When muscle pains and aches present from health conditions, work, exercise, housework, etc., many individuals turn to topical sprays, creams, ointments, and gels to bring relief. Can magnesium spray be beneficial in the fight against neuromusculoskeletal pain?
Magnesium Spray
Magnesium spray is a liquid form of magnesium applied externally to the skin that has been marketed to promote muscle relaxation, improve sleep, and manage migraines. However, studies of its effectiveness have had mixed results. Some studies have shown that topical use can:
Improve chronic muscle and joint pain. Example: fibromyalgia.
Decrease the frequency and severity of nerve pain symptoms. Example: peripheral neuropathy.
Reduce the incidence and severity of an intubation-related sore throat after surgery.
Further studies of various groups are necessary to clarify the optimal dose for each condition and to determine how topical magnesium affects magnesium blood levels.
What is It?
Magnesium is a mineral that has an important role in many of the body’s processes and is essential for the following (Gröber U. et al., 2017)
Nerve transmission
Muscle contraction
Blood pressure regulation
Blood sugar regulation
Protein production
DNA and RNA production
Currently, there is no recommended dosage for topical magnesium use. However, some major health institutions have established a recommended daily amount taken by mouth. Listed are the recommended daily magnesium intake based on age and other factors. (National Institutes of Health Office of Dietary Supplements, 2022)
14 to 18 years old: 410 mg for males, 360 mg for females and when lactating, and 400 mg when pregnant.
19 to 30 years old: 400 mg for males, 310 mg for females and when lactating, and 350 mg when pregnant.
31 to 50 years old: 420 mg for males, 320 mg for females and when lactating, and 360 mg when pregnant.
51 years old and above: 420 mg for males and 320 mg for females.
Although self-care is appropriate for minor injuries or exercise, individuals are encouraged to see their healthcare provider for severe musculoskeletal pain symptoms.
Benefits
Though taking oral magnesium supplements is common, there is limited research on using magnesium on the skin to improve magnesium levels. Studies comparing the absorption of magnesium taken by mouth with the spray applied to the skin require further research. However, some studies look at the localized effect of magnesium spray on improving a sore throat after surgery and nerve, muscle, and joint pain.
Intubation-Related Sore Throat
Topical magnesium reduced the severity of sore throat after surgery in individuals undergoing tracheal intubation compared to a placebo. (Kuriyama, A. et al., 2019) However, further studies are necessary to clarify the optimal dose.
Nerve Pain
Peripheral neuropathy is nerve damage that causes a tingling and numbing sensation in the arms or legs. In a study of individuals with chronic kidney disease, the daily application of magnesium sprays to limbs affected by peripheral neuropathy for twelve weeks decreased the frequency and severity of nerve pain symptoms. However, one limitation was that it was performed mostly in females. (Athavale, A. et al., 2023)
Chronic Muscle and Joint Pain
A small study assessed whether applying magnesium to the skin could improve the quality of life of female participants with fibromyalgia – a chronic condition that causes muscle and joint pain, fatigue, and other symptoms. The study found that four sprays of magnesium chloride applied twice daily to the upper and lower limbs for four weeks could benefit those with fibromyalgia. However, further research with larger studies is needed to confirm the results. (Engen D. J. et al., 2015)
Does The Spray Increase Overall Magnesium Levels?
Magnesium is transported into cells through magnesium transporters. The outer layer of the skin does not contain these transporters, so absorption occurs in the small areas of the sweat glands and hair follicles. (Gröber U. et al., 2017) One study suggested that applying magnesium to the skin can help with magnesium deficiency within four to six weeks, compared to four to 12 months in the case of oral magnesium supplementation. However, there is minimal research on topical magnesium and its impact on magnesium levels. Another study suggested that 56 mg of magnesium cream applied daily on the skin for 14 days had no statistically significant effect on magnesium blood levels. Although the results were statistically insignificant, a clinically relevant increase in magnesium blood levels was observed. (Kass, L. et al., 2017) Because it remains unclear if magnesium absorption via the skin is more effective than by mouth, further studies are necessary to confirm the amount of magnesium absorbed into the skin.
Using The Spray
In one study, a magnesium chloride solution was poured into a spray bottle and applied as follows (Engen D. J. et al., 2015)
The solution was sprayed into the palm and applied evenly on the affected area.
There is a four-hour wait time between spray dose applications.
Individuals should wait at least one hour after application before showering or washing the product off.
Leave the product on the skin throughout the day and wash it off before bed.
Rinse the solution off with water if the skin becomes irritated.
Avoid applying to open wounds.
Precautions
Avoid magnesium chloride sprays if you are allergic to them or their components. If you have a severe allergic reaction, such as itching, hives, or shortness of breath, seek immediate medical attention. Topically applied magnesium solution has no known side effects other than skin irritation. (Engen D. J. et al., 2015)
Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop a personalized treatment plan through an integrated approach to treating injuries and chronic pain syndromes, improving flexibility, mobility, and agility programs to relieve pain and help individuals return to optimal function. If other treatments are needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments.
