Hamstring muscle injuries are common, especially in athletes and individuals with physically demanding jobs. Is there a better chance of full recovery with surgical repair and post-op rehabilitation?
Hamstring Muscle Tear
Most often, hamstring muscle injuries are partial tears of the muscle. These types of injuries are muscle strains that occur when the muscle fibers are stretched beyond their normal limits. Complete tears of the hamstring muscle are unusual, but they do occur in both athletes and non-athletes. Determining the optimal treatment plan depends on:
The severity of the tendon tear
The expectations of the injured individual.
Incomplete tears are when the hamstring muscle is stretched too far, but not completely detached.
Complete tears usually occur at the top of the muscle where the tendon tears away from the pelvis.
A complete tear usually occurs when there is a sudden flexion of the hip and extension of the knee joint – when the muscle contracts in this position, it gets stretched beyond its limits.
Basic hamstring strains can be treated with simple steps – rest, ice, anti-inflammatory medications, and conservative therapies.
Symptoms
Symptoms of a hamstring muscle strain can include pain, bruising, swelling, and movement difficulty. (American Academy of Orthopaedic Surgeons. 2021) Individuals who sustain this injury typically experience sudden sharp pain. Signs of a tear can include:
Sharp pain where the buttock and thigh meet.
Difficulty walking.
Sitting can be difficult as the edge of a chair can place pressure directly on the injury.
Spasms and cramping sensations in the back of the thigh.
Weakness in the leg, specifically when bending the knee or lifting the leg behind the body.
Numbness or burning sensations as a result of sciatic nerve irritation.
Swelling and bruising in the back of the thigh – over time it can travel down to the back of the knee and calf and possibly into the foot.
With a complete hamstring tear, there is usually significant swelling and bruising that develops in the back of the thigh.
Diagnosis
The symptoms can be difficult to spot in the early stages which is why X-rays of the hip or thigh are usually obtained.
In some situations, a fragment of bone can get pulled off the pelvis along with the hamstring muscle attachment. MRI testing can be performed to evaluate the attachment and can define critical features of a complete hamstring muscle tear, including: (American Academy of Orthopaedic Surgeons. 2021)
The number of tendons involved.
Complete versus incomplete tearing.
The amount of retraction – the amount the tendons have pulled back.
This will guide the development of treatment.
Treatment
The treatment of a complete tear will depend on different factors. The other variable is the patient and their expectations.
Treatment is more aggressive in younger individuals like high-level athletes.
Treatment is less aggressive in middle-aged individuals.
Often a single tendon tear can be treated non-surgically.
When one tendon is involved, it is typically not pulled very far from its normal attachment and will develop scar tissue in a positive position.
Conversely, when three tendons have been torn, they usually pull more than a few centimeters away from the bone. These cases have better results with surgical repair. (UW Health. 2017)
Surgeons will use patient characteristics – high-level athletes or less physically active individuals – to guide treatment recommendations.
Rehabilitation
Rehabilitation following surgery can take 3-6 months or longer.
The first six weeks limit weight-bearing with the use of crutches.
Patients may be recommended to wear a brace to reduce tension on the repaired hamstring tendons.
Strengthening does not begin until three months post-op, and even light activities are usually delayed. (UW Health. 2017)
Because this injury can have a long recovery time, some individuals may choose nonsurgical treatment.
Sometimes these individuals experience symptoms of discomfort from sitting and may exhibit long-term weakness of the hamstring muscle.
Full recovery from a complete hamstring muscle injury takes time. Studies have shown high-level athletes are able to resume competitive sports after the repair and rehabilitation of an acute hamstring muscle injury. (Samuel K. Chu, Monica E. Rho. 2016)
Delaying surgical treatment may not always lead to optimal results.
When the tendon is torn away from its normal attachment, it begins to scar around the surrounding soft tissues.
When there is a delay of more than a few weeks following the initial injury, regaining the full length of the tendon and muscle can be challenging.
This could delay the rehabilitation process and may limit the potential for full recovery. (Ho Yoon Kwak, et al., 2011)
With severe injuries, there is a better chance of full recovery with surgical repair but could involve a long recovery and commitment to a post-op rehabilitation plan.
