Back Clinic Health Team. The level of functional and metabolic efficiency of a living organism. In humans, it is the ability of individuals or communities to adapt and self-manage when facing physical, mental, psychological, and social changes in an environment. Dr.Alex Jimenez D.C., C.C.S.T, a clinical pain doctor who uses cutting-edge therapies and rehabilitation procedures focused on total health, strength training, and complete conditioning. We take a global functional fitness treatment approach to regain complete functional health.
Dr. Jimenez presents articles both from his own experience and from a variety of sources that pertain to a healthy lifestyle or general health issues. I have spent over 30+ years researching and testing methods with thousands of patients and understand what truly works. We strive to create fitness and better the body through researched methods and total health programs.
These programs and methods are natural and use the body’s own ability to achieve improvement goals, rather than introducing harmful chemicals, controversial hormone replacement, surgery, or addictive drugs. As a result, individuals live a fulfilled life with more energy, a positive attitude, better sleep, less pain, proper body weight, and education on maintaining this way of life.
Dr. Alex Jimenez, D.C., presents how stress can impact many individuals and correlate with many conditions in the body in this 2-part series. We refer our patients to certified medical providers who provide multiple available treatments for many people suffering from hypertension associated with the cardiovascular, endocrine, and immune systems affecting the body. We encourage each of our patients by mentioning them to associated medical providers based on their analysis appropriately. We understand that education is a delightful way when asking our providers questions at the patient’s request and understanding. Dr. Jimenez, D.C., only uses this information as an educational service. Disclaimer
How Stress Impacts the Body
Dr. Alex Jimenez, D.C., presents: Now everyone responds to changes in the environment differently. When it comes to many individuals doing everyday activities from working at their job, opening on the weekends, traffic jams, taking exams, or preparing for a big speech, the body goes through a constant state of hyperreactive to a stage of emotional, mental exhaustion that leaves the individual to be exhausted and stressed out. And the key is to recognize this before it happens, as we see this impact of stress on our patients and ourselves. And the first thing to realize is what the initiating event is causing this impact.
Whatever the initiating event, the most important part is our perception of the event. What does it mean to us? Is it our perception? When the body goes through this initiating event, it can cause the perception to lead to the response and the effect on our body. So perception is everything as we talk about stress and the stress response. Now, we have over 1400 chemical reactions that occur in the body. So for this talk’s purpose, we’ll discuss the three key ones: adrenaline and neuro-adrenaline, aldosterone, and of course, cortisol.
And why are these important? Because every one of these has a huge impact on cardiovascular disease. Now, in the 1990s, many doctors were starting to understand the effect of stress on the physical body. And what happens to people when their HPA-axis signals that they are under threat and start flooding their bodies with stress hormones? Well, we see enhanced coagulation. We see a shift in the renin and angiotensin system. It revs up. We see weight gain in people and insulin resistance. What a lot of people don’t realize is that lipids become abnormal with stress. Almost every one of our patients knows that tachycardia and arrhythmia occur when our adrenaline is flowing, and our blood pressure increases. Now, think about this through the language of medicine.
Around the 1990s, doctors were giving aspirin and Plavix at the time for coagulation. We continue to provide ACEs and ARBs to our patients. The impact of cortisol causes weight gain and insulin resistance. We give statins; we give metformin. We provide beta blockers for that, tachycardia, and calcium blockers for that high blood pressure. So every single hormone that gets turned on with stress, we have a drug that we’re using to balance that. And quite frankly, for years, we talked about how good beta blockers were for the heart. Well, when you think about that, beta blockers do block adrenaline. So when doctors look at this, they begin to think, “Well, maybe we need to medicate and meditate, right? We’re using all these drugs, but we may need to look at other ways to transform the stress response.”
What is Vasoconstriction?
Dr. Alex Jimenez, D.C., presents: We won’t read every one of these symptoms because there are so many, but it all comes down to the same thing. Stress. We have to think of someone who’s in an auto accident, for example, and that person is bleeding. So the body is beautiful in that it puts together a way to stop the individual from bleeding or vasoconstriction. Vasoconstriction is constructing these blood vessels and making the platelets sticky so they form a clot, and the blood can stop. This increases the cardiac output by raising the heart rate and increases aldosterone, which causes salt and water retention to raise the blood pressure. So for someone in a medical emergency, like an accident, bleeding, or losing volume, this is the beauty of the human body. But unfortunately, we see people living this way, literally 24/7. So we know the vasoconstriction and the platelet stickiness, and we see increases in markers for inflammation, homocysteine, CRP, and fibrinogen, all of which increase cardiovascular risk.
We see the impact of cortisol, not only raising blood pressure, not only causing diabetes and insulin resistance, but also depositing abdominal fat around the midline. And then, as you’ll see in a few minutes, there are links between stressful events and arrhythmias like atrial fibrillation and even ventricular fibrillation. For the first time in medicine, in cardiology, we have a syndrome called takosubo cardiomyopathy, which is affectionately called broken heart syndrome. And this is a syndrome in which the myocardium becomes acutely stunned to the point of causing severe left ventricular function or dysfunction. And usually, this is triggered by bad news and an emotionally stressful event. It looks like someone needs a heart transplant. So when we think about the old Framingham risk factors, we say, which of these are impacted by stress?
Symptoms of Stress
Dr. Alex Jimenez, D.C., presents: People have all sorts of maladaptive behaviors to stress, whether 20 friends in this pack of cigarettes, eating this Cinnabon because it makes me feel good right now, or all the cortisol will make me fat and diabetic. Lipids go up under stress; blood pressure goes up under stress. So every one of these risk factors is impacted by stress hormones. And, of course, we know that with the turning on of the RAS system or the renin-angiotensin system, we always see a worsening in heart failure. And this is very much described in the literature. And, for those of you who may work in the emergency room, ask your patients what they were doing before coming in with their episode of congestive heart failure or chest pain. And you’re going to hear stories like, I was watching a bad movie, or I was watching a war movie, or I got upset over the football game, or something like that.
We’ll talk about heart rate variability, which gets impacted by stress. And, of course, stress affects our ability to resist infections. And we know that people are under stress when they’re vaccinated. For example, Cleco lasers work but don’t produce antibodies to the vaccine when they’re under stress. And, of course, as you’ll see in a minute, severe stress can cause sudden cardiac death, MI, and so on. So it is a bad player that’s overlooked. And for many of our patients, stress drives the train. So when we’re talking about eating brussels sprouts and cauliflower and, you know, lots of green leafy vegetables, and someone is under so much stress that they’re trying to figure out, “How am I going to get through the day?” They’re not hearing any of the other things that we’re recommending.
So, chronic stress and affective disorders, whether depression, anxiety, or panic, put our foot on the accelerator and rev up the sympathetic nervous system. We know that the same things we see with aging, as you’ll see in a minute, are linked to increased levels of stress hormones, especially cortisol. So whether it’s osteoporosis, decreased bone density, endothelial dysfunction, platelet activation, hypertension, central obesity, or insulin resistance, this comes from a stress response. And we have to have a plan for our patients on how to handle this. American Institute of Stress says that 75 to 90% of all healthcare provider visits result from stress-related disorders. And that’s way too high, but by looking at the patients and where they were coming in with, they tell their stories to their doctors. The results are the same; it doesn’t matter whether it was headaches, muscle tension, angina, arrhythmia, or irritable bowel; it almost always had some stress trigger.
