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.
Can electrolyte chewing gum help physically active individuals, fitness enthusiasts, and athletes experiencing extreme heat and dehydration?
Electrolyte Chewing Gum
Electrolyte powder mix and drinks have been marketed as efficient and time-saving for fast-paced lives. Now, electrolytes are in chewing gum form. These gums work by activating salivary glands and making the mouth water. Manufacturers claim the gum’s sour taste makes the mouth water, quenches thirst, and replenishes some electrolytes. Some brands don’t list the percentages or amounts of ingredients, making determining each gum’s electrolyte content difficult. However, electrolyte chewing gum is designed to eliminate feelings of thirst and is not meant to hydrate the body. This can be dangerous because it gives the individual a false sense of hydration. When the thirst mechanism is impaired, an individual may not drink enough fluids, leading to dehydration. The Food and Drug Administration has not studied the effectiveness of electrolyte gum.
Signs The Body Is Not Getting Enough Electrolytes
Electrolyte deficiency can result from insufficient fluids or excessive sweating (National Library of Medicine, 2024). Signs that the body is not getting enough electrolytes can vary because the body needs each electrolyte for specific functions. The symptoms can range from neurological symptoms such as headaches and seizures in the case of low sodium to muscle cramps and weakness when there are low potassium levels. (National Library of Medicine, 2023) (National Library of Medicine, 2023) However, individuals can still have electrolyte imbalances even if they do not have symptoms. This is why proper hydration and intake of electrolytes through water and food are important.
Ingredients
The ingredients listed on electrolyte chewing gum include:
Sugar
Gum base
Corn syrup
Citric acid
Glycerin
Natural flavors
Soy lecithin
Artificial sweeteners
Artificial color
Electrolytes in sodium citrate and potassium citrate
However, gum brands fail to include the percentages of the ingredients, making it hard to figure out the actual electrolyte content. The amount can determine their effectiveness. Given their size, estimates point to very little electrolyte content, possibly around 10 milligrams of sodium per piece, which is insufficient to hydrate the body.
Rehydrating the Body
Food and fluids are reliable sources of electrolytes that the body can absorb. Sources include:
Fruits like bananas and oranges contain potassium and magnesium.
Vegetables also contain potassium and magnesium.
Dairy for calcium.
Electrolyte supplements are generally unnecessary if you eat a balanced diet. However, these products could be useful during exercise, especially for their sodium content (National Library of Medicine, 2024). When exposed to the heat, consider a rehydration solution like sports drinks or making your own. The presence of sugar increases the absorption of sodium by the intestine. Sugar in electrolyte solutions does not add calories; it helps the intestine absorb the sodium faster and holds water in the bloodstream, helping maintain blood pressure. While chewing a piece of electrolyte gum might make it easy to get balanced electrolytes, it is not enough to replenish the body. Individuals who need more electrolytes should talk to their healthcare provider about the best way to meet their body’s needs. They may recommend drinks or powders specially formulated to provide an electrolyte boost.
Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop highly effective treatment plans through an integrated approach for each patient and restore health and function to the body through nutrition and wellness, functional medicine, acupuncture, Electroacupuncture, and integrated medicine protocols. If the individual needs other treatment, they will be referred to a clinic or physician best suited for them. Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, nutritionists, and health coaches to provide the most effective clinical treatments.
Replenishing electrolytes and maintaining hydration is essential for individuals who work out, fitness enthusiasts, and those who play recreational or serious sports and want to improve overall health. Can making a homemade sugar-free electrolyte drink help individuals achieve health goals faster?
Homemade Electrolyte Drink
Sports drinks can help replenish the body’s lost electrolytes. Individuals who follow a low-carb diet and exercise or who are on a low-carb diet and get sick need double the added electrolytes. There is evidence that electrolytes are very effective in regulating the body’s fluid balance, especially during and after exercise or illness, and for those on a strict low-carb diet. (Maughan R. J. 1991)
Why More Electrolytes Are Needed
On a low-carb diet, insulin levels drop, so the kidneys retain less sodium. As the body excretes water, important minerals, such as the electrolytes calcium, sodium, magnesium, chloride, and potassium, are also excreted from the body’s system. Therefore, it is important to replenish them to avoid negative symptoms like lightheadedness and dehydration—especially when exercising or ill. (Bostock E. C. S. et al., 2020)
Two tablespoons of lemon juice contain almost the same amount of potassium in an 8-ounce sports drink.
A pinch of salt supplies 110 milligrams of sodium, the same amount in 8 ounces of a sports drink.
Individuals can make a low-carb homemade electrolyte sports drink. Many sports drinks contain a lot of sugar and other additives. The science behind why many of these drinks contain sugar is that a quick hit of sugar provides glucose for replenishing energy stores. Most individuals benefit from having small amounts of carbohydrates during heavy exercise. However, those who want to avoid sugar might want a sugar-free option to replace fluids and electrolytes.
Basic Recipe
Homemade Electrolyte Drink Mix:
1 cup or 8 ounces of non-carbonated water
Two tablespoons of lemon juice
A small pinch of salt—a teaspoon contains 2,300 milligrams of sodium, but the body needs 1/20th of a teaspoon.
Flavoring and sweetener for taste are optional. Try unsweetened Kool-Aid, Crystal Light Drink Mix, or sugar-free flavored syrups.
