The buttock and the lower back have a casual relationship to the body, as the lower back has various muscles and nerves surrounding the spinal column. In contrast, the buttock region has multiple muscles and the sciatic nerve to keep the body upright. The sciatic nerve travels from the lumbar region of the spine across the gluteus muscles and down to the legs. The gluteus muscles include the Maximus, medius, and minimus, and they work with the sciatic nerve regarding good posture. When normal or traumatic factors begin to affect the body, like sciatica or poor posture, it can lead to developing trigger points associated with the gluteus minimus affecting the sciatic nerve. Today’s article examines the gluteus minimus, how trigger points mimic sciatic pain on the gluteus minimus, and various treatments to relieve sciatic nerve pain. We refer patients to certified providers who incorporate multiple methods in the lower body extremities, like sciatic pain treatments related to trigger points, to aid individuals dealing with pain symptoms along the gluteus medius muscles associated with sciatica. We encourage and appreciate patients by referring them to associated medical providers based on their diagnosis, especially when it is appropriate. We understand that education is an excellent solution to asking our providers complex questions at the patient’s request. Dr. Jimenez, D.C., utilizes this information as an educational service only. Disclaimer
What Is The Gluteus Minimus?
Have you been experiencing radiating pain traveling down to your leg? Do you have difficulty walking or sitting down? Do you feel tenderness or referred pain near your buttock region? Some of the issues correlate with trigger points affecting the gluteus minimus, causing pain in the sciatic nerve. As the smallest muscle in the gluteal region of the buttock, the gluteus minimus shares similar characteristics to the gluteus medius while being located beneath the medius muscle. One of the primary functions of the gluteus minimus is that it predominantly acts as a hip stabilizer and abductor. The nerves from the gluteal muscles include the sciatic nerve, which is on top of the gluteus muscles and the other nerves help supply the muscles to function in the posterior region of the body. Studies reveal that the structural integrity of the gluteus minimus muscles is the key to the lateral hip muscle, which contributes to pelvic stability and lower extremity function. However, when issues affect the gluteal muscles’ posterior region could trigger point pain mimicking sciatica.
How Trigger Points Mimic Sciatic Pain On The Gluteus Minimus?
When the lower body extremities begin to suffer from multiple issues that cause the individual to have mobility dysfunction, various factors could correlate to the dysfunction. When the gluteus minimus muscles have been overused or been through a traumatic experience, they can develop trigger points along the muscle fibers and even cause nerve entrapment along the sciatic nerve. Trigger points along the gluteus minimus can mimic sciatic nerve pain down to the back or even the side of the legs that causes excruciating and deep pain in the posterior region. Studies reveal that pain in the buttock region is a deep gluteal syndrome caused by non-discogenic pain that causes sciatic nerve entrapment.
The book, “Myofascial Pain and Dysfunction,” written by Dr. Janet G. Travell, M.D., states that many patients with active trigger points located in their gluteus minimus would complain about hip pain that could cause them to limp-walk when they are going to places. The pain caused by the active trigger points can make it difficult to stand up from a seated position due to the painful movements. The associated pain that the trigger points are causing to the gluteus minimus can be constant and excruciating; even small stretches can not alleviate the pain. The book also mentioned that trigger points could cause referred pain to the gluteus minimus that can cause various somato-visceral issues to the hips, legs, and knees if the pain worsens.
Sciatic Type Pain: Gluteus Minimus Trigger Points- Video
Are you dealing with pain in your hips, low back, and legs? Do you find it difficult to walk or stand up constantly? Or are you experiencing sciatic nerve pain that is radiating down your leg? All these pain-like symptoms are associated with trigger points along the gluteus minimus affecting the sciatic nerve. The gluteus minimus is the smallest of the gluteal muscles with the same function as the gluteus medius and predominately acts as the hip’s stabilizer and abductor. When the gluteus minimus muscles have been overused from traumatic events or normal factors, they can develop trigger points in the muscle fibers, entrap the sciatic nerve and irritate the nerve causing sciatica. The video above explain where the gluteus minimus is located and pinpoints where the trigger points are in the muscle fibers. Trigger points along the gluteus minimus can mimic sciatica by causing referred pain to travel down the leg. This can cause the individual to be unable to walk or even stand up due to the excruciating pain that they are in. Luckily, trigger points are treatable even though they are tricky to diagnose.
