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Using Heat and Ice For A Pinched Nerve

Using Heat and Ice For A Pinched Nerve

Most if not all of us have probably used heat and/or ice on a sprain, strain, or sore area of the body. Having a pinched nerve, however, has a different feeling than a sprain or strain. Chiropractic treatment for a pinched nerve is recommended, but if the pain isn’t too bad, then home care can work. Which is better for a pinched nerve, heat or ice? Both. Using heat and ice helps reduce swelling, increases blood flow to the area, and relaxes the muscles around the pinched nerve. The objective is to know when to use ice and/or heat.

Using Heat and Ice For A Pinched Nerve

Applying Heat on a Pinched Nerve

Applying heat on a pinched nerve is fine. The general guideline for a pinched nerve is to use heat only after the pain has subsided/reduced.

  • When pain presents or flares up, use ice before using heat.
  • Do not apply heat to the area directly after applying ice.
  • Wait 30 minutes to an hour.
  • Keep the heat on the affected area for 10 to 20 minutes at a time.
  • Take a minimum 30-minute break between sessions.
  • If the heat helps, make the heat moderate and use it on the area for an hour or more.
  • Extended heat therapy is beneficial for severe pain from a pinched nerve.
  • The equivalent is like soaking in a hot bath.

Heat for a Pinched Nerve Benefits

  • Heat soothes and relaxes both the muscles and the mind.
  • Heat increases healing abilities by circulating new blood to the injured/affected area, helping to flush toxins away.
  • Decreases tension and spasms in the muscles.
  • Increases the range of motion in the joints.

When Not To Use Heat Therapy

It can be dangerous for individuals with pre-existing conditions. Conditions include:

  • Deep vein thrombosis
  • Diabetes
  • Vascular disease
  • Multiple sclerosis
  • Consult a doctor if unsure.

Applying Ice

Tips to safely use ice on a pinched nerve.

  • Keep the ice pack on for 15-20 minutes at a time, then remove.
  • Take an hour break between icing sessions.
  • Ice massage, apply ice directly to the affected area for 5 minutes at a time using circular, massaging motions.

Ice for a Pinched Nerve Benefits

  • Relieves pain quickly by numbing the area.
  • Reduces swelling by slowing blood flow to the area.
  • Cools the muscle fibers.
  • Reduces muscle spasms.

When Not To Use Ice

  • Individuals, especially those who have difficulty feeling pain, can damage the skin with an ice pack.
  • Those with diabetes should take special care, as nerve damage can make it hard to feel or discern pain.
  • If trying to relieve soreness and/or stiffness in joints or muscles, use heat instead.

Making a Pinched Nerve Worse

A pinched nerve can become worse. Examples of things to avoid when managing a pinched nerve.

  • Lifting heavy objects.
  • Making sudden, twisting, shifting, jerking movements.
  • Engaging in high-intensity or high-speed exercise.
  • Engaging in contact sports.
  • Sitting too much.
  • Laying down too much.
  • Not consulting a doctor or chiropractor if the pain continues.

Home Remedies and Prevention

A few other home remedies and prevention tips for a pinched nerve.

  • Practice maintaining proper posture.
  • Maintain a healthy diet and weight.
  • Incorporate anti-inflammatory foods.
  • Get 7 to 8 hours of healthy sleep.
  • Get a professional therapeutic massage.
  • Incorporate stretching and or yoga.
  • If home remedies don’t work, know when to consult a chiropractor.

Doctors of chiropractic specialize in pinched/compressed nerves. A chiropractor is trained in different techniques to relieve the pressure and release the nerve back to its proper position.


Body Composition


Peripheral Artery Disease

Peripheral artery disease or PAD is the narrowing of the arteries that carry blood away from the heart to the other areas of the body. What to know about PAD:

  • Peripheral artery disease risks increase with age.
  • Over half of affected individuals do not present with symptoms.
  • Around one-fourth of individuals with peripheral artery disease have diabetes mellitus.
  • Smokers have an increased risk of developing PAD.
  • This is why it’s important to monitor blood pressure.
References

Chandler, Anne, et al. “Using heat therapy for pain management. (clinical practice).” Nursing Standard, vol. 17, no. 9, 13 Nov. 2002, pp. 40+. Accessed 15 Sept. 2021.

Edzard Ernst, Veronika Fialka, Ice freezes pain? A review of the clinical effectiveness of analgesic cold therapy, Journal of Pain and Symptom Management, Volume 9, Issue 1, 1994, Pages 56-59, ISSN 0885-3924, https://doi.org/10.1016/0885-3924(94)90150-3.