Chu, S. K., & Rho, M. E. (2016). Hamstring Injuries in the Athlete: Diagnosis, Treatment, and Return to Play. Current sports medicine reports, 15(3), 184–190. https://doi.org/10.1249/JSR.0000000000000264
Kwak, H. Y., Bae, S. W., Choi, Y. S., & Jang, M. S. (2011). Early surgical repair of acute complete rupture of the proximal hamstring tendons. Clinics in orthopedic surgery, 3(3), 249–253. https://doi.org/10.4055/cios.2011.3.3.249
Tomatoes are low-calorie and nutrient-dense, what health benefits can individuals gain from their consumption?
Tomato Benefits
All varieties of tomatoes offer nutrients, including potassium and vitamin C, making them part of a balanced diet.
Raw tomatoes contain vitamin C, which brightens skin and fights inflammation.
Cooking tomatoes releases more antioxidants which are vital in small quantities such as lycopene, for maintaining heart health and preventing certain cancers.
Other benefits contribute to heart, prostate, and cognitive/brain health.
Various tomato recipes and products can offer a balance of nutrients. Variety is key and this applies to all fruits and vegetables. Try them raw, cooked, and steamed, as the different methods can offer different benefits.
Cooked and Raw Tomatoes
Tomatoes are low in calories and rich in nutrients. A raw, medium-sized tomato contains roughly 22 calories and less than 1 gram of fat. It is low sodium and low glycemic, with just 6 milligrams of sodium and 3 grams of sugar. They are an excellent source of hydration as a raw tomato contains about half a cup of water.
Tomatoes contain several essential vitamins and minerals that support the immune system and the bones and blood.
Antioxidants help combat free radicals and unstable molecules that damage the body’s cells. (Edward J. Collins, et al., 2022)
Antioxidants like lycopene, lutein, and zeaxanthin, are better absorbed with cooked tomatoes.
Raw tomatoes contain small amounts of vitamins A and K, fluoride, folate, and beta-carotene.
Heart Health
Tomatoes provide a healthy serving of potassium.
Potassium and sodium are both vital for heart function.
Potassium is essential for relaxing the blood vessels.
One medium tomato contains around the same amount as a banana.
The heart needs these electrolytes to contract and expand.
Most individuals with high blood pressure can benefit from high potassium, fiber, and lycopene levels.
Studies have linked lycopene to lower heart disease risk and mortality. (Bo Song, et al., 2017)
Exercise Recovery
Electrolytes are essential for basic cell function.
Potassium, sodium, magnesium, and fluoride can help decrease muscle soreness and exercise fatigue after physical activity or workouts.
The anti-inflammatory properties come from the vitamin C.
Eating tomatoes before or after physical activity can help replenish magnesium which is essential for muscle contraction. (Edward J. Collins, et al., 2022)
Protection Against Dementia
Potassium provides power to the heart and has a role in body nerve function.
One recent study found that individuals who consumed more potassium and less sodium had improved cognitive function. (Xiaona Na, et al., 2022)
Another study analyzed how carotenoids/antioxidants that affect the color of vegetables affect long-term brain health.
Researchers found that individuals with increased blood levels of lutein and zeaxanthin, which are both present in cooked tomatoes had a lower rate of dementia. (May A. Beydoun, et al., 2022)
Lutein and zeaxanthin are also known for protecting eye health as the body ages.
Help Prevent Prostate Cancer
Cooking tomatoes compromises the vitamin C content, but increases the availability of several antioxidants that can protect against cancer growth.
Especially for men, lycopene is beneficial to help reduce prostate-related issues.
Studies have found that men who eat tomatoes, including raw, sauce, and on pizza have a lower risk of developing prostate cancer due to the total amount of lycopene absorbed, which is optimized in cooked tomatoes. (Joe L. Rowles 3rd, et al., 2018)
Lycopene and other plant pigments/carotenoids are believed to protect against cancer because of their antioxidant properties. (Edward J. Collins, et al., 2022)
Lycopene and other antioxidants in tomatoes can also benefit male fertility by improving sperm count and sperm motility. (Yu Yamamoto, et al., 2017)
Balance Blood Sugar
Tomatoes can help manage blood sugar in individuals with diabetes.
They have fiber that helps regulate blood sugar and bowel movements.
Fiber naturally slows digestion to keep the body fuller and longer and does not negatively impact blood sugar levels.
