How do healthcare professionals in a chiropractic clinic provide a clinical approach to preventing medical errors for individuals in pain?
Introduction
Medical errors resulted in 44,000–98,000 hospitalized American deaths annually, and many more caused catastrophic injuries. (Kohn et al., 2000) This was more than the number of people who died annually from AIDS, breast cancer, and auto accidents at the time. According to later research, the actual number of deaths may be closer to 400,000, placing medical errors as the third most common cause of death in the US. Frequently, these mistakes are not the product of medical professionals who are inherently bad; rather, they are the outcome of systemic issues with the health care system, such as inconsistent provider practice patterns, disjointed insurance networks, underutilization or absence of safety protocols, and uncoordinated care. Today’s article looks at the clinical approach to preventing a medical error in a clinical setting. We discuss associated medical providers specializing in various pretreatments to aid individuals suffering from chronic issues. We also guide our patients by allowing them to ask their associated medical providers very important and intricate questions. Dr. Alex Jimenez, DC, only utilizes this information as an educational service. Disclaimer
Defining Medical Errors
Determining what medical error is the most crucial step in any conversation about preventing medical errors. You might assume this is a very easy chore, but that is only until you delve into the vast array of terminology utilized. Many terms are used synonymously (sometimes mistakenly) since some terminology is interchangeable, and occasionally, the meaning of a term depends on the specialty being discussed.
Even though the healthcare sector stated that patient safety and eliminating or reducing medical errors were priorities, Grober and Bohnen noted as recently as 2005 that they had fallen short in one crucial area: determining the definition of “perhaps the most fundamental question… What is a medical error? A medical error is a failure to complete a planned action in a medical setting. (Grober & Bohnen, 2005) However, none of the terms that one would often identify expressly with a medical error—patients, healthcare, or any other element—are mentioned in this description. Despite this, the definition offers a solid framework for further development. As you can see, that specific definition consists of two parts:
An execution error: A failure to complete a planned action as intended.
A planning error: is a technique that, even with perfect execution, does not produce the desired results.
The concepts of faults of execution and planning errors are insufficient if we are to define a medical error adequately. These may occur anywhere, not only at a medical establishment. The component of medical management must be added. This brings up the idea of unfavorable occurrences, known as adverse events. The most common definition of an adverse event is unintentional harm to patients brought about by medical therapy rather than their underlying disease. This definition has gained international acceptance in one way or another. For example, in Australia, the term incidents are defined as in which harm resulted in a person receiving health care. These consist of infections, injury-causing falls, and issues with prescription drugs and medical equipment. Certain unfavorable occurrences might be avoidable.
Common Types of Medical Errors
The only issue with this notion is that not all negative things happen accidentally or intentionally. Because the patient may ultimately benefit, an expected but tolerated adverse event may occur. During chemotherapy, nausea and hair loss are two examples. In this instance, refusing the recommended treatment would be the only sensible approach to prevent the unpleasant consequence. We thus arrive at the concept of preventable and non-preventable adverse occurrences as we further refine our definition. It isn’t easy to categorize a choice to tolerate one impact when it is determined that a favorable effect will occur simultaneously. But purpose alone isn’t necessarily an excuse. (Patient Safety Network, 2016, para.3) Another example of a planned mistake would be a right foot amputation due to a tumor on the left hand, which would be accepting a known and predicted unfavorable event in the hopes of a beneficial consequence where none has ever arisen before. There is no evidence to support the anticipation of a positive outcome.
Medical errors that cause harm to the patient are typically the focus of our research. Nonetheless, medical mistakes can and do occur when a patient is not harmed. The occurrence of near misses could provide invaluable data when planning how to reduce medical errors in a healthcare facility. Still, the frequency of these events compared to the frequency clinicians report them needs to be investigated. Near misses are medical errors that could have caused harm but did not to the patient, even if the patient is doing well. (Martinez et al., 2017) Why would you acknowledge something that could potentially result in legal action? Consider the scenario where a nurse, for whatever reason, had just been looking at photographs of different medications and was about to provide a medication. Maybe something lingers in her memory, and she decides that’s not how a specific medication looks. Upon checking, she found that the incorrect medicines had been administered. After checking all the paperwork, she fixes the mistake and gives the patient the right prescription. Would it be possible to avoid an error in the future if the administration record included photographs of the proper medication? It is easy to forget that there was a mistake and a chance for harm. That fact remains true regardless of whether we were fortunate enough to find it in time or suffer any negative consequences.
