The sciatic nerve is the longest in the body and is the central nerve in the leg. A critical nerve that comes off the spine runs through the pelvis, into the buttocks, down the back of each thigh, and finally into the feet. It is a mixed nerve meaning it is made up of both motor/movement) and sensory/sensation fibers. The nerves merge with the spinal nerve roots before they enter the spinal cord, where the sensory information travels to and from the brain. If the nerve is inflamed, compressed, twisted, damaged, or injured, this can negatively affect the muscles’ function, leading to chronic pain conditions. Injury Medical Function Restoration Chiropractors will do precisely that for the sciatic nerve and the rest of the body.
Nerve Roots and Branches
Different nerve roots make up the sciatic nerve, with two starting in the lower back and three at the bottom of the spine or sacrum. At the knees, the nerve splits into two branches:
The peroneal nerve runs from the knee’s outer part to the foot’s outer part and splits into two main branches below the knee.
The tibial nerve goes down the back of the calf, extending to the heel and sole.
There are smaller branches at the:
Hips
Inner thighs
Calves
Feet
Sciatic Nerve Function
The sciatic nerve’s purpose serves motor functions by assisting the muscles in the legs and feet to move, walk, run, and stand. And for the sensory function of feeling sensations in the legs and feet includes pain, numbness, burning, and electrical sensations.
Motor Functions
The nerve provides motor functions that power movement to the muscles that move the thighs, legs, and feet. Essential motor functions:
Motor function signs of sciatic nerve problems include difficulty or inability to walk, bend the leg, and/or stand on tiptoe or the heel.
Sensory Functions
The nerve provides sensation to the different areas; when the nerve is injured, the corresponding area may feel unique/abnormal sensations with differing degrees of numbness, pins-and-needles, and pain. Commonly affected areas include:
Front, back, and outside the thigh.
Front, back, and outside the lower leg.
The top and outer side of the foot.
Bottom of the foot.
Between the toes.
Like motor function disruption, sensory impairment is determined by where the problems are occurring.
Function Restoration Chiropractor
Affected, reduced, and inhibited motor and sensory functions can lead to muscle weakness, chronic pain, and permanent nerve damage. Function restoration chiropractor and physical therapeutic massage can help manage nerve compression and irritation. Spinal manipulations restore misaligned vertebral discs taking the pressure off the nerve relieving the pain, and regaining nerve signal flow and mobility. Chiropractic will induce deep muscle relaxation to stop muscle spasms, release tension, soothe the nerve, release endorphins, and restore sciatic nerve function.
Spinal Decompression
References
Bouche, P. “Compression and entrapment neuropathies.” Handbook of clinical neurology vol. 115 (2013): 311-66. doi:10.1016/B978-0-444-52902-2.00019-9
Cook, Chad E et al. “Risk factors for first-time incidence sciatica: a systematic review.” Physiotherapy research international: the journal for researchers and clinicians in physical therapy vol. 19,2 (2014): 65-78. doi:10.1002/pri.1572
Giuffre BA, Jeanmonod R. Anatomy, Sciatic Nerve. [Updated 2021 Jul 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482431/
Cheerleading and the physically intensive gymnastics and acrobatics put participants’ body’s/musculoskeletal systems at an increased risk of injury. A wrong move or falling at the wrong angle can cause permanent damage. Cheerleaders must follow a balanced diet and maintain physical fitness, strength, endurance, and flexibility to be successful cheerleaders. Cheerleading conditioning builds the musculature and spinal strength to decrease the risk and prevent injury.
Cheerleading Conditioning
Cheerleaders must have a solid musculoskeletal system to ensure their safety and the safety of their squads. Workouts include cardio, strength training, and flexibility exercises.
Warming Up
Before any workout, the muscles need to be warmed up.
Spend five minutes jumping rope, running in place, jogging on a treadmill, or doing any mild activity to raise the heart rate.
Try tree pose by standing on the right foot, and the left leg bent on the right knee.
The left thigh should be parallel to the ground.
Raise arms overhead and make a V motion keeping the abdominal muscles pulled in tight.
Balance for up to one minute.
Switch to the other foot.