Various Treatments To Release Sciatic Nerve Pain
Even though trigger points along the gluteus minimus are tricky to diagnose, they are treatable through various treatments to alleviate the pain that the person is experiencing and can reduce sciatic nerve pain from causing more issues in the legs. Studies reveal that the effectiveness of active soft tissue release and trigger point block treatments combined can release entrapped nerves from the gluteus minimus and reduce low back and sciatic pain from the lower extremities. Now the treatments alone can only do so much to the individual, as many doctors tell their patients to take corrective actions or techniques to reduce the chances of trigger points from forming again on the gluteus minimus. Techniques like glute stretches, ischemic compressions, or using a foam roller can break the myofascial triggers from the gluteus minimus muscles and reduce the pain in the glutes and legs. This will help bring mobility back to the lower extremities.
Conclusion
As the smallest muscle in the body’s gluteal region, the gluteus minimus is the lower body’s predominant hip stabilizer and abductor. The gluteus minimus contributes to pelvic stability and lower extremity functionality that can be overused and can develop trigger points associated with sciatica. Trigger points along the gluteus minimus can cause referred pain to the legs and lower back while mimicking sciatic nerve pain. Thankfully various treatments and techniques can help reduce the chances of trigger points forming along the gluteus minimus and release nerve entrapment from the aggravated muscles pressing on the sciatic nerve, bringing back lower extremity mobility to the body.
References
Greco, Anthony J, and Renato C Vilella. “Anatomy, Bony Pelvis and Lower Limb, Gluteus Minimus Muscle.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 29 May 2022, https://www.ncbi.nlm.nih.gov/books/NBK556144/.
Kameda, Masahiro, and Hideyuki Tanimae. “Effectiveness of Active Soft Tissue Release and Trigger Point Block for the Diagnosis and Treatment of Low Back and Leg Pain of Predominantly Gluteus Medius Origin: A Report of 115 Cases.” Journal of Physical Therapy Science, The Society of Physical Therapy Science, Feb. 2019, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6382483/.
Martin, Hal David, et al. “Deep Gluteal Syndrome.” Journal of Hip Preservation Surgery, Oxford University Press, July 2015, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4718497/.
Travell, J. G., et al. Myofascial Pain and Dysfunction: The Trigger Point Manual: Vol. 2:the Lower Extremities. Williams & Wilkins, 1999.
Whiler, Lisa, et al. “Gluteus Medius and Minimus Muscle Structure, Strength, and Function in Healthy Adults: Brief Report.” Physiotherapy Canada. Physiotherapie Canada, University of Toronto Press, 2017, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5963550/.
Sciatica pain can radiate to the knee. Individuals with sciatica do report unique/unusual knee pain that was never there and no past or recent physical injuries. Sciatica is the culprit, as the knee muscles are powered and controlled by nerves in the lower spine. Irritation or compression of these nerves can cause symptoms that can include: random back pain, hamstring tightness, weakness in the hips or quadriceps, the development of bunions, and knee pain and/or weakness. Chiropractic treatment can release the compression, heal the sciatic nerve, and alleviate knee problems.
Sciatica Pain Can Radiate To The Knee
Spine conditions that can cause sciatica include:
Disc herniation – Where the inside of the discs leak out and compress and/or irritate surrounding nerves.
Spinal stenosis – The spinal canal begins to narrow, not allowing enough space for the nerves to rest comfortably, resulting in compressed nerves.
Spondylolisthesis – A condition that occurs when a vertebrae slips forward onto the vertebrae below it.
Any can cause irritation, inflammation, or compression of the sciatic nerve leading to painful sensations that extends from the lower back down through the leg.
Symptoms
Common knee symptoms that may be experienced with sciatica include:
A dull ache, warm sensation, or sharp pain around the knee.
Bunions form from weakened stabilizing muscles that affect walking, running, and standing posture.
As sciatica pain can radiate to the knee, individuals will usually also experience pain in their buttocks, thigh, calf, and/or foot. The nerve sensations and other symptoms in the knee can be felt through a branch of the sciatic nerve known as the peroneal nerve.
Duration
The knee pain will last as long as sciatica does, depending on the type of sciatica, whether it is acute or chronic.
An acute sciatic episode usually resolves after a few weeks, with possible future flare-ups.
Chronic sciatica is a long-term condition that does not resolve independently and necessitates intervention by a specialist.