Errors of Outcomes & Process
We need complete data to develop solutions that improve patient safety and decrease medical errors. At the very least, when the patient is in a medical facility, everything that can be done to prevent harm and put them in danger should be reported. Many doctors have determined that using the phrases errors and adverse events was more comprehensive and suitable after reviewing mistakes and adverse events in health care and discussing their strengths and weaknesses in 2003. This combined definition would increase data gathering, including mistakes, close calls, near misses, andactive and latent errors. Additionally, the term adverse events includes terms that usually imply patient harm, such as medical injury and iatrogenic injury. The only thing that remains is determining whether a review board is a suitable body to handle the separation of preventable and non-preventable adverse events.
A sentinel event is an occurrence where reporting to the Joint Commission is required. The Joint Commission states that a sentinel event is an unexpected occurrence involving a serious physical or psychological injury. (“Sentinel Events,” 2004, p.35) There isn’t a choice, as it needs to be documented. Most healthcare facilities, however, do keep their records outlining sentinel incidents and what to do in the event of one to guarantee that the Joint Commission standards are met. This is one of those situations when it’s better to be safe than sorry. Since “serious” is a relative concept, there may be some wriggle room when defending a coworker or an employer. On the other hand, reporting a sentinel event incorrectly is better than failing to report a sentinel event. Failing to disclose can have serious consequences, including career termination.
When considering medical errors, people frequently make the mistake of focusing just on prescription errors. Medication errors are undoubtedly frequent and involve many of the same procedural flaws as other medical errors. Breakdowns in communication, mistakes made during prescription or dispensing, and many other things are possible. But we would be gravely misjudging the issue if we assumed that drug errors are the only cause of harm to a patient. One major challenge in classifying the different medical errors is determining whether to classify the error based on the procedure involved or the consequence. It is acceptable to examine those classifications here, given numerous attempts have been made to develop working definitions that incorporate both the process and the outcome, many of which are based on Lucian Leape’s work from the 1990s.
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Analyzing & Preventing Medical Errors
Operative and nonoperative were the two main categories of adverse events that Leape and his colleagues distinguished in this study. (Leape et al., 1991) Operative problems included wound infections, surgical failures, non-technical issues, late complications, and technical difficulties. Nonoperative: headings such as medication-related, misdiagnosed, mistreated, procedure-related, fall, fracture, postpartum, anesthesia-related, neonatal, and a catch-all heading of the system were included under this category of adverse occurrences. Leape also classified errors by pointing out the point of process breakdown. He also categorized these into five headings, which include:
System
Performance
Drug Treatment
Diagnostic
Preventative
Many process faults fall under more than one topic, yet they all help to pinpoint the exact cause of the issue. If more than one physician was engaged in determining the precise areas that need improvement, then additional questioning might be required.
Technically, a medical error can be made by any staff member at a hospital. It is not limited to medical professionals like physicians and nurses. An administrator may unlatch a door, or a cleaning crew member could leave a chemical within a child’s grasp. What matters more than the identity of the perpetrator of the mistake is the reason behind it. What before it? And how can we make sure that doesn’t occur again? After gathering all the above data and much more, it’s time to figure out how to prevent similar errors. As for sentinel events, the Joint Commission has mandated since 1997 that all of these incidents undergo a procedure called Root Cause Analysis (RCA). However, using this procedure for incidents that need to be reported to outside parties would need to be corrected.
What Is A Root Cause Analysis?
RCAs “captured the details as well as the big picture perspective.” They make evaluating systems easier, analyzing whether remedial action is necessary, and tracking trends. (Williams, 2001) What precisely is an RCA, though? By examining the events that led to the error, an RCA can focus on events and processes rather than reviewing or placing blame on specific people. (AHRQ,2017) This is why it is so crucial. An RCA frequently makes use of a tool called the Five Whys. This is the process of continuously asking yourself “why” after you believe you have determined the cause of an issue.
The reason it’s called the “five whys” is because, while five is an excellent starting point, you should always question why until you identify the underlying cause of the problem. Asking why repeatedly could reveal many process faults at different stages, but you should keep asking why about every aspect of the issue until you run out of other things that could be adjusted to provide a desirable result. However, different tools besides this one can be utilized in a root cause investigation. Numerous others exist. RCAs must be multidisciplinary and consistent and involve all parties involved in the error to avoid misunderstandings or inaccurate reporting of occurrences.
Conclusion
Medical errors in healthcare institutions are frequent and mostly unreported events that seriously threaten patients’ health. Up to a quarter of a million individuals are thought to pass away each year as a result of medical blunders. These statistics are unacceptable in a time when patient safety is supposedly the top priority, but not much is being done to alter practices. If medical errors are accurately defined and the root cause of the problem is found without assigning blame to specific staff members, this is unnecessary. Essential changes can be made when fundamental causes of system or process faults are correctly identified. A consistent, multidisciplinary approach to root cause analysis that uses frameworks like the five whys to delve down until all issues and defects are revealed is a helpful tool. Although it is now necessary for the wake of sentinel events, the Root Cause Analysis may and should be applied to all mistake causes, including near misses.
