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Golfing Wrist Injuries

Golfing Wrist Injuries

Golfing wrist injuries are common with treatment requiring 1-3 months of rest and immobilization and if tears are present surgery. Can chiropractic treatment help avoid surgery, expedite recovery, and rehabilitation?

Golfing Wrist Injuries

Golfing Wrist Injuries

Golfing Wrist Injuries: According to a study, there are over 30,000 golf-related injuries treated in American emergency rooms every year. (Walsh, B. A. et al, 2017) Nearly a third are related to a strain, sprain, or stress fracture.

  • One of the most common causes of wrist pain is overuse. (Moon, H. W. et al, 2023)
  • Repeated swinging generates added stress on the tendons and muscles, leading to inflammation and pain.
  • Improper swing techniques can cause the wrists to twist uncomfortably, resulting in inflammation, soreness, and injuries.
  • Golfers who grip the club too tightly can add unnecessary strain on their wrists, leading to pain and weakened grip.

Wrist Tendonitis

  • The most common wrist injury is an inflammation of the tendons. (Ray, G. et al, 2023)
  • This condition is often caused by overuse or repetitive motion.
  • It usually develops in the leading hand from bending the wrist forward on the backswing and then extends backward at the finish.

Wrist Sprains

  • These can occur when the golf club hits an object, like a tree root, and makes the wrist bend and/or twist awkwardly. (Zouzias et al., 2018)

Hamate Bone Fractures

  • When the club hits the ground abnormally it can compress the handle against the bony hooks at the end of the smaller hamate/carpal bones.

Ulnar Tunnel Syndrome

  • This can cause inflammation, and numbness, and is usually caused by an improper or loose grip.
  • It causes nerve damage to the wrist from repeated bumping of the golf club handle against the palm.

de Quervain’s Tenosynovitis

  • This is a repetitive motion injury below the thumb at the wrist. (Tan, H. K. et al, 2014)
  • This causes pain and inflammation and is usually accompanied by a grinding sensation when moving the thumb and wrist.

Chiropractic Treatment

Given the nature of these injuries, medical attention should be sought out for image scans to look at any damage and properly immobilize the wrist. Once a fracture has been ruled out or healed, golfing wrist injuries can benefit from chiropractic and physical therapy(Hulbert, J. R. et al, 2005) A typical treatment may involve a multifaceted approach involving various therapies including:

  • Active release therapy, myofascial release, athletic taping, corrective exercise, and stretching. 
  • A chiropractor will examine the wrist and its functioning to determine the nature of the injury.
  • A chiropractor may recommend using a splint to immobilize the wrist, particularly in cases of overuse.
  • They will relieve pain and swelling first, then focus on strengthening the joint.
  • They may recommend a regimen of icing the hand.
  • Adjustments and manipulations will relieve pressure on the nerves to reduce swelling and restore mobility.

Peripheral Neuropathy Successful Recovery


References

Walsh, B. A., Chounthirath, T., Friedenberg, L., & Smith, G. A. (2017). Golf-related injuries treated in United States emergency departments. The American journal of emergency medicine, 35(11), 1666–1671. https://doi.org/10.1016/j.ajem.2017.05.035

Moon, H. W., & Kim, J. S. (2023). Golf-related sports injuries of the musculoskeletal system. Journal of exercise rehabilitation, 19(2), 134–138. https://doi.org/10.12965/jer.2346128.064

Ray, G., Sandean, D. P., & Tall, M. A. (2023). Tenosynovitis. In StatPearls. StatPearls Publishing.

Zouzias, I. C., Hendra, J., Stodelle, J., & Limpisvasti, O. (2018). Golf Injuries: Epidemiology, Pathophysiology, and Treatment. The Journal of the American Academy of Orthopaedic Surgeons, 26(4), 116–123. https://doi.org/10.5435/JAAOS-D-15-00433

Tan, H. K., Chew, N., Chew, K. T., & Peh, W. C. (2014). Clinics in diagnostic imaging (156). Golf-induced hamate hook fracture. Singapore medical journal, 55(10), 517–521. https://doi.org/10.11622/smedj.2014133

Hulbert, J. R., Printon, R., Osterbauer, P., Davis, P. T., & Lamaack, R. (2005). Chiropractic treatment of hand and wrist pain in older people: systematic protocol development. Part 1: informant interviews. Journal of chiropractic medicine, 4(3), 144–151. https://doi.org/10.1016/S0899-3467(07)60123-2

Joint Manipulation Health Benefits

Joint Manipulation Health Benefits

Individuals at work, school, etc, perform all kinds of repetitive physical tasks that put their bodies through a great deal of musculoskeletal stress, what are the effects and benefits of joint manipulation therapy for pain relief?

Joint Manipulation Health Benefits

Joint Manipulation Health Benefits

Joint manipulation is a form of manual therapy that involves applying force to the spinal or peripheral joints to:

  • Relieve pain symptoms.
  • Realign the joints to their proper position.
  • Restore flexibility.
  • Improve mobility.
  • Increase range of motion.