Chiropractic Treatment Plan
Depending on the diagnosis, a chiropractor will develop a personalized treatment plan to address the root cause and heal the injury. The treatment plan will include therapeutic massage, posture training, and at-home self-care to help heal and prevent future sciatica.
Massage Rehabilitation
Physical therapy and therapeutic massage will loosen and relax the muscles, nerves, tendons, and ligaments.
Heat and ice, exercises, and stretches will prepare the muscles and nerves for chiropractic decompression adjustments.
Posture Training
Training will be provided to maintain the back, hips, knees, and feet in proper alignment.
Training on removing pressure from the lower back and restabilizing the rest of the body.
Training on proper body mechanics, safe lifting techniques, and injury prevention.
Self-Pain Management
Training on self-care habits that include healthy weight, core strengthening exercises and stretches for the back muscles, and proper rest for a full recovery.
An anti-inflammatory diet to reduce/eliminate inflammation and achieve a healthy weight and a nutrition plan to maintain overall health.
Surgery
Surgery is the final option when conservative treatments are not working.
Treating Severe & Complex Sciatica Syndromes
References
Dydyk AM, Khan MZ, Singh P. Radicular Back Pain. [Updated 2021 Nov 2]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK546593/
Hirabayashi, Hiroki, et al. “Characteristics of L3 nerve root radiculopathy.” Surgical neurology vol. 72,1 (2009): 36-40; discussion 40. doi:10.1016/j.surneu.2008.08.073
Jandre Reis, Felipe Jose, and Adriana Ribeiro Macedo. “Influence of Hamstring Tightness in Pelvic, Lumbar and Trunk Range of Motion in Low Back Pain and Asymptomatic Volunteers during forwarding Bending.” Asian spine journal vol. 9,4 (2015): 535-40. doi:10.4184/asj.2015.9.4.535
Jeong, Ui-Cheol, et al. “The effects of self-mobilization techniques for the sciatic nerves on physical functions and health of low back pain patients with lower limb radiating pain.” Journal of physical therapy science vol. 28,1 (2016): 46-50. doi:10.1589/jpts.28.46
Many live with chronic discomfort and pain regularly in one or both knees. This could be from past injuries, being overweight, lack of physical conditioning, degeneration, or arthritis. Many take prescription or over-the-counter pain medication to deal with the discomfort. Pain medications only dull and mask the pain and discomfort associated with the symptoms. As a result, living with masked knee pain can worsen the condition, and the surrounding bones, joints, and tissues can begin to deteriorate. Chiropractic combined with massage, decompression, and traction therapy can significantly reduce or eliminate knee pain.
Knee Discomfort and Pain
The knee’s joint and ligaments need to be strong and healthy to support activities. The most common issues that individuals develop include:
Acute Injuries
Knee injuries can be caused by auto accidents, physical strain, playing sports, work accidents, workplace ergonomics, and walking up and down stairs.
Chronic or inflammatory medical conditions can wear down the cartilage cushion between the upper and lower leg bones.
Most common include gout, septic arthritis, osteoarthritis, and rheumatoid arthritis.
Unhealthy postures and obesity can also contribute to the chronic degradation of the knee joint.
Knee discomfort and pain can present in various ways. Some might hear an acute popping in the knee followed by swelling. Others might notice the gradual development of stiffness and weakness over time. When injured or compromised, localized pain is one of the first indicators. Chronic knee and joint pain can lead to weakness, nerve damage, or create new injuries/problems. Not all knee pain is caused by injury; in many cases, a triggering incident, like an awkward step or misstep, a stretch that went too far, or a walk, can create an injury. Even a sedentary lifestyle can contribute to knee degeneration as the surrounding muscles can lose strength, placing unnecessary strain on the joints when movement is necessary.
Chiropractic
A chiropractor will examine the knee through a series of analyses, including x-rays, digital imaging, and a physical exam. The chiropractor will develop a personalized treatment plan to treat, rehabilitate, and strengthen the knee. The treatment can include:
Posture correction to distribute body weight evenly, lessening the stress on an affected knee.
Targeted exercises and nutritional recommendations will ensure long-term healing.
Q Angle of the Knee
References
Cimino, Francesca, et al. “Anterior cruciate ligament injury: diagnosis, management, and prevention.” American family physician vol. 82,8 (2010): 917-22.