Shu, Jun, and Gaetano Santulli. “Update on peripheral artery disease: Epidemiology and evidence-based facts.” Atherosclerosis vol. 275 (2018): 379-381. doi:10.1016/j.atherosclerosis.2018.05.033

Relaxing The Low Back Muscles

Relaxing The Low Back Muscles

Relaxing the low back muscles. The low back supports the weight of the upper body and provides mobility. The lumbar spine/low back is a complex structure of interconnecting:

  • Bones
  • Joints
  • Nerves
  • Ligaments
  • Muscles
  • All work together to provide support, strength, and flexibility.

However, this complex structure is highly susceptible to injury and pain. The muscles in the low back support the spinal column and are responsible for flexing, rotating the hips when walking. The nerves in the low back supply sensation and power the muscles in the pelvis, legs, and feet. The most common acute low back pain cases are brought on from injury to the:

  • Muscles
  • Ligaments
  • Joints
  • Discs

The body also reacts to injury by triggering an inflammatory response. Inflammation can cause severe pain. The key is relaxing the muscles and keeping them loose.

Relaxing The Low Back Muscles

Lower back pain causes

The most common cause is muscle spasms, which can be triggered by:

  • Constant improper posture
  • Repetitive and overuse motions
  • Chronic inflammation brought on by underlying condition/s
  • Quick awkward movements like twisting, reaching, and/or bending at the wrong angle can set off pain symptoms.
  • If the same back muscles are getting strained and/or pulled continuously, this could indicate an underlying problem with a misaligned vertebra.

Correct improper postures

Improper posture and body positioning eventually present with discomfort and pain. Individuals are constantly hunched over and slumped in front of computers and devices, along with sitting with crossed legs, sleeping on a non-supportive mattress, and there is a perfect recipe for low back pain. Adjusting sitting, desk, and computer ergonomics and using smart devices with posture awareness will go a long way to correct improper posture.

Stretch and loosen tight muscles

Stretch out throughout the day and before going to bed. Sitting all day at work, then going home and sitting all evening is not healthy for the body’s muscles. The muscles shorten, as do the ligaments and tendons. Stretching keeps the body loose and limber. Try out different forms of stretching, as well as foam rolling for the back.

Get the body moving

Cramped or pulled muscles need time to recover. Too much rest or being completely inactive makes sense but is not recommended. Light movement keeps the blood flowing, especially in and around the injured/sore area. This increases healing and shortens recovery time.  Just some light walking is recommended. Getting up and moving while relaxing around the house will get the muscles back in shape.


Body Composition


Benefits of collagen

Gastrointestinal Health

Collagen generates a protective barrier effect on the intestinal mucosa that lines the digestive tract. One study found that collagen supplementation protects against the breakdown of the intestinal wall after a burn injury. A lack of collagen from aging or other factors could impair the structure of the intestinal mucosa. This could lead to digestive problems like leaky gut syndrome and irritable bowel syndrome.

Joint Health and Mobility

Collagen provides structure and cushion in the joints. As the body ages, the cushion wears down, and joint mobility decreases. This increases the risk of injury. Taking collagen supplements can help improve symptoms of osteoarthritis, rheumatoid arthritis, and other conditions.

References

Finta, Regina et al. “The effect of diaphragm training on lumbar stabilizer muscles: a new concept for improving segmental stability in the case of low back pain.” Journal of pain research vol. 11 3031-3045. 28 Nov. 2018, doi:10.2147/JPR.S181610

Lugo, James P et al. “Efficacy and tolerability of an undenatured type II collagen supplement in modulating knee osteoarthritis symptoms: a multicenter randomized, double-blind, placebo-controlled study.” Nutrition journal vol. 15 14. 29 Jan. 2016, doi:10.1186/s12937-016-0130-8

National Institute of Neurological Disorders and Stroke. Pain: Hope Through Research. https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Hope-Through-Research/Pain-Hope-Through-Research. June 9, 2017.

Tight, Sore, Painful Gluteal Muscles and Chiropractic Release

Tight, Sore, Painful Gluteal Muscles and Chiropractic Release

The Gluteus Maximus Muscle is the largest and the outermost of the gluteal muscles. It stretches from the sacrum and coccyx, parts of the spinal column, down to the femur. The other gluteal muscles include the gluteus minimus and medius. They each have a role in the normal function of the hips and legs. They are prone to tightness resulting in soreness, aches, and pain around the hips and in and around the buttocks.

