Whenever stepping out onto a playing field or gym, there is a risk of suffering sports back injuries. Back pulls, strain and sprain injuries are the most common. Low back pain is one of the most prevalent complaints at all levels of competition. 90% of these acute back injuries will heal on their own, usually in about three months. However, sometimes these injuries can be more severe and require professional medical care. Treatment options for different groups of athletes include nonsurgical motorized spinal decompression.
Sports Back Injuries
Injury mechanisms vary from sport to sport, but there are recommendations regarding spinal decompression treatment for these injuries and return to play. Chiropractic healthcare specialists understand the sport-specific injury patterns and treatment guidelines for athletes following a back injury. Spinal decompression treatments are beneficial and result in higher rates of return to play depending on the specific sport of the injured athlete. A chiropractor will create a personalized spinal decompression treatment plan for the sport-specific context to meet the athlete’s short and long-term needs.
An estimated 10–15% of athletes will experience low back pain.
All types of sports place increased stress on the lumbar spine through physically demanding and repetitive movements/motions.
The repetitive shifting, bending, twisting, jumping, flexion, extension, and spinal axial loadingmotions contribute to low back pain even though the athletes are in top shape with increased strength and flexibility.
Injury patterns demonstrate the increased stresses that athletes place on the lumbar spine.
Common Spine Sports Injuries
Cervical Neck Injuries
Stingers are a type of neck injury.
A stinger is also known as a burner is an injury that happens when the head or neck gets hit to one side, causing the shoulder to be pulled in the opposite direction.
These injuries manifest as numbness or tingling in the shoulder from stretching or compressing the cervical nerve roots.
Lumbar Lower Back Sprains and Strains
When trying to lift too much weight or using an improper lifting technique when working out with weights.
Fast running, quick stopping, and shifting can cause the low back and hip muscles to get overly pulled/stretched.
Staying low to the ground and springing/jumping up can cause abnormal stretching or tearing of the muscle fibers.
Fractures and Injuries to the Supporting Spinal Structures
In sports that involve repetitive extension movements, spinal stress fractures are relatively common.
Excessive and repeated strain to the spinal column area leads to low back pain and injury.
Nonsurgical Spinal Decompression
Nonsurgical spinal decompression is motorized traction that is used to relieve compression pressure, restore spinal disc height, and relieve back pain.
Spinal decompression works to gently stretch the spine changing the force and position of the spine.
The gel-like cushions between the vertebrae are pulled to open up the spacing taking pressure off nerves and other structures.
This allows bulging or herniated discs to return to their normal position and promotes optimal circulation of blood, water, oxygen, and nutrient-rich fluids into the discs to heal, as well as, injured or diseased spinal nerve roots.
DRX 9000 Decompression
References
Ball, Jacob R et al. “Lumbar Spine Injuries in Sports: Review of the Literature and Current Treatment Recommendations.” Sports medicine – open vol. 5,1 26. 24 Jun. 2019, doi:10.1186/s40798-019-0199-7
Jonasson, Pall et al. “Prevalence of joint-related pain in the extremities and spine in five groups of top athletes.” Knee surgery, sports traumatology, arthroscopy: official journal of the ESSKA vol. 19,9 (2011): 1540-6. doi:10.1007/s00167-011-1539-4
Lawrence, James P et al. “Back pain in athletes.” The Journal of the American Academy of Orthopaedic Surgeons vol. 14,13 (2006): 726-35. doi:10.5435/00124635-200612000-00004
Petering, Ryan C, and Charles Webb. “Treatment options for low back pain in athletes.” Sports health vol. 3,6 (2011): 550-5. doi:10.1177/1941738111416446
Sanchez, Anthony R 2nd et al. “Field-side and prehospital management of the spine-injured athlete.” Current sports medicine reports vol. 4,1 (2005): 50-5. doi:10.1097/01.csmr.0000306072.44520.22
Any vehicle crash, collision, or accident can cause various injuries, with back pain issues as a primary injury or a side effect from other injuries. Usually, injury symptoms begin right after the collision, but in other cases, individuals may not start experiencing symptoms until hours, days, or even weeks later. This is from the adrenaline that rushes throughout the body during the collision/fight or flight response delaying the injury symptoms. There are reports of individuals who walk away from an accident unscathed but require urgent medical treatment a short while later. Chiropractic care can provide manual and spinal motorized decompression benefits.