Acute & Chronic Stress
Dr. Alex Jimenez, D.C., presents: There’s a difference between acute and chronic stress with our perception and social connection. Even though we gain some strength from a higher power, stress can impact anyone, and most of us might not be able to handle it well. So a great study was done many years ago by Dr. Ray and Holmes that stated, 50 years ago, put together a method for quantifying life-changing events. So let’s look at some areas, such as life-changing events. How do life-changing events and how do they rank? Which are the big ones, and which are the little ones?
And how does that ranking lead to major medical problems like cancer, heart attack, and sudden death in the future? So they looked at 43 life-changing events, ranked them originally, and re-ranked them in the 1990s. And some of them remained the same. They gave an adjustment score to the event, and then they looked at numbers that would be linked to major illness. So, for example, a life-changing event. Number one, 100 life-changing units, is a death of a spouse. Anyone could relate to that. Divorce was number two, separation number three, and the end of a close family member. But also noticed that some things got ranked that are, you might not equate with, being a major life-changing event that can impact a stress response like marriage or retirement.
Conclusion
Dr. Alex Jimenez, D.C., presents: So it wasn’t the actual single event that made the difference. It was the adding up of events. And what they found after looking at 67 physicians was if you had a life-changing unit score of somewhere between zero and one 50, not a big deal, no real major illness, but once you hit that 300 mark, there was a 50% chance of major illness. So this timeline of events in the patient’s life. We want to know what was going on in their life when their symptoms started and then bring it back earlier to understand the environment in which this individual was living. The impact of stress can make many individuals develop chronic conditions and mask other symptoms that can lead to muscle and joint pain. In part 2, we will dive in more about how the impact of stress affects a person’s body and health.
Dr. Alex Jimenez, D.C., presents how hypertension affects the human body and how to find ways to manage the symptoms associated with hypertension affecting many individuals in this 2-part series. Part 1 looked into the various factors that correlate with hypertension, and part 2 looked at the different genes and body levels affected by hypertension. We refer our patients to certified medical providers who provide multiple available treatments for many people suffering from hypertension associated with the cardiovascular, endocrine, and immune systems affecting the body. We encourage each of our patients by mentioning them to associated medical providers based on their analysis appropriately. We understand that education is a delightful way when asking our providers questions at the patient’s request and understanding. Dr. Jimenez, D.C., only makes use of this information as an educational service. Disclaimer
What Are ADMA Levels In Hypertension
Dr. Alex Jimenez, D.C., presents: Okay, so what affects ADMA levels? Upregulation of NRF-2 can decrease ADMA levels. So that’s great. So looking at things high in EGCG, think of green tea, sulforaphane, resveratrol, and exercises that reduce ADMA levels in the body. Improving blood sugar control improves ADMA levels, addressing the homocysteine pathway and looking at acidencial homocysteine. So this asks the question, what is the most common over-the-counter medication in the United States for gastroesophageal reflux or hyperacidity of the stomach that increases ADMA levels? And that is proton pump inhibitors, a poor diet, or elevated homocysteine. These are a couple of touch points on the ADMA that you can consider.
Let’s shift a little bit. Remember we talked about increased oxidative stress? There’s a whole enzyme system orchestra that addresses oxidative stress. And chronic oxidative stress can lead to hypertension. It also leads to fibrosis or gradual fibrosis of end organs. And so when you have elevated, reactive oxygen species, cell proliferation, migration changes, apoptosis changes, there’s increased inflammation. Reactive oxygen species make your tissue at the basal membrane level stiffer; your tissue becomes stiffer when you have increased oxidative stress. You start shifting with increased oxidative stress, extracellular matrix enzymes, and structure, and then you start getting endothelial dysfunction.
Many enzymes are influenced by nutrition and our genetic makeup that shift our balance of oxidative stress. Some of those enzymes are glutathione and glutathione peroxidase. The fifth enzyme down is GPX, which is the enzyme that helps us react to inflammation and toxins by altering the glutathione balance. We mentioned glutathione multiple times. We’ll talk about glutathione as a biomarker that you can check to assess oxidative stress in your patient. So is your oxidative stress because of mitochondrial dysfunction, or is your increased oxidative stress due to inflammation? We’ve seen this as a side effect in many patients, as increased inflammation leads to increased oxidative stress associated with increased mitochondrial dysfunction. This triangle is a matrix of interaction between the energy node, mitochondrial dysfunction, reactive oxygen species, and the defense and repair node inflammatory markers. We have seen this multiple in multiple different conditions.
How Oxidative Stress Is Associated With ADMA Levels?
Dr. Alex Jimenez, D.C., presents: When we see oxidative stress findings in many different organ systems in many other conditions in our medical practices, in many patients, we often see all these chronic conditions associated with oxidative stress as part of their symptoms. When this happens, we have to consider how to modulate them by asking them a few simple questions. We would ask them what kind of spices and herbs they use when they cook. Or what is their diet plan? These questions are important to analyze and assist the patient because culinary spices can affect many aspects of our body’s metabolism that could influence blood pressure.
By looking at the list of various spices, it is important to add them to food preparations or to alter the taste of food to add flavor and improve your health. Another thing to look for when it comes to lowering blood pressure is by adding these various spices into your food as part of your daily routine and being referred to a health coach or a nutritionist, whose main job is to add more spices to a patient’s diet and coming up with numerous recipes that have these spices. Remember, it doesn’t take a lot; a teaspoon to a tablespoon of mixed herbs in your food throughout the day could help normalize your blood pressure.
How To Come Up With A Plan To Lower Hypertension
Dr. Alex Jimenez, D.C., presents: Okay, how will you address oxidative stress, and what biomarkers might you look at? Well, oxidative stress affects many different levels of our cellular and subcellular levels. Oxidative stress can cause damaged DNA and change the fats in the membranes of the mitochondrial cell. It can induce increased lactation and disrupt protein structure in our bodies. So we start looking at total antioxidant capacity. Total antioxidant capacity is influenced by the nutritional adequacy of essential fats of too many simple carbohydrates of enough minerals, vitamins, and phytonutrients. So you can check glutathione levels in the serum, cysteine levels, enzymes, glutathione peroxidase, superoxide dismutase, and lipid peroxide on this list to see what is elevated in the body. You can check these different markers and get a clue of what portion of the cells or organ system is influenced by oxidative stress.
When we see these results, we need to develop a plan to increase the fat-soluble antioxidants, which can be fat and water-soluble, like alpha-lipoic acid. Or, say, for example, somebody has elevated eight-hydroxy-deoxy guanosine. What are the things that help you repair their DNA sequence? Well, it’s the components in one cellular, one-carbon metabolism. It’s your B vitamins. It’s methyl groups from essential fats. But then you have to ask, why is this elevated? Is it elevated because of micronutrient deficiency, mitochondrial toxicity, chronic inflammation, or hyperglycemia? So it’s common for your cardiometabolic patients to frequently see increased DNA oxidation marker eight-hydroxy-deoxy-guanosine.