Why Choose Chiropractic?
References
Gröber, U., Werner, T., Vormann, J., & Kisters, K. (2017). Myth or Reality-Transdermal Magnesium?. Nutrients, 9(8), 813. https://doi.org/10.3390/nu9080813
National Institutes of Health Office of Dietary Supplements. (2022). Magnesium. Retrieved from https://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional/#h2
Kuriyama, A., Maeda, H., & Sun, R. (2019). Topical application of magnesium to prevent intubation-related sore throat in adult surgical patients: a systematic review and meta-analysis. Application topique de magnésium pour prévenir les maux de gorge liés à l’intubation chez les patients chirurgicaux adultes: revue systématique et méta-analyse. Canadian journal of anaesthesia = Journal canadien d’anesthesie, 66(9), 1082–1094. https://doi.org/10.1007/s12630-019-01396-7
Athavale, A., Miles, N., Pais, R., Snelling, P., & Chadban, S. J. (2023). Transdermal Magnesium for the Treatment of Peripheral Neuropathy in Chronic Kidney Disease: A Single-Arm, Open-Label Pilot Study. Journal of palliative medicine, 26(12), 1654–1661. https://doi.org/10.1089/jpm.2023.0229
Engen, D. J., McAllister, S. J., Whipple, M. O., Cha, S. S., Dion, L. J., Vincent, A., Bauer, B. A., & Wahner-Roedler, D. L. (2015). Effects of transdermal magnesium chloride on quality of life for patients with fibromyalgia: a feasibility study. Journal of integrative medicine, 13(5), 306–313. https://doi.org/10.1016/S2095-4964(15)60195-9
Kass, L., Rosanoff, A., Tanner, A., Sullivan, K., McAuley, W., & Plesset, M. (2017). Effect of transdermal magnesium cream on serum and urinary magnesium levels in humans: A pilot study. PloS one, 12(4), e0174817. https://doi.org/10.1371/journal.pone.0174817
Can chiropractic treatment alleviate pain and correct swayback posture, a postural deformity that can cause lower back pain and mobility issues, for individuals experiencing it?
Swayback Posture
Swayback posture is a common dysfunction involving the pelvis and hip joints tilted forward in front. This causes the pelvis to shift forward, which exaggerates the curves in the lower and upper back, known as lordosis and kyphosis. The pelvis may tilt backward relative to the upper half, causing the buttocks to tuck under. The pelvis coordinates the movements of the head, shoulders, and trunk with those of the feet, legs, and thighs. A neutral pelvis, the ideal position, generally supports a mild curve/normal lordosis in the lower back. The small arch helps the body balance the skeletal parts as they work together to support and move the body’s weight. When a postural deformity occurs, one or more bones may shift from their ideal position to compensate for any pain or loss of balance caused by the original deviation. This deviation can lead to muscle strain, ligament sprain, and/or pain. (Czaprowski, D. et al., 2018)
Postural Deviations
Swayback posture causes the thoracic spine to move backward and round over into kyphosis. At the same time, the pelvis is tilted forward, resulting in an exaggeration of the normal lumbar lordosis. (Czaprowski, D. et al., 2018)
Healthcare providers, chiropractors, and physical therapists use exact measurements to define and treat postural deformities.
A neutral pelvis is a position of balance the entire body uses to help it stay upright, move, and be pain-free.
The ideal or neutral pelvic tilt is a 30-degree angle between the vertical and the plane that passes through the top of the sacrum and the axis of the hip joint socket in the front.
Swayback posture causes the pelvis to tilt forward another 10 degrees.
As a result, the spine compensates, exaggerating the curves in the lower back/lordotic curve and in the mid and upper back/kyphotic curve.
When viewed from the side, individuals can see a backward movement of the thoracic spine.
In front, the chest tends to sink in.
Muscle Group Imbalances
Healthcare providers look at different contributors or causes of postural deviations. Swayback can sometimes be associated with strength imbalances between muscle groups that move the hips, spine, and pelvis and hold the body upright. This includes:
Weakened hip flexors and overly strong or tense hip extensors/the hamstrings.
Tight upper abdominals, weak lower abdominals, and weak mid-back muscles may also contribute.
A corrective exercise program after seeing a physical therapist will help address some or all underlying muscle imbalances.
Risk Factors
Because weight in the abdominal region pulls the pelvis forward, pregnant women and obese individuals can have an increased risk of developing a swayback posture. (Vismara, L. et al., 2010)
Symptoms
The symptoms of swayback posture often include:
Severe lower back pain
Difficulty sitting or standing for long periods
Difficulty performing certain physical activities.
Tightness in the hamstrings and hip flexors
Tightness in the upper back muscles
Headaches or migraines
Chiropractic Treatment
Chiropractic adjustments are a common treatment used to correct swayback posture and can be corrected through various treatments. These include:
Spinal adjustments: The doctor applies pressure to specific spine areas to realign them and help restore proper spinal function.
