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Treating Neck Pain with Acupuncture: A Guide

Treating Neck Pain with Acupuncture: A Guide

Can individuals dealing with neck pain incorporate acupuncture as part of their health and wellness treatment to relieve headaches?

Introduction

As part of the musculoskeletal system, the neck allows the head to go into full rotation without feeling discomfort or pain. The neck is part of the cervical spine region and is surrounded by numerous ligaments, muscles, and tissues that help protect the spinal cord and the spinal column. However, the neck is also the most susceptible to injury neck to back pain as it is one the top three complaints many individuals suffer from at some point in their lives. When people experience neck pain, numerous causes can contribute to developing neck pain, while pain-like symptoms like headaches contribute to the body. This causes many individuals to seek treatment and find the relief they are looking for to reduce neck pain while continuing their daily routine. Today’s article looks at how neck pain is associated with headaches and how treatments like acupuncture can help with neck pain and reduce the painful effects of headaches. We talk with certified medical providers who utilize our patients’ information to provide acupuncture treatments to lessen the impact of headaches caused by neck pain. We also inform patients how multiple non-surgical treatments can help reduce headaches and pain-like symptoms associated with neck pain. We encourage our patients to ask their associated medical providers intricated and important questions about the pain-like symptoms they are experiencing from neck pain. Dr. Jimenez, D.C., incorporates this information as an academic service. Disclaimer.

 

Neck Pain & Headaches

Have you been experiencing unexplained stiffness along the sides of your neck? Do you feel a dull ache at the base of your neck or skull after looking down at your phone for an extended period? Or do you experience frequent headaches that are constant throughout the day? Many people dealing with these pain-like issues are associated with neck pain that is affecting their quality of life. Neck pain is amongst the top three complaints many people have experienced at some point. Neck pain has common presenting symptoms that are diagnosed, and the prevalence is much higher in older adults due to degenerative spinal changes in the facet joints and spinal discs. (Childress & Stuek, 2020) Many individuals experience common musculoskeletal pain conditions like muscle strains and stiffness when this happens. At the same time, neck pain can also be associated with neurological conditions that cause overlapping risk profiles, forcing many individuals to miss out on important events. Neck pain is a multifactorial musculoskeletal condition affecting many individuals as it induces them to miss work. This is because various modifiable and non-modifiable risk factors contribute to developing neck pain. (Kazeminasab et al., 2022) These risk factors can range from physical inactivity to poor posture, causing overlapping risk profiles that can trigger neck pain to advance over time. 

 

 

So, how are headaches associated with neck pain? When a person is experiencing a headache, many would often think that the headaches are caused by not eating enough food or drinking enough water. Those are some of the factors that contribute to headaches, but they can also be due to the stress and comorbidities that are associated with neck pain. This is due to the risk factors many individuals don’t realize contribute to neck pain. Factors like the forward head position from smartphone usage cause tension on the cervical structures, generating potential degeneration and tearing of the neck structures. (Maayah et al., 2023) As repetitive motions affect the neck structure more over time, the nerve roots that surround the spine and spread through the upper extremities can become aggravated, and cause referred pain to different areas of the body, leading to headaches. When dealing with headaches associated with neck pain, they will feel stress, affecting their productivity. The headaches can range from acute to chronic, depending on the severity. Fortunately, many individuals dealing with headaches associated with neck pain will seek treatment to reduce the pain-like symptoms and feel the relief to return to their daily routine.


Healing After Trauma- Video

Many individuals who are dealing with neck pain often deal with headaches as a sign that risk factors are in play, like poor posture, slouching, or traumatic injuries that can affect their ability to work or participate in activities. This can cause many people to feel miserable and decrease their quality of life, thus causing them to seek out treatment for their pain, hence why many individuals opt for non-surgical treatments due to them being affordable and personalized. Non-surgical treatments range from chiropractic care to acupuncture, depending on the severity and location of where the pain is in the body. The video above shows how non-surgical treatments can help many individuals positively influence healing after a traumatic injury and restore a person’s well-being.


Acupuncture For Neck Pain

Non-surgical treatments are excellent for individuals trying to find the relief they seek in their neck pain. As stated earlier, non-surgical treatments are cost-effective and tailored to the person’s pain. Acupuncture is a form of non-surgical treatment that can help reduce the comorbidities associated with neck pain. Acupuncture is a medical practice in which highly trained, licensed, and certified professionals use solid, super-thin needles to be placed at specific points to treat the body. What this does is that when the needles are penetrating the points, it will begin to open any blockage or excess energy to flow correctly, restore balance to the body, and relieve the individual’s symptoms. (Berger et al., 2021) Some of the beneficial results that acupuncture can provide individuals with neck pain is a reduction of pain and disability to the neck while treating referred pain that is causing overlapping risk profiles to induce headaches. (Peron et al., 2022

 

Acupuncture Relieving Headaches

Since headaches are associated with neck pain, acupuncture can help relieve the headaches from progressing further and enable many individuals to get back to their routine. Some overlapping risk profiles contributing to headaches include trigger points on the neck muscles that can cause non-dermatomal referral pain and discomfort. (Pourahmadi et al., 2019) When an acupuncturist is treating individuals for their headaches, many individuals will begin to feel the relief after a few consecutive sessions, and, combined with physical therapy to strengthen neck and shoulder muscles, will notice that the pain has been reduced significantly. Acupuncture is a safe, helpful, and available alternative treatment that is beneficial for many individuals dealing with headaches associated with neck pain. (Urits et al., 2020) By incorporating acupuncture as part of a person’s treatment plan, they can begin to feel the relief they deserve while also being more mindful of how they are treating their bodies to prevent pain-like symptoms from returning.


