For individuals living with chronic pain and various diseases like Parkinson’s, arthritis, and diabetes, can water aerobics be beneficial?
Water Aerobics
Water aerobics are low-impact exercises performed commonly in swimming pools. It is a great way to exercise for a full-body, low-impact workout without overworking the body’s joints and muscles. Other names used include:
Aquafitness
Aqua aerobics
Aquarobics
Many types can be tailored to individual needs, injuries, and/or conditions. The exercises have various health benefits, especially for those who cannot perform higher-impact movements.
Individuals participating in water aerobics will need a bathing suit, towel, goggles, and a swim cap to protect their eyes or hair from chlorinated water. Individuals do not need other special equipment while exercising as the water acts as extra resistance. Foam dumbbells or paddles can be used to increase resistance. Other optional equipment includes: (Plunge San Diego, 2024) (Harvard Health Publishing Harvard Medical School, 2023)
Kickboards
Wrist and ankle weights
Water-jogging belts
Swim bar
Pool Exercises
There are many types of pool exercises to help reach health and fitness goals. They include:
Water Walking
The basic act of walking in water is a great way to get a full-body workout.
Start by standing in waist-deep water with the feet planted on the bottom of the pool.
Lengthen the spine by bringing the shoulders up and back and aligning the shoulders with the hips and knees.
Once in a good starting position, walk through the water, putting pressure on the heel first and then the toes, just like walking out of the water, while swinging the arms back and forth through the water.
This exercise can be done for five to 10 minutes.
The muscles that will get the most attention are the arms, core, and the lower body.
Arm Lifts
Stand up to the shoulders in water.
With the palms facing up, draw the elbows into the torso while lifting the forearms in front of the body up to the water’s surface.
Once at the surface, rotate the palms to face down and slowly move the forearms back down to the sides.
For more resistance, this exercise can also be done using foam dumbbells.
Repeat the action 10–15 times for one to three sets.
The muscles targeted are the core and the arm muscles.
Jumping Jacks
Water resistance makes jumping jacks in the water much more difficult than on land.
To perform, start by standing in chest-level water with your feet together and your arms straight down the sides.
Once in position, begin by simultaneously swinging the legs out to the side and arms over the head before returning to the starting position.
Muscles targeted include the entire body and cardiovascular system.
Add wrist or ankle weights for more resistance and to make the exercise more challenging.
High-Knee-Lift Extensions
High-knee-lift extensions are performed while standing in water that is waist deep.
To do the exercise, engage the core and lift one leg in a bent position until it is level with the water’s surface.
Hold the position for a few seconds, then extend the leg out in front and hold again.
After the hold period, move the leg back down through the water to the starting position while keeping it straight and flexing the foot.
Repeat on both legs for two to three sets of 15 reps per leg.
Use weights on the ankles to increase resistance.
The muscles targeted include the core, glutes, and lower body.
Risks
While exercising in water, individuals may not notice how much they sweat. This can make it seem like the workout is not as hard and can lead to dehydration. Individuals should always hydrate before and after a pool workout. Individuals who cannot swim well should avoid exercises that do not require a flotation device. Sometimes pools are heated, so choosing one 90 degrees F or below is recommended so the body doesn’t get overheated while exercising.
Stop Pool Exercises Immediately
Performing pool exercises can often seem easier than they are, leading to overworking. Stop exercising immediately if you feel:
Pain in any area of the body
Shortness of breath
Nauseated
Faint
Dizzy
Pressure in the upper body or chest
Other Health Conditions That Benefit
Water aerobics is recommended for most individuals, completely healthy or with a chronic disease. Those with chronic disease have been shown to benefit from the low-impact exercise. (Faíl, L. B. et al., 2022) One study looked at individuals with various health conditions, with the results showing that the following conditions saw improvements after 12 weeks of regular water exercise (Faíl, L. B. et al., 2022)
Diabetes
Arthritis
Fibromyalgia
Bone diseases
High blood pressure
Coronary artery disease
Stroke
Multiple sclerosis (MS)
Parkinson’s disease
While the benefits of water aerobics have been studied and proven effective, individuals should be cleared by a medical professional before starting any new exercise regimen. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution through an integrated approach to treating injuries and chronic pain syndromes, improving flexibility, mobility, and agility programs to relieve pain and help individuals return to normal. Our providers create personalized care plans for each patient. If other treatments are needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments.