Tight, Sore, Painful Gluteal Muscles and Chiropractic Release

The Gluteal/Rear End Muscles

There are three rear-end muscles:

  • The Gluteus Maximus extends the hip and rotates the thigh outwards, straightens the legs when moving, and provides strength.
  • Gluteus Minimus
  • Gluteus Medius
  • The minimus and medius are underneath the Maximus and stabilize the hip when:
  • Walking
  • Jumping
  • Other physical activities

There is another group of diagonal muscles under the gluteus minimus that attaches to the femur. The uppermost is the piriformis that is attached to the sacrum. The sciatic nerve and major arteries run below it.

Tightness and Irritation

The primary function of the muscles is to open the hips and push the legs out. Sitting for long periods shortens the gluteal muscles causing them to become tight, limiting normal hip function. The gluteal muscles are susceptible to tightness brought on from overuse and lack of development/strength. This can develop into tender/tight muscle bands that interfere with the normal function of the muscles. To get an example of what is happening imagine flexing and contracting one of the bicep muscles 6-10 hours a day. It would be extremely sore, tight, and tender.

Sports and Physically Active

Athletes and individuals that are physically active can also have tight gluteal muscles. This can cause post-game/exercise muscle soreness. Intense activities force the gluteal muscles to work overtime to support the back and knees. Sports that require a lot of leg muscle activation include:

  • Running
  • Soccer
  • Football
  • Crossfit
  • Dancing
  • Weight training

Awkward Walking Gait

Individuals that move with an unusual gait are vulnerable to straining the muscles. What happens is the muscles become stiff from the awkward positions/postures. This places additional strain on the back and hip muscles and worsens their overall posture. The hip muscles are also attached to the pelvis, and when the muscles begin to tighten they can pull on the gluteal muscles. Irritation of the sacroiliac joint can also place pressure on the piriformis, causing spasms that affect the gluteal muscles. Piriformis muscle spasms can also place pressure on the sciatic nerve, causing sciatica.

Diagnosis and Treatment

An examination will be necessary to diagnose whether the soreness or pain is due to muscle inflammation or other cause. Sciatica symptoms and problems at the hip level that involves the gluteus minimus and medius can be felt in the leg. The examination includes seeing and feeling muscle reactions, responses, contractions through a series of motion exercises and movements that involve different muscles. Common treatment includes:

  • Range of motion exercises
  • Strengthening exercises like bridging and resistance bands
  • Deep tissue massages
  • Heat and cold packs
  • Physical therapy
  • Electric muscle stimulation

Tightness in the glutes can be managed with chiropractic treatment. This includes:

  • Soft tissue work
  • Spinal joint manipulation
  • Lifestyle adjustments
  • Stretching
  • Diet
  • Health coaching

Simple exercises can help engage and strengthen the muscles. These include:


Body Composition


Insulin Resistance

Individuals that sit for long periods of time, don’t get enough physical activity, and have an unhealthy diet can experience insulin resistance. This happens when insulin is not able to transport excess blood sugar out of the blood and into the muscles. A study found that women who sat for eight hours a day had an increased chance of developing diabetes. Diabetics can be inclined to have more fat within the body, specifically visceral fat. This further encourages insulin resistance. Diabetics also experience rapid loss of muscle mass as they age, intensifying symptoms and further affecting body composition.

References

Cochrane, Darryl J et al. “Does short-term gluteal activation enhance muscle performance?.” Research in sports medicine (Print) vol. 25,2 (2017): 156-165. doi:10.1080/15438627.2017.1282358

Coratella, Giuseppe et al. “The Activation of Gluteal, Thigh, and Lower Back Muscles in Different Squat Variations Performed by Competitive Bodybuilders: Implications for Resistance Training.” International journal of environmental research and public health vol. 18,2 772. 18 Jan. 2021, doi:10.3390/ijerph18020772

Distefano, Lindsay J et al. “Gluteal muscle activation during common therapeutic exercises.” The Journal of orthopedic and sports physical therapy vol. 39,7 (2009): 532-40. doi:10.2519/jospt.2009.2796

Kalyani, Rita Rastogi et al. “Age-related and disease-related muscle loss: the effect of diabetes, obesity, and other diseases.” The lancet. Diabetes & endocrinology vol. 2,10 (2014): 819-29. doi:10.1016/S2213-8587(14)70034-8

Selkowitz, David M et al. “Which exercises target the gluteal muscles while minimizing activation of the tensor fascia lata? Electromyographic assessment using fine-wire electrodes.” The Journal of orthopedic and sports physical therapy vol. 43,2 (2013): 54-64. doi:10.2519/jospt.2013.4116

Straining, Spasming, Injuring The Lat Muscles

Straining, Spasming, Injuring The Lat Muscles

The latissimus dorsi or lats are the large flat muscles on each side covering the width of the middle and lower back. They connect the bone of the upper arm to the spine and the hip. When pain presents in these muscles, it is typically caused by:

  • Repetitive overuse in a job or doing a task/chore that requires constant
  • Bending
  • Pulling
  • Pushing
  • Reaching
  • Twisting
  • Kneeling
  • A result of poor technique in sports or similar physical activities.