Okay, those are biomarkers you can check in the urine or the blood. What’s another biomarker that you can check by looking at the nitric oxide angiotensin balance? What are ways that you can check endothelial function? What are ways that you can improve endothelial function even without checking? Well, there are different things that you can do to enhance nitric oxide. We’ve mentioned them before, like improving the bacterial balance, eating more flavonoids, increasing foods rich in nitrates, or even adding yoga to your regimen. There are ways that you can improve endothelial function without medications like sildenafil, as noted, that could potentially correlate with sleep apnea. It may address whether they have sleep apnea, need a mandibular split, and address some of the conditions they carry with them. Or, at the very bottom, it may manage their high-fat meals.
Okay, if you have somebody on a ketogenic diet, you must recognize potential oxidative stress and address it with your patients. So what are some early ways to detect vascular or endothelial dysfunction? One of the outpatient tools you can use is the vascular reactivity index. This detects vascular disease and looks at the pliability of the flexibility of the small capillaries and how well you profuse tissue downstream of an obstruction. So instead of looking at coronary arteries or carotids, it’s looking down at the level of the arterial, and we look at what’s called reactive hyperemia. So, it gives you some prognostic inflammation.
Measuring Blood Pressure
Dr. Alex Jimenez, D.C., presents: And there have been studies that follow people with reactive hyperemia to look at endothelial dysfunction and how that interacts with the Framingham risk score. And we know that when somebody has an abnormal index that predicts cardiovascular events, combining it with the end path lowers the lower endothelial function readings, which is associated with long-term cardiovascular disease. So how does it happen? You put a blood pressure cuff on your arm with a monitor on your finger. You blow the blood pressure cuff up to obstruct blood flow. You then, after five minutes, release it, and your vascular response to that surge of blood after having the blood flow occluded predicts hypertension and coronary heart disease. On the left, you see the normal endothelial function; the blue line on the top graph on the left is the obstruction of blood flow.
And then, after five minutes, you release the cuff, and you see this almost bell-shaped flow of blood down to the capillaries. You know the response, the endothelial function. That is a normal curve on the right. It is poor endothelial function. You can see there are no signs of arterial capillary flexibility. And so this is predictive up to seven years later. So then you ask yourself, is there anything that can improve endothelial function when I expect endothelial function dysfunction, or do I have an abnormal vascular reactivity index? And yes, let’s choose one as an example. Eating blueberries twice a day or taking them in powder form is rich in anthocyanins. To that point, you can add them to a smoothie that you have incorporated into your diet and have antioxidants in your system. The anthocyanins and their metabolites can help improve vascular function while increasing the mediated flow dilation and lowering 24-hour systolic blood pressure.
We use a lot of carotid in medial thickness because if I have somebody with hyperlipidemia, hyperglycemia, or hypertension, I want to use it as a leverage point to see if they have inflammation, their carotid bull or their internal carotid on each side to track to see if we’re getting systemic improvement in inflammation or can we get reversal with plaque. And so we’ve successfully done that through testing our clinic, advanced lipids, and education through group medical visits along with lifestyle interventions with nutraceuticals. And we have had a reduction in plaque and mark modulation and improvement in inflammation. If you don’t do anything helpful, the average increase in carotid intimal medial thickness per year is between 10 and 20% of the abnormal level. You can use this as a tool, as an outpatient, very easily to monitor the reduction in systemic vascular inflammation in plaque.
Looking At The Emerging Markers
Dr. Alex Jimenez, D.C., presents: Some other emerging markers, like HSCRP, uric acid, heavy metals, nutritional deficiencies, and TMAO, correlate with hypertension. And by improving those markers, you get improvement in blood pressure. Here’s the thing to remember. When you look at an HSCRP and see that it’s above one, here’s the connection. Now HSCRP inhibits endothelial nitric oxide synthase. So when you see an elevated HSCRP, you make a connection to lower nitric oxide. If you see an elevated HSCRP that downregulates the angiotensin-two receptors, it can increase blood pressure and is associated with increased cardiovascular risk.
How often do you check uric acid? It’s important to prevent uric acid in hypertensive patients. If it’s above six, you need to address it. How do you manage elevated uric acid levels? Well, by removing purine-rich foods or improving the metabolism of urine through your one carb metabolism, b12, fully b6, limiting their alcohol or avoiding a lot of extra high fructose sugar or improving their body weight, or addressing insulin resistance. All these mediate uric acid. If you have somebody who’s hyperemic, remember these five areas of modifiable physiologic imbalance. So I hope you’ve seen that hypertension is a syndrome. It’s not one thing; it’s not stiffness; it’s a syndrome in that you have three areas that you have to consider inflammation, oxidative stress, and immune response. You can look at a lot of the different imbalances around this dial.
Conclusion
Dr. Alex Jimenez, D.C., presents: You can look at your patient; you can look at what ways you can further evaluate them. And so, when you see a patient with hypertension, consider the treatments outlined in your clinical decision tree. And then, you can apply the modifiable lifestyle factors and the things to lower their blood pressure. Incorporating these lifestyle applications can improve the root cause and help you find the root cause of hypertension through the functional medicine lens.
There are various reasons for getting sick, but stress is one of the most common. Stress from family, work, school, traveling, etc., wreaks havoc on the body and mind. Working odd or different hours and staying up late disrupts routines and schedules and can generate significant stress. Trying to keep on top of everything and still trying to manage the usual responsibilities and duties can result in a weakened immune system that contributes to persistent illnesses. Chiropractic care combined with functional medicine can strengthen the immune system and restore optimal function.
Weakened Immune System
The immune system is a network of organs, white blood cells, proteins/antibodies, and chemicals. It protects the body from bacteria, viruses, parasites, and fungi that cause infection, illness, and disease. It’s normal for healthy adults to get sick a few times a year, but constantly being sick signals a weakened immune system. Individuals with weak immune systems also experience digestion issues. This could be constipation or frequent diarrhea. Approximately 70% of the immune system is in the gastrointestinal tract, where the healthy/beneficial bacteria and microorganisms live. If the amount of healthy bacteria is low, it is harder to protect the body from viruses, chronic inflammation, or autoimmune disorders.
Properly Working
When the immune system works properly, it can tell which cells are the body’s and which substances are foreign and don’t belong there.
It activates, mobilizes, and destroys the outside germs.
After exposure, the immune system stores the germs’ identities to develop antibodies to protect the body.
Depleted Immunity
Chronic stress wears down and prematurely ages the immune system. When the body must constantly adapt to changes from stress, it makes the immune system less responsive.
Depleted immunity is when the cells that should be ready to activate and fight viruses and bacteria are low in numbers.
Ongoing stress, over time, can make the body more vulnerable to illnesses, from colds and flu to chronic diseases like diabetes and heart disease.
High-stress levels can cause depression and anxiety, leading to higher levels of inflammation.
