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It Could Be More Than Triceps Muscle Pain

By
Dr. Alex Jimenez
-

Introduction

One of the many muscles that help stabilize the shoulders and provide movement when the arms are in motion. The tricep muscles are one of the most underrated muscles that many people don’t seem to take care of when working out. The other muscles in the upper arms and shoulders are more likely to be worked on when it comes to being physically active. The deltoids, biceps, and brachialis muscles are some of the muscles that get much more attention when working on shoulder mobility. Still, the triceps provide the functionality to the shoulders as well. When the shoulders or the upper arms are injured and develop pain-like symptoms in the muscle groups, it can develop trigger points along the affected muscle. Today’s article looks at the tricep muscles, how trigger points affect them, and ways to manage trigger points along the tricep muscles. We refer patients to certified providers who specialize in arm pain treatments to aid individuals suffering from trigger points associated with the tricep muscles along the upper arms and elbows. We also guide and inform our patients by referring them to our associated medical providers based on their examination when appropriate. We established that education is a great solution to asking our providers profound questions the patient requests. Dr. Jimenez DC takes note of this information as an educational service only. Disclaimer

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What Do The Tricep Muscles Do?

 

Do you experience pain underneath your forearm? How about feeling a dull ache on your elbows? Or do you feel a numbing sensation on your ring and pinky fingers? Individuals experiencing these symptoms in their arms could potentially develop trigger points along their tricep muscles. The tricep muscles are located under the upper arm and are a large, thick horseshoe-shaped muscle at the end of the arm. As stated earlier, the tricep muscles are one of the most underrated muscles in the arm that no one tends to work on during a workout, so they can be easily overlooked. However, the tricep muscles help in providing stability to the shoulders and help strengthen the arms. One of the main functions the triceps offer is that they allow the extension of the elbow joints. Studies reveal that the three head tendons that make up the triceps can influence elbow extension torque. The three heads of the triceps have different patterns of force when it comes to various activities during different shoulder evaluations. To that point, multiple combinations of the shoulder and elbows at different angles can affect the tricep’s shoulder extensions. Since many individuals don’t work on their triceps often, it can potentially develop issues that can make this underrated muscle weak.

 

How Trigger Points Affect The Tricep Muscles?

 

When the triceps don’t get worked on during a workout, it can lead to muscle weakness when doing pushups or when someone suffers from an injury with direct trauma in the elbows. When the tricep muscles become affected, it can lead to chronic conditions that are associated with myofascial pain or trigger points. Trigger points in the triceps can be formed when there are restrictions in extending the elbow joints. Studies reveal that when the triceps become overloaded from overusing the forearms from normal activities, it could potentially lead to tricep tendon rupture. To that point, which leads to the development of trigger points to invoke pain in the triceps and elbow joint. According to  Dr. Janet Travell, M.D., trigger points associated with the tricep muscles could potentially involve referred pain in the vicinity of the elbow joints. What this refers to is that trigger points can mimic other chronic conditions so in this case, referred pain caused by trigger points associated with the tricep muscles can be mistakenly attributed to arthritis on the elbow joints. All is not lost, as there are ways to manage trigger points affecting the tricep muscles.

 

Treating Trigger Points On The Triceps- Video

Treating Trigger Points - Triceps

Have you been experiencing pain in your shoulders, elbows, and hands? Do you have limited mobility when extending your elbows? Or do you notice that your triceps are weaker than normal? If you have been dealing with any of these symptoms, it could be due to trigger points associated with the tricep muscles that are causing referred pain to the upper arms and elbows. The triceps in the upper arms is one of the most underrated muscles people tend to overlook. When individuals begin to succumb to injuries that affect their triceps, it can lead to the development of trigger points along the muscle fibers in the tricep muscles. Trigger points can occur in the tricep muscles due to overusing the forearm muscles, causing stress in the elbow joint and the muscle itself. When the trigger points become active, it can lead to limited mobility to the elbow joint, causing the individual thinks they are developing arthritis when it is the trigger points causing the referred pain. There are ways that many people can manage trigger points associated with the elbows along the triceps to relieve the pain from the muscle. The video above shows where the active trigger points are located and how to release them through palpations and massage. Treating the trigger points along the tricep muscles allows many individuals to regain mobility in their elbows and upper arms.

Managing Trigger Points Along The Triceps

 

As stated earlier, the triceps are the underrated muscle that people tend to forget. When the tricep muscles succumb to trigger points, it can lead to referred pain along the elbow joints, causing pain-like symptoms affecting the elbow’s mobility function. When this happens to the upper arms, there are various ways to strengthen the tricep muscles and manage trigger points from developing in the future. Incorporating exercises targeting the tricep muscles can help improve mobility to the elbows and shoulders. If a person is playing sports like tennis, they can opt for a lighter racket and have a more lightweight grip on the handle. Suppose a person is in pain from their triceps. In that case, however, studies reveal that upper limb rehabilitation can help reduce the pain along the triceps and improve the mobility range caused by pain associated with trigger points. People can continue their daily activities without pain when they utilize these various ways to enhance their triceps’ functionality. 

 

Conclusion

As the most underrated muscle that people tend to forget to work out, the tricep muscle can be overlooked. This large, thick horseshoe-shaped muscle has a job that provides stability to the shoulders and allows an extension to the elbow joints. When individuals don’t work on their tricep muscles, it can lead to muscle weakness and pain-like symptoms that lead to the development of trigger points. Trigger points associated with the tricep muscles can cause referred pain to the elbow joint, making many individuals believe they have arthritis. However, many individuals can regain mobility to their elbows by incorporating exercises targeting the triceps and utilizing treatments to manage trigger points along the muscle fibers. They can do daily activities that require the triceps without pain.

 

References

Landin, Dennis, et al. “Functions of the Triceps Brachii in Humans: A Review.” Journal of Clinical Medicine Research, Elmer Press, Apr. 2018, www.ncbi.nlm.nih.gov/pmc/articles/PMC5827912/.

Lennon, Olive, et al. “Effect of the Triceps Brachii Facilitation Technique on Scapulohumeral Muscle Activation during Reach and Point in a Healthy Population.” Physiotherapy Canada. Physiotherapie Canada, University of Toronto Press, 2019, www.ncbi.nlm.nih.gov/pmc/articles/PMC6855346/.

Mangano, Tony, et al. “Chronic Tendonopathy as a Unique Cause of Non Traumatic Triceps Tendon Rupture in a (Risk Factors Free) Bodybuilder: A Case Report.” Journal of Orthopaedic Case Reports, Indian Orthopaedic Research Group, 2015, www.ncbi.nlm.nih.gov/pmc/articles/PMC4719357/.

Tiwana, Manpreet S, et al. “Anatomy, Shoulder and Upper Limb, Triceps Muscle.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 6 Aug. 2021, www.ncbi.nlm.nih.gov/books/NBK536996/.

Disclaimer

Fermented Foods and Gut Health: Functional Sciatica Clinic

By
Dr. Alex Jimenez
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Young couple choosing fermented milk products in market. Customers buying sour cream and kefir in food store

Fermentation is a process where bacteria and yeast are used to break down foods. The fermentation process has been around for centuries and was initially produced to preserve foods, improve flavor and eliminate toxins. Research has found that eating fermented foods can also increase the beneficial bacteria/probiotics in the gut. Functional medicine practitioners recommend these foods for their health benefits, including improved digestion, increased immunity, and weight loss and maintenance.Fermented Foods and Gut Health: Functional Medicine Clinic

Fermented Foods

Fermented foods and beverages undergo controlled microbial growth and fermentation in which microorganisms like yeast and bacteria break down food elements like sugars/glucose into other products like organic acids, gases, or alcohol. The process gives fermented foods unique taste, aroma, texture, and appearance. There are many different types of fermented foods, including:

Whole foods like vegetables, fruits, cereals, dairy, meat, fish, eggs, legumes, nuts, and seeds can go through fermentation. These foods are nutritious in their original form, but through fermentation, they can provide probiotic and prebiotic health benefits.

Probiotics

Probiotics are live microorganisms that benefit the gut by creating a more favorable digestive environment. This helps:

  • Digest food easier.
  • Support a healthy immune system.
  • Support organ health – lungs, reproductive organs, skin.
  • Improves mood.

However, not all fermented foods contain probiotics, especially commercially produced foods that are pasteurized, killing bacteria and their associated health benefits.

Prebiotics

Prebiotics are food ingredients that the microorganisms like gut bacteria consume to grow and live, leading to improving the digestive environment. These include:

  • Milk
  • Honey
  • Tomato
  • Garlic
  • Onions
  • Asparagus
  • Wheat
  • Barley
  • Rye

However, most fruits, vegetables, and legumes contain prebiotics.

The Benefits of Fermented Foods

Fermented foods’ health benefits include reduced risk of:

  • Diabetes
  • Inflammation
  • High blood pressure
  • Cardiovascular disease
  • Obesity

They have also been linked to:

  • Better weight management
  • Improved brain activity
  • Increased bone health
  • Faster recovery after exercise and physical activity

There are currently no official guidelines regarding how often individuals should eat fermented foods. It is recommended to consult a nutritionist or dietician to figure out the best nutrition plan for the individual and their needs.

The Science

References

Aslam, Hajara, et al. “Fermented foods, the gut, and mental health: a mechanistic overview with implications for depression and anxiety.” Nutritional neuroscience vol. 23,9 (2020): 659-671. doi:10.1080/1028415X.2018.1544332

Dimidi, Eirini, et al. “Fermented Foods: Definitions and Characteristics, Impact on the Gut Microbiota and Effects on Gastrointestinal Health and Disease.” Nutrients vol. 11,8 1806. 5 Aug. 2019, doi:10.3390/nu11081806

King, Sarah, et al. “Effectiveness of probiotics on the duration of illness in healthy children and adults who develop common acute respiratory infectious conditions: a systematic review and meta-analysis.” The British journal of nutrition vol. 112,1 (2014): 41-54. doi:10.1017/S0007114514000075

Kok, Car Reen, and Robert Hutkins. “Yogurt and other fermented foods as sources of health-promoting bacteria.” Nutrition reviews vol. 76, Suppl 1 (2018): 4-15. doi:10.1093/nutrit/nuy056

Parker, Elizabeth A et al. “Probiotics and gastrointestinal conditions: An overview of evidence from the Cochrane Collaboration.” Nutrition (Burbank, Los Angeles County, Calif.) vol. 45 (2018): 125-134.e11. doi:10.1016/j.nut.2017.06.024

Şanlier, Nevin, et al. “Health benefits of fermented foods.” Critical reviews in food science and nutrition vol. 59,3 (2019): 506-527. doi:10.1080/10408398.2017.1383355

Trigger Points Affecting The Brachialis Muscles

By
Dr. Alex Jimenez
-

Introduction

When it comes to the human body in motion, the arms can carry, lift, and move items from one place to another without pain. The arms have different muscles that work together to protect the arm and shoulder joints while providing mobility and movement. One of the muscles that help the arms carry items is the brachialis muscles, which work together with the bicep and tricep muscles. As part of the forearm, it can succumb to various injuries affecting the muscle, tendons, and ligaments. When this happens, referred pain can affect the arm and develop trigger points to overlap chronic conditions that can potentially cause more pain. Today’s article looks at the brachialis muscle’s function, how trigger points affect the muscle, and various ways to manage brachialis trigger points. We refer patients to certified providers who specialize in arm pain treatments to aid individuals suffering from trigger points associated with the brachialis muscles along the upper arms. We also guide and inform our patients by referring them to our associated medical providers based on their examination when appropriate. We established that education is a great solution to asking our providers profound questions the patient requests. Dr. Jimenez DC takes note of this information as an educational service only. Disclaimer

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What Is The Brachialis Muscle Function?