Non-surgical decompression
Massage therapies
Muscle Energy Technique, or MET, improves muscle strength, flexibility, and function.
Acupuncture
Exercises to strengthen and stabilize the core muscles
Lifestyle adjustments to help reduce stress on the spine
Posture exercises
Biomechanics training
Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop a personalized care plan for each patient through an integrated approach to treating injuries and chronic pain syndromes, improving flexibility, mobility, and agility programs to relieve pain and help individuals return to optimal function. If other treatments are needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments.
How I Gained My Mobility Back With Chiropractic Care
References
Czaprowski, D., Stoliński, Ł., Tyrakowski, M., Kozinoga, M., & Kotwicki, T. (2018). Non-structural misalignments of body posture in the sagittal plane. Scoliosis and spinal disorders, 13, 6. https://doi.org/10.1186/s13013-018-0151-5
Vismara, L., Menegoni, F., Zaina, F., Galli, M., Negrini, S., & Capodaglio, P. (2010). Effect of obesity and low back pain on spinal mobility: a cross sectional study in women. Journal of neuroengineering and rehabilitation, 7, 3. https://doi.org/10.1186/1743-0003-7-3
For individuals who don’t have time for a full workout, could incorporating sprint exercise training be an option to improve their cardiovascular and overall health?
Sprint Exercise Training
Most think of running when they hear the word sprinting. However, sprinting can be performed in any aerobic activity, whether swimming, cycling, rollerblading, or exercising on an elliptical machine. Sprint exercise training means varying the intensity levels of the activity. It is also known as sprint interval training or speed drills. It targets cardiovascular endurance and is suitable for all fitness levels, from beginners to advanced. This type of training is demanding and requires high motivation, but it can lead to significant improvements and help achieve fitness goals faster.
Sprint workouts are a time saver. Many exercise guidelines recommend up to 60 minutes of moderate exercise 3 times a week; however, many people don’t have the time. Studies have shown that short, high-intensity sprint exercise training improves aerobic capacity and endurance in half the time of traditional endurance exercise. Sprint exercise training burns calories, improves cardiovascular health, builds muscle, and increases speed and power. Sprint workouts are great for individuals who lack time for traditional steady endurance exercise but want to improve cardiovascular health. (Vollaard, N. B. J., and Metcalfe, R. S. 2017) Adding them to a workout routine can take training to a new level.
Training
The key to sprint training is performing an activity at a certain percentage of all-out effort to increase heart rate. Sprint exercise training is recommended three times a week, with at least one to two days of rest or other easy exercises between sprint workouts. How to do.
Warm-up
Warm up with easy exercise for five to 10 minutes.
Slowly perform the exercise that will be done for the sprints to prepare the body for the intense sprint.
Do the First Sprint
Perform the first sprint at around 60% intensity.
Slow down and continue warming up if there is muscle tightness or joint pain.
Rest
Recover for four minutes by slowing to a comfortable pace, but continue moving.
Do the Second Sprint
Perform the next sprint at 80% max intensity.
Rest
Rest for four minutes.
Do the Third Sprint
Perform the remainder of the sprints at 100% intensity or all-out efforts for 30 seconds.
Push to the maximum for each exercise.
Rest
Recover for four minutes after each sprint to slow down breathing and heart rate, and can hold a conversation without gasping.
Repeat
Repeat the sprint/recovery routine four to eight times, depending on fitness level and ability.
For the first workout, stop at four sprints.
Gradually build up to eight.
Benefits
Sprint exercise training enhances endurance performance and can be effectively used by athletes, fitness enthusiasts, and individuals who want to improve their fitness and health. (Litleskare, S. et al., 2020) In one study, participants who completed eight weeks of sprint training saw improvements in maximal oxygen uptake or VO2 max. The test is one way to measure cardiovascular fitness. (Litleskare, S. et al., 2020) These short bursts of intense exercise improve muscle health and performance comparable to several weeks of traditional training. (Gunnarsson, T. P. et al., 2013) Other studies have found that short, high-intensity exercise burns more calories than the same amount of moderate-level cardiovascular exercise. (Vollaard, N. B. J., and Metcalfe, R. S. 2017)
Variations
There are different ways to structure a sprinting routine, and different fitness goals will determine the intensity, duration, and number of sprints that should be performed.
Beginners
Those new to sprinting should start slow, as overdoing it can lead to injury. Work on building up a base level of fitness before introducing sprinting into an exercise routine. Start with one set of four sprint/rest cycles when trying sprints. As fitness goals are achieved, add more sprints to each set or different sprints.
Intermediate
Once a sprinting exercise routine is begun, it may only be a few weeks before one is ready to advance to an intermediate level. Try increasing the number of sprints at different intensity levels. However, avoid sprint exercises too often weekly as the body needs adequate rest.
