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Plantar Fasciitis & Trigger Points On The Feet

Plantar Fasciitis & Trigger Points On The Feet

Introduction

Everyone worldwide knows that feet are important. The feet allow many individuals to run, walk, or jog for long periods without feeling pain for a moderate amount of time. To that point, the various muscles and tendons surrounding the foot provide full body flexion, extension, and stability. Even though it is very easy to get in the recommended amount of steps into being healthy, around 75% of individuals will have foot pain that can impact their ability to walk. One of the most common foot pains is plantar fasciitis, which can become a painful foot condition if it is not treated as soon as possible. Today’s article looks at plantar fasciitis, its symptoms, how trigger points correlate, and treatments for it. We refer patients to certified providers incorporating techniques and therapies for individuals dealing with plantar fasciitis. By locating where the trigger points are coming from, many pain specialists can develop a treatment plan to reduce the effects that plantar fasciitis is causing on the feet. 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 terrific 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 Is Plantar Fasciitis?

 

Have you been dealing with constant heel pain? Do you feel pain shooting up your leg when you step or walk? Or do you feel a stabbing ache in your heel? Many of these pain issue people are dealing with correlate with plantar fasciitis. Studies reveal that plantar fasciitis results from degenerative irritation on the plantar fascia and its ligaments. This causes the muscle ligaments to become inflamed, swollen, and weak, which then causes the bottom of the foot or heel to hurt when a person is walking or standing. To that point, when there is a repetitive strain on the feet, it causes microtears in the plantar fascia. The plantar fascia in the foot plays an important role as it comprises three segments that support the medial arch and shock absorption when stepping down. As one of the most common causes of heel pain, the residual pain from plantar fasciitis tends to be a sharp, stabbing sensation. Plantar fasciitis is more prominent in middle-aged people. Still, anyone at any age can develop plantar fasciitis, especially if they have labor jobs requiring them to be constantly on their feet.

 

Symptoms Of Plantar Fasciitis

Since around 2 million Americans could potentially develop plantar fasciitis, it is important to know that when a person has been on their feet constantly, there will be inflammation along the tissues in the feet. Many individuals with a busy lifestyle that requires them to be on their feet frequently would often ignore the pain or discomfort. Some of the symptoms that plantar fasciitis causes include the following:

  • Pain on the bottom of the heel
  • Pain in the arch 
  • Pain that is usually worse when waking up
  • Pain that increases over months
  • Swelling on the bottom of the heel

However, when the pain becomes overbearing, many people would often think they have sore feet or low back pain from being overly tired from work, under constant stress, or over-exerting their bodies. When this happens, many would think the pain would go away in a few days after resting for a short period.

 

Trigger Points Associated With Plantar Fasciitis

 

Now many individuals would often think that plantar fasciitis just only affects the heels, however, it can affect any part of the structure of the foot since all the surrounding muscle tissues are at risk of inflammation. When people start to ignore the pain and discomfort that plantar fasciitis is causing on the feet, it can overlap and develop trigger points in other areas of the body:

  • Ankles
  • Knees
  • Hips
  • Lower back

Studies reveal that trigger points or myofascial pain syndrome are hard, discrete, small nodules that are along the taut musculoskeletal band that causes numerous issues like inflammation, hypersensitivity, and pain to the affected muscle groups in the body. According to “Myofascial Pain and Dysfunction” written by Dr. Travell, M.D., it mentions that when the deep intrinsic muscles that work with the plantar fascia are affected by trigger points, would cause symptoms of numbness and the feeling of swelling in the foot. This causes many people to have limited mobility and have intense pain when walking, which can negatively impact their lifestyle.

 


An Overview Of Plantar Fasciitis- Video

Have you been dealing with aching feet? Do you feel a sharp, radiating pain in your feet? Or do you have difficulty walking? Many often think they are dealing with sore feet or other issues causing them pain. Around 75% of Americans often have foot pain affecting their ability to walk, and one of them is plantar fasciitis. The video above explains plantar fasciitis and how it can affect the feet. When the plantar fascia tendons become overused, it causes micro-tears in the muscle ligaments. When added compressive force starts to push against the heel boner, it can lead to a pathological state whereby the plantar fascia degenerates and creates dysfunction and pain. When this happens, it can lead to other conditions like trigger point pain along the muscle fibers in the foot. The pain and tenderness caused by trigger points in the plantar muscles may mask as plantar fasciitis. To that point, when plantar fasciitis becomes an issue and causes the individual to be in immense pain, it can become problematic. As luck would have it, treatments are available to reduce the pain from plantar fasciitis.