Donnell-Fink, Laurel A et al. “Effectiveness of Knee Injury and Anterior Cruciate Ligament Tear Prevention Programs: A Meta-Analysis.” PloS one vol. 10,12 e0144063. 4 Dec. 2015, doi:10.1371/journal.pone.0144063
Hoskins, Wayne, et al. “Chiropractic treatment of lower extremity conditions: a literature review.” Journal of manipulative and physiological therapeutics vol. 29,8 (2006): 658-71. doi:10.1016/j.jmpt.2006.08.004
Neogi, Tuhina, et al. “Sensitivity and sensitization in relation to pain severity in knee osteoarthritis: trait or state?.” Annals of the rheumatic diseases vol. 74,4 (2015): 682-8. doi:10.1136/annrheumdis-2013-204191
Psoriatic arthritis can develop in individuals who have psoriasis, affecting various joints, especially the knees. Psoriasis is a skin condition that causes skin cells to build up and form patches of itchy, dry skin known as plaques. Psoriatic arthritis is a long-term inflammatory disease that can cause inflammation, stiffness, and pain. Symptoms can progressively worsen over time without treatment. Early diagnosis is vital to minimize damage to the joints and slow the condition’s progress with treatment.
Psoriatic Arthritis
Psoriatic arthritis symptoms like stiffness and swelling can present differently from person to person. For example, some individuals with psoriatic knee arthritis will experience stiffness or pain in one knee, while others experience symptoms in both knees. Psoriatic arthritis in the knee can also cause swelling in the surrounding:
Ligaments
Tendons
Synovial membranes
Symptoms can also present in the:
Elbows
Feet
Hands
Symptoms
Symptoms usually begin between the ages of 30 and 50. Common symptoms include:
Stiffness after resting or sleeping.
Swelling.
Inflammation in the knee and surrounding area.
Warm or hot skin on the knee from the inflammation.
Pain in and around the joints, tendons, or ligaments.
Joint sticking, difficulty moving, or reduced range of motion.
Other symptoms include:
Back pain
Fatigue
Pain and redness in the eyes
Swollen fingers or toes
Difficulty walking from pain in the feet or Achilles tendon.
The severity of psoriasis does not determine psoriatic arthritis symptoms. Symptoms can go through a pattern of relapses and remissions. Individuals can have a sudden attack where symptoms get worse over a short time. After the flare-up, symptoms can improve as the condition goes into remission. Symptoms may not present for a long time until another flare-up. For example, an individual may have severe psoriasis but only mild psoriatic arthritis.
Causes
Psoriatic arthritis develops when the body’s immune system mistakenly attacks healthy cells and tissues. The faulty immune response causes the body to quickly generate new skin cells that stack on top of each other forming plaques. When the condition affects the joints, it leads to inflammation. While there is no apparent cause for psoriatic arthritis, researchers have found connections to genetics and the environment, as well as, individuals with close relatives that have psoriatic arthritis could be more likely to develop the condition. Other factors that could influence the development include:
Severe psoriasis
Traumatic injury/s
Obesity
Nail disease
Smoking
The condition can happen at any age, but according to the National Psoriasis Foundation, most individuals first notice symptoms about ten years after their psoriasis begins. However, only 30% of individuals with psoriasis develop psoriatic arthritis.
Diagnosis
Doctors use imaging tools to diagnose psoriatic arthritis in the knee. They will use:
MRI
X-rays
Ultrasound
To help them check for irregularities or signs of inflammation in the joint and surrounding tissues.
Additional tests are used to rule out other common forms of arthritis like rheumatoid and osteoarthritis.
Blood tests check for inflammation and specific antibodies.
In some cases, a small amount of fluid from the joint is taken to help eliminate the possibility of other underlying conditions like an infection.
Treatment
There is currently no cure for psoriatic arthritis, but treatments are being developed and show promise for long-term management. Current treatments focus on managing symptoms and improving the quality of life for the individual.
Biologics
Biologic medications like tumor necrosis factor or TNF inhibitors are recommended as the first-line therapy for most individuals with a new diagnosis of psoriatic arthritis. These meds help block TNF, which plays a crucial role in inflammation. They have shown to be effective at reducing the severity of symptoms and the frequency of flare-ups. Biologics can cause unwanted side effects, especially in individuals that experience frequent infections and need routine monitoring.
Small Molecule Medications
Individuals that cannot use biologic medications may be recommended a new class of medication called oral small molecules or OSMs. Examples include apremilast – Otezla and tofacitinib – Xeljanz.