Advanced
Advanced athletes can intensify the routine by increasing intensity and adding reps. One way is by adding resistance. For example, for those running or cycling, try sprinting hills, or if rollerblading, try wearing wrist and ankle weights to increase the load. Swimmers can use strength-building techniques to focus on specific body areas or add resistance. The intensity of any sprinting activity can be intensified by wearing a weighted vest.
Beginner Errors
A few common starting mistakes include going too hard, advancing too quickly, and doing too many for too long. Sprints are not meant to replace moderate-intensity exercise. The goal is to modulate the intensity of aerobic activities. A study showed that not getting enough rest between sprints led to an inability to perform as well during sprinting. (Selmi, M. A. et al., 2016)
Safety
Sprint workouts can be done with running, swimming, cycling, or other aerobic cardiovascular exercises. The following precautions should be considered before adding sprint training to a workout schedule:
Safety
Because sprinting is a high-intensity exercise, it is recommended that individuals consult with a healthcare professional and review the physical activity readiness questionnaire (PAR-Q) before beginning a sprint training workout.
Base Fitness
A strong fitness base in the sprint activity is also important.
To build a fitness base, follow the 10% rule and gradually increase training volume.
Frequency
Because of the intensity, sprint workouts should not be done more than three times a week.
Muscle Soreness
Launching into a sprint program can cause delayed-onset muscle soreness.
Experts recommend having about three to four weeks of base fitness before beginning.
Injuries are more likely if the body isn’t properly prepared.
The goal is to do a sprint workout six times in two weeks, then only perform 2 times a week for maintenance for six to eight weeks before changing the workout. On the days following a sprint workout, aim for 20–30 minutes of the same aerobic activity at an easier pace to help recover but maintain results. If pleased with the results, continue with the routine longer, but it is recommended to vary the workouts every few months and throughout the year. Modify the routine to find what works best.
Military Training and Chiropractic Care: Maximizing Performance
References
Vollaard, N. B. J., & Metcalfe, R. S. (2017). Research into the Health Benefits of Sprint Interval Training Should Focus on Protocols with Fewer and Shorter Sprints. Sports medicine (Auckland, N.Z.), 47(12), 2443–2451. https://doi.org/10.1007/s40279-017-0727-x
Litleskare, S., Enoksen, E., Sandvei, M., Støen, L., Stensrud, T., Johansen, E., & Jensen, J. (2020). Sprint Interval Running and Continuous Running Produce Training Specific Adaptations, Despite a Similar Improvement of Aerobic Endurance Capacity-A Randomized Trial of Healthy Adults. International journal of environmental research and public health, 17(11), 3865. https://doi.org/10.3390/ijerph17113865
Gunnarsson, T. P., Christensen, P. M., Thomassen, M., Nielsen, L. R., & Bangsbo, J. (2013). Effect of intensified training on muscle ion kinetics, fatigue development, and repeated short-term performance in endurance-trained cyclists. American journal of physiology. Regulatory, integrative and comparative physiology, 305(7), R811–R821. https://doi.org/10.1152/ajpregu.00467.2012
Selmi, M. A., Haj, S. R., Haj, Y. M., Moalla, W., & Elloumi, M. (2016). Effect of between-set recovery durations on repeated sprint ability in young soccer players. Biology of sport, 33(2), 165–172. https://doi.org/10.5604/20831862.1198636
Can learning about comminuted fracture symptoms and repair help individuals and healthcare providers develop effective treatment and rehabilitation programs?
Comminuted Fractures
A comminuted fracture is a severe break in which the bone splits into at least three pieces. Comminuted fractures typically happen in the long bones like those in the arms and legs. But they can also happen in other places, including the ribs. (Corinne Tarantino, 2022) They are usually caused by intense impact, like an automobile collision/accident or a severe fall. Depending on the location of the fracture, recovery from a comminuted fracture can take months and often involves:
Surgery – A surgeon will place screws and rods to hold the pieces of the bone in position. Sometimes, the hardware is left in permanently. (American Academy of Orthopaedic Surgeons, 2021)
Wearing a cast for several months.
Physical therapy.
Types
In these types of fractures, the bone is completely broken, not just cracked. The break is a highly comminuted fracture if the bone is broken into four or more pieces. (Corinne Tarantino, 2022)
Symptoms
The symptoms are the same as those of other broken bones, but they can be more intense because the bone is broken in multiple areas, which means there may also be more soft tissue injuries than with a simple fracture. Broken bone symptoms include: (MedlinePlus, 2024)
Persistent pain
Swelling
Bruising
Deformity – the bone looks out of place or is at an odd angle.
Tingling
Numbness
Difficulty moving the limb.
Causes
An intense force causes a comminuted fracture, often a car accident or a hard fall, but it can also result from sports injuries. (Corinne Tarantino, 2022)
Diagnosis
A comminuted fracture is diagnosed by X-ray, which shows where the bone has broken and how many pieces it has split into (MedlinePlus, 2024). Healthcare providers will diagnose any broken bones but also look for other injuries.