Chiropractors, massage, and physical therapists use various manipulation techniques to help move and feel better after an injury or illness that causes loss of functional mobility. Here we explain joint manipulation, its applications, and if the technique is safe for you and your condition.

Joint Popping

  • The joints in the body are places where two or more bones come together to allow movement.
  • On the ends of a bone is a lining of hyaline cartilage.
  • The cartilage allows the joint surfaces to glide/slide smoothly.
  • If the cartilage is injured or damaged, pain and limited motion can present.
  • When a joint doesn’t move properly, the muscles surrounding that joint don’t contract properly.
  • If a joint is dysfunctional for some time, significant muscle wasting and atrophy can occur around the joint, leading to difficulty with mobility like standing, walking, or reaching. (Hurley MV.1997)

The body is made up of cells that breathe by converting energy and releasing waste materials. One type of waste material from cell respiration is carbon dioxide. The gas is transported through the blood and delivered out of the body while breathing. Small pockets of gas can get trapped in the joints that expand and contract as pressure around the joint changes during movement, known as cavitation. When the gas is released through joint manipulation, there can be a popping or snapping sound as the joint is moved. Once the gas is released, joint pressure is decreased and mobility is increased. (Kawchuk, et al., 2015)

Causes

Non-medical

There are non-medical and medical causes of joint dysfunction and derangement that include:

  • Overuse and repetitive strain.
  • Unhealthy sitting and/or standing posture.
  • Lack of physical activity.
  • Over-stretching or stretching incorrectly.

In these situations, the joints can be temporarily placed in a dysfunctional/compromised position. When moving to the correct position, a popping sound can present as built-up pressure is released.

Medical

Joint problems can occur from medical conditions that can include:

  • Herniated cervical or lumbar discs.
  • Spinal arthritis.
  • Rheumatoid arthritis.
  • Osteoarthritis.
  • Joint contracture after being immobilized for some time.

In these cases, a medical problem can be causing a limitation in the joint’s position and movement. (Gessl, et al., 20220)

Benefits

If a chiropractic practitioner determines there is joint dysfunction then manipulation may be a treatment option. The benefits include:

Pain Relief

  • When a chiropractor or therapist gets an injured joint moving properly, the receptors in and around the area get reset allowing for pain relief.

Improved Muscle Activation

  • As a chiropractor manipulates a joint into its correct anatomical position, the surrounding muscles can flex and contract properly.

Improved Range of Motion

  • The joint is repositioned for proper movement.
  • This improves the range of motion and relieves tightness and stiffness.

Improved Functional Mobility

  • Once a joint is manipulated, the improved range of motion and muscle activation around the joint can lead to improved overall functional mobility. (Puentedura, et al., 2012)

Candidates

Joint manipulation is a safe manual therapy technique for certain individuals. (Puentedura, et al., 2016) This includes:

  • Individuals with acute neck, back, or peripheral joint pain.
  • Adults aged 25 to 65 with no serious medical conditions.
  • Athletes who have been injured from their sport.
  • Individuals who have been immobilized after injury or surgery.

Joint manipulation is not recommended for everyone and can be dangerous or lead to injury in individuals with certain conditions. (Puentedura, et al., 2016) These include individuals with:

Osteoporosis

  • Weakened bones may fracture if a high-velocity force is applied to a joint via manipulation

Joint fractures

  • Individuals with a joint fracture, should not have that specific joint manipulated.

Post Spinal Fusion Surgery

  • Individuals that have had spinal fusion in the neck or lower back should avoid spinal joint manipulations or adjustments for at least one year after the procedure.
  • The bones need time to heal thoroughly.
  • Manipulation can cause a failure of the fusion.

Individuals with Arterial Insufficiency In Their Neck

  • A rare but dangerous side effect of a neck adjustment is the risk of tearing an artery in the neck known as the vertebrobasilar artery. (Moser, et al., 2019)

If there is pain, loss of movement, or decreased mobility after an injury or surgery, a chiropractic adjustment with joint manipulation can be beneficial to help regain movement. Manual techniques can help improve joint mobility, alleviate pain, and increase strength and stability around the joints. Joint manipulation isn’t for everyone and is recommended to consult with a healthcare professional to see if it is safe for your specific condition.


Arthritis Explained


References

BASTOW J. (1948). Indications for joint manipulation. Proceedings of the Royal Society of Medicine, 41(9), 615.

