“For individuals that have difficulty getting plenty of fruits and vegetables, can incorporating green powder supplements increase nutritional levels for a balanced diet?”
Green Powder Supplements
Meeting daily nutrient needs through whole, unprocessed foods can’t always be met when access is limited or for other reasons. A green powder supplement is a great way to fill in the gaps. Green powder supplements are a daily supplement that helps increase vitamin, mineral, and fiber intake and enhances overall health. Green powders are easy to mix in water with a favorite beverage or smoothie or bake into a recipe. They can help:
Increase energy
Nourish the immune system
Improve digestion
Promote mental clarity
Contribute to healthy blood sugar levels
Reduce the risk of chronic disease
Promote optimal liver and kidney function
What Are They?
Green powder supplements are forms of vitamins, minerals, fiber, antioxidants, phytochemicals, and other bioactive compounds.
They are derived from fruits, vegetables, herbs, and algae to combine ingredients into a convenient supplement. (Giulia Lorenzoni et al., 2019)
Nutrients
Because most green powders comprise a combination of ingredients, the nutrient density is high. Green powder supplements can be considered a vitamin and mineral product. They typically contain:
Vitamins A, C, and K
Iron
Magnesium
Calcium
Antioxidants
The recommended daily intake of vitamins and minerals can be helpful for individuals with limited access to produce or who want to supplement their diet with additional nutrients.
Energy
The phytochemicals found in fruits and vegetables have been shown to improve energy levels. Studies on their effects on physical performance and endurance have resulted in positive outcomes. Researchers found that phytonutrients like those in green powders helped to increase energy, improve agility, reduce fatigue perception, improve memory, and decrease recovery time. (Nicolas Monjotin et al., 2022)
Digestive Health
Green powders are rich in soluble and insoluble fiber, which contribute to feeling full and satisfied after a meal and are important for healthy digestion and regular bowel movements. Eating fiber-rich foods is associated with optimal blood sugar control and improved gut microbiota diversity. These factors are important for maintaining a healthy body weight and decreasing the risk of chronic disease, for example, type 2 diabetes. (Thomas M. Barber et al., 2020) Phytochemicals, including flavonoids, have been shown to have therapeutic effects on gas, bloating, constipation, and diarrhea associated with IBS. Other phytonutrients have been shown to reduce certain symptoms of ulcerative colitis. (Nicolas Monjotin et al., 2022)
Immune System Function
Supplemental green powder supplements have shown the ability to maintain a healthy immune system and reduce inflammation by their antioxidant content. Green powders containing seaweed or algae are rich in phytochemical and poly-unsaturated fatty acids that have antioxidant properties to reduce inflammation and prevent oxidative damage to cells. (Agnieszka Jaworowska, Aliza Murtaza 2022) A randomized trial found that a fruit, berry, and vegetable powder concentrate blend decreased oxidation and reduced inflammation, attributed to the phytochemicals found in fruits and vegetables.(Manfred Lamprecht et al., 2013)
Detoxification
The liver and kidneys are the main organs of natural detoxification. The liver helps the body absorb nutrients from consumed foods and removes waste and toxins through the kidneys. (National Library of Medicine. 2016) Plants are packed with antioxidants and phytochemicals that protect the liver and kidneys from free radical damage and oxidative stress. (Yong-Song Guan et al., 2015) The green powder supplements are made from these plants. When drinking green powders, fluid intake naturally increases as a standard serving of green powder is mixed with 8 to 12 ounces of water.
Whether mixed, blended, or made into a shake, powdered greens are a convenient and efficient way to get the daily dose of antioxidants, vitamins, minerals, and other nutrients.
The Healing Diet: Combat Inflammation, Embrace Wellness
References
Lorenzoni, G., Minto, C., Vecchio, M. G., Zec, S., Paolin, I., Lamprecht, M., Mestroni, L., & Gregori, D. (2019). Fruit and Vegetable Concentrate Supplementation and Cardiovascular Health: A Systematic Review from a Public Health Perspective. Journal of clinical medicine, 8(11), 1914. https://doi.org/10.3390/jcm8111914
Monjotin, N., Amiot, M. J., Fleurentin, J., Morel, J. M., & Raynal, S. (2022). Clinical Evidence of the Benefits of Phytonutrients in Human Healthcare. Nutrients, 14(9), 1712. https://doi.org/10.3390/nu14091712
Barber, T. M., Kabisch, S., Pfeiffer, A. F. H., & Weickert, M. O. (2020). The Health Benefits of Dietary Fibre. Nutrients, 12(10), 3209. https://doi.org/10.3390/nu12103209
Jaworowska, A., & Murtaza, A. (2022). Seaweed Derived Lipids Are a Potential Anti-Inflammatory Agent: A Review. International journal of environmental research and public health, 20(1), 730. https://doi.org/10.3390/ijerph20010730
Lamprecht, M., Obermayer, G., Steinbauer, K., Cvirn, G., Hofmann, L., Ledinski, G., Greilberger, J. F., & Hallstroem, S. (2013). Supplementation with a juice powder concentrate and exercise decrease oxidation and inflammation, and improve the microcirculation in obese women: randomised controlled trial data. The British journal of nutrition, 110(9), 1685–1695. https://doi.org/10.1017/S0007114513001001
InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. How does the liver work? 2009 Sep 17 [Updated 2016 Aug 22]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK279393/
Guan, Y. S., He, Q., & Ahmad Al-Shatouri, M. (2015). Complementary and Alternative Therapies for Liver Diseases 2014. Evidence-based complementary and alternative medicine : eCAM, 2015, 476431. https://doi.org/10.1155/2015/476431
For individuals dealing with knee pain symptoms from injury and/or arthritis, can incorporating an acupuncture and/or electroacupuncture treatment plan help in pain relief and management?