 

Have you been experiencing muscle strain in your forearms? What about stiffness in your wrist? Or do your arm muscles begin to spasm out of nowhere? Many people who have experienced these pain symptoms might be caused by trigger points associated with the brachialis muscle. The brachialis is an important muscle that flexes the forearm at the elbow. This muscle works with the biceps as it can carry heavy items, like the deltoid, and is the opposite of the tricep muscles. However, it can become overused and succumb to injuries that can invoke pain in the arm muscles, thus leading to the development of trigger points along the brachialis muscle.

 

How Does Trigger Points Affect The Brachialis Muscle?

 

When the brachialis muscle becomes injured, many people will experience pain when flexing their elbows inward or outward. According to Dr. Travell, M.D., these pain symptoms may be due to referred pain and tenderness from brachialis trigger points or radial nerve entrapment. During heaving lifting, the forearm flexion stress overload activates trigger points along the brachialis. Studies reveal that excessive sudden physical stress or repetitive activities may result from a muscle sprain or tear in the brachialis muscle. To that point, these symptoms associated with trigger points can cause overlapping risk profiles that can mask the condition. Some of the conditions that can overlap and activate trigger points include: 

  • Carrying heavy groceries
  • Holding power tools
  • Tennis elbow
  • Playing a string instrument

Studies also reveal that active trigger points along the affected muscle can increase weight coefficients and alter motor control without co-contraction patterns. This is due to trigger points becoming tricky to diagnose and mimic other conditions affecting the arms’ muscle group. Many people with pain-like symptoms associated with trigger points often complain about numbness or deep pain in their arms and hands. To that point, trigger points can also be involved with nerve entrapment in the brachialis muscles.

 

The Brachialis Trigger Points Release-Video

How To Treat Trigger Points - Brachioradialis

Have you been experiencing stiffness in your hands and arms? What about muscle spasms near your elbow? Or does constant pain affect your forearm muscles when you bend your arm? Many of these symptoms are associated with trigger points affecting the brachialis muscle that is causing pain in the forearms. Trigger points or myofascial pain syndrome can affect a person’s well-being by impairing their mobility in the affected areas, causing pain, and even reducing their overall sense of life. Trigger points affecting the brachialis muscles can mimic chronic conditions like nerve entrapment that can affect the motor function of the forearm. Luckily, trigger points are treatable, and there are ways to reduce the pain-like symptoms from the affected brachialis muscles. The video above shows how to treat trigger points along the forearm. Incorporating non-invasive treatments to reduce future trigger points to form can reduce the pain symptoms and release the trapped nerves that are causing motor function problems in the arms.

Ways To Manage Brachialis Trigger Points

 

As stated earlier, trigger points are tricky to diagnose since they can mimic other chronic conditions along the affected muscles. When the affected muscle succumbs to injuries and is not treated, it can develop tiny knots along the taut muscle band fibers known as trigger points over time. To that point, it can cause referred pain-like symptoms along the muscle group. Luckily, treatments can help reduce pain-like symptoms and prevent trigger points from forming along the muscle fibers. Studies reveal that trigger point injections are one of the various treatments that can help reduce pain in the brachialis muscle. With gentle stretching and physical therapy, allow mobility back to the arm. One way to manage brachialis trigger points that many people can use is to place a pillow at the angle of the elbow to prevent the arms from tightening or use a hot pack to relax the forearm muscles to relieve muscle strain and aches. Another way is not to overuse their forearms when playing an instrument or carrying items on their forearms. This can prevent trigger points from forming in the future and reduce pain-like symptoms from affecting the forearms.

 

Conclusion

The brachialis is the main muscle that is important to the forearms. This large muscle works with the bicep and tricep muscles to help the host carry heavy objects while bending at the elbows. However, like all the muscles in the body, the brachialis muscles can succumb to injuries and develop trigger points along the brachialis muscle fiber bands. Trigger points along the brachialis muscle are associated with pain-like symptoms that can mimic conditions like tennis elbow or nerve entrapment in the forearms. Fortunately, various treatments are utilized by doctors to help many patients dealing with trigger points along the brachialis muscle and can help reduce pain in the forearms. This allows mobility back to the arms and prevents future trigger points from forming.

 

References

Geri, Tommaso, et al. “Myofascial Trigger Points Alter the Modular Control during the Execution of a Reaching Task: A Pilot Study.” Scientific Reports, Nature Publishing Group UK, 5 Nov. 2019, www.ncbi.nlm.nih.gov/pmc/articles/PMC6831581/.

Plantz, Mark A, and Bruno Bordoni. “Anatomy, Shoulder and Upper Limb, Brachialis Muscle.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 22 Feb. 2022, www.ncbi.nlm.nih.gov/books/NBK551630/.

Sharma, Pankaj, et al. “Isolated Traumatic Brachialis Muscle Tear: A Case Report and Review of Literature.” Bulletin of Emergency and Trauma, Shiraz University of Medical Sciences, Oct. 2017, www.ncbi.nlm.nih.gov/pmc/articles/PMC5694606/.

Suh, Mi Ri, et al. “Ultrasound-Guided Myofascial Trigger Point Injection into Brachialis Muscle for Rotator Cuff Disease Patients with Upper Arm Pain: A Pilot Study.” Annals of Rehabilitation Medicine, Korean Academy of Rehabilitation Medicine, Oct. 2014, www.ncbi.nlm.nih.gov/pmc/articles/PMC4221396/.

Disclaimer

Spondylitis Types Injury Medical Chiropractic Sciatica Clinic

By
Dr. Alex Jimenez
-
Two doctors in uniform look and discuss an X-ray or MRI scan of the patient spine in clinic

Spondyloarthritis is a group of inflammatory, immune-mediated diseases that cause chronic low back pain, inflammation, irritating aches, and pains. The conditions mostly affect the spine but can affect joints in the arms, legs, hips, skin, eyes, and intestines. Spondylitis types can significantly affect daily function, physical activity and compromise bone health.Spondylitis Types

Spondylitis Types

The main types include:

  • Ankylosing spondylitis
  • Psoriatic arthritis
  • Enteropathic arthritis
  • Reactive arthritis
  • Juvenile spondylitis
  • Undifferentiated spondylitis

Axial Spondylitis vs. Peripheral Spondylitis Types

Spondylitis conditions are classified as axial – axSpA or peripheral – pSpA.

  • Axial means relating to the body’s central region, as in the trunk and head.
  • Axial spondyloarthritis is arthritis and inflammation in the hips and spine.
  • The condition starts before age 45.
  • The pain typically starts in the low back but can begin in the neck or other regions.
  • Characterized by back pain, usually in the lower back and/or buttocks.
  • Morning back stiffness lasting 30 minutes or longer.
  • Sacroiliac joint inflammation can also present.
  • The back pain gradually progresses.
  • Lasts longer than three months.
  • Improves with physical movement, not with rest.
  • Peripheral spondyloarthritis is arthritis and inflammatory pain in the peripheral joints and tendons and does not include the spine.
  • Individuals can have peripheral and axial spondylitis symptoms simultaneously.
  • Diagnosis depends on whether symptoms are primarily peripheral or axial.

Spondylitis and Spondylosis

Spondylosis and spondylitis are similar in they cause pain and inflammation in the back and hips. The difference is in each condition’s triggers.

  • Spondylitis is a disease in which the body’s immune system degrades joints, causes inflammation, overproduces bone formation, and causes bone fusion.
  • Spondylosis is a category of arthritis that presents as the spine ages from normal wear and tear.
  • It happens during the degeneration of the spine’s discs and joints.
  • It also presents when bone spurs develop on the spine’s vertebrae.

Ankylosing Spondylitis

Ankylosing spondylitis is the most common form of arthritis affecting the spine, other joints, and body regions. The condition causes spinal joint inflammation causing extreme discomfort and chronic pain. In some cases, the inflammation progresses to ankylosis, where spine sections fuse and become immobile. Other body areas that can trigger inflammation include:

  • The ribs
  • Heels
  • Shoulders
  • Hips
  • Small joints of the feet and hands.

Ankylosing spondylitis symptoms vary from person to person. Common early symptoms include:

  • There is general discomfort, appetite loss, and mild fever early in the condition.
  • Persistent stiffness and pain in the buttocks and low back, gradually progressing over a couple of weeks or months.
  • The pain and stiffness can travel into the neck and spine within months or years.
  • The pain is usually spread out and dull.
  • The stiffness and pain are worse in the morning and night and improve with light exercise or a warm shower.
  • The pain typically becomes chronic, lasts for a minimum of 3 months, and can be felt on both sides.
  • Tenderness and pain in the hips, thighs, shoulder blades, heels, and ribs may also occur.

Treatment approaches include applications of ice and heat to reduce swelling, increase circulation, and decrease joint pain, posture exercises, stretches, physical therapy, and medication.

Psoriatic Arthritis

Psoriatic arthritis causes swelling, pain, and inflammation in the small joints of the hands and feet; however, the joints of the knees, ankles, and wrists can also be affected. Psoriasis is a rash that causes scaly skin patches.