Chiropractic Restoration
Chiropractic care can help strengthen the body’s natural ability to heal and recover from illness by realigning the spine, improving circulation, and releasing toxins. Chiropractic works on the central nervous system, which comprises the spine and brain. As proper function and communication are restored, the central and peripheral nervous systems work together to help control the body’s ability to perceive and handle internal and external stress. Injury Medical Chiropractic and Functional Medicine Clinic treatment include:
Massage therapy
Spinal realignment
Decompression therapy
Health Coaching
Nutritional assistance
Stress Impact
References
Childs, Caroline E et al. “Diet, and Immune Function.” Nutrients vol. 11,8 1933. Aug 16, 2019, doi:10.3390/nu11081933
InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. How does the immune system work? [Updated 2020 Apr 23]. Available from: www.ncbi.nlm.nih.gov/books/NBK279364/
Nicholson, Lindsay B. “The immune system.” Essays in biochemistry vol. 60,3 (2016): 275-301. doi:10.1042/EBC20160017
Segerstrom, Suzanne C, and Gregory E Miller. “Psychological stress and the human immune system: a meta-analytic study of 30 years of inquiry.” Psychological bulletin vol. 130,4 (2004): 601-30. doi:10.1037/0033-2909.130.4.601
Dr. Alex Jimenez, D.C., presents how hypertension affects the human body and some causes that can increase hypertension in many individuals in this 2-part series. We refer our patients to certified medical providers who provide multiple available treatments for many individuals suffering from hypertension associated with the cardiovascular and immune systems affecting the body. We encourage each of our patients by mentioning them to associated medical providers based on their analysis appropriately. We understand that education is a delightful way when asking our providers questions at the patient’s request and understanding. Dr. Jimenez, D.C., only makes use of this information as an educational service. Disclaimer
How To Look For Hypertension
Dr. Alex Jimenez, D.C., presents: Let’s go back to the decision tree so you can begin to think about how you will apply the go-to-it model in functional medicine to hypertension and how you will start better assessing somebody with hypertension rather than telling them that their blood pressure is elevated. Is the body influenced by inflammation, oxidative stress, or immune response? Is it affecting endothelial function or vascular smooth muscle from those three categories of reactions, inflammation, oxidative stress, or immune response? Do we choose a diuretic calcium channel blocker or an ACE inhibitor? And so to do that, it’s really important in our gather section. Taking the medical history and the timeline of their hypertension, you get a clue about the organ damage to the questionnaires. You’re looking at their anthropometrics.
This includes the following questions:
What are the inflammatory markers?
What are the biomarkers and clinical indicators?
Those are outlined through the clinical decision tree. And already just doing that, you’re going to expand and fine-tune your lens on what you might see in your hypertensive patient. Let’s add to the timeline when does hypertension begin? The timeframe of hypertension begins actually in prenatally. It’s important to ask your patient if they were early or large educational age. Was their mother stressed? Were they born early or premature? Was there nutritional stress in their pregnancy? If they know that, you can have two people with the same kidney size, but the person who didn’t have enough protein during pregnancy can have up to 40% less glomeruli. Knowing that will change how you adjust the medication decades later if you know they possibly have 40% less glomeruli.
The Timeline For Blood Pressure
Dr. Alex Jimenez, D.C., presents: So it’s important to take the timeline of their blood pressure. Then it’s also important to recognize what is happening when we begin to organize and collect data through the biomarkers; the basic biomarkers will give you clues about whether they have issues with insulin lipids, whether they have problems with vascular reactivity, autonomic nervous system balance, imbalance, coagulation, or immune toxin effects. So this is a reasonable thing to print off because, in your hypertensive patient, this is through just the biomarkers you can begin to get a clue as to what areas of dysfunction affect inflammation, oxidative stress, and immune response and how these biomarkers reflect that information for you. This is very reasonable to have in front of you to help change your thoughts about hypertension and also enables you to refine some of the characteristics of the person on the other side of your stethoscope in a more personalized, precise way.
But let’s start at the very beginning. Does your patient have high blood pressure? We know that depending on the end organ effects of their comorbidities, you may run someone a slightly higher blood pressure if you have a profusion issue in the brain and the kidneys or the heart, but some guidelines are there. Our 2017 American Heart Association guidelines for blood pressure categories are listed here. They’ve waxed and waned back and forth over the last couple of decades, but this is very clear. Having elevated blood pressure, anything above 120, really shifted how many people we start seeing or considering addressing the root causes of their blood pressure. So we will come back to this, especially in the case to help us look at how we categorize people with blood pressure issues.
The Criteria To Mesure Blood Pressure
Dr. Alex Jimenez, D.C., presents: What is the first step? It’s how do you have the blood pressure taken in your patient? Do they monitor it at home? Do they bring those numbers to you? How do you monitor blood pressure in your clinic? How do you get accurate readings in your clinic? Here are the criteria to accurately measure blood pressure and the questions to consider whether you’re doing all these.
Do you ask your patient whether they’ve had caffeine in the last hour?
Whether they’ve smoked in the previous hour?
Were they exposed to smoke in the last hour?
Is the place where you’re taking blood pressure warm and quiet?
Are they sitting with their back supported in a chair with their feet on the ground?
Do you use the roll-around side table to rest your arm at the heart level?
Are they sitting at the exam table with their feet dangling, and a nurse aide elevates their arm and puts in their axillary fold to hold their arm there?
Are their feet on the ground?
Have they sat there for five minutes?
Have they exercised in the previous 30 minutes?
You may have systolic blood pressure if everything is in the criteria. Here’s the challenge. There are 10 to 15 millimeters of mercury higher when it comes to sitting and taking blood pressure. What about the cuff size? We know last century; most adults had an upper arm circumference of fewer than 33 centimeters. Over 61% of people now have an upper arm circumference greater than 33 centimeters. So the size of the cuff is different for around 60% of your adult patients, depending on your population. So you have to use a large cuff. So take a look at how blood pressure is collected in your office. Let’s say the blood pressure is elevated in your patients; then we have to ask, is it normal? Great.
The Different Types Of Hypertension
Dr. Alex Jimenez, D.C., presents: Is it elevated because of white-coat hypertension? Do they have normal blood pressure, elevated outside the clinic, or masked hypertension? Or do they just have sustained hypertension which is a challenge? We’ll talk about that. So when you interpret, it is also important to consider ambulatory blood pressure monitoring. So if you have somebody who’s hypertensive and don’t know whether the blood pressure goes down and you’re trying to figure out whether they have sustained hypertension, you can use 24-hour blood pressure monitoring. The mean daytime blood pressure above 130 over 80 is hypertensive the mean nighttime blood pressure above 110 over 65 is hypertensive. So why is this important? The average blood pressure dips to around 15% at night because of the issue with blood pressure dipping. Failure to have blood pressure drop while you sleep at night could develop problems that can affect a person throughout the day.