Once balance is mastered on the ground, try balancing on a cushion to add instability.
Repeat three to five times on each foot.
Common Injuries
Common injuries include:
Hand and finger injuries.
Ligament sprains in the knees and ankles.
Muscle strains in the hip, low back, and legs.
Overuse injuries
Cheerleading is becoming a year-round sport.
Starting with tryouts during spring.
Teams may hold or go to organized summer cheerleading camps to learn new skills, improve skill sets, and create routines for competition.
Continuous training and competitions increase the chance of overuse injuries.
The wrists, elbows, knees, and ankles can be injured by repetitive stress.
More severe injuries are:
The repetitive tumbling places significant pressure on the spine and can cause stress fractures.
Dislocation of the shoulder or elbow.
Injury Causes
Lack of arm and shoulder, foot, and ankle strength.
Little to no core and abdominal strength.
Flexibility problems.
Improper conditioning.
Unhealthy diet.
Performing skills that are advanced for the cheerleader’s current level.
Chiropractic Enhancement
Chiropractic care can treat injuries and strengthen the body’s musculoskeletal system to prevent injuries. Chiropractic’s goal is optimal body performance by redistributing blood circulation, nerve energy flow, correct muscle positioning, and skeletal alignment. Many cheerleading teams are incorporating chiropractic. Injury Medical Chiropractic and Functional Medicine Clinic also specializes in sports medicine rehabilitation, strength training, nutrition, and health coaching.
Cheerleading Strength Training Workout
References
Boden, Barry P, and Christopher G Jarvis. “Spinal injuries in sports.” Neurologic clinics vol. 26,1 (2008): 63-78; viii. doi:10.1016/j.ncl.2007.12.005
Miners, Andrew L. “Chiropractic treatment and the enhancement of sport performance: a narrative literature review.” The Journal of the Canadian Chiropractic Association vol. 54,4 (2010): 210-21.
Mueller, Frederick O. “Cheerleading injuries and safety.” Journal of athletic training vol. 44,6 (2009): 565-6. doi:10.4085/1062-6050-44.6.565
Pang, Yanbin, et al. “Premature exhaustion of mesenchymal stromal cells from myelodysplastic syndrome patients.” American journal of translational research vol. 9,7 3462-3468. 15 Jul. 2017
Wan, Jing-Jing, et al. “Muscle fatigue: general understanding and treatment.” Experimental & molecular medicine vol. 49,10 e384. 6 Oct. 2017, doi:10.1038/emm.2017.194
The body needs protein which is essential in building muscle, repairing tissue, producing enzymes and hormones and is a source of energy. Whey is a complete protein source that provides all the essential amino acids, vitamins, minerals, and other nutrients that increase anabolism, also known as muscle growth. It is used for various reasons. Some individuals want to build muscle mass and gain strength, while others want to lose weight and achieve improved results from working out. Even individuals who don’t exercise can benefit from the supplement as it supports immune function, helps reduce blood pressure, and improves insulin response.
Whey Protein
Whey protein is made from the liquid produced during the cheese-making process.
Milk comprises two forms of protein: casein (80%) and whey (20%).
It contains less than 0.5 g of fat and only 5 mg of cholesterol per serving.
Pure whey does not contain any gluten.
It is referred to as the most nutritious protein available.
It’s easy to digest.
Incorporating whey into a healthy diet can help lower the risk of diabetes.
Types
There are three primary types of whey protein in supplements.
Hydrolysate is a form that has already gone through partial hydrolysis, a process so the body can absorb protein.
It is considered pre-digested, so it gets absorbed quicker.
Concentration is the most popular and least expensive option that retains the most nutrients. However, some individuals can tolerate isolate and hydrolysate a lot better and are ideal for those trying to cut down on carbs and fats.
Benefits
Increased Strength and Muscle
Helps to increase protein consumption.
Most brands contain 80 to 90 percent without added carbs or fats.
Helps to build muscle and increase strength after physical activity/exercise recovery.
Can Help Burn Fat
A study found a group of adults that supplemented their diet with whey protein experienced a decrease in body fat and weight.
Combining whey protein and resistance training, participants found their weight and fat loss were even higher.