  • Individuals can develop dactylitis when a finger or toe swells between the surrounding joints.
  • Spinal stiffness and pain can present.
  • Typically the ends of the finger joints are most affected and experience pain and inflammation.
  • The condition also includes fingernail and toenail symptoms.
  • Medications frequently utilized to treat ankylosing spondylitis can be used.
  • Exercise helps preserve the range of motion and maintain strength.
  • Isometric exercises work muscles without joint motion reducing the risk of further injury to inflamed joints.
  • Occupational and physical therapy can significantly assist in optimizing arthritic joint function.

Enteropathic Spondylitis

Enteropathic Arthritis is chronic inflammatory arthritis linked to inflammatory bowel disease. The most recognized are Crohn’s and ulcerative colitis.

  • The peripheral limb joints and sometimes the whole spine are the most prevalent body areas afflicted with enteropathic spondylitis.
  • The main symptom is intestine inflammation, including bowel and joint pain and/or inflammatory back pain.
  • Other symptoms can include weight loss, blood in the stool, abdominal pain, and/or chronic diarrhea.
  • Managing enteropathic arthritis typically means managing the underlying bowel disease.

Juvenile Spondyloarthritis

Juvenile spondyloarthritis is a group of childhood rheumatic diseases that cause arthritis before age 16 and can continue through adulthood. Juvenile spondyloarthritis encompasses:

  • Enteropathic arthritis
  • Enthesitis-related arthritis
  • Undifferentiated spondyloarthritis
  • Psoriatic arthritis
  • Reactive arthritis
  • Juvenile ankylosing spondylitis

Juvenile spondyloarthritis causes inflammation and pain in joints in the lower body, like the ankles, hips, knees, and pelvis. Other body areas that could be affected include:

  • The bowels
  • Eyes
  • Skin
  • Spine

Lethargy and fatigue can also present. The symptoms can be unpredictable and episodic, appearing and disappearing without a specific cause. The condition cycles between flare-ups and remission. Common treatment approaches include:

  • Medication
  • Exercise
  • Posture training
  • Physical therapy, medication
  • Ice and heat to decrease joint pain and relax muscles.
  • In severe cases, surgery could be recommended.

Reactive Arthritis or Reiter’s Syndrome

Reactive arthritis is arthritis that causes pain and inflammation in the mucous membranes, bladder, skin, joints, eyes, and genitals.

  • Reactive arthritis is believed to be a reaction to an infection, usually in the gastrointestinal or urinary tract.
  • Reactive arthritis does not affect the sacroiliac joints and spine in most cases.
  • Reactive arthritis is typically treated with nonsteroidal anti-inflammatory medications, steroids, and rheumatoid arthritis medications.
  • A physician could prescribe antibiotics if a bacterial infection brought on reactive arthritis.

Undifferentiated Spondyloarthritis

Undifferentiated spondyloarthritis is where the signs and symptoms of spondylitis don’t meet the criteria for a specific rheumatoid disorder. Individuals diagnosed with undifferentiated spondyloarthritis will have one or more of the symptoms that include:

  • Fatigue
  • Back inflammation
  • Back pain
  • Buttock pain that alternates or presents on both sides.
  • Swollen toes or fingers
  • Heel pain
  • Arthritis in the small joints.
  • Arthritis in the large limb joints.
  • Enthesitis or inflammation where the ligament or tendon connects to the bone.
  • Eye inflammation
  • Individuals can also present symptoms of other spondylitis types, like psoriatic or ankylosing.

Treatment approaches include:

  • Exercise
  • Physical therapy
  • Posture training
  • Ice and heat to decrease joint pain and loosen up muscles.

Spondylitis Types Diagnosis of Spondyloarthritis

References

Carron, Philippe, et al. “Peripheral spondyloarthritis: a neglected entity-state of the art.” RMD open vol. 6,1 (2020): e001136. doi:10.1136/rmdopen-2019-001136

Dougados, Maxime, and Dominique Baeten. “Spondyloarthritis.” Lancet (London, England) vol. 377,9783 (2011): 2127-37. doi:10.1016/S0140-6736(11)60071-8

Gill, Tejpal, et al. “The intestinal microbiome in spondyloarthritis.” Current opinion in rheumatology vol. 27,4 (2015): 319-25. doi:10.1097/BOR.0000000000000187

Rosenbaum, James T. “The eye in spondyloarthritis✰.” Seminars in arthritis and rheumatism vol. 49,3S (2019): S29-S31. doi:10.1016/j.semarthrit.2019.09.014

Seo, Mi Ryoung et al. “Delayed diagnosis is linked to worse outcomes and unfavorable treatment responses in patients with axial spondyloarthritis.” Clinical rheumatology vol. 34,8 (2015): 1397-405. doi:10.1007/s10067-014-2768-y

Sharip, Aigul, and Jeannette Kunz. “Understanding the Pathogenesis of Spondyloarthritis.” Biomolecules vol. 10,10 1461. 20 Oct. 2020, doi:10.3390/biom10101461

The Biceps Being Affected By Trigger Points

By
Dr. Alex Jimenez
-

Introduction

The upper arms allow the individual to move the arms, hands, and fingers, enabling them to do everyday activities without feeling pain or injuries. Different muscles in the upper arms allow precise movements, from threading a needle to throwing a ball across the field. These muscles also work with the shoulders, allowing a full range of motion and flexion. One of the muscles that help the upper arms is the bicep brachii, which provide flexion to the arm. However, like all the muscles in the body, they can succumb to pain caused by trigger points. Today’s article looks at the bicep muscles’ function, how trigger points affect the muscles, and how to manage trigger points associated with the bicep muscles. We refer patients to certified providers who specialize in arm pain treatments to aid individuals suffering from trigger points associated with the bicep brachii muscles along the upper arms. We also guide and inform our patients by referring them to our associated medical providers based on their examination when appropriate. We established that education is a great solution to asking our providers profound questions the patient requests. Dr. Jimenez DC takes note of this information as an educational service only. Disclaimer

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What Are The Bicep Muscles Function?

Have you been dealing with radiating pain down to your elbow? Do your upper arm muscle ache when carrying items from place to place? Or have you experienced muscle spasms in your arms and hands? Many people experiencing these symptoms might risk developing trigger points along their bicep muscles. The bicep brachii is a large, thick muscle that covers the joints and is located in the upper arms. The bicep muscle consists of two attachments: the short head (caput breve) and the ling head (caput longum). It works together with the coracobrachialis muscle to support stability to the shoulders.

 

Studies reveal that these two muscle bands work together to provide multiple actions between the shoulder and elbow joints by being in conjunction with the other muscles. The main function of the bicep muscles is that it is one of the three muscles that can flex the elbow and shoulders. The biceps also allow flexion and supination or outward rotation of the forearms at 90 degrees. This muscle is very important for athletes that require lifting, carrying, or throwing and can make the individual stronger. To that point, the bicep muscle can also succumb to injuries that can cause pain to the upper arms and shoulders.

 

How Does Trigger Points Affect The Bicep Muscles?

 

When the bicep muscles succumb to injuries, it can be due to overusing the long head of the bicep muscles and can lead to bicep tendon rupture. When the bicep muscle succumbs to a tendon rupture, it is due to excessive eccentric force that brings the arms to an extension rather than flexion. Other issues affecting the biceps can correlate to rotator cuff pathology and can be associated with being a common source of shoulder pain. Studies reveal that since the bicep is closely associated with the rotator cuff, tendinopathy can form due to repetitive traction, friction, and rotation of the shoulder joints. To that point, it can lead to the development of trigger points along the bicep muscles. Trigger point pain can be complicated to diagnose since it can mimic other chronic conditions. For trigger points to occur along the bicep muscles, pain-like symptoms are caused when the arm is above the shoulder. To that point, it causes symptoms of aches, stiffness, and muscle weakness in the bicep muscles.

 

Trigger Points Affecting The Bicep Brachii- Video

Trigger Point of the Week - Bicep Brachii

Have you experienced muscle aches and stiffness when lifting your arms above your shoulders? Do you find difficulty to bend your elbows? Or have you been experiencing radiating pain along the shoulders, arms, and hands? These pain-like symptoms are associated with trigger points along the bicep muscles and can evoke motor dysfunction in the upper arms. The video above gives an overview how trigger points affect the bicep brachii and cause symptoms like “frozen shoulder” to affect the entire arm. Studies reveal that trigger points are the most frequent causes of chronic musculoskeletal pain that causes the muscle tissue to become hyperirritable. Trigger points can also cause referred pain to the affected muscles, causing limited range of motion to the joints. When the bicep muscles are being affected by trigger points, it can cause stress on the muscle and cause hyper-extension to the arm. According to Dr. Travell, M.D., when trigger points affect the bicep brachii muscles and cause referred pain and tenderness on the ball-and-socket joint, the symptoms associated with trigger points are mistaken as a rheumatic joint disease unless the affected bicep is examined for trigger points. Thankfully, there are ways to manage trigger points associated with the bicep muscles to reduce pain in the upper arms.

Managing Trigger Points Associated With The Bicep Muscles

 

 

When individuals are suffering from pain along their bicep muscles, it can cause them to be miserable as they cannot participate in various activities that require their arms; when trigger points are formed along the taut muscle band of the bicep muscles, the radiating pain from the shoulder to the elbow, causing stiffness and muscle aches. Fortunately, various techniques can help manage trigger points associated with the bicep muscles. Studies reveal that many people can manage trigger points related to the bicep muscles to reduce shoulder pain by resting, modifying their activities, and seeking more non-invasive treatments to reduce the pain associated with the bicep muscles. Many people can do various arm and shoulder stretches to reduce the stiffness of the bicep muscles. This allows gentle stretching along the upper arm muscles and releases tension through slow, even breathing and prolonged shortening of the bicep muscles.

 

Conclusion

The bicep has two attachments that provide mobility and are a large thick muscle that covers the upper arm joints. The bicep muscles also work together with the coracobrachialis muscle to help support the shoulders by making them stable. When the bicep muscles become overused and succumb to injuries, they can develop trigger points along the bicep muscles, causing referred pain to the arms and shoulders. When this happens, the muscles become stiff and can become painful when doing simple actions like lifting their arms or playing a sport. When this happens, many individuals become miserable since they can’t participate. Fortunately, various techniques can help reduce the pain symptoms in the arms and prevent future injuries. Gentle stretching and muscle massages can release the trigger points from the bicep muscles and improve arm mobility to the biceps.

 

References

Akamatsu, Flávia Emi, et al. “Trigger Points: An Anatomical Substratum.” BioMed Research International, Hindawi Publishing Corporation, 2015, www.ncbi.nlm.nih.gov/pmc/articles/PMC4355109/.