Disease-modifying Antirheumatic Drugs
Disease-modifying antirheumatic drugs – DMARDs are a long-term option. They are used to slow the progression of psoriatic arthritis, and examples include methotrexate and cyclosporine. DMARDs work best when an individual begins taking them as early as they can take time to work. However, individuals are encouraged to continue taking them, even if symptoms do not improve right away.
Easing Inflammation
A doctor may prescribe nonsteroidal anti-inflammatory drugs – NSAIDs and corticosteroid injections when knee symptoms flare-up. These are short-term treatments that provide immediate relief, as long-term use can lead to side effects. Individuals can find relief with combined self-care that includes:
Taking over-the-counter NSAIDs like ibuprofen/Advil or naproxen/Aleve.
Applying ice and heat packs.
Gentle exercise to promote a full range of motion.
Gentle stretching or yoga can help relax tight muscles.
However, chiropractic is not the primary treatment for arthritis but is intended to be used in combination to relieve pain, loosen and stretch the muscles and balance the body.
InBody
Strength, Balance, and Improved Body Composition
Functional fitness is the ability to move comfortably every day. The benefits of physical activity also contribute to improved body composition. Working to reach a certain level of functional fitness can help the aging process that has been shown to reduce metabolic rate. Inactivity is why individuals lose Lean Body Mass as they age, leading to increased body fat. Lean Body Mass contributes to the body’s overall Basal Metabolic Rate or BMR, also known as metabolism. This is the number of calories the body needs to support essential functions. Everyone is encouraged to engage in strength training or resistance exercises, but specifically older adults. This can help regain muscle loss which can lead to an increase in lean body mass. The increase in Lean Body Mass increases BMR, which helps prevent fat gain.
References
Chang, K. L., et al. (2015). Chronic pain management: Nonpharmacological therapies for chronic pain [Abstract]. https://www.ncbi.nlm.nih.gov/pubmed/25970869
Chiropractic care for arthritis. (n.d.). arthritis.org/health-wellness/treatment/complementary-therapies/physical-therapies/chiropractic-care-for-arthritis
Around a half-million high school students in the U.S. play volleyball. Whether the parent of a volleyball player or part of a recreational league, the goal is to be ready for the season, which means preventing and addressing volleyball injuries. It is a highly demanding sport with quick movements, jumping, twisting, diving, spiking, etc. Despite being fit and healthy, extensive training along with match play takes a toll on the body. Chiropractic can benefit volleyball players.
Common Volleyball Injuries
Why Chiropractic Works
Chiropractic treatment and rehabilitation, especially by a sports chiropractor, is recommended for volleyball injuries because it addresses acute and chronic injuries to all areas of the body. Chiropractic treats the entire musculoskeletal system. Proper joint alignment from chiropractic adjustments in the spine and throughout the body maintains the biomechanic integrity. This reduces high-impact forces in the joints. Soft tissue treatments like instrument-assisted soft tissue mobilization can help resolve injuries by providing the tissues with more blood flow into the affected area allowing for faster healing. Most volleyball injuries result from overuse to the joints and muscles, resulting in repetitive strain. In volleyball, repetitive/overuse injuries are common in the knees, ankles, and shoulders. This comes from all the jumping, serving, and spiking.
Player Benefits
Body Soreness Is Reduced/Alleviated
Many athletes, including volleyball players, do not get the proper recovery time from training or playing.
Reduced recovery periods cause body soreness and stiffness that can overlap into an injury.
Chiropractic can reduce and alleviate body soreness.
Chiropractic promotes faster recovery.
Optimal Performance
Studies show that athletes that receive regular chiropractic care found speed and mobility performance enhanced.
Athletes require fast reflexes and optimal hand-eye coordination.
Speed, mobility, reflexes, and coordination depend on a healthy nervous system.
90% of the central nervous system travels through the spine.
Spinal alignment can either allow for proper nerve flow or disrupt nerve flow.
Even when just one spinal segment is misaligned and out of place, the nervous system can impact reflexes, speed, mobility, and hand-eye coordination.
A properly functioning spine and nervous system will ensure the player is at their best.
Faster Injury Recovery Time
Healing the body properly takes time. Just like the body needs sleep/rest to function properly, so it is with injuries.
The issue for athletes is how much time healing takes.
