Maximize the Freshness of Almonds with Correct Storage Methods

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hand hold a jar of a almond nuts with copy space .

Fans of almonds may have noticed that they can go stale and taste awful. Can knowing how to store almonds help extend their shelf life?

Table of Contents

Almonds

Almonds are a healthy, satisfying snack rich in nutrients, including fiber and protein. However, they can go stale and should not be eaten. Whole almonds stay fresh the longest because chopped, roasted, or ground almonds release their oils, which are exposed to more oxygen and go rancid more quickly.

Storage

They should be stored in an airtight container in the refrigerator or freezer for extended life. They are not recommended to be stored at room temperature for long periods, so storing them in the pantry is not recommended. However, enough for a snack can be taken from storage for a day or two while keeping the rest safe and fresh.

Shelf-Life

The shelf-life depends on how they’re produced, processed, and packaged. (Almond Board of California, 2024)

Natural almonds can be stored in the refrigerator or freezer for two years or more.
Roasted almonds can stay fresh for up to a year in an airtight container in the refrigerator or freezer.
Almond paste is recommended to be refrigerated and can stay fresh for 2 to 2 1/2 years.

Rancidity

Almonds are rich in omega-3 and monounsaturated fats, so they are recommended for heart health. (Cleveland Clinic, 2023) However, the fats become rancid if the almonds are exposed to oxygen, especially at room temperature. Rancid oil gives the stale almonds a bad taste. Spoiled almonds are not poisonous, but the fats no longer benefit health. It is possible that rancid fat could contribute to chronic health problems if consumed regularly. (Estévez M. et al., 2017) Almonds last longer than other nuts because they contain some phytochemical antioxidants that protect the nuts. So, if they taste bad, it’s time to throw them out. (University of California Agriculture and Natural Resources, 2010)

Salmonella

Salmonella is a bacteria that causes symptoms of food-borne illness, including upset stomach, vomiting, diarrhea, and fever. Almonds are generally safe from salmonella. However, raw almonds were responsible for two salmonella outbreaks in the United States and Canada. Salmonella outbreaks have also been reported in Australia. In response to those cases, the nuts now must be roasted, blanched, processed, steamed, or treated with a gas called propylene oxide. And none of these treatments remove the nutritional benefits.

Injury Medical Chiropractic and Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic providers use an integrated approach to create customized care plans for each patient and restore health and function to the body through nutrition and wellness, chiropractic adjustments, functional medicine, acupuncture, Electroacupuncture, and sports medicine protocols. If the individual needs other treatment, they will be referred to a clinic or physician best suited for them. Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, nutritionists, and health coaches to provide the most effective clinical treatments.

Functional Nutrition

References

Almond Board of California. (2024). Shelf Stability and Shelf Life. www.almonds.com/tools-and-resources/food-safety-and-quality/shelf-stability-and-shelf-life

Cleveland Clinic. Clinic, C. (2023). Nutrition: Nuts & Heart Health. health.clevelandclinic.org/benefits-of-nuts

Estévez, M., Li, Z., Soladoye, O. P., & Van-Hecke, T. (2017). Health Risks of Food Oxidation. Advances in food and nutrition research, 82, 45–81. doi.org/10.1016/bs.afnr.2016.12.005

University of California Agriculture and Natural Resources. (2010). Nuts: Safe Methods for Consumers to Handle, Store, and Enjoy. ucfoodsafety.ucdavis.edu/sites/g/files/dgvnsk7366/files/inline-files/44384_0.pdf

Diagnosing and Treating Finger Injuries

By

Dr. Alex Jimenez

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Concept Women's sport. Hands hold the ball. One hand in tapes. Second hand with manicure

For individuals dealing with finger injuries, which can occur from various causes, including overuse, jobs, sports, and more, can knowing the cause of finger pain help healthcare providers determine what steps to take for treatment?

Table of Contents

Finger Injuries

Finger injuries are common and can range from minor to serious. (van Veenendaal L. M. et al., 2014) Symptoms can result from an acute injury, including broken fingers and sprains, or chronic conditions like arthritis.

Fractures

Finger fractures can vary and can be serious and lead to permanent damage, deformity, and loss of function if not treated properly. What is important is that fractures are appropriately diagnosed so the proper treatment plan can be initiated. Most finger fractures can be addressed with simple treatments, while others may require surgery. (Oetgen M. E., and Dodds S. D. 2008)

Sprain and Dislocation

Sprains and dislocations are common finger injuries. (Prucz R. B. and Friedrich J. B. 2015) Both damage the ligaments that support the finger joints. In more severe injuries, a dislocation can occur, necessitating the finger to be put back into place or reduced. Individuals with a sprain or dislocation often notice finger swelling or stiffness for months after the injury.

Ligament Damage

Some call this injury skier’s or gamekeeper’s thumb, which results from a specific type of thumb dislocation. Here, the ulnar collateral ligament of the thumb is damaged. This ligament helps keep the thumb stable and supports grip and hand strength. However, this type of ligament injury often requires surgery. (Christensen T. et al., 2016)

Arthritis

Arthritis causes damage to normal joint surfaces where two bones come together. Fingers are one of the most common locations where arthritis occurs. (Spies C. K. et al., 2018) Two types of arthritis commonly affect the fingers: osteoarthritis and rheumatoid arthritis.

Arthritis of The Thumb

Arthritis of the thumb usually occurs at the joint where the thumb meets the wrist. This joint called the carpometacarpal/CMC joint, helps with gripping and pinching. Thumb arthritis is more common in women than men and increases in frequency over 40. (Deveza L. A. et al., 2017)

Trigger Finger

Trigger finger or stenosing tenosynovitis, is a common injury that causes pain and snapping of the fingers’ tendons, resulting in a sensation of locking or catching when bending and straightening the digits. (Makkouk A. H. et al., 2008) Other symptoms include pain and stiffness in the fingers and thumb. Treatments can vary from observation, rest, splinting, injections, and surgery.

Tendon Injuries

Mallet finger

A mallet finger is an injury to the tip of the finger. Usually, it occurs when the end of a straightened finger or thumb is hit, jamming the finger. After the injury, the individual may notice that they cannot fully straighten the tip of the finger. Treatment almost always uses a splint that has to stay on for about six weeks without removal. (Alla, S. R., Deal, N. D., and Dempsey, I. J. 2014) Very rarely is a surgical procedure necessary.

Jersey Finger

This is an injury to the finger flexor tendon. The flexor tendon pulls the finger into the palm when contracting the forearm flexor muscles. The injury occurs at the tip of the finger; typically, the tendon snaps back to the finger’s base or into the palm.

Ring Injuries

Injuries to the finger while wearing wedding bands or other finger jewelry can lead to serious complications. Even minor injuries can have devastating complications if the severity of the injury is not recognized and addressed. If an injury occurs while wearing the jewelry and there is soft tissue damage, including blood circulation being cut off, immediate medical attention is necessary.

Other Injuries

Bruises

The most common finger injury is caused by direct trauma to the skin and muscles. Symptoms include pain, swelling, tenderness, and discoloration of the skin.

Cuts and Scrapes

These can range from minor to more serious, such as injuries that cut through blood vessels, nerves, and tendons.

Injury Medical Chiropractic and Functional Medicine Clinic

After the initial inflammation and swelling have subsided, a doctor will recommend a treatment plan that usually involves physical therapy, self-performed physical rehabilitation, or supervision by a physical therapist or team. At Injury Medical Chiropractic and Functional Medicine Clinic, our areas of practice include Chronic Pain, Personal Injury, Auto Accident Care, Work Injuries, Back Injury, Low Back Pain, Neck Pain, Migraine Headaches, Sports Injuries, Severe Sciatica, Scoliosis, Complex Herniated Discs, Fibromyalgia, Chronic Pain, Complex Injuries, Stress Management, Wellness & Nutrition, Functional Medicine Treatments, and in-scope care protocols. We focus on what works for you to relieve pain and restore function. If other treatment is needed, individuals will be referred to a clinic or physician best suited to their injury, condition, and/or ailment.

Sports Injury Rehabilitation

References

van Veenendaal, L. M., de Klerk, G., & van der Velde, D. (2014). A painful finger as first sign of a malignancy. Geriatric orthopaedic surgery & rehabilitation, 5(1), 18–20. doi.org/10.1177/2151458514522125

Oetgen, M. E., & Dodds, S. D. (2008). Non-operative treatment of common finger injuries. Current reviews in musculoskeletal medicine, 1(2), 97–102. doi.org/10.1007/s12178-007-9014-z

Prucz, R. B., & Friedrich, J. B. (2015). Finger joint injuries. Clinics in sports medicine, 34(1), 99–116. doi.org/10.1016/j.csm.2014.09.002

Christensen, T., Sarfani, S., Shin, A. Y., & Kakar, S. (2016). Long-Term Outcomes of Primary Repair of Chronic Thumb Ulnar Collateral Ligament Injuries. Hand (New York, N.Y.), 11(3), 303–309. doi.org/10.1177/1558944716628482

Spies, C. K., Langer, M., Hahn, P., Müller, L. P., & Unglaub, F. (2018). The Treatment of Primary Arthritis of the Finger and Thumb Joint. Deutsches Arzteblatt international, 115(16), 269–275. doi.org/10.3238/arztebl.2018.0269

Deveza, L. A., Hunter, D. J., Wajon, A., Bennell, K. L., Vicenzino, B., Hodges, P., Eyles, J. P., Jongs, R., Riordan, E. A., Duong, V., Min Oo, W., O’Connell, R., & Meneses, S. R. (2017). Efficacy of combined conservative therapies on clinical outcomes in patients with thumb base osteoarthritis: protocol for a randomised, controlled trial (COMBO). BMJ open, 7(1), e014498. doi.org/10.1136/bmjopen-2016-014498

Makkouk, A. H., Oetgen, M. E., Swigart, C. R., & Dodds, S. D. (2008). Trigger finger: etiology, evaluation, and treatment. Current reviews in musculoskeletal medicine, 1(2), 92–96. doi.org/10.1007/s12178-007-9012-1

Alla, S. R., Deal, N. D., & Dempsey, I. J. (2014). Current concepts: mallet finger. Hand (New York, N.Y.), 9(2), 138–144. doi.org/10.1007/s11552-014-9609-y

Effective Strategies for Addressing SIBO, Gut Health, and Back Pain

By

Dr. Alex Jimenez

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Can individuals dealing with back pain find treatment to reduce gut pain associated with SIBO to improve body health?