Landin, Dennis, et al. “Actions of the Biceps Brachii at the Shoulder: A Review.” Journal of Clinical Medicine Research, Elmer Press, Aug. 2017, www.ncbi.nlm.nih.gov/pmc/articles/PMC5505302/.

McDevitt, Amy W, et al. “Physical Therapy Interventions for the Management of Biceps Tendinopathy: An International Delphi Study.” International Journal of Sports Physical Therapy, NASMI, 1 June 2022, www.ncbi.nlm.nih.gov/pmc/articles/PMC9159730/.

Raney, Elise B, et al. “Pain and the Pathogenesis of Biceps Tendinopathy.” American Journal of Translational Research, e-Century Publishing Corporation, 15 June 2017, www.ncbi.nlm.nih.gov/pmc/articles/PMC5489872/.

Tiwana, Manpreet S, et al. “Anatomy, Shoulder and Upper Limb, Biceps Muscle.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 11 Aug. 2021, www.ncbi.nlm.nih.gov/books/NBK519538/.

Disclaimer

Nerve Damage Symptoms Chiropractic Sciatica Clinic

By
Dr. Alex Jimenez
-
Orthopedist or neurologist shows the problem areas on the model of the spine to female patient and explains the cause of her pain

Nerve damage is also known as peripheral neuropathy. Peripheral nerves transmit information to and from the brain through the spinal cord to the rest of the body. Nerve damage symptoms are common in the neck, arms, hands, low back, legs, and feet. Communication becomes weakened, interrupted, or no longer transmits sensation signals. Nerve damage can be a complication from conditions like diabetes or present after an injury. Injury Medical Chiropractic and Functional Medicine Clinic recognize the symptoms and can treat the injuries rehabilitating the nerves back to functional health.Nerve Damage Symptoms Chiropractor

Nerve Damage Symptoms

Nerve damage symptoms can happen to a single nerve or a group of nerves that can affect the rest of the body. Damage depends on the severity of the condition or injury.

  • Partially damaged nerves can heal on their own with minimal treatment to ensure they heal correctly. 
  • Nerves are made up of fibers called axons.
  • The fibers are covered with tissues that are a type of insulation.
  • Sometimes only the fibers get damaged.
  • Sometimes a nerve gets stuck or jammed inside a tight space, causing irritation and, over time, scarring.
  • Severe nerve damage can involve the fibers and tissues and often require surgery.

Symptoms can range from mild to severe and depend on which nerve fibers are damaged. These could be the following:

Motor nerves

  • These nerves regulate all the muscles under conscious control.
  • These control motor functions like walking, talking, and grabbing and holding objects.
  • Damage to these nerves usually causes muscle weakness, cramps, and uncontrollable muscle twitching or spasms.

Sensory nerves

  • These nerves relay sensory information, including touch, taste, smell, vision, temperature, and pain.
  • Symptoms can include numbness or tingling.
  • There can also be difficulties:
  • Sensing pain
  • Sensing temperature changes.
  • Walking
  • Maintaining balance with your eyes closed.
  • Working with the hands.

Autonomic nerves

  • This group of nerves regulates unconscious actions, including breathing, heart and thyroid function, and digestion.
  • Symptoms include excessive sweating, blood pressure variations, inability to tolerate heat, and gastrointestinal issues.
  • Various symptoms can be experienced as many peripheral nerve injuries affect more than one type of nerve.

Signs

Improperly functioning nerves can cause uncomfortable or painful sensations because the nerves cannot carry the correct signals from the brain to the spinal cord. The signs of nerve damage include the following:

  • Feeling like you’re wearing an overly tight glove or sock constricting circulation and movement.
  • Numbness or tingling.
  • Pins and needles or what feels like mild electrical sensations.
  • Specific body/limb positions can cause or decrease numbness, tingling, or pins and needles.
  • Muscle weakness.
  • Dropping objects regularly.
  • Sharp pains in the hands, arms, low back, legs, or feet.

Restoring Function

Chiropractic treatments can help restore function and include:

Therapeutic Massage

  • Therapeutic massage will promote circulation to relieve numbness and tightness and help restore function and feeling.

Chiropractic

  • Chiropractic adjustments will realign the body and keep affected muscles and joints active.

Electrical Stimulation

  • Stimulators can activate injured nerves and muscles while the nerve regenerates and recovers.

Braces or Splints

  • These devices could be used to maintain the position of the affected limb, fingers, hand, or foot to improve muscle function and promote healing.

Exercise

  • Specifically, prescribed exercises will improve muscle strength, help to maintain range of motion, and reduce muscle cramps.

Diet

  • A nutritionist will develop a personalized anti-inflammatory diet to expedite healing.

Peripheral Therapy

References

Chen, Zhengrong. “Progress of peripheral nerve repair.” Chinese Journal of traumatology = Zhonghua Chuang Shang za Zhi vol. 5,6 (2002): 323-5.

Gordon, Tessa. “Electrical Stimulation to Enhance Axon Regeneration After Peripheral Nerve Injuries in Animal Models and Humans.” Neurotherapeutics: the journal of the American Society for Experimental NeuroTherapeutics vol. 13,2 (2016): 295-310. doi:10.1007/s13311-015-0415-1

www.ninds.nih.gov/peripheral-neuropathy-fact-sheet

WEBB, E M. “Peripheral nerve injuries; early surgical treatment.” California medicine vol. 80,3 (1954): 151-3.

Welch, J A. “Peripheral nerve injury.” Seminars in veterinary medicine and surgery (small animal) vol. 11,4 (1996): 273-84. doi:10.1016/s1096-2867(96)80020-x

Trigger Points Affecting The Upper Arm Muscles

By
Dr. Alex Jimenez
-

Introduction

The upper extremities of the body, which include the head, neck, shoulders, chest, and arms, all have a specific job of keeping the body functioning and helping move from place to place. The head and neck work together to allow the host to have the mobility to turn, rotate from side to side, and lean from one side. The shoulders work with the arms to let the muscles have a full range of motion and even help stabilize the upper body. The shoulders have various muscles, tendons, and ligaments to protect the skeletal joints and even work to do everyday activities like carrying or lifting items. When injuries begin to affect the muscle groups of the upper body, it can lead to pain-like symptoms that can lead to chronic conditions developing over time if not treated right away. One of the muscles in the upper body is called the coracobrachialis muscle, which can be affected by injuries. Today’s article observes the coracobrachialis muscle, how trigger points affect the upper arm muscles, and how to manage trigger points associated with the coracobrachialis muscle. We refer patients to certified providers who specialize in shoulder pain treatments to aid individuals suffering from trigger points associated with the coracobrachialis muscles along the upper arms. We also guide and inform our patients by referring them to our associated medical providers based on their examination when appropriate. We established that education is a great solution to asking our providers profound questions the patient requests. Dr. Jimenez DC takes note of this information as an educational service only. Disclaimer

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What Is The Coracobrachialis Muscle?

 

Have you been dealing with pain from the upper arms to the hands? Do simple arm and shoulder stretches seem to be difficult to do? Or have you been dealing with symptoms of pain, stiffness, or tenderness in your upper arms? Experiencing these pain-like symptoms could overlap other conditions affecting the upper arms and develop trigger points along the muscles, including the coracobrachialis. The coracobrachialis is the smallest muscle located in the front of the upper arm’s anterior that originated in the shoulder coracoid process. This small muscle is connected to the tendon located at the short head of the bicep brachii, and according to Dr. Janet Travell, M.D., the coracobrachialis muscle function helps flex and adduct the arms at the shoulders while working together with the surrounding muscles of the upper arm and shoulders. This allows the arms to move forward slightly and inward. This means that the coracobrachialis muscle will enable individuals to place their arms behind their back without pain. However, like any muscle in the body, injuries can occur in the upper arms and lead to the development of trigger points along the upper arm muscles affecting the coracobrachialis muscle.

 

How Trigger Points Affect The Upper Arm Muscles?

When the upper arm and the coracobrachialis muscle suffer from pain, tiny nodules along the muscle fiber bands known as trigger points can cause referred pain to the upper arms. Now trigger points are tricky to diagnose due to mimicking overlapping conditions affecting the upper arms. Studies reveal that non-specific arm pain could potentially be one of the causes that trigger points mimic due to strenuous physical activities or work-related activities that can overuse the upper arm muscles.

 

Studies reveal that individuals with idiopathic arm pain deal with high variable upper-extremity dysfunction, which could play a factor in pain-like symptoms along the surrounding muscles of the arms and shoulders. Many people often experience pain when reaching behind their back for the coracobrachialis affected by trigger points. Since the coracobrachialis works with the surrounding muscles in the shoulders and upper arms, trigger points associated with the coracobrachialis correspond to those muscles causing overlapping risk profiles. Trigger points affecting the coracobrachialis muscle can also mimic nerve entrapment since the coracobrachialis helps the bicep muscles when flexing. Pain associated with trigger points could potentially irritate the surrounding nerves in the muscle fibers, which causes radiating pain along the arms.

 

Treating The Coracobrachialis Muscle-Video

Musculotaneous Nerve Entrapment - Treating Coracobrachialis

Does your arm feel stiff when trying to reach behind your back? Do your shoulders ache for no apparent reason? Or have you experienced sharp, shooting pain down your arm? Many people experience pain along their shoulders and arms, affecting their mobility to hold and carry items. They deal with overlapping symptoms associated with trigger points along the coracobrachialis muscle. Trigger points along the coracobrachialis muscle are developed when the upper arm muscles have been overused and irritate the surrounding nerves. This causes radiating referred pain down the arms and can affect a person’s ability to hold items. Thankfully there are ways to manage trigger points along the coracobrachialis and its surrounding muscles. The video above demonstrates a massage technique that works along the coracobrachialis muscle to release nerve entrapment and manage trigger points along the surrounding muscles.

Ways To Manage Trigger Points Affecting The Coracobrachialis

 

There are various techniques that many specialists, like chiropractors, massage therapists, and physiotherapists, can use to identify and manage trigger points in the body. Since trigger points are tricky to diagnose due to causing referred pain along the surrounding muscles, treatments like stretching, massages, acupuncture, and chiropractic adjustments can help alleviate the pain and reduce future trigger points from forming. Studies reveal that pain specialists could manage trigger points associated with shoulder pain along the coracobrachialis through treatments of manual compression and other various techniques. Once treatments have been incorporated to relieve trigger point pain along the affected muscle, many people can further prevent the symptoms from returning by not lifting or carrying heavy objects and not forcing their coracobrachialis to be a substitute for their bicep muscles.