Can Help Stabilize Blood Sugar
Consuming whey protein with a high glycemic index before a meal can help stimulate insulin production while preventing spikes in blood sugar levels.
The protein naturally reduces blood sugar levels after meals when consumed before the meal.
Improves Heart Health
It can help reduce blood pressure and arterial stiffness.
It has been linked to improving individual lipid profiles.
Promotes heart health by building muscle and helping with weight loss.
Increased Immunity
It can help encourage glutathione synthesis, which increases immune system function.
It is also rich in vitamins and minerals that promote immune function.
It helps the body recover from oxidative stress and inflammation.
Improves Energy Levels
It helps to increase glycogen, a source of energy during exercise or other physical activities.
It also increases leptin which helps balance the body’s energy levels.
Whey is easily digested, which can be quickly converted to energy.
Factors to Consider When Choosing
Flavor
The flavor is crucial because nobody wants to drink a daily protein shake they cannot enjoy.
Options like chocolate and vanilla are usually safe.
If experimenting, get a small container to start.
Mixability
Not all supplements mix properly or thoroughly.
Find a brand that dissolves quickly and has little clumping.
Container Size
Most protein supplements are available in 1 lb, 2 lb, 5 lb, or 10 lb containers.
Larger sizes are more cost-effective.
One 5 lb package is cheaper than buying five 1 lb containers.
Everything You Need To Know
References
Ebaid, Hossam et al. “Whey protein enhances normal inflammatory responses during cutaneous wound healing in diabetic rats.” Lipids in health and disease vol. 10 235. 14 Dec. 2011, doi:10.1186/1476-511X-10-235
Hashemilar, Mazyar, et al. “Effect of Whey Protein Supplementation on Inflammatory and Antioxidant Markers, and Clinical Prognosis in Acute Ischemic Stroke (TNS Trial): A Randomized, Double-Blind, Controlled, Clinical Trial.” Advanced pharmaceutical bulletin vol. 10,1 (2020): 135-140. doi:10.15171/apb.2020.018
Kim, Jooyoung, et al. “Effect of timing of whey protein supplement on muscle damage markers after eccentric exercise.” Journal of exercise rehabilitation vol. 13,4 436-440. 29 Aug. 2017, doi:10.12965/jer.1735034.517
Marshall K. Therapeutic applications of whey protein. Alternative Medicine Review. 2004;9(2):136-156.
Pradhan, Geetali, et al. “Ghrelin: much more than a hunger hormone.” Current opinion in clinical nutrition and metabolic care vol. 16,6 (2013): 619-24. doi:10.1097/MCO.0b013e328365b9be
Volek, Jeff S et al. “Whey protein supplementation during resistance training augments lean body mass.” Journal of the American College of Nutrition vol. 32,2 (2013): 122-35. doi:10.1080/07315724.2013.793580
Fatigue Ankylosing Spondylitis: Fatigue is a significant complaint for individuals dealing with ankylosing spondylitis. Ankylosing spondylitis is chronic inflammation of the spine’s joints that can cause them to become fused or locked up. The process can cause the spine to stiffen, limiting movement, reducing flexibility, and generating a severe hunched posture. Symptoms can include back pain, stiffness, and the inability to take a deep breath if the ribs are involved. Fatigue can have a variety of causes, but in ankylosing spondylitis, inflammation and cytokines play a significant role. The underlying cause of ankylosing spondylitis is still being researched, but it currently affects around 300,000 Americans.
Fatigue Ankylosing Spondylitis
Most individuals with ankylosing spondylitis experience pain in the lower back but can also feel pain in their hips and neck, have abdominal pain, or experience problems with vision. Inflammatory back pain is usually strongest in the morning but can also come from inactivity.
Spinal Condition and Extreme Exhaustion
The inability to move along with a decreased spinal range of motion impacts body functionality, sleep quality, and respiratory function affecting energy levels and leading to mild to severe fatigue. Studies have shown that 50% – 85% of individuals with ankylosing spondylitis experience fatigue.
