As the body ages, individuals want to stay active and maintain a healthy pain free lifestyle. Can regenerative cells for arthritis and cartilage damage be the future of neuromusculoskeletal medicine and joint healing?
Regenerative Cells For Arthritis and Cartilage Damage
Individuals want to continue to do the physical activities they love, which require healthy joints. Scientists are learning how to harness the abilities of regenerative cells to repair and regrow damaged and deteriorated cartilage. Current stem cell treatment of cartilage problems has not been shown to reverse the effects of arthritis and while studies show clinical improvement, further research is necessary. (Bryan M. Saltzman, et al., 2016)
Cartilage and How It Gets Damaged
Cartilage is a type of connective tissue. In the joints, there are a few types of cartilage. The most commonly referred to is the smooth lining known as articular or hyaline cartilage. This type forms a smooth layer of cushion on the end of a bone at the joint. (Rocky S. Tuan, et al., 2013)
The tissue is very strong and has the ability to compress and absorb energy.
It is very smooth allowing a joint to glide effortlessly through a limb’s range of motion.
When joint cartilage is damaged, the cushioning can wear down.
In traumatic injuries, a sudden force can cause the cartilage to break off and/or suffer damage, that exposes the underlying bone.
In osteoarthritis – degenerative or wear-and-tear arthritis, the smooth layer can wear down thin and unevenly.
Eventually, the cushion wears away, the joints become inflamed and swollen and movements become stiff and painful.
There are treatments for arthritis and cartilage damage, but these treatments are usually focused on relieving symptoms by smoothing down the damaged cartilage or replacing the joint surface with an artificial implant, like knee replacement or hip replacement surgeries. (Robert F. LaPrade, et al., 2016)
Regenerative Cells
Regenerative stem cells are special cells that have the ability to multiply and develop into different types of tissue. In an orthopedic surgery setting for joint problems, stem cells are obtained from adult stem cell primary sources which are bone marrow and fatty tissue. These cells have the ability to develop into cartilage cells, called chondrocytes. (Rocky S. Tuan, et al., 2013)
They also help by stimulating the body to reduce inflammation, stimulate cell repair, and improve blood circulation.
This process is caused by cellular signals and growth factors to stimulate the body to activate the healing processes.
Once stem cells have been obtained, they need to be delivered to the area of cartilage damage.
Cartilage is a complex tissue that is described as a scaffold structure that is composed of collagen, proteoglycans, water, and cells. (Rocky S. Tuan, et al., 2013)
To regenerate cartilage, the complex tissues must also be reconstructed.
There are studies on types of tissue scaffolds engineered to recreate a similar type of cartilage structure.
The stem cells can then be injected into the scaffold, in hopes of restoring a normal type of cartilage.
Non-Surgical Arthritis Treatments
Standard treatments such as cortisone shots or physical therapies work as well and provide benefits that could be utilized in combination with regenerative cells for arthritis and cartilage damage in the near future. Data takes time and therefore how this impacts the long-term health of a joint needs continued research in terms of tissue engineering and cell delivery to determine the best approach to help individuals.
Arthritis
References
LaPrade, R. F., Dragoo, J. L., Koh, J. L., Murray, I. R., Geeslin, A. G., & Chu, C. R. (2016). AAOS Research Symposium Updates and Consensus: Biologic Treatment of Orthopaedic Injuries. The Journal of the American Academy of Orthopaedic Surgeons, 24(7), e62–e78. https://doi.org/10.5435/JAAOS-D-16-00086
Saltzman, B. M., Kuhns, B. D., Weber, A. E., Yanke, A., & Nho, S. J. (2016). Stem Cells in Orthopedics: A Comprehensive Guide for the General Orthopedist. American journal of orthopedics (Belle Mead, N.J.), 45(5), 280–326.
Tuan, R. S., Chen, A. F., & Klatt, B. A. (2013). Cartilage regeneration. The Journal of the American Academy of Orthopaedic Surgeons, 21(5), 303–311. https://doi.org/10.5435/JAAOS-21-05-303
Can adding calisthenics resistance training to a fitness routine provide health benefits like flexibility, balance, and coordination?
Calisthenics Resistance Training
Calisthenics resistance training requires no equipment, they can be done with minimal space, and are a great way to get a quick burn.
They are a form of resistance training using your own body weight that is low-impact, which makes it accessible to individuals of all ages and fitness levels.
They effectively help build agility, and cardiovascular health, and improve balance, coordination, and flexibility.