If avoiding artificial sweeteners, Stevia could be an option.
Sports Drink Ingredients
What goes into most sports drinks and adapting to a low-carb diet?
Water
Water is a primary ingredient, as the goal is to hydrate the body.
Sugar
Sports drinks can contain a lot of sugar, but only about half the sugar of most commercial beverages. For example,
A 20-ounce bottle of Gatorade has about 34 grams of sugar.
A 20-ounce soda has about 69 grams of sugar.
Sports drinks have less sugar to prevent gastrointestinal cramping during exercise and strenuous physical activity. Although Gatorade contains less sugar than soda, depending on individual health goals, it may not be the best option. Studies of nutritional needs during exercise for those restricting carbohydrates are not extensive. However, it is known that when individuals cut carbs, their bodies switch from primarily using carbohydrates to using fat for energy. This change, known as keto-adaptation, can take two to three weeks. Native populations, like the Inuit, traditionally ate a very low-carbohydrate diet and could maintain vigorous endurance for a long time without ill effects. (Phinney S. D. 2004) This suggests that bodies adapt to using fat for energy during physical activity and exercise over time. However, cutting carbohydrates too much and too soon can lead to symptoms like the keto flu. (Harvard Medical School, 2018). Individuals may need to replace carbohydrates during training for longer, more vigorous workouts, such as running longer than an hour. In addition, what is eaten before and after exercise can also affect physical performance. Working with a registered dietitian, nutritionist, or health coach could be helpful to achieve specific fitness goals.
Electrolytes
Electrolytes are molecules of certain minerals that contain an electrical charge. The nervous system runs on those charges generated by manipulating molecules called ions. (Faber D. S. and Pereda A. E. 2018) Every body function that depends on the nervous system, which includes muscle movement, breathing, digestion, thinking, etc., requires electrolyte activity. Those who exercise strenuously for long periods, individuals who follow a low-carb diet, or those with illness may need extra salt and potassium. Sports drinks contain small amounts of sodium and potassium. A balanced diet will supply plenty of minerals for electrolyte needs for individuals engaged in moderate exercise.
Using an integrated approach to treat and prevent injuries and chronic pain syndromes, improve flexibility, mobility, and agility, and help individuals return to normal activities, Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop a personalized treatment, nutrition, and fitness programs. Each case is different and requires reviewing individual medical history and physical examination to determine the proper and most effective plan. Dr. Jimenez has teamed up with top trainers, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments and training.
Is Intermittent Fasting the Ultimate Weight Loss Hack?
References
Maughan R. J. (1991). Fluid and electrolyte loss and replacement in exercise. Journal of sports sciences, 9 Spec No, 117–142. doi.org/10.1080/02640419108729870
Bostock, E. C. S., Kirkby, K. C., Taylor, B. V., & Hawrelak, J. A. (2020). Consumer Reports of “Keto Flu” Associated With the Ketogenic Diet. Frontiers in nutrition, 7, 20. doi.org/10.3389/fnut.2020.00020
Phinney S. D. (2004). Ketogenic diets and physical performance. Nutrition & metabolism, 1(1), 2. doi.org/10.1186/1743-7075-1-2
Faber, D. S., & Pereda, A. E. (2018). Two Forms of Electrical Transmission Between Neurons. Frontiers in molecular neuroscience, 11, 427. doi.org/10.3389/fnmol.2018.00427
Do individuals with muscle pain know the difference between heat stroke and heat exhaustion and can find ways to stay cool?
Introduction
As the temperature rises worldwide, many individuals are enjoying their time outside and getting more sun in their lives. However, rising temperatures also mean the rise of heat-related illnesses. The two most common heat-related illnesses are heat stroke and heat exhaustion, which can impact an individual’s musculoskeletal system and have different symptoms in terms of severity. Today’s article focuses on the differences between these two heat-related illnesses, how they affect the musculoskeletal system and treatments to stay cool while reducing muscle pain. We discuss with certified associated medical providers who consolidate our patients’ information to assess heat-related illnesses associated with muscle pain. We also inform and guide patients while asking their associated medical provider intricate questions to integrate treatments and ways to stay cool when temperatures rise and reduce muscle pain. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer.
Heat Exhaustion VS Heat Stroke
By understanding the differences between heat stroke and heat exhaustion is crucial. Do you often feel overheated after simple activities? Have you experienced muscle pain or cramps? Or do you struggle to cool down? These are all signs of heat-related illnesses. Heat-related illnesses often occur when the body cannot dissipate heat, leading to dysfunctional thermoregulation. (Gauer & Meyers, 2019) The two most common types are heat exhaustion and heat stroke. While they share similar causes, they differ significantly in terms of severity, symptoms, and treatment. (Prevention, 2022)
Heat exhaustion is a mild condition that often occurs when the human body loses excessive water and salt from profusely sweating. This causes the external temperatures to be more moderate when associated with intense physical activity. (Leiva & Church, 2024) Additionally, when a person is dealing with heat exhaustion, some of the symptoms that they will experience include:
Heavy sweating
Fatigue
Headaches
Muscle cramps
Pale, cool, moist skin
Fast, weak pulse
Even though heat exhaustion is a mild heat-related condition, it can develop into severe heat-related conditions like heat stroke if not treated immediately. Heat stroke is a severe heat-related illness that is not only life-threatening buthas two forms that can affect a person’s body temperature: classic and exertional. Classic heat stroke often affects elderly individuals who have chronic medical conditions, while exertional heat stroke affects healthy individuals who are doing strenuous physical activities. (Morris & Patel, 2024) Some of the symptoms associated with heat stroke include:
High body temperature (104°F or higher)
Hot, red, dry skin
Rapid, strong pulse
Confusion
Seizures
Loss of consciousness
How Do Both Conditions Affect The Muscles?