Individual athletes receiving chiropractic care have been shown to heal faster.
Mobility and Strength
A chiropractic doctor can reduce the pressure around the nerve roots that exit the spine, which will help improve player performance. This includes:
Range of motion
Mobility and flexibility
Strength
Endurance
To find out how chiropractic can help, contact Injury Medical Chiropractic and Functional Medicine Clinic. We will perform a thorough musculoskeletal and nervous system examination.
Ankle Sprain Treatment
How Many Calories Over 24 hours
Myths that offer strategies that avoid the hard work and commitment that diet and exercise demand should be avoided. Individuals cannot expect to experience healthy body composition changes by increasing/decreasing meal frequency if they are living a sedentary lifestyle. It is not important how often or what time an individual takes in calories (has a meal). What is important is how many calories an individual has over a 24-hour period. A study looked at healthy individuals that ate one large meal a day for two weeks and then later ate the same meal but spread out over five smaller meals for another two weeks. It was concluded that there was no statistical difference in body weight gain or loss between the two eating methods. 2000 calories over 3 meals is the same 2000 calories consumed over 5 meals. There is no substitute for proper diet and exercise. The focus should be on what and how much you eat.
References
Eerkes, Kevin. “Volleyball injuries.” Current sports medicine reports vol. 11,5 (2012): 251-6. doi:10.1249/JSR.0b013e3182699037
Gouttebarge, Vincent et al. “Preventing musculoskeletal injuries among recreational adult volleyball players: design of a randomized prospective controlled trial.” BMC musculoskeletal disorders vol. 18,1 333. 2 Aug. 2017, doi:10.1186/s12891-017-1699-6
Kilic, O et al. “Incidence, etiology, and prevention of musculoskeletal injuries in volleyball: A systematic review of the literature.” European journal of sports science vol. 17,6 (2017): 765-793. doi:10.1080/17461391.2017.1306114
Seminati, Elena, and Alberto Enrico Minetti. “Overuse in volleyball training/practice: A review on the shoulder and spine-related injuries.” European journal of sports science vol. 13,6 (2013): 732-43. doi:10.1080/17461391.2013.773090
Wolfram, G et al. “Thermogenese des menschen bei unterschiedlicher mahlzeitenhäufigkeit” [Thermogenesis in humans after varying meal time frequency]. Annals of nutrition & metabolism vol. 31,2 (1987): 88-97. doi:10.1159/000177255
Knee Injuries, Surgeries, and Vitamin D Status. The knee joint is one of the largest and complex joints. It connects the thigh bone to the shinbone, which has a very important role in:
Supporting the body’s weight
Facilitating movement
Allowing the ability to bend the knee
Because of the complexity of the knee joint, it is highly susceptible to injuries. The most common injuries include tears in the:
Ligaments
Tendons
Cartilage
The kneecap itself can be fractured and/or dislocated.
Tears
Meniscal Tears
The meniscus is the cartilage between the knee joint that absorbs the impact/shock when running, playing sports, yard work, hiking, bicycling, etc. It cushions the joint and maintains stability.
Meniscus tears are common in sports that have a lot of jumping, starting/stopping quickly, changing direction suddenly, like volleyball, basketball, tennis, soccer, football. This is when the meniscus tears. Surgery can be required, depending on the severity/extent of the injury and tear.
Tendon Tears
The patellar tendon works with the knee muscles in the front of the thigh to straighten the leg. Tears in the patellar tendon are common among middle-aged individuals and those that participate in running or jumping sports.
A complete tear is considered a disabling injury that requires surgery for full functional recovery.
Fortunately, most tears are partial and require rest and chiropractic/physical therapy to heal.
Dislocation
Knee dislocations happen when the knee bones shift out of position. This can happen after a fall, car crash, or high-speed impact. It can also be caused by twisting the knee while the foot stays planted. Dislocations require relocation. However, sometimes a dislocated kneecap corrects itself and returns to the proper position. Other cases can require a mild sedative to allow a doctor to relocate the knee. Dislocations generally take around six weeks to fully heal.
Anterior Cruciate Ligament – ACL Injury
The anterior cruciate ligament or ACL is knee tissue that joins the upper and lower leg bones and maintains the knees’ stability. The ACL can be torn if the lower leg over-extends forward or if the leg gets twisted. ACL injuries are common knee injuries and account for around 40% of sports-related injuries. These injuries can range from a small tear in the ligament to a severe injury where the ligament tears completely or gets separated from the bone. Treatment depends on the severity of the injury. Depending on various factors including the severity of the tear, surgery could be required.