Treatment
Typically, broken bones can be treated with casts, braces, or a boot to keep them immobilized. (MedlinePlus, 2024) Because comminuted fractures are more severe, they often need other treatments, including surgery. Sometimes, the bone can be reset instead of surgery using a closed reduction technique, where the healthcare provider resets the bone manually. Surgery may be recommended if that’s not possible or doesn’t work.
Types of Surgery
Surgery allows the healthcare provider to correctly position all the pieces of the bone to heal in a strong, stable formation. The two types commonly used to treat comminuted fractures are: (American Academy of Orthopaedic Surgeons, 2021)
External Fixation
This surgery uses rods and screws outside the body to stabilize the bone.
This external frame is placed during surgery and later removed.
Open Reduction Internal Fixation – ORIF
During this surgery, the bone is stabilized with metal plates, screws, rods, and/or wires placed inside your body.
Sometimes, these are permanent, but in other cases, they are removed later.
An orthopedic surgeon performs these surgeries.
Casting
After surgery, a cast is usually needed to prevent the bone from moving and allow healing. Typically, the cast is worn for six to eight weeks, but it may need to be worn longer with comminuted fractures. Some need a cast for several months (American Academy of Orthopaedic Surgeons, 2021). Sometimes, those with an external fixation must continue wearing a cast after removing the pins and rods, giving the bone more time to stabilize. The healthcare provider will inform the patient how long the cast will need to be worn and which sports activities should be avoided even after the cast comes off.
Physical Therapy
The healthcare provider may recommend physical therapy to help treat the fracture. Usually, when the cast is removed, physical therapy is activated to help rebuild strength and range of motion. (Corinne Tarantino, 2022)
Prognosis
Although these fractures are severe, they are treatable. The prognosis is good for individuals who follow their healthcare provider’s treatment plan. Most don’t have lingering pain after the initial injury and can eventually return to regular activities. (American Academy of Orthopaedic Surgeons, 2021)
Recovery
Healing a comminuted fracture can take months. During that time, it’s helpful to focus on tasks that can be accomplished, like new hobbies that don’t involve physical injury. Talk to the healthcare provider about any problems with the cast or ongoing pain and what to expect during recovery.
Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution through an integrated approach to treating injuries and chronic pain syndromes, improving flexibility, mobility, and agility programs to relieve pain and help individuals return to normal. Our providers create personalized care plans for each patient. If other treatments are needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments.
The Path to Healing Personal Injury
References
Corinne Tarantino, MPH. Osmosis. (2022). Comminuted Fracture: What is it, Examples and More. https://www.osmosis.org/answers/comminuted-fracture
Throckmorton T.W. American Academy of Orthopaedic Surgeons. (2021). Fractures (broken bones). https://orthoinfo.aaos.org/en/diseases–conditions/fractures-broken-bones/
MedlinePlus. National Library of Medicine. (2024). Fractures Also called: Broken bone. Retrieved from https://medlineplus.gov/fractures.html
For individuals living with chronic pain and various diseases like Parkinson’s, arthritis, and diabetes, can water aerobics be beneficial?
Water Aerobics
Water aerobics are low-impact exercises performed commonly in swimming pools. It is a great way to exercise for a full-body, low-impact workout without overworking the body’s joints and muscles. Other names used include:
Aquafitness
Aqua aerobics
Aquarobics
Many types can be tailored to individual needs, injuries, and/or conditions. The exercises have various health benefits, especially for those who cannot perform higher-impact movements.
Individuals participating in water aerobics will need a bathing suit, towel, goggles, and a swim cap to protect their eyes or hair from chlorinated water. Individuals do not need other special equipment while exercising as the water acts as extra resistance. Foam dumbbells or paddles can be used to increase resistance. Other optional equipment includes: (Plunge San Diego, 2024) (Harvard Health Publishing Harvard Medical School, 2023)
Kickboards
Wrist and ankle weights
Water-jogging belts
Swim bar
Pool Exercises
There are many types of pool exercises to help reach health and fitness goals. They include:
Water Walking
The basic act of walking in water is a great way to get a full-body workout.
Start by standing in waist-deep water with the feet planted on the bottom of the pool.
Lengthen the spine by bringing the shoulders up and back and aligning the shoulders with the hips and knees.
Once in a good starting position, walk through the water, putting pressure on the heel first and then the toes, just like walking out of the water, while swinging the arms back and forth through the water.
This exercise can be done for five to 10 minutes.
The muscles that will get the most attention are the arms, core, and the lower body.
Arm Lifts
Stand up to the shoulders in water.
With the palms facing up, draw the elbows into the torso while lifting the forearms in front of the body up to the water’s surface.
Once at the surface, rotate the palms to face down and slowly move the forearms back down to the sides.
For more resistance, this exercise can also be done using foam dumbbells.
Repeat the action 10–15 times for one to three sets.
The muscles targeted are the core and the arm muscles.
Jumping Jacks
Water resistance makes jumping jacks in the water much more difficult than on land.