References

Berger, A. A., Liu, Y., Mosel, L., Champagne, K. A., Ruoff, M. T., Cornett, E. M., Kaye, A. D., Imani, F., Shakeri, A., Varrassi, G., Viswanath, O., & Urits, I. (2021). Efficacy of Dry Needling and Acupuncture in the Treatment of Neck Pain. Anesth Pain Med, 11(2), e113627. doi.org/10.5812/aapm.113627

Childress, M. A., & Stuek, S. J. (2020). Neck Pain: Initial Evaluation and Management. American Family Physician, 102(3), 150-156. www.ncbi.nlm.nih.gov/pubmed/32735440

www.aafp.org/pubs/afp/issues/2020/0801/p150.pdf

Kazeminasab, S., Nejadghaderi, S. A., Amiri, P., Pourfathi, H., Araj-Khodaei, M., Sullman, M. J. M., Kolahi, A. A., & Safiri, S. (2022). Neck pain: global epidemiology, trends and risk factors. BMC Musculoskelet Disord, 23(1), 26. doi.org/10.1186/s12891-021-04957-4

Maayah, M. F., Nawasreh, Z. H., Gaowgzeh, R. A. M., Neamatallah, Z., Alfawaz, S. S., & Alabasi, U. M. (2023). Neck pain associated with smartphone usage among university students. PLOS ONE, 18(6), e0285451. doi.org/10.1371/journal.pone.0285451

Peron, R., Rampazo, E. P., & Liebano, R. E. (2022). Traditional acupuncture and laser acupuncture in chronic nonspecific neck pain: study protocol for a randomized controlled trial. Trials, 23(1), 408. doi.org/10.1186/s13063-022-06349-y

Pourahmadi, M., Mohseni-Bandpei, M. A., Keshtkar, A., Koes, B. W., Fernandez-de-Las-Penas, C., Dommerholt, J., & Bahramian, M. (2019). Effectiveness of dry needling for improving pain and disability in adults with tension-type, cervicogenic, or migraine headaches: protocol for a systematic review. Chiropr Man Therap, 27, 43. doi.org/10.1186/s12998-019-0266-7

Urits, I., Patel, M., Putz, M. E., Monteferrante, N. R., Nguyen, D., An, D., Cornett, E. M., Hasoon, J., Kaye, A. D., & Viswanath, O. (2020). Acupuncture and Its Role in the Treatment of Migraine Headaches. Neurol Ther, 9(2), 375-394. doi.org/10.1007/s40120-020-00216-1

Disclaimer

The Splenius Capitis: How it Works and How to Maintain it

The Splenius Capitis: How it Works and How to Maintain it

For individuals dealing with neck or arm pain and migraine headache symptoms it could be a splenius capitis muscle injury. Can knowing the causes and symptoms help healthcare providers develop an effective treatment plan?

The Splenius Capitis: How it Works and How to Maintain it

Splenius Capitis Muscles

The splenius capitis is a deep muscle located on the upper back. Along with the splenius cervicis, it comprises the superficial layer – one of the three – of intrinsic back muscles. The splenius capitis works with the splenius cervicis, a smaller muscle located below it, to help rotate the neck and lower the chin to the chest, known as flexing. Maintaining a healthy posture is important because it helps keep the head in a neutral position.

  • Starting at the midline of the spine at C3 to T3, the splenius capitis spans the levels between the 7th cervical vertebra to the 3rd or 4th thoracic vertebrae, which varies for different individuals.
  • The muscle inserts at the nuchal ligament, which is a strong ligament of the neck.
  • The splenius capitis muscle angles up and out, attaching to the skull.
  • The splenius capitis and cervicis cover the vertical paraspinals, which are deeper and comprise the intermediate layer of the intrinsic back muscles.
  • The splenius muscles look like a bandage for the paraspinals and the vertical muscles that comprise the deepest layer.
  • The splenius muscles hold these deeper layers in the correct position.
  • These muscles start at the center of the spine and together form a V shape.
  • The sides of the V are thick, and the central indentation is shallow.