Benefits
Muscle Strength
Because calisthenics are easily adaptable to any fitness level, require minimal or no equipment, and are great for beginners and experienced exercise enthusiasts it is a fantastic full-body workout and an excellent way to build strength and muscle. Research supports that calisthenics resistance training can improve muscle strength in various ways.
One study found that eight weeks of calisthenics not only improved posture and body mass index/BMI but can impact strength, even with exercises not routinely performed. (Thomas E, et al., 2017)
During the study, one group did calisthenics and the other maintained regular training routines.
The researchers discovered that the group that did calisthenics increased their repetitions of exercises that were not included.
The group who continued with their regular training routines did not improve on what they could do before the eight-week study. (Thomas E, et al., 2017)
Cardiovascular Fitness
Regular participation in calisthenic resistance training can lead to improved cardiovascular health, including increased endurance and a healthier heart.
Certain calisthenic exercises, like burpees and mountain climbers, are high-intensity movements that can increase heart rate and blood circulation just from the movements.
Gradually performing these exercises at a faster pace, research indicates could potentially experience the same cardiovascular benefits from interval or treadmill running. (Bellissimo GF, et al., 2022) – (Lavie CJ, et al., 2015)
Balance, Coordination, and Flexibility
The movements require a full range of motion that stretches and strengthens the muscles, tendons, and ligaments.
These exercises can help decrease the risk of injury and make daily physical activities easier to perform without over-exertion.
Incorporating calisthenics resistance training on a regular basis can help improve posture, balance, and flexibility, depending on which exercises are recommended.
Exercises like stretches, lunges, and squats help to improve flexibility and mobility.
Exercises like single-leg squats and one-arm push-ups can work the balance, coordination, and proprioception of the body.
Mental Health
Exercise, in general, is known to improve mood, reduce stress, and improve overall well-being.
Calisthenic resistance training can have additional impacts on mental well-being.
For example, the discipline and focus required to perform the movements can help concentration and mental clarity.
One study found that calisthenics can reduce cognitive decline and may be useful for dementia prevention. (Osuka Y, et al., 2020)
Another study found that calisthenics helped mental well-being in individuals with diseases like ankylosing spondylitis and multiple sclerosis. (Taspinar O, et al., 2015)
Types
Bodyweight exercises that use an individual’s own body weight as resistance are the foundation. Common examples include push-ups, squats, and lunges. An overview of some of the types of exercises.
Pulling
These exercises focus on training the muscles for pulling movements, which include the back, shoulders, and arms.
Examples include pull-ups, chin-ups, and rows.
Pushing
These exercises focus on training the muscles for pushing movements, like the chest, shoulders, and triceps.
Examples include dips, push-ups, and handstand push-ups.
Core
Core exercises focus on training the abdominal and lower back muscles, which are responsible for maintaining stability and balance.
Examples of core exercises include planks, sit-ups, and leg raises.
Single-Leg
Single-leg exercises focus on training one leg at a time.
These target the muscles of the legs, hips, and core.
Examples of single-leg exercises include single-leg squats, lunges, and step-ups.
Plyometric
Calisthenics resistance training focuses on powerful explosive movements.
Plyometric exercises challenge the muscles to work quickly and forcefully.
Examples include jump squats, clap push-ups, and box jumps.
Getting Started
Start by making sure calisthenics is an appropriate workout option, especially if you are a beginner or have pre-existing medical conditions.
Once cleared to exercise start with familiar movements that can be done with the correct form.
Pushups, bodyweight squats, planks, lunges, and other basic movements are a good place to start.
Make sure to warm up with light and easy motions that mimic the workout movements.
Aim to work each body part during the workout.
Try for at least two workouts a week.
It is recommended to split the movement patterns.
Reps can be counted or set a timer to switch exercises every minute. This is called EMOM-style or every minute on the minute.
Pick four to five exercises that target various areas.
For example, sit-ups can be done for the core, lunges for the glutes and thighs, planks can be done for the shoulders and core, and jumping jacks or jumping rope for cardiovascular.
Calisthenic resistance training is easily modifiable and can be adjusted to individual needs.
Core Strength
References
Thomas, E., Bianco, A., Mancuso, E. P., Patti, A., Tabacchi, G., Paoli, A., … & Palma, A. (2017). The effects of a calisthenics training intervention on posture, strength, and body composition. Isokinetics and exercise science, 25(3), 215-222.