Treatments For Plantar Fasciitis

 

When treating plantar fasciitis, many available treatments can reduce the inflammatory effects in the heel and prevent trigger points from coming back. One of the available treatments is chiropractic care. Chiropractic care is an alternative treatment option to prevent, diagnose, and treat numerous injuries and conditions associated with the spine, primarily subluxations or spinal misalignments. Chiropractic focuses on restoring and maintaining the overall health and wellness of the musculoskeletal and nervous systems through spinal manipulation and adjustments. A chiropractor can carefully re-align the spine, improving a patient’s strength, mobility, and flexibility. Regarding plantar fasciitis, chiropractic care can work with other treatments, including physical therapy, massage, and even injections, to manage the pain and treat the condition. Even though plantar fasciitis takes several months to heal, chiropractic care can involve a precise technique that involves adjustments to the feet, ankles, and spinal alignment. This provides several benefits, which include the following:

  • Reduces Stress in the Plantar Fascia 
  • Promotes Healing 
  • Provides Effective Pain Management 
  • Reduces the Risk of Further Injury 

 

Conclusion

As many individuals worldwide are on their feet constantly, foot pain can hinder one’s ability to move. One of the most common foot pain is plantar fasciitis which can correlate with trigger points along the various muscles of the foot. Plantar fasciitis results from degenerative irritation on the plantar fascia and its ligaments, which causes sharp, stabbing pain on the heel. When this happens, it can cause the heel to be inflamed, swollen, and weak. To that point, it causes instability and pain when walking. However, plantar fasciitis can be treated when it is caught early through various treatments like chiropractic care. Chiropractic care can reduce the stress in the plantar fascia and help reduce the risk of further injuries. Combined with other therapies, many people can function normally and regain their walking ability without pain.

 

References

Buchanan, Benjamin K, and Donald Kushner. “Plantar Fasciitis – StatPearls – NCBI Bookshelf.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 30 May 2022, https://www.ncbi.nlm.nih.gov/books/NBK431073/.

Petrofsky, Jerrold, et al. “Local Heating of Trigger Points Reduces Neck and Plantar Fascia Pain.” Journal of Back and Musculoskeletal Rehabilitation, U.S. National Library of Medicine, 2020, https://pubmed.ncbi.nlm.nih.gov/31594202/.

Shah, Jay P, et al. “Myofascial Trigger Points Then and Now: A Historical and Scientific Perspective.” PM & R : the Journal of Injury, Function, and Rehabilitation, U.S. National Library of Medicine, July 2015, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4508225/.

Travell, J. G., et al. Myofascial Pain and Dysfunction: The Trigger Point Manual: Vol. 2:the Lower Extremities. Williams & Wilkins, 1999.

Disclaimer

Foot Pain, Plantar Fasciitis, & Trigger Point Pain

Foot Pain, Plantar Fasciitis, & Trigger Point Pain

Introduction

The various muscles and tendons surrounding the foot play an important role as they provide stability to the lower parts of the body and allow the individual to move and flex their feet. These various muscles and tendons help support the ankles and allow leg movement. Many people will be on their feet constantly as the world moves and sometimes have to deal with various issues affecting their walking ability. As the body naturally ages, many people will shuffle their feet around, which causes strain on the foot muscles and can affect the calves and legs over time. To that point, it can lead to foot pain and other conditions that can affect the individual. Other issues that can affect the feet and their muscles could be incorrect footwear, how they are standing, or how they walk. When this happens, conditions like plantar fasciitis and trigger point pain can affect the feet differently. Today’s article focuses on the superficial intrinsic foot muscles, how trigger points and plantar fasciitis correlate with foot pain, and how to strengthen the foot muscles. We refer patients to certified providers incorporating techniques and therapies in the lower body extremities of trigger points affecting the feet. This helps many people with trigger point pain symptoms associated with plantar fasciitis along the intrinsic foot muscles. 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 terrific way to ask our providers intricated questions at the patient’s request and understanding. Dr. Alex Jimenez, D.C., only utilizes this information as an educational service. Disclaimer

The Superficial Intrinsic Foot Muscles

 

As stated earlier, the foot has various muscles and tendons that allow stability to the ankles and allow movement when a person is walking. The foot has two muscle groups: the extrinsic and intrinsic muscles. Today, we will look at the intrinsic foot muscles and their importance to the foot. Studies reveal that the intrinsic foot muscles are highly important as they are contained to the foot and contribute to supporting the medial longitudinal arch. The intrinsic foot muscles are superficial and help keep the toes straight while providing flexion and extension when in motion. The foot has about 29 muscles, including 10 surrounding the foot and ankle, while the other 19 are intrinsic and provide the roles for gait and posture. The 19 intrinsic muscles have the following:

  • Abductor Hallucis
  • Quadratus Plantae
  • Flexor Hallucis Brevis
  • Flexor Digitorum Brevis
  • Abductor Digiti Minimi
  • Flexor Digiti Minimi
  • The Interossei Muscles
  • The Lumbricals

These muscles allow individuals to walk, run, or jog without pain. However, when the intrinsic muscles become impaired, studies reveal that intrinsic foot muscle function could be linked to various foot conditions that affect a person’s walking ability.