Both heat-related illnesses can have a significant effect on the musculoskeletal system and cause muscle pain to not only the extremities but also the entire body system. The issue affects the musculoskeletal system and can lead to painful muscle cramps, involuntary muscle contractions, and muscle pain. Since muscle pain is a multi-factorial condition, heat-related illnesses like heat stroke and exhaustion can influence a person’s lifestyle and comorbid health factors. (Caneiro et al., 2021) When that happens, many individuals can seek treatments to stay cool from heat exhaustion and heat stroke and reduce muscle pain.
Secrets Of Optimal Wellness-Video
Treatments For Staying Cool & Reduce Muscle Pain
While it is important to understand the difference between heat stroke and heat exhaustion due to the crucial timing and effective interventions, finding various treatments to reduce muscle pain and find ways to stay cool is important. Many individuals can wear technology to monitor the person’s physiological status actively and prevent injuries while providing early detection for heat-related illnesses. (Dolson et al., 2022) This can reduce the chances of muscle pain and help regulate body temperature. For individuals dealing with heat exhaustion, they can:
Move to a cooler environment
Be well-hydrated with water and electrolyte-rich drinks
Rest
Wear cool clothes to lower body temperature
For individuals dealing with heat stroke, they can:
Call emergency services immediately
Apply cool clothes or ice packs to the body
Monitor vital signs
Both treatments can ensure positive results in preventing life-threatening situations that can affect the musculoskeletal system.
Conclusion
Given the significant impact both heat stroke and heat exhaustion can have on the musculoskeletal system, it’s essential to take proactive measures. Proper hydration, cooling, and rest can help manage and alleviate muscle pain associated with these heat-related illnesses. By staying informed, maintaining hydration, and taking proactive steps to protect yourself from excessive heat, you can significantly reduce the chances of these heat-related illnesses affecting your outdoor activities.
References
Caneiro, J. P., Bunzli, S., & O’Sullivan, P. (2021). Beliefs about the body and pain: the critical role in musculoskeletal pain management. Braz J Phys Ther, 25(1), 17-29. doi.org/10.1016/j.bjpt.2020.06.003
Dolson, C. M., Harlow, E. R., Phelan, D. M., Gabbett, T. J., Gaal, B., McMellen, C., Geletka, B. J., Calcei, J. G., Voos, J. E., & Seshadri, D. R. (2022). Wearable Sensor Technology to Predict Core Body Temperature: A Systematic Review. Sensors (Basel), 22(19). doi.org/10.3390/s22197639
Can individuals with osteoarthritis can incorporate cycling to reduce joint pain and regain their joint mobility?
Introduction
The joints in the musculoskeletal system allow the individual to be mobile while allowing the extremities to do their jobs. Just like the muscles and ligaments of the body, the joints can also wear and tear through repetitive motions, leading to joint pain in the extremities. Over time, the wear and tear from the joints can lead to the potential development of osteoarthritis, which then can affect joint mobility and lead to a life of pain and misery for individuals. However, numerous ways exist to reduce osteoarthritis’s pain-like symptoms and help restore joint mobility through cycling. Today’s article looks at how osteoarthritis affects the joints, how cycling is incorporated for osteoarthritis, and how it can reduce joint pain. We discuss with certified associated medical providers who consolidate our patients’ information to assess osteoarthritis and its associated pain symptoms affecting the joints in the extremities. We also inform and guide patients while asking their associated medical provider intricate questions to integrate cycling into their personalized treatment plan to manage the pain correlated with osteoarthritis affecting their joints. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer.
Osteoarthritis Affecting Joint Mobility
Do you feel pain and stiffness every morning in your joints only for it to feel better throughout the day? Do you experience pain in your knees, hips, and hands? Or have you noticed that your range of motion has decreased drastically? Many individuals, both young and old, can be affected by these pain-like issues and could be at risk of developing osteoarthritis in their joints. Osteoarthritis is the largest and most common musculoskeletal condition that causes a disturbance of the inflammatory cytokine balance, damaging the cartilage and other intra-articular structures surrounding the joints. (Molnar et al., 2021) This is because osteoarthritis develops over time, causing the cartilage to wear away and causing the connecting bones to rub against each other. This, in turn, can affect the extremity’s joint mobility, causing symptoms of stiffness, pain, swelling, and reduced range of motion to the joints.
Additionally, osteoarthritis is multifactorial as it can cause an imbalance in the joints due to genetics, environmental, metabolic, and traumatic factors that can contribute to its development. (Noriega-Gonzalez et al., 2023) This is because repetitive motions and environmental factors can impact the body and cause overlapping risk profiles to correlate with osteoarthritis. Some overlapping risk profiles associated with osteoarthritis are pathological changes in the joint structure that cause abnormal loading on the joints, which causes joint malalignment and muscle weakness. (Nedunchezhiyan et al., 2022) This causes many people to be in constant pain and trying to find relief from joint pain associated with osteoarthritis.