Acupuncture For Knee Pain
Acupuncture involves inserting very thin needles into the skin at specific acupoints on the body. It is based on the premise that the needles restore the flow of the body’s energy to activate and promote healing, relieve pain, and help the body relax.
Acupuncture can help address various health conditions, including knee pain caused by arthritis or injury.
Depending on the type and severity of pain, treatments can help reduce the pain for days or weeks.
Acupuncture is often used as a complementary therapy – treatment in addition to other treatment or therapy strategies like massage and chiropractic.
Acupuncture Benefits
Knee pain caused by osteoarthritis or injury can reduce flexibility, mobility, and quality of life. Acupuncture can help provide relief.
When the acupuncture needles are placed on the body, a signal is sent along the spinal cord to the brain, which triggers a release of endorphins/pain hormones. Medical researchers believe this helps reduce pain. (Qian-Qian Li et al., 2013) Acupuncture also helps decrease the production of cortisol, a hormone that helps control inflammation. (Qian-Qian Li et al., 2013) With reduced pain sensations and less inflammation after acupuncture treatments, knee function and mobility can be improved.
Various factors play a role in the pain relief experienced from acupuncture. Some evidence suggests that an individual’s expectations may impact the results of acupuncture treatment. (Stephanie L. Prady et al., 2015)
Researchers are currently assessing whether the expectation that acupuncture is beneficial contributes to a better outcome after treatment. (Zuoqin Yang et al., 2021)
In 2019, acupuncture was recommended in treating knee osteoarthritis in the American College of Rheumatology/Arthritis Foundation guidelines for hand, hip, and knee osteoarthritis pain management. (Sharon L. Kolasinski et al., 2020)
Research
Different clinical studies support acupuncture’s ability to help in knee pain relief and management.
One study found that acupuncture helps manage various conditions that cause chronic pain. (Andrew J. Vickers et al., 2012)
A scientific review analyzed previous studies on pain management interventions after knee surgery and found supporting evidence that the treatments delayed and reduced the use of medications for pain relief post-surgery. (Dario Tedesco et al., 2017)
Osteoarthritis
A systematic review analyzed randomized control studies to determine whether or not acupuncture reduced pain and improved joint function in individuals with chronic osteoarthritis knee pain. (Xianfeng Lin et al., 2016)
Individuals received six to twenty-three weekly acupuncture sessions for three to 36 weeks.
The analysis determined that acupuncture can improve short and long-term physical function and mobility and provide up to 13 weeks of pain relief in individuals with chronic knee pain caused by osteoarthritis.
Rheumatoid Arthritis
Rheumatoid arthritis is a chronic disease that affects joints, including the knee joint, causing pain and stiffness.
Acupuncture is beneficial in treating rheumatoid arthritis/RA.
A review found that acupuncture alone and in combination with other treatment modalities benefits individuals with RA. (Pei-Chi, Chou Heng-Yi Chu 2018)
Acupuncture is believed to have anti-inflammatory and antioxidant effects to help regulate immune system function.
Chronic Knee Pain
Various conditions and injuries can cause chronic knee pain, making mobility difficult.
Individuals with joint pain often turn to complementary therapies for pain relief management, with acupuncture being one of the popular modalities. (Michael Frass et al., 2012)
Working with a licensed, professional acupuncture practitioner can reduce the risk of unwanted side effects and complications.
Types
Other acupuncture options that may be offered include:
Electroacupuncture
A modified form of acupuncture where a mild electrical current passes through the needles, providing additional stimulation to the acupoints.
In one research study, individuals with knee osteoarthritis reported significant improvements in their pain, stiffness, and physical function after electroacupuncture treatment. (Ziyong Ju et al., 2015)
Auricular
Auricular or ear acupuncture works on acupoints in the ear corresponding to the body’s different parts.
A research review analyzed several studies on auricular acupuncture for pain relief and found that it can provide relief within 48 hours of pain onset. (M. Murakami et al., 2017)
Battlefield Acupuncture
The military and veteran healthcare facilities use a unique form of auricular acupuncture for pain management.
Studies show that it is effective at providing immediate pain relief, but more research is necessary to determine long-term pain relief effectiveness. (Anna Denee Montgomery, Ronovan Ottenbacher 2020)
Before trying acupuncture, consult a healthcare professional for guidance, as it may be integrated with other therapies and lifestyle adjustments.