Chiropractic and Integrative Healthcare
References
Harvard Health Publishing Harvard Medical School. (2023). Basic types of water-based exercises. HealthBeat. https://www.health.harvard.edu/healthbeat/basic-types-of-water-based-exercise
Pereira Neiva, H., Brandão Faíl, L., Izquierdo, M., Marques, M. C., & Marinho, D. A. (2018). The effect of 12 weeks of water-aerobics on health status and physical fitness: An ecological approach. PloS one, 13(5), e0198319. https://doi.org/10.1371/journal.pone.0198319
Harvard Health Publishing Harvard Medical School. (2024). Advantages of water-based exercise. HealthBeat. https://www.health.harvard.edu/healthbeat/advantages-of-water-based-exercise
Plunge San Diego. (2024). 5 must-have pieces of aquatic exercise equipment for water aerobics. Plunge San Diego. https://plungesandiego.com/what-equipment-needed-water-aerobics-shoes/
Faíl, L. B., Marinho, D. A., Marques, E. A., Costa, M. J., Santos, C. C., Marques, M. C., Izquierdo, M., & Neiva, H. P. (2022). Benefits of aquatic exercise in adults with and without chronic disease-A systematic review with meta-analysis. Scandinavian journal of medicine & science in sports, 32(3), 465–486. https://doi.org/10.1111/sms.14112
Golfing wrist injuries are common with treatment requiring 1-3 months of rest and immobilization and if tears are present surgery. Can chiropractic treatment help avoid surgery, expedite recovery, and rehabilitation?
Golfing Wrist Injuries
Golfing Wrist Injuries: According to a study, there are over 30,000 golf-related injuries treated in American emergency rooms every year. (Walsh, B. A. et al, 2017) Nearly a third are related to a strain, sprain, or stress fracture.
This causes pain and inflammation and is usually accompanied by a grinding sensation when moving the thumb and wrist.
Chiropractic Treatment
Given the nature of these injuries, medical attention should be sought out for image scans to look at any damage and properly immobilize the wrist. Once a fracture has been ruled out or healed, golfing wrist injuries can benefit from chiropractic and physical therapy. (Hulbert, J. R. et al, 2005) A typical treatment may involve a multifaceted approach involving various therapies including:
Active release therapy, myofascial release, athletic taping, corrective exercise, and stretching.
A chiropractor will examine the wrist and its functioning to determine the nature of the injury.
A chiropractor may recommend using a splint to immobilize the wrist, particularly in cases of overuse.
They will relieve pain and swelling first, then focus on strengthening the joint.
They may recommend a regimen of icing the hand.
Adjustments and manipulations will relieve pressure on the nerves to reduce swelling and restore mobility.
Peripheral Neuropathy Successful Recovery
References
Walsh, B. A., Chounthirath, T., Friedenberg, L., & Smith, G. A. (2017). Golf-related injuries treated in United States emergency departments. The American journal of emergency medicine, 35(11), 1666–1671. https://doi.org/10.1016/j.ajem.2017.05.035
Moon, H. W., & Kim, J. S. (2023). Golf-related sports injuries of the musculoskeletal system. Journal of exercise rehabilitation, 19(2), 134–138. https://doi.org/10.12965/jer.2346128.064
Ray, G., Sandean, D. P., & Tall, M. A. (2023). Tenosynovitis. In StatPearls. StatPearls Publishing.
Zouzias, I. C., Hendra, J., Stodelle, J., & Limpisvasti, O. (2018). Golf Injuries: Epidemiology, Pathophysiology, and Treatment. The Journal of the American Academy of Orthopaedic Surgeons, 26(4), 116–123. https://doi.org/10.5435/JAAOS-D-15-00433
Tan, H. K., Chew, N., Chew, K. T., & Peh, W. C. (2014). Clinics in diagnostic imaging (156). Golf-induced hamate hook fracture. Singapore medical journal, 55(10), 517–521. https://doi.org/10.11622/smedj.2014133
Hulbert, J. R., Printon, R., Osterbauer, P., Davis, P. T., & Lamaack, R. (2005). Chiropractic treatment of hand and wrist pain in older people: systematic protocol development. Part 1: informant interviews. Journal of chiropractic medicine, 4(3), 144–151. https://doi.org/10.1016/S0899-3467(07)60123-2
Dislocations impact the joint and are injuries that force/knock the bones out of position. Dislocations can be caused by a motor vehicle collision, falls, sports trauma, or weakened muscles and tendons. However, less impact/force is needed to dislocate smaller joints. Dislocations commonly occur at the shoulders, ankles, knees, hips, elbows, fingers and toes, and the jaw. The experience causes swelling, inability to move, and pain. A joint dislocation chiropractor can manipulate, reset, rehabilitate and strengthen the affected area and rebalance the body.