Table of Contents

Introduction

Many individuals have noticed that when it comes to improving their health and well-being, many will incorporate small changes into their daily routines. From exercising for at least 30 minutes to incorporating healthy nutritional foods into their diet, many people don’t realize that the best way to have a healthy style starts with the gut. The gut system helps the body digest food and nutrients to be transported to the body, helps regulate growth and metabolism, and provides immune support to all the organ systems. However, when harmful pathogens and environmental factors start to impact the gut, it can cause the development of harmful pathogens inside the gut system and, over time, cause overlapping risk profiles in the body. This leads to gut dysfunction and musculoskeletal issues in the individual and can cause pain and discomfort if not treated right away. Luckily, numerous ways exist to improve gut health and reduce musculoskeletal issues. Today’s article focuses on a gut issue known as SIBO, how SIBO is correlated with back pain, and what treatments can help reduce SIBO. We talk with certified associated medical providers who provide our patients’ information to assess and identify how SIBO is correlated with back pain. We also inform patients while asking their associated medical provider intricate questions to formulate customized treatment plans to reduce the effects of SIBO and help restore gut health. Dr. Alex Jimenez, D.C., includes this information as an academic service. Disclaimer.

What is SIBO?

How often do you feel general aches or pain in your gut or around your lower back? Do you constantly feel tired throughout the day, even after a full night’s rest? Or have you been constantly feeling constipated or bloated after eating a meal? Many of these scenarios are associated with a gut issue known as SIBO or small intestinal bacterial overgrowth. Before diving into what SIBO is, it is important to see the gut’s main function to the body. Known as the second brain of the body, the gut system is home to trillions of good bacteria that help with food digestion and protect the body from bad bacteria. When environmental factors like poor dieting, physical inactivity, or inflammatory effects affect the body, the gut’s delicate ecosystem is also affected. This can cause gut dysfunction to the body and, over time, when it is not being treated, lead to SIBO.

SIBO is the presence of excess bad bacteria in the small intestines, which causes protective barriers that help the small intestines weaken. (Sorathia et al., 2024) Additionally, SIBO can correlate with conditions as it can accompany other gut issues by stimulating the immune system. (Banaszak et al., 2023) When the immune system becomes hyperactively stimulated by SIBO, it can cause the inflammatory cytokines to mass produce and cause a ripple effect on the entire body. Since inflammation is the body’s natural response to remove harmful pathogens that cause issues, mass production of inflammatory cytokines in the gut can cause toxins and bad bacteria to enter the bloodstream and travel to different body areas to cause pain. At the same time, SIBO can disrupt the gut-brain axis, which leads to intestinal motility changes and secretion, thus causing overlapping risk profiles like back pain to affect the body. (Carter et al., 2023)

Eating Right to Feel Better- Video

Eating Right to Feel Better | El Paso, Tx (2023)

How Does Back Pain Correlate With SIBO?

Now, many people are wondering how back pain is correlated with SIBO. Since SIBO causes the immune system to be hyperactive and mass-produce inflammatory cytokines to reduce the integrity and function of the gastrointestinal barrier, it can cause chronic inflammation and induce pain, which includes musculoskeletal conditions like back pain. (Hui et al., 2023) Additionally, the gut-brain axis being over-runed by SIBO and chronic inflammation being an overlapping risk factor can cause negative influences on the gut microbiome composition, and how the individual reacts to the changes can lead to abnormal bone growth and reabsorption due to the excess bacteria. (Geng et al., 2023) The excess bacteria produced by SIBO can affect intervertebral disc homeostasis and, when combined with environmental factors, can further enhance the inflammatory damage to the back muscles. (Yao et al., 2023) However, there are ways to not only reduce the back pain but also treat SIBO from causing more issues in the gut.

Treatments To Reduce SIBO

When it comes to treating SIBO, it depends on what treatment a person will be combined. The main goals for creating a treatment plan for SIBO are:

Reducing the bad bacteria
Bio-transform the gut
Preventing a relapse

Additionally, many individuals can make small changes in their routine by making dietary changes that can modify the intestinal microbiota. (Souza et al., 2022) This, in turn, helps promote gut health and replenish the nutrients while restoring the good bacteria to the gut. Regarding back pain associated with SIBO, chiropractic care can help individuals decrease or alleviate musculoskeletal symptoms by realigning the spine while massaging the muscles. This can help increase circulation while soothing the inflammatory effects caused by SIBO. Chiropractic care can be implemented as part of a person’s customizable treatment plan through a whole body approach by incorporating lifestyle changes and restoring gut health. By making these small changes with the right treatments to manage the overlapping symptoms caused by SIBO, many individuals can make these small changes to their routine to prevent SIBO from reappearing and causing issues in the body.

References

Banaszak, M., Gorna, I., Wozniak, D., Przyslawski, J., & Drzymala-Czyz, S. (2023). Association between Gut Dysbiosis and the Occurrence of SIBO, LIBO, SIFO and IMO. Microorganisms, 11(3). doi.org/10.3390/microorganisms11030573

Carter, J., Bettag, J., Morfin, S., Manithody, C., Nagarapu, A., Jain, A., Nazzal, H., Prem, S., Unes, M., McHale, M., Lin, C. J., Hutchinson, C., Trello, G., Jain, A., Portz, E., Verma, A., Swiderska-Syn, M., Goldenberg, D., & Kurashima, K. (2023). Gut Microbiota Modulation of Short Bowel Syndrome and the Gut-Brain Axis. Nutrients, 15(11). doi.org/10.3390/nu15112581

Geng, Z., Wang, J., Chen, G., Liu, J., Lan, J., Zhang, Z., & Miao, J. (2023). Gut microbiota and intervertebral disc degeneration: a bidirectional two-sample Mendelian randomization study. J Orthop Surg Res, 18(1), 601. doi.org/10.1186/s13018-023-04081-0

Hui, J., Chen, Y., Li, C., Gou, Y., Liu, Y., Zhou, R., Kang, M., Liu, C., Wang, B., Shi, P., Cheng, S., Yang, X., Pan, C., Jia, Y., Cheng, B., Liu, H., Wen, Y., & Zhang, F. (2023). Insight into the Causal Relationship between Gut Microbiota and Back Pain: A Two Sample Bidirectional Mendelian Randomization Study. Adv Genet (Hoboken), 4(4), 2300192. doi.org/10.1002/ggn2.202300192

Sorathia, S. J., Chippa, V., & Rivas, J. M. (2024). Small Intestinal Bacterial Overgrowth. In StatPearls. www.ncbi.nlm.nih.gov/pubmed/31536241

Souza, C., Rocha, R., & Cotrim, H. P. (2022). Diet and intestinal bacterial overgrowth: Is there evidence? World J Clin Cases, 10(15), 4713-4716. doi.org/10.12998/wjcc.v10.i15.4713

Yao, B., Cai, Y., Wang, W., Deng, J., Zhao, L., Han, Z., & Wan, L. (2023). The Effect of Gut Microbiota on the Progression of Intervertebral Disc Degeneration. Orthopaedic Surgery, 15(3), 858-867. doi.org/10.1111/os.13626

Disclaimer

Using Blood Tests to Determine the Underlying Cause of Back Pain

By

Dr. Alex Jimenez

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Medical report with tubes of blood — Coronavirus, COVID-19, 2019-nCoV. Positive Blood Sample in Doctors Hand with gloves. Respiratory Syndrome. Coronavirus outbreaking

Are there blood tests for individuals with chronic and severe back pain symptoms that can help healthcare providers diagnose?

Table of Contents

Blood Tests To Help Diagnose Back Pain

If a healthcare provider suspects an infection or inflammatory arthritis is the cause of back pain, blood tests may be used to diagnose. When trying to find the cause of back pain, a healthcare provider will examine the patient’s medical history, perform a physical examination, and, if necessary, order diagnostic tests. (Dansie E. J. and Turk D. C. 2013) For example, the National Institute of Arthritis and Musculoskeletal and Skin Diseases says that MRIs can reveal abnormalities in the spine. Still, a person may not feel pain or experience any other symptoms. The NIAMS also says healthy, pain-free individuals can have elevated SED levels. A high sedimentation rate or sed rate, also known as an erythrocyte sedimentation rate (ESR) test, can indicate inflammation in the body. (National Institute of Arthritis and Musculoskeletal and Skin Diseases, 2023)

Commonly Used Tests

Blood tests that can help diagnose back pain include:

Complete Blood Count – CBC

This test can indicate inflammation or infections.

Sed Rate or Erythrocyte Sedimentation Rate

This test measures inflammation by analyzing how red blood cells settle through plasma.
Inflammation could point to an infection. (Harrison M. 2015)
If the SED rate indicates that inflammation is present, the possibility of an underlying cause may be some form of arthritis or a tumor, which is rare.

CRP or C-reactive Protein

Another test that measures inflammation that could indicate an infection or some form of arthritis. (Sproston N. R. and Ashworth J. J. 2018)

HLA-B27

A genetic marker in the blood that is more common in individuals with ankylosing spondylitis and reactive arthritis. (McMichael A. and Bowness P. 2002)
This marker may be tested if the healthcare provider suspects either disease.
Ankylosing spondylitis is an inflammatory arthritis affecting the sacroiliac joints, hips, and spine. (Sieper J. et al., 2002)
Reactive arthritis is a type that occurs after an infection in a different body system or area. (Hamdulay S. S., Glynne S. J., and Keat A. 2006)

Injury Medical Chiropractic and Functional Medicine Clinic

At Injury Medical Chiropractic and Functional Medicine Clinic, we focus on what works for you to relieve pain and restore function. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. Our areas of practice include Chronic Pain, Personal Injury, Auto Accident Care, Work Injuries, Back Injury, Low Back Pain, Neck Pain, Migraine Headaches, Sports Injuries, severe sciatica, Scoliosis, Complex Herniated Discs, Fibromyalgia, Chronic Pain, Complex Injuries, Stress Management, Wellness and nutrition, Functional Medicine Treatments, and in-scope care protocols. They can also work with other associated medical professionals to develop a personalized treatment plan to help relieve muscle pain, improve the body’s flexibility and mobility, resolve musculoskeletal issues, and prevent future pain symptoms from reoccurring.

Integrative Medicine Approach

References

Dansie, E. J., & Turk, D. C. (2013). Assessment of patients with chronic pain. British journal of anaesthesia, 111(1), 19–25. doi.org/10.1093/bja/aet124

National Institute of Arthritis and Musculoskeletal and Skin Diseases. (2023). Back Pain. Retrieved from www.niams.nih.gov/health-topics/back-pain

Harrison M. (2015). Erythrocyte sedimentation rate and C-reactive protein. Australian prescriber, 38(3), 93–94. doi.org/10.18773/austprescr.2015.034

Sproston, N. R., & Ashworth, J. J. (2018). Role of C-Reactive Protein at Sites of Inflammation and Infection. Frontiers in immunology, 9, 754. doi.org/10.3389/fimmu.2018.00754

McMichael, A., & Bowness, P. (2002). HLA-B27: natural function and pathogenic role in spondyloarthritis. Arthritis research, 4 Suppl 3(Suppl 3), S153–S158. doi.org/10.1186/ar571

Sieper, J., Braun, J., Rudwaleit, M., Boonen, A., & Zink, A. (2002). Ankylosing spondylitis: an overview. Annals of the rheumatic diseases, 61 Suppl 3(Suppl 3), iii8–iii18. doi.org/10.1136/ard.61.suppl_3.iii8

Hamdulay, S. S., Glynne, S. J., & Keat, A. (2006). When is arthritis reactive?. Postgraduate medical journal, 82(969), 446–453. doi.org/10.1136/pgmj.2005.044057

Implementing a Heart-Clinical Approach to Trafficking: Key Strategies for Success

By

Dr. Alex Jimenez

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Can healthcare professionals implement H.E.A.R.T. protocols for trafficked individuals while providing a safe space?