Pain

It’s common for individuals to experience pain associated with injury to the splenius capitis. This type of pain is known as splenius capitis syndrome. (Ernest E, Ernest M. 2011)

Symptoms

A headache stemming from injury often mimics a migraine headache. Symptoms of splenius capitis syndrome include: (Ernest E, Ernest M. 2011)

  • Neck pain
  • Arm pain
  • Pain at the back of the head
  • Headache at the temples
  • Pressure behind the eye
  • Pain behind, above, or under the eye
  • Sensitivity to light

Causes

Injury to the splenius capitis can result from: (Ernest E, Ernest M. 2011)

  • Unhealthy posture for prolonged periods
  • Constantly flexing or rotating the neck
  • Sleeping in awkward positions
  • Falling injuries
  • Automobile collision
  • Sports injuries

Treatment

It’s recommended to contact a healthcare provider if experiencing symptoms that interfere with daily activities or quality of life. A healthcare provider will:

  • Review the individual’s medical history
  • Ask questions about the injury
  • Perform a physical exam (Ernest E, Ernest M. 2011)

Treatment protocols and approaches to relieve symptoms and restore function can involve one or a combination of treatments that include:

  • Ice and heat applications
  • Physical therapy
  • Therapeutic massage
  • Chiropractic realignment
  • Non-surgical decompression
  • Acupuncture
  • Neck stretches
  • Pain medication (short-term)
  • Injections
  • Minimally invasive surgery

Neck Injuries


References

Ernest E, Ernest M. Practical Pain Management. (2011). Splenius Capitis Muscle Syndrome.

Understanding Healthy Spinal Rotation

Understanding Healthy Spinal Rotation

For individuals trying to maintain a healthy spine, can understanding the causes and prevention of rotated vertebrae help protect the spine from harmful rotation of vertebrae?

Understanding Healthy Spinal Rotation

Spinal Rotation

Healthy spine rotation is an important aspect of injury prevention, and rotated vertebrae or a twisted spine can result from spine, nerve, or muscle disease or certain movements.

Normal Spine Twisting Capability

The spine can move in several ways. Spine movements include:

  • Bending  – Rounding forward
  • Extending – Arching backward
  • Tilting sideways is powered by muscles that aid in twisting.

Although the spine can move in many directions, there are limits to how far it can and should go. (Xinhai Shan et al., 2013). This is especially true with twisting. The spinal column is made of 26 interconnected bones called vertebrae. When moving, each vertebrae bone moves accordingly. Rotated or twisted vertebrae, especially when bending forward like lifting heavy objects, are associated with a risk of back injuries like strain and herniated discs.

How Rotation Works

Rotation is a basic movement in which individuals can turn their spinal column. When twisting, the spine also bends to the side. The muscles involved in spine rotation include:

  • The internal oblique abdominals and the external oblique abdominals don’t directly attach to the spine but are the primary muscles responsible for powering spinal rotation in the lower back.
  • Intrinsic muscles, including the multifidus and longissimus, contribute to twisting movement as well.
  • The multifidus helps the spine twist when one side is contracted/activated and extends the lumbar spine when both sides contract.
  • The multifidus helps control the movement, and the longissimus provides the movement with some extension.

Age and The Spine

As individuals age, the body accumulates tension and/or weakness in the oblique abdominal and other trunk muscles. Sedentary habits primarily bring on these changes. (Pooriput Waongenngarm et al., 2016)

  • Chronically tight back and abdominal muscles impair the range of motion of the trunk, as well as twisting ability.
  • Muscle weakness and tightness affect spinal movements.
  • Weakened muscles can decrease support for spinal movement and decrease overall trunk stability.

Spinal Rotation and Scoliosis

Scoliosis is a common condition that causes a lateral curve of the spine. Some of the vertebrae become displaced to the side. Often, abnormal vertebral rotation underlies this displacement. Treatment often focuses on controlling vertebral rotation with medical guidance and physical therapy. (John P. Horne et al., 2014)

Over-Rotating The Spine

Many individuals over-rotate their spines with manual work, which can increase the risk of back injuries. (National Institutes of Health. 2020). Over-rotation can happen with activities like digging or shoveling.

Exercise For A Healthy Spine

A recommended way to achieve optimal rotation of the spine is with daily back exercises. (National Spine Health Foundation. 2015). An effective back exercise program will consist of movements in every direction.

  • Yoga is recommended because it places emphasis on developing flexibility and strength in all directions.
  • Pilates does the same.
  • An injury prevention exercise program will work the hip and pelvic muscles as well.
  • Individuals with a spine condition should consult their healthcare provider or physical therapist about how to exercise the spine safely, as rotation exercises could worsen back problems like bulging or herniated discs.

Core Strength For A Pain-Free Back


References

Shan, X., Ning, X., Chen, Z., Ding, M., Shi, W., & Yang, S. (2013). Low back pain development response to sustained trunk axial twisting. 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, 22(9), 1972–1978. doi.org/10.1007/s00586-013-2784-7

Waongenngarm, P., Rajaratnam, B. S., & Janwantanakul, P. (2016). Internal Oblique and Transversus Abdominis Muscle Fatigue Induced by Slumped Sitting Posture after 1 Hour of Sitting in Office Workers. Safety and health at work, 7(1), 49–54. doi.org/10.1016/j.shaw.2015.08.001

Horne, J. P., Flannery, R., & Usman, S. (2014). Adolescent idiopathic scoliosis: diagnosis and management. American family physician, 89(3), 193–198.