Chiropractic Solutions For Osteoarthritis-Video
Cycling For Osteoarthritis
Engaging in physical activities may seem daunting when managing osteoarthritis symptoms, but it can help restore joint mobility while reducing the pain associated with osteoarthritis. One of the physical activities that has little impact and does not impact the joints is cycling. Cycling for osteoarthritis has many beneficial properties as it can:
Strengthen surrounding muscles
Retain joint mobility
Improve range of motion
Weight management
Enhancing cardiovascular health
Cycling can help the individual focus on strengthening the lower extremity muscles surrounding the joints, which can help improve pain and functionality. (Katz et al., 2021) This, in turn, helps provide better support and stability to the joints, thus reducing overload on the body while minimizing the risk of injuries. Additionally, cycling can help improve many individuals looking for a healthier change and increase bone mineral density in the joints, thus decreasing the risk of fractures. (Chavarrias et al., 2019)
Cycling Reducing Joint Pain
Cycling is a safe and effective exercise for anyone, whether they’re just starting or haven’t been active for a while. The key to optimal recovery and joint functionality is to consult a doctor. This ensures that cycling is a safe option for you, helps you choose the right bike, and provides guidance on how to start slowly, warm up and stretch, maintain proper form, and stay consistent with the cycling sessions. This professional guidance is crucial, as it allows many individuals with joint pain to achieve complete functional recovery to their joints. (Papalia et al., 2020) Cycling is an excellent way to manage osteoarthritis and its associated symptoms. For many individuals with osteoarthritis, this low-impact exercise can be a game-changer, promoting muscle strengthening, improving joint range of motion, and helping alleviate osteoarthritis symptoms.
References
Chavarrias, M., Carlos-Vivas, J., Collado-Mateo, D., & Perez-Gomez, J. (2019). Health Benefits of Indoor Cycling: A Systematic Review. Medicina (Kaunas, Lithuania), 55(8). doi.org/10.3390/medicina55080452
Katz, J. N., Arant, K. R., & Loeser, R. F. (2021). Diagnosis and Treatment of Hip and Knee Osteoarthritis: A Review. JAMA, 325(6), 568-578. doi.org/10.1001/jama.2020.22171
Molnar, V., Matisic, V., Kodvanj, I., Bjelica, R., Jelec, Z., Hudetz, D., Rod, E., Cukelj, F., Vrdoljak, T., Vidovic, D., Staresinic, M., Sabalic, S., Dobricic, B., Petrovic, T., Anticevic, D., Boric, I., Kosir, R., Zmrzljak, U. P., & Primorac, D. (2021). Cytokines and Chemokines Involved in Osteoarthritis Pathogenesis. Int J Mol Sci, 22(17). doi.org/10.3390/ijms22179208
Nedunchezhiyan, U., Varughese, I., Sun, A. R., Wu, X., Crawford, R., & Prasadam, I. (2022). Obesity, Inflammation, and Immune System in Osteoarthritis. Front Immunol, 13, 907750. doi.org/10.3389/fimmu.2022.907750
Noriega-Gonzalez, D., Caballero-Garcia, A., Roche, E., Alvarez-Mon, M., & Cordova, A. (2023). Inflammatory Process on Knee Osteoarthritis in Cyclists. J Clin Med, 12(11). doi.org/10.3390/jcm12113703
Papalia, R., Campi, S., Vorini, F., Zampogna, B., Vasta, S., Papalia, G., Fossati, C., Torre, G., & Denaro, V. (2020). The Role of Physical Activity and Rehabilitation Following Hip and Knee Arthroplasty in the Elderly. J Clin Med, 9(5). doi.org/10.3390/jcm9051401
High temperatures can disrupt the body’s sleep cycles, leading to health problems. Can knowing strategies and remedies help manage sleep quality?
Hot Weather Sleep
Sleep is important for refreshing the mind and body and being productive in school, work, relationships, and overall health. With record-breaking temperatures becoming the norm, consistently sleeping healthy is becoming difficult as forecasters predict another scorching summer with above-average temperatures. 2023 was the hottest year ever recorded. (National Oceanic and Atmospheric Administration. 2024) Studies show that high temperatures make it hard to fall asleep and stay asleep, which can negatively affect the immune system, cardiovascular system, cognitive performance, and mood. (Zheng, G., Li, K., and Wang, Y. 2019) (Obradovich, N. et al., 2017) Throughout the night, the body cycles through different sleep stages. (National Heart, Lung, and Blood Institute, 2022)
Because the body’s temperature regulation is less effective during certain stages, a hot environment can cause waking so the body can thermoregulate. The right temperature is imperative for a healthy night’s sleep. For optimal sleep, it is recommended that the bedroom temperature be between 65 and 69 degrees Fahrenheit. However, this isn’t always possible without air conditioning, which increases electricity bills. Here are other strategies to help keep the body cool for better sleep in hot weather.
Cooler Sleeping Environment
Thinking creatively about sleeping arrangements can help. Try to find the place that is the coolest and has the most airflow. Shutters or curtains during the day can help keep the room dark and cooler, and opening the windows can increase airflow. (Fergus Nicol, 2019) Using a fan can help improve air circulation, and putting ice behind the fan can blow cooler air for improved sleep.
