Can individuals experiencing back pain from various factors incorporate MET (muscle energy techniques) to restore mobility?
Factors That Causes Back Pain
More often than not, many individuals have experienced back pain in various parts of their lives. As one of the leading pains that people have dealt with worldwide, many factors can contribute to the development of back pain, and it can affect different musculoskeletal locations in the upper and lower body quadrants. Back pain has often been associated with the workplace or environmental factors. For back pain, the problem can range from all back sections, affecting the muscles, ligaments, tissues, intervertebral joints, or the bone itself. (Wiberg, 1949) People are constantly in motion, and the muscles can be overstretched and tight over time. When that happens, many people seek treatment to reduce back pain’s overlapping risk profiles and restore mobility. Today’s article focuses on the factors associated with back pain and how non-surgical treatments like MET (muscle energy technique) can help reduce back pain and restore mobility. We discuss with certified medical providers who inform our patients how various environmental factors are correlated with back pain and how it can affect the body. While asking informed questions to our associated medical providers, we advise patients to include various non-surgical treatments like MET to be incorporated to reduce overlapping risk profiles associated with back pain. Dr. Alex Jimenez, D.C., encompasses this information as an academic service. Disclaimer.
How often do you experience pain in different locations in your back after doing some strenuous activities? Do you feel like you are taking many breaks due to feeling tightness or sharp sensations in your back? Or have you felt that your posture is more hunched than normal? Many of these environmental factors scenarios are correlated with back pain, and it can become an issue over time. Back pain can be in two categories: specific and non-specific, and it can impact a person’s quality of life. Non-specific back pain can be associated with mobility impairment in the different back sections, referred to as radiating pain in the lower extremities or musculoskeletal disorders. (Delitto et al., 2012) This causes issues like repetitive loading to the spine and various pain-like symptoms to the back, causing a disbalance to the individual. (Zemková & Zapletalová, 2021) When it comes to environmental factors correlating with back pain, there are numerous ways for it to be developed and, over time, cause discomfort for the individual, as back pain symptoms vary for everyone.
Sleep
When it comes to the connection between sleep and back pain, these two issues can cause a vicious cycle of disturbed sleep and issues like insomnia. (Van Looveren et al., 2021) Now, when it comes to sleep disturbances and back pain, many individuals may be sleeping with the wrong mattress, causing their bodies to can cause pressure on their joints and spinal discs. This causes in-bed sleep behaviors like movements and postures could lead to health complications like pressure sores, apnea, and painful muscle spasms in the back and lower extremities. (Elnaggar et al., 2023) Luckily, there are various ways to reduce back pain, improve sleep quality, and restore body motion.
Understanding Academic Low Back Pain-Video
What Is MET?
When people come in for back pain treatment, non-surgical therapies can help stretch the overworked and tired back muscles and restore mobility to the body’s upper and lower extremities. One of the non-surgical treatments that pain specialists like chiropractors and massage therapists use is MET therapy or muscle energy technique therapy. MET comprises soft tissue manipulation that uses controlled isometric and isotonic contractions. (Sarkar et al., 2021) This helps the body not only improve the physiological function of the muscles but also decrease pain. MET can also be combined with other therapies to help lengthen short muscles, improve the range of motion from the joints, and increase fluid drainage from the body’s peripheral regions. (Batool et al., 2024)
MET Reducing Back Pain
Regarding MET, reducing back pain is possible as MET can be integrated with physical therapy to improve the disability and functionality of the person with back pain. (Wahyuddin et al., 2020) When people start to incorporate MET and non-surgical treatments as part of their routine for their health and well-being, they will begin to notice that the pain they have been experiencing in their back is diminishing over time. This allows them to be more mindful of their backs and bodies while making small changes to their routine. Sleeping better with a correct mattress, exercising more to stretch and strengthen muscles, eating healthier foods, and relaxing more allow people to be pain-free in their health and wellness journey.