Gessl, I., Popescu, M., Schimpl, V., Supp, G., Deimel, T., Durechova, M., Hucke, M., Loiskandl, M., Studenic, P., Zauner, M., Smolen, J. S., Aletaha, D., & Mandl, P. (2021). Role of joint damage, malalignment, and inflammation in articular tenderness in rheumatoid arthritis, psoriatic arthritis, and osteoarthritis. Annals of the rheumatic diseases, 80(7), 884–890. https://doi.org/10.1136/annrheumdis-2020-218744

Hurley M. V. (1997). The effects of joint damage on muscle function, proprioception, and rehabilitation. Manual therapy, 2(1), 11–17. https://doi.org/10.1054/math.1997.0281

Kawchuk, G. N., Fryer, J., Jaremko, J. L., Zeng, H., Rowe, L., & Thompson, R. (2015). Real-time visualization of joint cavitation. PloS one, 10(4), e0119470. https://doi.org/10.1371/journal.pone.0119470

Moser, N., Mior, S., Noseworthy, M., Côté, P., Wells, G., Behr, M., & Triano, J. (2019). Effect of cervical manipulation on the vertebral artery and cerebral hemodynamics in patients with chronic neck pain: a crossover randomized controlled trial. BMJ open, 9(5), e025219. https://doi.org/10.1136/bmjopen-2018-025219

Puentedura, E. J., Cleland, J. A., Landers, M. R., Mintken, P. E., Louw, A., & Fernández-de-Las-Peñas, C. (2012). Development of a clinical prediction rule to identify patients with neck pain likely to benefit from thrust joint manipulation to the cervical spine. The Journal of orthopedic and sports physical therapy, 42(7), 577–592. https://doi.org/10.2519/jospt.2012.4243

Puentedura, E. J., Slaughter, R., Reilly, S., Ventura, E., & Young, D. (2017). Thrust joint manipulation utilization by U.S. physical therapists. The Journal of manual & manipulative therapy, 25(2), 74–82. https://doi.org/10.1080/10669817.2016.1187902

Recommended Nutrition For Constipation

Recommended Nutrition For Constipation

The digestive system breaks down the foods eaten so the body can absorb the nutrients. During digestion, the unnecessary parts of these foods are turned into waste/stool, which is evacuated during a bowel movement. When the digestive system stops functioning properly due to factors such as diet change, eating unhealthy foods, lack of physical activity/exercise, medications, and certain health conditions, can cause constipation. Constipation occurs when the body cannot have a regular bowel movement. The distention, gas, bloating and not being able to have a bowel movement cause irritability and stress, which can worsen constipation. Incorporating recommended nutrition can help restore regular bowel movements and gut function.

Recommended Nutrition For Constipation

Recommended Nutrition For Constipation

Symptoms like abdominal pain, bloating, and difficult bowel movements are common. Diet and proper hydration have a significant role in digestive health, especially in relieving and preventing constipation. High-fiber foods, prebiotics, and adequate hydration from foods and beverages are essential for healthy bowel movements.

  • Fiber is found in whole grains, starches, fruits, and vegetables.
  • Soluble and insoluble fiber are important for digestive health.
  • Focusing on incorporating high-fiber fruits, vegetables, and whole grains.
  • Foods rich in prebiotics like fermented foods are recommended when constipated.

The recommended nutrition for constipation, according to a dietitian includes.

Avocados

  • Avocados can be paired with just about anything and are full of nutrients and fiber.
  • One avocado contains around 13.5 grams of fiber.
  • One avocado will provide almost half daily fiber needs.
  • Other high-fiber fruits: pomegranates, guava, raspberries, blackberries, and passionfruit.

Figs

  • Figs can be eaten fresh and dried.
  • Figs are considered a laxative and have been shown to treat and reduce constipation.
  • They contain antioxidants, polyphenols, polyunsaturated fatty acids, and vitamins.
  • Other fruits similar to a fig: dried apricots, prunes, and plums.

Plums

  • Plums, prunes dried plums are packed with fiber and prebiotics that have a natural laxative effect.
  • Sorbitol – a sugar found in plums and prunes, acts as an osmotic laxative that retains water.
  • The added H2O makes the stools softer and easier to pass.
  • Natural fruit juices, like pear, apple, or prune are often prescribed for constipation.
  • Other fruits that aid in bowel movements: peaches, pears, and apples.

Kefir

  • Fermented foods like kefir are rich in beneficial bacteria that work to maintain digestive system health.
  • It can be consumed on its own or used in smoothies, cooking, and baking recipes.
  • Other fermented foods: kombucha, yogurt, sauerkraut, kimchi, miso, and tempeh.

Oat Bran

  • Oat bran is oatmeal that has not had the bran removed.
  • The bran contains beneficial nutrients including fiber, antioxidants, vitamins, and minerals.
  • Oat bran contains soluble and insoluble fiber, as well as beta-glucan/non-starchy polysaccharides.
  • All improve the composition of gut bacteria and promote healthy bowel movements.
  • Other beneficial grains: oatmeal, wheat bran, rye, and barley.

Incorporating Gut-Beneficial Foods

How to incorporate recommended nutrition gut-beneficial foods into a regular menu:

Smoothie

  • Use kefir or yogurt as a base then balance it out with fiber-rich fruits like mango, blueberries, and kiwi.

Snacks

  • Diversify snacks with a plate of fiber and prebiotics.
  • Nuts, cheese, crackers, fruit, and a yogurt or avocado dip.

Oatmeal

  • Try oat bran to increase fiber.
  • Sprinkle a serving of flaxseeds, chia seeds, or hemp seeds for added fiber and healthy fats.