To perform, start by standing in chest-level water with your feet together and your arms straight down the sides.
Once in position, begin by simultaneously swinging the legs out to the side and arms over the head before returning to the starting position.
Muscles targeted include the entire body and cardiovascular system.
Add wrist or ankle weights for more resistance and to make the exercise more challenging.
High-Knee-Lift Extensions
High-knee-lift extensions are performed while standing in water that is waist deep.
To do the exercise, engage the core and lift one leg in a bent position until it is level with the water’s surface.
Hold the position for a few seconds, then extend the leg out in front and hold again.
After the hold period, move the leg back down through the water to the starting position while keeping it straight and flexing the foot.
Repeat on both legs for two to three sets of 15 reps per leg.
Use weights on the ankles to increase resistance.
The muscles targeted include the core, glutes, and lower body.
Risks
While exercising in water, individuals may not notice how much they sweat. This can make it seem like the workout is not as hard and can lead to dehydration. Individuals should always hydrate before and after a pool workout. Individuals who cannot swim well should avoid exercises that do not require a flotation device. Sometimes pools are heated, so choosing one 90 degrees F or below is recommended so the body doesn’t get overheated while exercising.
Stop Pool Exercises Immediately
Performing pool exercises can often seem easier than they are, leading to overworking. Stop exercising immediately if you feel:
Pain in any area of the body
Shortness of breath
Nauseated
Faint
Dizzy
Pressure in the upper body or chest
Other Health Conditions That Benefit
Water aerobics is recommended for most individuals, completely healthy or with a chronic disease. Those with chronic disease have been shown to benefit from the low-impact exercise. (Faíl, L. B. et al., 2022) One study looked at individuals with various health conditions, with the results showing that the following conditions saw improvements after 12 weeks of regular water exercise (Faíl, L. B. et al., 2022)
Diabetes
Arthritis
Fibromyalgia
Bone diseases
High blood pressure
Coronary artery disease
Stroke
Multiple sclerosis (MS)
Parkinson’s disease
While the benefits of water aerobics have been studied and proven effective, individuals should be cleared by a medical professional before starting any new exercise regimen. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution through an integrated approach to treating injuries and chronic pain syndromes, improving flexibility, mobility, and agility programs to relieve pain and help individuals return to normal. Our providers create personalized care plans for each patient. If other treatments are needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments.
Chiropractic and Integrative Healthcare
References
Harvard Health Publishing Harvard Medical School. (2023). Basic types of water-based exercises. HealthBeat. https://www.health.harvard.edu/healthbeat/basic-types-of-water-based-exercise
Pereira Neiva, H., Brandão Faíl, L., Izquierdo, M., Marques, M. C., & Marinho, D. A. (2018). The effect of 12 weeks of water-aerobics on health status and physical fitness: An ecological approach. PloS one, 13(5), e0198319. https://doi.org/10.1371/journal.pone.0198319
Harvard Health Publishing Harvard Medical School. (2024). Advantages of water-based exercise. HealthBeat. https://www.health.harvard.edu/healthbeat/advantages-of-water-based-exercise
Plunge San Diego. (2024). 5 must-have pieces of aquatic exercise equipment for water aerobics. Plunge San Diego. https://plungesandiego.com/what-equipment-needed-water-aerobics-shoes/
Faíl, L. B., Marinho, D. A., Marques, E. A., Costa, M. J., Santos, C. C., Marques, M. C., Izquierdo, M., & Neiva, H. P. (2022). Benefits of aquatic exercise in adults with and without chronic disease-A systematic review with meta-analysis. Scandinavian journal of medicine & science in sports, 32(3), 465–486. https://doi.org/10.1111/sms.14112
For individuals who sit at work for long hours, can years of practicing unhealthy posture be corrected through a step-by-step approach to ensure optimal body position while sitting?
Sitting Posture
Sitting up straight with a healthy posture requires the conscious alignment of the hips, pelvis, lower back, upper back, shoulders, neck, and head. Learning or retraining oneself to maintain correct sitting posture can relieve lower back pain, improve respiration and digestion, and reduce tension in the neck and shoulders. (Albarrati, A. et al., 2018) It starts by paying attention to posture throughout the day and correcting it whenever forward head posture, leaning, or slouching develops. Targeted exercises can also help build upper-body strength, and stretching can stabilize and strengthen the core muscles, lower back, and pelvic joints. (Albarrati, A. et al., 2018)
Sit Up Straight Guide
Sitting up straight can be uncomfortable because it is not a natural position for the body to be in for an extended time. Nowadays, work, school, appointments, and other activities require us to sit much longer than intended. The muscles also have to work against gravity, leading to muscle exhaustion, slouching, and slumping, which can cause chronic back, leg, neck, and/or shoulder pain. (Jung, K. S. et al., 2020)
Sitting up straight may seem simple, but the focus tends to be on straightening just the lower/lumbar spine. This posture is unsustainable and exhausts and stresses the upper and lower back. (Jung, K. S. et al., 2020) The whole body needs to be considered when protecting the stability and balance of the spine. Learning and maintaining the ability to sit up straight is a process that requires practice. Find a comfortable chair to sit in, and follow these steps to achieve the optimal postural alignment (Canadian Centre for Occupational Health and Safety, 2022)
Knee Spacing
The hips should be at a roughly 90-degree angle.