 

Conclusion

The coracobrachialis is a short muscle that works with the bicep muscle and helps with mobility and motor functions for the arms and shoulders. This muscle allows the arms to move forward and can be placed in the back without pain. When muscle injuries affect the surrounding muscles that work with the coracobrachialis, it can develop trigger points associated with pain along the upper arms. When this happens, it can lead to symptoms of stiffness, pain, and tenderness in the upper arms, causing mobility issues. Pain specialists for trigger points can utilize various treatments to relieve the pain and reduce the effects that trigger points cause on the affected muscle. This allows the upper arms to gain mobility back and the host to do various activities without feeling pain.

 

References

Bron, Carel, et al. “Treatment of Myofascial Trigger Points in Patients with Chronic Shoulder Pain: A Randomized, Controlled Trial.” BMC Medicine, BioMed Central, 24 Jan. 2011, www.ncbi.nlm.nih.gov/pmc/articles/PMC3039607/.

Georgiev, Georgi P, et al. “Coracobrachialis Longus Muscle: Humeroepitrochlearis.” Cureus, Cureus, 13 May 2018, www.ncbi.nlm.nih.gov/pmc/articles/PMC6044495/.

Moradi, Ali, et al. “Nonspecific Arm Pain.” The Archives of Bone and Joint Surgery, Archives of Bone and Joint Surgery Co., Dec. 2013, www.ncbi.nlm.nih.gov/pmc/articles/PMC4151410/.

Ring, David, et al. “Idiopathic Arm Pain.” The Journal of Bone and Joint Surgery. American Volume, U.S. National Library of Medicine, July 2004, pubmed.ncbi.nlm.nih.gov/15252084/.

Disclaimer

Tendons and Ligaments Injuries Chiropractic Sciatica Clinic

By
Dr. Alex Jimenez
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Male doctor shows model of human artificial knee joint in medical office

Tendons and Ligaments: A tendon is a fibrous flexible, strong tissue similar to a rope that attaches the muscles to the bones. Tendons allow for the movement of the body’s limbs and help prevent muscle injury by absorbing muscles’ impact when running, jumping, or performing other actions. Ligaments are bands of solid elastic tissue that connect bone to bone, hold structures together and keep them stable, support the joints and limit their movement.Tendons and Ligaments Injuries Chiropractic Team

Tendons and Ligaments

  • Tendons are strong and non-flexible.
  • Ligaments are flexible and elastic.
  • Both comprise collagen and living cells, essential in joints and bones and integral to locomotion.
  • Tendons allow body movement by transmitting force from muscle to bone, allowing the body to stand, walk, and jump.
  • Ligaments work by allowing for the full range of motion.
  • Ligaments are around the knees, ankles, elbows, shoulders, and other joints.

Connective Tissue

  • The collagen connective tissue that makes up tendons and ligaments is the same; their patterns are different.
  • Tendon fibers are laid out in a parallel pattern.
  • Tendon connective tissue needs to have more elasticity to help move the muscles.
  • Ligament fibers are laid out in a crisscross pattern. 
  • Ligament connective tissue stabilizes and strengthens the bones’ joint structure.

Tendon Injury

A tendon that gets overstretched or torn is known as a strain. Common areas affected by strains are the:

  • Leg
  • Foot
  • Back

Strains often result from repetitive work movements, intense physical activity, and sports. Individuals who overuse their bodies without proper rest and muscle repair recovery have an increased risk of injury. Symptoms include:

  • Inflammation
  • Swelling
  • Pain
  • Cramping
  • Weakness

Ligament Injury

A ligament that gets overstretched or torn results in a sprain. Sprains can happen suddenly from a fall, awkward movement, or trauma. Sprains commonly occur in the:

  • Ankle
  • Knee
  • Wrist

Examples include:

  • Misstep causing the ankle to twist in an awkward position, snapping a ligament and causing unstableness or wobbliness.
  • There could be a popping sensation or the feeling of a tear when the injury occurs.
  • Wrist sprains often happen when reaching out and extending the hands to break a fall, and the wrist hyperextending back.
  • The hyperextension overstretches the ligament.

Symptoms of a sprained ligament include:

  • Inflammation
  • Swelling
  • Bruising
  • Pain
  • The joint may feel loose or weak and unable to take on weight.

The intensity of symptoms varies depending on whether the ligament is overextended or torn. Sprains are classified by grade:

  • Grade 1 – a mild sprain with slight stretching of the ligament.
  • Grade 2 – a moderate ligament tear, but not a complete tear.
  • Grade 3 – a complete ligament tear, making the joint unstable.

Chiropractic Care

Tendons and ligaments do not receive full blood circulation like other soft tissues. Depending on the severity of the injury, and the slower transfer of oxygen and nutrients, ligament and tendon injuries can take six to twelve weeks to heal, and repeatedly stressing the injured area from overuse can extend recovery. Chiropractic adjustments, and massage therapy, combined with corrective exercises and stretches, will reduce inflammation, decrease pain, improve the range of motion, increase nerve and muscle function, and strengthen the muscles. Chiropractic treatment involves:

  • Soft tissue work
  • Percussive massage
  • Cross friction massage
  • Deep tissue massage
  • Trigger point therapy
  • Rest
  • Ice
  • Compression
  • Elevation
  • Ultrasound
  • Anti-inflammatory nutritional recommendations

Knee Injuries Adjustment

References

Childress, Marc A, and Anthony Beutler. “Management of chronic tendon injuries.” American family physician vol. 87,7 (2013): 486-90.

Fenwick, Steven A et al. “The vasculature and its role in the damaged and healing tendon.” Arthritis research vol. 4,4 (2002): 252-60. doi:10.1186/ar416

Leong, Natalie L et al. “Tendon and Ligament Healing and Current Approaches to Tendon and Ligament Regeneration.” Journal of orthopedic research: official publication of the Orthopaedic Research Society vol. 38,1 (2020): 7-12. doi:10.1002/jor.24475

orthoinfo.aaos.org/en/diseases–conditions/sprains-strains-and-other-soft-tissue-injuries

Scalcione, Luke R et al. “The athlete’s hand: ligament and tendon injury.” Seminars in musculoskeletal radiology vol. 16,4 (2012): 338-49. doi:10.1055/s-0032-1327007

Working With A Nutritionist: Chiropractic Functional Sciatica Clinic

By
Dr. Alex Jimenez
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Young smiling brunette woman nutritionist plus size in white shirt working at laptop on table with house plant in the bright modern office. Doctor communicates with patient online

Nutritionists are medical professionals in food and nutrition and work one-on-one to develop an optimal nutrition plan for their body type, age, and health conditions. They explain the right foods to eat, how different foods impact the body, and what foods to avoid. Individuals can benefit from working with a nutritionist to help achieve a healthier lifestyle through education and healthy choices.Chiropractic Functional Medicine Team: Working With A Nutritionist

Working With A Nutritionist

Nutritionists work with individuals to enhance their knowledge about general nutrition, food, and health. Their focus is on food behavior, which includes developing and implementing meal plans to improve the individual’s or family’s nutrition. Nutritionists work in:

  • Clinical settings – hospitals, nursing homes, long-term care facilities, fitness and health, and chiropractic clinics.
  • Government – local health departments.
  • School districts –  regarding school nutrition standards.
  • Private business – independent work in combination with other medical professionals.
  • Research – with various health and/or sports organizations.

Benefits

Working with a nutritionist will determine what factors are challenging an individual’s eating habits and triggers and find ways to overcome those barriers. Benefits include:

  • Nutrition plans are based on nutritional needs, current health, and lifestyle.
  • Nutrition plans cut down on grocery bills.
  • Shopping with a specific list cuts down on the extra foods being purchased.
  • Proper nutrition can help manage chronic diseases like diabetes and heart disease, combined with a primary care doctor or specialist treatment.
  • Nutritionists can help individuals dealing with food allergies or who have been diagnosed could require a diet change.
  • Nutritionists can help motivate when struggling to maintain a healthy lifestyle.

Responsibilities and Daily Activities

Nutritionists help individuals reach various goals, like weight loss, healthier eating habits, and stress management, and can be responsible for the following:

  • Evaluating health needs.
  • Screening for nutritional risk.
  • Discussing nutrition and eating habits.
  • Providing educational resources.
  • Developing personalized nutrition plans.
  • Talking about nutritional issues with individual families.
  • Discussing nutrition plans with primary doctors and other healthcare teams.
  • Equipping individuals with food behavior modification tools.
  • Adjusting plans as needed.
  • Monitoring progress.
  • Treating conditions and disease management through nutrition.

Functional Nutrition

References

Carrard, Isabelle et al. “Un outil pour évaluer les comportements alimentaires: ESSCA” [A tool for assessing eating behaviors: ESSCA]. Revue medicale suisse vol. 12,511 (2016): 591-6.

Golan, M, and A Weizman. “Reliability and validity of the Family Eating and Activity Habits Questionnaire.” European journal of clinical nutrition vol. 52,10 (1998): 771-7. doi:10.1038/sj.ejcn.1600647

Greenwood, Jessica L J, et al. “Healthy eating vital sign: a new assessment tool for eating behaviors.” ISRN obesity vol. 2012 734682. 22 Jul. 2012, doi:10.5402/2012/734682

Kelley, Claire P et al. “Behavioral Modification for the Management of Obesity.” Primary care vol. 43,1 (2016): 159-75, x. doi:10.1016/j.pop.2015.10.004

Deltoid Muscles Being Affected By Trigger Points

By
Dr. Alex Jimenez
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Introduction

The shoulders help stabilize the upper extremities of the body and provide a wide range of movements for the arms. The shoulders have many muscles, ligaments, and tendons that help support the joints from injuries and utilize the motor function to do everyday actions like throwing a ball or stretching for long distances. Even though the shoulders help stabilize the upper extremities, they are still prone to injuries since the shoulder muscles are constantly used throughout the day. One of the shoulder muscles that are continuously utilized is the deltoid muscle, which can lead to the development of trigger points when it becomes injured. Today’s article examines the deltoid muscles, how trigger points affect the deltoids and shoulders, and managing trigger points associated with the deltoid muscles. We refer patients to certified providers specializing in shoulder pain treatments to aid individuals suffering from trigger points associated with the deltoid muscles along the shoulders. We also guide and inform our patients by referring them to our associated medical providers based on their examination when appropriate. We ensure that education is a great solution to asking our providers insightful questions the patient requests. Dr. Jimenez DC observes this information as an educational service only. Disclaimer

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What Is The Deltoid Muscle?