Chiropractic treatment, along with exercises, can help prevent and relieve this pain.

Straining, Spasming, Injuring The Lat Muscles

Symptoms of lat pain

The objective is to diagnose whether the pain is located in the latissimus dorsi or other muscles in the shoulders or back. If the latissimus dorsi is injured, an individual might feel pain in several areas, these include:

  • Lower, middle, and upper back
  • Back of the shoulders
  • The base of the shoulder blade
  • Lower arms
  • Inside of the arms, extending down to the fingers

In certain cases, the pain will present without warning and can be felt in the surrounding muscles. This type of pain often gets worse when the individual:

  • Extends their hands forward and out in front
  • Raises their hands above their head
  • Tosses or throws an object

Damage or injury to the latissimus dorsi

Tissue damage or injury can cause other symptoms to present. These include:

  • Tingling in the lower arms
  • Breathing causes aching and/or pain
  • Tendonitis in the middle and/or lower back

If the source of the back pain cannot be identified, or if it is accompanied by:

  • Fever
  • Breathing problems
  • Abdominal pain
  • Consult a doctor as these could be symptoms of a more serious condition.

Uses and Causes

The lat muscles are used in everyday activities. These include:

  • Picking up objects like grocery bags
  • Opening heavy doors
  • Chest expansion for breathing
  • Pushing against the armrests of a chair to stand up
  • Using handrails to climb stairs

For sports or working out, the lats are used in:

  • Weightlifting exercises using the upper body
  • Bench-presses
  • Rowing
  • Swimming
  • Throwing

Common causes of pain include:

  • Overusing the muscles
  • Using poor techniques
  • Exercising without warming up

Risk of injury

Individuals that are at risk of developing this injury include those that:

  • Are continually reaching overhead
  • Regularly chop wood
  • Perform regular shoveling
  • Move furniture or other heavy objects
  • Regularly practice poor posture

Tearing the latissimus dorsi is possible, especially for athletes. Some athletes with increased risk include:

  • Golfers
  • Baseball pitchers
  • Gymnasts
  • Swimmers
  • Tennis players

Exercises that can help bring relief

Certain exercises can alleviate the aches, pain, and strengthen the lat muscles to prevent and/or worsen the injury. It is recommended to consult a doctor, sports chiropractor, or personal trainer before beginning a therapeutic exercise regimen. This is to ensure that the exercises are right for the individual and their condition and that they use the correct form. Here are two exercises that can help reduce the pain. The doctor, chiropractor, or trainer will recommend the frequency the individual should perform the exercises.

Back bow

This pose is known as the superman pose. To perform:

  • Lay facedown on the floor
  • Extend the legs so they are straight
  • Stretch arms away from the body, so they are in front of the head
  • Use the back to raise the shoulders
  • Extend the arms and legs upward
  • Hold the position for 10 seconds

Pelvic raise/lift

To perform this exercise:

  • Lay flat on your back with the arms at the sides
  • Bend the knees like for a sit-up with the heels close to the buttocks
  • Keeping the hands and feet in place
  • Lift the pelvis upward
  • Slowly lower back to the floor

Prevention

Individuals can prevent lat pain with lifestyle adjustments. These include:

  • Using proper technique and posture during work, sports, and exercise
  • Staying aware to not overuse the muscles
  • Staying hydrated
  • Warming up and cooling down thoroughly before and after a workout, sports, physical activities
  • Regular stretching
  • Applying ice and heat before and after work, sports, and physical activities
  • Chiropractic care
  • Physical therapy massage

Body Composition


Nutrition and Recovery Advantage

Two important steps to achieve optimal health include:

Nutrition

Having a proper protein intake is important for muscle adaptability or the way muscles adapt to stress during exercise and/or strength training. This is also important to stimulate muscle protein synthesis after exercising and/or strength training. To ensure the body is getting the strength and hypertrophy improvement from exercise and strength training, it is recommended to eat around 25g of high-quality protein after workout sessions.

Recovery

For those doing aerobic and strength training, maximize recovery time between workout sessions. This is because strength and aerobic fitness health gains are low when the two only have a separation of 6 hours or less. Twenty-four hours between sessions is recommended especially if the priority is endurance performance.