References
Batool, K., Mehmood, M., Jafar, M., & Gull, M. (2024). Comparative efficacy of muscle energy technique and Bowen technique on hamstrings muscle tightness in chronic low back pain patients. Pak J Med Sci, 40(9), 2080-2084. https://doi.org/10.12669/pjms.40.9.8517
Delitto, A., George, S. Z., Van Dillen, L., Whitman, J. M., Sowa, G., Shekelle, P., Denninger, T. R., & Godges, J. J. (2012). Low Back Pain. Journal of Orthopaedic & Sports Physical Therapy, 42(4), A1-A57. https://doi.org/10.2519/jospt.2012.42.4.a1
Elnaggar, O., Arelhi, R., Coenen, F., Hopkinson, A., Mason, L., & Paoletti, P. (2023). An interpretable framework for sleep posture change detection and postural inactivity segmentation using wrist kinematics. Sci Rep, 13(1), 18027. https://doi.org/10.1038/s41598-023-44567-9
Sarkar, M., Goyal, M., & Samuel, A. J. (2021). Comparing the Effectiveness of the Muscle Energy Technique and Kinesiotaping in Mechanical Sacroiliac Joint Dysfunction: A Non-blinded, Two-Group, Pretest-Posttest Randomized Clinical Trial Protocol. Asian Spine Journal, 15(1), 54-63. https://doi.org/10.31616/asj.2019.0300
Van Looveren, E., Bilterys, T., Munneke, W., Cagnie, B., Ickmans, K., Mairesse, O., Malfliet, A., De Baets, L., Nijs, J., Goubert, D., Danneels, L., Moens, M., & Meeus, M. (2021). The Association between Sleep and Chronic Spinal Pain: A Systematic Review from the Last Decade. J Clin Med, 10(17). https://doi.org/10.3390/jcm10173836
Wahyuddin, W., Vongsirinavarat, M., Mekhora, K., Bovonsunthonchai, S., & Adisaipoapun, R. (2020). Immediate effects of muscle energy technique and stabilization exercise in patients with chronic low back pain with suspected facet joint origin: A pilot study. Hong Kong Physiother J, 40(2), 109-119. https://doi.org/10.1142/S1013702520500109
Wiberg, G. (1949). Back pain in relation to the nerve supply of the intervertebral disc. Acta Orthop Scand, 19(2), 211-221, illust. https://doi.org/10.3109/17453674908991094
Zemková, E., & Zapletalová, L. (2021). Back Problems: Pros and Cons of Core Strengthening Exercises as a Part of Athlete Training. International Journal of Environmental Research and Public Health, 18(10), 5400. https://doi.org/10.3390/ijerph18105400
Can individuals receive a full night’s rest by recognizing sleep disturbances to only get proper muscle function and improve their health?
What Causes Sleep Disturbances?
As many people are in a constant state of motion and trying to complete their tasks, they will feel extremely exhausted and tempted to take a quick nap on their bed. However, a short nap can sometimes turn longer and thus affect a person’s sleep schedule. At the same time, when the body is ready to go to sleep, sometimes the mind is wide awake, causing people to become more tired throughout the day. These types of sleep disturbances can not only affect the person but also affect the body as well. In today’s article, we will be looking at what causes sleep disturbances, how improper sleep affects the muscles in the body, and how to incorporate various ways to reduce sleep disturbances. We discuss with certified medical providers who inform our patients how various sleep disturbances can affect the individual and the body. While asking informed questions to our associated medical providers, we advise patients to include various techniques to reduce sleep disturbances that can impact the musculoskeletal system. Dr. Alex Jimenez, D.C., encompasses this information as an academic service. Disclaimer.
How often do you feel general aches and pains in your upper and lower extremities that make you sluggish? Do you experience constant headaches that make it difficult to get out of bed? Or do you feel stiffness in your neck, shoulder, and back in the morning that goes away throughout the day? When it comes to the correlation between what causes sleep disturbance to the body, it can vary from person to person, depending on the situation. Let’s say a person is dealing with a stressful situation that causes them to be unable to get a good night’s rest; that would be known as a sleep disturbance. Sleep disturbances, by definition, are causes that can impact a person’s fundamental aspects of their sleep hygiene. (Cormier, 1990) Understandably, everyone is trying to practice good sleep hygiene; however, when environmental factors cause overlapping risk profiles to develop into sleep disturbances, they can affect the body. These can range from cognitive disorders to musculoskeletal conditions and chronic conditions.
How Does Improper Sleep Affect The Muscles & Body?
When classifying sleep disorders that can cause improper sleep in the body, four major categories can be the issue. They are:
Disorders that initiate and maintain sleep
Excessive somnolence disorders
Sleep-wake schedule disorders
Various dysfunctions are associated with sleep (Weitzman, 1981)
These four categories can cause many people to develop improper sleeping habits that can affect their bodies and muscles. Symptoms like fatigue correlate with poor sleep quality and can increase muscle pain intensity. At the same time, many individuals dealing with fatigue can experience muscle pain intensity associated with comorbidities that can make a person feel miserable. (Boggero et al., 2022) Environmental factors affecting the musculoskeletal system can correlate with metabolic disorders and thus affect sleep. Additionally, improper sleep and disturbances have been interplayed with metabolic disorders that can increase the risk of obesity, hypertension, insulin resistance and cause many people to have improper sleeping habits and, which, in turn, affects their musculoskeletal system. (Wei et al., 2022) Some of the effects of improper sleep that can affect muscle include:
Muscle weakness
Instability
Muscle pain
Discomfort
However, when people start to decide to try to improve their sleep schedule and reduce sleep disturbances, many people start to look for ways to get a full night’s rest.