Bellissimo, G. F., Ducharme, J., Mang, Z., Millender, D., Smith, J., Stork, M. J., Little, J. P., Deyhle, M. R., Gibson, A. L., de Castro Magalhaes, F., & Amorim, F. (2022). The Acute Physiological and Perceptual Responses Between Bodyweight and Treadmill Running High-Intensity Interval Exercises. Frontiers in physiology, 13, 824154. https://doi.org/10.3389/fphys.2022.824154
Osuka, Y., Kojima, N., Sasai, H., Ohara, Y., Watanabe, Y., Hirano, H., & Kim, H. (2020). Exercise Types and the Risk of Developing Cognitive Decline in Older Women: A Prospective Study. Journal of Alzheimer’s disease: JAD, 77(4), 1733–1742. https://doi.org/10.3233/JAD-200867
Taspinar, O., Aydın, T., Celebi, A., Keskin, Y., Yavuz, S., Guneser, M., Camli, A., Tosun, M., Canbaz, N., & Gok, M. (2015). Psychological effects of calisthenic exercises on neuroinflammatory and rheumatic diseases. Zeitschrift fur Rheumatologie, 74(8), 722–727. https://doi.org/10.1007/s00393-015-1570-9
Lavie, C. J., Lee, D. C., Sui, X., Arena, R., O’Keefe, J. H., Church, T. S., Milani, R. V., & Blair, S. N. (2015). Effects of Running on Chronic Diseases and Cardiovascular and All-Cause Mortality. Mayo Clinic Proceedings, 90(11), 1541–1552. https://doi.org/10.1016/j.mayocp.2015.08.001
Can musculoskeletal therapies treat individuals with upper crossed syndrome to relieve pain, improve posture, and strengthen the muscles in the neck, shoulders and chest?
Upper Crossed Syndrome
Upper crossed syndrome is a condition in which the muscles of the shoulders, neck, and chest become weak and tight, and is usually brought on from practicing unhealthy posture. Symptoms typically include:
Neck stiffness and pulling sensations.
Jaw tension and/or tightness
Upper back tension, lack of flexibility, stiffness, and aching soreness.
Neck, shoulder, and upper back pain.
Tension headaches
Rounded shoulders
Hunched spine
Upper Crossed Syndrome and Posture
The condition affects healthy posture by creating imbalanced muscles between the upper back and chest.
The tight short muscles in the upper chest get overly stretched and remain in a semi-contracted state pulling on the back muscles.
This causes the muscles in the upper back, shoulders, and neck to get pulled and weaken.
The result is a hunched back, forward shoulders, and protruded neck.
The specific muscles affected include the trapezius and the levator scapula/side of the neck muscles. (Hospital for Special Surgery. 2023)
Prescription anti-inflammatory medication for pain symptoms – short-term.
Individuals may be advised by the chiropractic therapy team to avoid too much bed rest and to limit or avoid activities that can cause pain or worsen symptoms. (Cedars-Sinai. 2022)
Studies have shown chiropractic spinal manipulation effectively reduces neck, spine, and low back pain symptoms. (Gevers-Montoro C, et al., 2021)
Increasing or decreasing physical activity as recommended by the therapy team.
Using ice or heat packs to relieve pain and increase circulation to promote muscle rehabilitation and healing.
Using topical pain creams or gels.
Over-the-counter nonsteroidal – NSAIDs, like Advil or Motrin and Aleve.
Muscle relaxants to relieve tension short-term.
Enhance Your Lifestyle
References
Hospital for Special Surgery. Move with the purpose to combat upper and lower crossed syndromes.
National Institute of Arthritis and Musculoskeletal and Skin Diseases. Back pain.
Seidi, F., Bayattork, M., Minoonejad, H., Andersen, L. L., & Page, P. (2020). Comprehensive corrective exercise program improves alignment, muscle activation, and movement pattern of men with upper crossed syndrome: a randomized controlled trial. Scientific reports, 10(1), 20688. https://doi.org/10.1038/s41598-020-77571-4
Bae, W. S., Lee, H. O., Shin, J. W., & Lee, K. C. (2016). The effect of middle and lower trapezius strength exercises and levator scapulae and upper trapezius stretching exercises in upper crossed syndrome. Journal of physical therapy science, 28(5), 1636–1639. https://doi.org/10.1589/jpts.28.1636
National Institute of Neurological Disorders and Stroke. Back pain.
Cedars-Sinai. Back and neck pain.