 

How Does Foot Pain Correlate With Plantar Fasciitis & Trigger Points?

Studies reveal that foot pain can cause an unpleasant sensory and emotional experience. Many factors can affect how a person walks, leading to various issues affecting the mobility of the lower extremities. When multiple problems affect a person’s walking, the intrinsic muscle and other muscles surrounding the ankle and foot could become strained and overlap with other foot conditions. Coexisting muscle impairments could affect the alignment, motion, load distribution, and muscle performance that involves the legs when foot pain affects the intrinsic foot muscles. When these impairments cause foot pain, it can correlate with trigger points and conditions like plantar fasciitis, affecting a person’s walking ability. But how does foot pain connect with plantar fasciitis and trigger points?

 

According to Dr. Travell, M.D.’s book “Myofascial Pain and Dysfunction,” when tension starts to overload the foot, the intrinsic muscles develop tiny nodules in the muscle fibers and reduce the muscle strength of the medial arch. To that point, it can collapse and cause the foot to create inflammation associated with repetitive actions that cause plantar fasciitis in the feet. When this happens, it can affect a person’s ability to walk, run, and stand and affect the lower extremities’ mobility. If not treated right away, it can cause muscle and joint pain in the hips, legs, knees, and lower back.

 


An Overview Of The Intrinsic Foot Muscles-Video

Have you been dealing with issues on your feet? Do you find it difficult to step down or walk? Or have you been rubbing your feet constantly to reduce the soreness in your feet? Many of these issues correlate with trigger points affecting the intrinsic foot muscles that could cause foot issues like plantar fasciitis. The foot has various muscles, like the intrinsic muscles, that allow gait and stability to the body. Multiple factors affecting the intrinsic foot muscles can lead to instability, muscle strain, tendon stress, and muscle and joint pain. This can affect how a person moves throughout the day and their quality of life. The video above explains where each muscle is, which ones are extrinsic and intrinsic, and how each muscle helps with foot function. When various issues begin to affect the foot and cause mobility issues, multiple techniques are available to help strengthen the foot muscles and prevent future problems from affecting the feet.


Strengthening The Foot Muscles

 

Regarding trigger point pain affecting the intrinsic foot muscles, various techniques can reduce the pain-like symptoms of trigger points and prevent foot issues like plantar fasciitis from re-occurring. Studies reveal that light, non-weight-bearing exercises like cycling and swimming can minimize muscle overload on the foot. Other ways to strengthen the intrinsic foot muscles are by stretching the toe flexors to help improve stability and prevent hypermobility in the foot. Different techniques to reduce trigger points in the foot’s muscle fibers include using a cylindrical or spherical object and rolling under the arches to massage and loosen stiff muscles. Many of these techniques could help restore foot functionality and stability while reducing future issues like plantar fasciitis in the feet. To that point, people should be allowed to walk pain-free again.

 

Conclusion

The foot has 29 muscles, including ten extrinsic muscles surrounding the foot and ankle and 29 intrinsic muscles on the foot. The intrinsic muscles are highly important for foot functionality as they are superficial and contribute to supporting the medial longitudinal arch. The intrinsic foot muscles also help keep the toes straight and allow flexion and extension when in motion. These muscles also help a person walk and stabilize the ankle. When various factors affect a person’s walking ability, it can lead to muscle strain and tendon stress to the foot, developing trigger points in the intrinsic muscle fibers and causing pain. This could cause foot conditions like plantar fasciitis and other co-existing muscle impairments that can affect the lower extremities’ mobility while causing muscle and joint pain in the hips, legs, knees, and lower back. Luckily, available techniques can help massage, stretch, and strengthen the intrinsic foot muscles while reducing trigger points and preventing their associated symptoms from recurring. To that point, these techniques can allow many individuals to walk without feeling pain.

 

References

Card, Ryan K, and Bruno Bordoni. “Anatomy, Bony Pelvis and Lower Limb, Foot Muscles.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 27 Feb. 2022, https://www.ncbi.nlm.nih.gov/books/NBK539705/.

Gooding, Thomas M, et al. “Intrinsic Foot Muscle Activation during Specific Exercises: A T2 Time Magnetic Resonance Imaging Study.” Journal of Athletic Training, U.S. National Library of Medicine, Aug. 2016, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5094843/.

Hawke, Fiona, and Joshua Burns. “Understanding the Nature and Mechanism of Foot Pain.” Journal of Foot and Ankle Research, U.S. National Library of Medicine, 14 Jan. 2009, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2631512/.

Hayter, Matt. “Why Do We Need the Intrinsic Muscles of the Foot? [Guide 2022].” Dynamic Podiatry, 2022, https://foothealthguy.com/hammer-toes-causes-and-treatment/

Lim, Ang Tee, et al. “Management of Plantar Fasciitis in the Outpatient Setting.” Singapore Medical Journal, U.S. National Library of Medicine, Apr. 2016, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4853481/.