Chronic Pain Chiropractic Care- Video
Ways To Reduce Sleep Disturbances
When trying to improve sleep quality while reducing disturbances, many people start to find ways to incorporate proper sleeping habits. Since sleep’s ultimate goal is to help individuals maintain and improve physical and mental health, many can achieve long-term sleep improvement through appropriate sleep hygiene and modifications. (Baranwal et al., 2023) Some of the ways many people can reduce sleep disturbances are the following:
Exercise
Sleeping on the right mattress
Establish a bedtime routine
Limit electronic screen time
Reduce eating and drinking caffeinated drinks before bed
Incorporating these small changes allows the individual to have proper sleeping habits and reduce overlapping risk profiles affecting the body and musculoskeletal function.
Finding The Right Mattress
Everyone knows that finding the best mattress is important for a good night’s rest. It is also important for people to find the right mattress to stay asleep and reduce musculoskeletal conditions. When it comes to finding the right mattress, it is important to ensure that the mattress’s firmness plays a huge role in improving a person’s sleep quality and reducing pain and disability for people dealing with sleep disorders associated with musculoskeletal conditions. (Caggiari et al., 2021) This allows the individual to have few sleep disturbances and helps them have that full 8 hours of sleep.
Reduce Screen Time
The next way to reduce sleep disturbances is by reducing screen time to prevent it from affecting sleep habits. Since many people are more technologically advanced, it is hard not to doom scroll at night. When many people are on their phones in bed, it can lead to sleep onset latency and cause issues like daytime tiredness. (Brautsch et al., 2023) The best way to reduce tiredness and sleep issues at night is by allowing 30 minutes to digitally disconnect and place any electronic away from the bed to ensure that the 8 hours of sleep is met. This, in turn, allows the brain to turn off and disassociate from anything digital or social media. When it comes to incorporating proper sleep habits, making small changes in a person’s routine can become beneficial in the long run as not only the body can relax but also the muscles.
References
Baranwal, N., Yu, P. K., & Siegel, N. S. (2023). Sleep physiology, pathophysiology, and sleep hygiene. Prog Cardiovasc Dis, 77, 59-69. https://doi.org/10.1016/j.pcad.2023.02.005
Boggero, I. A., Pickerill, H. M., & King, C. D. (2022). Fatigue in Adults with Chronic Arthralgia/Myalgia in the Temporomandibular Region: Associations with Poor Sleep Quality, Depression, Pain Intensity, and Future Pain Interference. J Oral Facial Pain Headache, 36(2), 155-163. https://doi.org/10.11607/ofph.2944
Brautsch, L. A., Lund, L., Andersen, M. M., Jennum, P. J., Folker, A. P., & Andersen, S. (2023). Digital media use and sleep in late adolescence and young adulthood: A systematic review. Sleep Med Rev, 68, 101742. https://doi.org/10.1016/j.smrv.2022.101742
Caggiari, G., Talesa, G. R., Toro, G., Jannelli, E., Monteleone, G., & Puddu, L. (2021). What type of mattress should be chosen to avoid back pain and improve sleep quality? Review of the literature. J Orthop Traumatol, 22(1), 51. https://doi.org/10.1186/s10195-021-00616-5
Cormier, R. E. (1990). Sleep Disturbances. In H. K. Walker, W. D. Hall, & J. W. Hurst (Eds.), Clinical Methods: The History, Physical, and Laboratory Examinations (3rd ed.). https://www.ncbi.nlm.nih.gov/pubmed/21250242
Wei, Z., Chen, Y., & Upender, R. P. (2022). Sleep Disturbance and Metabolic Dysfunction: The Roles of Adipokines. International Journal of Molecular Sciences, 23(3), 1706. https://doi.org/10.3390/ijms23031706
Is applying ice the best option for individuals who experience an acute back strain injury?
Temperature Treatment
Ice temperature treatment, also known as cryotherapy or cold therapy, is a treatment that uses freezing temperatures to reduce pain and swelling. It can be applied in a variety of ways, including:
Ice packs:
Ice massage
Coolant sprays
Whirlpools
Ice baths
Ice is usually recommended for acute injuries and is a common and simple way to treat pain and swelling. Individuals can buy freezable gel packs or make their own with ice cubes in a plastic bag or towel. Heat therapy tends to be used more with chronic issues involving muscle spasms to increase blood circulation.
How Ice Relieves Pain and Reduces Inflammation
Ice temperature treatment works by:
Narrowing blood vessels slows blood circulation to the injured area and soft tissues and reduces swelling.