Table of Contents

Introduction

Across the world, many local media and organizations are paying close attention to a phenomenon that many people should be aware of. This phenomenon is known as trafficking, and it can be associated with numerous activities, from forced labor to sex labor, and can affect a person’s sense of self-worth. While many people will correlate that trafficking affects many women and children, it can affect many individuals regardless of age, gender, and background. While many survivors of trafficking are dealing with the psychological and physical injuries that they obtain from their traffickers, many medical professionals can implement protocols and roles through the implementation of H.E.A.R.T. to provide a safe space for individuals suffering from trafficking. Today’s article focuses on the definition of trafficking, what H.E.A.R.T. is, and how it is used in a clinical setting. We discuss with certified associated medical providers who consolidate our patients’ information to assess and identify trafficking in a clinical approach while providing a safe space. We also inform and guide patients while asking their associated medical provider intricate questions to formulate customized treatment plans for their pain and provide them with a safe space and positive experience. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer.

The Definition Of Trafficking

When it comes to defining trafficking, it can be challenging as it is frequently associated with other issues. However, the main definition for trafficking is “recruiting, transporting, transferring, or harboring many individuals or a person that are threatened or forced to achieve the consent of a person having control of the individuals for exploitation.” With human trafficking being a pressing public concern that affects all races, social classes, demographics, and genders, it can impact society and the individual who is being trafficked. (Toney-Butler et al., 2024) Additionally, many people often mistake trafficking and smuggling as they are completely different. Smuggling requires a person to be transported into a nation through voluntary illicit means. While trafficking can come in two forms, which are labor and commercial sex, it can happen within the person’s own home. (Rambhatla et al., 2021) This is because many survivors who are going to get healthcare services will feel various emotions of fear or shame that can prevent them from asking for help due to what they have been through with their trafficker. However, when many individuals who are trafficking survivors are suffering from significant physical, mental, and social health problems and are seeking healthcare services, many healthcare professionals play an important role by creating a safe and responsive space for them. (The Lancet Regional Health-Western, 2022)

Beyond the Surface: Understanding the Effects of Personal Injury- Video

Beyond the Surface: Understanding the Effects of Personal Injury | El Paso, Tx (2024)

What is H.E.A.R.T In A Clinical Setting

When it comes to creating a safe and positive space in a clinical setting, many healthcare professionals often miss the signs of trafficking due to a lack of training or confidence to identify and treat patients who are trafficking victims. (Lee et al., 2021) However, healthcare protocols should be implemented, and H.E.A.R.T. should be incorporated into a clinical approach to assess and develop a customized treatment plan for the patient. Healthcare professionals can engage with the patient in a one-on-one discussion away from their trafficker and can offer important medical and psychological care resources. (Exeni McAmis et al., 2022) By incorporating H.E.A.R.T. protocols in a healthcare clinic, many doctors and medical professionals can help many patients be in a safe environment. Below is what H.E.A.R.T. stands for.

H-Hearing

The “H” in H.E.A.R.T. is for hearing as many medical professionals not only to hear but to see what is going on in the clinic and to establish environmental awareness. This is due to looking at the patient and who is accompanied by them. With healthcare providers being at the front, they interact with patients and may not know what health concerns are affecting them. This could be due to the following:

Language or cultural barriers
Fear of criminal repercussions
Fear of the trafficker
Distrust of the healthcare provider (Gutfraind et al., 2023)

By incorporating the hearing aspect in H.E.A.R.T., many healthcare professionals can provide a safe, thoughtful, and engaging approach to the patient and know what to look for when a patient is coming in for treatment.

E-Evaluating

The “E“ in H.E.A.R.T. is used to evaluate its importance in enhancing patient interactions in a trauma-informed care facility. This is highly important because the individual is seeking health care. For the patients being trafficked, it is important to notice the red flags the individual is experiencing. Some of the red flags that many healthcare providers should look for are:

Physical health
Behavioral Health
The patient is with a controlling person
The patient does not have possession of their I.D.

Additionally, it is always important to show compassion, be sensitive to the individual while addressing their needs and concerns, and use a non-judgmental approach during the interview process. This helps the individual ensure they are in a safe environment when discussing sensitive topics. At the same time, it is important not to let the patient be re-traumatized while avoiding the impulse to rescue and overpromise the patient to mental health as we want them to have their self-worth. At the same time, it is best to remember the four “Rs“ when doing a trauma-informed approach; they are:

Realize: Understanding how trauma can affect people.
Recognize: Recognizing the signs of trauma.
Respond: Have all staff trained, use evidence-based practices, and provide a safe environment.
Resist Re-trauma: Recognizing how some practices may trigger painful memories while avoiding re-traumatizing the patient.

By implementing the four “Rs“ and the “E“ in H.E.A.R.T., many healthcare professionals can provide valuable resources to trafficking survivors with a strong support system.

A-Activating

The “A“ in H.E.A.R.T. stands for activating, where healthcare professionals must have proper protocols to engage all employees. This allows the healthcare providers to understand how beneficial it is to develop a protocol for a person who is being trafficked, understand their state and federal reporting laws, and list key elements of effective trauma-informed screening procedures when assessing the patient. This allows a foundational structure to support a response for suspected patients who are being trafficked. At the same time, by following HIPAA laws and organization policies, many healthcare providers must explain the reporting process to the right officials. Additionally, the benefits of developing a protocol for trafficking are by:

Clarifying procedures
Enhance staff training
Optimize the interactions with the trafficking patients
Improve staff confidence
Prepare for any threatening situations
Maximizing preparedness to aid trafficking patients
Optimize support for patients
Develop collaborative outside resources

R-Resourcing

The “R“ in H.E.A.R.T. stands for resourcing, as many healthcare providers must identify the referral systems. This allows healthcare professionals to understand the important message to convey when assessing trafficking victims and the importance of responding to safety, emergency, and reporting requirements. When assessing and interviewing the patient, many will have to recognize that their patient may be a possible victim of trafficking, what their immediate needs are, and what long-term resources can help.

T-Training

The “T” in H.E.A.R.T. stands for training, as it is important that many healthcare providers continuously train to spot trafficking; this provides confidence to many healthcare workers and can help save a person’s life. By implementing H.E.A.R.T. protocols, the “T” allows the doctor to respect the individual’s decision to want help, providing a positive support system while encouraging them to come back, offering to help with a safety plan, and building a resource network. This is because if the patient is accompanied by someone who is controlling and answering for the patient, handing out information discreetly can provide a bit of hope to the individual to make the move. At the same time, providing local and immediate assistance resources can help the individual in the long run. This allows healthcare providers to build a trusting relationship and even help individuals to have a safe and positive experience on their health and wellness journey.

References

Exeni McAmis, N. E., Mirabella, A. C., McCarthy, E. M., Cama, C. A., Fogarasi, M. C., Thomas, L. A., Feinn, R. S., & Rivera-Godreau, I. (2022). Assessing healthcare provider knowledge of human trafficking. PLOS ONE, 17(3), e0264338. doi.org/10.1371/journal.pone.0264338

Gutfraind, A., Yagci Sokat, K., Muscioni, G., Alahmadi, S., Hudlow, J., Hershow, R., & Norgeot, B. (2023). Victims of human trafficking and exploitation in the healthcare system: a retrospective study using a large multi-state dataset and ICD-10 codes. Front Public Health, 11, 1243413. doi.org/10.3389/fpubh.2023.1243413

Lee, H., Geynisman-Tan, J., Hofer, S., Anderson, E., Caravan, S., & Titchen, K. (2021). The Impact of Human Trafficking Training on Healthcare Professionals’ Knowledge and Attitudes. J Med Educ Curric Dev, 8, 23821205211016523. doi.org/10.1177/23821205211016523

Rambhatla, R., Jamgochian, M., Ricco, C., Shah, R., Ghani, H., Silence, C., Rao, B., & Kourosh, A. S. (2021). Identification of skin signs in human-trafficking survivors. Int J Womens Dermatol, 7(5Part B), 677-682. doi.org/10.1016/j.ijwd.2021.09.011

The Lancet Regional Health-Western, P. (2022). Human trafficking is more than a crime. Lancet Reg Health West Pac, 20, 100444. doi.org/10.1016/j.lanwpc.2022.100444

Toney-Butler, T. J., Ladd, M., & Mittel, O. (2024). Human Trafficking. In StatPearls. www.ncbi.nlm.nih.gov/pubmed/28613660

Disclaimer

The Benefits of Walking with a Cane for Injury Recovery

By

Dr. Alex Jimenez

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Elderly patient trying to stand and walking with caregiver nurse — Senior man with knee problems, Elderly patient on sofa trying to stand and walking with caregiver nurse at home, Young physiotherapist taking care and supporting senior man to exercise

Can using a cane help individuals after an injury, living with chronic pain or balance issues, or post-surgery?

Table of Contents

Walking With A Cane

A cane is an assistive device that can help individuals walk after injury or surgery and aids with balance and stability. It can be used for:

Balance or Stability Issues

Canes can help with minor balance or stability issues, such as weakness in the leg or trunk, or after an injury.

Pain

Canes can help reduce stress on painful joints or limbs.

Independence

Canes can help people continue living independently, especially the elderly.

There are different types of canes, including single-point and quad canes. Single-point canes are generally the least expensive. Quad canes have four points and can provide more stability. It is important to use it correctly to prevent falls and injuries.

Post-surgery or Injury

A cane can help reduce pressure on the leg or back after surgery or injury. Healthcare providers may recommend a cane as a step-down device after using a walker or crutches. Before walking with the cane, ensure it is at the right height. Hold the cane in the hand on the opposite side of the injury. Hold the cane’s handle at the level of the bend in the wrist when standing with the elbow slightly bent. (American Academy of Orthopaedic Surgeons, 2020) If there are issues in both legs or a cane is used after back surgery, keep the cane in the hand with the most support.

Practicing Taking Steps

To practice taking steps with a cane, try the following (American Academy of Orthopaedic Surgeons, 2020)

Place the cane firmly on the ground.
Take a small step forward with the injured leg.
Step the opposite foot forward to meet the injured leg.
Continue this process until you can take multiple steps in a row with balance.

Progress to a step-to-walking pattern (Hirayama K. et al., 2022)

Step forward with the cane and injured leg at the same time.
Step the non-injured leg up with the cane firmly on the ground to meet the injured leg.
The feet should be side by side.

Walking Normally

Once comfortable taking practice steps, try walking normally with the cane. Step forward with the cane and injured leg simultaneously. The cane should be off the ground when the wounded leg is in the air. Firmly plant the cane when stepping onto the injured leg. Step forward with the cane and the injured leg first, then step past the injured leg with the good leg.