Overcoming an ACL Injury
References
Li, Q. Q., Shi, G. X., Xu, Q., Wang, J., Liu, C. Z., & Wang, L. P. (2013). Acupuncture effect and central autonomic regulation. Evidence-based complementary and alternative medicine : eCAM, 2013, 267959. https://doi.org/10.1155/2013/267959
Prady, S. L., Burch, J., Vanderbloemen, L., Crouch, S., & MacPherson, H. (2015). Measuring expectations of benefit from treatment in acupuncture trials: a systematic review. Complementary therapies in medicine, 23(2), 185–199. https://doi.org/10.1016/j.ctim.2015.01.007
Yang, Z., Li, Y., Zou, Z., Zhao, Y., Zhang, W., Jiang, H., Hou, Y., Li, Y., & Zheng, Q. (2021). Does patient’s expectation benefit acupuncture treatment?: A protocol for systematic review and meta-analysis. Medicine, 100(1), e24178. https://doi.org/10.1097/MD.0000000000024178
Kolasinski, S. L., Neogi, T., Hochberg, M. C., Oatis, C., Guyatt, G., Block, J., Callahan, L., Copenhaver, C., Dodge, C., Felson, D., Gellar, K., Harvey, W. F., Hawker, G., Herzig, E., Kwoh, C. K., Nelson, A. E., Samuels, J., Scanzello, C., White, D., Wise, B., … Reston, J. (2020). 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee. Arthritis care & research, 72(2), 149–162. https://doi.org/10.1002/acr.24131
Vickers, A. J., Cronin, A. M., Maschino, A. C., Lewith, G., MacPherson, H., Foster, N. E., Sherman, K. J., Witt, C. M., Linde, K., & Acupuncture Trialists’ Collaboration (2012). Acupuncture for chronic pain: individual patient data meta-analysis. Archives of internal medicine, 172(19), 1444–1453. https://doi.org/10.1001/archinternmed.2012.3654
Tedesco, D., Gori, D., Desai, K. R., Asch, S., Carroll, I. R., Curtin, C., McDonald, K. M., Fantini, M. P., & Hernandez-Boussard, T. (2017). Drug-Free Interventions to Reduce Pain or Opioid Consumption After Total Knee Arthroplasty: A Systematic Review and Meta-analysis. JAMA surgery, 152(10), e172872. https://doi.org/10.1001/jamasurg.2017.2872
Lin, X., Huang, K., Zhu, G., Huang, Z., Qin, A., & Fan, S. (2016). The Effects of Acupuncture on Chronic Knee Pain Due to Osteoarthritis: A Meta-Analysis. The Journal of bone and joint surgery. American volume, 98(18), 1578–1585. https://doi.org/10.2106/JBJS.15.00620
Chou, P. C., & Chu, H. Y. (2018). Clinical Efficacy of Acupuncture on Rheumatoid Arthritis and Associated Mechanisms: A Systemic Review. Evidence-based complementary and alternative medicine : eCAM, 2018, 8596918. https://doi.org/10.1155/2018/8596918
Frass, M., Strassl, R. P., Friehs, H., Müllner, M., Kundi, M., & Kaye, A. D. (2012). Use and acceptance of complementary and alternative medicine among the general population and medical personnel: a systematic review. Ochsner journal, 12(1), 45–56.
Hinman, R. S., McCrory, P., Pirotta, M., Relf, I., Forbes, A., Crossley, K. M., Williamson, E., Kyriakides, M., Novy, K., Metcalf, B. R., Harris, A., Reddy, P., Conaghan, P. G., & Bennell, K. L. (2014). Acupuncture for chronic knee pain: a randomized clinical trial. JAMA, 312(13), 1313–1322. https://doi.org/10.1001/jama.2014.12660
National Center for Complementary and Integrative Health. (2022). Acupuncture in depth. National Center for Complementary and Integrative Health. https://www.nccih.nih.gov/health/acupuncture-what-you-need-to-know
Harvard Medical School. (2023). Acupuncture: what is it? Harvard Health Publishing Harvard Medical School Blog. https://www.health.harvard.edu/a_to_z/acupuncture-a-to-z#:~:text=The%20most%20common%20side%20effects,injury%20to%20an%20internal%20organ.
Ju, Z., Guo, X., Jiang, X., Wang, X., Liu, S., He, J., Cui, H., & Wang, K. (2015). Electroacupuncture with different current intensities to treat knee osteoarthritis: a single-blinded controlled study. International journal of clinical and experimental medicine, 8(10), 18981–18989.
Murakami, M., Fox, L., & Dijkers, M. P. (2017). Ear Acupuncture for Immediate Pain Relief-A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Pain medicine (Malden, Mass.), 18(3), 551–564. https://doi.org/10.1093/pm/pnw215
Montgomery, A. D., & Ottenbacher, R. (2020). Battlefield Acupuncture for Chronic Pain Management in Patients on Long-Term Opioid Therapy. Medical acupuncture, 32(1), 38–44. https://doi.org/10.1089/acu.2019.1382
Could pita bread be a possible option for individuals trying to eat healthier?
Pita Bread
Pita bread is a yeast-leavened, round flatbread made with wheat flour. When baked, the dough turns into two layers. These layers create a pocket that can be filled with vegetables, meats, or vegetarian proteins. Pita bread offers health benefits because of its low carbohydrate count, the amount of nutrients in one serving, and the use of wheat flour.
The carbohydrate count for pita bread is 17 grams per serving or a little more than one carb count – 15 grams, used in meal planning for individuals with diabetes.
Non-keto bread is around 20 grams of carbohydrates per serving or slice.
Pita bread has a lower carbohydrate count than most breads.
Fats
Pita breads are relatively low in fat content.
The total lipid fat is under 2 grams, only 2% of the recommended daily amount or RDA.
The bread contains no fatty acids or trans or saturated fat.
Protein
Four grams of protein are in one serving of pita bread.
The protein content is found in the wheat flour.
Vitamins and Minerals
Other minerals in pita bread include:
Calcium, with 60.1 milligrams per serving.