References

Anderson, S. E., Hertel, R., Johnston, J. O., Stauffer, E., Leinweber, E., & Steinbach, L. S. (2005, November). Latissimus dorsi tendinosis and tear: imaging features of a pseudotumor of the upper limb in five patients. American Journal of Roentgenology, 185(5), 1145–1151
https://www.ajronline.org/doi/abs/10.2214/AJR.04.1247

Donohue, Benjamin F et al. “Sports Injuries to the Latissimus Dorsi and Teres Major.” The American journal of sports medicine vol. 45,10 (2017): 2428-2435. doi:10.1177/0363546516676062http://journals.sagepub.com/doi/abs/10.1177/0363546516676062?journalCode=ajsb

Henseler, J. F., Nagels, J., Nelissen, R. G. H. H., & de Groot, J. H. (2014, April). Does the latissimus dorsi tendon transfer for massive rotator cuff tears remain active postoperatively and restore active external rotation? Journal of Shoulder and Elbow Surgery, 23(4), 553–560
http://www.jshoulderelbow.org/article/S1058-2746(13)00399-6/fulltext%20

George, Michael S, and Michael Khazzam. “Latissimus Dorsi Tendon Rupture.” The Journal of the American Academy of Orthopaedic Surgeons vol. 27,4 (2019): 113-118. doi:10.5435/JAAOS-D-17-00581

Lehman, Gregory J et al. “Variations in muscle activation levels during traditional latissimus dorsi weight training exercises: An experimental study.” Dynamic medicine: DM vol. 3,1 4. 30 Jun. 2004, doi:10.1186/1476-5918-3-4

Weight Training To Strengthen The Back Muscles

Weight Training To Strengthen The Back Muscles

When back pain presents for a prolonged period, the back muscles reduce in mass but increase fat content, resulting in more stiffness. This leads to chronic muscle fatigue and results in chronic pain symptoms. Adding resistance to a workout routine in weight machines, free weights, and/or resistance bands helps reduce back pain. Studies have shown that specific therapeutic back muscle weight training is safe and can help relieve pain. A sports chiropractic specialist can recommend appropriate exercises for individuals and their specific condition/s to safely participate in strength training.

Weight Training To Strengthen The Back Muscles

Back muscles development

With time, back pain and increased fatigue can lead to a fear of moving the body and engaging in physical activity. This results in spinal deconditioning and instability. Weight training works on incrementally/progressively increasing the load that the back muscles can tolerate. This technique gradually improves the body’s ability and strength to perform regular daily activities without strain and in optimal fashion. Weight training improves whole-body health because:

  • Back muscles and core muscles increase in function and performance.
  • Muscles are strengthened.
  • Lean muscle mass increases.
  • The range of motion of the spine increases.
  • Body fat decreases.

Guidelines while using weights

When weight training, it is important to understand safety guidelines to help relieve back pain and not worsen or cause further injury. Weighted treatment exercises are for individuals that have been cleared by their physician or chiropractor and are specific to their injury and /or condition. Depending on the underlying pain source, weight training may not be suitable for individuals that have:

  • Severe pain.
  • Back pain that originates from:
  • Previous spinal surgery
  • Tumor
  • Nerve root compression
  • Neurological symptoms
  • Sciatica
  • Spinal fracture/s
  • Spinal infection/s

Medical professionals and chiropractors can accurately diagnose and determine if weight training is safe and which specific exercises to perform. Guidance from a trained therapist or therapeutic trainer is recommended for optimal results.

  • Weight training techniques to alleviate back pain are different from regular weight or resistance exercises.
  • Trained physical/occupational therapists and sports chiropractors can educate an individual on:
  • Correct techniques
  • Frequency
  • Type of training that will help an individual’s condition.
  • Therapeutic training can significantly reduce the risk of further injury and damage to the spine.
  • After initial training, individuals are encouraged to exercise to maintain back muscles and total body health.

Smaller weights build strength progressively

Effective ways to strengthen the spine.

  • Begin with small/light weights and exercise slowly.
  • Fast rapid movements or incorrect lifting and pulling techniques can cause additional damage to the tissues.
  • It is recommended to start with:
  • Low-load motor control exercises without weights activate and stretch the muscles and improve balance.
  • Simple stretches

Exercise machines can be recommended instead of free weights.

  • Exercise machines can provide safe, effective, and progressive resistance to the exercises.
  • The machines can help reduce/prevent injury compared to free weights.
  • The machines can maintain proper support on the back and spine.