Joint Dislocation
The region where two or more bones come together is a joint. Each has a primary function, but their functions overlap. The joints allow the bones to move/articulate the skeletal system. Maintaining the body’s balance requires mobility and stability.
Mobility is the ability to move the body without restriction.
Stability is maintaining equilibrium, healthy posture, and support during movement.
The stable joints do not dislocate easily because their structures are not as flexible.
Mobile joints are at an increased risk, as they can move in almost any direction.
The kinetic chain is a sequence of joints forming an alternating pattern of stability and mobility that create a solid platform for dynamic movement. However, any joint can become dislocated, causing the affected area to become unsteady or immobile, strain or tear the surrounding muscles, nerves, and tendons which are the tissues that connect the bones to a joint.
A joint can be partially dislocated/subluxation or fully dislocated.
Joints dislocated previously have an increased risk of re-dislocating because the surrounding tissues that hold the joint have been torn or overly stretched.
Symptoms
Symptoms vary depending on the severity and location of the injury. Common symptoms include:
Instability
Loss of ability to move
Swelling
Bruising
Pain
Visible deformation
Increased Risk
Various factors can lead to joint dislocation, including:
Weakness of the supporting ligaments and muscles from natural wear and tear/age or lack of physical conditioning.
Older individuals with poor balance are more vulnerable to falls that can knock joints out of place.
Young children developing have more elastic supporting ligaments and are prone to falls, collisions, and other injuries.
Previous dislocations with overstretched or torn supporting tissues.
Repeated dislocations are likely to follow the shoulder, knee, and hip.
Physical activities like extreme sports, contact sports, or sports that involve quick body shifts, twists, and turns on the feet.
Physically demanding job.
Operating heavy machinery/equipment.
Joint hypermobility is common in children and around 5% of adults. It can be caused by weak or loose ligaments, weak or loose muscles, and/or shallow joint sockets.
Joint Dislocation Chiropractic
Treatment will vary based on the severity of the injury and the dislocated joint. Depending on the location and severity, a chiropractor will perform different movements/manipulations to realign the joint and strengthen the area.
Significant force could be necessary to pull the bones apart to realign them back into their proper position.
The joint may need to be pulled out and rotated slightly before being put back.
The focus is on increasing ligament strength.
Once the joint is back in place, it may need to remain immobile, possibly using a sling or splint to help fully heal the injury.
Physical therapy exercises will be recommended to strengthen the muscles and ligaments around the joint to support it optimally.
Shoulder Pain Chiropractic
References
Dizdarevic, Ismar, et al. “Epidemiology of Elbow Dislocations in High School Athletes.” The American journal of sports medicine vol. 44,1 (2016): 202-8. doi:10.1177/0363546515610527
Hodge, Duncan K, and Marc R Safran. “Sideline management of common dislocations.” Current sports medicine reports vol. 1,3 (2002): 149-55. doi:10.1249/00149619-200206000-00005
Prechel, Ulla et al. “The Treatment of Temporomandibular Joint Dislocation.” Deutsches Arzteblatt international vol. 115,5 (2018): 59-64. doi:10.3238/arztebl.2018.0059
Skelley, Nathan W et al. “In-game Management of Common Joint Dislocations.” Sports health vol. 6,3 (2014): 246-55. doi:10.1177/1941738113499721
T-bone accidents/collisions, also known as side-impact or broadside collisions where the front end of one car slams into the side of another, can result in severe injuries and tend to have a more devastating effect on the body. Side impact collisions account for 24% of driver or passenger deaths; even at 30 mph, side-impacts regularly cause injuries to the occupants of the struck car. Modern vehicles have many safety features, including safety belt features, airbags, and collision avoidance systems that protect drivers and passengers from front and rear collisions; however, when it comes to side-impact, occupants tend to remain unprotected.
T-Bone Side Collision Causes
T-bone accidents usually happen at intersections. Usual Causes of T-bone accidents involve someone failing to yield the right of way. The most common causes include:
A driver makes a risky left turn at an intersection, believing the other car/s will stop.