Parfait

  • Yogurt parfaits can maximize nutrients, flavor, and textures in a bowl.
  • Layer up on a favorite yogurt with granola, nuts, fruit, and seeds.

Grain Bowl

  • Fiber found in whole grains and seeds like barley, farro, and quinoa, helps promote healthy digestion.
  • Make a bowl with a grain base, then top with a protein, fresh or grilled veggies, avocado, and dressing.

Talk with a registered nutritionist or other healthcare provider to discuss recommended nutrition plan options.


Balancing Body and Metabolism


References

Arce, Daisy A et al. “Evaluation of constipation.” American family physician vol. 65,11 (2002): 2283-90.

Bharucha, Adil E. “Constipation.” Best practice & research. Clinical gastroenterology vol. 21,4 (2007): 709-31. doi:10.1016/j.bpg.2007.07.001

Gray, James R. “What is chronic constipation? Definition and diagnosis.” Canadian Journal of Gastroenterology = Journal Canadien de Gastroenterology vol. 25 Suppl B, Suppl B (2011): 7B-10B.

Jani, Bhairvi, and Elizabeth Marsicano. “Constipation: Evaluation and Management.” Missouri medicine vol. 115,3 (2018): 236-240.

Naseer, Maliha, et al. “Therapeutic Effects of Prebiotics on Constipation: A Schematic Review.” Current clinical pharmacology vol. 15,3 (2020): 207-215. doi:10.2174/1574884715666200212125035

National Institute of Diabetes and Digestive and Kidney Diseases. Symptoms and Causes of Constipation.

National Institute of Diabetes and Digestive and Kidney Disease. Your Digestive System and How It Works.

Sinclair, Marybetts. “The use of abdominal massage to treat chronic constipation.” Journal of bodywork and movement therapies vol. 15,4 (2011): 436-45. doi:10.1016/j.jbmt.2010.07.007

Hiking Training Tips and Preparation

Hiking Training Tips and Preparation

Hiking is a form of exercise accessible to a wide range of physical abilities, which makes it a great outdoor activity for all. The health benefits include improved blood pressure, sleep, and reduced stress and anxiety. However, being out in the elements without conditioning the body can lead to serious injuries and other health issues. Many trails are rough, uneven, and have elevation gain, so even the easiest courses require balance and strength to avoid injury. Hiking training that includes strength, cardio, and practice will help condition the body to allow the trip to be more enjoyable and safe.

Hiking Training Tips and Preparation

Hiking Training

Two of the most common hiking injuries are rolling the ankle and ankle sprains. Individuals that are out of shape or haven’t been active for some time are recommended to start with basic movements and exercises to warm up the muscles and increase heart rate.

Walk/Run Through Sand

  • This builds the muscles that protect the knees and ankles.

Increase Range of Motion

  • Using a resistance band will strengthen muscles through their full extension.
  • Standing on a tennis ball or balance disc is great as it builds the small stabilizer muscles around the ankles and knees.

Crunches

  • Building core strength will help maintain balance on uneven surfaces.

Squats and Lunges

  • Keep the back straight and take each squat and lunge slowly to strengthen the core muscles.

Push-ups

  • Sufficient upper body strength, especially the back muscles will help on long trips and when carrying a heavy pack.

Cardiovascular

  • Walking around the neighborhood, on a treadmill, or stationary bike will work to increase cardiovascular ability.
  • The objective is to get the heart rate up to build lung capacity.

Step-ups

  • Before a backpacking trip, weigh the pack – try 20 lbs. – and step up onto a park bench 16 to 18 inches high.
  • Add 5 pounds a week until the pack is as heavy as it will be on the hike.

Strength Hiking Training for Backpacking

Carrying a heavy pack activates many muscles, including those of the arms and shoulders, and back. Hiking for an extended period with a backpack requires getting used to the weight and feel of it. Nothing conditions the body for a pack better than actually experiencing it.

Shoulder and Neck

  • The trapezius muscles radiate out from the base of the neck.
  • This is where the shoulder harness of the pack sits.
  • Strong traps help prevent soreness.
  • Most of the pack’s weight should be on and around the hips, but it doesn’t always happen due to pack design and ​​body shape.

Shoulder and Arm

  • The shoulder of the arm used to put on and take off the pack does a lot of work at awkward angles.
  • The rotator cuff of the shoulder is vulnerable to these loads.

Upper Back

  • The muscles of the upper and mid back contract to stabilize the pack, especially with heavy loads.
  • Beginning hikers and backpackers tend to get a dull pain right in the center of the shoulder blades.

Lower Back

  • The lower back takes the brunt of the force from lifting and twisting the posterior chain of muscles.

Abdominal Muscles

Legs

  • Walking, squatting, and standing with the pack requires strong support from the legs.
  • Strong legs, especially thighs, make a difference.
  • An all-around beginner’s workout is a good place to begin.