It is recommended to combine regular walking activity with a weight training program.

  • Low impact aerobic exercises increase blood circulation along with essential nutrients to the muscles and soft tissues.
  • This promotes healing and reduces stiffness.

Training program and benefits

Gaining the most benefits from strength training, tips to keep in mind:

  • Warm up for a few minutes using heat therapy and simple stretches.
  • Try for 2 or 3 times a week for 30 minutes.
  • Focus on building strength in the core muscles – back, abdominals, obliques, buttocks, and pelvic leg muscles.
  • There is no need to join a gym or buy expensive equipment.
  • Work out at home with small hand weights, resistance bands, and body weight.
  • The therapist or chiropractor will inform the individual on which exercises to avoid, which require extreme or quick moves.
  • Slow, steady resistance training takes advantage of muscle lengthening exercises and muscle shortening exercises for strengthening.
  • If back pain presents with a sustained increase, take time off or modify the strength training exercises.
  • Some soreness is to be expected, but sharp pain is not. If any sharp, sudden pain presents while exercising, stop immediately.
  • Ice therapy can be beneficial after exercising to decrease inflammation and alleviate pain.

Record the amount of weight when beginning the training and note when progressing to a heavier weight. Consistent improvements in pain, flexibility, strength, and function will help maintain motivation. Consult with a professional sports injury chiropractor today to see if weight training is a suitable and safe treatment.


Body Composition


Carbohydrates and Muscle Growth

Simple carbs are a quick, periodic source of energy. Complex carbs are a recommended source of steady energy. Complex carbs are not as readily available for immediate energy as simple carbs are but are more efficient and healthier. Complex carbs offer sustainable energy, meaning the energy is constant with no crash like simple carbs. Because complex carbs have slow-release properties, they should be the largest component of daily energy consumption.

Carbs prevent muscle weakness.

Some glycogen is stored in the muscles. When those muscles are used during exercise, the body taps into the glycogen stores in that specific muscle. Lifting weights with the arms, for example, access the glycogen in the biceps. Athletes take advantage of glycogen by loading up on carbs by consuming a day or more before a workout. This maximizes the muscle glycogen stores. This delays muscle fatigue, making for a better workout and stronger muscles, and can improve athletic performance.

Carbs help muscles recover after exercise.

Recovery goes back to the glycogen stores. Right after exercising, the body needs to replenish its glycogen stores to prevent glycogen depletion. Glycogen depletion, when the stores run out, causes gluconeogenesis. What happens is the body forms glucose from new sources. This is to compensate for the lack of glucose from carbohydrates. This is when the body turns to sources like fat and protein to fill the need. Protein is the last line of defense when energy is required, meaning that energy is running low. When the body breaks down protein for glucose production, it takes what it needs from the muscle/s, causing them to shrink and break down.

References

Dreisinger TE. Exercise in the management of chronic back pain. Ochsner J. 2014;14(1):101–107.

Lee JS, Kang SJ. Strength exercise and walking effects on lumbar function, pain level, and body composition in chronic back pain patients. J Exerc Rehabil. 2016;12(5):463–470. Published 2016 Oct 31. doi:10.12965/jer.1632650.325

Michaelson P, Holmberg D, Aasa B, Aasa U. High load lifting exercise and low load motor control exercises as interventions for patients with mechanical low back pain: A randomized controlled trial with 24-month follow-up. J Rehabil Med. 2016;48(5):456-63.

Welch N, Moran K, Antony J, et al. The effects of a free-weight-based resistance training intervention on pain, squat biomechanics, and MRI-defined lumbar fat infiltration and functional cross-sectional area in those with chronic low back. BMJ Open Sport Exerc Med. 2015;1(1):e000050. Published 2015 Nov 9. doi:10.1136/bmjsem-2015-000050

Quadriceps Thigh Strain: Chiropractic

Quadriceps Thigh Strain: Chiropractic

The quadriceps muscle consists of four muscles in front of the thigh that connects to the knee right below the knee cap. These muscles straighten the knee for walking, running, and jumping. They also help bend the knee for squatting. They move the leg forward when running and fire/transmit electrical impulses when the foot hits the ground to absorb shock. When jumping, the muscles provide stability coming down as well as when standing on one leg.

Quadriceps Thigh Strain: Chiropractic

Quadriceps Strain

Thigh strains are common in sports. Most players are sidelined because of this injury when compared to strains in the hamstrings or groin. Factors that can increase the risk of injury include:

  • Exhaustion
  • Muscle weakness
  • The strength of the quadriceps to the hamstrings is uneven, causing one set to get overused.
  • Consistent sprinting and/or kicking
  • Previous strain and/or injury

The quadriceps is made up of four muscles.  One is the rectus femoris, which gets injured the most. It’s the only muscle that crosses two joints – the hip joint and the knee joint.