Cooling Pillows and Breathable Pajamas
Pajamas and bedding made from breathable fabrics can help keep the body cool, and cooling mattress toppers or pillows can also help. Cooling pillows have gel overlays that absorb body heat and cool the head and neck. Keep an ice pack on the bedside table and a towel and ice to keep the body cool.
Take a Slightly Warm Shower
Taking a cold shower can cool the body down quickly, but studies have shown that showering in warm water before bed can make it easier to fall asleep. (Tai, Y. et al., 2021) The warm shower signals the body into cooling mode, which can help promote sleep as the body temperature falls at night. However, the water shouldn’t be too warm, which could exacerbate sweating.
Sleep Hygiene
It can be difficult to create the perfect sleep environment in hot weather. A healthy going-to-bed routine is essential in the summer, as stress and anxiety can significantly affect sleep quality. Avoid eating close to bedtime, avoid alcohol, and add some time to relax and unwind before going to bed. Sleep experts suggest general sleep hygiene habits like keeping a consistent bedtime and turning off screens an hour before bed can help improve sleep, even in hot weather. (Baranwal, N., Yu, P. K., and Siegel, N. S. 2023)
Chiropractic Treatment
Chiropractic care, massage, and decompression therapy can help improve sleep. Treatment retrains the body to relax; stretching and pulling the muscles increases blood circulation and advanced and improved brain signals telling the body to relax. A chiropractor will evaluate the individual’s sleeping patterns and recommend various strategies. Benefits include:
Muscle tension relief.
Stimulates nerve and blood circulation.
Relaxes the whole body.
Enhances central nervous system function.
Relieves pain and discomfort.
A chiropractor will also provide:
Sleeping position recommendations.
Postural stretches and exercises.
Recommendations on supportive mattresses.
Ergonomics for work, home, and bed.
Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution through an integrated approach to treating injuries and chronic pain syndromes, improving flexibility, mobility, and agility programs to relieve pain and help individuals return to normal. Our providers create personalized plans for each patient. If other treatments are needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments.
Beyond Adjustments: Chiropractic and Integrative Healthcare
Zheng, G., Li, K., & Wang, Y. (2019). The Effects of High-Temperature Weather on Human Sleep Quality and Appetite. International journal of environmental research and public health, 16(2), 270. doi.org/10.3390/ijerph16020270
Obradovich, N., Migliorini, R., Mednick, S. C., & Fowler, J. H. (2017). Nighttime temperature and human sleep loss in a changing climate. Science advances, 3(5), e1601555. doi.org/10.1126/sciadv.1601555
Tai, Y., Obayashi, K., Yamagami, Y., Yoshimoto, K., Kurumatani, N., Nishio, K., & Saeki, K. (2021). Hot-water bathing before bedtime and shorter sleep onset latency are accompanied by a higher distal-proximal skin temperature gradient in older adults. Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 17(6), 1257–1266. doi.org/10.5664/jcsm.9180
Baranwal, N., Yu, P. K., & Siegel, N. S. (2023). Sleep physiology, pathophysiology, and sleep hygiene. Progress in cardiovascular diseases, 77, 59–69. doi.org/10.1016/j.pcad.2023.02.005
How can healthcare professionals recognize and establish protocols for individuals who are being trafficked and provide a safe place?
Introduction
Today, we will look at part two of this series, which is about recognizing trafficking in a clinical setting. Today’s article in this two-part series of recognizing trafficking helps inform many healthcare professionals to understand the roles and protocols for identifying trafficking that is affecting their patients and help provide a safe, positive space for them. We discuss with certified associated medical providers who consolidate our patients’ information to assess and identify trafficking in the clinic while taking the proper protocols to ensure patient safety. We also inform and guide patients while asking their associated medical provider intricate questions to integrate and provide them with a safe and positive space. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer.
Health Care Professional’s Role in Identifying Trafficking
Even though they may come across victims of human trafficking and have the chance to step in, many healthcare professionals believe they lack the knowledge and self-assurance needed to recognize these victims and offer them the kind of aid they need. As an illustration:
Just 37% of social workers and medical professionals surveyed again had any training in recognizing and supporting victims of human trafficking (Beck et al., 2015).
It is extremely hard for processors to identify and aid victims because traffickers move their victims around a lot and employ various strategies to evade discovery. Frequently, it could be your final interaction with the victim (Macy & Graham, 2012).
There can be a companion who comes across as very domineering, who won’t let the patient spend time alone with you, or who insists on filling out paperwork or talking on the patient’s behalf.
It’s possible that neither the victim nor their friend will have identification or insurance paperwork and will just pay in cash.
The victim or their companion may refuse to answer questions.
The victim may decline additional testing and follow-up care.
The victim may have physical injuries, sexually transmitted diseases, and signs of psychosocial stress.
The victim may not know the city and state that they are in.
The victim may appear fearful when asked questions or in the presence of their companion.
The victim may exhibit feelings of shame, guilt, helplessness, or humiliation.
You may notice inconsistencies in basic information, such as age, name, address, work history, or information regarding living status and daily activities.
If the patient does not speak English, where are they from, and how did they arrive?
If the patient is a minor, who and where is the guardian?
The victim may have unusual tattoos to indicate that they are the “property” of their trafficker.