Iron with 1.08 milligrams per serving – helps the body create hemoglobin, a protein in red blood cells that carries oxygen from the lungs. (National Institute of Health, 2023)
Sodium with 120 milligrams.
According to the Federal Drug Administration, this is a low amount of sodium. However, individuals should stay aware of sodium intake and limit it to no more than 2,300 milligrams per day.
Pita bread for a sandwich contains fewer calories than two slices of regular bread.
Benefits
Potential health benefits include the following:
Glucose Levels Lowered
Whole wheat can be beneficial to glucose levels.
The American Diabetes Association suggests that choosing bread with whole wheat grains, like pita bread, instead of white bread, can work to keep blood sugar levels from spiking. (American Diabetes Association 2024)
Digestion Support
Whole-grain pita bread fiber content can benefit the digestive system by regulating bowel movements.
Complex carbohydrates are digested slower than simple carbohydrates, keeping the body fuller for longer and assisting in weight management. (Harvard Health 2022)
Protein Source
Pita bread provides a healthy amount of protein.
A serving contains around 8% of protein.
Consuming the proper amount of protein helps in muscle repair. (Harvard Health 2024)
Allergies
Major allergies or intolerances can cause individuals to pass on the bread. What individuals need to know.
Celiac Disease
Celiac disease is a heredity autoimmune disease that occurs in genetically predisposed individuals.
Individuals with the disease cannot ingest gluten – a protein found in wheat – which can lead to small intestinal damage.
Individuals who experience gastrointestinal distress when eating wheat should consult a healthcare professional to get tested. (Celiac Disease Foundation 2023)
Wheat Allergy
A wheat allergy may mimic celiac disease symptoms, but they are different allergies.
The allergy occurs when the body produces antibodies to wheat proteins.
USDA. Pita Bread. (2021). Pita Bread. Retrieved from https://fdc.nal.usda.gov/fdc-app.html#/food-details/2134834/nutrients
National Institute of Health, Office of Dietary Supplements. (2023). Iron. Retrieved from https://ods.od.nih.gov/factsheets/Iron-HealthProfessional/
Food and Drug Administration. (2022). Sodium in your diet. Retrieved from https://www.fda.gov/food/nutrition-education-resources-materials/sodium-your-diet
American Diabetes Association. (2024). Types of carbohydrates (Food and Nutrition, Issue. https://diabetes.org/food-nutrition/understanding-carbs/types-carbohydrates
Harvard Health. (2022). Fiber (The Nutrition Source, Issue. https://www.hsph.harvard.edu/nutritionsource/carbohydrates/fiber/
Harvard Health. (2024). Protein (The Nutrition Source, Issue. https://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/protein/
Celiac Disease Foundation. (2023). What is celiac disease? (About Celiac Disease, Issue. https://celiac.org/about-celiac-disease/what-is-celiac-disease/
American College of Allergy, Asthma, and Immunology. (2024). Wheat (Allergic Conditions, Issue. https://acaai.org/allergies/allergic-conditions/food/wheat-gluten/
For individuals considering acupuncture for sciatica relief and management, can knowing how it works and what to expect during a session help in making the decision?
Acupuncture Sciatica Treatment Session
Acupuncture for sciatica is a safe and effective medical treatment to relieve and manage pain symptoms. Studies suggest it is as effective as other treatment strategies and causes fewer side effects. (Zhihui Zhang et al., 2023) The frequency of acupuncture to relieve sciatica pain depends on the severity of the condition and injury, but many report improvement within two to three weeks. (Fang-Ting Yu et al., 2022)
Needle Placement
Circulation problems can cause the body’s energy to stagnate in one or more meridians/channels, leading to pain in and around the surrounding area. (Wei-Bo Zhang et al., 2018)
The objective of acupuncture is to restore optimal circulation by stimulating specific points in the body called acupoints.
Thin, sterile needles stimulate the acupoints to activate the body’s natural healing abilities and relieve pain. (Heming Zhu 2014)
Some practitioners use electroacupuncture – a gentle, mild electrical current is applied to the needles and passes through the tissues to activate the nervous system. (Ruixin Zhang et al., 2014)
Acupoints
Acupuncture sciatica treatment involves specific acupoints along the bladder and gallbladder meridians.
Bladder Meridian – BL
The bladder meridian/BL runs down the back along the spine, hips, and legs. The acupoints within the meridian for sciatica include: (Fang-Ting Yu et al., 2022)
BL 23 -Shenshu – Location on the lower back, near the kidney.
BL 25 – Dachangshu – Location on the lower back.
BL 36 – Chengfu – Location on the back of the thigh, just below the buttocks.
GB 30 – Huantiao – Location on the back, where the buttocks meet the hips.
GB 34 – Yanglingquan – Location on the outside of the leg, below the knee.
GB 33 – Xiyangguan – Location lateral to the knee, on the side.
Stimulating acupoints in these meridians increases blood flow to the area, reduces inflammation, and releases endorphins and other pain-relieving neurochemicals to relieve symptoms. (Ningcen Li et al., 2021) The specific acupoints vary depending on symptoms and the root cause. (Tiaw-Kee Lim et al., 2018)
Example Patient
An example of acupuncture sciatica treatment session: A patient with persistent shooting pain extending down the back and side of the leg. A standard treatment consists of the following:
The acupuncturist thoroughly goes over the patient’s medical history and symptoms and has the patient point to where the pain is located.
Then, they palpate on and around the area to find where the pain worsens and lessens, communicating with the patient as they go along.