Collins, E. J., Bowyer, C., Tsouza, A., & Chopra, M. (2022). Tomatoes: An Extensive Review of the Associated Health Impacts of Tomatoes and Factors That Can Affect Their Cultivation. Biology, 11(2), 239. https://doi.org/10.3390/biology11020239
Song, B., Liu, K., Gao, Y., Zhao, L., Fang, H., Li, Y., Pei, L., & Xu, Y. (2017). Lycopene and risk of cardiovascular diseases: A meta-analysis of observational studies. Molecular nutrition & food research, 61(9), 10.1002/mnfr.201601009. https://doi.org/10.1002/mnfr.201601009
Na X, Xi M, Zhou Y, et al. Association of dietary sodium, potassium, sodium/potassium, and salt with objective and subjective cognitive function among the elderly in China: a prospective cohort study. (2022). Glob Transit. 4:28-39. doi:10.1016/j.glt.2022.10.002
Beydoun, M. A., Beydoun, H. A., Fanelli-Kuczmarski, M. T., Weiss, J., Hossain, S., Canas, J. A., Evans, M. K., & Zonderman, A. B. (2022). Association of Serum Antioxidant Vitamins and Carotenoids With Incident Alzheimer Disease and All-Cause Dementia Among US Adults. Neurology, 98(21), e2150–e2162. https://doi.org/10.1212/WNL.0000000000200289
Rowles, J. L., 3rd, Ranard, K. M., Applegate, C. C., Jeon, S., An, R., & Erdman, J. W., Jr (2018). Processed and raw tomato consumption and risk of prostate cancer: a systematic review and dose-response meta-analysis. Prostate cancer and prostatic diseases, 21(3), 319–336. https://doi.org/10.1038/s41391-017-0005-x
Yamamoto, Y., Aizawa, K., Mieno, M., Karamatsu, M., Hirano, Y., Furui, K., Miyashita, T., Yamazaki, K., Inakuma, T., Sato, I., Suganuma, H., & Iwamoto, T. (2017). The effects of tomato juice on male infertility. Asia Pacific journal of clinical nutrition, 26(1), 65–71. https://doi.org/10.6133/apjcn.102015.17
Quagliani, D., & Felt-Gunderson, P. (2016). Closing America’s Fiber Intake Gap: Communication Strategies From a Food and Fiber Summit. American journal of lifestyle medicine, 11(1), 80–85. https://doi.org/10.1177/1559827615588079
For individuals about to engage in physical activity or exercise, how does warming up the body help prepare for the work ahead?
Central Nervous System Activation
A proper warm-up before physical activity or working out prepares the mind and body to reduce risks of injury, mentally and physically transition to physical activity work, and enhance performance. A well-designed warm-up also primes the central nervous system/CNS for activity. The central nervous system transmits messages to the muscles to prepare them for action. Central nervous system activation increases motor neuron recruitment and engages the sympathetic nervous system so the body can better handle the physical stressors. The process may seem complex, but priming the nervous system is as simple as warming up with light aerobic activity before getting into more explosive movements.
CNS
The CNS consists of the brain and spinal cord. This central communication system uses another part of the nervous system known as the peripheral nervous system or PNS to transmit and receive messages throughout the body. The PNS is connected to the entire body and the brain and spinal cord (CNS).
Nerves run throughout the body, receiving signals from the CNS to the muscles, fibers, and organs, transmitting various information back to the brain. (Berkeley University. N.D.)
There are two types of systems within the peripheral nervous system – somatic and autonomic.
Somatic nervous system actions are those controlled by the person through voluntary actions like choosing to pick something up.
Properly preparing the body for an intense strength training session or other physical activity needs the correct messages to be sent through the autonomic nervous system.
Parasympathetic and Sympathetic States
The autonomic nervous system consists of two subcategories, which are parasympathetic and sympathetic.
The sympathetic nervous system helps the body get ready to face stress which includes physical stress. (R. Bankenahally, H. Krovvidi. 2016)
The fight, flight, or freeze response describes the sympathetic nervous system’s aspect.
The parasympathetic nervous system is responsible for relaxation and de-stressing.
Individuals are recommended to perform a few calming movements and actions after a workout to return the body to a parasympathetic state. This can be:
Activating the CNS can increase performance and prevent injuries. The process wakes up and alerts the body for the activity. Individuals are recommended before beginning a training session, to communicate to the body about the physical stress it is about to endure and to prepare for the work ahead. This is a concept known as post-activation potentiation/PAP. (Anthony J Blazevich, Nicolas Babault. 2019) PAP helps increase force and power production, which enhances physical performance.
Whenever an individual trains, the brain adapts and learns what the body is doing and the purpose of the training.