Using The Stairs

When walking up and down stairs, it’s important to use proper technique to prevent losing balance. (American Academy of Orthopaedic Surgeons, 2020)

Walking Up the Stairs

Step up with the good leg.
Bring the injured leg and cane up to the step.

Walking Down the Stairs

Step down with the injured leg while lowering the cane to the step below.
Make sure the cane is firmly on the stairs.
Bring the good leg down to the same step.

If a handrail is available, use it. Although doing so may require moving the cane to the other hand, even if it’s on the same side as the injured leg, it will improve stability and reduce the risk of falling. Once proficient on the stairs, individuals may alternate placing one foot on each step.

Walking With Chronic Pain

Walking with a cane with a chronic pain condition is similar to using it with an injury. The location of the pain will determine which hand the cane is held in. If the pain is on the right side of the body, keep the cane on the left side or vice versa. If chronic pain is not in the legs but, for example, back pain makes it difficult to walk, hold the cane on either side, whichever feels more supportive and comfortable. If there is weakness on one side of the body or decreased sensation/numbness in one of the legs or feet, hold the cane on the opposite side of the pain, weakness, or numbness. Walking with a cane can also benefit individuals with other medical conditions. For example, assistive devices may be recommended for those with balance issues. (National Library of Medicine, 2023)

Cane Types

There are two primary types of canes, characterized by their points, and choosing the right one depends on the reason it’s needed. (Arthritis Foundation, N.D.)

Single-point

Single-point canes have one tip at the end.
These are recommended for those who need to relieve some pressure off an injured leg or need support due to occasional difficulties with balance.

Quad

Quad canes have four tips or feet to provide more stability.
They provide more support and are recommended for those with significant weakness in one leg or difficulty maintaining their balance while walking.

The traditional cane has a rounded C handle. Other types have contoured handles for a more secure grip. Talk to a doctor, physical therapist, or other health care professional for suggestions on which cane is right for you.

Losing Balance

A potential risk of using a cane is losing balance. If unable to maintain balance with a cane, individuals may want to consider a different walking device, such as a walker or crutches. To reduce the risk of falls, consider the following tips (American Academy of Orthopaedic Surgeons, 2020)

Wear shoes with nonskid soles.
Add lighting so you can see where you are walking.
Remove throw rugs or objects that can cause tripping.
Arrange furniture to allow for wide walking paths throughout the home.
Carry objects in a backpack or fanny pack rather than holding them.

Injury Medical Chiropractic and Functional Medicine Clinic

Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other associated medical professionals to develop a personalized treatment plan to help relieve muscle pain, improve the body’s flexibility and mobility, resolve musculoskeletal issues, and prevent future pain symptoms from reoccurring.

Osteoporosis

References

American Academy of Orthopaedic Surgeons. (2020). How to use crutches, canes, and walkers. orthoinfo.aaos.org/en/recovery/how-to-use-crutches-canes-and-walkers/

Hirayama, K., Otaka, Y., Kurayama, T., Takahashi, T., Tomita, Y., Inoue, S., Honaga, K., Kondo, K., & Osu, R. (2022). Efficiency and Stability of Step-To Gait in Slow Walking. Frontiers in human neuroscience, 15, 779920. doi.org/10.3389/fnhum.2021.779920

National Library of Medicine. (2023). Using a cane. Retrieved from medlineplus.gov/ency/patientinstructions/000343.htm

Arthritis Foundation. (N.D.). How to choose the right cane. www.arthritis.org/health-wellness/healthy-living/managing-pain/joint-protection/how-to-choose-the-right-cane

A Comprehensive Guide to Anterolisthesis and its Implications

By

Dr. Alex Jimenez

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Back is hurting, spine pain. Foreman is in the storehouse, shipping distribution business.

Individuals who have experienced spinal or back trauma, suffered fractures, are going through spinal degeneration, or are dealing with a spinal condition have an increased risk of anterolisthesis, where a vertebra slips forward relative to the vertebra below it. Can healthcare providers help prevent and treat the condition?

Anterolisthesis

The spine consists of 33 individual bones or vertebrae stacked on one another. Anterolisthesis occurs when one vertebral segment slips forward over another. The condition can be mild, asymptomatic, or cause significant pain and neurological symptoms. Many different things, including osteoarthritis, osteoporosis, trauma, or a fracture, can cause this vertebral shifting. (Cedars Sinai, 2022) Spondylolisthesis is a general term for shifting a spinal vertebra over the one below it. It includes anterolisthesis, forward moving, and the less common retrolisthesis, or backward shifting.

Grades

Anterolisthesis is typically graded using the Meyerding scale, which assigns one of five grades according to how much slippage has occurred. These grades include:

Grade 1

0 to 25% slippage

Grade 2

25 to 50% slippage

Grade 3

50 to 75% slippage

Grade 4

75 to 100% slippage

Grade 5

More than 100% slippage or spondyloptosis

Grade 1 and 2 cases are generally mild, while grades 3, 4, and 5 are more severe. (Koslosky E., and Gendelberg D. 2020)

Symptoms

Anterolisthesis can lead to various symptoms, depending on the severity and if the surrounding spinal nerves have been affected. The most common complaints include:

Lower back stiffness
Lower back pain
Shooting pain into the leg
Weakness when standing or walking for a long time
Cramping in the leg muscles
Numbness or tingling in the leg that improves when sitting or bending forward (American Academy of Orthopaedic Surgeons, 2021)

Causes

Cases of anterolisthesis are also typically categorized based on what led to the condition. The most common causes include:

Degenerative anterolisthesis

Shifting occurs when arthritis (spondylosis) causes the spine’s joints and discs to deteriorate.
The degenerative version of the anterolisthesis is the most common, particularly in women and adults over 50.
African Americans tend to experience this condition at a higher rate than the general population. (American Academy of Orthopaedic Surgeons, 2021)

Isthmic anterolisthesis

Slippage is caused by a fracture in a portion of the spine called the pars, also known as a pars defect.

Congenital or Dysplastic anterolisthesis

Slippage is caused by a condition present at birth or spinal abnormality.

Traumatic anterolisthesis

Acute shifting of the vertebrae caused by a traumatic injury.

Pathologic anterolisthesis

Anterolisthesis occurs because of a bone disease like osteoporosis.

Iatrogenic – Postsurgical anterolisthesis

Slippage that occurs as a result of a prior spinal decompression surgical procedure. (Hospital for Special Surgery, 2023)

Diagnosis

Diagnosis begins with a subjective evaluation and a physical examination. During these, the healthcare provider will assess sensation, strength, and reflexes and will order one of several diagnostic tests, including:

X-rays

Visualizes the vertebrae in the spine and their position relative to those above and below.
Also provides a clear picture of spinal arthritis or disc degeneration.

Magnetic Resonance Imaging – MRI

Allows the spinal cord, nerves, muscles, and discs to be assessed for compression or damage.

Computed Tomography – CT scan

Provides a cross-sectional image of the spine in very clear detail. (American Academy of Orthopaedic Surgeons, 2021)

Treatment

Several factors determine how the condition is treated, including:

The grade of the slippage.
The cause.
The symptoms.
The presence of instability on a diagnostic test such as an X-ray.

Stable and mildly symptomatic cases are usually treated with a combination that can involve:

Physical therapy
Activity modification
Bracing
Nonsteroidal anti-inflammatory medications/NSAIDs like ibuprofen.
Spinal injections

In more severe cases in which spinal instability or significant neurological symptoms are present, surgery may be recommended. This commonly involves a spinal decompression or fusion procedure. The technique varies based on the surgeon’s preferences and anatomy. (Koslosky E., and Gendelberg D. 2020)

Prognosis

Most individuals with this condition don’t know they have it until it is found accidentally on an X-ray or an MRI for something else. Mild cases can cause minimal symptoms and can be well-managed with conservative treatments. Cases of unstable anterolisthesis or those with neurological compression often require surgical intervention. These surgeries restore stability to the spine and alleviate any pressure on the nerves. More than 85% of individuals who need surgery have a successful outcome. (American Academy of Orthopaedic Surgeons, 2021)

Self-Care and Management

For individuals experiencing pain, numbness, or tingling from anterolisthesis, getting symptoms evaluated by a healthcare provider is an important first step. The healthcare provider may suggest one of several management strategies, which include:

Core Strengthening

To alleviate symptoms, exercises targeting the core muscles in the hips, pelvis, abdomen, and lower back are recommended.
Formal physical therapy may also be recommended.

Over-the-counter Meds

A healthcare provider may suggest pain-relieving medications like ibuprofen or naproxen to reduce soreness.

Activity Modification

Sticking to gentle, pain-free activities and avoiding excessive or repetitive extension of the spine can help prevent symptom aggravation. (American Academy of Orthopaedic Surgeons, 2021)

Injury Medical Chiropractic and Functional Medicine Clinic

At Injury Medical Chiropractic and Functional Medicine Clinic, our areas of practice include Chronic Pain, Personal Injury, Auto Accident Care, Work Injuries, Back Injury, Low Back Pain, Neck Pain, Migraine Headaches, Sports Injuries, Severe Sciatica, Scoliosis, Complex Herniated Discs, Fibromyalgia, Chronic Pain, Complex Injuries, Stress Management, Wellness & Nutrition, Functional Medicine Treatments, and in-scope care protocols. We focus on what works for you to relieve pain and restore function. If other treatment is needed, individuals will be referred to a clinic or physician best suited to their injury, condition, and/or ailment.

Degenerative Disc Disease Treatment

References

Cedars Sinai. (2022). Anterolisthesis. www.cedars-sinai.org/health-library/diseases-and-conditions/a/anterolisthesis.html

Koslosky, E., & Gendelberg, D. (2020). Classification in Brief: The Meyerding Classification System of Spondylolisthesis. Clinical orthopaedics and related research, 478(5), 1125–1130. doi.org/10.1097/CORR.0000000000001153

American Academy of Orthopaedic Surgeons. (2021). Adult spondylolisthesis in the low back. orthoinfo.aaos.org/en/diseases–conditions/adult-spondylolisthesis-in-the-low-back

Hospital for Special Surgery. (2023). Spondylolisthesis. www.hss.edu/condition-list_spondylolisthesis.asp

Proper Posture: The Key to Effective and Safe Workouts

By

Dr. Alex Jimenez

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Can individuals incorporate proper posture in their workouts to provide effective results and reduce muscle pain in their bodies?

Table of Contents

Introduction

Many people have started participating in various physical activities to improve their health and wellness. Additionally, engaging in different physical activities can provide numerous beneficial properties for the body as it can help strengthen the various muscles, bones, and ligaments that have succumbed to multiple injuries, strains, or conditions that cause many individuals to be in pain. When many people with musculoskeletal conditions start incorporating exercises as part of their treatment, maintaining proper posture while doing each set of stretches or exercises for each muscle can help reduce any unwanted strain or pulls that can cause more harm than good. Today’s post focuses on how maintaining proper posture can help make any workouts more efficient, how adequate posture can provide stability and strength to weak muscles, and how incorporating proper posture in a customized treatment plan can prevent numerous injuries from reoccurring. We discuss with certified associated medical providers who consolidate our patients’ information to assess many individuals to understand the importance of proper posture. We also inform and guide patients while asking their associated medical provider intricate questions to integrate non-surgical treatments to reduce the overlapping symptoms correlating with poor posture and help create a customized treatment plan that utilizes proper posture during exercises. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer.