Decompression Benefits
Head Injuries
Head injuries occur when drivers and/or passengers hit their heads on the steering wheel, windows, dashboard, metal frame, and sometimes each other.
A head injury is considered a severe condition that can cause concussions, skull fractures, comas, hearing loss, cognitive and memory issues, and vision problems.
A significant head injury can cause extensive and costly medical treatment with the possibility of long-term medical care.
Neck Injuries
Neck injuries are common in vehicle collisions.
The most common is whiplash, with the head and neck-snapping from indirect blunt force, like being rear-ended.
Whiplash can cause significant damage to the ligaments and muscles, like swelling and neck pain, and temporary paralysis of the vocal cords.
Injury patterns of whiplash can differ depending on the speed, force, and overall health of the individual involved.
Back Injuries
Back injuries can range in severity from sprains to significant damage involving the nerves and/or the spinal cord.
If the damage is severe, it can lead to loss of sensation in the body, loss of limb control, or permanent paralysis.
Disc herniation/s can lead to disability, muscle weakness, tingling and numbness in the limbs, and radiating body pain.
Chest and Torso Injuries
Vehicle collision forces can result in severe chest injuries that include broken ribs.
Broken ribs might not sound dangerous by themselves; they can puncture the lungs leading to other injuries and internal bleeding.
The legs, feet, arms, and hands are frequently injured, broken, and sometimes dislocated.
Motorcyclists are also at a higher risk for significant injury that includes:
Multiple fractures, internal injury, head injuries, and severe ligament damage.
Pedestrians struck by a vehicle have an increased risk for a combination of all injuries at once.
Non-Surgical Decompression Benefits
Chiropractors are trained to identify and treat injuries from vehicle collisions.
Non-surgical spinal decompression gently stretches the spine using a motorized traction device to help reposition the spine and remove the pressure.
As the pressure is taken off, the spinal discs regain their natural height, relieving the pressure on the nerves and other spinal structures.
Optimal healing is promoted by an improved circulation of nutrients, water, and oxygen to the injury site.
Decompression helps to strengthen the muscles in the affected area.
It provides positive spinal structural changes.
Improves nervous system function.
Non-surgical decompression is a tool for correcting injuries and relieving pain, allowing optimal health for the individual.
DOC Decompression Table
References
Apfel, Christian C et al. “Restoration of disk height through non-surgical spinal decompression is associated with decreased discogenic low back pain: a retrospective cohort study.” BMC musculoskeletal disorders vol. 11 155. 8 Jul. 2010, doi:10.1186/1471-2474-11-155
Koçak, Fatmanur Aybala et al. “Comparison of the short-term effects of the conventional motorized traction with non-surgical spinal decompression performed with a DRX9000 device on pain, functionality, depression, and quality of life in patients with low back pain associated with lumbar disc herniation: A single-blind randomized controlled trial.” Turkish Journal of physical medicine and rehabilitation vol. 64,1 17-27. 16 Feb. 2017, doi:10.5606/tftrd.2017.154
Macario, Alex, and Joseph V Pergolizzi. “Systematic literature review of spinal decompression via motorized traction for chronic discogenic low back pain.” Pain practice: the Official Journal of World Institute of Pain vol. 6,3 (2006): 171-8. doi:10.1111/j.1533-2500.2006.00082.x
Restaurant work takes a toll on the body with the repetitive moving, bending, twisting, reaching, prepping, cutting, serving, and washing. This is especially true of the shoulders, arms, and hands. When individuals avoid treating their aches and pains, this can lead to chronic pain conditions that can cause severe and permanent damage to the musculoskeletal system. Chiropractic can alleviate the tingling and pain by removing the compression, re-stretching/lengthening, and strengthening the muscles and nerves to perform at optimal levels.