Symptoms and Injury Grades

Individuals commonly report a pulling/stretching sensation in the front of the thigh. Common symptoms include:

  • Pain
  • Swelling
  • Bruising
  • Muscle tenderness
  • For minor quadriceps strains or tears, moderate to dull pain presents along with stiff movement.

Grades categorize the severity of the strain:

  • Grade 1 presents with mild discomfort in the thigh with no loss of strength.
  • Grade 2 presents with moderate pain, swelling, and some loss of strength.
  • Grade 3 is a complete rupture of the fibers. Individuals are in severe pain and unable to walk.
  • Grade 3 is where surgery is required.

Symptoms can vary depending on the type of injury that has been sustained and the severity. There is pain and localized swelling for both strains and contusions. If a muscle rupture has happened, there could be a bump/lump within the muscle or a gap in the muscle. If rupture of the Quadriceps Tendon has occurred, individuals often report hearing a pop when the injury happens. The swelling often makes straightening the leg difficult or impossible.

Injury causes

Thigh strains usually happen when slowing down/decelerating after a sprint. This can be because the individual takes too small or too large steps causing the muscles to overstretch, much like a rubber band that, if overstretched, tears, and if under stretched, it bunches up, which can cause spasms and tears.

Treatment

In the initial stages after a quadriceps strain, it is recommended to follow the RICE Procedure for 24 hours: This includes:

  • Rest
  • Ice
  • Compression
  • Elevate
  • The leg needs to be rested every 2-3 hours in 20-minute sessions.
  • A bandage can provide added support.
  • For slight tears and strains, it is recommended to stretch the quadriceps gently.
  • This helps prevent the muscles from experiencing shortening. This happens by the formation of scar tissue that pulls the muscle/s, making them shorter.
  • Gentle stretches allow the muscles to heal with minimal shortening. This helps prevent further and/or re-injury.

Chiropractic Physical Therapy Rehabilitation

After the acute stage of the injury, receiving regular chiropractic sports adjustments, physical therapy massage, coupled with strength training exercises will speed up recovery.

  • Physical therapy massage will remove scar tissue and keep the muscle/s loose and flexible.
  • Exercises for strengthening the muscles after injury will be recommended according to the individual’s condition/case.
  • Following correct post-injury-care, exercises, and physical therapy.
  • Healing time can be 4- 6 weeks.

Body Composition


Strength Training: The Inverted Row

This workout targets the back muscles, spine and scapular stabilizers, deep abdominals, and arms. Everyday activities that require various types of pulling motion, lifting, etc., become easier. To perform:

  • Lie flat on your back.
  • Grab a stable barbell or set of straps that are above you.
  • Pull your upper body up as high as possible while keeping the back straight.
  • Squeeze the shoulder blades together at the top.
  • Complete as many reps as possible.
  • Once enough strength and endurance have been built, try a pullup.
References

Kary, Joel M. “Diagnosis and management of quadriceps strains and contusions.” Current reviews in musculoskeletal medicine vol. 3,1-4 26-31. 30 Jul. 2010, doi:10.1007/s12178-010-9064-5

Hillermann, Bernd, et al. “A pilot study comparing the effects of spinal manipulative therapy with those of extra-spinal manipulative therapy on quadriceps muscle strength.” Journal of manipulative and physiological therapeutics vol. 29,2 (2006): 145-9. doi:10.1016/j.jmpt.2005.12.003

Wenban, Adrian B. “Influence of active release technique on quadriceps inhibition and strength: a pilot study.” Journal of manipulative and physiological therapeutics vol. 28,1 (2005): 73. doi:10.1016/j.jmpt.2004.12.015

Bursitis Types

Bursitis Types

Bursitis types: This is a condition that affects the bursae, which are the small, fluid-filled sacs that provide cushion for the:

  • Muscles
  • Tendons
  • Bones near joints

The bursae make it easier for tissues to slide over each other. The body has around one hundred and sixty bursae. However, only a few become clinically affected. These include the:

  • Wrist
  • Elbow
  • Shoulder
  • Hips
  • Knees
  • The base of the big toe and heel

The condition typically presents near joints constantly being used repetitively, like a job, sports, house/yard chores, etc. What happens is one or more of the bursae sacs become inflamed, resulting in pain.