 

Have you been feeling pain on the top of your shoulders? Do your shoulders feel stiff when rotating them? Or do you feel radiating pain along your upper arms? Individuals with shoulder pain may be experiencing trigger points affecting their deltoid muscles. The deltoids are large triangular-shaped muscles that are associated with the shoulder girdle. The deltoids sit on top of the shoulder girdle and have anterior and posterior sections that work together with the rotator cuff muscles that provide a full range of motion to the arms. Studies reveal that the deltoid muscles have a more complex structure since the intramuscular tendons from the deltoids help provide different functions when it comes to the shoulders and arms’ motor function. According to Dr. Janet G. Travell, M.D., the anterior sections of the deltoid muscles are used in sports activities. In contrast, the posterior section works with the rotator cuff muscles for mobility. Injuring the deltoid muscles can lead to the development of trigger points associated with shoulder pain. 

 

How Do Trigger Points Affect The Deltoids & Shoulders?

 

Regarding the shoulders, they can succumb to various injuries that can become an issue over time, lead to the development of trigger points in the shoulder muscles, and cause referred pain to the upper arms. Trigger points or myofascial pain syndrome along the deltoid muscles may invoke referred pain to the shoulders. Studies reveal that myofascial pain syndrome is often described as the sensory, motor, and autonomic symptoms caused by trigger points that cause tender spots on the hardened muscle to produce pain. Trigger points are a bit tricky to diagnose since they mimic other chronic conditions in the body. The deltoid muscles are superficial, and trigger points can cause referred pain to the muscles that mimic arthritis in the shoulder joints. Some of the other symptoms associated with trigger points along the shoulders and deltoids include:

  • Limited range of mobility
  • Tenderness in the shoulder muscles
  • Muscle spasms
  • Muscle pain
  • Stiffness in the deltoid muscles

Pain in the shoulders can cause the body to become unstable and cause many individuals to develop a hunched position over time to reduce the pain they are feeling; fortunately, there are various ways to manage the pain associated with trigger points along the shoulders and deltoid muscles.

 

Trigger Point Release On The Deltoid Muscle- Video

Deltoid Muscle Trigger Point Release

Have you been feeling stiffness along the shoulders or the deltoid muscles? Have you experienced muscle tenderness in your upper arms? Or do you feel like being hunched over reduces the pain in your shoulders? If you have been experiencing any of these symptoms, it could be the development of trigger points associated with shoulder pain along the deltoid muscles. Trigger points cause referred pain to the affected muscle area and are developed when the muscles are overused. For the deltoid muscles, when active trigger points affect the deltoids’ anterior or posterior sections, it can cause the muscles to twitch and later cause moderate tension. The video above explains where the trigger points are located on the deltoid muscles and how to release them through palpations and massages. This is one of the techniques that can help manage trigger points from affecting the shoulders and deltoid muscles.

Managing Trigger Points Associated With The Deltoid Muscles

 

When dealing with trigger points associated with the deltoid muscles can be managed through various techniques that many people can utilize to reduce the pain symptoms along the upper arms and shoulders. Studies reveal that dry needling is one of the techniques that can relieve trigger points to ease the pain intensity and irritability to the shoulders. Other techniques that many people can utilize are to correct how they carry heavy objects to reduce the load on their shoulders, stretch the arms and shoulders to minimize soreness and alleviate tight muscles, and even take a hot shower to relax the shoulder muscles, can reduce the chances of trigger points from forming in the future. 

 

Conclusion

The deltoid is located on top of the shoulder girdle and is a large triangular-shaped muscle that works together with the rest of the shoulder and the rotator cuff muscles. The shoulders have many muscles, ligaments, and tendons that provide stability and perform everyday functionality to the body. When the shoulders become injured, the affected muscles could potentially develop trigger points to cause referred pain to the shoulders and upper arms. When trigger points affect the deltoid muscles, it can cause them to have symptoms of stiffness, tenderness, and pain that mimic other chronic conditions affecting the shoulders and arms. Thankfully, various techniques relieve referred pain from the arms and help manage trigger points along the deltoid muscle. This allows the deltoid muscle to relax and reduce trigger points from developing further on the shoulders.

 

References

Bron, Carel, and Jan D Dommerholt. “Etiology of Myofascial Trigger Points.” Current Pain and Headache Reports, Current Science Inc., Oct. 2012, www.ncbi.nlm.nih.gov/pmc/articles/PMC3440564/.

Calvo-Lobo, César, et al. “Dry Needling on the Infraspinatus Latent and Active Myofascial Trigger Points in Older Adults with Nonspecific Shoulder Pain: A Randomized Clinical Trial.” Journal of Geriatric Physical Therapy (2001), Wolters Kluwer Health, Inc., 2018, www.ncbi.nlm.nih.gov/pmc/articles/PMC5728593/.

Elzanie, Adel, and Matthew Varacallo. “Anatomy, Shoulder and Upper Limb, Deltoid Muscle.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 15 May 2022, www.ncbi.nlm.nih.gov/books/NBK537056/.

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Uneven Hips Chiropractic Sciatica Clinic

By
Dr. Alex Jimenez
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Physiotherapist man doing treatment to woman patient at home,Physical therapy concept

Uneven hips can throw the back out of natural alignment and cause back stiffness, tightness, discomfort, and pain. Hips that are off-balance unhealthily affect standing, sitting, sleeping posture, walking gait, and overall movements. Biomechanics issues cause the core and spine stabilizing muscles to become weakened and fatigued from overcompensating to keep the body up and moving. Over time this can lead to chronic pain in the back, hips, knees, and feet. Chiropractic care can restore proper hip and spinal alignment and wellness.Uneven Hips Chiropractor

Uneven Hips

Misaligned hips can be caused by work or sports injury, exercise, vehicle collision, and/or general wear and tear. When hips are out of alignment, they have shifted from their centered position. They could be rotated forward or backward, forcing the spine and the lower limbs to compensate, resulting in the spine tilting that can make the legs appear uneven. Discomfort may be one-sided low back pain near the sacroiliac joint, causing a stiff/tight back, limited motion, and/or pain symptoms. Because the spine and lower limbs have to compensate for the unevenness, the shoulders and upper back, connected to the pelvis through the spine, are also affected and result in:

  • Back pain.
  • Hip and gluteal muscle pain.
  • Uneven leg length.
  • Knee, ankle, and foot issues and pain.
  • Uneven shoulders.
  • The shoulder blades can stick out on the side of the lower hip.
  • Rib discomfort and pain.
  • The rib cage could protrude out on one side. However, this could be due to advanced scoliosis.

Therapy

Staying active is recommended and includes stretching and core strengthening. General stretches recommended to optimize hip equity include:

Hamstring stretch

  • For this stretch, lie on a flat surface with your legs extended straight out.
  • Bend the right leg at the knee, placing the right foot on the ground.
  • Use a towel, belt, or band to grab and wrap around the left foot.
  • Keep the hip/buttock on the left side planted on the floor.
  • Slowly raise the left leg upward as far as possible until you feel the stretch.
  • Once you feel a stretch or restriction in the hamstring, hold the position for 30 seconds.
  • Repeat on the other side.
  • Perform 2 to3 times.

Hip flexor stretch

  • Kneel on the affected leg and bend the healthy leg out in front with the foot flat on the floor.
  • Back straight.
  • Slowly push the hips forward until you feel the stretch in the upper thigh and hip.
  • Hold the stretch for around 15 to 30 seconds.

Chiropractic Care

Chiropractic treatment is a highly recommended non-surgical option for uneven hips and pelvic tilt. Depending on the severity of the misalignment, underlying issues, and body scanning images, hip alignment treatment could include:

  • Soft tissue therapeutic massage
  • Chiropractic muscle release for tight hip flexors, quadriceps, hamstrings, and glutes.
  • Decompression
  • Traction
  • Custom orthotics
  • Bracing
  • Posture training
  • Activity modification
  • Health Coaching

Chiropractic Care For Hip Injury

References

Kiapour, Ali et al. “Biomechanics of the Sacroiliac Joint: Anatomy, Function, Biomechanics, Sexual Dimorphism, and Causes of Pain.” International journal of spine surgery vol. 14, Suppl 1 3-13. 10 Feb. 2020, doi:10.14444/6077

Lee, Jeong-Hoon, et al. “The effect of Graston technique on the pain and range of motion in patients with chronic low back pain.” Journal of physical therapy science vol. 28,6 (2016): 1852-5. doi:10.1589/jpts.28.1852

Patel, Rikin V et al. “Pelvic Tilt and Range of Motion in Hips With Femoroacetabular Impingement Syndrome.” The Journal of the American Academy of Orthopaedic Surgeons vol. 28,10 (2020): e427-e432. doi:10.5435/JAAOS-D-19-00155

Rivière, C et al. “Spine-hip relations add understandings to the pathophysiology of femoro-acetabular impingement: A systematic review.” Orthopaedics & traumatology, surgery & research : OTSR vol. 103,4 (2017): 549-557. doi:10.1016/j.otsr.2017.03.010

Suits, William H. “Clinical Measures of Pelvic Tilt in Physical Therapy.” International journal of sports physical therapy vol. 16,5 1366-1375. 1 Oct. 2021, doi:10.26603/001c.27978

What Causes Superficial Backaches & Round Shoulders?

By
Dr. Alex Jimenez
-

Introduction

Many individuals do not realize they are in pain until they begin to feel symptoms of stiffness or tenderness in certain areas of their body. Many people have two most common complaints: back and shoulder pain. The shoulder and the back have a casual relationship that stabilizes the upper body and protects the spine’s thoracic region. When injuries or ordinary factors affect not only the shoulders but the back, it can lead to symptoms of pain and stiffness along the muscles, causing the development of trigger points along the upper back and shoulder muscles. One of the muscles affected by trigger points is the rhomboid muscles located in the upper back behind the scapula (shoulder blades). Today’s article looks at the rhomboid muscle, how superficial backaches and round shoulders can affect the rhomboid muscle, and managing trigger points associated with the rhomboid muscle. We refer patients to certified providers specializing in back pain treatments to aid individuals suffering from trigger points associated with the upper back along the rhomboid muscles. We also guide our patients by referring them to our associated medical providers based on their examination when appropriate. We ensure that education is a great solution to asking our providers insightful questions. Dr. Jimenez DC observes this information as an educational service only. Disclaimer

Download

What Is The Rhomboid Muscle?