If your patient sleeps at night, it should drop about 15% when they sleep. If they have non-dipping blood pressure, it is associated with comorbidities. What are some of those comorbidities in non-dipping blood pressure? Some of the conditions correlated with non-dipping blood pressure include:
Congestive Heart Disease
Cardiovascular Disease
Cerebrovascular Disease
Congestive Heart Failure
Chronic Renal Failure
Silent Cerebral Infractions
Co-morbidities Associated With Non-Blood Pressure
Dr. Alex Jimenez, D.C., presents: These are the comorbidities associated with non-blood pressure. All of us agree that elevated blood pressure is not necessarily good in all those conditions. So when you look at different people groups or other comorbidities, non-dipping blood pressure is most commonly associated with sodium-sensitive folks, people who have renal insufficiency, people who have diabetes, people who have left ventricular hypertrophy, people who have refractory hypertension or autonomic nervous system dysfunction and finally, sleep apnea. So, non-dipping blood pressure increases your association with subclinical cardiac damage. Okay, Reverse dipping means you are more hypertensive at night and is more ascent associated than during the day is more related to hemorrhagic stroke. And if you have somebody with nocturnal hypertension, you have to start thinking about things like the carotid arteries and increased carotid, internal medial thickness. You start thinking about left ventricular hypertrophy and may see it on EKG. Here’s what we know about nocturnal hypertension. Nocturnal hypertension is a nighttime blood pressure greater than 120 over 70. It is associated with greater predictability of cardiovascular morbidity and mortality.
If you have nocturnal hypertension, it increases your risk of mortality from cardiovascular disease by 29 to 38%. We must know what’s happening at night when we sleep, right? Well, what’s another refinement? Another refinement is recognizing that resting blood pressure is controlled by your renin-angiotensin system. Waking blood pressure is controlled by your sympathetic nervous system. So let’s talk about how their renal angiotensin system drives their nighttime hypertension, and you think about what medication they’re taking. You might change the medication dosing to nighttime. Well, studies have shown that if you have nighttime hypertension and are a non-dipper, it’s best to take your ACE inhibitors, ARBs, calcium channel blockers, and certain beta blockers at night before bed. But it makes sense that you wouldn’t move your diuretics to nighttime, or you will have a disruptive sleep.
Addressing Daytime & Nighttime Blood Pressure
Dr. Alex Jimenez, D.C., presents: So if we don’t address daytime and nighttime blood pressure, we have to consider the effect of blood pressure load. What is your average daytime blood pressure and your moderate sleeping blood pressure is. We know that blood pressure load in young adults is hypertensive only about 9% of the time. So meaning the systolic load is about 9% versus in the elderly, about 80% of the blood pressure load is systolic. And so when you have a higher systolic load, you have more complications and end-organ damage. So what we’re talking about is helping identify your patient with hypertension; what is their timeline? What is their phenotype? Are they only hypertensive during the day, or they’re hypertensive at night also? We have to look at what helps balance that.
Here’s the other point, only about 3.5% of people with hypertension do it have a genetic cause. Only 3.5% of people their genes cause hypertension. The power is at the bottom of the matrix and recognizing these patterns, right? So you look at exercise, sleep, diet, stress, and relationships. So we know that these four autonomic balances help determine blood pressure. We will examine the renal angiotensin system, plasma volume where they hold onto too much fluid, secondary salt load, and endothelial dysfunction. Abnormalities in any of these can lead to hypertension. We’ve been talking about another one that can lead to hypertension: the link between insulin resistance and hypertension.
This diagrammatically gives you an idea of the physiologic interactions between insulin resistance and hypertension. It affects increasing sympathetic tone and increasing renal-angiotensin system balance. So let’s spend a few minutes on the renin-angiotensin system pathway angiotensinogen down to angiotensin two. We take advantage of these enzymes by giving inhibitors to angiotensin-converting enzymes in our hypertensives patients. Elevated angiotensin two leads to cardiovascular hypertrophy, leads to sympathetic phase constriction, increased blood volume, sodium fluid, retention, and aldosterone release. Can you inquire about your patient biomarkers? Can you ask whether they have elevated renin levels?
Look For The Signs
Dr. Alex Jimenez, D.C., presents: Well, you can. You can check plasma renin activity and aldosterone levels. It’s important to do this if your patient is hypertensive and has never been on medication because this is where nitrous oxide is so important. This is where your endothelial nitric oxide synthase is present. This is where you have sheer and hemodynamic stress. This is where dietary intake of arginine or the environment that affects nitric oxide plays such a role in the health of this layer of endothelia. If you lay it all together somehow, miraculously, or at least in your mind’s eye, it’ll cover six tennis courts in the average adult. It’s a huge surface area. And the things that cause endothelial dysfunction are not new news to people in functional medicine. Increased oxidative stress and inflammation are two things we mentioned that play an effect.
And then, look at some of these other components, your ADMA being elevated and correlated with insulin resistance. It all begins to form together in a matrix that interacts. So you look at one comorbidity in cardiometabolic syndrome, and it affects another comorbidity. You suddenly see the interrelation between them or hyperhomocysteinemia, which is a one-carbon metabolism marker, meaning you’re looking at the adequacy of folate, b12, b6, riboflavin, and that activity of your one-carbon metabolism. So let’s look at some of these emerging risk markers to improve and track in patients with hypertension. Let’s reanalyze ADMA again. ADMA stands for asymmetric dimethyl arginine. Asymmetric, dimethyl arginine is a biomarker of endothelial dysfunction. That molecule inhibits nitric oxide synthase while impairing endothelial function, and in all of the comorbidities associated with cardiometabolic syndrome, ADMA can be elevated.
Conclusion
So, as a quick review, L-arginine is converted to nitric oxide via nitric oxide synthase, and nitric oxide adequacy leads to vasodilation. ADMA blocks this conversion. And if your ADMA levels are elevated and your nitric oxide levels are low, then you have decreased nitric oxide platelet aggregation increases in LDL oxidation. So many things reduce nitric oxide or are associated with lower nitric oxide levels, sleep apnea, low dietary arginine, protein, zinc insufficiency, and smoking.
Dr. Alex Jimenez, D.C., presents how anti-inflammatory phytochemicals can reduce inflammation and treat other chronic conditions that inflammation is correlated with. We dive into what medicines can trigger inflammatory cytokines and some treatments that work together to reduce chronic inflammation. We refer our patients to certified medical providers incorporating multiple therapies for many individuals suffering from chronic inflammation and its correlating symptoms affecting the body. We encourage each of our patients by mentioning them to associated medical providers based on their analysis appropriately. We understand that education is a delightful way when asking our providers questions at the patient’s request and understanding. Dr. Jimenez, D.C., only makes use of this information as an educational service. Disclaimer
How Medications Associate With Inflammation
Dr. Alex Jimenez, D.C., presents: When it comes to a person’s health and wellness, it is important to know that when you are introducing them to potential antigenic medication, that person’s immune system is already imbalanced and much more likely to make abnormal immune responses, which then can lead to inflammatory effects in the body’s system. You see them mostly with chimeric human marine antibodies, which are the ones that make antibodies for the immune system, to that point, will elicit a much higher immune response. When this happens, it becomes a challenge to long-term pharmacotherapy. So when people go to their doctors for a prescription, about 20-30% of medication prescriptions are never filled because, most of the time, the prescription will never fill them in the drugstore, which can cascade into various issues.