Depending on the site and severity, they may start placing needles at the lower back, focusing on the site of the injury.
Sometimes, the sacrum is involved, so the acupuncturist will place needles on those acupoints.
They then move to the back of the leg and insert needles.
The needles are retained for 20-30 minutes.
The acupuncturist leaves the room or treatment area but regularly checks in.
The patient may feel a warmth, tingling, or mild heaviness, which is a normal response. This is where patients report a calming effect. (Shilpadevi Patil et al., 2016)
The needles are carefully removed.
The patient may feel deeply relaxed and will be advised to get up slowly to avoid dizziness.
There may be soreness, redness, or bruising at the needle insertion site, which is normal and should resolve quickly.
The patient will be given recommendations as to avoiding strenuous activity, properly hydrating, and performing gentle stretches.
Acupuncture Benefits
Acupuncture has been shown to be a complementary therapy for pain relief and management. The benefits of acupuncture:
Improves Circulation
Acupuncture stimulates blood circulation, which nourishes damaged or irritated nerves and promotes healing.
This helps relieve sciatica symptoms, like numbness, tingling, and pain. (Song-Yi Kim et al., 2016)
Releases Endorphins
Acupuncture triggers the release of endorphins and other natural pain-relieving chemicals, which help relieve pain. (Shilpadevi Patil et al., 2016)
Regulates the Nervous System
Acupuncture rebalances the sympathetic and parasympathetic responses, which reduces stress, tension, and pain. (Xin Ma et al., 2022)
Relaxes the Muscles
Nerve pain often accompanies muscle tension and spasms.
Acupuncture relaxes tight muscles, reducing pressure and providing relief. (Zhihui Zhang et al., 2023)
From Symptoms to Solutions
References
Zhang, Z., Hu, T., Huang, P., Yang, M., Huang, Z., Xia, Y., Zhang, X., Zhang, X., & Ni, G. (2023). The efficacy and safety of acupuncture therapy for sciatica: A systematic review and meta-analysis of randomized controlled trails. Frontiers in neuroscience, 17, 1097830. https://doi.org/10.3389/fnins.2023.1097830
Yu, F. T., Liu, C. Z., Ni, G. X., Cai, G. W., Liu, Z. S., Zhou, X. Q., Ma, C. Y., Meng, X. L., Tu, J. F., Li, H. W., Yang, J. W., Yan, S. Y., Fu, H. Y., Xu, W. T., Li, J., Xiang, H. C., Sun, T. H., Zhang, B., Li, M. H., Wan, W. J., … Wang, L. Q. (2022). Acupuncture for chronic sciatica: protocol for a multicenter randomised controlled trial. BMJ open, 12(5), e054566. https://doi.org/10.1136/bmjopen-2021-054566
Zhang, W. B., Jia, D. X., Li, H. Y., Wei, Y. L., Yan, H., Zhao, P. N., Gu, F. F., Wang, G. J., & Wang, Y. P. (2018). Understanding Qi Running in the Meridians as Interstitial Fluid Flowing via Interstitial Space of Low Hydraulic Resistance. Chinese journal of integrative medicine, 24(4), 304–307. https://doi.org/10.1007/s11655-017-2791-3
Zhu H. (2014). Acupoints Initiate the Healing Process. Medical acupuncture, 26(5), 264–270. https://doi.org/10.1089/acu.2014.1057
Zhang, R., Lao, L., Ren, K., & Berman, B. M. (2014). Mechanisms of acupuncture-electroacupuncture on persistent pain. Anesthesiology, 120(2), 482–503. https://doi.org/10.1097/ALN.0000000000000101
Perreault, T., Fernández-de-Las-Peñas, C., Cummings, M., & Gendron, B. C. (2021). Needling Interventions for Sciatica: Choosing Methods Based on Neuropathic Pain Mechanisms-A Scoping Review. Journal of clinical medicine, 10(10), 2189. https://doi.org/10.3390/jcm10102189
Li, N., Guo, Y., Gong, Y., Zhang, Y., Fan, W., Yao, K., Chen, Z., Dou, B., Lin, X., Chen, B., Chen, Z., Xu, Z., & Lyu, Z. (2021). The Anti-Inflammatory Actions and Mechanisms of Acupuncture from Acupoint to Target Organs via Neuro-Immune Regulation. Journal of inflammation research, 14, 7191–7224. https://doi.org/10.2147/JIR.S341581
Lim, T. K., Ma, Y., Berger, F., & Litscher, G. (2018). Acupuncture and Neural Mechanism in the Management of Low Back Pain-An Update. Medicines (Basel, Switzerland), 5(3), 63. https://doi.org/10.3390/medicines5030063
Kim, S. Y., Min, S., Lee, H., Cheon, S., Zhang, X., Park, J. Y., Song, T. J., & Park, H. J. (2016). Changes of Local Blood Flow in Response to Acupuncture Stimulation: A Systematic Review. Evidence-based complementary and alternative medicine : eCAM, 2016, 9874207. https://doi.org/10.1155/2016/9874207
Patil, S., Sen, S., Bral, M., Reddy, S., Bradley, K. K., Cornett, E. M., Fox, C. J., & Kaye, A. D. (2016). The Role of Acupuncture in Pain Management. Current pain and headache reports, 20(4), 22. https://doi.org/10.1007/s11916-016-0552-1
Ma, X., Chen, W., Yang, N. N., Wang, L., Hao, X. W., Tan, C. X., Li, H. P., & Liu, C. Z. (2022). Potential mechanisms of acupuncture for neuropathic pain based on somatosensory system. Frontiers in neuroscience, 16, 940343. https://doi.org/10.3389/fnins.2022.940343
For individuals experiencing musculoskeletal issues and pain symptoms, can learning about biomechanics and how it applies to movement, physical training, and performance, help in injury treatment and prevention?