Recognizing the Signs of Trafficking
You can more easily spot possible victims and offer the right help if you are aware of the typical warning indicators of human trafficking. The following are typical signs that someone is being trafficked. Naturally, not all victims or forms of trafficking will exhibit all of the indicators. Work and Living Conditions (National Human Trafficking Hotline, n.d.):
The victim may not be able to come and go on their own or leave their current home or work situation.
Human trafficking victims are often minors who are forced to engage in commercial sex acts.
The individual may work in the commercial sex industry and be under the control of a pimp or manager.
The victim may be required to work unusual or excessively long hours.
The victim may receive little, if any, pay or may only receive tips.
The victim may be subjected to unusual or extreme restrictions at work or may not be allowed to take breaks.
The victim may owe a large debt to their “employer.”
The victim may have been lured to their current work or living situation through false promises about the nature of their work or living environment.
The victim’s home or work location may have unusually high security, such as opaque or boarded-up windows, bars on windows, high fences, and security cameras.
The victim may be required to live at their work location.
The victim may experience various signs of abuse at the hands of their employer.
The victim may not be paid directly. Instead, the money is directed to the supervisor or manager, who deducts a large percentage for living expenses and other debts.
The victim may be forced to meet unreasonable daily quotas.
The victim may be forced to work in unsafe work environments without the proper safety equipment.
Chiropractic Care for Healing After Trauma-Video
Best Practice Guidelines for Interviewing Trafficking Individuals
As a healthcare provider, you must continuously weigh the different courses of action at every interview process step. To establish trust and ensure safety, practitioners must, above all, put aside preconceived notions and assumptions about the victims and their behavior (Hodge, 2014; DeBoise, 2014; Hemmings, Jakobowitz, & Abas, 2016). Zimmerman and Watts (2003) suggest that the World Health Organization has produced rules for every phase of the interview process, which include the following recommendations:
It’s critical to keep in mind that every trafficking scenario and survivor is distinct, making it crucial to pay attention to and accept each person’s account.
It could take some time for victims to open up and be willing to talk about their experiences because it can be hard for them to build rapport and trust.
You should take precautions to protect both you and the victim because you should anticipate that the victim is at risk of psychological, bodily, social, and legal harm.
To prevent further upsetting the victim, you should consider the risks and advantages before beginning the interview process, as it can be a traumatic experience in itself.
While you should direct victims to available resources when necessary, you should avoid making unfulfilled promises or pledges.
The amount of time it takes for victims of human trafficking to be prepared to embrace change might vary greatly. Some victims can be eager to look for new possibilities and to improve their circumstances. Some people can be less likely to accept assistance because they haven’t developed enough trust issues or because they fear retaliation from their trafficker.
Depending on the situation, many service providers or interpreters must be present during the interview. Everyone taking part in the interview process ought to be reasonably knowledgeable about human trafficking, including how traffickers manipulate their victims and how to interact with them in a way that respects their cultural differences. To maintain anonymity and ensure the victim can communicate freely and honestly, you should refrain from using interpreters who are acquainted with the victim or who live in the same neighborhood.
Having an emergency safety plan in place is crucial to shielding the victim from harm—both from others and self-harm.
Consent must always be obtained voluntarily for all interventions, including interviews. For many victims who have never known autonomy or self-determination, this may be a foreign idea.
Avoid using legal or technical jargon.
Furthermore, it’s critical to remember that trauma survivors may suffer after treatment can have a lasting effect on all facets of their lives, making psychological, emotional, and physical safety a top priority. It is reasonable to presume that the person provides the most accurate account of their experience at that time. A person’s guarded, defensive, and belligerent behavior may be only their coping mechanism for their trauma. (V. Greenbaum, 2017)
How to Report Known or Suspected Trafficking
The best way to report suspected trafficking is by calling the National Human Trafficking Hotline or texting the number 711 if the patient responds affirmatively to the evaluation questions if your findings imply that they might be victims of human trafficking. Additionally, you can text 233733. Basic details about the case will be requested from you, such as (National Human Trafficking Hotline, n.d.):
the location of the suspected trafficking
the name of the alleged trafficker, if possible
your city and state
how you learned about the hotline
Health care providers who know or believe that a youngster is being abused, neglected, or abandoned should report their concerns to law enforcement or the relevant child welfare agency right away, as they are required reporters under child abuse and neglect statutes. You can report abuse online or by calling the Department of Children and Families Abuse Hotline in the state you are residing in.
Documenting Physical Findings
Physical findings should be meticulously and precisely recorded using written descriptions, freehand sketches that have been identified and annotated, and digital or film photos with the patient’s consent. Regarding photography, the picture should show the patient’s face and the lesion or injury measured using a coin, ruler, or other common object. The photo should include a piece of paper bearing the date the picture was taken. More photos can capture up close shots of every pertinent lesion or injury. Serial follow-up photos over seven to ten days can be used to record the healing or advancement of ecchymoses and other injury-related symptoms. A statement identifying the photographer and attesting to the accuracy and integrity of the images ought to be incorporated into the chart. Before any photos are taken, consent for the photographic documentation should be sought and recorded. Patients should be aware of their rights, which include the ability to decline all photographic documentation or limit it to a limited number of specified locations.
In addition to providing essential medical care, the healthcare professional should work to establish an environment where each patient feels respected, comfortable, cared for, validated, and empowered to reveal if they so choose. If the patient does not feel “ready” to demonstrate in the clinical environment, disclosure may happen later. As a result, for at-risk patients, every single clinical interaction should be seen as a step toward their eventual safety.