And when people follow their prescription, sometimes they’ll take it for a little while, and after six months, they stop taking it. So the drop in prescriptions taken for longer than six months is quite low. In the last article, we discussed NSAIDs, DMARDs, and biologics, and we will touch base with acetaminophen. Acetaminophen is another one that’s just really widely used, and it’s because it’s put into all of these different cold and flu, and pain products. They sneak it into many other medications; you must read the labels. This is because some people metabolize acetaminophen quickly, which can become toxic. This can lead to individuals getting random headaches throughout the day and causes their glutathiones to be used promptly. So when looking for cold and flu medicine, it is best to look at the labels for acetaminophen because it doesn’t have anti-inflammatory responses since it is used for pain control.
How Acetaminophen Affects the Immune System
Dr. Alex Jimenez, D.C., presents: So even though we do not know how exactly how the analgesic effects work when people take cold and flu medicines, however, we do know that when people take a ubiquitous amount of acetaminophen, it could increase the pain threshold by inhibiting nitric oxide pathways in the body through mediation through the receptors for NMDA and substance P. We still don’t have a great handle on that, but that’s how it works. So, these drugs can be quite useful in the short term, but long-term use has serious side effects.
When looking for medications, it is important to read the labels that have a black box warning, which is the highest warning that the FDA issues for any potential overlapping risk profiles that the FDA issues. This can include severe liver injuries or serious possible allergic reactions that can develop into chronic inflammation of the muscles and joints. Now there are ways to reduce inflammation and prevent the body from being in more pain by slowly introducing anti-inflammatory botanicals and phytochemicals to detoxify the medication causing these complications.
Some individuals may not realize that constant medication for various pains and issues affecting the body can mask other problems involving the body’s systems. This can include:
Endocrine system
Cardiovascular system
Gastrointestinal system
Reproductive system
When these systems have been affected by medications, they can develop inflammatory markers in the vital organs and cause lead to visceral-somatic dysfunction in the body. When pain medications target pain localized in one location, but the issue is in a different area, this is known as referred pain. Referred pain is where the pain is in one muscle group location but is felt in another area of the body. When the organs are involved, it can cause inflammatory symptoms in the system. To that point, this causes the immune system to be induced into autoimmunity.
How The Immune System Is Induced Into Autoimmunity
Dr. Alex Jimenez, D.C., presents: When the immune system has been induced with autoimmunity, the corticosteroids can develop side effects that can be long termed and delay the healing process. Some of the physical symptoms that are visible with autoimmunity include:
Muscle weakness
Diabetes
High blood pressure
Thin bones
Delay wound healing
Flare-ups
Rheumatoid arthritis
Mood changes
When dealing with these inflammatory symptoms associated with pain, there are fundamental functional treatment approaches that can reduce the inflammatory cytokines causing joint and muscle pain.
Treatments To Target Inflammation
Dr. Alex Jimenez, D.C., presents: Some of the treatments that target inflammation include the following:
Slowly incorporating healthy lifestyle choices into a person’s daily lifestyle can reduce the effects of inflammatory cytokines affecting the vital organs, muscles, and joints. It is important to know that incorporating antioxidants, phytonutrients, and anti-inflammatory supplements can reduce residual symptoms in the body. All these treatments are some of the foundations that can address these inflammatory triggers and help reduce muscle and joint pain associated with inflammation.
Anti-Inflammatory Vitamins & Supplements
Dr. Alex Jimenez, D.C., presents: Another important note about these treatments is that vitamins and supplements can combine to help treat inflammatory effects that are causing issues in the body. These anti-inflammatory botanicals and phytochemical agents can not only act on the different pathways in the body but also have different mechanisms similar to healthy nutritional foods. Incorporating anti-inflammatory botanicals and phytochemical agents into the body will help modulate the inflammatory cascades and provide multiple synergistic activities to the body.
These agents down-regulate the inflammatory pathways caused by NF-kappaB. They can act as modulators that dissociate the cytokines from causing more issues like oxidative stress or infections triggering inflammation. However, we need inflammation to heal the body from wounds and infections. We mustn’t want the cytokines too high to cause inflammatory effects. So incorporating anti-inflammatory botanicals and phytochemicals provides a much safer option to the body and can be used in many chronic inflammatory conditions.
Conclusion
Since many botanicals and phytochemicals have anti-inflammatory properties, it can be difficult to find a good amount that the body needs to reduce chronic inflammation. Since many cultures and places have used many nutritional plants and herbs for years worldwide, it can be exhausting. Some of the botanical supplements include:
Zinc
Green tea extract
Capsaicin
S-adenosylmethionine
Ginger
To summarize how it is important to know which supplements have anti-inflammatory properties, doing research and incorporating small changes into a daily lifestyle can provide amazing results and allow the individual to be pain-free and have good health when combining botanicals and phytonutrients.
Dr. Alex Jimenez, D.C., presents how anti-inflammatory botanicals and phytochemicals can reduce inflammatory cytokines that can cause pain-like issues in the body. We dive into how different pharmaceuticals could influence NF-kappaB and how chronic conditions can affect inflammation. We refer our patients to certified providers that incorporate techniques and multiple therapies for many individuals suffering from inflammation, and its correlating symptoms can affect the musculoskeletal system. We encourage and appreciate each patient by referring them to associated medical providers based on their diagnosis when it is appropriate. We understand that education is a fantastic way when asking our providers intricated questions at the patient’s request and understanding. Dr. Jimenez, D.C., only utilizes this information as an educational service. Disclaimer
How Does The Body Deal With Inflammation
Dr. Alex Jimenez, D.C., presents: Our objectives are to look at the evidence for using selective phytochemicals and botanicals as anti-inflammatory and analgesic agents. Controlled studies have grown into mass numbers over the years, and we can feel more confident in some of their findings because a lot of these studies have been done with good-quality investigators and well-designed studies. And even though we get those studies published, the problem is that we rarely hear about them. The media needs to pick them up, and they usually don’t make it into the medical community despite their studies. If you compare that to when pharmaceutical research is done, you know it often makes the headlines and news. Let’s look at some of these botanicals and phytochemicals today.
In autoimmune conditions, pain is a huge issue in the body, and we also want to use its analgesic properties. And then, we have to identify the most appropriate phytochemicals and botanicals for specific inflammatory and pain conditions. So, before we jump into that, we want to review some of the mechanisms of the pharmaceuticals that are very commonly prescribed for inflammatory and autoimmune conditions. Even some of the newer biologics we’ve referred to a little bit, we want to look into them and, and look at how they work and some of their drawbacks, and then we’ll delve into these botanicals that are at our disposal. So it is important to remind anyone that all degenerative diseases have this pro-inflammatory state or inflammation as part of their underlying biochemical ideology. And that inflammation is a final common pathway for all these different dysfunctions. Diabetes, Alzheimer’s, atherosclerosis, cancer, and even some psychiatric disorders like schizophrenia and depression all have inflammation as one of their root causes. Now in this module, we’re focusing on the ones that are in the circles and these.