Gevers-Montoro, C., Provencher, B., Descarreaux, M., Ortega de Mues, A., & Piché, M. (2021). Clinical Effectiveness and Efficacy of Chiropractic Spinal Manipulation for Spine Pain. Frontiers in pain research (Lausanne, Switzerland), 2, 765921. https://doi.org/10.3389/fpain.2021.765921
Are treatments more successful when patients know key terms that describe their back pain and associated conditions?
Nerve Pain Types
When individuals need to better understand their spine diagnosis, being able to distinguish between key terms can make a significant difference in understanding the development of a personalized treatment plan. Terms that describe back pain and various associated conditions can include:
Sciatica
Radiating and Referred pain
Radiculopathy
Radiculitis
Neuropathy
Neuritis
Causes of Back Pain
Back pain symptoms are most commonly caused by the continued practice of unhealthy/poor posture and overcompensated and weakened muscles. Even for individuals that exercise regularly, the movement choices that are made throughout the day can disrupt the way the muscles, tendons, ligaments, and fascia function to maintain proper body alignment.
Injuries to, and conditions of, the structures of the spinal column like the bones, discs, and nerves, are generally more serious than posture problems and soft tissue-related pain.
Depending on the diagnosis, structural problems can cause symptoms related to nerve compression, irritation, and/or inflammation. (Michigan Medicine, 2022)
Spine and Nervous System
The peripheral nerves extend out to the extremities with sensation and movement capabilities.
Nerve roots exit the spinal canal which is part of the peripheral nervous system.
The branching of nerves from the spinal cord and exit out of the foramina occurs at every level of the spine.
Terms
There are different medical terms when getting a spine diagnosis or going through the treatment process.
Radiculopathy
Radiculopathy is an umbrella term, describing any disease process that affects a spinal nerve root and is something that’s happening to the body.
When a healthcare provider informs you that your pain is due to radiculopathy, a number of more specific diagnoses, clinical signs, and symptoms may be included as part of the description.
Common causes of radiculopathy include herniated disc/s and spinal stenosis.
Less common causes can include a synovial cyst or tumor that presses on the nerve root. (Johns Hopkins Medicine, 2023)
Radiculopathy can occur in the neck, low back, or in the thoracic area.
Often, radiculopathy is brought on by some form of compression of the nerve root.
For example, extruded material from a herniated disc can land on a nerve root, causing pressure to build.
This can cause symptoms associated with radiculopathy, including numbness, weakness, pain, or electrical sensations. (Johns Hopkins Medicine, 2023)
Even though there’s a spinal nerve root on either side of the spinal column, injury, trauma, or issues stemming from degeneration affect the nerves in an asymmetric fashion. Degenerative changes, known as normal wear and tear, typically occur in this fashion. Using the previous herniated disc example, the material that leaks from the disc structure tends to travel in one direction. When this is the case, the symptoms tend to be experienced on the side where the nerve root makes contact with the disc material, but not the other side. (American Association of Neurological Surgeons, 2023)
Radiculitis
Radiculitis is a form of radiculopathy but it is about inflammation and not compression. (Johns Hopkins Medicine, 2023)
Radicu– refers to the spinal nerve root.
The suffix – itis refers to inflammation.
The word refers to a spinal nerve root that is inflamed and/or irritated rather than compressed.
In disc herniations, it is the gel substance that contains various chemicals that is inflammatory.
When the gel substance makes contact with nerve roots, an inflammatory response is triggered. (Rothman SM, Winkelstein BA 2007)
Radiating or Referred Pain
Radiating pain follows the path of one of the peripheral nerves that transmit sensory information like heat, cold, pins and needles, and pain.
Referred pain is experienced in a different area of the body that is away from the pain source which tends to be an organ. (Murray GM., 2009)
It can be brought on by myofascial trigger points or visceral activity.
An example of referred pain is symptoms in the jaw or arm when an individual is having a heart attack. (Murray GM., 2009)
Radicular
The terms radicular pain and radiculopathy tend to get confused.
Radicular pain is a symptom of radiculopathy.
Radicular pain radiates from the spinal nerve root to either part or all the way down the limb/extremity.
However, radicular pain does not represent the complete symptoms of radiculopathy.
Radiculopathy symptoms also include numbness, weakness, or electrical sensations like pins and needles, burning, or shock that travels down the extremity. (Johns Hopkins Medicine, 2023)
Neuropathy
Neuropathy is another umbrella term that refers to any dysfunction or disease that affects the nerves.
It’s usually classified according to the cause, like diabetic neuropathy, or the location.
Neuropathy can occur anywhere in the body – including the peripheral nerves, the autonomic nerves/organ nerves, or nerves that are located inside the skull and innervate the eyes, ears, nose, etc.