Fatigue is brought on by inflammation, as the body generates the same chemicals when fighting a cold or flu; an individual’s body constantly works to reduce inflammation, leaving them drained and unable to perform ordinary tasks. Inflammatory diseases take a significant toll on the whole body, leading to an increased risk of depression and increased fatigue levels.
Exercise, Massage, and Diet
Many individuals find that their symptoms flare up after long periods of inactivity, like sleeping. This can make wanting to fall and stay asleep complicated, exacerbating fatigue and vice versa, creating a vicious cycle. Even though it can be challenging to move, gentle exercise is recommended. Exercise can help slow the disease progression, build muscle, and improve sleep. It is recommended to speak with a spine specialist, doctor, chiropractor, physical therapist, or exercise trainer about a customized exercise treatment program.
Many individuals with ankylosing spondylitis find therapeutic massage helpful in temporarily relieving pain, and stiffness, reducing stress and improving flexibility from increased blood circulation. A combination of gentle chiropractic massage, exercise, ergonomic adjustments, and rheumatology treatment is recommended for many cases. An anti-inflammatory diet comprised of foods like fatty fish, fruits, nuts, and leafy green vegetables can fight inflammation and decrease fatigue.
AS Causes, Symptoms, Diagnosis, Treatment, and Pathology
References
Cornelson, Stacey M et al. “Chiropractic Care in the Management of Inactive Ankylosing Spondylitis: A Case Series.” Journal of chiropractic medicine vol. 16,4 (2017): 300-307. doi:10.1016/j.jcm.2017.10.002
Li, Ting, et al. “Fatigue in Ankylosing Spondylitis Is Associated With Psychological Factors and Brain Gray Matter.” Frontiers in medicine vol. 6 271. 21 Nov. 2019, doi:10.3389/fmed.2019.00271
Zhang, Jun-Ming, and Jianxiong An. “Cytokines, inflammation, and pain.” International anesthesiology clinics vol. 45,2 (2007): 27-37. doi:10.1097/AIA.0b013e318034194e
The ribs are designed to protect the lungs and heart and assist breathing. Twenty-four ribs start at the shoulders in the thoracic spine region and run down the mid-back covering the front, back, and side of the chest. Almost all ribs are attached in two places, including the spine in the back and the sternum in the front of the chest, by cartilage joints. Trauma, poor posture, intense coughing, sneezing, and heaving are a few factors that can cause mechanical rib dysfunction or rib misalignment.
Rib dysfunction and misalignment are typically caused by unhealthy postures like slumped back and rounded shoulders, weakened posterior muscles, and repetitive stress from work, sports, and intense physical activity. Any ribs can become misaligned, causing dysfunction and stress on the body. A chiropractor can adjust and reset the rib as they do for misaligned and compressed spinal joints.
Rib Cage Design
The ribcage is flexible and expands when inhaling. Each rib is attached to the spine by three joints in the back and the breastbone in the front. Breathing is an involuntary reflex that is impossible to avoid movement in these joints. The joints are small but allow flexing, so the ribs rise and fall with each breath. These rib joints can become inflamed from rib misalignment causing movement problems that can restrict breathing.
Rib Misalignment
Rib misalignment symptoms can include:
Difficulty breathing.
Difficulty when trying to sit up.
Dull, achy, deep pain next to the spine or under the shoulder blade.
Unexplained back pain.
Pain when moving or walking.
Painful sneezing and/or coughing.
Tenderness and pain in the front of the chest.
The formation of a lump over the affected rib.
Swelling and/or bruising in the region.
Numbness in nearby or surrounding ribs.
Radiating pain from the back to the front and vice versa.
Improvement when pressure is applied to the affected rib.
Rib Dysfunction
Up to 50% of emergency room visits for chest pain symptoms result from non-cardiac factors, with the majority being rib misalignment and the muscles and joints around the rib cage becoming irritated/inflamed.
Causes
There can be several reasons for a misaligned rib. The more common causes include:
Unhealthy Postures
Unhealthy postures stress the body that can place pressure on the posterior portion of the ribcage.
With time, the ribs can start to shift out of alignment.
Physical Activity, Exercise, and Sports
Working out intensely can cause the ribs to shift out of position.