Knee Surgery
For most cases, surgery is done using arthroscopytechnology. This procedure uses small incisions to insert a camera and surgical instruments into the joint. Usually, two or three incisions are needed with recovery time being quicker than large incision surgery where the whole knee is opened. Minimally invasive arthroscopic surgery is preferred by sports medicine experts. With this procedure:
There is no need to cut the tendons or muscles
Bleeding is reduced
Small incisions decrease scarring
Recovery time is shorter
However, sometimes a large incision is required for complex surgical techniques. Common knee surgery procedures include:
Arthroscopy Surgery
This method allows the ability to see inside the knee joint. The procedure is often recommended for:
Diagnosis
Minor repairs to ligaments and/or tendons
Cartilage or bone that needs to be removed
Total Knee Replacement
A full knee replacement is known as arthroplasty. When the joint is damaged beyond repair from injury or disease, an implant is placed in the knee joint restoring function. A small amount of cartilage and bone from the shinbone and thigh bone gets removed for perfect placement of the new knee joint.
Revision Knee Replacement
Most knee replacements last around 15 – 20 years. For individuals that have knee replacement early, then a new operation for new implants could be required. Here, the surgeon removes the original prosthesis and replaces it with a new one.
Partial Knee Replacement
Some knee injuries do not require complete replacement. Here, only the worn-out portion of the joint is replaced. As an example, the cartilage that has been lost in an area of the knee can be repaired with a partial replacement.
Vitamin D Status
A study on athletes that underwent ACL surgery looked at their vitamin d status and how it affected their recovery.
The research concluded that vitamin D status had no effect on surgery outcomes.
However, those with the lowest vitamin D status had three times the failure rate than those with higher vitamin D
The average age of the individuals was around twenty-four and were healthy athletes.
Each of the patients in this study had their vitamin levels measured before the operation and were grouped based on their vitamin D status:
Group 1 vitamin D below 20 ng/mL – considered deficient
Group 2 vitamin D between 20-30 ng/mL – considered low but in a technical range
Group 3 vitamin D above 30 ng/mL – considered sufficient, but not optimal
All were followed for two years with their surgery recovery being measured with two systems.
The Lysholm score, which is a 100 point scoring system that looks at an individual’s knee functions that include:
Mechanical locking
Instability
Pain
Swelling
Stair climbing
Squatting
The WOMAC score is a scoring system that measures:
After 2 years, the Lysholm score and the WOMAC scores were similar.
However, there was a difference in the graft failure rate which was about 6% in group 1 with the lowest vitamin D and around 2% in groups 2 and 3. This shows that the lowest vitamin D status has three times the failure rate compared with those that had increased vitamin D levels. Vitamin D is a known anti-inflammatory with metabolic functions that are documented. Therefore, vitamin D does improve surgical success and recovery in healthy athletes.
Body Composition
Disclaimer
The information herein is not intended to replace a one-on-one relationship with a qualified health care professional, licensed physician, and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the musculoskeletal system’s injuries or disorders. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request. We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.
Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, CTG*
email: [email protected]
phone: 915-850-0900
Licensed in Texas & New Mexico
References
Brambilla, Lorenzo, et al. “Outcome of total hip and total knee arthroplasty and vitamin D homeostasis.” British medical bulletin vol. 135,1 (2020): 50-61. doi:10.1093/bmb/ldaa018
European Journal of Orthopedic Surgery and Traumatology, January 2021
Zhang, Hao et al. “Vitamin D Status and Patient Outcomes after Knee or Hip Surgery: A Meta-Analysis.” Annals of nutrition & metabolism vol. 73,2 (2018): 121-130. doi:10.1159/000490670
Tennis is an intense sport that requires strength, agility, flexibility, stamina, endurance, and conditioning. And it’s a great way to stay in shape. However, with all of this intensity is the risk of injuries. Although they are lower compared to other sports injuries, injuries are more cumulative/repetitive based and wear and tear over time type. Tennis injuries can be painful and impair daily life. They can be treated and prevented with chiropractic medicine and strength training. Chiropractic can help the body heal quicker, and address underlying issues that led to the injury. This will help to worsen and prevent re-injury. The most common tennis injuries include…
Wrist Tendonitis
This is an injury that can happen to beginner players that don’t have a great deal of arm/wrist strength, use a racquet that is too heavy, and begin developing an improper form to compensate. But it can also be caused by repetitive/overusing the wrist instead of the whole arm. Symptoms are chronic stiffness and pain in the area surrounding the wrist joint. Chiropractic sports massage, physical rehabilitation, and learning proper form will help alleviate the pain and prevent worsening or developing new injuries.