Laws & Policies for Human Trafficking
The United States has enacted a variety of laws and policies designed to prevent human trafficking, punish the perpetrators, and protect the survivors. One of these laws and policies is the Trafficking Victims Protection Act law or the TVPA (U.S. Congress).
This is the centerpiece of federal human trafficking legislation. The act focuses on three primary areas:
The TVPA seeks to prevent human trafficking through increased training and awareness.
The act seeks to protect trafficking victims by providing them access to services using federal funds similar to other refugees.
The act establishes trafficking and related crimes as federal offenses subject to stiff penalties.
One way that the legislation protects victims of human trafficking is that it absolves them of consequences for engaging in criminal activities that arise from their trafficking experience, such as entering the nation using fraudulent documents or working without the proper authorization. In addition, families of trafficking victims are qualified for T visas, which let them stay in the nation to support federal law enforcement in their pursuit of the offenders. After three years, victims can then apply to become permanent residents. Depending on the specific circumstances, many individuals may be entitled to assistance and benefits, such as access to the Witness Security Program and reparations. In addition, individuals between 16 and 24 could qualify for the Job Corp program and work permits.
Others criticize the TVPA. Usually, the onus is on the victim to prove their innocence or compulsion first. Second, the act emphasizes sex trafficking more than other types of human trafficking, which ignores how intricate human trafficking is. Only victims and survivors of “severe” types of trafficking who are prepared to cooperate with the investigation and prosecution of their offenders are eligible for the services provided under the act. This ignores the severity of the abuse the victims endured and the degree of mistrust and terror they might harbor toward both the abuser and others in positions of power.
Preventing Trafficking Through Awareness, Interventions, & Resources
In the shadows, human trafficking flourishes. We eradicate the shadows where human traffickers lurk by increasing public and health practitioner awareness of the problem (Hodge, 2008; Gozdziak & MacDonnell, 2007). For instance, putting up signs and pamphlets on human trafficking can not only help to enhance public awareness but also boost the chance that victims may come forward on their own. Brochures and posters are free from the Campaign to Rescue and Restore Victims of Trafficking.
When assisting victims of human trafficking, practitioners and service providers need to be able to engage with a variety of governmental, legal, medical, and social service organizations and institutions. Generally speaking, there are three main categories into which the care and services that a victim falls (Dell et al., 2019; Johnson, 2012; Oram & Domoney, 2018):
Immediate Services
Services Related to Recovery
Services About Reintegration
Resources for Providers
The National Human Trafficking Resource Center’s referral database can be consulted by providers looking to connect with local programs that assist victims of human trafficking or who need assistance for a victim or survivor. Many healthcare providers can check out the website to provide helpful resources in their local area.
Conclusion
Any human trafficking violates fundamental rights. Since human trafficking has many underlying roots, eradicating the issue would need different approaches on various fronts. When it comes to addressing racism, poverty, oppression, prejudice, and other factors that lead to human trafficking, healthcare professionals need to be dedicated to facing this issue both within their patient population and in partnership with colleagues from different disciplines. Physicians, social workers, counselors, and other health care professionals are required by their code of ethics to lead in addressing power abuses and advancing social justice. Practitioners can accomplish this, among other things, by teaching others and themselves about the intricate dynamics and international scope of human trafficking.
References
Beck, M. E., Lineer, M. M., Melzer-Lange, M., Simpson, P., Nugent, M., & Rabbitt, A. (2015). Medical providers’ understanding of sex trafficking and their experience with at-risk patients. Pediatrics, 135(4), e895-902. doi.org/10.1542/peds.2014-2814
DeBoise, C. (2014). Human Trafficking and Sex Work: Foundational Social-Work Principles. Meridians: Feminism, Race, Transnationalism, 12(1), 227–233. muse.jhu.edu/article/541879/pdf
Dell, N. A., Maynard, B. R., Born, K. R., Wagner, E., Atkins, B., & House, W. (2019). Helping Survivors of Human Trafficking: A Systematic Review of Exit and Postexit Interventions. Trauma Violence Abuse, 20(2), 183-196. doi.org/10.1177/1524838017692553
Gozdziak, E., & MacDonnell, M. (2013, March 4). Closing the Gaps: the Need to Improve Identification and Services to Child Victims of Trafficking by School of Foreign Service – Georgetown University – Issuu. Issuu.com. issuu.com/georgetownsfs/docs/gozdziak-closing-the-gaps
Greenbaum, V. J. (2017). Child sex trafficking in the United States: Challenges for the healthcare provider. PLoS Med, 14(11), e1002439. doi.org/10.1371/journal.pmed.1002439
Hemmings, S., Jakobowitz, S., Abas, M., Bick, D., Howard, L. M., Stanley, N., Zimmerman, C., & Oram, S. (2016). Responding to the health needs of survivors of human trafficking: a systematic review. BMC Health Serv Res, 16, 320. doi.org/10.1186/s12913-016-1538-8
Hodge, D. R. (2008). Sexual trafficking in the United States: a domestic problem with transnational dimensions. Soc Work, 53(2), 143-152. doi.org/10.1093/sw/53.2.143
Macy, R. J., & Graham, L. M. (2012). Identifying domestic and international sex-trafficking victims during human service provision. Trauma Violence Abuse, 13(2), 59-76. doi.org/10.1177/1524838012440340
Oram, S. (2021). Responding to the mental health needs of trafficked women. European Psychiatry, 64(S1), S12-S12. doi.org/10.1192/j.eurpsy.2021.55
Zimmerman, C., & Watts, C. (2003). Ethical and safety recommendations for intervention research on violence against women. Www.who.int. www.who.int/publications/i/item/9789241510189
Can increasing endurance help individuals who want to improve their physical abilities or extend the time they perform these activities?