National Institutes of Health. (2020). Low Back Pain Fact Sheet.

National Spine Health Foundation. (2015). Breaking Down The Exercises That Break Down Your Spine.

Gain Flexibility, Improve Posture: The Sit and Reach Test

Gain Flexibility, Improve Posture: The Sit and Reach Test

For individuals experiencing tightness in the lower back and hamstrings, can utilizing the sit and reach test help determine an individual’s risk for future pain and injury?

Gain Flexibility, Improve Posture: The Sit and Reach Test

Sit and Reach Test

Lower back and hamstring tightness and pain symptoms are usually brought on by muscle stiffness. The sit-and-reach test is one of the most common ways to measure lower back and hamstring flexibility. Exercise physiologists, physical therapists, chiropractors, and fitness trainers use the sit-and-reach test to measure lower back and hamstring flexibility to assess baseline flexibility. The test has been around since 1952 (Katharine F. Wells & Evelyn K. Dillon 2013) and has an extensive database of results across all age groups and genders.

  • Individuals can use the sit-and-reach test to compare flexibility to the average result for individuals of the same gender and age.
  • For healthcare providers, the test may be repeated after several weeks to determine flexibility progress.

Measurement

The test can be a valuable measurement of functional flexibility to sit with the legs straight in front and reach the toes. Jobs, sports, and everyday tasks regularly require bending over, reaching, and lifting objects. These are real-life examples of how having a healthy back and hamstring flexibility is vital in preventing pain symptoms and injuries. New flexibility assessments are currently being developed, and many trainers and therapists use their own versions with patients and clients. But even with more advanced specialized flexibility tests, the sit and reach test can be a functional testing tool for tracking general flexibility changes over time. (Daniel Mayorga-Vega et al., 2014)

Performing The Test

A special sit-and-reach testing box is used; however, individuals can make their own testing box by finding a heavy-duty box around 30cm or 11.811 inches tall. Set a measurement ruler/stick on top of the box so that 26 cm or 10.2362 inches of the ruler extends over the front edge toward the individual being tested. The 26cm mark should be at the edge of the box.

  1. Get into position – Remove shoes and sit on the floor with legs stretched out in front with the knees straight and feet flat against the front end of the test box.
  2. Start the movement – In a slow, steady motion, lean forward, keeping the knees straight, and slide the hands up the ruler as far as possible.
  3. Stretch and repeat – Extend as far as possible, record the results, rest, and repeat three times.
  4. Calculate the results – Average the results.

Results

Results compare flexibility over time to norms, or averages, for gender and age. Adequate flexibility is reaching the toes – the 26-cm mark on the ruler while keeping the legs straight.

Adult Women

  • 37cm or 14.5669 inches or above: Excellent
  • 33 to 36cm or 12.9921 inches: Above average
  • 29 to 32cm or 11.4173 inches:  Average
  • 23 to 28cm or 9.05512 inches: Below average
  • Below 23cm or 8.66142 inches: Poor

Adult Men

  • 34cm or 13.3858 inches or above: Excellent
  • 28 to 33cm or 11.0236 inches:  Above average
  • 23 to 27cm or 9.05512 inches:  Average
  • 16 to 22cm or 6.29921 inches: Below average
  • Below 16cm or 5.90551 inches: Poor

Alternatives

Individuals can test their own hamstring and lower back flexibility with some easy at-home tests. Use these methods while working on flexibility, and keep a record to see improvements. (Brittany L. Hansberger et al., 2019) One alternative is the V-sit reach test.

  • To perform this, make a line on the floor with tape, then place a measuring tape perpendicular to the tape, making a cross.
  • Sit with the feet in a V shape, touching the tape, feet about a foot apart, with the measuring tape between the legs; the 0 end starts where the legs part.
  • Overlap hands with arms outstretched in front.
  • Repeat three times, leaning forward and reaching with hands out.
  • Then, repeat and take note of how far the hands could reach.

Another alternative is the fingertip-to-floor-distance test.

  • Individuals will need someone to measure the distance between their fingertips and the floor.
  • Warm up with a few practice stretches of standing and bending toward the floor.
  • Then, measure how far from the floor the fingertips are.
  • The ability to touch the floor is a good sign.

Improving Flexibility

Individuals with less than adequate flexibility are recommended to work on stretching the major muscle groups in both the upper and lower body on a regular basis to improve and maintain body flexibility.