Muscle memory describes this interaction.
Individuals who have started up a new strength training routine or after an extended break report feeling awkward for the first few sessions, or even weeks, depending on their experience. (David C Hughes, Stian Ellefsen, Keith Baar, 2018)
However, after a few sessions, the body is more adept at performing the movements and ready to increase resistance, repetitions, or both.
This has to do with the neural drive and muscle memory than it has to do with true potential physical abilities. (Simon Walker. 2021)
The first step is a general warm-up that should use large muscle groups and be of low intensity so as not to exhaust the body before beginning the actual training. General warm-up benefits central nervous system activation and the entire body include: (Pedro P. Neves, et al., 2021) (D C. Andrade, et al., 2015)
Increases blood circulation.
Assists the release of oxygen from hemoglobin and myoglobin.
Warms the muscles, so they contract more effectively.
Increases nerve impulse speed.
Increases nutrient delivery.
Lowers joints’ resistance through increased synovial fluid/joint lubrication.
Increases joint range of motion.
Improves joint resiliency.
Removes metabolic waste quicker.
Reduces risk of injury.
A general warm-up can be simple as any aerobic activity will work. This can include:
Performing bodyweight movements – light jumping jacks or jogging in place.
Treadmill
Rowing machine
Stair climber
Elliptical trainer
It is recommended to use the rating perceived exertion scale/RPE to determine the general warm-up effort. An exertion rating of between 5 to 6 is equivalent to moderate walking or a slow jog. Individuals should be able to speak clearly without taking a pause.
Try this strategy before the next workout to see increased performance and reduced injury risks.
Blazevich, A. J., & Babault, N. (2019). Post-activation Potentiation Versus Post-activation Performance Enhancement in Humans: Historical Perspective, Underlying Mechanisms, and Current Issues. Frontiers in physiology, 10, 1359. https://doi.org/10.3389/fphys.2019.01359
Hughes, D. C., Ellefsen, S., & Baar, K. (2018). Adaptations to Endurance and Strength Training. Cold Spring Harbor perspectives in medicine, 8(6), a029769. https://doi.org/10.1101/cshperspect.a029769
Walker S. (2021). Evidence of resistance training-induced neural adaptation in older adults. Experimental gerontology, 151, 111408. https://doi.org/10.1016/j.exger.2021.111408
Andrade, D. C., Henriquez-Olguín, C., Beltrán, A. R., Ramírez, M. A., Labarca, C., Cornejo, M., Álvarez, C., & Ramírez-Campillo, R. (2015). Effects of general, specific, and combined warm-up on explosive muscular performance. Biology of sport, 32(2), 123–128. https://doi.org/10.5604/20831862.1140426
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
“For individuals looking to improve their quality of life, can substituting healthy meal ingredients be a simple step toward better health?”
Food Substitutions
Eating well does not mean having to give up favorite foods. Part of the enjoyment of home cooking is putting one’s own style on each dish. Individuals soon discover they prefer healthy food substitutions to the original high-fat, high-sugar, or high-sodium ingredients. Healthy swaps can be introduced gradually to allow the taste buds to adapt. It is possible to reduce:
Calories
Unhealthy fats
Sodium
Refined sugars
Simply making smart swaps that replace some ingredients with more beneficial ones.
Ingredients for Healthier Meals
Recipes are the sum of their parts. A dish made with multiple ingredients adds its own nutrition for healthy or unhealthy. Ingredients high in calories, saturated fat, added sugars, and/or sodium can make a dish less nutritious. By making strategic food substitutions, individuals can transform a high-calorie, high-fat, sugary dish into something more nutritious. When done regularly this adjustment leads to long-term healthy behavior changes. Making small adjustments leads to improvements in weight management, heart health, and risk of chronic diseases.
Substituting Unhealthy Fats and Oils
Fat is a necessary nutrient, however, diets high in saturated fat have been linked with an increased risk of coronary artery disease, (Geng Zong, et al., 2016)
and high cholesterol levels. (American Heart Association. 2021)
Foods like butter, coconut oil, and lard are some of the most used saturated fats.
Conversely, research shows that eating more unsaturated fats is usually associated with better cardiovascular health and lower overall mortality. (Harvard T.H. Chan School of Public Health. 2016)
Instead of baking with butter, try using applesauce, mashed avocados, or mashed bananas.
These plant-based alternatives don’t overload the body with saturated fat.