Weight lifting improperly can cause the body to shift along with the muscles involved not being strong enough to handle the added weight and movement, causing rib misalignment.
Pregnancy
As a woman’s body changes, the weight shifts to the front.
This can create a downward pull on the rib cage, increasing misalignment risk.
Intense Coughing or Sneezing
Excessive or severe coughing, associated with asthma, bronchitis, or pneumonia, can significantly strain the ribcage.
Coughing from a common cold can generate stress to cause a rib to dislocate.
Sneezing hard can also cause a rib to shift out of place.
Illnesses associated with constant coughing and sneezing can increase an individual’s susceptibility to rib misalignment because of the weakened state of the muscles.
Intense Vomiting
Vomiting intensely or heaving can cause the condition.
Vomiting does not necessarily involve the lungs, but the convulsive action can cause a rib shift/pop out.
Chiropractic Treatment
Chiropractic can diagnose and treat rib misalignment/dysfunction by using various stretching or massage techniques to loosen the area, making the muscles more flexible, then applying firm pressure to realign the rib back. The treatment plan will include specific stretches, postural exercises, diet, and other recommendations to prevent rib problems.
Spinal Decompression In 90 Seconds
References
Flodine TE, Thomas M. Osteopathic Manipulative Treatment: Inhaled Rib Dysfunction. [Updated 2021 Aug 15]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK560751/
Jawed, Muzamil. and Bruno Bordoni. “Osteopathic Manipulative Treatment: Muscle Energy Procedure – Exhaled Ribs.” StatPearls, StatPearls Publishing, 19 February 2022.
Muscle tension happens when the muscles stay contracted after working, sports, exercise, and stress, presenting with stiffness and achiness that progresses to chronic myofascial pain. Myofascial is used to describe the connective tissues throughout the body. Myo refers to the muscles, and fascia refers to the body tissues. Myofascial pain syndrome describes muscle pain in various forms. Most individuals have experienced chronic muscle tension in muscle pain or tension headaches. Myofascial pain can vary, ranging from mild to severe. Chiropractic can provide treatment and post-prevention plans to eliminate the pain and strengthen the body.
Connective Tissue
Myofascial pain syndrome is a complex condition that could be repetitive stress injuries on the muscles or nervous system malfunction and is often characterized by symptoms like:
Each symptom is not a sign of the condition, but it could be myofascial pain syndrome when combined and does not resolve with some time. This chronic pain disorder is associated with referred pain that appears in one part of the body but the root cause in another region.
Chiropractic Care
Chiropractic medicine will get to the root of the problem with a thorough diagnosis. This will be done through physical examination, medical history, and symptom review. The chiropractor will perform a detailed exam of the affected muscles, including a range of motion test, strength test, and palpations of suspected trigger points to see how the muscles respond, twitch, and/or cause pain in a specific pattern or region. Sometimes blood tests are ordered to look for other causes, like vitamin D deficiency or hypothyroidism. Chiropractic can combine treatment therapies that include:
Massage therapy
Therapeutic massage will loosen the tight, knotted muscles and relieve cramping and/or spasms.
Physical Therapy
Includes stretching, postural, and strengthening exercises.
Pain medications are directly injected into the trigger points.
Chiropractic physicians work on the whole body and not just the hurting areas. Chiropractors are trained to incorporate treatment with primary care and specialists. Patients receive education in exercise programs, corrective exercises, nutritional recommendations, and health coaching.
Spine Decompression
References
American Chronic Pain Association. Resource Guide to Chronic Pain Management. (https://www.theacpa.org/wp-content/uploads/2018/05/ACPA_Resource_Guide_2018-Final_Feb.pdf) Accessed 4/17/2019.