Maintaining Posture Is Important For Effective Workouts

How often do you feel muscle strain on your shoulders, neck, and lower back after a strenuous long day? Do you notice that you feel more hunched over that you feel muscle aches and discomfort? Or do you feel discomfort when stretching your muscles that it causes temporary relief? More often than not, when the world has been on its entire feet or sitting down all day from working, school, or commuting to different locations, many individuals will often slip into an unhealthy habit of slouching when relaxing after a hard day. This, in turn, can cause many individuals to develop neck and back issues that often correlate with an increased stress load in the neck and lower back area. (Hansraj, 2014) Hence, postural correction and its beneficial effects on the back and neck are limited. However, when manual and physical therapists incorporate a PSB (postural-structural-biomechanical) model, it can help ascertain the various causes of musculoskeletal conditions and play an important role in clinical assessment and managing multiple muscle pains. (Lederman, 2011)

So why is it important to exercise to maintain proper posture? Well, when many individuals are in a hunched position from looking at their phones or leaning a lot more while being on the computer or driving, it can cause the muscles in the neck, shoulders, and upper back to be in a static position, causing the muscles to be overused. (Abd El-Azeim et al., 2022) Additionally, say a person is working out to relieve stress, they would have to maintain a proper posture to prevent injuries and use the equipment to achieve muscular activity. When doing an effective workout, many individuals can improve their posture through muscle stretching exercises that can help improve postural alignment, which plays a role in preventing and treating musculoskeletal pain disorders. (Matsutani et al., 2023) At the same time, maintaining proper posture while working out can provide effective, good-quality movement and neutral spinal alignment.(Katzman et al., 2021)

Discovering The Benefits Of Chiropractic Care- Video

Discovering the Benefits of Chiropractic Care | El Paso, Tx (2023)

Proper Posture Stabilizes Weak Muscles

At the same time, having proper posture can help stabilize weak muscles in the upper and lower body quadrants. This is because environmental factors like obesity, repetitive movements, and excessive sitting or standing can cause the muscles to be overused and weak over time when a person is not taking a break. This causes strength imbalances between the muscle groups, causing the accessory muscles to take over the main muscle’s job function and causing the spine to compensate and exaggerate the body’s natural curve. Hence why, exercises, especially core exercises, can help distribute the weight of the overbearing load and can help many individuals reduce the forward lean motion while decreasing muscle strain and fatigue on the upper and lower quadrants. Core exercises can help induce muscular contractions while influencing neuromuscular potentiation. (Lyons et al., 2021) This can help strengthen the weak muscles and stabilize the other muscles so the body can be realigned to invoke proper posture. Also, poor posture can correlate with lumbar spine and pelvis instability as the muscles can become weak. (Kim & Yim, 2020) Incorporating stability exercises into the weak muscles can help many individuals improve their posture when performing exercises.

Incorporating Proper Posture In A Customed Treatment Plan

When it comes to musculoskeletal pain conditions, many individuals can seek out pain specialists like chiropractors, acupuncturists, massage therapists to ease the pain in the muscles from an initial visit. Visiting a chiropractic care office or going to a gym and being assigned to a personal trainer can help practice healthy habits in maintaining and incorporating proper posture in a customized treatment plan. A chiropractic team can help mitigate the pain through spinal adjustments that can help the body realign itself and can work with other associated medical professionals to come up with a customer treatment plan that can help relieve muscle pain, improve the body’s flexibility and mobility, resolve musculoskeletal issues and prevent future pain symptoms from reoccurring. Additionally, a physical therapist can work together with a chiropractor to incorporate targeted exercises to help improve posture while stretching and strengthening the targeted muscles. This, in turn, helps with improving neuromuscular improvement to maintain correct posture. When many individuals develop improper posture over time, it can lead to dire consequences, as muscle pain can cause overlapping risk profiles in the body. Making small adjustments to how people sit or stand can help maintain proper posture. That way, the body can realign itself over time, and many can have a pain-free, healthy lifestyle.

References

Abd El-Azeim, A. S., Mahmoud, A. G., Mohamed, M. T., & El-Khateeb, Y. S. (2022). Impact of adding scapular stabilization to postural correctional exercises on symptomatic forward head posture: a randomized controlled trial. Eur J Phys Rehabil Med, 58(5), 757-766. doi.org/10.23736/S1973-9087.22.07361-0

Hansraj, K. K. (2014). Assessment of stresses in the cervical spine caused by posture and position of the head. Surg Technol Int, 25, 277-279. www.ncbi.nlm.nih.gov/pubmed/25393825

Katzman, W. B., Parimi, N., Gladin, A., Wong, S., & Lane, N. E. (2021). Long-Term Efficacy of Treatment Effects After a Kyphosis Exercise and Posture Training Intervention in Older Community-Dwelling Adults: A Cohort Study. J Geriatr Phys Ther, 44(3), 127-138. doi.org/10.1519/JPT.0000000000000262

Kim, B., & Yim, J. (2020). Core Stability and Hip Exercises Improve Physical Function and Activity in Patients with Non-Specific Low Back Pain: A Randomized Controlled Trial. Tohoku J Exp Med, 251(3), 193-206. doi.org/10.1620/tjem.251.193

Lederman, E. (2011). The fall of the postural-structural-biomechanical model in manual and physical therapies: exemplified by lower back pain. J Bodyw Mov Ther, 15(2), 131-138. doi.org/10.1016/j.jbmt.2011.01.011

Lyons, K. D., Parks, A. G., Dadematthews, O., Zandieh, N., McHenry, P., Games, K. E., Goodlett, M. D., Murrah, W., Roper, J., & Sefton, J. M. (2021). Core and Whole Body Vibration Exercise Influences Muscle Sensitivity and Posture during a Military Foot March. Int J Environ Res Public Health, 18(9). doi.org/10.3390/ijerph18094966

Matsutani, L. A., Sousa do Espirito Santo, A., Ciscato, M., Yuan, S. L. K., & Marques, A. P. (2023). Global posture reeducation compared with segmental muscle stretching exercises in the treatment of fibromyalgia: a randomized controlled trial. Trials, 24(1), 384. doi.org/10.1186/s13063-023-07422-w

Disclaimer

Understanding Arm Numbness and Tingling

By

Dr. Alex Jimenez

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handsome mature patient in casual attire on appointment with his rehabilitologist in hospital

Can determining whether arm numbness occurs suddenly or gradually and whether there are other symptoms help healthcare providers diagnose and treat the condition?

Table of Contents

Arm Numbness

Arm numbness or tingling are common symptoms that various medical conditions can cause. Numbness can be caused by a sudden health emergency, nerve disorder, or nutritional deficiency. (National Institute of Neurological Disorders and Stroke, 2024) Sometimes, this symptom results from an arm falling asleep and could resolve after just a few minutes. The sensation may be temporary, caused by something like sleeping in the wrong position. However, arm numbness and tingling may also be caused by neuropathy and chronic and progressive nerve damage and can also suddenly occur due to serious conditions, such as a heart attack or a stroke.

Circulation Issues

Deficient blood circulation in the arm could cause numbness and tingling as the nerves cannot receive enough oxygen. Conditions can interfere with normal blood flow and include: (Bryan L. and Singh A. 2024)

Atherosclerosis – plaque buildup in the arteries that may require medication or surgery.
Severe frostbite can damage the blood vessels but can be resolved with proper warming and wound care.
Vasculitis – is inflammation of the blood vessels that can be treated with medication.

Sleeping Position

A common example of sudden numbness and tingling is the feeling that the arm has fallen asleep. This usually occurs after sleeping awkwardly or leaning on the arm for a long time. Known as paresthesia, this sensation is related to the compression or irritation of nerves. (Bryan L. and Singh A. 2024) Sleeping in certain positions has been associated with nerve compression, especially when the hands or wrists are tucked or curled under the body, as well as maintaining proper spine alignment when sleeping, is the best way to prevent arm numbness.

Nerve Injuries and Conditions

Numbness that persists may be related to an injury or underlying health problem that affects the brachial plexus, a group of nerves that runs from the lower neck to the upper shoulders and controls movement and sensation in the arms. (Mount Sinai, 2022) Possible injuries that affect these nerves include: (Smith, S. M. et al., 2021)

A herniated disc caused by aging or trauma causes the disc to leak out and press on the nerve root.
Burner or stinger injuries that affect the neck and shoulders.
Backpacker’s palsy is caused by pressure on the shoulders.
Birth injuries such as Erb-Duchenne’s palsy and Klumpke’s palsy.
Traumatic nerve root avulsion injury in which spinal nerves are damaged.

Diseases and disorders that can cause numbness in the arms include conditions that affect the nervous system, like multiple sclerosis, fibromyalgia, Raynaud phenomenon, and shingles. (National Heart, Lung, and Blood Institute, 2023) (Smith, S. M. et al., 2021)

Numbness and Serious Health Conditions

Stroke

This is a medical emergency in which a blockage prevents blood from getting to the brain.
One sign of a stroke is a tingling sensation on one side of the body.
Individuals may also be unable to move one or more limbs. (Centers for Disease Control and Prevention, 2024)
Seek emergency medical care.

Heart Disease

When the heart is damaged, blood cannot circulate and can lead to a minor or major heart attack.
Signs of a heart attack include numbness in one or both arms, and it is not always the left arm. (National Heart, Lung, and Blood Institute, 2022)
Pressure pain in the chest and shortness of breath are other signs that require immediate medical attention.

Spinal Osteoarthritis

Wear and tear in the spine’s joints can lead to spinal stenosis, the narrowing of the spinal canal that causes the nerves to be compressed. (National Institute of Arthritis and Musculoskeletal and Skin Diseases, 2023)
Physical therapy and medication can manage spinal stenosis.

Cancer

Neoplasm tumors can affect the brachial plexus nerves, causing loss of feeling in the arms.
Breast and lung cancers are the most likely. (Smith, S. M. et al., 2021)

Diabetes

Loss of feeling in the arms can be a sign of peripheral neuropathy, which can be caused by uncontrolled diabetes. (Johns Hopkins Medicine, 2024)
Treatment requires managing blood sugar and oral and topical medications.

Medication Numbness

The relationship between arm numbness and medication usage can be complex. (Senderovich H. and Jeyapragasan G. 2018)

Many medications, like gabapentin, can be used to alleviate the sensations of arm numbness.
Some medications can cause numbness as a side effect.
Some medications can cause complications, and arm numbness could be a symptom of those complications.

Inform healthcare providers about medications being taken to determine the relationship between them and any sensory changes.