A driver decides to run a red light crashing into a vehicle making a left turn.
A driver runs through a stop sign, slams into a vehicle, or gets slammed.
Back injuries can damage the spinal cord causing herniated discs, sciatica, and chronic pain that can radiate to the rest of the body.
Treatment and Recovery
Individuals have different recovery times and depend on the severity of the injury and on any pre-existing conditions. Brain injuries and spinal issues can take months to recover fully. Fractures placed in a hard or soft cast to heal for weeks or months can lead to muscle atrophy. Chiropractic therapeutic massage and decompression strengthens muscle weakness, resets and realigns the spinal column, improves range of motion/movement, strengthens grip, and relieves pain.
Neurosurgeon Explains DRX9000
References
Gierczycka, Donata, and Duane Cronin. “Importance of impact boundary conditions and pre-crash arm position for the prediction of thoracic response to pendulum, side sled, and near side vehicle impacts.” Computer methods in biomechanics and biomedical engineering vol. 24,14 (2021): 1531-1544. doi:10.1080/10255842.2021.1900132
Hu, JunMei, et al. “Chronic widespread pain after motor vehicle collision typically occurs through immediate development and nonrecovery: results of an emergency department-based cohort study.” Pain vol. 157,2 (2016): 438-444. doi:10.1097/j.pain.0000000000000388
Lidbe, Abhay, et al. “Do NHTSA vehicle safety ratings affect side impact crash outcomes?.” Journal of safety research vol. 73 (2020): 1-7. doi:10.1016/j.jsr.2020.02.001
Mikhail, J N. “Side impact motor vehicular crashes: patterns of injury.” International journal of trauma nursing vol. 1,3 (1995): 64-9. doi:10.1016/s1075-4210(05)80041-0
Shaw, Greg et al. “Side impact PMHS thoracic response with a large-volume airbag.” Traffic injury prevention vol. 15,1 (2014): 40-7. doi:10.1080/15389588.2013.792109
Diabetes and severe blood sugar fluctuations can lead to back pain and spinal conditions. The negative impacts on the body from diabetes can be destructive as it is a state of chronic inflammation.
Spine Conditions and Diabetes
Spinal conditions being researched and their link to diabetes can affect each condition and its development differently.
Spinal Stenosis
Spinal stenosis is when the spine’s openings foraminabegin to shrink and narrow, causing the nerve roots that branch off the spinal cord to have less space to function.
The stenosis can compress one or more lumbar spinal nerves.
Pain, tingling, weakness, and/or numbness in the legs can begin to present.
Spinal Epidural Abscess
Spinal epidural abscess is an infection between the vertebral bones and the spinal cord membrane.
Diabetes increases the risk of infection and increases the risk of developing an abscess.
Hypertension and obesity can also increase the risk of infection.
Lumbar Disc Degeneration
The back contains spinal discs between each vertebra that are the shock absorbers.
Lumbar disc degeneration occurs when one or more discs begin to break down.
The disc’s deterioration causes changes in the lumbar/lower back structure.
The degeneration also causes back pain.
Disc degeneration is a normal part of aging and is expected. However, those who have lived with diabetes for over ten years have a higher risk of developing advanced lumbar disc degeneration. To prevent disc degeneration and/or minimize the adverse effects, it’s essential to maintain blood sugar levels.
Vertebral Osteomyelitis
Vertebral osteomyelitis is a rare spinal infection resulting from a spinal injury or post-surgical complication/s.
It is a bacterial infection that can travel to the spine from another location.
Diabetes increases susceptibility to infections.
For example, an individual with diabetes could have a foot ulcer, lower back pain, and a fever, symptoms that could indicate the development of vertebral osteomyelitis.
Chiropractic and Decompression Therapy
Spinal decompression is an effective non-surgical technique that can relieve back pain, leg pain, and symptoms associated with spinal conditions and disorders. It works by gently creating traction/pulling force with a specialized mechanical decompression table combined with chiropractic massage and adjustments. Benefits include:
Pain relief
Decompression relieves tension in tight, spasming, or injured muscles.
Stimulates the nervous system to release chemical signals that bring pain relief.
Heals spinal disc tissues
Decompression creates a vacuum force on the spinal discs, helping to circulate much-needed fluids, cells, and other substances to the damaged tissue/s.
Restores spinal disc and joint alignment
Stress, poor posture, poor body mechanics, and other factors can cause joints to shift out of place or the discs to herniate.