Peripheral nerves are the long, thin strands that supply sensation, feeling, and movement impulses to all areas of the body located outside the central nervous system.
Piriformis syndrome is where a tight buttock/piriformis muscle constricts the sciatic nerve, which runs underneath. (Cass SP. 2015)
Chiropractic
Chiropractic adjustments, non-surgical decompression, MET, and various massage therapies can relieve symptoms, release stuck or trapped nerves and restore function. Through the treatments, the chiropractor and therapists will explain what is happening and why they are using a specific technique. Knowing a little about how the neuromusculoskeletal system operates can help the healthcare provider and the patient in developing and adjusting effective treatment strategies.
Sciatica During Pregnancy
References
Michigan Medicine. Upper and Middle Back Pain.
American Academy of Neurological Surgeons. Anatomy of the Spine and Peripheral Nervous System.
Johns Hopkins Medicine. Health Conditions. Radiculopathy.
American Association of Neurological Surgeons. Herniated Disc.
American Academy of Orthopaedic Surgeons. OrthoInfo. Cervical Radiculopathy (Pinched Nerve).
Rothman, S. M., & Winkelstein, B. A. (2007). Chemical and mechanical nerve root insults induce differential behavioral sensitivity and glial activation that are enhanced in combination. Brain Research, 1181, 30–43. https://doi.org/10.1016/j.brainres.2007.08.064
Murray G. M. (2009). Guest Editorial: referred pain. Journal of applied oral science: Revista FOB, 17(6), i. https://doi.org/10.1590/s1678-77572009000600001
American Academy of Orthopaedic Surgeons. OrthoInfo. Carpal Tunnel Syndrome.
Bostelmann, R., Zella, S., Steiger, H. J., & Petridis, A. K. (2016). Could Spinal Canal Compression be a Cause of Polyneuropathy? Clinics and practice, 6(1), 816. https://doi.org/10.4081/cp.2016.816
Cleveland Clinic. Mononeuropathy.
American Association of Neurological Surgeons. Glossary of Neurosurgical Terminology.
National Institutes of Health. U.S. National Library of Medicine. Medline Plus. Peripheral Nerve Disorders.
Cleveland Clinic. Spinal Stenosis.
Cass S. P. (2015). Piriformis syndrome: a cause of non-discogenic sciatica. Current sports medicine reports 14(1), 41–44. https://doi.org/10.1249/JSR.0000000000000110
Individuals at work, school, etc, perform all kinds of repetitive physical tasks that put their bodies through a great deal of musculoskeletal stress, what are the effects and benefits of joint manipulation therapy for pain relief?
Joint Manipulation Health Benefits
Joint manipulation is a form of manual therapy that involves applying force to the spinal or peripheral joints to:
Relieve pain symptoms.
Realign the joints to their proper position.
Restore flexibility.
Improve mobility.
Increase range of motion.
Chiropractors, massage, and physical therapists use various manipulation techniques to help move and feel better after an injury or illness that causes loss of functional mobility. Here we explain joint manipulation, its applications, and if the technique is safe for you and your condition.
Joint Popping
The joints in the body are places where two or more bones come together to allow movement.
The cartilage allows the joint surfaces to glide/slide smoothly.
If the cartilage is injured or damaged, pain and limited motion can present.
When a joint doesn’t move properly, the muscles surrounding that joint don’t contract properly.
If a joint is dysfunctional for some time, significant muscle wasting and atrophy can occur around the joint, leading to difficulty with mobility like standing, walking, or reaching. (Hurley MV.1997)
The body is made up of cells that breathe by converting energy and releasing waste materials. One type of waste material from cell respiration is carbon dioxide. The gas is transported through the blood and delivered out of the body while breathing. Small pockets of gas can get trapped in the joints that expand and contract as pressure around the joint changes during movement, known as cavitation. When the gas is released through joint manipulation, there can be a popping or snapping sound as the joint is moved. Once the gas is released, joint pressure is decreased and mobility is increased. (Kawchuk, et al., 2015)
Causes
Non-medical
There are non-medical and medical causes of joint dysfunction and derangement that include:
Overuse and repetitive strain.
Unhealthy sitting and/or standing posture.
Lack of physical activity.
Over-stretching or stretching incorrectly.
In these situations, the joints can be temporarily placed in a dysfunctional/compromised position. When moving to the correct position, a popping sound can present as built-up pressure is released.
Medical
Joint problems can occur from medical conditions that can include:
Herniated cervical or lumbar discs.