Restaurant Work
The arms and hands are designed to accomplish various tasks. When functioning normally, tasks can be performed flawlessly. Repetitive/Overuse or trauma can cause nerve compression, stiffness, and pain, decreasing function and affecting daily routines.
Carpal Tunnel
Carpal tunnel syndrome is one of the most common disorders that affect the arm and hands.
The carpal tunnel is a space where a nerve and several tendons pass. If the nerve becomes compressed, it can cause numbness, tingling in the fingers, pain, and muscle weakness, making it difficult to grip objects.
Discomfort and pain start gradually in one or both hands.
It can cause tightness and pain in the shoulder, forearm, wrist, and hand.
It can also cause numbness in the palm and fingers.
Avoid scheduling multiple consecutive long shifts for jobs that require repetitive hand motions.
Body Composition
Sticking To A Meal Plan
Identify personal motivation to stick to a meal plan other than improving body composition. To keep motivation high, individuals need to identify other reasons behind goals. This could be:
Saving money from the food budget.
Spending time with loved ones preparing a healthy recipe.
Setting an example to family and friends.
It can be whatever motivates you.
Reassess and tweak the meal plan as needed.
Nutritional needs or dietary preferences change.
Meal planning should be a dynamic process.
Don’t get disappointed if not going as planned.
Refocus by making changes as needed.
References
Gentzler, Marc D, and Janan A Smither. “Using practical ergonomic evaluations in the restaurant industry to enhance safety and comfort: a case study.” Work (Reading, Mass.) vol. 41 Suppl 1 (2012): 5529-31. doi:10.3233/WOR-2012-0872-5529
Laperrière, Ève et al. “Work activity in foodservice: The significance of customer relations, tipping practices and gender for preventing musculoskeletal disorders.” Applied ergonomics vol. 58 (2017): 89-101. doi:10.1016/j.apergo.2016.05.013
Masear, V R et al. “An industrial cause of carpal tunnel syndrome.” The Journal of hand surgery vol. 11,2 (1986): 222-7. doi:10.1016/s0363-5023(86)80055-7
As the body gets older, slouching, little to no physical activity, and regular stretching cause muscle fatigue, weakness, tension, leading to poor posture complications. The complications include:
Posture can be improved along with overall spinal health and a better quality of life through chiropractic treatment. Chiropractic will improve posture through adjustments, postural exercise training and stretching, education on ergonomics, and nutrition to strengthen the body.
Complications Poor Posture
Symptoms
Symptoms vary as they depend on the severity of the case and condition.
Skeletal muscle comprises two types of muscle fiber. They are static or slow-twitch muscles and phasic or fast-twitch muscles. Static muscle fibers are found in the deeper muscle layers. Static fibers burn energy slowly and keep working without tiring. They help the body maintain posture without effort and contribute to balance by sensing the body’s position and transmitting the information to the brain. Phasic muscle fibers are used for movement and activity but can quickly run out of energy. Poor posture causes muscle fatigue because the phasic fibers are used rather than the static fibers to maintain the body’s proper position.
Muscle Strength and Length
Over time, the body constantly needs support from the phasic muscle fibers. This causes the deeper supporting muscles to waste away because they are not being used. Weak, unused muscles begin to tighten, causing a shortening of muscle length that can compact the spine’s bones and cause back complications.
Nervous System Feedback
The deeper layers of muscle sense the body’s position in space and relay this information to the brain. The brain does not receive complete transmission if the phasic muscle fibers take over this function. The brain assumes that the body needs to be propped up/corrected to counteract the poor posture effects, triggering further muscle contraction, adding to the fatigue and pain.