Knee Position
The knees should be at a 90-degree angle level with the hips.
Use a pillow to achieve the right knee position if the seat is too low.
Keep the Feet Flat on the Floor
If feet don’t reach the floor, place a footstool, box, book, or other flat object underneath them.
Sitting Bones
Also known as the ischial tuberosities, these are two knobby bones on the underside of the pelvis.
Feel around to find them.
Pelvis Adjustment
Shift the body so that the sitting bones are directly under the pelvis rather than situated too far back, stressing the lower back or too far forward, leading to slumping.
Spine Check
There should be a slight spinal curve, and one should be able to slip a hand between the lower back and the back of the chair.
Shoulder Check
The shoulders should be level and vertically aligned with the hips.
If the shoulder blades are pulled back or the shoulders are lifted or curled forward, relax them into a neutral position.
Head Positioning
The head tends to tilt too far forward while sitting as work and the day progresses.
Adjust the head position to align the neck with the upper spine.
The head should be slightly tilted forward, with the ears aligned with the shoulders.
Check for Pain and Discomfort
Pain may be due to structural imbalances of the spine, pelvis, or hips.
Use a lumbar chair support or place a rolled-up towel or cushion at the lower back to keep the back straight.
Added Tips
Tools and tricks to help prevent and avoid back, hip, and neck pain.
Chairs
All the bells and whistles for an ergonomic desk chair are unnecessary.
Focus on features like adjustable seat height and lumbar support. The correct seat depth recommendations are deeper if tall and shallower if short. (van Niekerk, S. M. et al., 2012)
Cushions
If sitting on a cushion or using one to bolster the back or hips, recommendations are not to go too soft.
Cushions that are too soft allow the ability to shift from one hip to the next, often without realizing it.
They usually eventually flatten and lose support.
Monitor Position
There is no point in sitting straight if the monitor is too high or too low.
The monitor should be at eye level to maintain the proper head and shoulder alignment.
If the monitor is too low, place a box or book underneath it.
If it is too high, raise the chair’s height and place a footrest under the feet to keep them flat.
Avoid Crossing Legs or Feet
Crossing the legs or feet places stress on the opposite hip, thigh, and knee and wears the body out faster.
If the hips or legs are tiring prematurely, the individual is not sitting correctly or in the wrong chair.
Use Comfortable Footwear
Maintaining flat feet on the floor while sitting is imperative.
This is not possible in high heels or platform shoes.
Change into a comfortable pair of flat shoes while sitting.
Take Regular breaks
Even with an ergonomic desk chair, the body is not meant to be sitting for hours and hours.
Get up at least every hour, walking and stretching to reactivate the muscles and circulation.
Sitting up straight requires body alignment awareness, stable core muscles, and balanced pelvis, hips, spine, shoulders, neck, and head positioning. It may take some time before these steps become normal, but they will become second nature with perseverance and practice. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution that fully benefits the individual to get back to normal. Using an integrated approach to treat injuries and chronic pain syndromes to improve ability through flexibility, mobility, and agility programs to relieve pain. Our providers create personalized care plans for each patient, including Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine principles. If other treatment is needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments.
Posture and Mobility
References
Albarrati, A., Zafar, H., Alghadir, A. H., & Anwer, S. (2018). Effect of Upright and Slouched Sitting Postures on the Respiratory Muscle Strength in Healthy Young Males. BioMed research international, 2018, 3058970. https://doi.org/10.1155/2018/3058970
Jung, K. S., Jung, J. H., In, T. S., & Cho, H. Y. (2020). Effects of Prolonged Sitting with Slumped Posture on Trunk Muscular Fatigue in Adolescents with and without Chronic Lower Back Pain. Medicina (Kaunas, Lithuania), 57(1), 3. https://doi.org/10.3390/medicina57010003
Canadian Centre for Occupational Health and Safety. (2022). Working in a sitting position – good body position. Retrieved from https://www.ccohs.ca/oshanswers/ergonomics/sitting/sitting_position.html
van Niekerk, S. M., Louw, Q. A., & Hillier, S. (2012). The effectiveness of a chair intervention in the workplace to reduce musculoskeletal symptoms. A systematic review. BMC musculoskeletal disorders, 13, 145. https://doi.org/10.1186/1471-2474-13-145
For individuals wanting to try Pilates for back pain and exercise, can learning how to find their neutral spine help improve flexibility and increase the range of motion in the joints?