Reduced blood flow also helps control excessive swelling.
Ice has a short-term analgesic-numbing effect. The coldness numbs nerve endings, relieving pain symptoms.
Relieving the pain allows the muscles to relax.
Controlling blood circulation helps control pain by reducing the flow of irritating chemicals that can inundate the injury site. These chemicals are a natural and the correct response to inflammation, but the ice keeps them in check to help control pain.
After a Back Injury
For a back strain injury, ice and anti-inflammatory medication like NSAIDs are the first line of treatment during the inflammatory phase, which usually lasts 24 to 72 hours. Because heat can increase inflammation by increasing blood circulation, it is not recommended as an initial treatment. After the first few days, most doctors and pain specialists recommend using ice or heat, depending on the individual’s preference. While researchers continue to investigate the best ways to treat acute injuries, most doctors still recommend ice as the first line of defense for back injuries.
A review of studies evaluated 20 different treatment categories to learn about their safety and effectiveness. (McIntosh G. & Hall H. 2011) Treatments included over-the-counter pain medications, acupuncture, McKenzie exercises, other back exercises, and temperature treatments. Regarding temperature treatment, the review found moderate evidence that using a heat wrap 5 days after the injury could help relieve pain. However, there was not enough evidence to support the effectiveness of any of the temperature treatments, necessitating more research. (McIntosh G. & Hall H. 2011)
Physical Therapy and Activity
The review found that prolonged rest should be avoided, and gentle exercise and a progressive return to physical activity should be encouraged to achieve the best outcomes for pain relief and restoring function. Staying active significantly reduces time off from work and chronic disability for up to 1 year compared to traditional medical treatment. (McIntosh G. & Hall H. 2011) Research also found that introducing physical therapy early on could expedite recovery. Mobility work, targeted exercises, and strengthening exercises have been shown to relieve pain, reduce injury recurrence, and improve overall function. More research supports physical activity and exercise as effective treatment options for acute lower back strains. However, further research regarding temperature treatments is required. (French S. D. et al., 2006) (See Q. Y. et al., 2021)
Injury Medical Chiropractic and Functional Medicine Clinic
It is important to talk with a healthcare provider to determine the cause and extent of the injury to provide individualized patient education regarding treatment. This can include physical therapy, rest, health coaching, medication, and surgery, which may be recommended in certain cases. Overcoming these limitations is possible. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.
Beyond the Surface: Understanding the Effects of Personal Injury
References
McIntosh, G., & Hall, H. (2011). Low back pain (acute). BMJ clinical evidence, 2011, 1102.
French, S. D., Cameron, M., Walker, B. F., Reggars, J. W., & Esterman, A. J. (2006). A Cochrane review of superficial heat or cold for low back pain. Spine, 31(9), 998–1006. https://doi.org/10.1097/01.brs.0000214881.10814.64
See, Q. Y., Tan, J. B., & Kumar, D. S. (2021). Acute low back pain: diagnosis and management. Singapore Medical Journal, 62(6), 271–275. https://doi.org/10.11622/smedj.2021086
For individuals going through post surgery, injury rehabilitation, illness and/or chronic condition management, can physical therapy isometric exercises help?
Isometric Exercise
Isometric exercises are used in physical therapy to help build muscle endurance, improve range of motion, relieve pain, and reduce blood pressure more effectively than other types of exercise. Because they don’t involve joint movement, they are a solid starting point for rehabilitation and are suitable for individuals with a limited range of motion. They can be performed by pushing against an immovable object, like a wall, or by having a therapist provide resistance. Examples of isometric exercises include:
A physical therapist/PT may have a patient perform isometric exercises after injury or illness. During an isometric contraction, the muscle does not change in length, and there is no motion around the joint surrounding the muscle/s. (Rhyu H. S. et al., 2015)
When To Use
Isometric muscular contractions can be used at any time during physical rehabilitation and strengthening or a home exercise program and are regularly used with the following (Rhyu H. S. et al., 2015)
Post-surgery
When muscles cannot contract forcefully enough to move the joint it surrounds.
To help increase neuromuscular input to a specific muscle/s.
When injury or condition frailty makes other forms of exercise dangerous and not beneficial.
A healthcare provider or physical therapist should be consulted first if isometrics are used in a rehabilitation program.
Benefits
The benefits of using isometric exercise after injury or surgery may include the following:
No special equipment is necessary to perform isometric exercises.
The ability to safely contract a muscle while protecting a surgical incision or scar tissue.
The muscles can be strengthened in a specific range of motion around a joint. (NikolaidouO. et al., 2017)
A physical therapist can help determine whether isometric exercise benefits the specific condition.