As you know, most chronic diseases are linked to excessive, persistent inflammation. We’ve pounded that point home well enough, as chronic inflammation occurs when the injury is ongoing or when a predisposed immune system just doesn’t shut off. It fails at counter-regulation and acute inflammation, which is beneficial; however, it can turn into a chronic inflammation if left untreated. Many chronic diseases have been associated with excessive or persistent inflammation. When it comes to chronic inflammation develops when an injury or traumatic event is ongoing, causing the muscles to tense up or when the immune system begins to attack the body when there are no pathogens that are affecting the body. And that the conventional pharmacological treatment focuses on specific pathways that are often really downstream in that inflammatory process, and from a functional medicine perspective, we want to look a bit more upstream to figure out what is the cause of chronic inflammation that is causing this many issues to this person and how anti-inflammatory botanicals and phytochemicals can dampen these inflammatory effects in the body.
How Do Pharmaceuticals Affect The Body?
Dr. Alex Jimenez, D.C., presents: One of the factors that can enhance inflammatory markers is pharmaceutical drugs. So, for example, pharmacologic controls like NSAIDs can inhibit the COX enzyme, while leukotriene inhibitors inhibit the LOX enzyme. DMARDs can affect various immune mechanisms that can influence the development of chronic inflammation. Biologics can inhibit multiple cytokines in the body, including the TNF-alpha and steroids, which can affect NF-kappaB and phospholipase-A2. So there are numerous ways to influence the inflammatory pathway and cause muscle and joint pain issues.
Pharmaceuticals are not the only factors that can cause inflammatory triggers to affect the body; it can be the food we eat or the environment that we live in that can trigger NF-kappaB, which disassociates from I-kappaB while going into the nucleus and binding to the DNA. That point leads to the transcription of many different genes. The body’s genes not only make DNA but can make RNA. When the body makes RNA, it is then biotransformed into DNA, leading to the turning of different inflammatory pathways. So when the pharmaceutical starts entering the body, it can inhibit the other cytokines and enzymes from turning on and cause chronic inflammation, thus causing the anti-inflammatory markers to dampen and causing the immune system to focus on the NF-kappaB.
NSAIDs
Dr. Alex Jimenez, D.C., presents: So let’s start looking at the non-steroidal anti-inflammatories or NSAIDs, which are ubiquitous as they are very common for many people to reach for when they are in pain. And the reason they use them is that they do work. NSAIDs inhibit cyclooxygenase enzymes and prevent those inflammatory prostaglandins, which cause inflammation and pain in the muscles or joints. Now paracetamol is on here, or acetaminophen is not technically an NSAID, but we will look at that separately.
But these NSAIDs, you know, aren’t without issues, as 70 million prescriptions for NSAIDs are written in the U.S. annually. And that over-the-counter uses included 30 billion doses of NSAIDs. That’s an enormous amount, and it’s no wonder most of us have taken them; we’re part of that 30 billion. However, that amount can lead to a leaky gut in our body system. We know their association with peptic ulcers and G.I. bleeding while inhibiting that resolving pathway, which is important to shut off the inflammatory response. So let’s look at DMARDs or disease-modifying anti-rheumatic agents. They’re the first-line therapy for rheumatoid arthritis. And one of the reasons they’re the first line of treatment is that they’re inexpensive but are slow acting and do decrease inflammation, but they don’t work very well to relieve pain directly.
So methotrexate is hydroxychloroquine, or Plaquenil is a very well-known one right now, especially with its use today. Still, methotrexate inhibits RNA and DNA synthesis, which has been used as a chemotherapy agent in cancer. And when it inhibits, it affects the dihydrofolate reductase, which is needed to make DNA and RNA; however, it also suppresses T and B-cell activation while inhibiting IL1 beta from binding to its receptors. So, unfortunately, even though they’re the first-line therapy, they come with several fairly severe side effects. But we keep talking about this idea of side effects; it’s no side effects. They’re the direct effects of the medication.
The Effects Of Pharmaceuticals
Dr. Alex Jimenez, D.C., presents: You know, they may be unwanted effects like rashes, stomach upset, liver, bone marrow, toxicity, congenital disabilities, and, of course, which we’ll see repeatedly. Any time that you shut down your immune system, you open yourself up for infections. So you become much more susceptible to infections. So, look at these biological DMARDs, which work as TNF-alpha blockers. These biological DMARDs work by curbing either T-cell activation or blocking TNF, which is the most common one, but they also can stop things like IL-six, deplete T-cells, and work in other ways. These biologics are called biologics because they’re actually monoclonal antibodies. And so these monoclonal antibodies, as antibodies do, they have very strong specific binding affinities.
And so, using antibodies as medications has been a great advance. Now, as we’re going to see, they may not be the ultimate solution for treating autoimmune disease, but they hold a lot of promise, especially when we need their specificity. So there are many chronic conditions that NSAIDs DMARDs or Biologic DMARDs that can mask inflammation and cause pain to the muscles and joints. Some of the chronic conditions include:
Ankylosing-spondylitis
Arthritis
Crohn’s disease
Endometriosis
Psoriasis
Rheumatoid Arthritis
Osteoarthritis
Fibromyalgia
Lupus
Conclusion
Dr. Alex Jimenez, D.C., presents: These pharmaceuticals can reduce the pain that the person is experiencing with these conditions, but they are short-termed and only mask the issue until a person goes into treatment. When a person has an autoimmune or chronic disorder associated with inflammation, the cost of any medication is high. Even though good pharmaceuticals are important, we need to look at treatments that can examine the lesser-known or rarer conditions that can reduce the inflammatory effects that cause joint and muscle pain. Incorporating anti-inflammatory botanicals and supplements like:
Fish oil
Curcumin
Ginger extract
Green Tea Extract
Resveratrol
All have anti-inflammatory properties that can reduce inflammatory cytokines from the muscle and joints and combine with physical therapy. Physical therapy can allow the body to heal itself and will enable the individual to be pain-free naturally.
The hips in the lower portions of the body allow the legs to move the host from one location to another and provide stability to support the upper body’s weight. The hips will enable the torso to twist and turn without feeling pain. This is due to the various muscles and ligaments surrounding the pelvic bone and hip joint socket that allow the motion to be possible. However, when various injuries or factors start to affect the multiple muscles surrounding the pelvis or there is a chronic condition like osteoarthritis that causes wear and tear on the hip joints can cause underlying symptoms associated with the hips and cause many individuals to have difficulty when moving around. Luckily there are ways to improve hip mobility and the surrounding muscles in the hip and pelvic region of the body. Today’s article looks at the causes of the development of tight hips in the body and how different stretches can release tight hip flexor muscles. We refer our patients to certified providers that incorporate techniques and multiple therapies for many individuals suffering from hip pain and its correlating symptoms that can affect the musculoskeletal system in the hips, legs, and lumbar region of the spine. We encourage and appreciate each patient by referring them to associated medical providers based on their diagnosis when it is appropriate. We understand that education is a fantastic way when asking our providers intricated questions at the patient’s request and understanding. Dr. Jimenez, D.C., only utilizes this information as an educational service. Disclaimer
What Causes The Body To Develop Tight Hips?