The vacuum force helps realign the joints and discs.
Prevents further pain and inflammation.
Restores mobility and function.
Relieves pressure on nerves
Spinal nerves can get pinched when discs, bones, or other tissues compress the small spaces causing inflammation and pain.
Non-surgical decompression increases the space around the nerves, allowing the nerves to heal.
Injury Medical Chiropractic and Functional Medicine Clinic offer spinal decompression as one of many treatment approaches to restore a high quality of life.
DOC Decompression Table
References
Anekstein, Yoram, et al. “Diabetes mellitus as a risk factor for the development of lumbar spinal stenosis.” The Israel Medical Association journal: IMAJ vol. 12,1 (2010): 16-20.
Eivazi, Maghsoud, and Laleh Abadi. “Low back pain in diabetes mellitus and importance of preventive approach.” Health promotion perspectives vol. 2,1 80-8. 1 Jul. 2012, doi:10.5681/hpp.2012.010
Heuch, Ingrid et al. “Associations between serum lipid levels and chronic low back pain.” Epidemiology (Cambridge, Mass.) vol. 21,6 (2010): 837-41. doi:10.1097/EDE.0b013e3181f20808
Rinaldo, Lorenzo, et al. “Diabetes and Back Pain: Markers of Diabetes Disease Progression Are Associated With Chronic Back Pain.” Clinical diabetes: a publication of the American Diabetes Association vol. 35,3 (2017): 126-131. doi:10.2337/cd16-0011
Automobile accidents and crashes can cause all kinds of damage to the body even when the accident/crash is not severe. Physical symptoms might not present at all for several days, even weeks. This is known as having delayed injury symptoms. These can include:
Swelling.
Stiffness.
Aching.
Pain that radiates all over the body.
Sleep problems.
Headaches.
Brain fog.
Disorientation.
Memory problems.
Chiropractic and physical therapy rehabilitation can restore the body’s alignment, stop inflammation, loosen, stretch and strengthen the musculoskeletal system restoring optimal health.
Adrenaline
When the body is involved in a dangerous physical situation, it protects itself by releasing a surge of adrenaline. This hormone protects the body, causing the fight or flight response when in danger. Adrenaline causes several preservation responses that include:
Intense increase in energy.
Little or no pain.
Enlarged blood vessels and airways increase oxygen flow.
Increased strength from increased blood flow to the muscles.
Changes in vision and hearing that focus on sights and sounds all around.
Endorphins are released that make the body feel calm and in control.
Endorphins affect the way the body responds to pain and stress.
Individuals don’t start feeling aches and pains until the adrenaline and endorphins wear off. However, because everybody is different and the emergency response has turned off, the body still might not feel the injury symptoms. These are delayed injury symptoms.
Rate of Speed
When riding in a vehicle, the body moves at the same speed as the vehicle. During an impact, the vehicle stops, but the body continues moving until it stops, typically with a lot of force from the seatbelt, airbag, or other barriers. The intense momentum change can cause soft tissue damage and ligament or muscle strains from the stretching, pulling, contracting, and tearing. Also, the intervertebral discs can tear, bulge, or herniate over time, creating pressure on nerves and the surrounding tissues.
Delayed Injury Symptoms
Headaches
Headaches that develop days after an accident/crash are common.
They can signal a possible injury to the neck or head, a blood clot on the brain, or a concussion.
Back pain can be caused by injury to the muscles, ligaments, nerves, or damage to the vertebrae.
Low back pain occurs in more than half of rear-impact collisions and almost three-quarters of side-impact crashes.
Chiropractic Rehabilitation
After an accident, soft tissues can sustain minimal damage; however, the minimal damage left untreated can start to worsen and turn into a painful condition. Emergency room visits are to rule out major injuries like brain/nerve injuries, bleeding, punctures, lacerated organs, fractures that require emergency stabilization. Chiropractors look for other symptoms and mechanisms that indicate damage to the body’s soft tissues and nerves to see if they have been stretched or torn and dysfunction in the nervous system.
Body Composition
Calorie Counting
Counting calories can be a stepping stone to change behavior towards food. Tracking what foods are being taken into the body promotes mindfulness of dietary habits. Studies on the subject reveal a significant association between self-monitoring and weight loss. Takeaways include:
Take small steps by saying no to second portions during dinner or take a healthy sweet snack or piece of fruit instead of a pastry, cookie, etc.