Biomechanics
Biomechanics studies all life forms and their mechanical workings. Many think of biomechanics in sports and athletic performance, but biomechanics helps create and improve technologies, equipment, and injury rehabilitation techniques. (Tung-Wu Lu, Chu-Fen Chang 2012) Scientists, sports medicine doctors, physiotherapists, chiropractors, and conditioning specialists utilize biomechanics to help develop training protocols and techniques to improve therapy outcomes.
Body Movement
Biomechanics studies the movement of the body, including how muscles, bones, tendons, and ligaments work together, especially when movement is not optimal or correct. It is part of the larger field of kinesiology, specifically focusing on motion mechanics and analysis of how all the individual parts of the body work together to make up athletic and normal movements. (José M Vilar et al., 2013) Biomechanics includes:
Structure of bones and muscles.
Movement ability.
Mechanics of blood circulation, renal function, and other functions.
The study of forces and the effects of these forces on the tissues, fluid, or materials used for diagnosis, treatment, or research. (Jose I. Priego-Quesada 2021)
Sports
Sports biomechanics studies motion in exercising, training, and sports, which incorporates physics and the laws of mechanics. For example, the biomechanics of a specific exercise looks at:
Body position.
Movement of the feet, hips, knees, back, shoulders, and arms.
Knowing the correct movement patterns helps make the most of the exercise while preventing injuries, correcting form mistakes, informing training protocols, and increasing positive results. Understanding how the body moves and why it moves the way it does helps medical professionals prevent and treat injuries, alleviate pain symptoms, and improve performance.
Equipment
Biomechanics is used in the development of physical and sports equipment to improve performance. For example, a shoe can be designed for optimal performance for a skateboarder, long-distance runner, or soccer player. Playing surfaces are also studied for this purpose, such as how the surface stiffness of artificial turf affects athletic performance. (Jose I. Priego-Quesada 2021)
Individuals
Biomechanics can analyze an individual’s movements for more effective movement during training and games.
For example, an individual’s running gait or swing can be filmed with recommendations on what to change to improve.
Injuries
The science studies the causes, treatment, and prevention of neuromusculoskeletal injuries.
The research can analyze the forces that cause injuries and provide information for medical professionals on how to reduce the risk of injury.
Training
Biomechanics studies sports techniques and training systems to develop ways to improve efficiency.
This can include research on positioning, release, follow-through, etc.
It can analyze and help design new training techniques based on the mechanical demands of the sport, aimed at resulting in better performance.
For example, muscle activation is measured in cycling using electromyography and kinematics, which helps researchers analyze factors like posture, components, or exercise intensity that affect activation. (Jose I. Priego-Quesada 2021)
Motions
In biomechanics, the body’s motions are referred to from anatomical positioning:
Standing upright, with the gaze straight ahead
Arms at the sides
Palms facing forward
Feet spaced slightly apart, toes forward.
The three anatomical planes include:
Sagittal – median – Dividing the body into right and left halves is the sagittal/median plane. Flexion and extension occur in the sagittal plane.
Frontal – The frontal plane divides the body into front and back sides but also includes abduction, or moving a limb away from the center, and adduction, or moving a limb towards the center in the frontal plane.
Transverse – horizontal. – The upper and lower parts of the body are divided by the transverse/horizontal plane. Rotating movements occur here. (American Council on Exercise 2017)
Moving the body in all three planes occurs with daily activity. This is why performing exercises in each plane of motion to build strength, function, and stability is recommended.
Tools
Various tools are used to study biomechanics. Studies are usually performed using a device known as electromyography or EMG sensors. Sensors are placed on the skin and measure the amount and degree of muscle fiber activation in certain muscles during test exercises. EMGs can help:
Researchers understand which exercises are more effective than others.
Therapists know whether patients’ muscles are properly operating and functioning.
Dynamometers are another tool that helps measure muscle strength.
They measure the force output generated during muscle contractions to see if the muscles are sufficiently strong.
They are used to measure grip strength, which can be an indicator of overall strength, health, and longevity. (Li Huang et al., 2022)
Beyond Adjustments: Chiropractic and Integrative Healthcare
References
Lu, T. W., & Chang, C. F. (2012). Biomechanics of human movement and its clinical applications. The Kaohsiung journal of medical sciences, 28(2 Suppl), S13–S25. https://doi.org/10.1016/j.kjms.2011.08.004
Vilar, J. M., Miró, F., Rivero, M. A., & Spinella, G. (2013). Biomechanics. BioMed research international, 2013, 271543. https://doi.org/10.1155/2013/271543
Priego-Quesada J. I. (2021). Exercise Biomechanics and Physiology. Life (Basel, Switzerland), 11(2), 159. https://doi.org/10.3390/life11020159
American Council on Exercise. Makeba Edwards. (2017). Planes of Motion Explained (Exercise Science, Issue. https://www.acefitness.org/fitness-certifications/ace-answers/exam-preparation-blog/2863/the-planes-of-motion-explained/
Huang, L., Liu, Y., Lin, T., Hou, L., Song, Q., Ge, N., & Yue, J. (2022). Reliability and validity of two hand dynamometers when used by community-dwelling adults aged over 50 years. BMC geriatrics, 22(1), 580. https://doi.org/10.1186/s12877-022-03270-6
Knee injuries can present in physically active individuals that lift weights. Can understanding the types of weightlifting knee injuries help in prevention?