Listening To The Body
The objective is to form a habit of regularly listening to what the body is saying. Make minor adjustments while standing and sitting throughout the day/night. Often what happens is individuals become so immersed in their work, school tasks that they ignore any physical discomfort and push through and forget to change positions/move around to get the muscles moving and the blood pumping. If there is muscle tension or fatigue, don’t just work through the pain; move into another healthy position.
Posture Improvement
Suggestions include:
Try to avoid sitting in soft chairs.
Switch to ergonomic chairs for any activity that requires sitting for long periods.
Use a lumbar roll to support the lower back when sitting in regular chairs or driving.
Remember to reverse the curve; an example could be if leaning over a desk/workstation, stretch the back in the other direction.
As the body ages, it loses muscle mass, known as sarcopenia. Between the ages of 30 and 80, both men and women can lose 30-50 percent of their muscle strength. Decreasing strength can make it a challenge to lead an active lifestyle or have energy levels to complete the daily errands. Individuals can be reluctant to improve fitness levels through resistance workouts believing there is nothing left after years of inactivity. This is not true as anybody can strength train. With the right mindset, and health coaching team, goals can be set to:
Improve body composition
Improve energy levels
Maintain an active lifestyle
References
Creze, Maud et al. “Posture-related stiffness mapping of paraspinal muscles.” Journal of anatomy vol. 234,6 (2019): 787-799. doi:10.1111/joa.12978
Deliagina, Tatiana G et al. “Physiological and circuit mechanisms of postural control.” Current opinion in neurobiology vol. 22,4 (2012): 646-52. doi:10.1016/j.conb.2012.03.002
Korakakis, Vasileios et al. “Physiotherapist perceptions of optimal sitting and standing posture.” Musculoskeletal Science & practice vol. 39 (2019): 24-31. doi:10.1016/j.msksp.2018.11.004
Pollock, A S et al. “What is balance?.” Clinical rehabilitation vol. 14,4 (2000): 402-6. doi:10.1191/0269215500cr342oa
Waters, Thomas R, and Robert B Dick. “Evidence of health risks associated with prolonged standing at work and intervention effectiveness.” Rehabilitation nursing: the official journal of the Association of Rehabilitation Nurses vol. 40,3 (2015): 148-65. doi:10.1002/rnj.166
Back pain and soreness are widespread conditions that affect all genders, races, and lifestyles. The causes for back pain are varied from injury, poor posture, arthritis, age, overuse, etc. If back pain is frequent, perhaps the last assumption is that the pain could be caused by cancer. While it’s far from the most common causes, cancer back pain is possible, which makes consulting a doctor that will figure out the root cause, especially if there are other non-related symptoms, and treat the back pain very important.
Cancer Back Pain
Back pain that could be caused by cancer usually occurs with other symptoms and include:
Back pain that is not related to movement.
Pain does not get worse with activity.
Back pain usually presents at night or early in the morning and fades away or improves as the day progresses.
Back pain persists even after physical therapy or other treatments.
Changes in bowel movements or blood in urine or stool.
Like lung cancers, some breast cancer tumors can press on nerves connected to the spine, causing discomfort and pain.
Gastrointestinal
Cancers of the stomach, colon, and rectum can cause back pain.
The pain radiates from where the cancer is to the back.
Tissue and Blood Cancers
Blood and tissue cancers like:
Multiple myeloma
Lymphoma
Melanoma
Can cause back pain.
Diagnosing Cancer and Back Pain
Medical treatments for back pain-related cancer depend on its type and how advanced it is. A doctor will consider symptoms and medical history when diagnosing possible back pain causes. Because cancer is a rare cause of back pain, a doctor may recommend various treatments before a full cancer work-up. The doctor may order imaging studies and blood testing if the pain persists after chiropractic, physical therapy, or anti-inflammatory medications. These tests will help identify potential cancer markers causing back pain.