Soysa, Achini, et al. “Importance and Challenges of Measuring Intrinsic Foot Muscle Strength.” Journal of Foot and Ankle Research, U.S. National Library of Medicine, 26 Nov. 2012, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3544647/.

Travell, J. G., et al. Myofascial Pain and Dysfunction: The Trigger Point Manual: Vol. 2:the Lower Extremities. Williams & Wilkins, 1999.

Disclaimer

Sciatica Foot and Ankle Issues: El Paso Back Clinic

Sciatica Foot and Ankle Issues: El Paso Back Clinic

It didn’t happen at work, school, or exercise, and there haven’t been any trips and/or falls, but you can’t pinpoint what is causing foot and ankle discomfort and sensations. However, the cause could be originating in the lumbar spinal region. Sciatica is a set of symptoms that refer to pain, numbness, and tingling radiating down the leg from the lower back, affecting the legs, hips, buttocks, and feet. Injury Medical Chiropractic and Functional Medicine Clinic can release the compressed nerve, massage circulation back into the nerve, and restore mobility and function.Sciatica Foot and Ankle Issues: Injury Medical Chiropractic

Sciatica Foot and Ankle

Sciatic nerve sensations can run down the back of the leg down into the foot.

  • Compression or irritation to any nerve roots can present with symptoms in the hip, thigh, calf, and foot.
  • Sciatica foot and ankle symptoms can accompany numbness and muscle weakness.
  • Sciatic nerve irritation mostly causes symptoms on the outside of the foot but can spread to other areas.

Nerve Roots

One or more of the lower spine’s sciatic nerve roots are being compressed or pinched. The foot symptoms location depends on which nerve root is affected.

  • If the S1 root is affected, symptoms will radiate to the sole and side of the foot.
  • If L5 is affected, symptoms will radiate to the top of the foot and the big toe.
  • If the L4 root is affected, symptoms can radiate to the medial or inside the ankle area.

Chiropractic Care and Relief

Foot Massage

A foot massage can be helpful.

  • A massage therapist finds points around the ankles that are tender.
  • Tenderness indicates a lymphatic blockage or muscle tension that needs to be worked out.
  • They will apply varying pressures to massage the muscles and get the circulation flowing.
  • The therapist will loosen the tarsal and metatarsal bones to loosen the muscles and nerves.
  • Moving the bones resupplies the joints, forces out inflammatory metabolic waste, opens the space for the nerves, and allows improved lymphatic drainage and blood flow to expedite healing.

Nerve Flossing

Nerve flossing exercises can help stretch and maintain the released nerve.

  • A chiropractor will perform and train the individual on targeted stretches to the Achilles tendon and plantar fascia.
  • They will stretch, release, and open the ankle and sciatic nerve.

Injections

A cortisone injection where the nerve is affected can help in certain cases.

  • Injections of a corticosteroid, an anti-inflammatory medicine, can offer relief for up to three months and are given under local anesthesia.
  • The medicine reduces the inflammation and swelling around the nerve roots.

Foot Orthotics

  • Custom foot orthotics can help support a postural foot or ankle problem.
  • Overpronation is when the ankles collapse inward, which creates an imbalance of leg lengths that affects the hips, pelvis, and spine.
  • Orthotics can help provide symptom relief.

Nutrition

Part of a treatment plan will include an anti-inflammatory and antioxidant nutritional plan.

  • A professional nutritionist will make recommendations based on the individual’s case.
  • Magnesium-rich foods are generally recommended for sciatica as this nutrient aids the body in releasing muscle contractions.
  • 99 percent of the body’s magnesium is stored in the bones, muscles, and soft tissues, with only 1 percent concentrated in the blood.

Foods rich in magnesium include:

  • Avocado
  • Bananas
  • Apricots
  • Dried pumpkin seeds
  • Dairy
  • Dark chocolate
  • Dried figs
  • Black beans
  • Brown rice
  • Fish
  • Spinach
  • Swiss chard
  • Yogurt

Benefits of Custom Foot Orthotics


References

Davis, David, et al. “Sciatica.” StatPearls, StatPearls Publishing, 6 May 2022.