Weightlifting Knee Injuries
Weight training is very safe for the knees as regular weight training can improve knee strength and prevent injury as long as the correct form is followed. For Individuals with knee injuries from other activities, incorrect weight-training exercises could worsen the injury. (Ulrika Aasa et al., 2017) As well as, sudden twisting movements, poor alignment, and pre-existing injuries can increase the risk of worsening or creating further injuries. (Hagen Hartmann et al, 2013) The body and the knees are designed to support vertical forces on the joints.
Common Injuries
Weightlifting knee injuries occur as the knee joints endure a wide range of stresses and strains. In weight training, the ligaments that attach to the complex bone system of the knee joint can be damaged by incorrect movements, overloading the weight, and increasing the weight too soon. These injuries can result in pain, swelling, and immobility that can range from minor to severe, from a sprain or a slight tear to a complete tear in serious cases.
Anterior Cruciate Ligament – ACL – Injury
This ligament attaches the thigh’s femur bone to the lower leg’s shin bone/tibia and controls excessive rotation or extension of the knee joint. (American Academy of Family Physicians. 2024)
Anterior means front.
ACL injuries are seen mostly in athletes but can happen to anybody.
Severe damage to the ACL usually means surgical reconstruction and up to 12 months of rehabilitation.
When weightlifting, try to avoid twisting knee movements, intentionally or accidentally, under excessive load.
Posterior Cruciate Ligament – PCL – Injury
The PCL connects the femur and tibia at different points to the ACL.
It controls any backward motion of the tibia at the joint.
Injuries occur most with high-impact forces as a result of accidents and sometimes in activities where forceful trauma to the knee occurs.
Medial Collateral Ligament – MCL – Injury
This ligament maintains the knee from bending too far to the inside/medially.
Injuries mostly occur from impact to the outside of the knee or from accidental bodyweight force on the leg that bends at an unusual angle.
Lateral Collateral Ligament – LCL – Injury
This ligament connects the smaller bone of the lower leg/fibula to the femur.
It is opposite to the MCL.
It maintains excessive outward movement.
LCL injuries occur when a force pushes the knee out.
Cartilage Injury
Cartilage prevents bones from rubbing together and cushions impact forces.
Knee menisci are cartilage that cushions the knee joints inside and outside.
Other types of cartilage protect the thigh and shin bones.
When cartilage gets torn or damaged, surgery may be required.
Tendonitis
Aggravated and overused knee tendons can lead to weightlifting knee injuries.
A related injury known as iliotibial band syndrome/ITB causes pain to the outside of the knee, usually in runners, but it can occur from overuse.
Rest, stretching, physical therapy, and anti-inflammatory medication are a common treatment plan.
The condition causes the cartilage to deteriorate and bones to rub together, resulting in pain and stiffness.
Prevention
Individuals can minimize their risk of weightlifting knee injuries and pain by following their doctor’s and personal trainers’ recommendations.
Individuals with an existing knee injury should follow their doctor’s or physical therapist’s recommendations.
A knee sleeve can keep the muscles and joints secure, providing protection and support.
Stretching the leg and knee muscles can maintain joint flexibility.
Avoid sudden lateral movements.
Possible recommendations can include:
Avoiding Certain Exercises
Isolation exercises like leg curls, standing, or on a bench, as well as using the leg extension machine, can stress the knee.
Deep Squat Training
Research shows that the deep squat can protect against lower leg injury if the knee is healthy. However, this is when done with proper technique, under expert supervision, and with a gradual progressive load. (Hagen Hartmann et al, 2013)
Individuals should talk to their doctor before beginning a new exercise routine. A personal trainer can provide training in learning the proper technique and weightlifting form.
How I Tore my ACL Part 2
References
Aasa, U., Svartholm, I., Andersson, F., & Berglund, L. (2017). Injuries among weightlifters and powerlifters: a systematic review. British journal of sports medicine, 51(4), 211–219. https://doi.org/10.1136/bjsports-2016-096037
Hartmann, H., Wirth, K., & Klusemann, M. (2013). Analysis of the load on the knee joint and vertebral column with changes in squatting depth and weight load. Sports medicine (Auckland, N.Z.), 43(10), 993–1008. https://doi.org/10.1007/s40279-013-0073-6
American Academy of Family Physicians. ACL injury. (2024). ACL injury (Diseases and Conditions, Issue. https://familydoctor.org/condition/acl-injuries/
Mellinger, S., & Neurohr, G. A. (2019). Evidence based treatment options for common knee injuries in runners. Annals of translational medicine, 7(Suppl 7), S249. https://doi.org/10.21037/atm.2019.04.08
Driban, J. B., Hootman, J. M., Sitler, M. R., Harris, K. P., & Cattano, N. M. (2017). Is Participation in Certain Sports Associated With Knee Osteoarthritis? A Systematic Review. Journal of athletic training, 52(6), 497–506. https://doi.org/10.4085/1062-6050-50.2.08
For individuals experiencing lower back pain can understanding the anatomy and function of the multifidus muscle help in injury prevention and in the development of a highly effective treatment plan?