Treatments usually include chemotherapy and radiation to shrink a tumor.
A doctor will recommend surgery to remove a tumor.
Chiropractic
Cancer patients have found chiropractic treatment to be effective for:
Pain management.
Flexibility improvement.
Mobility improvement.
Strengthening muscles.
Helping to reduce stress.
Helping the body function more efficiently.
Chiropractic physiotherapy benefits patients undergoing chemotherapy, as it helps the body withstand the debilitating effects of the treatment based on the whole-body approach.
Body Composition
Don’t Hate Dieting
Individuals hate dieting, usually because they go about it the wrong way. Individuals do not need to starve themselves and live at the gym. Reaching quick weight loss goals might sound appealing; however, going through it for an extended time can make individuals feel:
Tired
Depressed
Unmotivated
Individuals can find a nutrition plan/exercise balance that works for them and their lifestyle. For some individuals, dieting alone is effective, but more than likely, they have increased metabolisms. Trying to lose fat by only cutting calories can be difficult for individuals with smaller metabolisms. The goal is to find a balance between diet and exercise. This does not mean having to go on an extreme diet, skip meals, or cut out entire macronutrient groups like fat or carbs, as the body needs both of these nutrients. Finding a sustainable long-term nutrition plan takes planning and support. A dietician, nutritionist, or health coach can offer a variety of nutrition and exercise plans customized to the individual.
References
Downie, Aron et al. “Red flags to screen for malignancy and fracture in patients with low back pain: a systematic review.” BMJ (Clinical research ed.) vol. 347 f7095. 11 Dec. 2013, doi:10.1136/bmj.f7095
Mabry, Lance M et al. “Metastatic cancer mimicking mechanical low back pain: a case report.” The Journal of manual & manipulative therapy vol. 22,3 (2014): 162-9. doi:10.1179/2042618613Y.0000000056
Vasser, Melinda, and Matthew Koroscil. “When Back Pain Turns Deadly: An Unusual Presentation of Lung Cancer.” Respiratory medicine case reports vol. 29 101009. 28 Jan. 2020, doi:10.1016/j.rmcr.2020.101009
Verhagen, Arianne P et al. “Red flags presented in current low back pain guidelines: a review.” The European spine journal: official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society vol. 25,9 (2016): 2788-802. doi:10.1007/s00586-016-4684-0
Chiropractic and spinal health. Most individuals seek out chiropractic care only after an injury and when pain presents. Because traditional medical care tends to focus on treating disorders and diseases, individuals are used to seeking care only when something is imbalanced. For many, chiropractic is known for its ability to resolve back and neck pain, correct postural misalignments, manage acute or chronic conditions and accelerate the healing of injuries. Chiropractic is different in that it is a tool for increasing overall wellness and vitality when no injury or imbalance is present.
Chiropractic and Spinal Health
Chiropractic is an invaluable treatment that raises the baseline of an individual’s health by:
Increasing performance
Extending lifespan and longevity
Improving overall comfort
Increasing agility in the body
Chiropractic helps to achieve these transformational results by improving the function of the:
Circulatory system
Immune system
Respiratory system
Muscular system
Nervous system
Skeletal system
Circulation Increased
The circulation system includes the heart and its chambers, arteries, veins, lungs, lobes, and capillaries. The structures within this system move blood, nutrients, and waste throughout the body. The quality of health and life depends on the level of functioning in this system. The better and more efficient the tissues receive clean blood, nutrients, and oxygen, the better the body is able to utilize these building blocks to achieve whatever function is required. The slower and more unclean these building blocks, the lower quality of function. The nervous system is the communication system that includes the brain, spinal cord, and nerves that run throughout the body. Everything in the body and the work functions as a result of this communication system.