Hiking Training: Preparing For A Weekend Hike

  • Go out for a walk two or three times during the week.
  • Make sure to move briskly enough to get the heart rate up, and keep it up for at least 30 minutes.
  • Wear a lightly-weighted daypack on weekday walks to prepare for the essential gear.
  • Wear the same shoes that you will be wearing on the hike.
  • A definite way to get blisters is to walk for a long time in shoes that haven’t been worn in a while or at all.

Take The Essentials

For simple day hikes, here are some essentials to have on hand:

  • Plenty of water
  • Simple first-aid kit
  • Map – paper type
  • Compass
  • Food
  • Fire-starter or matches
  • Multi-purpose knife or tool
  • Flashlight and batteries
  • Sun hat
  • Sunscreen and sunglasses

Start small and go slow until you feel comfortable in the surroundings. Start off with lightweight and short distances and gradually extend to heavier weights and longer distances. Remember to go at your own pace and don’t try to be an expert.


Hikers Strength Training


References

Chrusch, Adam, and Michelle Kavin. “Survey of Musculoskeletal Injuries, Prehike Conditioning, and On-Trail Injury Prevention Strategies Self-Reported by Long-Distance Hikers on the Appalachian Trail.” Wilderness & environmental medicine vol. 32,3 (2021): 322-331. doi:10.1016/j.wem.2021.04.004

Fleg, Jerome L. “Aerobic exercise in the elderly: a key to successful aging.” Discovery Medicine vol. 13,70 (2012): 223-8.

Gatterer, H et al. “Effect of weekly hiking on cardiovascular risk factors in the elderly.” Zeitschrift fur Gerontologie und Geriatrie vol. 48,2 (2015): 150-3. doi:10.1007/s00391-014-0622-0

Huber, Daniela, et al. “Sustainability of Hiking in Combination with Coaching in Cardiorespiratory Fitness and Quality of Life.” International journal of environmental research and public health vol. 19,7 3848. 24 Mar. 2022, doi:10.3390/ijerph19073848

Liew, Bernard, et al. “The Effect of Backpack Carriage on the Biomechanics of Walking: A Systematic Review and Preliminary Meta-Analysis.” Journal of applied biomechanics vol. 32,6 (2016): 614-629. doi:10.1123/jab.2015-0339

Li, Simon S W, et al. “Effects of a backpack and double pack loads on postural stability.” Ergonomics vol. 62,4 (2019): 537-547. doi:10.1080/00140139.2018.1552764

Li KW, Chu JC, Chen CC. Strength decrease, perceived physical exertion, and endurance time for backpacking tasks. Int J Environ Res Public Health. 2019;16(7):1296. doi:10.3390/ijerph16071296

Mitten, Denise, et al. “Hiking: A Low-Cost, Accessible Intervention to Promote Health Benefits.” American Journal of lifestyle medicine vol. 12,4 302-310. 9 Jul. 2016, doi:10.1177/1559827616658229

Stiffness and Pain Developing In The Shoulder

Stiffness and Pain Developing In The Shoulder

Stiffness and pain developing in the shoulder could be adhesive capsulitis, (frozen shoulder), a condition in the shoulder’s ball-and-socket joint/glenohumeral joint. It usually develops over time and limits the functional use of the arm. The pain and tightness restrict arm movement, and the duration of symptoms can persist for 12-18 months. The cause is often unknown, but it is more common in individuals over 40, individuals with diabetes, thyroid disease, and cardiac conditions have an increased risk of developing the condition, and women tend to develop the condition more than men. Chiropractic treatment can be effective at relieving pain and expediting recovery.

Stiffness and Pain Developing In The Shoulder

Stiffness and Pain

The shoulder joint allows more movement than any other joint in the body. A frozen shoulder causes the capsule surrounding the shoulder joint to contract and form scar tissue. The capsule contraction and the formation of adhesions cause the shoulder to become stiff, restrict movement, and cause pain and discomfort symptoms.

Stages

The progression is marked by three stages:

Freezing

  • Stiffness and pain begin to restrict motion.

Frozen

  • Movement and motion are severely restricted.

Thawing

  • The shoulder starts to loosen up.
  • It can take years to fully resolve symptoms.
  • In mild cases, a frozen shoulder can go away on its own but that does not mean that it is truly healed and correctly aligned.
  • Even in mild cases seeking treatment is recommended, rather than just waiting for it to go away.

Symptoms

  • Limited range of motion.
  • Stiffness and tightness.
  • Dull or aching pain throughout the shoulder.
  • Pain can radiate into the upper arm.
  • Pain can be triggered by the smallest movements.
  • The symptoms are not always due to weakness or injury, but actual joint stiffness.

Causes

Most frozen shoulders occur with no injury or discernible cause but the condition is often linked to a systemic condition or one that affects the entire body.

Age and Gender

  • Frozen shoulder most commonly affects individuals between the ages of 40 to 60, and is more common in women than in men.

Endocrine Disorders

  • Individuals with diabetes have an increased risk of developing a frozen shoulder.
  • Other endocrine abnormalities like thyroid problems can also lead to the development of this condition.