  • Individuals can incorporate dynamic stretching, which consists of active movements utilizing a full range of motion as part of warming up for workouts, sports, or other activities.
  • Static stretching is recommended when cooling down after the muscles are warmed up and joints are lubricated.
  • The American College of Sports Medicine recommends 2 to 3 sessions a week of flexibility training and learning to stretch daily.
  • Stretches should be held for 15 to 30 seconds, then released and repeated 2 to 4 times. (Phil Page 2012)

This will take time and dedication, but with the help of trained specialists, regaining flexibility and full range of motion can be accomplished.


Benefits of Stretching


References

Katharine F. Wells & Evelyn K. Dillon (1952) The Sit and Reach—A Test of Back and Leg Flexibility, Research Quarterly. American Association for Health, Physical Education and Recreation, 23:1, 115-118, DOI: 10.1080/10671188.1952.10761965

Mayorga-Vega, D., Merino-Marban, R., & Viciana, J. (2014). Criterion-Related Validity of Sit-and-Reach Tests for Estimating Hamstring and Lumbar Extensibility: a Meta-Analysis. Journal of sports science & medicine, 13(1), 1–14.

Hansberger, B. L., Loutsch, R., Hancock, C., Bonser, R., Zeigel, A., & Baker, R. T. (2019). EVALUATING THE RELATIONSHIP BETWEEN CLINICAL ASSESSMENTS OF APPARENT HAMSTRING TIGHTNESS: A CORRELATIONAL ANALYSIS. International journal of sports physical therapy, 14(2), 253–263.

Page P. (2012). Current concepts in muscle stretching for exercise and rehabilitation. International journal of sports physical therapy, 7(1), 109–119.

A Comprehensive Look at the Thoracodorsal Nerve

A Comprehensive Look at the Thoracodorsal Nerve

Individuals experiencing pain symptoms like shooting, stabbing, or electrical sensations to the latissimus dorsi of the upper back could be caused by a nerve injury to the thoracodorsal nerve. Can knowing the anatomy and symptoms help healthcare providers develop an effective treatment plan?

A Comprehensive Look at the Thoracodorsal Nerve

Thoracodorsal Nerve

Also known as the middle subscapular nerve or the long subscapular nerve, it branches out from a part of the brachial plexus and provides motor innervation/function to the latissimus dorsi muscle.

Anatomy

The brachial plexus is a network of nerves that stem from the spinal cord in the neck. The nerves supply most of the sensation and movement of the arms and hands, with one on each side. Its five roots come from the spaces between the fifth through eighth cervical vertebrae and the first thoracic vertebra. From there, they form a larger structure, then divide, re-combine, and divide again to form smaller nerves and nerve structures as they travel down the armpit. Through the neck and chest, the nerves eventually join and form three cords that include:

  • Lateral cord
  • Medial cord
  • Posterior cord

The posterior cord produces major and minor branches that include:

  • Axillary nerve
  • Radial nerve

The minor branches include:

  • Superior subscapular nerve
  • Inferior subscapular nerve
  • Thoracodorsal nerve

Structure and Position

  • The thoracodorsal nerve branches off the posterior cord in the armpit and travels down, following the subscapular artery, to the latissimus dorsi muscle.
  • It connects to the upper arm, stretches across the back of the armpit, forming the axillary arch, and then expands into a large triangle that wraps around the ribs and the back.
  • The thoracodorsal nerve lies deep in the latissimus dorsi, and the lower edge typically reaches close to the waist.

Variations

  • There is a standard location and course of the thoracodorsal nerve, but individual nerves are not the same in everyone.
  • The nerve typically branches off the posterior cord of the brachial plexus from three different points.
  •  However, different subtypes have been identified.
  • The thoracodorsal nerve supplies the teres major muscle in about 13% of individuals. (Brianna Chu, Bruno Bordoni. 2023)
  • The lats can have a rare anatomical variation known as a Langer’s arch, which is an extra part that connects to muscles or connective tissue of the upper arm beneath the common connecting point.
  • In individuals with this abnormality, the thoracodorsal nerve supplies function/innervation) to the arch. (Ahmed M. Al Maksoud et al., 2015)

Function

The latissimus dorsi muscle cannot function without the thoracodorsal nerve. The muscle and nerve help:

  • Stabilize the back.
  • Pull the body weight up when climbing, swimming, or doing pull-ups.
  • Assist with breathing by expanding the rib cage during inhalation and contracting when exhaling. (Encyclopaedia Britannica. 2023)
  • Rotate the arm inward.
  • Pull the arm toward the center of the body.
  • Extend the shoulders by working with the teres major, teres minor, and posterior deltoid muscles.
  • Bring down the shoulder girdle by arching the spine.
  • To bend to the side by arching the spine.
  • Tilt the pelvis forward.