Kohn, L. T., Corrigan, J., Donaldson, M. S., & Institute of Medicine (U.S.). Committee on Quality of Health Care in America. (2000). To err is human : building a safer health system. National Academy Press. books.nap.edu/books/0309068371/html/index.html
Leape, L. L., Brennan, T. A., Laird, N., Lawthers, A. G., Localio, A. R., Barnes, B. A., Hebert, L., Newhouse, J. P., Weiler, P. C., & Hiatt, H. (1991). The nature of adverse events in hospitalized patients. Results of the Harvard Medical Practice Study II. N Engl J Med, 324(6), 377-384. doi.org/10.1056/NEJM199102073240605
Martinez, W., Lehmann, L. S., Hu, Y. Y., Desai, S. P., & Shapiro, J. (2017). Processes for Identifying and Reviewing Adverse Events and Near Misses at an Academic Medical Center. Jt Comm J Qual Patient Saf, 43(1), 5-15. doi.org/10.1016/j.jcjq.2016.11.001
For individuals looking to improve their diet, can knowing the different salt types help in food preparation and health?
Salt Types
Salt brings out the natural flavor of foods and can be used as a preservative. Salt types come in various colors and textures for cooking, flavor, and health. Some are considered healthier compared to regular table salt, like pink Himalayan salt and different sea salts. Some individuals prefer them because most go through less processing and can have more trace minerals like magnesium and potassium. However, all salts are healthy in moderation, as sodium is a necessary part of a balanced diet. Although essential for the body, sodium can be harmful when too much is consumed. A study examining consumer-grade pink Himalayan sea salts available in Australia determined that to receive the additional health benefits of the minerals from this type of salt, individuals must consume so much that it elevates the amount of sodium in the body to dangerous levels. (Flavia Fayet-Moore et al., 2020)
Salt
Salt is a mineral made from the combined elements:
Sodium – Na
Chlorine -Cl
Together, they form crystallized sodium chloride NaCl.
The majority of salt production comes from evaporated seawater and salt mines. Many salts used in food preparation are iodized. Iodine is added to various refined salt products to help meet nutritional requirements. Iodine intake levels that fall below the recommended values could result in a deficiency and develop goiter. Goiter is associated with hypothyroidism. (Angela M. Leung et al., 2021) Lack of iodine can also have adverse effects on growth and development. (National Institutes of Health Office of Dietary Supplements. 2023)
Essential for Health
Salt sustains life and optimal bodily function. Sodium and chlorine are important elements that maintain:
Cellular balance
Circulation
Blood sugar levels
Sodium is a mineral and an electrolyte. Common electrolytes include potassium, calcium, and bicarbonate. Without adequate sodium levels, the brain cannot send the necessary impulses to the rest of the body to function properly. However, consuming too much salt can cause health issues.
Higher salt intake in individuals who are sensitive to salt can increase blood pressure.
Doctors usually recommend that individuals with hypertension reduce sodium intake or follow a low-sodium diet.
Elevated sodium levels also cause water retention – considered a protective response as the body works to regulate serum sodium levels concentration in the blood to maintain balance.
If levels are too high, a condition known as hypernatremia can develop, which can cause:
Excessive thirst
Vomiting
Infrequent urination
Diarrhea
Sodium levels that are too low can lead to hyponatremia, which can cause:
Though there are different types of salt, they all contain roughly the same amount of sodium.
Types
The average sodium intake by adults is around 3,393mg per day, ranging between 2,000–5,000mg. Guidelines recommend a maximum intake of 2,300mg per day. (U.S. Department of Health and Human Services and U.S. Department of Agriculture. 2020) Whether from unhealthy dietary choices like processed foods or incorrect knowledge of sodium content when cooking, an American Heart Association survey showed that more than half of respondents inaccurately stated that sea salt had a lower sodium content than table salt. (American Heart Association. 2024)
Refined – Table Salt
Refined/iodized salt is finely granulated and commonly used in cooking. This type is highly refined to remove impurities and eliminate trace minerals often found in specialty salts. Because the salt is finely ground, anti-caking agents are added to ensure the salt doesn’t clump. Some table salts also have added sugar and other additives.
Refined table salt is about 97–99% sodium chloride (NaCl).
Iodine is added to prevent iodine deficiency.
Individuals trying to reduce sodium intake but meet iodine levels can do so with foods like eggs, dairy products, and fish.
Kosher
Kosher salt is coarse and flakey and can add a crunchy texture to dishes and drinks. Pure kosher salt does not contain additives like anti-caking agents and iodine. The size of the salt crystals is ideal for drawing out moisture.