Try using half butter and half an alternative to cut calories and fats.
For cooking, try sautéing, roasting, or pan-frying in olive or avocado oil.
Both contain healthy monounsaturated fats.
These oils can be used for dipping bread with dinner or for a quick snack.
Fresh herbs or a dash of balsamic vinegar can add flavor.
Refined Sugars
Enjoying sweets can be healthy, but the objective is to be mindful of how much-refined sugar is consumed. Sweet flavors send signals to the reward centers in the brain, increasing positive associations with sugar. However, eating high amounts of sugar can lead to:
An array of other herbs and spices can amplify the flavor of meals.
Purchase or create various flavor blends.
For example, cumin, chili powder, oregano, and red pepper flakes can spice up a dish or a blend of thyme, paprika, garlic powder, and onion powder can add savory notes.
A study found that adding lemon juice to recipes could reduce sodium content and add tanginess. (Sunkist Growers. 2014)
Whole Grains
Individuals don’t have to choose brown rice or whole wheat pasta for every meal but try to select whole grains half of the time. Food substitutions that can help achieve the halfway point include:
Popcorn or whole wheat crackers instead of refined flour crackers.
Whole wheat pizza crust instead of regular crust.
Substitute brown rice for white in stir-fries or casseroles.
Oatmeal instead of refined grain cereal.
Whole wheat pasta for spaghetti and meatballs or other pasta dishes.
Quinoa as a side dish instead of white rice or couscous.
More whole grains equals more fiber and B vitamins to help sustain energy, prevent blood sugar spikes, and promote digestive health. Eating more whole grains has been linked with a reduced risk of heart disease (Caleigh M Sawicki, et al. 2021) and a lower risk of colon cancer. (Glenn A. Gaesser. 2020)
Finding the right combination of each of these substitutions takes time. Go slow and taste often to see how each substitution affects a recipe’s taste and texture.
Boost Metabolism
References
Zong, G., Li, Y., Wanders, A. J., Alssema, M., Zock, P. L., Willett, W. C., Hu, F. B., & Sun, Q. (2016). Intake of individual saturated fatty acids and risk of coronary heart disease in US men and women: two prospective longitudinal cohort studies. BMJ (Clinical research ed.), 355, i5796. https://doi.org/10.1136/bmj.i5796
American Heart Association. Saturated fat.
Harvard T.H. Chan School of Public Health. Different dietary fat, different risk of mortality.
Faruque, S., Tong, J., Lacmanovic, V., Agbonghae, C., Minaya, D. M., & Czaja, K. (2019). The Dose Makes the Poison: Sugar and Obesity in the United States – a Review. Polish journal of food and nutrition sciences, 69(3), 219–233. https://doi.org/10.31883/pjfns/110735
Harvard Health Publishing. The sweet danger of sugar.
American Heart Association. How much sugar is too much?
Centers for Disease Control and Prevention. How to Reduce Sodium Intake.
Sunkist Growers. Sunkist Growers and Chefs from Johnson & Wales University Release New S’alternative® Research.
Sawicki, C. M., Jacques, P. F., Lichtenstein, A. H., Rogers, G. T., Ma, J., Saltzman, E., & McKeown, N. M. (2021). Whole- and Refined-Grain Consumption and Longitudinal Changes in Cardiometabolic Risk Factors in the Framingham Offspring Cohort. The Journal of nutrition, 151(9), 2790–2799. https://doi.org/10.1093/jn/nxab177
Gaesser G. A. (2020). Whole Grains, Refined Grains, and Cancer Risk: A Systematic Review of Meta-Analyses of Observational Studies. Nutrients, 12(12), 3756. https://doi.org/10.3390/nu12123756
Individuals striving to be healthy may not know where or how to start. Can hiring a health coach help individuals start their wellness journey and reach their goals?
Hiring A Health Coach
It’s easy to get caught up in the desire to make changes, but it is another thing to actually set a consistent plan in motion. Hiring a health coach can help individuals understand the information, develop an effective wellness routine that suits their lifestyle, and achieve health and wellness goals. A primary healthcare provider could be a resource and have referrals to reputable health coaches in the area.
What Do They Do?
Health coaches are experts in helping individuals reach health and wellness goals. This can be:
Reducing stress
Improving self-care
Focusing on nutrition
Starting exercise
Improving quality of life
A health coach helps create a plan and makes it happen.