Ge, Phillip S et al. “Iatrogenic pseudoaneurysm of the superior gluteal artery presenting as pelvic mass with foot drop and sciatica: case report and review of the literature.” Vascular and endovascular surgery vol. 44,1 (2010): 64-8. doi:10.1177/1538574409351990

Hughes, Michael S et al. “Post-traumatic catamenial sciatica.” Orthopedics vol. 31,4 (2008): 400. doi:10.3928/01477447-20080401-15

Mayo Clinic. “Sciatica.” https://www.mayoclinic.org/diseases-conditions/sciatica/symptoms-causes/syc-20377435?p=1

National Institutes of Health. “Sciatica.” https://medlineplus.gov/sciatica.html

Pan, Hung-Chuan, et al. “Magnesium supplement promotes sciatic nerve regeneration and down-regulates inflammatory response.” Magnesium research vol. 24,2 (2011): 54-70. doi:10.1684/mrh.2011.0280

Cyclist Chiropractic Decompression

Cyclist Chiropractic Decompression

Bicycling at any level is excellent healthwise, but the specific physical repetitive motions and postures can wear on a cyclist’s body, causing strains and injury to the:

  • Muscles
  • Ligaments
  • Tendons
  • Nerves
  • Spine

Injuries can be caused by falls, overused muscles, joints, posture, and/or balance problems, whether riding a bicycle for fun, health, or sport. Chiropractic decompression can treat cycling-related injuries and help prevent common injuries by helping cyclists with conditioning and exercises. Chiropractic adjustments, combined with health coaching and nutrition planning, can maximize the body’s overall athletic ability and increase/improve:

Cyclist Injuries Chiropractic Decompression

Common Cyclist Injuries

Competitive cyclists, commuters, and weekend riders all experience common cycling injuries that include:

Back Soreness and Pain

Many cyclists suffer from back pain overuse injuries that are caused by:

  • Incorrect saddle/seat height or an uneven seat/saddle
  • Not bending the knee at the end of a pedal stroke forces the cyclist to rock the pelvis side to side to generate enough power, placing added stress on the low back muscles.
  • Handlebars that are too far forward can cause over-stretching of the spine.
  • Constantly tilting the head can cause neck and shoulder pain.
  • Staying in the same position for an extended period strains the spine.
  • Repetitive hip flexion causes the muscles to become tight and perform less efficiently, straining the rest of the body to make up for the lost support.
  • Hamstrings that become tight can shorten in length, causing the body to pull on the pelvis and the spine.
  • Lack of core strength allows more stress to penetrate the glutes, back, and hips.
  • Riding on bumpy or rough terrain increases body jarring and spinal compression.

Chiropractic Decompression

Chiropractic decompression for cyclists can rehabilitate the body from injuries, alleviate pain, improve blood and nerve circulation and maintain the body’s flexibility. Advanced decompression techniques personalized to the individual realign and release the body from obstructions and toxins in the neural pathways. Nutritional and supplementation recommendations are incorporated to enhance the body’s natural healing abilities, and exercise/stretches to sustain the adjustments.


Spinal Decompress


References

Schultz, Samantha J, and Susan J Gordon. “Recreational cyclists: The relationship between low back pain and training characteristics.” International journal of exercise science vol. 3,3 79-85. 15 Jul. 2010

Silberman, Marc R. “Bicycling injuries.” Current sports medicine reports vol. 12,5 (2013): 337-45. doi:10.1249/JSR.0b013e3182a4bab7

Streisfeld, Gabriel M et al. “Relationship Between Body Positioning, Muscle Activity, and Spinal Kinematics in Cyclists With and Without Low Back Pain: A Systematic Review.” Sports health vol. 9,1 (2017): 75-79. doi:10.1177/1941738116676260

Thompson, M J, and F P Rivara. “Bicycle-related injuries.” American family physician vol. 63,10 (2001): 2007-14.

Virtanen, Kaisa. “Cyclist injuries.” Duodecim; laaketieteellinen aikakauskirja vol. 132,15 (2016): 1352-6.

Medial Tibial Stress Syndrome: Shin Splints

Medial Tibial Stress Syndrome: Shin Splints

When stress is placed on the shins with physical activity from walking, running, or exercise, the connective tissues attaching the leg muscles to the tibia can become inflamed, causing medial tibial stress syndrome, more commonly known as shin splints. This inflammation is caused by tiny tears in the muscles and tendons of the shin. Chronic shin pain could be related to foot arch problems, underlying issues with the muscles, or shoes that don’t support the feet properly. Although it usually goes away within a few days, it’s important to monitor to ensure that it does not progress into a stress fracture. A chiropractor can offer treatments to relieve the pain and help prevent shin splints from recurring.

Medial Tibial Stress Syndrome: Shin Splints

Medial Tibial Stress Syndrome

Medial tibial stress syndrome can impact anyone. It can come from walking far distances or in awkward positions like going downstairs with small steps, jumping rope, and playing with the kids on the playground can all cause burning, tightness, and pain in the shins. Shin splints affect individuals differently. For some, the pain recedes when the triggering activity is stopped. For others, the pain can become a chronic condition that results in continuous pain, even when at rest.

The Shin

  • The shin is a part of the tibia bone in the lower leg.
  • This bone absorbs the shocks when moving through daily activities.
  • The muscles that run along the shin support the foot’s arch and raise the toes during movement.
  • Medial tibial stress syndrome is caused by excessive force on the shinbone and the tissue around it, which causes the muscles to swell and increases pressure around the bone.
  • If left untreated, small tears in the muscle and the bone can form, leading to chronic pain and stress fractures.