Vitamin Deficiency

Peripheral neuropathy can also be caused by nutritional deficiencies and vitamin imbalances, which can damage nerves and cause sensation loss in the left or right arm. The most common sources are vitamin B12 deficiency and excess vitamin B6. (National Institute of Neurological Disorders and Stroke, 2024) Excessive alcohol consumption and other disorders that affect nutritional intake can also lead to nerve damage.

Injury Medical Chiropractic and Functional Medicine Clinic

At Injury Medical Chiropractic and Functional Medicine Clinic, our areas of practice include Chronic Pain, Personal Injury, Auto Accident Care, Work Injuries, Back Injury, Low Back Pain, Neck Pain, Migraine Headaches, Sports Injuries, Severe Sciatica, Scoliosis, Complex Herniated Discs, Fibromyalgia, Chronic Pain, Complex Injuries, Stress Management, Wellness & Nutrition, Functional Medicine Treatments, and in-scope care protocols. We focus on what works for you to relieve pain and restore function. If other treatment is needed, individuals will be referred to a clinic or physician best suited to their injury, condition, and/or ailment.

Chiropractic Care: The Natural Way to Recover From Injuries

References

National Institute of Neurological Disorders and Stroke. (2024). Paresthesia. Retrieved from www.ninds.nih.gov/health-information/disorders/glossary-neurological-terms#paresthesia

Bryan, L., Singh, A. Sleep Foundation. (2024). Numbness in Hands While Sleeping: Causes and Remedies. www.sleepfoundation.org/physical-health/numbness-in-hands-while-sleeping

Mount Sinai. (2022). Brachial plexopathy. www.mountsinai.org/health-library/diseases-conditions/brachial-plexopathy

Smith, S. M., McMullen, C. W., & Herring, S. A. (2021). Differential Diagnosis for the Painful Tingling Arm. Current sports medicine reports, 20(9), 462–469. doi.org/10.1249/JSR.0000000000000877

National Heart, Lung, and Blood Institute. (2023). Vasculitis. Retrieved from www.nhlbi.nih.gov/health/vasculitis/symptoms#:~:text=Nerve%20problems%2C%20including%20numbness%2C%20tingling,can%20also%20occur%20with%20vasculitis.

Centers for Disease Control and Prevention. (2024). Stroke signs and symptoms. Retrieved from www.cdc.gov/stroke/signs-symptoms/?CDC_AAref_Val=https://www.cdc.gov/stroke/signs_symptoms.htm

National Heart, Lung, and Blood Institute. (2022). What Is a Heart Attack? Retrieved from www.nhlbi.nih.gov/health/heart-attack

National Institute of Arthritis and Musculoskeletal and Skin Diseases. (2023). Spinal Stenosis Basics. Retrieved from www.niams.nih.gov/health-topics/spinal-stenosis/basics/symptoms-causes

Johns Hopkins Medicine. (2024). Peripheral Neuropathy. www.hopkinsmedicine.org/health/conditions-and-diseases/peripheral-neuropathy

Senderovich, H., & Jeyapragasan, G. (2018). Is there a role for combined use of gabapentin and pregabalin in pain control? Too good to be true?. Current medical research and opinion, 34(4), 677–682. doi.org/10.1080/03007995.2017.1391756

National Institute of Neurological Disorders and Stroke. (2024). Peripheral Neuropathy. Retrieved from www.ninds.nih.gov/health-information/disorders/peripheral-neuropathy

Unwrapping the Nutritional Facts of Marshmallows

By

Dr. Alex Jimenez

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Woman Enjoying Sweet Snacks at Work Close Up — Close up of young woman enjoying sweet snacks while working at home office, focus on hand holding marshmallow, copy space

Marshmallows and calories can add up when eating more than a single serving. Can marshmallows be consumed in moderation and still be healthy?

Table of Contents

Marshmallows

Many enjoy marshmallows with hot chocolate, sweet potatoes, and s’mores. However, their nutritional value is not the healthiest, as the ingredients typically include water, sugar, corn syrup, gelatin, and sometimes other ingredients for flavor and color. The key ingredient is whipped air, giving marshmallows their signature texture.

Nutrition

A serving weighs about 28 grams, around four large marshmallows or a half-cup of mini marshmallows. If consumed in their original form, they contain about 80 calories. (United States Department of Agriculture, 2018)

Carbohydrates

Marshmallows are made of different types of sugar (sucrose and corn syrup), and most of their calories come from carbohydrates. One marshmallow contains a little under 6 grams of carbohydrates, and a single serving provides about 23 grams of carbohydrates, primarily sugar. The glycemic index is estimated to be 62, making it a high-glycemic food. The estimated glycemic load of one marshmallow is 15, which is low. However, the glycemic load takes serving size into account. Because the serving size is small, the glycemic load is lower than expected.

Fats

Very little fat, less than 1 gram, is in a single serving.

Protein

Marshmallows are not a recommended source of protein.
There is less than 1 gram of protein in a single serving.

Micronutrients

There is no significant vitamin or mineral intake by consuming marshmallows.
A single serving does contain a small amount of phosphorus, around 2.2 milligrams, and potassium, around 1.4 milligrams.
It also increases sodium intake by 22.4 mg, providing little selenium 0.5 micrograms.

Health Benefits

Marshmallows are processed and provide little to no health benefits, but there are ways to include them in a balanced, healthy diet. They are a low-calorie, nearly fat-free food, so for those watching their weight, eating a marshmallow is a quick and easy way to satisfy a sweet tooth. Also, adding marshmallows to certain foods might help increase the intake of healthy vegetables, such as adding marshmallows to sweet potatoes, which are almost always gluten-free. For gluten-intolerant individuals, marshmallows are probably safe to consume. Some brands have also developed vegan marshmallows that use tapioca starch or agar instead of gelatin.

Storage

Marshmallows have a long shelf life. A bag can last up to six or eight months if not opened. They can last four months or less if the bag is open. Some can be purchased in an airtight tin and stored that way. However, they are most often in a plastic bag. Therefore, they should be placed in an airtight plastic container or sealed tightly after opening. Marshmallows do not need refrigeration, but many cooks freeze them to make them last longer. An unopened bag can be frozen, forming cubes that may stick together. To prevent sticking, dust with powdered sugar and place in an airtight container. When they are thawed, they regain their fluffy texture.

Allergies

Allergies are rare. However, those allergic to gelatin may want to avoid marshmallows since gelatin is a primary ingredient in almost all prepared and homemade versions.(Caglayan-Sozmen S. et al., 2019)

Injury Medical Chiropractic and Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic providers use an integrated approach to create customized plans for each patient and restore health and function to the body through nutrition and wellness, chiropractic adjustments, functional medicine, acupuncture, Electroacupuncture, and sports medicine protocols. If other treatment is needed, patients will be referred to a clinic or physician best suited for them. Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, nutritionists, and health coaches to provide the most effective clinical treatments.

Balancing Body and Metabolism

References

United States Department of Agriculture. FoodData Central. (2018). Candies, marshmallows. Retrieved from fdc.nal.usda.gov/fdc-app.html#/food-details/167995/nutrients

Caglayan-Sozmen, S., Santoro, A., Cipriani, F., Mastrorilli, C., Ricci, G., & Caffarelli, C. (2019). Hazardous Medications in Children with Egg, Red Meat, Gelatin, Fish, and Cow’s Milk Allergy. Medicina (Kaunas, Lithuania), 55(8), 501. doi.org/10.3390/medicina55080501

Navigating the Healing Stages: Neck and Back Injuries Explained

By

Dr. Alex Jimenez

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Experienced physical therapist conducting spinal palpation in patient — Qualified physiotherapist palpating paraspinal muscles of adult Caucasian man in standing position

Can knowing the characteristics of each stage of healing help expedite recovery for individuals who are healing after neck and back injuries?

Table of Contents

Back or Neck Injury Healing Stages

At each stage, different things happen at the injury site. This means recommended exercises and activity levels will vary depending on how long it’s been since the injury. The stages to know about when healing from a neck or back injury. (Brumitt J., and Cuddeford T. 2015)

Inflammation or Acute Stage

Also known as the inflammatory stage, the acute stage occurs during the injury and can continue for 72 hours. The body releases repair chemicals in response to tissue damage, causing inflammation and pain. Symptoms of inflammation, including redness, swelling, pain at rest, and diminished function, are expected. Inflammation and pain during the inflammation stage are caused by the body’s repair chemicals released in response to tissue damage. (Wu, Y. S. and Chen S. N. 2014) The biological reaction decreases mobility so the injured area can rest and heal, but the substances that promote healing also cause pain and swelling. (Shah A. and Amini-Nik S. 2017) Scar tissue also begins to form during the inflammatory stage. (Wilgus T. A. 2020) Initial treatment focuses on reducing pain, swelling, and muscle spasms. Individuals are encouraged to use ice packs, compression, and over-the-counter anti-inflammatory medications like ibuprofen or naproxen. (Duchesne E., Dufresne S. S., and Dumont N. A. 2017)

Subacute Stage

Inflammation decreases, and new connective tissue and capillaries grow to help repair damaged structures. The subacute phase generates new connective tissue and capillary growth and reduced inflammation. (Brumitt J., and Cuddeford T. 2015) Scar tissue continues to grow during this time, as well. The tissues are still fragile at this stage, stressing the injured area should be limited to when the therapist or doctor is examining or working with the patient. Most physical therapists recommend beginning with gentle movement during the subacute phase and gradually building up the intensity of exercise. Mild isometric and low-intensity exercises are often used. Because activity is restricted, the muscles may seem weak. Depending on the severity of the injury and the type of tissue that was injured (i.e., tendons have less blood circulation and tend to heal more slowly, it can take a few days to several weeks. (Brumitt J., and Cuddeford T. 2015)

The Chronic Stage or Maturation

The inflammation disappears entirely during the chronic or maturation stage of neck or back injury healing. The new collagen fibers build strength, and the wound shrinks. (Brumitt J., and Cuddeford T. 2015) During this stage, pain associated with the injury tends to be limited to the end joint’s range of motion. The first ten weeks of the chronic stage are essential for engaging in exercises that enhance healing and help remodel the fibers so they will function as close as possible to the way they did before the injury. (Azevedo P. S. et al., 2016) Exercises during the ten weeks are important because otherwise, individuals can permanently lose some of their ability to move and function.

After around ten weeks, the scar tissue can permanently change, so re-acquiring strength and flexibility may necessitate surgery or manual release treatment from a physical therapist or chiropractor. During this time, the scar tissue can be remodeled with exercise, meaning that the activities and motions performed on the injured area will affect the formation of new tissue fibers. The chronic stage of healing begins after 21 days and doesn’t end after the 10-week prime time (Brumitt J., and Cuddeford T. 2015). It can continue for quite some time.