Endurance
Individuals tend to think of endurance in terms of exercise and fitness, such as running, biking, swimming, and strength training. While this is true, endurance is involved in nearly every task we perform. For example, an individual has to have enough endurance to complete a full day of activities. This includes:
Carpooling the kids
Professional responsibilities
Home chores
Preparing dinner
Helping out kids with homework, etc.
Nearly every activity requires some level of endurance, which means the ability to maintain activity for an extended period of time. When endurance begins to wane, it usually results from not performing certain activities regularly. The body gets used to daily routines and activities. When it stops engaging in certain activities, like walking and exercising regularly, endurance slowly declines, and the ability to perform at the same caliber.
What Is It?
Endurance is an ability that is acquired after extensive physical and mental training. Physiological and psychological factors reinvigorate individuals to continue doing what they are doing longer. Factors include:
Fatigue
Individuals who didn’t sleep well the night before or are worn out may have difficulty following through with certain activities that require extensive output or stamina.
Fitness Levels
Current fitness levels are also a predictor of endurance.
How physically fit an individual is, coupled with their level of training, will impact endurance abilities.
Genetics is another factor, as everybody has different muscle fibers that can influence physical capabilities. While research shows that individuals can gradually alter the amount of these fibers, it also emphasizes the role of genetics in determining one’s muscle makeup. (de Souza, E. O. et al., 2014)
Individuals who constantly challenge themselves mentally and physically are continually building endurance.
Endurance and Stamina Difference
Endurance is often used interchangeably with stamina. However, the two are very different.
Stamina refers to how long an individual can perform a certain activity at maximum capacity or without getting tired.
Endurance revolves around an individual’s ability to perform a certain activity without performing at maximum capacity.
Types
Endurance can be divided into classifications defined by type. Here are the main types of endurance in physical fitness and what they mean.
Cardiovascular
Cardiovascular endurance is the stress an individual’s heart can take during physical activity.
When building cardiovascular endurance, the body becomes more efficient at pumping blood while performing a specific activity.
Individuals with more cardiovascular endurance can sustain longer and more intense overall training.
Muscular
Muscular endurance is the length of time muscles can continue to contract enough to allow the body to finish a certain activity.
An individual lacking in muscular endurance will succumb faster to excess lactic acid build-up, causing cramps.
An individual with significant muscular endurance can lift a weight for more repetitions before failure.
Anaerobic
Anaerobic means without oxygen, so anaerobic endurance refers to how long a muscle can continue working at a certain physical level without much or any oxygen.
Weightlifting is a great example of this.
Anaerobic exercise tends to be shorter in duration but more intense than aerobic exercise, like swimming or cycling.
Improvement
Through endurance training, individuals can improve their ability to carry out certain activities longer. Recommendations for how to improve include.
Interval Training
Interval training, or high-intensity interval training, involves increasing the intensity of the workout for a short period of time.
If running, intentionally push the pace harder than normal for 20-second intervals.
Followed by a slower recovery pace for about a minute.
This increases endurance and improves insulin sensitivity.
Pedaling on an air bike is another recommended activity to build strength and endurance.
Rest Less Between Sets
Resting in between certain types of physical activity is beneficial, it can also lower heart rate and endurance threshold.
Taking less rest between workout sets so that the heart rate stays elevated increases endurance with each workout.
Perform a Few More Reps On Each Set
Whatever the type of exercise being done, one way to enhance endurance is to add one more rep, one more mile, or a few more minutes to the fitness schedule.
The body will slowly adapt to that level, making it the new norm.
Increase Core Strength
No matter the workout—running, swimming, cycling, or weight lifting—it’s important to focus on strengthening the core. This will help improve endurance in any activity and prevent injuries.
Individuals having trouble taking their workouts to the next level and feeling that their endurance has flattened should consider enlisting the help of a certified personal trainer. If there is any discomfort or pain when working to increase endurance, seek advice from a healthcare professional. Injury Medical Chiropractic and Functional Medicine Clinic uses an integrated approach to treating injuries and chronic pain syndromes. It offers personalized care plans that improve ability through flexibility, mobility, and agility programs to relieve pain. Our providers use an integrated approach to create personalized care plans for each patient, including Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine principles. Our goal is to relieve pain naturally by restoring health and function to the body. If other treatment is needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments.
Unlocking Athletic Potential
References
de Souza, E. O., Tricoli, V., Aoki, M. S., Roschel, H., Brum, P. C., Bacurau, A. V., Silva-Batista, C., Wilson, J. M., Neves, M., Jr, Soares, A. G., & Ugrinowitsch, C. (2014). Effects of concurrent strength and endurance training on genes related to myostatin signaling pathway and muscle fiber responses. Journal of strength and conditioning research, 28(11), 3215–3223. doi.org/10.1519/JSC.0000000000000525
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