Bursitis Types

Causes

  • Inflamed or irritated bursae typically cause it from overuse or intense/vigorous activity.
  • It can also be caused by bacterial infection.
  • Arthritis and gout can also cause bursitis.
  • Another cause is age.
  • As tendons age, they can tear easily, lose their elasticity, and can’t take too much stress.

Intense physical activities can lead to bursitis. These include:

  • Gardening
  • Typing
  • Working with a computer mouse
  • Throwing
  • Golf
  • Tennis
  • Manual tasks
  • Carpentry

These types of activities can lead to incorrect posture, overuse, and injury/damage.

Symptoms

The main symptom is pain in and around the affected area that worsens with movement. Depending on the severity of the strain and the length of time it has been going on, the pain can be intense with active and passive movements. Other symptoms include:

  • Tenderness
  • Stiffness
  • For some individuals, it can present as acute, with the intensity increasing.
  • This happens when movement aggravates the condition.

Bursitis Types

Four major types include:

  • Prepatellar
  • Trochanteric
  • Olecranon
  • Retrocalcaneal

Prepatellar Bursitis

Prepatellar is an inflammation of the sac situated between the skin and the patella/kneecap. The most common causes are trauma from a fall and direct pressure/friction from repetitive kneeling. This is one of the bursitis types that can get infected. Overproduction of liquid places pressure on the other areas of the knee, causing swelling. Most individuals report swelling and knee pain just over the front of the knee.

Trochanteric Bursitis

This bursitis type goes over the lateral area of the hip. There is a distinctive tenderness and aching pain. This type is more common for individuals with arthritis conditions and fibromyalgia. This condition is also seen after surgery, mainly osteotomies. The bursa can become inflamed in case of injury or overuse. It tends to affect middle-aged or older folks. Common causes include:

  • Muscle tears
  • Hip injuries
  • Tight hip or leg muscles
  • Disc disease of the low back
  • Leg-length inequality
  • Improper walking technique from a minor injury or strain
  • Overuse of the gluteal muscles
  • Flat feet
  • Improper footwear

Olecranon Bursitis

Olecranon is a common bursitis type. It is diagnosed by the appearance of swelling over the elbow. The swelling happens just behind the olecranon process of the ulna. The bursa can become infected. This bursitis does cause blood to rupture out, and fluid could be present. Individuals are advised to avoid leaning or resting on the elbows.

Retrocalcaneal Bursitis

This is characterized by pain in the Achilles tendon. Chronic inflammation of the bursa is brought on by friction, supination, and overpronation.  The flexibility of the calf muscles can be significantly reduced. Severe pain and swelling of the posterior soft tissue in front of the Achilles tendon are common symptoms. This bursitis type is often accompanied by mid-portion insertional tendinosis.

Risk Of Getting Bursitis

Anybody at any age can develop bursitis, but older individuals, specifically those in their forties and beyond, are more susceptible. This comes from all the wear and tear of the muscles and bones.

Risk Factors

  • Overpronation of the foot
  • Leg length deviation
  • Osteoarthritis
  • Obesity
  • Tight hamstring muscles
  • Incorrect physical training
  • Not stretching properly

Body Composition


When Inflammation Becomes Permanent

When white blood cells cause inflammation, it’s signaling that the body’s immune system works properly. The process works like this:

  • Inflammation activates
  • White blood cells attack the foreign invader
  • The invader is neutralized
  • The inflammation deactivates

This is how the body’s defense system naturally works. But, white blood cells are not the only type of cell that emit cytokines. Adipocytes or fat cells are another type of cell that can emit cytokines and cause inflammation. Scientists have learned that fat is an active endocrine organ that secretes various proteins and chemicals, including inflammatory cytokines. The body stores excess calories as fat to be used later for energy. When the body keeps adding more adipose tissue, cytokines are released by the fat cells, triggering inflammation. Obesity is characterized as a state of low-grade, chronic inflammation. Increased fat cells place the body in a constant state of stress activating immune responses. This means the body is in a constant state of inflammation with the immune system switch permanently on.

References

Aaron, Daniel L et al. “Four common types of bursitis: diagnosis and management.” The Journal of the American Academy of Orthopaedic Surgeons vol. 19,6 (2011): 359-67. doi:10.5435/00124635-201106000-00006

Coelho, Marisa et al. “Biochemistry of adipose tissue: an endocrine organ.” Archives of medical science: AMS vol. 9,2 (2013): 191-200. doi:10.5114/aoms.2013.33181

Khodaee, Morteza. “Common Superficial Bursitis.” American family physician vol. 95,4 (2017): 224-231.

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