Treatment

Treatment focuses on engaging the injured muscles in light isometric contractions to help align new collagen fibers. Physical therapy helps rebuild mobility, strength, balance, and flexibility and can also help learn about injury and how to recover. A treatment that may also help during these phases is massage therapy. Extended bed rest or immobility can prolong symptoms and delay recovery. Tips to manage pain and recovery:

When sitting for long periods, get up and move around frequently.
Wear comfortable shoes.
When driving long distances, stop frequently to stand up and walk around.
Sleep on the side with a small pillow between the knees.
Limit how much weight is carried.
Add exercises gradually.

Most symptoms of back strain or sprain improve in about two weeks. Individuals may need additional treatment if symptoms continue for longer than two weeks. Maintaining exercises will continue to make the body stronger, more flexible, more functional, and pain-free.

Chiropractic Care for Healing After Trauma

References

Brumitt, J., & Cuddeford, T. (2015). CURRENT CONCEPTS OF MUSCLE AND TENDON ADAPTATION TO STRENGTH AND CONDITIONING. International journal of sports physical therapy, 10(6), 748–759.

Wu, Y. S., & Chen, S. N. (2014). Apoptotic cell: linkage of inflammation and wound healing. Frontiers in pharmacology, 5, 1. doi.org/10.3389/fphar.2014.00001

Shah, A., & Amini-Nik, S. (2017). The Role of Phytochemicals in the Inflammatory Phase of Wound Healing. International journal of molecular sciences, 18(5), 1068. doi.org/10.3390/ijms18051068

Wilgus T. A. (2020). Inflammation as an orchestrator of cutaneous scar formation: a review of the literature. Plastic and aesthetic research, 7, 54. doi.org/10.20517/2347-9264.2020.150

Duchesne, E., Dufresne, S. S., & Dumont, N. A. (2017). Impact of Inflammation and Anti-inflammatory Modalities on Skeletal Muscle Healing: From Fundamental Research to the Clinic. Physical therapy, 97(8), 807–817. doi.org/10.1093/ptj/pzx056

Azevedo, P. S., Polegato, B. F., Minicucci, M. F., Paiva, S. A., & Zornoff, L. A. (2016). Cardiac Remodeling: Concepts, Clinical Impact, Pathophysiological Mechanisms and Pharmacologic Treatment. Arquivos brasileiros de cardiologia, 106(1), 62–69. doi.org/10.5935/abc.20160005

Gym or Home: Factors to Consider for Your Fitness Routine

By

Dr. Alex Jimenez

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Blue home gym with black and yellow fitness equipment — Blue home gym with punching boxer,cyle and other fitness equipment - 3d rendering

Individuals getting into fitness may wonder whether they should join a gym or exercise at home. Is there an advantage to one versus the other?

Gym or Home

Exercising, whether at the gym or at home, depends on individual preference and budget. The first step is committing to a fitness health plan. Where to work out depends on the individual and their characteristics. For those who are self-motivated and will exercise no matter what, a home workout may be the best option. (Essery R. et al., 2017) Going to a gym may be a better choice for those who find too many distractions at home and other things to do besides the workout, like laundry, checking the phone, cleaning, etc. Working out at home is convenient; it takes driving out of the equation, changing into gym clothes, and going at the right time. However, the gym provides fewer distractions, community access, equipment like weights and cardiovascular machines, and group fitness classes. Each has pros and cons.

Pros and Cons – The Gym

Pros

Gym features and resources
Motivation
Focus
Classes
Community

Cons

Membership fees
Inconvenience
Too many people

Pros of a Gym

Features and Resources

Exercise can be so much easier when there are plenty of options.
There are various machines, such as treadmills, ellipticals, stair climbers, stationary bikes, and rowing machines.
Weights and machines, free weights, cable machines, bands, and more.

Motivation

Paying for a membership can be a motivating factor to regularly working out.
There is a friendly, competitive vibe with the other members who can help motivate each other.

Focus

Exercising at the gym can help maintain focus on fitness goals.
No chores, kids, or distractions to break off from the workouts.

Classes

Working out in a class can increase motivation and make working out fun.
There are online classes for working out at home, but it’s not the same as going to the gym and being around people.
Other features like a swimming pool, hot tub, tennis courts, etc may be available.

Community

Working out with others can give a sense of community.
People draw energy from others, pushing us to work harder.

Cons of a Gym

Gym membership drawbacks.

Cost

Membership fees can cause stress.
Some high-end gyms charge more than $100 monthly, while smaller gyms may charge only $10.

Inconvenience

Going to the gym includes packing a bag, driving there, parking, and waiting for the machines, weights, etc.
Total time will be longer because of the drive time.

Too Many People

At times, the gym can be packed with people.
Sometimes, individuals talk too loudly on their phones, leave sweat on the machines, and do not put weights away.
These could be the days or nights to work out at the house.

At Home Workouts

Pros

Cost
Convenience
Mix workouts

Cons

Space
Excuses
Boredom

Pros at Home

For some, home workouts could be the better option, and the benefits include:

Cost

There’s no membership fee.
Individuals can do bodyweight workouts that require no equipment.
Develop a house gym with inexpensive resistance bands, a few weights, and an exercise ball.

Convenience

Individuals do not have to get their gym bag, drive, and arrange for child care.
Individuals can work out in pajamas or underwear.
Individuals can also work out whenever they like if they need to split their workouts or work out at a specific time.

Mix Workouts

Although gyms also mix things up, individuals can do it at home at their convenience.
Combining weights and cardio and finishing up with yoga.
Individuals can go outside, watch exercise videos, stream live classes, use fitness mirrors, play exercise games, or download workout apps.
There is also versatile home gym equipment.

Cons at Home

These can cause individuals to lose home workout motivation.

Space

Although not much space is needed to work out, wanting to use a treadmill or other large equipment might not be practical, which could lead to boredom.

Excuses

There can be endless excuses to skip a workout.
Individuals who are not self-motivated might avoid workouts with chores or other important home tasks.

Boredom

At a gym, there is energy potential that motivates individuals to move.
If there is not enough exercise variety at home, boredom can set in.

Injury Medical Chiropractic and Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic treats patients’ injuries and chronic pain syndromes. We focus on improving ability through flexibility, mobility, and agility programs tailored to the individual. We use in-person and virtual health coaching and comprehensive care plans to ensure every patient’s personalized care and wellness outcomes. Our providers use an integrated approach to create customized care plans that include Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine principles. Our goal is to relieve pain naturally by restoring health and function to the body. Suppose he feels the individual needs other treatment. In that case, they will be referred to a clinic or physician best suited for them. Dr. Jimenez has teamed up with the top surgeons, clinical specialists, medical researchers, and premier rehabilitation providers to provide our community with the best clinical treatments.

The Right Way To Implement an Exercise Prescription

References

Essery, R., Geraghty, A. W., Kirby, S., & Yardley, L. (2017). Predictors of adherence to home-based physical therapies: a systematic review. Disability and rehabilitation, 39(6), 519–534. doi.org/10.3109/09638288.2016.1153160

When to Replace Walking Shoes: Maintaining Optimal Support

By

Dr. Alex Jimenez

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Close-up portrait of young woman in sportswear, jogging in the park by the sea, holding a smartphone — Close-up portrait of a young woman in sportswear, jogging in the park by the sea, holding a smartphone, talking on the phone. The concept of sports and communications. Cyberspace. Sunbeam of light.

For individuals who enjoy walking for exercise and health, can knowing when to replace walking shoes help protect their feet and prevent musculoskeletal injuries?

Replacing Walking Shoes

The best walking shoes must be replaced to ensure musculoskeletal health and prevent injuries. Wearing worn-out shoes during prolonged standing, distance walking or running, and high-impact workouts can exacerbate lower back stiffness, soreness, and pain. Comfortable walking shoes offer substantial support and superior cushioning, working to alleviate discomfort and prevent injury. However, they break down cushioning and support with each step. When an individual walks or runs 500 miles, most athletic shoes are ready for replacement and should be recycled or saved for non-exercise purposes.

500-Miles

Most athletic shoes are built to last 350 to 500 miles. (Cook, S. D., Kester, M. A., and Brunet, M. E. 1985) Walkers’ feet don’t impact their feet as hard as runners’, but individuals are unlikely to feel support and cushioning past 500 miles. Weight is also a factor; the more an individual weighs, the faster their shoes wear down.

It is recommended that individuals who walk 30 minutes daily or an average of three to four hours a week replace their shoes every six months.
Individuals who walk 60 minutes daily or seven hours weekly replace their shoes every three months.
Replace walking shoes every three to six months or every 500 miles.

Shoe Wear

When athletic shoes are glued together, they start to wear from the factory to the stores as the adhesive dries out. The air pockets in the cushioning slowly begin to dissipate. Walking shoes are often on sale when old models are discontinued and may already be over a year old. To get the longest life, buy the current model and ask staff how long they have been on the shelf.

Shoe Care

Shoes can last longer by following a few guidelines:

Use walking Shoes only for Walking Exercise

It is recommended not to wear them for daily use.
Use them only for walking.
Wearing them all day exposes them to foot moisture and bacteria, breaking them down faster.

Air Out Shoes Between Uses

Store walking shoes where they are exposed to air so they can dry out completely between uses.
Keeping them in a gym bag won’t allow them to breathe.

Wash Shoes and Air Dry

When washing walking shoes, use gentle soap and cold water to prevent the glue from breaking down.
Always air dry rather than placing them in a dryer.
Avoid heat, as this will contribute to faster glue breakdown.

Replace the Insoles

Individuals who prefer custom insoles should replace them each time shoes are replaced.
However, changing the insole is not a substitute for replacing the shoe.
Cushioning insoles do not provide the same support.
A new insole will not fix a broken-down walking shoe.

Rotate Walking Shoes

Alternate walking shoes every one to two months. The feet sense the difference when the older pair begins to break down. For individuals who walk one or more times daily, alternating shoes allow each pair to dry out fully between uses. Having two pairs of walking shoes to alternate will keep you from replacing them more frequently.

Signs It’s Time

Many wait until their shoes look worn out, with holes and torn laces, before considering replacing them. Here are a few guidelines for when to replace walking shoes:

Worn Tread

Many of today’s walking shoes change color through the sole to alert the individual.
If green turns to pink or some other combination, it’s time to replace the shoes.

Overpronation or Supination

This can lead to the heel of the shoe being worn down on one side more than the other.
This can affect your gait, making it important to replace your walking shoe.

Wrinkles On The Side or Bottom Of The Sole

The breakdown of support and cushioning can cause this.

Weak Ankle Support

This is usually from the uppers being broken down around the ankle.

Wear Patterns

Where and how the soles and heels of walking shoes are worn can tell a foot and shoe professional which shoes the individual should wear. It is recommended that used shoes be taken to the shoe store. They can indicate overpronation, a neutral gait, or supination.

Risks

The risks of wearing worn-out walking shoes include:

Lack of cushioning and support can lead to foot, knee, or leg pain.
Injuries include plantar fasciitis and iliotibial band syndrome. (Rethnam, U., and Makwana, N. 2011)
Individuals who notice new soreness and aches may indicate that the shoes need replacing.