Conditions

The thoracodorsal nerve can be injured anywhere along its path by trauma or disease. Symptoms of nerve damage can include: (U.S. National Library of Medicine: MedlinePlus. 2022)

  • Pain that can be shooting, stabbing, or electrical sensations.
  • Numbness, tingling.
  • Weakness and loss of function in the associated muscles and body parts, including wrist and finger drop.
  • Because of the nerve’s path through the armpit, doctors have to be cautious of the anatomical variants so they don’t inadvertently damage a nerve during breast cancer procedures, including axillary dissection.
  • The procedure is performed to examine or remove lymph nodes and is used in staging breast cancer and in treatment.
  • According to a study, 11% of individuals with axillary lymph node dissection suffered damage to the nerve. (Roser Belmonte et al., 2015)

Breast Reconstruction

  • In breast reconstruction surgery, the lats can be used as a flap over the implant.
  • Depending on the circumstances, the thoracodorsal nerve can be left intact or severed.
  • The medical community has not agreed on which method has the best outcomes. (Sung-Tack Kwon et al., 2011)
  • There is some evidence that leaving the nerve intact can cause the muscle to contract and dislocate the implant.
  • An intact thoracodorsal nerve may also cause atrophy of the muscle, which can lead to shoulder and arm weakness.

Graft Uses

A portion of the thoracodorsal nerve is commonly used in nerve graft reconstruction to restore function after injury, which includes the following:

  • Musculocutaneous nerve
  • Accessory nerve
  • Axillary nerve
  • The nerve can also be used to restore nerve function to the triceps muscle in the arm.

Rehabilitation

If the thoracodorsal nerve is injured or damaged, treatments can include:

  • Braces or splints.
  • Physical therapy to improve range of motion, flexibility, and muscle strength.
  • If there is compression, surgery may be required to alleviate the pressure.

Exploring Integrative Medicine


References

Chu B, Bordoni B. Anatomy, Thorax, Thoracodorsal Nerves. [Updated 2023 Jul 24]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK539761/

Al Maksoud, A. M., Barsoum, A. K., & Moneer, M. M. (2015). Langer’s arch: a rare anomaly affects axillary lymphadenectomy. Journal of surgical case reports, 2015(12), rjv159. doi.org/10.1093/jscr/rjv159

Britannica, The Editors of Encyclopaedia. “latissimus dorsi“. Encyclopedia Britannica, 30 Nov. 2023, www.britannica.com/science/latissimus-dorsi. Accessed 2 January 2024.

U.S. National Library of Medicine: MedlinePlus. Peripheral neuropathy.

Belmonte, R., Monleon, S., Bofill, N., Alvarado, M. L., Espadaler, J., & Royo, I. (2015). Long thoracic nerve injury in breast cancer patients treated with axillary lymph node dissection. Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 23(1), 169–175. doi.org/10.1007/s00520-014-2338-5

Kwon, S. T., Chang, H., & Oh, M. (2011). Anatomic basis of interfascicular nerve splitting of innervated partial latissimus dorsi muscle flap. Journal of plastic, reconstructive & aesthetic surgery : JPRAS, 64(5), e109–e114. doi.org/10.1016/j.bjps.2010.12.008

What You Need to Know About Gluteus Minimus Muscles

What You Need to Know About Gluteus Minimus Muscles

For individuals experiencing gluteus minimus pain and are unsure where to start to deal with it, can a physical therapist, chiropractor, or general practitioner help diagnose lower extremity pain and develop an appropriate treatment plan?

 

What You Need to Know About Gluteus Minimus Muscles

Gluteus Minimus Muscles

The gluteus minimus is the smallest muscle of the gluteal muscles. Combined with the gluteus maximus and gluteus medius, these muscles make up the glutes. The glutes help form the buttocks shape, stabilize the hips, rotate the legs, and raise the thighs. The gluteus minimus and medius specifically support the gluteus maximus’s ability to raise the leg to the side and rotate the thigh inwards. (ScienceDirect. 2011)

Anatomy

  • The gluteus minimus muscles are triangular and lie underneath the gluteus medius near the rotators of the hip joints. The muscles start in the lower ilium region, the upper and largest area of the hip bone that makes up the pelvis and attaches to the femur/thigh bone.
  • The fibers on the top part of the muscle are thick and compact, while the lower fibers are flat and spread out.
  • The superior gluteal nerves and blood vessels separate the gluteus minimus and the medius.
  • The gluteus medius muscles start on the upper ilium region, which covers the gluteus minimus muscle entirely. The location of the gluteus minimus muscles envelopes the sciatic notch or the area in the pelvis that houses the piriformis muscle, superior gluteal vein, and superior gluteal artery, which provide a certain amount of protection.

Function

Movement depends on the location of the femur. The gluteus minimus muscle’s function is to:

  1. Flex
  2. Rotate
  3. Stabilize
  • When the thigh is extended, it helps abduct or swing the leg out away from the body.
  • When the hip bones are flexed, the gluteus minimus rotates the thigh inward with the help of the gluteus medius.
  • The movements are done with the support of the muscle fibers, which contract to move the thigh in both directions. (ScienceDirect. 2011)
  • The gluteus minimus and the medius also stabilize the hips and pelvis during movement and when resting.