Shoulder Trauma and/or Surgery

  • Individuals who sustain a shoulder injury, or undergo surgery on the shoulder can develop a stiff and painful joint.
  • When injury or surgery is followed by prolonged immobilization/resting the arm, the risk of developing a frozen shoulder increases.

Other Systemic Conditions

Several systemic conditions such as heart disease have also been associated with an increased risk of developing the condition and can include:

  • High cholesterol
  • Adrenal disease
  • Heart and lung disease
  • Parkinson’s disease

Stiffness and pain can also be associated with damage to the joint from injuries or other shoulder problems that include:

  • Muscle or connective tissue injury
  • Rotator cuff tendinopathy
  • Calcific tendinitis
  • Dislocation
  • Fracture
  • Osteoarthritis
  • A frozen shoulder associated with any of these causes is considered secondary.

Treatment

A diagnosis is made by observing the range of motion in the shoulder, considering the two types:

Active Range

  • This is how far an individual can move a body part on their own.

Passive Range

  • This is how far another person like a therapist or doctor can move the body part.

Therapies

  • Chiropractic, massage, and physical therapy involve stretches, realignment, and exercises to relieve pain symptoms and restore mobility and function.
  • Usually, strength is not affected by a frozen shoulder but a chiropractor may want to strengthen the surrounding muscles to better support the shoulder and prevent worsening the injury or causing a new injury.
  • Anti-inflammatory medications and corticosteroid injections may help manage pain symptoms.
  • Getting a diagnosis and treatment during the freezing stage can keep the condition from progressing and expedite recovery time.

Enhancing Health: Evaluation and Treatment


References

Brun, Shane. “Idiopathic frozen shoulder.” Australian Journal of general practice vol. 48,11 (2019): 757-761. doi:10.31128/AJGP-07-19-4992

Chan, Hui Bin Yvonne, et al. “Physical therapy in the management of frozen shoulder.” Singapore medical journal vol. 58,12 (2017): 685-689. doi:10.11622/smedj.2017107

Cho, Chul-Hyun, et al. “Treatment Strategy for Frozen Shoulder.” Clinics in orthopedic surgery vol. 11,3 (2019): 249-257. doi:10.4055/cios.2019.11.3.249

Duzgun, Irem, et al. “Which method for frozen shoulder mobilization: manual posterior capsule stretching or scapular mobilization?.” Journal of Musculoskeletal & neuronal interactions vol. 19,3 (2019): 311-316.

Jain, Tarang K, and Neena K Sharma. “The effectiveness of physiotherapeutic interventions in the treatment of frozen shoulder/adhesive capsulitis: a systematic review.” Journal of back and musculoskeletal rehabilitation vol. 27,3 (2014): 247-73. doi:10.3233/BMR-130443

Kim, Min-Su, et al. “Diagnosis and treatment of calcific tendinitis of the shoulder.” Clinics in shoulder and elbow vol. 23,4 210-216. 27 Nov. 2020, doi:10.5397/cise.2020.00318

Millar, Neal L et al. “Frozen shoulder.” Nature reviews. Disease primers vol. 8,1 59. 8 Sep. 2022, doi:10.1038/s41572-022-00386-2

Learning To Sleep On Your Back

Learning To Sleep On Your Back

Individuals spend around one-third of their life sleeping or resting. Every person has their own preferred sleeping position. However, not all sleep positions are comfortable and supportive to the body, especially the spine. Individuals that sleep on their side or stomach that experience back pain might want to consider switching to sleeping on their back. Changing preferred sleeping positions can seem impossible,  however, learning to sleep on your back is possible with a little training and adjustment period.

Learning To Sleep On Your Back

Learning To Sleep On Your Back

After side sleeping, back sleeping is the second most common position. Individuals that are stomach or side sleepers that suffer from:

  • Body and back soreness.
  • Pain symptoms.
  • Tension headaches.
  • Heartburn or acid reflux.
  • Aches in the joints and ligaments.

Learning to sleep on your back is recommended because its health benefits can potentially solve all these problems and more.

  • Adapting this sleeping position can help maintain proper spinal alignment.
  • Relieves waking up with tension headaches.
  • Relieve sinus problems.

Individuals that are not natural back sleepers understand how difficult it is to force oneself to adapt to a new sleeping position. There are ways to condition the mind and body to fall and stay asleep on your back, resulting in healthy rest. These include:

A Pillow Under The Knees

  • It may help to place a supportive pillow under the knees.
  • The knees should be slightly bent and feel comfortable.
  • Check to make sure that the neck and spine feel comfortable and are in alignment.
  • Make adjustments as needed.

A Pillow Under The Low Back

  • In the beginning, switching to back sleeping can increase discomfort in the low back.
  • Placing a pillow under the lower back can help.
  • Using too large or thick a pillow could create added discomfort.
  • Try a few different pillows to find what works best and feels right.

Pillow Surround

  • Individuals that are active sleepers and tend to roll onto their side or stomach soon after falling asleep, can place pillows around the midsection and hips.
  • A small barrier of pillows around the body can assist in learning to sleep on your back.
  • The pillows help prevent the body from rolling.
  • It’s recommended to place pillows closely against either side of the body.
  • Using the pillows as an enclosure will force the body to remain in a neutral position throughout the night.