Effectiveness
Isometric exercise is very effective after injury or surgery. However, when a muscle is contracted isometrically, it gains strength in a very small area and with a short range of motion. For example, an isometric shoulder external rotation performed with the arm at the side will only strengthen the rotator cuff muscles in the specific position that the arm is in. (NikolaidouO. et al., 2017).
Strength gains are specific to the joint’s position during the exercise.
Individuals who want to strengthen their gluteal muscles in their hip using isometrics would have to contract their glute muscles in one specific position for several reps.
Once several reps of the exercise in one position have been performed, the individual moves their hip joint into a new position and repeats the gluteal contractions in the new position.
This makes the exercise time-consuming, but it is perfect for injury rehabilitation, preventing and avoiding worsening or further injuries.
How to Perform
To perform isometric exercises, all that is needed is something stable to push against. (Rhyu H. S. et al., 2015) For example, to strengthen the shoulder muscles:
Stand next to a wall and try to lift an arm out to the side.
Allow the hand to press against the wall so no motion occurs at the shoulder joint.
Once pressed against the wall, hold the contraction for 5 to 6 seconds and slowly release it.
Perform 6 to 10 repetitions of the exercise.
This could be one set of completed isometric exercises for the shoulder muscles.
Elastic resistance bands or tubing can also be used to perform isometric exercises. Hold the tubing in a specific position and then move the body away from the anchor point instead of moving the joint. The muscles will contract against the increased resistance of the elastic tubing, and no motion will occur at the joint. A physical therapist can show and train on how to perform isometric exercises with the bands.
Neuromuscular Stimulation
Isometric exercise can strengthen muscles and help improve the neuromuscular recruitment of the muscles being trained. This enhances muscle contraction and expedites gains in muscle recruitment while protecting the joint. Isometric exercise can also be used during physical therapy using neuromuscular electrical stimulation (NMES). (Fouré A. et al., 2014) For example, a PT may use NMES to improve muscular function for individuals who have difficulty contracting their quadriceps after knee surgery and may be instructed to perform isometric quad-setting exercises during the session.
Injury Medical Chiropractic and Functional Medicine Clinic
A physical therapist can use isometric exercises to help individuals injured or have had surgery and are experiencing difficulty with normal functional mobility by improving their strength during recovery. The exercises can safely enhance the function and stability of the muscles and return individuals to the previous level of activity and function. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.
Personal Injury Rehabilitation
References
Rhyu, H. S., Park, H. K., Park, J. S., & Park, H. S. (2015). The effects of isometric exercise types on pain and muscle activity in patients with low back pain. Journal of Exercise Rehabilitation, 11(4), 211–214. https://doi.org/10.12965/jer.150224
Nikolaidou, O., Migkou, S., & Karampalis, C. (2017). Rehabilitation after Rotator Cuff Repair. The Open Orthopaedics Journal, 11, 154–162. https://doi.org/10.2174/1874325001711010154
Fouré, A., Nosaka, K., Wegrzyk, J., Duhamel, G., Le Troter, A., Boudinet, H., Mattei, J. P., Vilmen, C., Jubeau, M., Bendahan, D., & Gondin, J. (2014). Time course of central and peripheral alterations after isometric neuromuscular electrical stimulation-induced muscle damage. PloS one, 9(9), e107298. https://doi.org/10.1371/journal.pone.0107298
What are the treatment options for individuals dealing with foot overpronation when the foot and ankle move too much downward and inward?
Overpronation
Pronation is the normal foot and ankle movement when taking a step and is usually associated with flat feet. Overpronation is a movement pattern in which the ankle rolls inward and downward, causing the foot’s arch to collapse with each stride. Overpronation can strain the muscles and ligaments in the feet and legs, leading to heel pain, ankle pain, shin splints, and low-back pain. (Pedorthic Association of Canada, 2023) Orthotic inserts for shoes, prescribed stretches, ankle braces, physical therapy, and surgery can all help alleviate the impact of overpronation. (Sánchez-Rodríguez, R. et al., 2020)
Signs and Symptoms
Some individuals with overpronation can have no symptoms at all. (Pedorthic Association of Canada, 2023) while others experience pain or other symptoms in their legs and feet. Overpronation is not a medical condition but a movement pattern that, if left untreated, can increase the risk for certain medical conditions because it strains the feet and leg muscles, joints, and ligaments. (Sánchez-Rodríguez, R. et al., 2020) Certain medical conditions can be a sign of overpronation and include: (Pedorthic Association of Canada, 2023)
Bunions
Heel pain
Plantar fasciitis
Achilles tendon pain
Posterior tibial tendonitis
Shin splints
Knee pain, including patellofemoral pain syndrome
Pain in the iliotibial or IT band
Lower back pain
Arthritis in foot and ankle joints
Stress fractures
Individuals may also experience pain in the midfoot or hips, which can be a symptom of flat feet.