Per teaspoon, kosher salt generally has less sodium than 1 teaspoon of table salt.
Because it has a coarser grain, less salt fits in the measuring spoon.
Sea Salt
Sea salt is produced from evaporated seawater and comes as fine grains or large crystals. Examples include:
Black Sea
Celtic
French – fleur de sel
Hawaiian sea salt
Sea salt can have trace amounts of minerals like iron, potassium, and zinc, which can produce different flavors in cooking but no additional health benefits with normal consumption. Some sea salts may also contain trace amounts of microplastics. However, research indicates these amounts are too low to warrant public health concerns. (Ali Karami et al., 2017)
Himalayan Pink Salt
Himalayan pink salt is mined in the red salt range in Pakistan, the second-largest salt mine in the world, and in the Andes mountains of Peru. Trace amounts of iron oxide make the salt pink. It is typically used at the end of cooking to add flavor and a crunch. Himalayan salt is popular for its health benefits and mineral properties. However, using Himalayan salt over other types has no known health advantages. Researchers concluded that the potential health benefits provided by the higher nutrient content would be counteracted by the large amount of sodium that would need to be consumed. (Flavia Fayet-Moore et al., 2020)
Substitutes
Salt substitutes contain some or all sodium and potassium, magnesium, or other minerals. Substitutes can be half sodium chloride and half potassium chloride. Monosodium glutamate/MSG can also be used as an alternative. A study found that substituting salt with MSG is safe and comparable to salt flavor. (Jeremia Halim et al., 2020) Individuals often use substitutes on a sodium-restricted diet but should check with their doctor before using these products, especially if they have kidney conditions.
Body In Balance – Chiropractic+Fitness+Nutrition
References
Fayet-Moore, F., Wibisono, C., Carr, P., Duve, E., Petocz, P., Lancaster, G., McMillan, J., Marshall, S., & Blumfield, M. (2020). An Analysis of the Mineral Composition of Pink Salt Available in Australia. Foods (Basel, Switzerland), 9(10), 1490. doi.org/10.3390/foods9101490
Leung, A. M., Braverman, L. E., & Pearce, E. N. (2012). History of U.S. iodine fortification and supplementation. Nutrients, 4(11), 1740–1746. doi.org/10.3390/nu4111740
Karami, A., Golieskardi, A., Keong Choo, C., Larat, V., Galloway, T. S., & Salamatinia, B. (2017). The presence of microplastics in commercial salts from different countries. Scientific reports, 7, 46173. doi.org/10.1038/srep46173
Halim, J., Bouzari, A., Felder, D., & Guinard, J. X. (2020). The Salt Flip: Sensory mitigation of salt (and sodium) reduction with monosodium glutamate (MSG) in “Better-for-You” foods. Journal of food science, 85(9), 2902–2914. doi.org/10.1111/1750-3841.15354
For individuals watching their food intake during the Thanksgiving holiday, can knowing the nutritional value of turkey help maintain diet health?
Nutrition and Benefits
Minimally processed turkey can be a beneficial source of protein, vitamins, and minerals. However, processed turkey can be high in sugar, unhealthy fats, and sodium.
Sarcopenia, or muscle wasting, commonly leads to frailty in elderly individuals.
Getting enough protein at every meal is essential for older adults to maintain muscle mass and physical mobility.
Turkey can help meet guidelines suggesting lean meat consumption 4-5 times a week to maintain muscle health with aging. (Anna Maria Martone, et al., 2017)
Reduces Diverticulitis Flare-Ups
Diverticulitis is inflammation of the colon. Dietary factors that influence the risk of diverticulitis include:
Fiber intake – lowers risk.
Processed red meat intake – raises risk.
Intake of red meat with higher total fat – raises risk.
Researchers studied 253 men with diverticulitis and determined that replacing one serving of red meat with a serving of poultry or fish reduces the risk of diverticulitis by 20%. (Yin Cao et al., 2018)
The study’s limitations are that the meat intake was recorded in men only, the intake was self-reported, and the amount consumed at each eating episode was not recorded.
It may be a helpful substitution for anyone at risk for diverticulitis.
Turkey is a lean alternative to other low-sodium meats, especially if the skin is removed and cooked fresh.
Turkey is also high in the amino acid arginine.