Try to start making a habit of eating less processed foods.
Meals high in protein and fiber are generally more filling, making the body feel fuller from fewer calories.
The more attention there is to the food choices, the more likely reexamination occurs.
References
Burke, Lora E et al. “Self-monitoring in weight loss: a systematic review of the literature.” Journal of the American Dietetic Association vol. 111,1 (2011): 92-102. doi:10.1016/j.jada.2010.10.008
D’Elia, Michael A et al. “Motor vehicle collision with seatbelt sign and traumatic abdominal wall hernia should raise suspicion for hollow viscus injury.” Trauma case reports vol. 22 100206. 25 May. 2019, doi:10.1016/j.tcr.2019.100206
Kacprzynski, Gregory, and Joshua Bucher. “Delayed vertebral artery dissection after mild trauma in a motor vehicle collision.” The American Journal of emergency medicine vol. 45 (2021): 678.e1-678.e2. doi:10.1016/j.ajem.2020.11.028
Olinger, Catherine, and Richard Bransford. “Upper Cervical Trauma.” The Orthopedic clinics of North America vol. 52,4 (2021): 451-479. doi:10.1016/j.ocl.2021.05.013
Sterling, Michele. “Whiplash-associated disorder: musculoskeletal pain and related clinical findings.” The Journal of manual & manipulative therapy vol. 19,4 (2011): 194-200. doi:10.1179/106698111X13129729551949
As the weather gets colder, individuals may feel like their muscles and joints are frequently stiff and experience more aches and pains. This is even more evident for individuals that work outside in the winter or with specific ailments/conditions. Colder weather can increase the risk of suffering musculoskeletal injuries and intensify the condition.
How Colder Weather Impacts The Muscles
Individuals with arthritic conditions might find that symptoms become exacerbated. This can keep individuals away from regular activities. Conditions like rheumatoid arthritis and osteoarthritis tend not to react well to weather sudden atmospheric changes, worsening symptoms. However, individuals are well aware of how their body feels and moves when colder weather is present with or without existing conditions. Movement slows down, and when trying to move, the muscles can contract involuntarily, causing tension and stiffness. This usually results in soreness and pain. Feeling warm, safe, and comfortable is essential for the body’s overall health. Overuse and overexertion can increase the risk of injury in colder temperatures.
Barometric Pressure
When the weather gets colder, barometric pressure drops. The Body’s tissues like the muscles, tendons, and ligaments expand. This places pressure on nerves near the joints, causing discomfort and pain.
In cold weather, the fluid density in the joints lessens, causing the bones to rub against each other harder because the fluid is not thick enough to allow for proper lubrication.
The cold makes the muscles shiver, contract, and tighten. This can compress the nerves in the joints and increase pain symptoms.
Prevent Stiffness and Musculoskeletal-Related Injuries
Maintain an active lifestyle
It is recommended to engage in physical activity to exercise the muscles and joints.
A chiropractor can also help manage musculoskeletal condition-related pain during the winter months and help prevent musculoskeletal conditions for individuals that work outdoors.
This can be split into 30 minutes a day on at least five days a week or in shorter sessions of 10 minutes several times a day throughout the week.
Aerobic exercise can include:
Running
Cycling
Hiking
Dancing
Walking
Resistance Training
Research has shown that resistance training with bands or weights can supplement aerobic exercise to reduce blood pressure.
It is recommended to complete 2 to 4 sets of 8 to 12 repetitions for each major muscle group during workout sessions.
Resistance training sessions should be spaced out throughout the week to limit muscle soreness and injury.
Resistance training can include:
Resistance bands with freehand movements, squats, push-ups, bicep curls
Free weights dumbbells, barbells
Gym weight machines like the chest press and shoulder press
References
https://www.cdc.gov/niosh/topics/coldstress/
Heil, Kieran et al. “Freezing and non-freezing cold-weather injuries: a systematic review.” British medical bulletin vol. 117,1 (2016): 79-93. doi:10.1093/bmb/ldw001
Kowtoniuk, Robert A et al. “Cutaneous Cold Weather Injuries in the US Military.” Cutis vol. 108,4 (2021): 181-184. doi:10.12788/cutis.0363
Long, William B 3rd et al. “Cold injuries.” Journal of long-term effects of medical implants vol. 15,1 (2005): 67-78. doi:10.1615/jlongtermeffmedimplants.v15.i1.80
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