Medial tibial stress syndrome is more likely to happen from:

  • Not stretching before physical activity or exercise.
  • Constantly walking or running on hard surfaces.
  • Wearing the wrong shoes that don’t provide enough cushioning or arch support.
  • Over-exertion on the body with activity and movement.
  • The body is not given the proper amount of time to recover.
  • Athletes often experience shin splints when they’ve intensified their training routine or changed it up.

Symptoms

  • Pain during exercise or activity.
  • Pain in the front of the lower leg.
  • Soreness in the lower leg.
  • Swelling in the lower leg.
  • Shin is hot to the touch.

Treatment

Whenever pain is being experienced, some muscles will either get tight or weak in response. By identifying the weak and/or tight muscles, a chiropractor can prescribe stretches and exercises that will help alleviate the pain and prevent it. One of the main principles of chiropractic is to treat the body as an interconnected system. A chiropractor may work on an unrelated part of the body to treat the symptomatic area. For example, they may work to align the spine and pelvis to lessen the impact on the lower legs.

Part of a treatment plan may include:

Soft Tissue Mobilization

  • A handheld instrument loosens tight tissues during soft tissue mobilization therapy and breaks scar tissue around the tibia.
  • Massaging tight muscles in the leg keeps them loose and alleviates the pain.
  • Percussion massage can be added to reduce muscle knots, improve blood flow, and loosen up scar tissue.
  • The treatment relieves pain and can help avoid shin splints when returning to normal activities.

Ultrasound and Low Laser Therapy

  • Ultrasound and low laser therapy use heat to warm the deep tissues in the lower leg gently.
  • The treatment eases pain, reduces inflammation, swelling, and increases blood flow.

Kinesio Taping

  • Applying flexible Kinesio tape to the foot and lower leg can reduce stress on the shins.
  • The chiropractor or physical therapist will show how to apply the tape correctly.

Foot Orthotics

  • Individuals may be more likely to develop shin splints if they have high or low arches or their feet tend to roll inward or outward when walking.
  • Prescription foot orthotics can be made to keep the feet properly balanced and supported.

Stretching Exercises

  • Shin splints could be related to tight muscles in the back of the calf and weak muscles in the front of the lower leg.
  • A chiropractor or physical therapist will show stretching and strengthening exercises to maintain muscle balance.

Body Composition


Retaining Water Due To Salt Intake

Salt/sodium is everywhere and hard to avoid.

It might not be a surprise that a single patty cheeseburger contains over 500 mg of sodium – almost a quarter of the daily recommended level, but it is a surprise to know that the ranch dressing on a salad contains as much as 270 mg or a tablespoon of soy sauce on a healthy, vegetable-only stir-fry has 879 mg of sodium. The Mayo Clinic estimates that the average individual consumes about 3,400 mg of sodium a day: close to double what is recommended. Sodium is linked with water retention, and it is the kidneys’ job to expel unneeded sodium out of the body. Until the kidneys activate, an individual will temporarily be retaining extra water. If daily water and sodium intake habits change daily, this can contribute to water retention, causing fluctuations in daily weight. So, if an individual was on a diet but flooded the body with more salt than usual, expect to see a temporary increase in weight.

References

Bates, P. “Shin splints–a literature review.” British journal of sports medicine vol. 19,3 (1985): 132-7. doi:10.1136/bjsm.19.3.132

Chiropractic Economics: The Science Behind Percussion Massage.

Gross, ML et al. “Effectiveness of orthotic shoe inserts in the long-distance runner.” The American journal of sports medicine vol. 19,4 (1991): 409-12. doi:10.1177/036354659101900416

Heer, Martina et al. “Increasing sodium intake from a previous low or high intake affects water, electrolyte and acid-base balance differently.” The British journal of nutrition vol. 101,9 (2009): 1286-94. doi:10.1017/S0007114508088041

McClure, Charles J. and Robert Oh. “Medial Tibial Stress Syndrome.” StatPearls, StatPearls Publishing, 11 August 2021.

Calf Muscle Tightness and Injury

Calf Muscle Tightness and Injury

Calf pain is common in individuals who spend a lot of time on their feet, whether standing at work, school, or training athletes. The calf muscle/s take on a tremendous amount of load throughout the day. Climbing stairs, jogging, running, and hiking increase strain on the muscles. In most cases, calf pain results from an overuse injury of the calf muscles. Improper footwear can also contribute to issues around the foot and ankle that include:

  • Tightness
  • Loss of strength of the foot
  • Decreased mobility

Short or tight calves can lead to dysfunctional movement, cramping symptoms, chronic pain, and stiffness. A combination of chiropractic active release treatment and physical therapy can help quickly eliminate calf pain.

Calf Muscle Tightness and Injury

Anatomy

The calves are comprised of two muscles, the gastrocnemius, and soleus.