Arginine can help keep arteries open and relaxed as a precursor to nitric oxide. (Patrick J. Skerrett, 2012)
Allergies
Meat allergies can happen at any age. A turkey allergy is possible and may be associated with allergies to other types of poultry and red meat. Symptoms can include: (American College of Allergy, Asthma & Immunology. 2019)
Martone, A. M., Marzetti, E., Calvani, R., Picca, A., Tosato, M., Santoro, L., Di Giorgio, A., Nesci, A., Sisto, A., Santoliquido, A., & Landi, F. (2017). Exercise and Protein Intake: A Synergistic Approach against Sarcopenia. BioMed research international, 2017, 2672435. doi.org/10.1155/2017/2672435
Cao, Y., Strate, L. L., Keeley, B. R., Tam, I., Wu, K., Giovannucci, E. L., & Chan, A. T. (2018). Meat intake and risk of diverticulitis among men. Gut, 67(3), 466–472. doi.org/10.1136/gutjnl-2016-313082
Individuals striving to be healthy may not know where or how to start. Can hiring a health coach help individuals start their wellness journey and reach their goals?
Hiring A Health Coach
It’s easy to get caught up in the desire to make changes, but it is another thing to actually set a consistent plan in motion. Hiring a health coach can help individuals understand the information, develop an effective wellness routine that suits their lifestyle, and achieve health and wellness goals. A primary healthcare provider could be a resource and have referrals to reputable health coaches in the area.
What Do They Do?
Health coaches are experts in helping individuals reach health and wellness goals. This can be:
Reducing stress
Improving self-care
Focusing on nutrition
Starting exercise
Improving quality of life
A health coach helps create a plan and makes it happen.
Health and wellness coaches use motivational interviewing and evidence-based approaches to empower individuals in their wellness journey. (Adam I Perlman, Abd Moain Abu Dabrh. 2020)
They help identify areas that need improvement, develop a plan, and encourage the individual all the way like a personal fitness trainer.
Health coaches work with physicians and/or other health professionals in a clinical setting or as individual providers.
Their role is to provide a holistic approach to health and wellness.
A health coach is someone who helps organize and balance various aspects of an individual’s life so they can learn to maintain optimal health.
They will help overcome barriers when struggling.
A health coach listens and provides support for whatever an individual’s goals may be.
A health coach is there until the goal is reached.
Qualifications
It is important to ensure the providers being considered have the necessary qualifications. Because some certification programs offer a focus on specific areas like nutrition, it’s recommended to identify what is needed before choosing a health coach. Health coaches do not need a university degree, however, many certifications are affiliated with colleges and have educational partnerships that qualify coursework and award college credits. Training to become a health coach consists of: (Shivaun Conn, Sharon Curtain 2019)
Health
Fitness
Goal setting
Coaching concepts
Nutritional concepts
Motivational interviewing
Stress management
Changing behaviors
Health Goal Examples
Health coaching is not a one-size-fits-all approach. A primary healthcare provider or physician provides a diagnosis and medical plan, and a health coach helps guide and support the individual through the plan. However, hiring a health coach does not require a medical condition to employ services. A few examples of health goals that health coaches address include:
There are many types of health coaches and some may specialize, therefore try to determine the expertise needed to achieve the goals.
Budget
Determine how much money will be invested, as many insurance providers do not cover the cost of a health coach.
Health coaches may charge between $50 to $300 per session.
Some will offer packages, memberships, and/or discounts.
Certifications
Look into their certification.
Is it accredited?
This will ensure choosing a coach who has received the training and expertise needed to provide quality care.
Compatibility
Consult with potential coaches.
Ask questions and see if they are compatible with specific health goals.
Interview as many as needed.
Availability/Location
Virtual sessions, in-person meetings, and/or a combination?
How long are the sessions?
Frequency of meetings?
Finding a coach that is flexible and convenient will help maintain a healthy coach/client relationship.
Multidisciplinary Evaluation and Treatment
References
Perlman, A. I., & Abu Dabrh, A. M. (2020). Health and Wellness Coaching in Serving the Needs of Today’s Patients: A Primer for Healthcare Professionals. Global advances in health and medicine, 9, 2164956120959274. doi.org/10.1177/2164956120959274
Conn, S., & Curtain, S. (2019). Health coaching as a lifestyle medicine process in primary care. Australian journal of general practice, 48(10), 677–680. doi.org/10.31128/AJGP-07-19-4984
Supplements To Ease Headaches: Individuals dealing with headaches or migraines should consider incorporating supplements to ease headaches’ severity and frequency. Nutrition and food habits affect all systems in the body. Although slower to take effect than medications, if a diet is used correctly to heal the body and maintain health, other treatments may not be necessary or require less. Many health providers understand that food is a medicine that can assist healing therapies like massage and chiropractic care, which makes the treatment more effective when used with dietary adjustments.
Supplements To Ease Headaches
An unhealthy lifestyle and diet are not the only contributing factor to headaches. Others include:
The goal of functional medicine is to help individuals reach their health and wellness goals that, include:
Regularly active lifestyle.