The circulatory system relies on the communication that runs through the nervous system, which is housed in the spine. If the spine is misaligned, moving improperly, or sustaining an injury, it can interfere with the function of the communication. Regular chiropractic care increases the health levels of the nervous system by keeping the spine as healthy and flexible as possible. The muscles are kept loose, which promotes blood flow, and the flow and movement of waste in the lymphatic system. Individuals that receive regular adjustments report:
Enhanced perception of sensations in their extremities.
Warmer hands and feet.
Improved cognitive response and clarity.
Decrease or eliminate tingling and numbness.
Maintaining the proper range of motion of the spine also facilitates better function and movement of the whole body.
Immune Response Improvement
Regular chiropractic improves immune responses that leads to improved response against foreign invaders and disease,fewer instances of illness, exhaustion, fatigue, and inflammation. When expert chiropractic and spinal health intervention is delivered it helps to realign bones and joints, alleviate muscle tension, and restore nerve function. The body immediately experiences a decrease in stress, downregulation of stress hormones and chemicals in the body leads to a reduction in inflammation.
Increased Mobility & Flexibility
Chiropractic helps to improve physical mobility and flexibility in the muscular and skeletal systems. This is accomplished through manual manipulation to restore ideal posture and achieve a balanced skeletal structure. Manual manipulation is also used to soften and relax tense muscles which have developed abnormalities to compensate for incorrect posture. When skeletal structure, muscular imbalances, and strain are corrected, the result is improved mobility and flexibility.
Pain Symptoms Are Decreased
Pain originates from the nervous, muscular, and skeletal systems. Chiropractic can help with back pain, neck pain, shoulder pain, migraines, nerve and sciatic pain, and other conditions and forms of discomfort. The origin of the pain can include:
Postural imbalance
Muscle tension
Damage from accident or injury
Spinal degeneration
Chiropractic and spinal health care helps soothe and de-inflame the comprised areas, allowing the natural healing systems to intervene and promote long-term reduction of discomfort and pain.
Bending, Standing, Sitting Activities Improve
For many individuals, bending, standing, and sitting are normal movements they engage in every day. This can be part of work occupation, school, house chores, etc, and for many these movements and positions can become painful over long durations of time and when it is repetitive. Regular chiropractic and spinal health treatment can restore optimal posture in the body, soothe strained and tense muscles, and resolve disrupted nerve energy flow which often leads to nerve pain like sciatica.
Body Composition
Pregnancy Hypertension
Hypertension in pregnancy falls into one of three categories. It can range from benign and easily controlled to serious with increased medical risks. This makes monitoring blood pressure important to individual health risks. The risks for hypertension in pregnancy include:
Preeclampsia develops after 20 weeks of pregnancy and is associated with a sharp spike in blood pressure levels. Notable symptoms include:
Sudden fluid swelling
Chronic headaches
Changes in vision
Nausea
Vomiting
Weight gain
References
Brown, Richard A. “Spinal Health: The Backbone of Chiropractic’s Identity.” Journal of chiropractic humanities vol. 23,1 22-28. 8 Sep. 2016, doi:10.1016/j.echu.2016.07.002
Bussières, André E et al. “Spinal Manipulative Therapy and Other Conservative Treatments for Low Back Pain: A Guideline From the Canadian Chiropractic Guideline Initiative.” Journal of manipulative and physiological therapeutics vol. 41,4 (2018): 265-293. doi:10.1016/j.jmpt.2017.12.004
Maher, Jennifer L et al. “Exercise and Health-Related Risks of Physical Deconditioning After Spinal Cord Injury.” Topics in spinal cord injury rehabilitation vol. 23,3 (2017): 175-187. doi:10.1310/sci2303-175
Meeker, William C, and Scott Haldeman. “Chiropractic: a profession at the crossroads of mainstream and alternative medicine.” Annals of internal medicine vol. 136,3 (2002): 216-27. doi:10.7326/0003-4819-136-3-200202050-00010
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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