Spinal arthritis.
Rheumatoid arthritis.
Osteoarthritis.
Joint contracture after being immobilized for some time.
In these cases, a medical problem can be causing a limitation in the joint’s position and movement. (Gessl, et al., 20220)
Benefits
If a chiropractic practitioner determines there is joint dysfunction then manipulation may be a treatment option. The benefits include:
Pain Relief
When a chiropractor or therapist gets an injured joint moving properly, the receptors in and around the area get reset allowing for pain relief.
Improved Muscle Activation
As a chiropractor manipulates a joint into its correct anatomical position, the surrounding muscles can flex and contract properly.
Improved Range of Motion
The joint is repositioned for proper movement.
This improves the range of motion and relieves tightness and stiffness.
Improved Functional Mobility
Once a joint is manipulated, the improved range of motion and muscle activation around the joint can lead to improved overall functional mobility. (Puentedura, et al., 2012)
Candidates
Joint manipulation is a safe manual therapy technique for certain individuals. (Puentedura, et al., 2016) This includes:
Individuals with acute neck, back, or peripheral joint pain.
Adults aged 25 to 65 with no serious medical conditions.
Athletes who have been injured from their sport.
Individuals who have been immobilized after injury or surgery.
Joint manipulation is not recommended for everyone and can be dangerous or lead to injury in individuals with certain conditions. (Puentedura, et al., 2016) These include individuals with:
Osteoporosis
Weakened bones may fracture if a high-velocity force is applied to a joint via manipulation
Joint fractures
Individuals with a joint fracture, should not have that specific joint manipulated.
Post Spinal Fusion Surgery
Individuals that have had spinal fusion in the neck or lower back should avoid spinal joint manipulations or adjustments for at least one year after the procedure.
The bones need time to heal thoroughly.
Manipulation can cause a failure of the fusion.
Individuals with Arterial Insufficiency In Their Neck
A rare but dangerous side effect of a neck adjustment is the risk of tearing an artery in the neck known as the vertebrobasilar artery. (Moser, et al., 2019)
If there is pain, loss of movement, or decreased mobility after an injury or surgery, a chiropractic adjustment with joint manipulation can be beneficial to help regain movement. Manual techniques can help improve joint mobility, alleviate pain, and increase strength and stability around the joints. Joint manipulation isn’t for everyone and is recommended to consult with a healthcare professional to see if it is safe for your specific condition.
Gessl, I., Popescu, M., Schimpl, V., Supp, G., Deimel, T., Durechova, M., Hucke, M., Loiskandl, M., Studenic, P., Zauner, M., Smolen, J. S., Aletaha, D., & Mandl, P. (2021). Role of joint damage, malalignment, and inflammation in articular tenderness in rheumatoid arthritis, psoriatic arthritis, and osteoarthritis. Annals of the rheumatic diseases, 80(7), 884–890. https://doi.org/10.1136/annrheumdis-2020-218744
Hurley M. V. (1997). The effects of joint damage on muscle function, proprioception, and rehabilitation. Manual therapy, 2(1), 11–17. https://doi.org/10.1054/math.1997.0281
Kawchuk, G. N., Fryer, J., Jaremko, J. L., Zeng, H., Rowe, L., & Thompson, R. (2015). Real-time visualization of joint cavitation. PloS one, 10(4), e0119470. https://doi.org/10.1371/journal.pone.0119470
Moser, N., Mior, S., Noseworthy, M., Côté, P., Wells, G., Behr, M., & Triano, J. (2019). Effect of cervical manipulation on the vertebral artery and cerebral hemodynamics in patients with chronic neck pain: a crossover randomized controlled trial. BMJ open, 9(5), e025219. https://doi.org/10.1136/bmjopen-2018-025219
Puentedura, E. J., Cleland, J. A., Landers, M. R., Mintken, P. E., Louw, A., & Fernández-de-Las-Peñas, C. (2012). Development of a clinical prediction rule to identify patients with neck pain likely to benefit from thrust joint manipulation to the cervical spine. The Journal of orthopedic and sports physical therapy, 42(7), 577–592. https://doi.org/10.2519/jospt.2012.4243
Puentedura, E. J., Slaughter, R., Reilly, S., Ventura, E., & Young, D. (2017). Thrust joint manipulation utilization by U.S. physical therapists. The Journal of manual & manipulative therapy, 25(2), 74–82. https://doi.org/10.1080/10669817.2016.1187902
Individuals dealing with or managing chronic back pain should incorporate swimming exercises. Swimming is a low-impact aerobic conditioning exercise that’s easy on the back and healthy for the spine. When an individual struggles with back problems, they may be tempted to rest and avoid physical activity/exercise. Total rest is not recommended as it can cause the muscles that support the back to weaken or atrophy. When the muscles weaken, they cannot stabilize the spine or body correctly, which causes conditions to worsen or contribute to new injuries. Starting swimming exercises can expand the spine, relieve painful pressure or strain on the back and strengthen the muscles for spinal health.