Optimal breathing patterns.
Quality sleep patterns.
Thorough hydration.
Healthy nutrition.
Improved digestive health.
Improved mental health.
Improved musculoskeletal health.
Pain Receptors – Headache
Pain and discomfort symptoms present when various head structures become inflamed or irritated. These structures include:
Nerves of the head and neck.
Muscles of the neck and head.
The skin of the head.
Arteries that lead to the brain.
Membranes of the ear, nose, and throat.
Sinuses that form part of the respiratory system.
The pain can also be referred, meaning that pain in one area can spread to nearby areas. An example is headache pain developed from neck stiffness and tightness.
Causes
Foods
Determining whether food sensitivities cause or contribute to headaches or migraines can be challenging. Nutritionists and dieticians recommend keeping a food journal to keep track of foods, snacks, drinks, alcohol intake, how the body reacts, and how the individual feels.
This process can help recognize foods or eating patterns that may contribute to headaches.
An integrative health practitioner can support this process and help identify sensitivities.
By eliminating and avoiding processed foods, headaches may be alleviated. This includes limited exposure to artificial colors, sweeteners, flavors, and other unnatural additives.
Foods naturally high in magnesium include legumes, almonds, broccoli, spinach, avocados, dried figs, and bananas.
Ginger Root
Ginger root is a natural remedy for nausea, diarrhea, upset stomach, and indigestion.
Ginger root extract can be taken in supplement form or fresh ginger added to meals and teas.
Coriander Seeds
Coriander syrup is effective against migraine pain.
A method to relieve a headache is to pour hot water over fresh seeds and inhale the steam.
To increase the effectiveness, place a towel over your head.
Celery or Celery Seed Oil
Celery can reduce inflammation and lower blood pressure.
However, pregnant women or individuals with kidney conditions, low blood pressure, taking thyroid medication, blood thinners, lithium, or diuretics should not use celery seed.
Peppermint and Lavender Essential Oils
Both have a natural numbing and cooling effect that helps relieve headache pain.
Peppermint oil has also been found to be a natural antibacterial, antiviral, antifungal, antiparasitic, and pain reliever.
Lavender oil can eliminate nervous tension, enhance blood circulation, and relieve pain.
Both are effective pain relief tools for headache and migraine sufferers.
Butterbur
This shrub grows in Europe, some parts of Asia, and North America.
A study found that individuals who consumed 75 mg of the extract twice daily reduced migraine attacks’ frequency.
Feverfew
A herb plant whose dried leaves have been found to relieve symptoms associated with headaches, migraines, menstrual cramps, asthma, dizziness, and arthritis.
Feverfew can be found in supplements.
It can alter the effects of certain prescription and non-prescription medications.
There is plenty of evidence to support the benefits of healthy nutrition. Combined with a healthy diet and lifestyle, these supplements can help relieve headaches. As with any supplement, talk to a doctor before starting a supplement regimen.
Chiropractic Care For Migraines
References
Ariyanfar, Shadi, et al. “Review on Headache Related to Dietary Supplements.” Current Pain and headache report vol. 26,3 (2022): 193-218. doi:10.1007/s11916-022-01019-9
Bryans, Roland, et al. “Evidence-based guidelines for the chiropractic treatment of adults with headache.” Journal of Manipulative and physiological therapeutics vol. 34,5 (2011): 274-89. doi:10.1016/j.jmpt.2011.04.008
Diener, H C et al. “The first placebo-controlled trial of a special butterbur root extract for the prevention of migraine: reanalysis of efficacy criteria.” European Neurology vol. 51,2 (2004): 89-97. doi:10.1159/000076535
Kajjari, Shweta, et al. “The Effects of Lavender Essential Oil and its Clinical Implications in Dentistry: A Review.” International Journal of clinical pediatric dentistry vol. 15,3 (2022): 385-388. doi:10.5005/jp-journals-10005-2378
Maier, Jeanette A et al. “Headaches and Magnesium: Mechanisms, Bioavailability, Therapeutic Efficacy and Potential Advantage of Magnesium Pidolate.” Nutrients vol. 12,9 2660. 31 Aug. 2020, doi:10.3390/nu12092660
Mansouri, Samaneh, et al. “Evaluating the effect of Coriandrum sativum syrup on being migraine-free using mixture models.” Medical Journal of the Islamic Republic of Iran vol. 34 44. 6 May. 2020, doi:10.34171/mjiri.34.44
Pareek, Anil, et al. “Feverfew (Tanacetum parthenium L.): A systematic review.” Pharmacognosy Reviews vol. 5,9 (2011): 103-10. doi:10.4103/0973-7847.79105
Skypala, Isabel J et al. “Sensitivity to food additives, vaso-active amines and salicylates: a review of the evidence.” Clinical and translational allergy vol. 5 34. 13 Oct. 2015, doi:10.1186/s13601-015-0078-3
Mountain and trail biking is a fun way to exercise. Mountain biking requires total body/core strength, explosive power, balance, endurance, and agility to maneuver the bike, build speed, and absorb the rough bumps and terrain. But it also means that certain muscles get overused, causing overcompensation in the body that can lead to musculoskeletal problems and conditions. Strength, cardiovascular, and cross-fit can benefit mountain biking training for improved performance, safer and more confident riding, and injury prevention.