  • The gastroc originates just above the knee.
  • The soleus is below the knee.

They both insert on the back of the ankle as they join to form the Achilles tendon. The gastrocnemius is the power muscle used for explosive movements like jumping. The soleus muscle is predominately a slow-twitch muscle. This means it is very active during extended activities, like standing, walking, exercising, and running. When dealing with calf and ankle issues, other muscles can also contribute. These include:

  • The posterior tibialis lies deep in the inner portion of the calf and plays a role in foot and ankle function.
  • The posterior tibialis is heavily involved with Medial Tibial Stress Syndrome or MTSS, also called shin splints.

Calf Muscle Pain

Most commonly, calf pain is caused by the overuse of the calf muscles. This is often the result of the consistent pounding of the feet and lower legs from standing, walking,  and working. Over time, the repetitive pounding can cause tiny tears in the muscles of the lower legs and calves. If detected, early rest and recovery are recommended to allow the muscles to relax, loosen, and heal. However, repeated use can lead to more severe injury without proper treatment, like compartment syndrome. Certain types of calf pain can signify a medical emergency that requires immediate treatment.

Compartment Syndrome

A tough and fibrous covering surrounds the calf called the fascia. During physical activity or exercise, blood flows into these muscles, causing them to increase in size. If the fascia cannot stretch enough when these muscles enlarge, pain and tightness can develop. This is known as chronic posterior compartment syndrome. The discomfort typically goes away when the activity stops but is likely to return without proper treatment.

Calf Overuse Injury

Soreness, tightness, and pain are usually felt along the back or inside of the lower leg. The calf muscles are generally not painful to touch but maybe tender when deep pressure is applied. Calf pain and tightness often come with extended physical activity, exercise and disappear once the activity is stopped. If the injury becomes chronic, calf stiffness can present even when not active, along with numbness and/or tingling in the lower leg or foot.

Treatment

It is recommended not to ignore any discomfort, pain, and stiffness in the calves. Continued overuse can lead to scar tissue formation and chronic pain potential without proper care. Active Release – ART, and chiropractic effectively treat this type of injury. ART breaks up scar tissue, returning normal function to the calf muscles. And chiropractic loosens up stiff joints in the hips, ankles, and feet that may be contributing to wear and tear on the calves. Together they can quickly and eliminate calf pain. Part of a treatment plan includes:

  • Joint manipulation or mobilization
  • Soft tissue mobilization
  • Nutritional recommendations
  • Rehab-based exercises and stretches

Body Composition


Metabolic Adaptations

Aerobic exercise substantially impacts the body’s muscles’ energy production system and cardiovascular adaptation. The blood delivers oxygen to the muscle cells to produce energy that powers all the exercise being done. Aerobic exercise primarily relies on oxidative energy production, which takes place within the cells called mitochondria. Aerobic exercise also breaks down fat molecules for energy, which can only happen within mitochondria.

  • Aerobic exercise training improves the muscle cells’ ability to burn fat by generating more mitochondria and enhancing their functionality. Specifically, the body burns more fat than usual in the hours following each training session.
  • With more precise quality and quantity of fat-burning machinery, aerobic training can increase the resting metabolic rate, resulting in more calories burned.
  • High-intensity aerobic exercise also increases the excess post-exercise oxygen consumption – EPOC, resulting in increased calorie burn in addition to what was burned during the exercising.
References

Alfredson, H et al. “Heavy-load eccentric calf muscle training for the treatment of chronic Achilles tendinosis.” The American journal of sports medicine vol. 26,3 (1998): 360-6. doi:10.1177/03635465980260030301

Bright, Jacob Michael et al. “Ultrasound Diagnosis of Calf Injuries.” Sports health vol. 9,4 (2017): 352-355. doi:10.1177/1941738117696019

Campbell, John T. “Posterior calf injury.” Foot and ankle clinics vol. 14,4 (2009): 761-71. doi:10.1016/j.fcl.2009.07.005

Green, Brady, and Tania Pizzari. “Calf muscle strain injuries in sport: a systematic review of risk factors for injury.” British journal of sports medicine vol. 51,16 (2017): 1189-1194. doi:10.1136/bjsports-2016-097177

Sciatica Causes: Genetics, Low Back Problems, Piriformis, Arthritis

Sciatica Causes: Genetics, Low Back Problems, Piriformis, Arthritis

Sciatica Causes: The sciatic nerve forms by the union of Lumbar4 to Sacral31 nerve roots and exits the pelvis through the greater sciatic foramen, below the piriformis muscle located deep in the buttocks. The nerve runs down the back of the thigh, into the leg, and ends in the foot. The sciatic nerve becomes inflamed, irritated, and/or mechanically compressed. Any type of pain and/or neurological symptom/s from the sciatic nerve is referred to as sciatica. Sciatica is a type of lumbar radiculopathy, which means that the pain originates from the low back and/or sacral nerve roots.