Underpronation
Pronation refers to the normal movement of the foot and ankle while walking. Overpronation and underpronation are both abnormal movement patterns.
Overpronation – when the ankle rolls too much inward and downward.
Underpronation – occurs when an individual’s foot lacks flexibility and moves too little. This condition is called supination and is often associated with a high-arch foot type.
Overpronation can be caused or worsened by flatfeet. However, some individuals have overpronation because their feet and ankles are very flexible, so they tend to move more. Risk factors for flatfeet can also increase the chances of developing overpronation and include:
Age, especially individuals over 40.
Wearing shoes like high heels and shoes with a narrow-toe box.
Women are more prone to overpronate because of the various shoes and high heels worn.
Being overweight
Doing repetitive, impactful movements like running.
Correction and Treatment
Treating overpronation focuses on alleviating strain on muscles in the foot, ankle, and leg to relieve symptoms in the heel, ankle, knees, hips, or back. Common treatments are wearing supportive shoes and/or using foot orthotics. Exercises and stretches are also recommended to maintain flexibility and strength. Surgery is rare, but correcting flat feet that can cause overpronation may be recommended. (Sánchez-Rodríguez, R. et al., 2020) Individuals with overpronation are advised to see a podiatrist who can explain the best treatment options.
Supportive Shoes
The first course of treatment is to wear added supportive footwear. This can include specialized shoes or inserts that support the foot and reduce ankle movement. Individuals are advised to use shoes with firm heel and midfoot support to help prevent disproportionate movement. (Pedorthic Association of Canada, 2023)
Orthotics
A healthcare provider can recommend orthotics for individuals with moderate overpronation. These are meant to support the foot, especially the arch, and reduce overpronation. (Naderi A. Degens H. and Sakinepoor A. 2019) Individuals can purchase orthotics from shoe stores and elsewhere, but those with severe overpronation may need custom orthotics molded to the foot to provide individualized support.
Exercises and Stretches
Exercises and stretches can also help. A study found that exercises targeting the feet, core, and hips helped correct pronation over nine weeks. The exercises included: (Sánchez-Rodríguez, R. et al., 2020)
Toe pickups in which the individuals grab small objects with their toes and move them from one position to another.
Flexing and pointing the toes using a resistance band placed around the toes.
Hip abduction exercises to target the hip and glutes.
Abdominal and oblique muscle exercises to stabilize the torso.
Short-foot exercise raises the foot arch off the ground, drawing the toes toward the heel. (Sulowska I. et al., 2016)
Surgery
Rarely will surgery be needed to treat flat feet and severe overpronation. But if necessary, reconstruction realigns the bones to support the arch better and reduce overpronation. A metal implant is used for flatfeet to stabilize the area. Surgery can also repair torn tendons or other damage contributing to overpronation. (Healthline, 2020)
Injury Medical Chiropractic and Functional Medicine Clinic
Individuals with overpronation but no symptoms don’t necessarily have to see a healthcare provider since this may be the body’s natural movement pattern. But if the feet, legs, hips, or back begin to present with pain and other symptoms, see a healthcare provider who can evaluate gait and recommend treatment options. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.
Enhance Performance with Functional Foot Orthotics
References
Pedorthic Association of Canada. (2023). Overpronation and Underpronation Correction. https://pedorthic.ca/services/foot-health/pronation/
Sánchez-Rodríguez, R., Valle-Estévez, S., Fraile-García, P. A., Martínez-Nova, A., Gómez-Martín, B., & Escamilla-Martínez, E. (2020). Modification of Pronated Foot Posture after a Program of Therapeutic Exercises. International journal of environmental research and public health, 17(22), 8406. https://doi.org/10.3390/ijerph17228406
Naderi, A., Degens, H., & Sakinepoor, A. (2019). Arch-support foot orthoses normalize dynamic in-shoe foot pressure distribution in medial tibial stress syndrome. European journal of sport science, 19(2), 247–257. https://doi.org/10.1080/17461391.2018.1503337
Sulowska, I., Oleksy, Ł., Mika, A., Bylina, D., & Sołtan, J. (2016). The Influence of Plantar Short Foot Muscle Exercises on Foot Posture and Fundamental Movement Patterns in Long-Distance Runners, a Non-Randomized, Non-Blinded Clinical Trial. PloS one, 11(6), e0157917. https://doi.org/10.1371/journal.pone.0157917
Healthline. (2020). All About Surgery for Flat Feet: Pros and Cons. https://www.healthline.com/health/flat-feet-surgery
Yips are involuntary wrist muscle spasms that affect athletes. They are often associated with golf, baseball, and sports that involve swinging and throwing motions, such as bowling, darts, cricket, and others. Can understanding the information and causes help diagnose and find the right therapy or training?