Tennis Elbow
Tennis elbow is a condition that is caused by inflammation of the outside muscles in the forearm and tendons. This is usually an overuse injury from all the swinging and hitting, but using the improper technique could also be a cause. Chiropractic adjustments are highly recommended instead of steroid injections and other anti-inflammatories. The adjustments and massage relieve the discomfort and pain by naturally relaxing, stretching, and strengthening the muscles and tendons.
Shoulder Rotator Cuff Tendonitis
The rotator cuff belongs to a group of tendons and muscles that surround the shoulder joint. This allows the shoulder to perform 360-degree arm circles and is what stabilizes the shoulders. Tendonitis happens when the tendons inside the rotator cuff become inflamed. The inflammation causes pain with movement, especially overhead motions decreasing the range of motion in the shoulder. This injury is often caused by serving and hitting overheads with an improper technique. Chiropractic adjusting, heat and ice therapy, and electro-muscular stimulation loosen and stretch the muscles/tendons back to their proper form.
Knee Sprains and Strains
The knee goes through a lot in sports. And tennis is no exception, much like basketball and volleyball with all the jumping, pounding, shifting, twisting,losing balance, or extending beyond the normal range of motion causes injuries that result in:
Pain
Swelling
Bruising
Loss of the ability to move
Chiropractic will help relieve that pain and relax the damaged muscles. It also speeds the healing process by addressing the underlying issues.
Ankle Sprain
An ankle sprain also known as a twisted ankle happens when the ligaments attached to the joint become over-stretched or partially tear. These sprains happen from the:
Quick start and stop movements
Changing direction rapidly
Quick sprints all around the court
Causing the ankle to roll and/or twist.
A chiropractor will realign the ankle and provide physical therapy massage to allow the ligaments to heal properly and faster. Chiropractic treatment will allow the player to return to play quicker and prevent reinjury that if not treated correctly can become chronic. Having the proper personalized treatment plan will ensure the body heals correctly, prevent misalignments, loss of functionality, and/or range of motion.
PUSH Fitness
Aerobic Training
Aerobic exercise is a cornerstone for weight loss. Having the heart rate elevated for a continuous amount of time is the key. This is how calories are burned. Research has found that individuals involved in aerobic training lose more weight overall, including more fat mass than resistance training alone. When combined, aerobic and resistance training individuals gain more fat-free mass, including lean muscle. Aerobics causes the cardiorespiratory system to adapt. Maintaining heart function and health and keeps the body’s energy metabolism system running at optimal levels. Aerobic exercise for fitness and weight loss is a key element of maintaining the body’s health.
Disclaimer
The information herein is not intended to replace a one-on-one relationship with a qualified health care professional, licensed physician, and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the musculoskeletal system’s injuries or disorders. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request. We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.
Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, CTG*
email: [email protected]
phone: 915-850-0900
Licensed in Texas & New Mexico
References
Dines, Joshua S et al. “Tennis injuries: epidemiology, pathophysiology, and treatment.” The Journal of the American Academy of Orthopaedic Surgeons vol. 23,3 (2015): 181-9. doi:10.5435/JAAOS-D-13-00148
Minghelli, Beatriz, and Jéssica Cadete. “Epidemiology of musculoskeletal injuries in tennis players: risk factors.” The Journal of sports medicine and physical fitness vol. 59,12 (2019): 2045-2052. doi:10.23736/S0022-4707.19.09842-6
Stuelcken, Max et al. “Wrist Injuries in Tennis Players: A Narrative Review.” Sports medicine (Auckland, N.Z.) vol. 47,5 (2017): 857-868. doi:10.1007/s40279-016-0630-x
Willis, Leslie H et al. “Effects of aerobic and/or resistance training on body mass and fat mass in overweight or obese adults.” Journal of applied physiology (Bethesda, Md.: 1985) vol. 113,12 (2012): 1831-7. doi:10.1152/japplphysiol.01370.2011
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