Sciatica Causes: Genetics, Low Back Problems, Piriformis, Arthritis

Sciatica Causes

Physical forces on the nerve can cause mechanical compression due to the following conditions:

Herniated Discs

  • A disc in the lower back can bulge or herniate, causing irritation and/or compression of a sciatic nerve root.

Foraminal Stenosis

  • Stenosis, the intervertebral opening through which the nerve roots travel, begins to narrow/close in, can compress or irritate the sciatic nerve.

Degeneration

  • Degenerative changes in the spine like the thickening of facet joint capsules and/or ligaments can compress the sciatic nerve.

Segmental Instability

  • Instability of a spinal vertebral segment that happens if one vertebra slips over the one beneath it – spondylolisthesis
  • Vertebral defects – spondylolysis
  • Complete dislocation of one or more vertebrae can compress the nerve root/s of the nerve.

Other Sciatica Causes

  • Tumors, cysts, infections, or abscesses in the lower spine or pelvic region can also cause sciatic nerve compression.

Chemical Inflammation

  • Chemical irritants can include hyaluronic acid and/or fibronectin/protein fragments that leak out of degenerated or herniated discs. These irritants can cause inflammation and/or irritation of the sciatic nerve.
  • Degenerated discs can cause nerve tissues to grow into the disc, penetrating the outer and inner layers of the disc, causing sciatica. Immune system responses can contribute to pain when exposed to disc fluid.
  • Substances such as glycosphingolipids/fats and neurofilaments /protein polymers secreted by the immune system are increased in individuals with sciatica. These substances are released from the reaction between nerve roots and exposed disc material, causing inflammation.

Job Occupation

Individuals with specific jobs have an increased risk of developing sciatica. Examples include:

  • Truck drivers
  • Desk workers
  • Teachers
  • Warehouse workers
  • Machine workers
  • Plumbers
  • Electricians
  • Carpenters
  • Fitness trainers

Sitting and standing for long periods, using improper posture, constantly bending, twisting, reaching, and regularly lifting are risk factors for sciatica.

Piriformis Syndrome

Piriformis syndrome is a condition where the piriformis muscle swells and spasms from overuse or inflammation irritating the sciatic nerve that is right underneath. The nerve can get trapped in the muscle causing sciatica-like symptoms that include:

  • Pain follows the same pattern in the leg as a compressed sciatic nerve root.
  • Tingling
  • Numbness

Discomfort from piriformis syndrome feels similar to sciatica, but it is not caused by compressed sciatic nerve root. Piriformis pain comes from compression of the sciatic nerve near the piriformis muscle.

Genetic Sciatica Causes

Sciatica caused by degenerated and/or herniated discs can be genetic. Research has shown that certain genetic factors are more prevalent in individuals with back and spinal problems. These congenital disabilities can cause the discs to become weak and susceptible to external stress. With time the proteins in the disc break down, compromising the integrity and function.

Arthritis and Joint Issues

Arthritis or other inflammatory conditions around the hip joint can cause pain down the leg, similar to sciatica. This is referred pain that spreads out from the source and is not radicular nerve pain that originates in the nerve roots.

  • Conditions like sacroiliac joint dysfunction or sacroiliitis can cause sciatica-like pain that runs down the back of the thigh but usually ends before or at the knee.
  • The pain can be acute and debilitating, like sciatica but is caused by an abnormal motion or malalignment of the sacroiliac joint.

Body Composition


Normal Cholesterol Ranges

High cholesterol can lead to severe consequences when left untreated, but it can be difficult to spot with no noticeable warning signs. This is why it’s essential to monitor cholesterol levels with blood tests, especially if there is an increased risk. Example of normal cholesterol levels for adults 20 years of age or older:

  • Total cholesterol 125-200 mg/dL
  • LDL <100 mg/dL
  • HDL >40 mg/dL men, >50 mg/dL women

Lifestyle

  • Lack of physical activity contributes to high cholesterol levels.
  • Diets that mainly consist of processed foods and saturated fats increase the risk of high LDL levels.
  • Smoking can lower HDL levels.

Aging

  • Individual risk for developing high cholesterol tends to increase as the body advances in age. This is why it is recommended to have regular physicals and blood tests.

Genetics

  • Some individuals are more genetically predisposed to developing high cholesterol and heart disease.
  • Knowing family medical history can help predict whether it may become a problem.
References

Davis D, Maini K, Vasudevan A. Sciatica. [Updated 2021 Sep 2]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507908/

Giuffre BA, Jeanmonod R. Anatomy, Sciatic Nerve. [Updated 2021 Jul 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482431/

Hicks BL, Lam JC, Varacallo M. Piriformis Syndrome. [Updated 2021 Jul 18]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK448172/

Raj MA, Ampat G, Varacallo M. Sacroiliac Joint Pain. [Updated 2021 Aug 30]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470299/

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