Yips
Yips are involuntary wrist spasms that athletes experience. The term is also used to refer to performance anxiety without physical spasms. Researchers believe they are caused by muscle overuse that leads to dystonia (a condition that causes muscles to contract involuntarily), and combined with psychological factors like performance anxiety and overthinking, can make them worse. (Beacon Health Systems, 2024)
The most common symptom is muscle spasms, often in the hands and wrists. That’s why it is the most common among athletes who play sports that require precision hand and wrist movements. Yips affect fine motor skills. (Aoyama, T. et al., 2021) In addition to muscle spasms, symptoms can also include: (Beacon Health Systems, 2024)
Twitching
Tremors
Freezing up
Psychological distress
Causes
Healthcare providers, trainers, coaches, and researchers know that psychological and physical factors cause yips. Underlying physical causes include overusing wrist muscles, which leads to dystonia or involuntary muscle movements. Also known as task-specific dystonia, it can also affect individuals who engage in repetitive muscle movements, like factory and assembly line workers, store check-out clerks, musicians, etc. (Clarke P., Sheffield D., and Akehurst S. 2020). Performance anxiety and psychological stress can worsen dystonia. (Aoyama, T. et al., 2021) Athletes can become so focused on their movements that they overthink their actions and perform worse. Individuals who have anxiety, self-consciousness, or stress about a game or performance often find that their involuntary wrist spasms are worse. (Clarke P., Sheffield D. and Akehurst S. 2020)
Increased Risk
Yips are most common in athletes who use their hands and wrists for their sport and are likely to impact more experienced, competing, and older athletes. (Beacon Health Systems, 2024) They are more common in athletes focused on smaller movements or shorter distances. For example, golfers commonly experience involuntary wrist spasms when putting, and baseball players are likelier to experience them when throwing less than 20 meters. (Clarke P., Sheffield D. and Akehurst S. 2020)
Diagnosis
There is no official diagnosis for yips. However, a coach, athletic trainer, sports doctors, and others can observe the pattern of symptoms and behavior and provide an informed diagnosis.
Once trigger/s are identified, they can be addressed. Treatments that can help include: (Beacon Health Systems, 2024)
Alternate Hand Positions
This can provide relief from dystonia and overthinking.
Using Different Equipment or Stabilizers
This allows the immobilization of certain muscles and the activation of different muscles.
Mindfulness
Reducing anxiety and distress can help relax the body.
Practicing mindfulness before games or tournaments can help reduce psychological triggers.
Botox Injections
Botox injections can treat certain types of dystonia.
Sports Psychology
A sports psychologist is a healthcare provider who studies individual athletes’ sports performance and how it affects their minds and skills.
A sports psychologist can help individuals create a program that reduces stress or anxiety around games and performance.
Injury Medical Chiropractic and Functional Medicine Clinic
Yips are common among athletes. It is important to address the physical and psychological components to treat the condition. Talking with a coach or a sports psychologist, other athletes, and supporting staff like trainers can help you find a solution. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.
Sports Injuries
References
Beacon Health Systems. (2024). Yips. https://www.beaconhealthsystem.org/library/diseases-and-conditions/yips/
Clarke, P., Sheffield, D., & Akehurst, S. (2020). Personality Predictors of Yips and Choking Susceptibility. Frontiers in psychology, 10, 2784. https://doi.org/10.3389/fpsyg.2019.02784
Aoyama, T., Ae, K., Souma, H., Miyata, K., Kajita, K., Kawamura, T., & Iwai, K. (2021). Difference in Personality Traits and Symptom Intensity According to the Trigger-Based Classification of Throwing Yips in Baseball Players. Frontiers in sports and active living, 3, 652792. https://doi.org/10.3389/fspor.2021.652792
The iliacus muscle is a triangle-shaped muscle in the pelvic bone that flexes and rotates the thigh bone. It works with the other muscles in the hip and thigh to help bend, run, walk, sit, and maintain correct posture. Injuries and common medical conditions can affect its function, causing pain and stiffness. Can physical therapy help?
The Iliacus Muscle
The iliacus is one of the body’s most important hip flexor muscles. The iliacus and surrounding muscles work together to produce the stability and range of motion required for bending, dancing, sitting, and walking.