Associated Conditions

One of the most common injuries is muscle wearing and tearing, which can cause pain over and around the greater trochanter. This is known as greater trochanteric pain syndrome or GTPS, a condition usually caused by a gluteus medius or minimus tendinopathy, which can include inflammation of the surrounding bursae. (Diane Reid. 2016) For a gluteus minimus tear, the pain/sensations will be felt outside the hip, especially when rolling or applying weight on the affected side. A tear can happen suddenly with no particular activity causing the tear to occur aside from normal use and stress on the muscle. Physical activities like walking may be painful.

Rehabilitation

Treatment depends on the severity of the condition. Usually, rest, ice, and over-the-counter medication can help reduce swelling and pain symptoms. For pain symptoms that are not subsiding, it’s recommended to see a healthcare provider who can run an MRI or X-ray to see the condition of the muscle and rule out other causes of pain. The healthcare provider will refer the patient to a physical therapy team that can evaluate the strength of the gluteus minimus and provide a list of exercises and stretches to help repair the muscle while conditioning the surrounding muscles. (SportsRec. 2017) Depending on the level of pain, sometimes the healthcare provider will prescribe a cortisone injection to the gluteus minimus muscle in conjunction with physical therapy. This will help alleviate the pain so that the physical therapy exercises can be done comfortably, allowing the gluteus maximus muscle to heal properly and strengthen. (Julie M. Labrosse et al., 2010)


The Science of Motion Chiropractic Care


References

ScienceDirect. (2011). Gluteus minimus muscle.

Reid D. (2016). The management of greater trochanteric pain syndrome: A systematic literature review. Journal of orthopaedics, 13(1), 15–28. doi.org/10.1016/j.jor.2015.12.006

SportsRec. (2017). Physical therapy exercises for the gluteus minimus.

Labrosse, J. M., Cardinal, E., Leduc, B. E., Duranceau, J., Rémillard, J., Bureau, N. J., Belblidia, A., & Brassard, P. (2010). Effectiveness of ultrasound-guided corticosteroid injection for the treatment of gluteus medius tendinopathy. AJR. American journal of roentgenology, 194(1), 202–206. doi.org/10.2214/AJR.08.1215

Nutritional Mistakes to Avoid for Muscle Building

Nutritional Mistakes to Avoid for Muscle Building

For individuals trying to build muscle but are not seeing results, can knowing factors like what foods to eat, how to work out, and genetics help achieve meaningful muscle gains?

Nutritional Mistakes to Avoid for Muscle Building

Muscle Growth Nutritional Mistakes

Muscle growth is an important element of overall fitness and health. Individuals can make nutritional mistakes like not eating enough protein or carbohydrates and not properly hydrating themselves which can prevent them from gaining muscle. Factors that contribute to muscle building, include:

  • Nutrition
  • Genetics
  • Training

Individuals who want to increase muscle mass more efficiently can rework these issues to maintain consistency and commitment to exercise and nutrition. Benefits include:

  • Building muscle helps strengthen bones
  • Improves balance
  • Decreases the risk of cardiovascular disease and diabetes.

Building muscle enhances strength and speed and can also reduce the risk of injuries or falls as you age. (American College of Sports Medicine. 2017)

Factors

Experts point out some common mistakes that can hinder muscle growth, like not eating enough protein, not consuming enough calories, overtraining, or practicing improper form and technique. As everybody is different there is no one-size-fits-all approach to building muscle or hypertrophy. These include:

Genetics

  • An individual’s genes contribute to how easy or difficult it can be to build muscle.
  • Some individuals have a higher proportion of fast-twitch muscle fibers, which increases growth potential.
  • The natural distribution of muscle and body fat also varies and can affect the rate and location of muscle growth.
  • There are also differences in individual recovery capabilities that can influence the frequency and intensity of training sessions.

Nutrition

  • Nutrition matters when trying to build muscle. Individuals need to eat enough protein for muscle repair and growth.
  • Individuals may need to consume more calories than they burn to create energy stores.
  • At the same time, individuals need to consume enough carbohydrates and healthy fats to fuel workouts and recovery.

Training

  • Gaining muscle requires regular resistance or strength training exercises.
  • These exercises cause micro tears in muscle fibers, which then repair and grow back stronger and larger.
  • Effective resistance training includes – consistency, intensity, recovery, and progressive overload.
  • Progressive overload means gradually increasing the weight, frequency, or number of repetitions in an exercise routine to challenge the muscles.

Muscle Strength for Healthy Aging

  • Research shows that performing exercises that build muscle mass can slow age-related cognitive decline and decrease the risk of neurodegenerative diseases like Alzheimer’s disease and dementia. (Joseph Michael Northey, et al., 2018)
  • Muscle-building exercise can also improve heart health and lower the risk of cardiovascular diseases. (Johns Hopkins Medicine. 2023)

Nutritional Mistakes

When trying to gain muscle, challenges can affect progress. Some of the most common mistakes that can delay or set back muscle growth and recommendations include.