Pilates Neutral Spine
Pilates is a functional exercise modality emphasizing core stability, which is fundamental to developing a balanced body. The exercises strengthen the muscles, improve flexibility, and increase the range of motion in the joints. (Kloubec J. 2011) It is considered a functional fitness method because its principles work to establish more graceful, efficient movements from everyday life, such as improving posture. Pilates has shown its effectiveness in that it is often used in physical therapy and rehabilitation settings. (Byrnes, K., Wu, P. J., and Whillier, S. 2018) However, knowing how to find the neutral spine is essential for performing various Pilates exercises correctly. (Barbosa, A. C. et al., 2018) This subtle adjustment during practice may help prevent injury and increase overall performance. A neutral spine is the natural position of the spine when all three curves:
Cervical (neck)
Thoracic (middle)
Lumbar (lower)
Are active and in healthy alignment.
This is the strongest position for the spine when standing or sitting, allowing the body to move more naturally.
Alignment
The following exercise can help find the Pilates neutral spine.
Basic Position
Lie on the back with knees bent and feet flat on the floor.
Ensure the legs are parallel to the hips, knees, heels, and toes.
Let the arms rest at your sides.
Relax
Relax the body, including the shoulders, neck, and jaw.
Allow the back to melt into the floor.
The rib cage will drop when the lower ribs are released to the floor.
Breathe Deep
Inhale all the way into the body, allowing it to move into the back and sides of the rib cage and all the way to the pelvis.
Pelvic Tilt
Exhale and use the abdominals to press the lower spine into the floor in a pelvic tuck. (Eickmeyer S. M. 2017)
Inhale to release.
Exhale and pull the lower spine off the floor, creating a pelvic tilt.
Inhale to release.
Pilates exercises don’t use excess energy or tension. Proper alignment and a neutral spine position can ensure that tension is released and excess energy is not exerted. (Byrnes, K., Wu, P. J., and Whillier, S. 2018) When performing the exercise, ensure that the shoulders, neck, and legs are relaxed and not involved in the movement.
When Exercising
Once a neutral spine is achieved, the goal is to maintain this spinal position during the exercises and when changing positions.
Start by lifting the right leg and placing it back down without letting the hips move.
Then, repeat the motion with the left leg.
Engage the abdominal muscles to help stabilize the pelvis, keeping it from moving and maintaining a neutral spine.
Repeat this process with each leg.
Once each leg can be lifted easily, test with both legs.
Exhale deeply and lift the legs while keeping the core and pelvis stable.
Then, lower them back down.
When performing this progression, there may be a want to release the abs and let the back arch.
This will cause a tuck and tilt position away from the neutral spine position.
If this progression is difficult, keep practicing until you can maintain a neutral spine.
Once this basic progression feels easy, try additional progressions and positioning.
Visualization Tips
Most people have their spines in one of two positions: tucked or tilted. A neutral spine requires individuals to be in between, with the lower abdominals flat and the lower spine’s natural curve slightly off the floor. The following visualization can help establish a neutral spine.
Balanced Pelvic Placement
Imagine a cup of water sitting on the lower abdomen, a couple of inches below the belly button.
Allow the abdominal muscles to drop toward the spine, flattening the belly.
You don’t want the water to spill, so the pelvis cannot be tipped forward or tucked under.
Body Scan Meditation
Once the body is relaxed with a balanced alignment on the floor.
Allow breathing to become deep and full and the abdominals to drop toward the floor.
The natural neck and lower spine curves should be off the floor.
Ensure the lower spine is not pressed into the floor, as this indicates a pelvic tilt.
If there is any discomfort or pain when working to increase endurance, seek advice from a healthcare professional. Injury Medical Chiropractic and Functional Medicine Clinic uses an integrated approach to treating injuries and chronic pain syndromes. It offers personalized care plans that improve ability through flexibility, mobility, and agility programs to relieve pain. Our providers use an integrated approach to create personalized care plans for each patient, including Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine principles. Our goal is to relieve pain naturally by restoring health and function to the body. If other treatment is needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments.
Is Motion Key to Healing?
References
Kloubec J. (2011). Pilates: how does it work and who needs it?. Muscles, ligaments and tendons journal, 1(2), 61–66.
Byrnes, K., Wu, P. J., & Whillier, S. (2018). Is Pilates an effective rehabilitation tool? A systematic review. Journal of bodywork and movement therapies, 22(1), 192–202. https://doi.org/10.1016/j.jbmt.2017.04.008
Barbosa, A. C., Vieira, E. R., Silva, A. F., Coelho, A. C., Martins, F. M., Fonseca, D. S., Barbosa, M. A., & Bordachar, D. (2018). Pilates experience vs. muscle activation during abdominal drawing-in maneuver. Journal of bodywork and movement therapies, 22(2), 467–470. https://doi.org/10.1016/j.jbmt.2017.05.002
Eickmeyer S. M. (2017). Anatomy and Physiology of the Pelvic Floor. Physical medicine and rehabilitation clinics of North America, 28(3), 455–460. https://doi.org/10.1016/j.pmr.2017.03.003
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