Mountain Biking Training
A few of the benefits of training are:
Increasing bone density.
Improving joint health.
Correcting imbalances and unhealthy posture.
Weight loss.
Aging muscle loss prevention.
Maintaining body posture centered on the bike requires core strength to perform the movements when moving the body backward and forwards, side to side, and pushing up and down when different obstacles pop up. The exercises’ objective is to work various body parts simultaneously and diagonally, like the movements used on the bike.
General Overview of Mountain Biking Training
Build strength – Target the quads, hamstrings, and abdominal muscles to power pedaling strokes.
Increase endurance – Avoid getting fatigued early because of weakened legs and aerobic performance.
Improve mountain bike skills – Ride faster and more efficiently by improving bike handling and technical skills.
Example Training Week
The terrain determines the intensity, but the same basic principles apply to mountain biking training as other endurance sports. Here’s a training example for a beginner that can be adjusted to the rider’s needs:
Monday
Stretching and training the muscles to relax prevent becoming stiff or cramping up during rides.
Cornering is a critical skill that should never stop being practiced and improved.
Cornering Drills
Pick a corner on a local trail and ride through it until mastered.
Focus on riding smoothly through the corner, and speed will generate.
As confidence builds in the corners, do the same on the opposite side.
Straighten Out
Ride to the furthest outside edge when approaching the turn.
Initiate the turn just before the sharpest point of the corner.
Stick to the furthest outside point of the corner when riding out of the corner.
Brake Before The Corner
Braking in the corner can cause the tires to slide out of control, causing a slip-and-fall accident.
Look through the turn as the bike follows where the eyes look.
Don’t stare at the front wheel, which could lead to a falling or flipping accident.
Eventually, riders can handle this technique, but it’s too advanced for beginners.
Smooth Ride
Beginners can be amazed at how much terrain bikes can ride over and through. Modern mountain bike suspension and tire systems can handle it. However, using the correct technique is essential to get through or around the obstacles and avoid crashes.
Stay aware of the surroundings.
Keep the body loose when approaching obstacles.
Decide how to overcome the obstacle – ride over, pop/raise the wheels, jump, or ride around.
Maintain confidence.
When riding over the obstacle, maintain an even balance on the pedals and keep the buttocks slightly off the saddle.
Keep arms and legs loose and let the body absorb the shock of the obstacle.
Trust the suspension and tires.
Ensure enough speed is generated to go over it and that it won’t stop the bike and cause a fall.
Some rough trail areas can require added strength to hold the bike steady.
Braking
There is no need to squeeze the brake handles with extreme force.
Extreme braking, especially the front, will likely lead to a flip or crash.
The brakes are made to stop with minimal force.
Beginners are recommended to learn to use a light touch when braking.
Improvement will follow with each riding session.
Foundation
References
Arriel, Rhaí André, et al. “Current Perspectives of Cross-Country Mountain Biking: Physiological and Mechanical Aspects, Evolution of Bikes, Accidents, and Injuries.” International journal of environmental research and public health vol. 19,19 12552. 1 Oct. 2022, doi:10.3390/ijerph191912552
Inoue, Allan, et al. “Effects of Sprint versus High-Intensity Aerobic Interval Training on Cross-Country Mountain Biking Performance: A Randomized Controlled Trial.” PloS one vol. 11,1 e0145298. 20 Jan. 2016, doi:10.1371/journal.pone.0145298
Kronisch, Robert L, and Ronald P Pfeiffer. “Mountain biking injuries: an update.” Sports medicine (Auckland, N.Z.) vol. 32,8 (2002): 523-37. doi:10.2165/00007256-200232080-00004
Muyor, J M, and M Zabala. “Road Cycling and Mountain Biking Produce Adaptations on the Spine and Hamstring Extensibility.” International Journal of sports medicine vol. 37,1 (2016): 43-9. doi:10.1055/s-0035-1555861
Ranchordas, Mayur K. “Nutrition for adventure racing.” Sports medicine (Auckland, N.Z.) vol. 42,11 (2012): 915-27. doi:10.1007/BF03262303
Providing the body with adequate hydration and nutrition at the right time can maximize performance abilities, endurance, and muscle repair and restoration. Eating the right foods at the right time will fuel the body to support intense exercises. That means plenty of energy for cardiovascular and strength training. The optimal combination of pre-workout nutrition depends on the type of workout and how long it takes for the body to absorb the nutrients to get moving. Injury Medical Chiropractic and Functional Medicine Clinic can develop a fitness and nutritional plan customized to the individual’s needs and health goals.