Not Enough Protein

  • Eating protein like lean meats, dairy products, and seafood, is crucial for muscle repair and growth.
  • Not consuming enough protein makes the body unable to grow muscles, and you’ll see suboptimal improvements.
  • Get enough protein from various sources like beef, lamb, chicken, turkey, fish, eggs, dairy, legumes, and plant-based proteins.
  • However, there is a limit to how much protein the body can use effectively at one time for muscle protein synthesis.
  • It is recommended to distribute protein intake evenly throughout the day, aiming for about 20 to 30 grams of high-quality protein in each meal.

Not Enough Calories

  • Muscles need calories to grow.
  • If the body is in a caloric deficit, the ability to grow muscle is limited.
  • Insufficient calorie intake can create energy deficits, making the body use muscle for energy instead of growing.
  • To fix this, individuals need to consume more calories than calories burned.
  • It can be helpful to track calorie intake with an application to make adjustments as needed.
  • Individuals having trouble increasing their calorie intake or there are questions about what the body needs, consult with a registered dietitian or nutritionist.

Not Enough Carbs

  • Carbohydrates are the body’s main energy source during high-intensity workouts.
  • Not consuming enough can lead to decreased performance and slower recovery.
  • Recommendations include consuming a variety of whole grains and minimally processed carbohydrates, such as brown rice, potatoes, sweet potatoes, oats, and quinoa.
  • For individuals doing regular, moderate-to-intense training, carbohydrate recommendations can range from 3 to 7 grams per kilogram of body weight per day.
  • For individuals doing endurance or intense frequency training routines may need to increase this range.

Not Hydrating Enough

  • Water is necessary for all bodily functions, including muscle contraction and repair.
  • Dehydration comes with symptoms like muscle cramps, fatigue, and decreased exercise performance. (Centers for Disease Control and Prevention. 2022)
  • For individuals who are not sure how much water they need? Recommendations include using half of an individual’s body weight as a starting point to figure out how many ounces to drink per day.
  • For example, individuals who weigh 140 pounds can set a baseline hydration goal of 70 ounces of water/8 cups per day which can be adjusted according to activities.

Water Intake Recommendations

  • The recommended total fluid intake from food and drink varies by age and sex. The general recommendations are around:
  • 11.5 cups per day for women
  • 15.5 cups for adult men
  • For just water, women need around 9 cups of fluid per day, and men need around 13 cups to replace fluids that are lost throughout the day.
  • However, the exact amount of water needed to stay properly hydrated also depends on an individual’s activity level and overall health. (Academy of Nutrition and Dietetics. 2022)
  • To prevent dehydration, sip water consistently throughout the day, especially before, during, and after workouts.
  • Foods with a high water content like certain fruits can help achieve daily hydration goals.

Not Enough Healthy Fats

  • Not consuming enough healthy fats can cause the body to not be able to produce enough hormones that support muscle growth.
  • Relying on supplements instead of getting nutrients from whole foods can also lead to nutritional deficiencies and imbalances.
  • Eating too many protein bars or shakes can also cause gastrointestinal side effects. (National Capital Poison Center. 2023)
  • Recommendations are to add more healthy fats, like avocados, nuts, seeds, fatty fish, and olive oil.

Forgetting Post-Workout Nutrition

  • After working out, the body is ready to absorb nutrients and start the process of muscle repair and growth.
  • The body needs nutrients to activate the recovery post-exercise
  • When the body lacks nutrition after a workout it can slow muscle growth and cause fatigue.
  • Recommendations are to pack a balance of protein and carbohydrates to refuel right after a workout.

Training Mistakes

  • Undertraining or performing low-intensity workouts can also slow down muscle growth.
  • Individuals who are not overloading their muscles – for example, using weights that are too light – will not break them down so they can grow bigger and stronger.
  • A lack of microdamage means muscle growth will be slower.
  • Muscle overload also requires rest.
  • Recommendations are to take at least one day of rest per week and avoid strength training in the same muscle group two days in a row.
  • When creating a lifting plan, be sure to include compound exercises like squats, deadlifts, and bench presses.
  • These exercises work with multiple muscle groups and are recommended for building strength and muscle.
  • A training routine should include a variety of compound movements, like lunges, split squats, leg presses, pull-downs, upright rows, and push-ups.
  • If unsure of which compound exercises to include, consult a personal trainer, physical therapist, or sports chiropractor.

Military Training and Chiropractic Care


References

American College of Sports Medicine. (2017). Resistance training and injury prevention.

Northey, J. M., Cherbuin, N., Pumpa, K. L., Smee, D. J., & Rattray, B. (2018). Exercise interventions for cognitive function in adults older than 50: a systematic review with meta-analysis. British journal of sports medicine, 52(3), 154–160. doi.org/10.1136/bjsports-2016-096587

Johns Hopkins Medicine. (2023). Exercise and the heart.

Centers for Disease Control and Prevention. (2022). Water and healthier drinks.

Academy of Nutrition and Dietetics. (2022). How much water do you need?

National Capital Poison Center. (2023). Do protein bars give you gas?