Multifidus Muscle
The multifidus muscles are long and narrow on either side of the spinal column, which helps stabilize the lower region of the spine or lumbar spine. (Maryse Fortin, Luciana Gazzi Macedo 2013) Sitting too much, practicing unhealthy postures, and lack of movement can progress to the multifidus muscle weakening or atrophy, which can lead to spinal instability, vertebral compression, and back pain. (Paul W. Hodges, Lieven Danneels 2019)
Anatomy
Known as the deep layer, it is the innermost layer of the three muscle layers of the back and controls the movement of the spine. The other two layers, known as the intrinsic and superficial, are responsible for the thoracic cage/rib cage and shoulder movement. (Anouk Agten et al., 2020) The multifidus has attachment points at:
The thoracic spine of the middle back.
The lumbar spine of the lower back.
The iliac spine – the base of the wing-shaped iliac bone of the pelvis.
Sacrum – series of bones at the base of the spine connected to the tailbone.
When standing or moving, the multifidus muscle works with the transversus abdominus and pelvic floor muscles to stabilize the lumbar spine. (Christine Lynders 2019)
Muscle Function
The main function is to stabilize the lower back, but it also helps extend the lower spine whenever reaching or stretching. (Jennifer Padwal et al., 2020) Because the muscle has numerous attachment points and is serviced by a specific branch of nerves known as the posterior rami, it allows each vertebra to work individually and more efficiently.
The multifidus muscle works with two other deep muscle groups to stabilize and move the spine. (Jeffrey J Hebert et al., 2015)
The rotatores muscle enables unilateral rotation, turning from side to side, and bilateral extension or bending backward and forward.
The semispinalis muscle above the multifidus allows extension and rotation of the head, neck, and upper back.
The multifidus muscle ensures spinal strength because it has more attachment points to the spine than the other layers, which reduces spinal flexibility and rotation but increases strength and stability. (Anouk Agten et al., 2020)
Lower Back Pain
A weak multifidus muscle destabilizes the spine and provides less support to the vertebra. This adds pressure on muscles and connective tissues between and adjacent to the spinal column, increasing the risk of lower back pain symptoms. (Paul W. Hodges, Lieven Danneels 2019) The loss of muscle strength and stability can cause atrophy or wasting away. This can cause compression and other back problems. (Paul W. Hodges et al., 2015) Back problems associated with multifidus muscle deterioration include (Paul W. Hodges, Lieven Danneels 2019)
Herniated discs – also bulging or slipped discs.
Nerve entrapment or compression pinched nerve.
Sciatica
Referred pain – nerve pain originating from the spine felt in other areas.
Osteoarthritis – wear-and-tear arthritis
Spinal osteophytes – bone spurs
Weak abdominal or pelvic floor muscles can compromise the core, increasing the risk of chronic lower back pain and injury.
Individuals are recommended to consult a physical therapist and chiropractor who can help develop the appropriate treatment, rehabilitation, and strengthening plan based on age, injury, underlying conditions, and physical abilities.
Can Core Exercises Help with Back Pain?
References
Fortin, M., & Macedo, L. G. (2013). Multifidus and paraspinal muscle group cross-sectional areas of patients with low back pain and control patients: a systematic review with a focus on blinding. Physical therapy, 93(7), 873–888. https://doi.org/10.2522/ptj.20120457
Hodges, P. W., & Danneels, L. (2019). Changes in Structure and Function of the Back Muscles in Low Back Pain: Different Time Points, Observations, and Mechanisms. The Journal of orthopaedic and sports physical therapy, 49(6), 464–476. https://doi.org/10.2519/jospt.2019.8827
Agten, A., Stevens, S., Verbrugghe, J., Eijnde, B. O., Timmermans, A., & Vandenabeele, F. (2020). The lumbar multifidus is characterised by larger type I muscle fibres compared to the erector spinae. Anatomy & cell biology, 53(2), 143–150. https://doi.org/10.5115/acb.20.009
Lynders C. (2019). The Critical Role of Development of the Transversus Abdominis in the Prevention and Treatment of Low Back Pain. HSS journal : the musculoskeletal journal of Hospital for Special Surgery, 15(3), 214–220. https://doi.org/10.1007/s11420-019-09717-8
Padwal, J., Berry, D. B., Hubbard, J. C., Zlomislic, V., Allen, R. T., Garfin, S. R., Ward, S. R., & Shahidi, B. (2020). Regional differences between superficial and deep lumbar multifidus in patients with chronic lumbar spine pathology. BMC musculoskeletal disorders, 21(1), 764. https://doi.org/10.1186/s12891-020-03791-4
Hebert, J. J., Koppenhaver, S. L., Teyhen, D. S., Walker, B. F., & Fritz, J. M. (2015). The evaluation of lumbar multifidus muscle function via palpation: reliability and validity of a new clinical test. The spine journal : official journal of the North American Spine Society, 15(6), 1196–1202. https://doi.org/10.1016/j.spinee.2013.08.056
Hodges, P. W., James, G., Blomster, L., Hall, L., Schmid, A., Shu, C., Little, C., & Melrose, J. (2015). Multifidus Muscle Changes After Back Injury Are Characterized by Structural Remodeling of Muscle, Adipose and Connective Tissue, but Not Muscle Atrophy: Molecular and Morphological Evidence. Spine, 40(14), 1057–1071. https://doi.org/10.1097/BRS.0000000000000972
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