 

Do muscle stiffness in your shoulders seem to be causing you pain? Have you noticed that your shoulders seem more rounded than usual? What about the unexplainable upper backaches after being in a hunched position for a long period? Many individuals with these pain symptoms could be associated with the rhomboid muscles. The rhomboid muscles are a collective group of muscles important for upper limb movement and stability for the shoulder’s girdle and scapula. The rhomboid muscles consist of two separate muscles: the rhomboid minor and the rhomboid major, deep within the trapezius muscle and behind the scapula (shoulder blades). The functionality of the rhomboid is that they provide stability to the shoulder and when they are active, the upper arms move back and forth while walking. 

 

How Superficial Backaches & Round Shoulders Affect The Rhomboid

While the rhomboid muscles provide stability to the shoulders, they can succumb to pain like any muscles in different body sections. Ordinary factors like a bad sitting posture can cause the upper back and shoulder muscles to contract and strain. Studies reveal that the effects of bad sitting posture can lead to the development of a forwarding head posture with rounded shoulders, causing pain in the rhomboid muscles. When the shoulder muscles, like the rhomboid muscles, experience this sort of change over time, it can increase muscle tone and continuous stress in the neck and shoulders. To that point, it can lead to various symptoms like pain, numbness, loss of functionality in the upper limbs, and nerve root symptoms. Other issues like back pain can also be one of the symptoms that can lead to referred pain in the rhomboid muscles and can potentially lead to the development of trigger points along the shoulders and rhomboid muscles.

Other issues that can affect the rhomboid muscles are trigger points. Trigger points can be latent or active as they are tiny knots formed in the body’s muscle fibers. For the rhomboid muscles according to Dr. Janet G. Travell, M.D., when a person hears snapping and crunching noises during the movement of the shoulder blades, it may be due to the trigger points in the rhomboid muscles. Studies reveal that since trigger points can be either active or latent and elicit local referred pain, that can lead to muscle imbalance, weak and impaired motor function, and expose the joints to suboptimal loading. This means that trigger points in the rhomboid muscles can cause referred pain to the shoulder and mimic other chronic symptoms. 

 

Stretching The Rhomboid Muscle & Managing Trigger Points-Video

Rhomboid Trigger Points - How to Stretch the Muscle

Do you hear any snapping or crunching noises when rotating your shoulders? What about muscle stiffness along your shoulders or upper back? Or do you feel muscle aches from being hunched over for a long time? These symptoms could potentially involve trigger points associated with the rhomboid muscles. The rhomboid muscles help stabilize the shoulders and provide movement to the arms. When people overuse their shoulder muscles, it can cause the surrounding muscles to develop trigger points and inflict pain-like symptoms on the shoulders and upper back. Thankfully, all is not lost, as various treatments are available to relieve shoulder and upper back pain associated with trigger points along the rhomboid muscles. The video above explains where the trigger points are located on the rhomboid muscles and how to stretch that muscle to relieve trigger points from causing referred pain to the shoulders.

Managing Trigger Points Associated With The Rhomboid Muscle

 

Since the rhomboid muscles can become stiff due to overuse and could develop trigger points to inflict pain along the upper back and shoulders, this can cause many symptoms associated with pain and make the individual feel hopeless. Thankfully, various treatments can help manage trigger point pain associated with the rhomboid muscles. Studies reveal that thoracic spinal manipulation can relieve pain pressure sensitivity of the rhomboid muscles. Chiropractors are excellent when finding trigger points along the musculoskeletal system by utilizing spinal manipulation on the thoracic spine to loosen up the stiff muscles along the shoulders and upper back. Another way to manage trigger points associated with the rhomboid muscle is to stretch the shoulder muscles after a hot shower. This allows the muscles to relax and prevent future trigger points from forming along the rhomboid muscles. 

 

Conclusion

The rhomboid muscles are a collective muscle group that has an important function in stabilizing the shoulder’s girdle and scapula (shoulder blades) while providing upper limb movement. The rhomboid muscles consist of two separate muscles: rhomboid minor and rhomboid major, which are behind the shoulder blades and deep within the trapezius muscles. When ordinary factors like poor posture or shoulder injuries affect the rhomboid muscles, it can develop trigger points that can cause stiffness in the rhomboid muscles. Various techniques can alleviate the referred pain along the shoulders, causing trigger points to develop along the rhomboid muscles. When these treatments are utilized on the rhomboid muscles, they can help prevent future shoulder issues.

 

References

Farrell, Connor, and John Kiel. “Anatomy, Back, Rhomboid Muscles.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 20 May 2022, www.ncbi.nlm.nih.gov/books/NBK534856/.

Haleema, Bibi, and Huma Riaz. “Effects of Thoracic Spine Manipulation on Pressure Pain Sensitivity of Rhomboid Muscle Active Trigger Points: A Randomized Controlled Trial.” JPMA. The Journal of the Pakistan Medical Association, U.S. National Library of Medicine, July 2021, pubmed.ncbi.nlm.nih.gov/34410234/.

Ribeiro, Daniel Cury, et al. “The Prevalence of Myofascial Trigger Points in Neck and Shoulder-Related Disorders: A Systematic Review of the Literature.” BMC Musculoskeletal Disorders, BioMed Central, 25 July 2018, www.ncbi.nlm.nih.gov/pmc/articles/PMC6060458/.

Yoo, Won-Gyu. “Effects of Pulling Direction on Upper Trapezius and Rhomboid Muscle Activity.” Journal of Physical Therapy Science, The Society of Physical Therapy Science, June 2017, www.ncbi.nlm.nih.gov/pmc/articles/PMC5468195/.

Disclaimer

Forklift and Lift Truck Accidents and Injuries Sciatica Clinic

By
Dr. Alex Jimenez
-
Male worker using forklift in warehouse

Forklifts, also known as lift trucks, are used for loading, unloading, and transporting various goods and materials in construction, shipping, and retail industries. They are heavy-duty equipment and require extensive training to operate safely. Forklifts are involved in many serious workplace accidents causing thousands of injuries annually. Chiropractors specialize in injury care and rehabilitation from vehicle accidents and collisions. They can help restore optimal musculoskeletal function and health through adjustments, massage, decompression, and traction therapies.Forklift and Lift Truck Accidents and Injuries Chiropractor

Forklift Operation

The forklift is one of the most widely used pieces of equipment to raise, lower, or remove pallets, boxes, crates, or other containers and transport and stock goods and materials. There are a variety of lift trucks that include:

Operation

The weight, speed, and operation difficulty increase the risk of an accident, increasing the risk of injuries. Other factors include:

  • They can reach up to 20 miles per hour or more.
  • They have front braking systems making it harder to stop.
  • The weight distribution is in the back.
  • The rear wheels turn instead of the front, causing tip-overs.
  • Most carry their loads in front and can obstruct an operator’s view.
  • Lifting too heavy a load can destabilize a forklift and cause it to turn over.

Accident and Injury Causes

Federal work safety regulations require individuals to complete a training program to operate a forklift safely. The most common causes of accidents include:

  • Lack of training and experience.
  • Lack of safety equipment – helmets, seatbelts, grab handles, roll cages, cage guards, warning lights, and sirens.
  • Lack of maintenance – bent forks, no load backrest, unbalanced wheels, etc.
  • Improper loading – off center, damaged goods, loose loads.
  • Lifting, moving or tilting the mast too fast.
  • Riding with a raised load.
  • Speeding.
  • Improper backing-up techniques.
  • Poor communication.
  • Horseplay.
  • Giving rides.
  • Failing to immobilize the machine when the operator leaves.
  • Failing to pay attention to the position of the forks.
  • Failing to yield to pedestrians.
  • Traveling up or down unsafe inclines.
  • Driving off the side of a ramp.
  • Design or manufacturing defects.

Common Accidents

The most common type of accidents involve:

  • Tip-overs and Rollovers.
  • Falling off the lift.
  • Getting struck by falling materials or objects.
  • Pedestrian injuries like getting hit by the vehicle or tripping over the forks.
  • Getting caught in or compressed/crushed by the vehicle or objects.

Injuries

The most common injuries that result from lift accidents include:

  • Contusions
  • Sprains
  • Muscle tears
  • Back pain disorders
  • Crush injuries
  • Fractures

Chiropractic Therapy and Rehabilitation

Chiropractic therapy can help heal and rehabilitate musculoskeletal injuries. A chiropractic team will relieve pain symptoms and restore the body’s alignment and function. Treatment includes:

Adjustments

  • To gently realign joints.
  • Decrease pain.
  • Increase range of motion.
  • Improves posture.

Soft-tissue massage

  • To relax tight muscles.
  • Relieve spasms.
  • Release tension in the connective tissue surrounding the muscles.
  • Reduces pain.
  • Improves the range of motion of the spine and joints.

Exercises and stretches

  • To restore and maintain flexibility, joint stability, and mobility.

Joint bracing and taping

  • To support sprained joints or muscles during healing.

Health Coaching

  • Guides diet and nutrition to reduce inflammation and promote healthy eating to manage weight.

Forklift Fails

References

Bage, T et al. “Forklift-related lower limb injuries: a retrospective case series study with patient-reported outcome measures (PROMs).” Annals of the Royal College of Surgeons of England vol. 103,10 (2021): 730-733. doi:10.1308/rcsann.2020.7124

Born, C T et al. “Patterns of injury and disability caused by forklift trucks.” The Journal of trauma vol. 40,4 (1996): 636-9. doi:10.1097/00005373-199604000-00020

Hong, Choon Chiet, et al. “Forklift-Related Crush Injuries of the Foot and Ankle.” Foot & ankle international vol. 36,7 (2015): 806-11. doi:10.1177/1071100715576486

Ull, Christopher et al. “Injuries after Forklift Trucks Accidents – Injury Patterns, Therapy and Outcome in the Context of the Statutory Accident Insurance.” “Gabelstaplerunfälle – Verletzungsmuster, Therapie und Outcome im berufsgenossenschaftlichen Kontext.” Zeitschrift fur Orthopadie und Unfallchirurgie, 10.1055/a-1402-1649. 19 Apr. 2021, doi:10.1055/a-1402-1649

Waters, Thomas et al. “Lower back disorders among forklift operators: an emerging occupational health problem?.” American journal of industrial medicine vol. 47,4 (2005): 333-40. doi:10.1002/ajim.20146

Volleyball Back Pain Chiropractic Sciatica Clinic

By
Dr. Alex Jimenez
-
Coach Teaching Teenage Girls At Court

The low back is a common source of discomfort and soreness among volleyball players because of repetitive jumping, bending, and rotating of the trunk. Adolescents have an increased risk of this injury because their vertebral bones are still developing, which increases the risk for stress fractures. Chiropractic care, massage therapy, decompression, rest, and athletic training can help expedite pain relief and heal the injury.Volleyball Back Pain Chiropractor

Volley Back Pain

Muscle or ligament strains are the most common injury from repetitive jumping, bending, rotating movements, and hyperextension during serving, hitting and setting. This can lead to excessive compression forces on the discs and joints, causing reduced blood circulation, increasing the risk of overload injuries. One study reported that low back pain is experienced in 63% of players. However, if low-back pain is accompanied by pain that runs down the leg along with numbness or weakness in the foot or ankle, the issue could be a herniated disc.