Sleeping On The Right Pillow

  • Individuals will want to make sure they are using the right sleeping pillow.
  • In addition to supporting the spine’s alignment, a quality pillow will also support the neck.
  • The recommended pillow for back sleeping should cradle the head and ensure it stays elevated.
  • A pillow that is too flat or too thick can cause the head to become unlevel with the body leading to:
  • Neck and upper body pain
  • Restricted airflow, which may cause you to snore or suffer from sleep apnea.
  • Digestive issues like acid reflux and heartburn.
  • Consider a pillow that’s made out of some type of memory foam to assist with learning to sleep on your back.
  • The thickness and hugging sensation can help to stay on the back and prevent inadvertently flipping over.

Sleeping On The Right Mattress

A positive back sleeping experience begins with the right mattress. There are so many mattress types to choose from. It is recommended to consider the materials, the firmness level, and the size. For comfortably sleeping on your back, the firmness level is essential.

  • Consider the positioning of your spine.
  • The objective is to keep the spine as straight as possible, which is achieved with the proper firmness.
  • A mattress that is too firm will create unwanted pressure and tension on the shoulders and the pelvic region.
  • A mattress that is too soft will cause the hips to sink, throwing spinal alignment off and causing back pain symptoms.
  • A medium-firm mattress is recommended.
  • Memory foam is a great option for learning to sleep on your back.
  • Memory foam cradles the natural curve of the body, and hugs the body during sleep, which helps avoid accidentally rolling onto your side or stomach.
  • Memory foam mattresses with integrated gel can provide cooling and ventilation to keep the body refreshed throughout the night.
  • A medium-firm memory foam mattress will make sure the body stays straight, with the proper cushioning around the pelvis and hips.

Training To Sleep On Your Back


References

Anderson, Ngaire H et al. “Association of Supine Going-to-Sleep Position in Late Pregnancy With Reduced Birth Weight: A Secondary Analysis of an Individual Participant Data Meta-analysis.” JAMA network open vol. 2,10 e1912614. 2 Oct. 2019, doi:10.1001/jamanetworkopen.2019.12614

Desouzart, Gustavo, et al. “Effects of sleeping position on back pain in physically active seniors: A controlled pilot study.” Work (Reading, Mass.) vol. 53,2 (2015): 235-40. doi:10.3233/WOR-152243

Khan, Bashir Ahmad, et al. “Effect of bed head elevation during sleep in symptomatic patients of nocturnal gastroesophageal reflux.” Journal of Gastroenterology and Hepatology vol. 27,6 (2012): 1078-82. doi:10.1111/j.1440-1746.2011.06968.x

Portale, G et al. “When are reflux episodes symptomatic?.” Diseases of the esophagus: official journal of the International Society for Diseases of the Esophagus vol. 20,1 (2007): 47-52. doi:10.1111/j.1442-2050.2007.00650.x

Skarpsno, Eivind Schjelderup, et al. “Sleep positions and nocturnal body movements based on free-living accelerometer recordings: association with demographics, lifestyle, and insomnia symptoms.” Nature and Science of Sleep vol. 9 267-275. 1 Nov. 2017, doi:10.2147/NSS.S145777

Surdea-Blaga, Teodora, et al. “Food and Gastroesophageal Reflux Disease.” Current medicinal chemistry vol. 26,19 (2019): 3497-3511. doi:10.2174/0929867324666170515123807

Sets, Reps, and Rest: A Strength Training Guide

Sets, Reps, and Rest: A Strength Training Guide

Fitness, exercising, weight, and strength training programs use terms like sets, reps, and rest intervals. Knowing what they mean and how to use them for optimal results is important to achieve health goals. An individual’s training program will differ in the weights, reps, sets, rest intervals, and execution speed depending on whether the training is for fitness, muscle growth, strength, power, or endurance. Here we offer a strength training guide on understanding these terms and how they apply to a workout program.

Strength Training Guide

Sets, Reps, and Rest: A Strength Training Guide

Reps

  • Rep means repetition.
  • A rep is one completion of an exercise, such as one bench press, or one bicep curl.
  • So, one bicep curl equals one rep, and 10 bicep curls equals 10 reps.
  • Reps make up a set, which is typically the total number of reps done before taking a break.
  • A repetition maximum – 1RM is an individual’s personal best or the most they can lift once in a single repetition.
  • A 10RM would be the most an individual could lift and successfully perform 10 reps with proper form.

Sets

  • A set is a series of repetitions performed sequentially.
  • For example, one set of bench presses could be eight reps
  • Sets are designed according to the individual’s workout program.