Pre-Workout Nutrition
The three main macronutrients are carbohydrates, proteins, and fats when preparing pre-workout meals and snacks. Ratios are based on the specific needs of the workout. For example, going for a one-mile jog or a light aerobics class requires different amounts for different purposes. The longer and more intense the exercise, the more food is needed. Individuals may only need to modify or adjust their eating habits slightly for light workouts. Their roles vary:
Carbohydrates
Fats
Proteins
Each has a different role in supplying fuel for powering through physical activity.
Carbohydrates
Carbs are an important fuel for exercise.
Carbs can be found in grains, fruits, vegetables, and dairy products.
These are the easiest energy foods for the body to turn into glucose.
Glucose is stored in the muscles as glycogen.
Without enough carbohydrates, the body will be depleted of energy and become exhausted.
Proteins
This macronutrient is found in poultry, eggs, fish, and nuts.
Takes longer for the body to digest.
Protein helps the body feel full.
The body uses various nutrients to repair and build muscles.
Getting protein throughout the day can help with recovery after a workout.
Fats
The body burns fat for longer low to moderate-intensity workouts, such as a long run or bicycle ride.
However, fat takes more effort and time for the body to digest.
So, eating healthy fats is not the best right before exercise.
Pre-Workout Nutrition Guidelines
The exact mix of foods/nutrients ideal for the workout depends on when the individual can eat in relation to the time of the activity and intensity of the exercise.
Two to Four Hours Before Exercising
Have a meal containing a mix of carbohydrates, fats, and protein.
Oatmeal with fruit and nuts, a turkey sandwich with vegetables and some fruit, or a chicken and rice bowl with vegetables and avocado.
One to Two Hours Before Exercising
A light meal or snack.
Cereal with low-fat milk, peanut butter with crackers, or a fruit smoothie.
Avoid foods high in fiber and fat because they take longer to digest and can lead to digestion/stomach issues during exercise.
Before Morning Exercise
Going to the gym or out for a run first thing in the morning, something small, like a banana or granola bar.
For individuals that can’t eat early, don’t force yourself.
Have an extra portion at dinner or a snack before bed to have enough fuel for the morning.
During Workout
Have easy-to-digest carbs if the exercise session lasts more than an hour.
A banana or pretzels.
Sports drink during the workout contains electrolytes and minerals like sodium, magnesium, and potassium that assist in regulating functions like muscle contractions lost as the body sweats.
Hydration
Liquids are lost when the body sweats. Sipping water before, during, and after the workout is important.
Even a small dip in hydration levels can lower exercise performance and lessen mental sharpness.
Drinking two to three cups of water two to three hours before exercise is recommended.
During the workout, you should get at least a half to a full cup of water every 15 to 20 minutes.
After the workout, replenish hydration levels with two to three more cups.
Pre-Workouts
References
Jensen, Jørgen, et al. “The role of skeletal muscle glycogen breakdown for regulation of insulin sensitivity by exercise.” Frontiers in physiology vol. 2 112. 30 Dec. 2011, doi:10.3389/Phys.2011.00112
Jeukendrup, Asker. “A step towards personalized sports nutrition: carbohydrate intake during exercise.” Sports medicine (Auckland, N.Z.) vol. 44 Suppl 1, Suppl 1 (2014): S25-33. doi:10.1007/s40279-014-0148-z
Lowery, Lonnie M. “Dietary fat and sports nutrition: a primer.” Journal of sports science & Medicine vol. 3,3 106-17. 1 Sep. 2004
Ormsbee, Michael J et al. “Pre-exercise nutrition: the role of macronutrients, modified starches, and supplements on metabolism and endurance performance.” Nutrients vol. 6,5 1782-808. 29 Apr. 2014, doi:10.3390/nu6051782
Rothschild, Jeffrey A et al. “What Should I Eat Before Exercise? Pre-Exercise Nutrition and the Response to Endurance Exercise: Current Prospective and Future Directions.” Nutrients vol. 12,11 3473. 12 Nov. 2020, doi:10.3390/nu12113473
Shirreffs, Susan M. “The importance of good hydration for work and exercise performance.” Nutrition Reviews vol. 63,6 Pt 2 (2005): S14-21. doi:10.1111/j.1753-4887.2005.tb00149.x
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