Causes

One common reason is endurance imbalances in the muscles that stabilize the low back. The core muscles provide stability to the low back and spine for all movements. If imbalances are present, a player may spike or serve the ball with intense turning and arching. The added actions cause increased pressure in the joints and hip, gluteal, and leg muscles, affecting the spine’s stability.

  • The gluteals run from the back of the pelvis/hip bones down to the outside of the thigh.
  • The gluteal muscles prevent the trunk and hips from overbending forward when landing.
  • If the gluteal muscles do not have the strength and endurance to perform this motion, the upper body will bend too far forward, causing poor landing posture and decreased spine stability.

Anterior Pelvic Tilt

Studies have shown that players with low back pain tend to stand and land with an anterior pelvic tilt. This is an unhealthy posture when the front of the pelvis tilts forward, and the back of the pelvis raises. Landing hard with an anterior pelvic tilt causes increased arching and increases the pressure in the joints.

Chronic back pain

Warning signs of a more serious back problem include:

  • Pain that has lasted for more than 1 week and is not improving or getting worse.
  • Pain that prevents sleep or causes the individual to constantly wake up.
  • Difficulty sitting.
  • Back soreness when performing basic tasks and chores.
  • Significant pain on the court when jumping, landing, or rotating.
  • Chronic pain ranges from aches to shooting or throbbing pain that can run down the buttocks and legs.

Chiropractic Care

A chiropractor can alleviate volleyball back pain, rule out a more severe injury, such as a stress fracture or herniated disc, and provide a healthier and faster recovery. According to a study, athletes who received chiropractic care showed better speed and mobility. Quick reflexes and hand-eye coordination depend on an optimal functioning nervous system. 90% of the central nervous system travels through the spine. When one or more spinal segments are misaligned, the effect on the nervous system can seriously impact and disrupt nerve circulation, affecting speed, mobility, reflexes, and hand-eye coordination. Chiropractic adjustments will:

  • Relax and reset the back muscles.
  • Realign and decompress the spine.
  • Remove the pressure around the nerve roots.
  • Strengthen the core.
  • Improve and increase range of motion, strength, and overall endurance.

Anterior Pelvic Tilt

References

Haddas R, Sawyer SF, Sizer PS, Brooks T, Chyu MC, James CR. “Effects of Volitional Spine Stabilization and Lower-Extremity Fatigue on the Knee and Ankle During Landing Performance in a Population With Recurrent Low Back Pain.” J Sport Rehabil. 2017 Sep;26(5):329-338. doi: 10.1123/jsr.2015-0171.

Hangai M. et al., Relationship Between Low Back Pain and Competitive Sports Activities During Youth, Am J Sports Med 2010; 38: 791-796; published online before print January 5, 2010, doi:10.1177/0363546509350297.

Jadhav, K.G., Deshmukh, P.N., Tuppekar, R.P., Sinku, S.K.. A Survey of Injuries Prevalence in Varsity Volleyball Players. Journal of Exercise Science and Physiotherapy, Vol. 6, No. 2: 102-105, 2010 102

Mizoguchi, Yasuaki, et al. “Factors associated with low back pain in elite high school volleyball players.” Journal of physical therapy science vol. 31,8 (2019): 675-681. doi:10.1589/jpts.31.675

Movahed,Marziehet al. (2019). “Single leg landing kinematics in volleyball athletes: A comparison between athletes with and without active extension low back pain.”

Sheikhhoseiniet al. (2018). “Altered Lower Limb Kinematics during Jumping among Athletes with Persistent Low Back Pain”

Trigger Points Affecting The Subscapularis Muscle

By
Dr. Alex Jimenez
-

Introduction

The body has various muscle groups that work together to make each section of the body move. The arms, shoulders, and neck muscles in the upper half of the body allow mobility and range of motion without discomfort. The muscles in the midsection protect the vital organs and spine while assisting in rotation. And the low half of the body, which includes the hips, legs, and feet, helps the body to move from place to place. However, just like all muscles, injuries can occur to the body and cause issues if they are not taken care of immediately. This allows the muscle fibers to develop myofascial pain syndrome or trigger points, causing overlapping risk profiles at risk of developing pain in the affected area. For the upper body, when trigger points affect the shoulders, it can lead to referred pain that can affect the arms. Today’s article examines the shoulder muscle known as the subscapularis muscle, how trigger points are associated with the subscapularis, and ways to manage trigger point pain on the subscapularis muscle in the shoulder. We refer patients to certified providers specializing in musculoskeletal pain treatments to aid individuals suffering from trigger points associated with the subscapularis muscles. We also guide our patients by referring them to our associated medical providers based on their examination when appropriate. We ensure that education is a great solution to asking our providers insightful questions. Dr. Jimenez DC observes this information as an educational service only. Disclaimer

Download

What Is The Subscapularis Muscle?

 

 

Have you been feeling a constant ache in your shoulder muscles? Does your wrist seem to hurt, making it hard to grasp objects? Or Do you feel pain in your triceps or shoulder muscles? Individuals experiencing these symptoms might risk developing trigger points associated with shoulder pain along the subscapularis muscle. The subscapularis is the largest, strongest muscle of the rotator cuff that lies in the anterior or front of the scapular surface and provides shoulder movement while helping maintain glenohumeral joint stability. The best way to describe how it looks is that it seems like a chicken wing. The subscapularis is also part of the rotator cuff muscles, which includes the teres minor, supraspinatus, and infraspinatus muscles, and is active when a person swings their arms forward. When issues affect the shoulders, it can lead to referred pain affecting the upper extremities, including the hands, arms, and even the shoulders.

 

Trigger Point Associated With The Subscapularis Muscle

When injuries affect the shoulders, the muscle fibers that help stabilize the shoulders begin to develop small nodules, known as trigger points, that can invoke pain from the shoulders to the wrist, causing referred pain. The subscapularis and its tendons become affected when it becomes injured and can be prone to tearing. Studies reveal that when the subscapularis tendon has partial tears in the rotator cuff, it would be considered forgotten with “hidden lesions” that can overlap pain symptoms in the shoulders. 

 

Active trigger points in the subscapularis muscle can mimic other pre-existing conditions affecting the shoulders. Once the subscapularis tendon has partial tears in the muscle, it can develop trigger points along the subscapularis muscle and become active, causing various shoulder conditions. One of those conditions is frozen shoulders, and studies reveal a strong association between the subscapularis trigger points and the frozen shoulder. The “frozen shoulder” or adhesive capsulitis of the body is a common shoulder condition often characterized by pain, restricted range of motion, and a high morbidity rate. When a person is dealing with a frozen shoulder, it is often mistaken for shoulder stiffness as it doesn’t respond to non-invasive treatments. All is not lost, as there are various ways of manage active trigger points associated with the subscapularis muscle.

Massage Technique For The Subscapularis Muscle-Video

Subscapularis Self Treatment Technique for Shoulder Pain- Myofascial

Have you been experiencing a limited range in your shoulders? Do your hands and wrist ache all the time when grasping items? Or does the pain seem to affect your biceps and shoulders constantly? These symptoms are signs associated with triggering points affecting the shoulders and the subscapularis muscle. The subscapularis muscle resembles a chicken wing, is in front of the scapula, and is part of the rotator cuff muscle group. When the shoulder gets injured or suffers from a traumatic event, it can later develop tiny knots known as trigger points to cause pain and stiffness to the muscle and affect a person’s mobility. To that point, it can mimic other chronic conditions that had pre-existed before the shoulders were affected. Thankfully, there are ways to manage trigger points associated with the subscapularis muscle along the shoulders. The video above explains how pain can be reduced along the subscapularis muscle through a massage technique.

Ways To Manage Trigger Point Pain On The Subscapularis Muscle

 

Since trigger points mimic other conditions, they can be difficult to diagnose and cause referred pain down the arms. Fortunately, there are ways to manage pain associated with trigger points on the subscapularis muscle. Studies reveal that clinical approaches like mobilizations, stretching, or massaging may help decrease shoulder stiffness while improving pain symptoms in patients with stiff shoulders and posterior shoulder tightness. Incorporating these techniques allows the tight, inflexible muscles to become loose and reduce the effects of referred pain caused by trigger points. To that point, it provides mobility and range of motion back to the shoulders and the subscapularis muscle.

 

Conclusion

The subscapularis muscle is located in the front of the scapula and resembles a chicken wing. This subscapularis is the largest and strongest of the rotator cuff muscles, providing shoulder movement and joint stability. When issues affect the shoulders, it can lead to referred pain that affects the hands, arms, and shoulders. These are trigger points and can cause overlapping symptoms of stiffness and pain in the shoulders and subscapularis muscles. Fortunately, there are therapeutic ways to manage the pain associated with trigger points along the shoulders and subscapularis muscles. When patients incorporate stretching, massaging, or mobilization techniques, a pain specialist can help reduce the trigger point pain and bring back mobility to their shoulders.

 

References

Aguirre, Kenneth, et al. “Anatomy, Shoulder and Upper Limb, Subscapularis Muscle.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 7 Aug. 2021, www.ncbi.nlm.nih.gov/books/NBK513344/.

Arjun, M V, and S Rajaseker. “Association between Subscapularis Trigger Point and Frozen Shoulder: A Cross Sectional Study.” Journal of Bodywork and Movement Therapies, U.S. National Library of Medicine, Oct. 2021, pubmed.ncbi.nlm.nih.gov/34776170/.

Lee, Julia, et al. “Subscapularis Tears: Hidden and Forgotten No More.” JSES Open Access, Elsevier, 1 Mar. 2018, www.ncbi.nlm.nih.gov/pmc/articles/PMC6334875/.

Disclaimer

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Sciatica Specialist
STOP SUFFERING! We specialize in advanced non-surgical approaches in treating sciatica. Our focus is to stop the pain, remove the cause and prevent chronic recurrence of complex sciatica pain syndromes. We treat with advanced protocols and supportive care plans. Blessings - Dr. Alex Jimenez DC, MSACP, IFMCP, CIFM, ATN
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