Rest

  • The rest interval is the time of resting between sets that allow the muscles to recover.
  • The rest period between sets can range from 30 seconds to two minutes.
  • Exercises can have short or long rests between reps.
  • The ideal rest period depends on the objective of the workout and health goals.
  • Muscle hypertrophy/building: 30 to 60 seconds
  • Muscle endurance: 30 to 60 seconds
  • Strength: 2 to 5 minutes
  • Power: 1 to 2 minutes
  1. It’s important to time rest between sets.
  2. Not resting long enough and starting with another set too soon can fatigue the muscles too soon, increasing the risk of injury.
  3. Resting too long between reps can cool the muscles down and release tension before starting again.

Execution Speed

  • The speed at which one rep of an exercise is performed is contraction velocity.
  • Concentric – shortening of the muscle is often the lifting part of a rep.
  • Eccentric – lengthening of the muscle, often the lowering part of a rep helps to build muscle mass.
  1. Strength: 1 to 2 seconds concentric and eccentric
  2. Hypertrophy: 2 to 5 seconds concentric and eccentric
  3. Endurance: 1 to 2 seconds concentric and eccentric
  4. Power: Less than 1 second concentric and 1 to 2 seconds eccentric

Choosing Weights

The distribution of repetitions against a percentage of 1RM maximum lift is as follows. This example uses a bench press where 1RM is 160 pounds.

  • 100% of 1RM: 160 pounds, 1 repetition
  • 60% of 1RM: 96 pounds, warm-up reps
  • 85% of 1RM: 136 pounds, 6 repetitions
  • 67% of 1RM: 107 pounds, 12 repetitions
  • 65% of 1RM: 104 pounds, 15 repetitions

An individual should be able to do one lift at 1RM, six reps at 85%, 15 reps at 65%, and so on.

Goals to Build a Program

A training program is a schedule of exercise types, frequency, intensity, and volume, for weight training or any other type of fitness training. Individuals can devise various combinations of sets, reps, rest, and exercise types to find what works best for them. A qualified strength and conditioning trainer can help develop a program. The variables can be adjusted and include:

  • Exercise selection
  • Weights or resistance used
  • Number of reps
  • Number of sets
  • Execution speed
  • Rest time between sets
  • Rest time between training sessions and days of the week

General Fitness

  • A basic strength training fitness program targets strength and muscle-building.
  • Between eight and 15 repetitions for two to four sets will help achieve both.
  • Choose eight to 12 exercises, making sure to hit the lower and upper body and core.

Strength

  • Building strength uses the most weight, the least number of reps, and the longest rest periods.
  • The neuromuscular system responds to heavy weights by increasing the body’s ability to lift heavy loads.
  • For example, individuals with a strength goal could use a 5×5 system.
  • This means five sets of five repetitions.

Muscle Growth

  • Muscle growth and bodybuilding training use lighter weights, more reps, and less rest periods.
  • Muscle requires metabolic stress to increase in size.
  • This means working the muscles to the point where lactate builds and the muscle suffers internal damage, sometimes called “training to failure.”
  • Then resting and proper nutrition help muscle repair and the muscle grows larger in the process.
  • A program could be three sets of 8 to 12 reps, with loads that reach or near the failure point on the last few reps.

Power

  • Power training uses slightly lighter weights, takes longer rest periods, and focuses on execution speed.
  • Power is the ability to move an object at high speed.
  • Each push, pull, squat, or lunge is done at a quick tempo.
  • This type of training requires practicing the acceleration of a lift, resting properly, and repeating.

Muscular Endurance

  • Endurance weight training requires more reps in each set, up to 20 or 30, with lighter weights.
  • Individuals should ask themselves what is the day-to-day physical activity that requires the most muscular endurance?
  • For example, runners will want to concentrate on increasing endurance in their legs.
  • Swimmers may shift and focus on their arms one day then legs another.

Movement as Medicine


References

Liu, Chiung-Ju, and Nancy K Latham. “Progressive resistance strength training for improving physical function in older adults.” The Cochrane Database of systematic reviews vol. 2009,3 CD002759. 8 Jul. 2009, doi:10.1002/14651858.CD002759.pub2

Loturco, Irineu, et al. “Muscle Contraction Velocity: A Suitable Approach to Analyze the Functional Adaptations in Elite Soccer Players.” Journal of sports science & medicine vol. 15,3 483-491. 5 Aug. 2016

Rønnestad, B R, and I Mujika. “Optimizing strength training for running and cycling endurance performance: A review.” Scandinavian Journal of Medicine & Science in Sports vol. 24,4 (2014): 603-12. doi:10.1111/sms.12104

Suchomel, Timothy J et al. “The Importance of Muscular Strength: Training Considerations.” Sports medicine (Auckland, N.Z.) vol. 48,4 (2018): 765-785. doi:10.1007/s40279-018-0862-z

Tøien, Tiril, et al. “Maximal strength training: the impact of eccentric overload.” Journal of Neurophysiology vol. 120,6 (2018): 2868-2876. doi:10.1152/jn.00609.2018

Westcott, Wayne L. “Resistance training is medicine: effects of strength training on health.” Current sports medicine reports vol. 11,4 (2012): 209-16. doi:10.1249/JSR.0b013e31825dabb8

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