-2759-6
Vaienti, E., Scita, G., Ceccarelli, F., & Pogliacomi, F. (2017). Understanding the human knee and its relationship to total knee replacement. Acta bio-medica : Atenei Parmensis, 88(2S), 6–16. doi.org/10.23750/abm.v88i2-S.6507
Mitani Y. (2017). Gender-related differences in lower limb alignment, range of joint motion, and the incidence of sports injuries in Japanese university athletes. Journal of Physical Therapy Science, 29(1), 12–15. doi.org/10.1589/jpts.29.12
Nessler, T., Denney, L., & Sampley, J. (2017). ACL Injury Prevention: What Does Research Tell Us? Current reviews in musculoskeletal medicine, 10(3), 281–288. doi.org/10.1007/s12178-017-9416-5
Sports activities will result in aches, pains, and injuries that need to be examined by a doctor or specialist for proper diagnosis and treatment. Finding the right sports injury specialist can be one of the most difficult parts of dealing with an injury. The following may help when deciding if a sports chiropractic specialist can help.
Sports Injury Specialist
Sports medicine is the study and practice of medical principles related to the science of sports:
Injury diagnosis and treatment
Sports medicine focuses on the medical and therapeutic aspects of sports physical activity. These individuals can be physicians, surgeons, chiropractors, physical therapists, or providers who regularly work with athletes. Athletes often prefer providers with athletic treatment experience.
Doctor To See First for a Sports Injury
Individuals that belong to an HMO or PPO may find that their primary care physician is the first doctor to see for injury.
A family doctor may not be a sports medicine specialist but may have the expertise to deal with the injury.
Minor musculoskeletal injuries like acute sprains and strains respond well to immediate standard treatments like rest, ice, compression, and elevation.
Individuals with complicated overuse or training injuries, chronic conditions such as tendonitis, or who require surgery will be referred to a specialist.
Family Doctor Treatment
Nearly all family practice physicians can diagnose and treat various sports-related injuries.
Other non-traditional methods to treat conditions and illnesses.
Some may have specific experience in treating sports-related injuries.
Finding the Right Specialist
It is important to find a doctor who can design a treatment plan to heal and rehabilitate the injury properly and get the athlete back to their sport quickly and safely. Medicine is science and art, and injury treatment should be personalized to specific goals of healing and performance. When selecting a healthcare provider to treat injuries or provide advice, personal recommendations from trusted sources are recommended to screen providers. As well as asking other athletes, local teams, gyms, athletic clubs, and healthcare organizations can direct individuals in the right direction. If you can’t find a confident recommendation, look for a certified sports medicine physician online or call the clinic. When calling the office, questions to think about include:
What is your treatment specialty?
What experience do you have treating athletes?
What special training do you have in sports injury care?
What degrees and certifications do you have?
How I Tore My ACL
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Gymnastics is a demanding and challenging sport. Gymnasts train to be powerful and graceful. Today’s moves have become increasingly technical acrobatic moves with a much higher degree of risk and difficulty. All the stretching, bending, twisting, jumping, flipping, etc., increases the risk of neuromusculoskeletal injuries. Gymnastics injuries are inevitable. Bruises, cuts, and scrapes are common, as are overuse strains and sprains, but severe and traumatic injuries can occur. Injury Medical Chiropractic and Functional Medicine Team can treat and rehabilitate injuries and help to strengthen and prevent injuries. The therapy team will thoroughly evaluate the individual to determine the injury/s severity, identify any weaknesses or limitations, and develop a personalized plan for optimal recovery, stability, and strength.
One of the main reasons injuries are more prevalent is because today’s athletes start earlier, spend more time practicing, perform more complex skill sets, and have higher levels of competition. Gymnasts learn to perfect a skill and then train to make their bodies look elegant while executing the routine. These moves require precision, timing, and hours of practice.
Sports injuries are classified as:
Chronic Overuse injuries: These cumulative aches and pains occur over time.
They can be treated with chiropractic and physical therapy and prevented with targeted training and recovery.
Acute Traumatic injuries: These are typically accidents that happen suddenly without warning.
These require immediate first aid.
Most Common Injuries
Gymnasts are taught how to fall and land to lessen the impact on the spine, head, neck, knees, ankles, and wrists.
Strength and/or flexibility imbalances – one side is stronger.
Our therapists will start with an evaluation and a biomechanical assessment to identify all the factors contributing to the injury. This will consist of a thorough medical history to understand overall health status, training schedule, and the physical demands on the body. The chiropractor will develop a comprehensive program that includes manual and tool-assisted pain relief techniques, mobilization work, MET, core strengthening, targeted exercises, and injury prevention strategies.
Facet Syndrome Chiropractic Treatment
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Farì, Giacomo, et al. “Musculoskeletal Pain in Gymnasts: A Retrospective Analysis on a Cohort of Professional Athletes.” International journal of environmental research and public health vol. 18,10 5460. 20 May. 2021, doi:10.3390/ijerph18105460
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