Health and wellness coaches use motivational interviewing and evidence-based approaches to empower individuals in their wellness journey. (Adam I Perlman, Abd Moain Abu Dabrh. 2020)
They help identify areas that need improvement, develop a plan, and encourage the individual all the way like a personal fitness trainer.
Health coaches work with physicians and/or other health professionals in a clinical setting or as individual providers.
Their role is to provide a holistic approach to health and wellness.
A health coach is someone who helps organize and balance various aspects of an individual’s life so they can learn to maintain optimal health.
They will help overcome barriers when struggling.
A health coach listens and provides support for whatever an individual’s goals may be.
A health coach is there until the goal is reached.
Qualifications
It is important to ensure the providers being considered have the necessary qualifications. Because some certification programs offer a focus on specific areas like nutrition, it’s recommended to identify what is needed before choosing a health coach. Health coaches do not need a university degree, however, many certifications are affiliated with colleges and have educational partnerships that qualify coursework and award college credits. Training to become a health coach consists of: (Shivaun Conn, Sharon Curtain 2019)
Health
Fitness
Goal setting
Coaching concepts
Nutritional concepts
Motivational interviewing
Stress management
Changing behaviors
Health Goal Examples
Health coaching is not a one-size-fits-all approach. A primary healthcare provider or physician provides a diagnosis and medical plan, and a health coach helps guide and support the individual through the plan. However, hiring a health coach does not require a medical condition to employ services. A few examples of health goals that health coaches address include:
There are many types of health coaches and some may specialize, therefore try to determine the expertise needed to achieve the goals.
Budget
Determine how much money will be invested, as many insurance providers do not cover the cost of a health coach.
Health coaches may charge between $50 to $300 per session.
Some will offer packages, memberships, and/or discounts.
Certifications
Look into their certification.
Is it accredited?
This will ensure choosing a coach who has received the training and expertise needed to provide quality care.
Compatibility
Consult with potential coaches.
Ask questions and see if they are compatible with specific health goals.
Interview as many as needed.
Availability/Location
Virtual sessions, in-person meetings, and/or a combination?
How long are the sessions?
Frequency of meetings?
Finding a coach that is flexible and convenient will help maintain a healthy coach/client relationship.
Multidisciplinary Evaluation and Treatment
References
Perlman, A. I., & Abu Dabrh, A. M. (2020). Health and Wellness Coaching in Serving the Needs of Today’s Patients: A Primer for Healthcare Professionals. Global advances in health and medicine, 9, 2164956120959274. https://doi.org/10.1177/2164956120959274
Conn, S., & Curtain, S. (2019). Health coaching as a lifestyle medicine process in primary care. Australian journal of general practice, 48(10), 677–680. https://doi.org/10.31128/AJGP-07-19-4984
Back problems and discomfort symptoms are a common ailment that many types of healthcare providers diagnose and treat it. Can knowing a little about what each back pain specialist does and what they have to offer help in choosing a provider?
Back Pain Specialists
Nowadays individuals have options for treating back pain. Primary healthcare providers, general practitioners, pediatricians, and emergency room workers are usually the first to examine the injury or problem. If they are unable to properly diagnose or treat the injury, they will refer the individual to a specialist. Specialists include:
Osteopaths
Chiropractors
Orthopedists
Rheumatologists
Neurologists
Neurosurgeons.
They specialize in chronic conditions and diseases like arthritis or problems like herniated discs. Complementary and alternative providers treat individuals solely or with help from a care team. They look at the whole body and focus on improving overall function.
Family and General Practitioners
When neck or back pain begins a regular doctor that’s usually a family or general practitioner/GP or primary care provider PCP is a recommended place to start. They will:
Order diagnostic tests.
Recommend exercises and stretches.
Prescribe medication.
Refer the patient to a physical therapist or other back pain specialist.
However, studies suggest general providers can be uninformed and slow to adopt new back treatments. (Paul B. Bishop, Peter C. Wing. 2006) It is recommended to research possible treatment options, ask a lot of questions during an appointment, and ask or request a referral to a specialist.
Pediatricians
Pediatricians diagnose and treat children. They cover a wide range of issues including back problems and injuries. As with a general practitioner or primary care provider, a child’s pediatrician is the place to start. Depending on the child’s needs, they’ll refer them to the proper specialist.