Starting Swimming Exercises
Swimming does not impact the spine and other musculoskeletal structures because the water suspends the body.
Swimming is a full-body, low-impact exercise which is excellent for individuals of all ages and all body shapes and sizes.
Talk to a healthcare professional about any questions or concerns about how swimming may impact your body.
Swimming benefits include stress relief, a strengthened musculoskeletal system, and support in heart health.
Swimming for Back Problems
Relaxes The Nervous System
Tense muscles can cause or contribute to back problems and pain symptoms and aggravate spinal conditions.
Swimming exercises release endorphins to relax the nervous system and tense muscles.
Relieves Pressure on Joints
The water lightens the body relieving pressure on the joints and muscles.
Builds Muscle to Support the Spine
The resistance and movement strengthen the whole body with the joints and spine supported.
Swimming engages muscles not always used, specifically those needed to improve spinal stability.
Exercises for Back Relief
Checking with a physician before exercising is recommended, especially if starting a new exercise routine. When you meet with the Injury Medical Chiropractic and Functional Medicine Cline team, we can determine if starting swimming exercises would benefit you. Once cleared, here are some swimming exercises that could help bring relief:
Walking
Walking around the pool means movement that the body needs to heal and build muscle without aggravating symptoms.
Aerobics
Water aerobics is perfect for working on cardiovascular health needed to build strength.
Increase mobility and flexibility.
Swimming Laps
Start slow when swimming laps, maybe only twice a week at first.
The different types of strokes work various muscles in the hips, chest, and back.
Treading water is a great way to get the body used to the movements.
A swim coach can provide tips on the proper technique and form.
Swim Exercise Tools and Accessories
Proper swimming equipment can make the exercise sessions much more enjoyable.
Swim Cap
Swim caps protect the hair from the water’s elements and keep hair from blocking the view.
Goggles
Goggles protect the eyes and help to see better underwater.
Look for a comfortable pair that doesn’t leak.
Sun protection and clothing
A day in the sun and water increases the risk of exposure to UV rays.
Waterproof Headphones
For listening to music or podcasts while swimming.
Kickboard
Many pools can provide kickboards that swimmers can borrow during their time there.
Lean the upper body on the board and kick, focusing on lower body movements.
Pull Buoy
Pull buoys help focus on the upper body and arm work.
It is placed between the upper thighs to help the legs float as the individual pulls with their arms.
It is recommended to take some lessons to learn how the body moves through the water. Once a basic understanding of balance and buoyancy is met, individuals can propel through the water more efficiently.
Sciatica Secrets Revealed
References
Bartels, Else Marie, et al. “Aquatic exercise for the treatment of knee and hip osteoarthritis.” The Cochrane Database of systematic reviews vol. 3,3 CD005523. 23 Mar. 2016, doi:10.1002/14651858.CD005523.pub3
Cole, A J et al. “Spine pain: aquatic rehabilitation strategies.” Journal of Back and musculoskeletal rehabilitation vol. 4,4 (1994): 273-86. doi:10.3233/BMR-1994-4407
Ferrell, M C. “The spine in swimming.” Clinics in sports medicine vol. 18,2 (1999): 389-93, viii. doi:10.1016/s0278-5919(05)70153-8
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Body stiffness is common, especially as the body ages. Stiffness can result from intense work, lack of physical exercise, or specific conditions. The reasons vary from individual to individual. Some feel stiff when they wake up, while others become stiff after stopping physical activity. For others, stiffness can result from practicing unhealthy postures, intense workouts, or something new that the body is beginning to get used to. There are several ways to prevent and treat stiffness, no matter the cause, including targeted physical movements, posture corrections, body decompression, chiropractic realignment, stretches, and therapeutic massage.
Body Stiffness
Knowing the cause of body stiffness and how to relieve it can help prevent and treat the condition so the body can function better. It’s vital to see a health care professional immediately if stiffness results from an injury, accompanied by pain, it does not go away with home treatments, or if an insect bite or infection could be the cause.