Lavelle, Elizabeth Demers, et al. “Myofascial trigger points.” Anesthesiology clinics vol. 25,4 (2007): 841-51, vii-iii. doi:10.1016/j.anclin.2007.07.003
Stults-Kolehmainen, Matthew A et al. “Chronic psychological stress impairs recovery of muscular function and somatic sensations over a 96-hour period.” Journal of strength and conditioning research vol. 28,7 (2014): 2007-17. doi:10.1519/JSC.0000000000000335
Tantanatip A, Chang KV. Myofascial Pain Syndrome. [Updated 2021 Aug 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK499882/
Vernon, Howard, and Michael Schneider. “Chiropractic management of myofascial trigger points and myofascial pain syndrome: a systematic review of the literature.” Journal of manipulative and physiological therapeutics vol. 32,1 (2009): 14-24. doi:10.1016/j.jmpt.2008.06.012
Cervical spinal stenosis is a condition that causes narrowing of the neck region of the spine. This narrowing can compress the nerves causing pain and discomfort. The symptoms are caused by the misalignment/subluxation of the neck, which is usually the c1 and c2 vertebrae. Misalignments can be caused by daily wear and tear; injuries and tumors can cause or worsen the condition. Cervical spinal stenosis is a severe condition that worsens as time progresses and can cause permanent damage and paralysis. Chiropractor recommendations and non-invasive techniques can alleviate the symptoms, along with therapeutic stretches and exercises, and diet is all part of a personalized treatment plan.
Stenosis Symptoms
The most common symptom is neck pain. Doctors recommend avoiding all activities that worsen the pain; however, chiropractors suggest remaining as active as possible to keep the muscles strong. This is because inactivity over time can lead to muscular deterioration around the neck. Other symptoms besides neck pain include:
Neck discomfort and pain
Headaches
Numbness, tingling in the shoulder, arm, hand
Difficulty maintaining balance
Walking problems
Chiropractor Recommendations
Pain Or Stiffness In The Neck Should Not Be Ignored
Pain or stiffness in the neck that worsens rapidly or does not ease up or go away after two weeks requires medical attention.
Ignoring or dismissing the pain or stiffness can worsen the condition.
Looking Down At A Phone Too Long
Looking down too long increases the strain on the neck.
Keeping the head forward for extended periods increases the chances of pinching/compressing nerves and causing radiculopathy.
Exercises That Roll The Neck Around
Exercises that roll or pull the neck are not advised as they can exacerbate the condition.
A chiropractor will recommend specific neck stretches and exercises on a case-by-case basis.
Heavy Bag, Purse, BackPack On One Shoulder
It is recommended to carry a backpack with both shoulders to distribute the weight evenly.
Over time, a backpack, bag, or purse on the same shoulder will disrupt the walk cycle and pull down on one side of the neck, exacerbating cervical spinal stenosis.
For bags and purses with one strap, it is recommended to alternate shoulders or use a crossbody strap.
Sleeping On The Stomach
Sleeping on the stomach means having to turn the neck to one side.
This stresses and aggravates cervical stenosis.
It is recommended to sleep on the side or back.
Treatment, Therapy, and Rehabilitation
Chiropractic is recommended for spinal stenosis because it corrects and re-aligns dislocated and herniated discs and decompresses the spine.
Treatment reduces pressure on the spinal cord and its joints and nerve networks.
Various techniques include physiotherapeutic massage, spinal adjustments, cervical traction, spinal decompression, and flexion-distraction, which will address stenosis symptoms, treat pain, reduce inflammation, numbness, and restore muscle function.
Non-Surgical Cervical Decompression
References
Clark, Aaron J et al. “Cervical spinal stenosis and sports-related cervical cord neurapraxia.” Neurosurgical focus vol. 31,5 (2011): E7. doi:10.3171/2011.7.FOCUS11173
Kukurin, George W. “The amelioration of symptoms in cervical spinal stenosis with spinal cord deformation through specific chiropractic manipulation: a case report with long-term follow-up.” Journal of manipulative and physiological therapeutics vol. 27,5 (2004): e7. doi:10.1016/j.jmpt.2004.04.009
Isaac Z. Evaluation of the patient with neck pain and cervical spine disorders. UpToDate. https://www.uptodate.com/contents/evaluation-of-the-patient-with-neck-pain-and-cervical-spine-disorders. Last updated May 2, 2016. Accessed February 25, 2018.
IFM's Find A Practitioner tool is the largest referral network in Functional Medicine, created to help patients locate Functional Medicine practitioners anywhere in the world. IFM Certified Practitioners are listed first in the search results, given their extensive education in Functional Medicine