Anatomy
The iliacus muscle is part of a complex muscle system in the hip and pelvis. Two iliacus muscles on each side of the pelvic bone enable the thigh to flex and rotate. They are innervated by the femoral nerve, which provides movement and sensation to the lower limbs. (Bordoni B. and Varacallo M. 2023) The iliacus muscle sits on the wing-shaped ilium and fits into the curved surface of the ilium, called the iliac fossa. The top of the muscle is attached to the upper wings of the ilium or iliac crest. It extends past the hip joint, which connects to the upper thigh bone/femur at the lesser trochanter protrusion. The iliacus is part of a major trio of muscles called the iliopsoas, including the major psoas and minor psoas muscles. These muscles are also attached to the upper femur but extend upward, connecting to the lumbar/lower spine at several attachment points. The iliopsoas also interact with the quadratus lumborum muscle, the deepest muscle of the lower back that starts at the iliac crest and attaches to the lumbar spine at several points. The quadratus lumborum enables flexion and elevation of the spine, while the iliopsoas enable the flexion and rotation of the hip and thigh.
Functions
The iliacus muscle has many functions that include: (Physiopedia, 2024)
Flexing and rotating the femur.
Helps maintain proper body posture while standing and sitting.
Produces hip movement that enables walking, running, and climbing stairs.
Provides hip flexion – bringing the knee to the chest.
Enables the forward tilt of the pelvis and side-bending.
Conditions
Several conditions can affect the iliacus muscle, specifically from under and/or overuse injuries. These conditions, collectively known as Iliopsoas syndrome, are typically the result of overuse/repetitive strain or injuries. These include:
Iliopsoas tendinopathy – which affects tendons.
Iliopsoas bursitis – which affects cushioning sacs known as bursae.
Iliopsoas syndrome can affect anyone but is common in:
Individuals and athletes who repeatedly use movements that flex the hips.
Track-and-field athletes
Gymnasts
Dancers
Iliopsoas Bursitis
This is the inflammation of the cushioning sac or bursa under the iliacus muscle, which helps the muscle slide over the pelvic bone. Symptoms can range from mild discomfort to pain that radiates through parts of the leg and hips. Runners, skiers, and swimmers are commonly affected, and individuals who regularly have tight hips and individuals with different forms of arthritis can also be affected. Early treatment can prevent the symptoms from worsening. Mild cases can be treated with self-care and stretching to help relieve tightness, rest, ice application, and over-the-counter nonsteroidal anti-inflammatory drugs. In severe cases, treatment options that may be recommended include: (Physiopedia, 2024)
Physical therapy
Assistant walking devices to relieve pressure – for example, a cane.
Corticosteroid steroid injections
Prescription anti-inflammatory medications
Iliopsoas Tendinopathy
Another condition affecting the iliacus muscles is iliopsoas tendinopathy, sometimes called snapping hip syndrome, because individuals can hear an audible snapping sound (Davenport KL. 2019). The condition is often experienced by dancers who repeatedly flex and hyperextend their hips and can result in hip and groin pain that gets worse with kicking or rotation. Treatment of iliopsoas tendinopathy can include:
Retraining muscle imbalances with strengthening and stretching exercises.
If these fail to provide relief, corticosteroid injections may be used. A saline hydro dissection can relieve stress around the tendon by injecting fluids that cushion and release trapped tissues.
Tendon release surgery may be recommended when all other options have failed. The surgical release involves severing the tendon to reduce pain and improve the range of motion.
Rehabilitation
Core muscle strengthening is essential to the rehabilitation of iliacus muscle injuries. The iliopsoas is an integral component of the core group and can benefit from stretching and strengthening exercises (Yogateket, 2019)
Lunge stretches
Straight leg raises
Knee-to-chest stretches
Standing hip flexion with resistance bands
Certain yoga poses can also help and include variations on the bridge pose that encourage hip flexion. (Yoga International, 2024)
Injury Medical Chiropractic and Functional Medicine Clinic
Iliopsoas pain is often felt at the front of the hips, thigh, mid-back, and lower back. Chiropractic care can help with iliacus muscle injuries through:
Evaluation
A chiropractor can evaluate the condition and determine if the iliacus muscle is causing pain.
Treatment plan
A chiropractor can create a personalized treatment plan that may include exercise instructions, manipulation, and other therapies.
Rehabilitation
A chiropractor can create a rehabilitation program to expedite healing.
Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.
Hip Labral Tear and Chiropractic Care
References
Bordoni, B., & Varacallo, M. (2024). Anatomy, Bony Pelvis, and Lower Limb, Iliopsoas Muscle. In StatPearls. https://www.ncbi.nlm.nih.gov/pubmed/30285403
Davenport KL. (2019). The professional dancer’s hip. Performing Arts Medicine, 77-87. https://doi.org/https://doi.org/10.1016/B978-0-323-58182-0.00009-2
Yogateket. Lizette Pompa. (2019). Essential yoga body parts. Hip flexor/psoas and yoga. Yogateket. https://www.yogateket.com/blog/hip-flexor-psoas-and-yoga
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