Have you been dealing with hip mobility issues? When you sit, do you feel uncomfortable, and your hip muscles become tight? Or do you have a decreased range of motion when moving your hips? It could correlate with your hips if you have been experiencing muscle pain issues in the lower extremities. The hips help stabilize the upper and lower portions of the body while providing the full leg’s range of motion. When a person begins to sit for long periods or twist their body in a weird position, it can cause the muscles that surround the hips to become shortened. Other issues, like chronic conditions, can play a role in developing tight hip flexors. Studies reveal that various pathologies affecting the hips, lumbar spine, and lower extremities could strongly correlate with restricted hip mobility that can cause harmful effects that can affect the hips. To that point, some of the symptoms associated with tight hip flexors include:
Instability
Hypermobility
Limited range of motion
Reduce muscle strength in the groin
Muscle cramps
Sharp, sudden pain in the hips, pelvis, or groin
Low back pain
Piriformis syndrome
Other research studies mentioned that hypermobility disorders could affect the hip joints. Hypermobility disorders like EDS (Ehlers-Danlos syndrome) could cause micro or macro-trauma on the hip joint and affect the ligaments surrounding the hip joint. To that point, it can cause the hip flexor muscles to become tense and potentially affect how a person moves, which then causes soft tissue injuries and chronic pain.
Hip Flexor Stretches-Video
Do you feel tight along your hips? Do you see yourself hobbling around when walking? Or do you feel aches or strains when stretching? Many of these issues correlate with tight hip flexors that could result from hip pain in the lower extremities. When a person has tight hip flexors, it could be due to them constantly sitting down, causing the hip muscles to be shortened, or chronic conditions that can affect the hip joint and muscles. However, there are various ways to prevent tight hip flexors and regain mobility back to the hips. Studies reveal that stretching combined with core stabilization can help improve the hip’s range of motion while ensuring core endurance exercises can help strengthen the surrounding muscles in the hip area. The video above shows stretches targeting the hip flexor muscles and helps improve hip mobility.
Different Stretches To Release Tight Hip Flexors
Studies have shown that the hip flexor muscles are the main contributors to lumbar spine stability when releasing tight hip flexor muscles. So when there are tight hip flexors, it can cause overlapping risk profiles to the lumbar spine, which leads to pain and impairment in performance. The best way to reduce the pain-like symptoms associated with tight hip flexors is by stretching the lower half of the body to reduce muscle strain and tightness in the hip flexors. Additional studies have found that stretching combined with exercises targeting the low back can reduce the pain caused in the low back and help improve stability and strengthen the surrounding muscles located in the hips. Now it is important to remember that stretching for at least 5-10 minutes before and after working out allows the muscles to warm up and improve flexibility. Below are some different stretches that can release tight hip flexors.
High Crescent Lunge
While standing on the mat, take a step forward to allow your right foot to be in a staggard stance *Think in a lunge position.
Bend the front knee gently while keeping the back leg straight, as this allows the heel in the back leg to be lifted off the mat; the bent front knee enables the thigh to be parallel to the floor, and the right foot is pressed flat on the mat.
Square up the hips, so they face toward the mat’s front.
Extend the arm up towards the ceiling to stretch upwards while pressing into the mat to feel the hips stretch
Hold for five breaths before slowly rising out of the lunge position and repeating on the other side.
This stretch helps release tension in the hip flexors and quads while warming up the muscles and increasing blood flow to the legs.
Knee-To Chest Stretch
Lie on the mat with both legs extended out and feet flexed.
Pull on the left knee to the chest while keeping the right leg straight, and the lumbar portion of the back is pressed into the mat.
Hold the position while taking deep breaths for 30 seconds to 2 minutes.
Release slowly and repeat on the right leg *You can lift both knees to your chest and rock slowly from side to side to relieve low back tension as an alternative.
This stretch is extremely helpful for tight hamstrings and allows the tense muscles on the hips and lower back to relax while increasing blood flow back to the muscles.
Piriformis Stretch
On the mat, sit with both legs extended out.
Cross the right leg over the left and place the other flat on the floor while the left foot is flexed
Place the right hand behind the body while the left elbow is on the right knee.
On inhale, press the right leg to the left while allowing the torso to twist on the right.
Take five breaths for a deeper stretch and switch sides to repeat the action with the left hand *If you have low back pain issues, the modified version allows you to use your left hand to pull the right quad in and out to the left and vice versa.
This stretch helps loosen tight muscles in the lower back, hips, and glutes. If you have sciatic nerve pain associated with piriformis syndrome, this stretch helps release muscle tension from the piriformis muscle aggravating the sciatic nerve.
Happy Baby Pose
Lie on the mat with both knees bent and feet on the ground.
On inhale, lift the feet off the ground and grab the outer sections of the feet with your hands.
Then gently pull the feet towards the chest and allow the knees to lower to the ground, on either side of the body, while keeping the back flat on exhale.
Hold the position for at least five breaths.
This stretch helps with the inner thigh muscles or hip adductors and helps them become loose and mobile without feeling any strain or tension.
Bridge Pose
On the mat, lie on your back and sides, and extend your arms while your feet are flat on the floor with your knees bent.
Press with your heels to lift the hips and allow the feet to walk a few steps toward the body. *Keep the feet and knees hip-width apart.
Clasp hands together underneath the body and press them into the mat
Hold the position for five breaths.
This stretch helps take the pressure off the hip muscles while strengthening the glutes and abdominal muscles.
Conclusion
When it comes to releasing tight hip flexors after sitting for a long time or having hip issues affecting your low back or pelvis, Doing different stretches that target the hips can reduce the pain and release tight muscles associated with other conditions that can affect the body. The hips are important to take care of since they provide mobility and stability to the upper and lower portions of the body. They support the upper body’s weight while providing a huge range of motion to the legs. Incorporating these different stretches can reduce the pain that they have been under and help warm up the other muscles that surround the lower extremities.
References
Lee, Sang Wk, and Suhn Yeop Kim. “Effects of Hip Exercises for Chronic Low-Back Pain Patients with Lumbar Instability.” Journal of Physical Therapy Science, U.S. National Library of Medicine, Feb. 2015, www.ncbi.nlm.nih.gov/pmc/articles/PMC4339134/.
Moreside, Janice M, and Stuart M McGill. “Hip Joint Range of Motion Improvements Using Three Different Interventions.” Journal of Strength and Conditioning Research, U.S. National Library of Medicine, May 2012, pubmed.ncbi.nlm.nih.gov/22344062/.
Reiman, Michael P, and J W Matheson. “Restricted Hip Mobility: Clinical Suggestions for Self-Mobilization and Muscle Re-Education.” International Journal of Sports Physical Therapy, U.S. National Library of Medicine, Oct. 2013, www.ncbi.nlm.nih.gov/pmc/articles/PMC3811738/.
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Weakened Immune System