Individuals should speak to a healthcare professional for frequent stiffness that interferes with their quality of life.
Most of the time, stiffness can be treated at home and reduced through preventative measures.
Stay active but not too hard until the body gets used to the activity.
Various relief methods include a warm bath, massage shower, or self-massage.
Intense Work or Exercise
The muscles incur tiny tears when exercising or performing heavy labor, especially when the body is not used to the intensity or duration.
These tears are normal and help build larger and stronger muscles.
Individuals may feel stiff and sore for 24-72 hours as the body repairs itself.
Inflammation surrounding the joints/synovial fluid after heavy activity or repetitive movements is another cause.
Inactivity
Moving around generates the synovial fluid that lubricates the joints.
When body movement stops, like going to sleep or long periods spent sitting, working, or watching tv, fluid production slows down, resulting in body stiffness.
The lack of fluid after movement can make the body feel stiff when returning to activity.
Unhealthy Posture
The body can become stiff and sore when routinely holding the body in a way that strains the muscles, tendons, and ligaments.
Sitting or standing incorrectly from an unhealthy workstation setup or postural habits contributes to stiffness and musculoskeletal problems.
Medical Conditions
Medical conditions can cause stiffness like rheumatoid arthritis, Lyme disease, thyroid disease, strains and sprains, and low vitamin D levels.
See medical attention if you suspect any medical causes are behind the body stiffness.
Prevention
Depending on the reason behind body stiffness, there are ways to prevent it.
Warm-Up
Warming up before any physical activity loosens up the muscles before fully engaging.
Soreness will present and is part of the muscle repair process.
Properly warming up can help the repair go faster.
Mobility and Flexibility Breaks
Taking breaks from inactivity by getting up and moving around, walking, or performing mobility movements could increase the secretions of joint fluid, prevent stiffness, and relieve the effects of poor postural habits you may have been making.
Set a timer to break up periods of inactivity and move around.
Get up for 5 minutes every hour to move the muscles and get the blood flowing.
Stay Aware of Posture and Form
Postural awareness can help prevent muscle strain that leads to stiffness.
Adjusting the workspace and posture can help prevent stiffness.
The posterior chain: head, neck, torso, and legs are aligned with the feet flat on the floor and back supported.
Stay Active
Maintaining muscle movement maintains blood circulation, which can help reduce stiffness.
Exercise helps reduce inflammation, increases synovial fluid production, and helps strengthen the muscles.
Active Recovery
Participating in active recovery can help bring blood flow to the muscles and prevent inflammation.
Light cardiovascular activities include swimming, cycling, walking, or bodyweight movements.
Anti-Inflammatory Nutrition
Anti-inflammation nutrition like the Mediterranean diet, which includes healthy fats, plenty of fruits and vegetables, lean proteins, seafood, and whole grains, can help reduce aches and stiffness.
Getting enough vitamin D can reduce stiffness.
Chiropractic Flexibility Restoration
Chiropractic adjustments, decompression, MET, and therapeutic massage techniques can relieve muscle soreness and stiffness and restore body function. The chiropractic team will evaluate the individual, diagnose the cause/s, and develop a personalized treatment plan. The team will provide posture training, stretching the body, using a percussive massager or foam roller to break tight, stiff muscles and release adhesions of tissues.
Enhance Your Lifestyle
References
Mailey, Emily L et al. “Comparing the effects of two different break strategies on occupational sedentary behavior in a real-world setting: A randomized trial.” Preventive medicine reports vol. 4 423-8. 9 Aug. 2016, doi:10.1016/j.pmedr.2016.08.010
Schleip, Robert, and Werner Klingler. “Active contractile properties of fascia.” Clinical Anatomy (New York, N.Y.) vol. 32,7 (2019): 891-895. doi:10.1002/ca.23391
Shimoyama, Daisuke, et al. “Reliability of shoulder muscle stiffness measurement using strain ultrasound elastography and an acoustic coupler.” Journal of medical ultrasonics (2001) vol. 48,1 (2021): 91-96. doi:10.1007/s10396-020-01056-0
Trube, Niclas, et al. “How muscle stiffness affects human body model behavior.” Biomedical engineering online vol. 20,1 53. 2 Jun. 2021, doi:10.1186/s12938-021-00876-6
Weerapong, Pornratshanee, et al. “The mechanisms of massage and effects on performance, muscle recovery, and injury prevention.” Sports medicine (Auckland, N.Z.) vol. 35,3 (2005): 235-56. doi:10.2165/00007256-200535030-00004
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