Emergency Healthcare Providers
When there is serious neck or back trauma, individuals need to go to the emergency room. Trauma can include automobile collisions, sports accidents, work accidents, and/or personal home accidents. Someone with a possible spinal injury should not be moved. (W Yisheng, et al., 2007) Go to the ER if there is back pain with loss of bowel or bladder control, or the legs become progressively weaker. These are symptoms of an emergency condition known as cauda equina syndrome. (American Association of Neurological Surgeons. 2023)
Orthopedists
Orthopedists and orthopedic surgeons treat the musculoskeletal system, which includes:
Muscles
Bones
Joints
Connective tissues
Cartilage
Common orthopedic issues include:
Repetitive stress injuries
Sports injuries
Bursitis
Tendonitis
Ruptured discs
Nerve impingement
Scoliosis
Osteoporosis
Osteoarthritis
Orthopedics can overlap with other specialties. As orthopedists and rheumatologists both treat arthritis and orthopedic surgeons and neurosurgeons do some of the same procedures that include spinal fusions and discectomies.
Rheumatologists
A rheumatologist treats autoimmune, inflammatory, and musculoskeletal conditions that can include different types of arthritis, lupus, and Sjogren’s syndrome. A primary care provider may refer a patient to a rheumatologist if they have symptoms that include:
Sacroiliitis – inflammation of the sacroiliac joint at the base of the spine.
Axial spondylosis – a form of spinal arthritis.
Axial spondylosis – spinal arthritis that causes the bones to fuse together.
Rheumatologists can also treat spinal stenosis or advanced osteoarthritis as they overlap with orthopedists.
Neurologists
A neurologist specializes in the function of the nervous system. They treat disorders of the brain, spinal cord, and nerves that include:
Parkinson’s disease
Multiple sclerosis
Alzheimer’s disease
Chronic back or neck pain
They are experts in the origins of pain. (David Borsook. 2012) However, a neurologist does not perform spine surgery.
Neurosurgeons
A neurosurgeon specializes in nervous system surgical procedures that include the brain, spine, and spinal cord. However, neurosurgeons do not provide overall treatment for back pain because they are usually the last to be seen after exhausting all other treatment options.
Osteopaths
An osteopath is a licensed physician who practices medicine using conventional treatments and osteopathic manipulative medicine. They have the same education as an MD plus 500 hours of musculoskeletal system studies. (National Library of Medicine. 2022) They take the same exams and are licensed as an MD. Many osteopaths are primary care providers. For back pain, they will focus on:
Posture rehabilitation and training.
Stretching
Therapeutic massage
Spinal manipulation
The goal is to relieve pain and muscle tension, increase mobility, and improve musculoskeletal function.
Physiatrists
Physiatrists are holistic providers that focus on physical function. They can be thought of as a primary care provider plus a physical therapist. These back pain specialists provide rehabilitation for various types of conditions and injuries including:
Back pain
Sports injuries
Stroke
Often they will coordinate a team of specialists to develop a targeted treatment plan.
Chiropractor
Chiropractic is a hands-on alternative medicine. The goal is to restore neuromusculoskeletal function by realigning the spine to its proper form. They do this with spinal manipulations, non-surgical mechanical decompression, traction, and massage techniques. (Michael Schneider, et al., 2016)
The purpose of most chiropractic adjustments is to relax and retrain tight muscles and increase flexibility.
Chiropractic helps to relieve stiff muscles and restore range of motion.
Individuals may not be referred to a chiropractor if they:
Have loose-joints
Have connective tissue problems or conditions.
Have osteoporosis/thinning bones
All types of back pain specialists provide various forms of therapy that may be able to help.
Spinal Decompression in Depth
References
Bishop, P. B., & Wing, P. C. (2006). Knowledge transfer in family physicians managing patients with acute low back pain: a prospective randomized control trial. The spine journal : official journal of the North American Spine Society, 6(3), 282–288. https://doi.org/10.1016/j.spinee.2005.10.008
Yisheng, W., Fuying, Z., Limin, W., Junwei, L., Guofu, P., & Weidong, W. (2007). First aid and treatment for cervical spinal cord injury with fracture and dislocation. Indian journal of orthopaedics, 41(4), 300–304. https://doi.org/10.4103/0019-5413.36991
Schneider, M., Murphy, D., & Hartvigsen, J. (2016). Spine Care as a Framework for the Chiropractic Identity. Journal of chiropractic humanities, 23(1), 14–21. https://doi.org/10.1016/j.echu.2016.09.004
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