Recycling

Keeping one or two pairs of used walking shoes is great for household chores. They can also be recycled or donated. Recycled walking shoes are used to make playground and track surfaces. Look for a shoe bin at a community recycling center or athletic shoe store. Shoes in decent condition can be donated to charity clothing centers.

Injury Medical Chiropractic and Functional Medicine Clinic

At Injury Medical Chiropractic and Functional Medicine Clinic, our areas of practice include Wellness & Nutrition, Chronic Pain, Personal Injury, Auto Accident Care, Work Injuries, Back Injury, Low Back Pain, Neck Pain, Migraine Headaches, Sports Injuries, Severe Sciatica, Scoliosis, Complex Herniated Discs, Fibromyalgia, Chronic Pain, Complex Injuries, Stress Management, Functional Medicine Treatments, and in-scope care protocols. We focus on what works for you to achieve improvement goals and create an improved body through research methods and total wellness programs. If other treatment is needed, individuals will be referred to a clinic or physician best suited to their injury, condition, and/or ailment.

Custom Foot Orthotics Benefits

References

Cook, S. D., Kester, M. A., & Brunet, M. E. (1985). Shock absorption characteristics of running shoes. The American journal of sports medicine, 13(4), 248–253. doi.org/10.1177/036354658501300406

Rethnam, U., & Makwana, N. (2011). Are old running shoes detrimental to your feet? A pedobarographic study. BMC research notes, 4, 307. doi.org/10.1186/1756-0500-4-307

Level Up Your Everyday Routine with Daily Massage Gun Self Care

By

Dr. Alex Jimenez

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Girl at home holding a therapeutic percussion vibrating massage gun in her hand and massaging her back muscles Sports recovery concept after a workout. . High quality photo

Therapeutic massage guns are great for athletes and fitness enthusiasts. Can daily massage gun use be incorporated into a daily routine?

Table of Contents

Daily Massage Gun Use

Athletes or individuals participating in recreational sports and exercise may want to consider adding a massage gun to their daily routine. Massage guns create short, repeated bursts of pressure on certain areas of the body. Most massage guns have multiple settings to allow for different preferences and levels of intensity. They can help by warming up the muscles and during recovery. While the benefits are still being researched, daily massage gun therapy can improve the quality of physical activity, exercise, and life.

Benefits

Because massage guns work by softly and repeatedly stimulating or massaging the muscles, they are gentle enough to use daily as long as they are used correctly. They offer several benefits, including increasing physical ability and reducing recovery time. One study found that consistently using a massage gun increased the quality of life in fibromyalgia patients, indicating potential beyond exercise and sports. (Kraft, K., Kanter, S., and Janik, H. 2013) Some of the benefits include:

Decrease Muscle Soreness

Delayed-onset muscle Soreness/DOMS is a feeling of soreness experienced after a workout or intense manual labor. An example is waking up and feeling sore from work or exercising the previous day (National Academy of Sports Medicine, 2024). A study compared the effectiveness of vibration and massage therapy on DOMS. Both were found to be equally effective in preventing delayed onset muscle soreness. (Imtiyaz, S., Veqar, Z., and Shareef, M. Y. 2014)

Help Prevent Muscle Fatigue

Muscle fatigue occurs when the muscles are overworked and cannot function. Reduced muscle performance can lead to shorter workouts and injuries. A study on non-athletic males found that massage therapy helped prevent or reduce muscle fatigue. Researchers also found that different massage gun settings prevented or prolonged the onset of muscle fatigue. (Otadi, K. et al., 2019)

Increase Range of Motion

Range of motion/ROM describes the flexibility of a muscle or joint in the body. When engaging in physical activity or exercise, it is vital to know and consider the range of motion of the joints to ensure proper form and decrease the risk of injury. One study found that massage therapy can improve joint performance by increasing an individual’s range of motion. (Lyu, B. J. et al., 2020) The performance of the joints depends in part on the muscles that expand and contract to move it. Another research study found that a five-minute massage on certain muscle groups improved muscle performance and range of motion. (Konrad, A. et al., 2020)

Increase Muscle Strength and Endurance

Muscle strength and endurance are key components of a healthy musculoskeletal system and are essential to avoid straining or overworking muscles. Muscle strength describes the immediate performance of a muscle or muscle group, and muscle endurance describes how long performance can be sustained. (Lyu, B. J. et al., 2020) Massage therapy has been shown to improve muscle strength and endurance by helping increase immediate performance and the number of repetitions an individual can endure. (García-Sillero, M. et al., 2021)

Improve Agility

Agility is the ability to accelerate, decelerate, stabilize, and quickly change directions while maintaining proper posture. (National Academy of Sports Medicine, 2024) It is a skill that needs to be developed. One study found that engaging in massage therapy before a workout could improve agility. (Lyu, B. J. et al., 2020)

Daily Use

A massage gun is safe to use daily as long as it is used properly. Using a massage device correctly will improve effectiveness and prevent discomfort or injury. Recommended daily usage of a massage gun includes:

Set the massage gun to the lowest setting.
Use a light touch.
Adjust the speed to comfort level, ensuring there is no pain.
Focus the massage gun on an area for 10 to 30 seconds.
Hover it across the muscle or tendon to allow the vibrations to do their job.
Do this over the desired areas as part of a warm-up and cool-down.

Safety

While massage guns are useful for warmups and workout recovery, they should be used cautiously. Individuals should use massage guns over muscles and not on bony or sensitive areas. Individuals should avoid massaging around vital organs and/or inflamed body areas as these areas could cause a jarring or uncomfortable sensation and lead to injury. If the massage gun is causing bruising, sensitivity, or discomfort, stop using it and allow the body to recover before trying again. If pain persists, talk to a healthcare provider or a physical therapist. They can determine what is causing issues, whether a massage gun is being used correctly, and whether it is an appropriate self-care treatment for the individual. There are situations where using a massage gun is not advised. Individuals should talk to a healthcare provider before using the device if they have any of the following:

Have a musculoskeletal condition like osteoporosis or arthritis.
Take blood thinners.
Have anemia.
Have other blood-related conditions.
Are older than 65.
Take several medications.
Have a broken bone or a fracture.
Have varicose veins or a history of deep vein thrombosis.

Using a massage gun can help improve performance and reduce recovery time and can be incorporated into a daily routine.

Injury Medical Chiropractic and Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic treats patients’ injuries and chronic pain syndromes. We focus on improving ability through flexibility, mobility, and agility programs tailored to the individual. We use in-person and virtual health coaching and comprehensive care plans to ensure every patient’s care and wellness outcomes. Our providers use an integrated approach to create customized care plans that include Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine principles. Our goal is to relieve pain naturally by restoring health and function to the body. Patients who need other treatment will be referred to a clinic or physician best suited for them. Dr. Jimenez has teamed up with the top surgeons, clinical specialists, medical researchers, and premier rehabilitation providers to provide our community with the best clinical treatments.

Enhance Your Lifestyle With Chiropractic!

References

Kraft, K., Kanter, S., & Janik, H. (2013). Safety and effectiveness of vibration massage by deep oscillations: a prospective observational study. Evidence-based complementary and alternative medicine : eCAM, 2013, 679248. doi.org/10.1155/2013/679248

National Academy of Sports Medicine. Kaminski, J. (2024). Muscle soreness & DOMS. NASM. blog.nasm.org/doms-muscle-sorenes

Imtiyaz, S., Veqar, Z., & Shareef, M. Y. (2014). To Compare the Effect of Vibration Therapy and Massage in Prevention of Delayed Onset Muscle Soreness (DOMS). Journal of clinical and diagnostic research : JCDR, 8(1), 133–136. doi.org/10.7860/JCDR/2014/7294.3971

Otadi, K., Ghasemi, M., Jalaie, S., Bagheri, H., Azizian, M., Emamdoost, S., Sarafraz, H., & Sepahvand, M. (2019). A prophylactic effect of local vibration on quadriceps muscle fatigue in non-athletic males: a randomized controlled trial study. Journal of physical therapy science, 31(3), 223–226. doi.org/10.1589/jpts.31.223

Lyu, B. J., Lee, C. L., Chang, W. D., & Chang, N. J. (2020). Effects of Vibration Rolling with and without Dynamic Muscle Contraction on Ankle Range of Motion, Proprioception, Muscle Strength and Agility in Young Adults: A Crossover Study. International journal of environmental research and public health, 17(1), 354. doi.org/10.3390/ijerph17010354

Konrad, A., Glashüttner, C., Reiner, M. M., Bernsteiner, D., & Tilp, M. (2020). The Acute Effects of a Percussive Massage Treatment with a Hypervolt Device on Plantar Flexor Muscles’ Range of Motion and Performance. Journal of sports science & medicine, 19(4), 690–694.

García-Sillero, M., Jurado-Castro, J. M., Benítez-Porres, J., & Vargas-Molina, S. (2021). Acute Effects of a Percussive Massage Treatment on Movement Velocity during Resistance Training. International journal of environmental research and public health, 18(15), 7726. doi.org/10.3390/ijerph18157726

National Academy of Sports Medicine. Miller, K. (2024). Speed, agility, and quickess: SAQ. NASM. blog.nasm.org/sports-performance/speed-agility-quickness-saq

The Distinct Nutritional Makeup of Honey and Maple Syrup

By

Dr. Alex Jimenez

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A stack of plain mini pancakes served with honey, maple syrup and jam over a white background.

For individuals who like sweet foods but want to maintain health, how do honey and maple syrup compare nutritionally?

Table of Contents

Honey and Maple Syrup

Reducing sugar intake is recommended for overall health, but that does not mean eliminating sweeteners completely for most. Honey and maple syrup can flavor various dishes, baked goods, beverages, and more. Because of their natural origins, honey and maple syrup can seem interchangeable as they are brown, thick, and sweet. Maple syrup and honey can be part of a healthy diet in moderation, sweetening everything from breakfast to dinnertime dishes. Depending on individual dietary goals or taste preferences, individuals may have a personal favorite, but neither is better than the other. The nutritional makeup of these two sweeteners is distinct, and there are recommended practices for when to include each in cooking and baking.

Nutrition

Honey is slightly higher in calories, carbohydrates, and sugar than maple syrup and somewhat lower in fat. Maple syrup comprises more micronutrients, such as calcium and manganese, but it also has more sodium than honey. Nutrition information for

One tablespoon of maple syrup (20 grams) (U.S. Department of Agriculture, 2018)
Honey (21 grams) (U.S. Department of Agriculture, 2018).

For food-labeling purposes, honey and maple syrup have different serving sizes:

One tablespoon of honey
1/4 cup of maple syrup

Nutritional Comparison

Honey 1 tbsp. Maple syrup 1 tbsp.

Calories: 64 – 52
Fat: 0g – >1g
Sodium: >1mg – 2.4mg
Carbohydrates: 17.3g – 13.4g
Fiber: >1g – 0g
Sugars: 17.2g – 12.1g
Protein: >1g – >1g
Calcium: 1.26mg – 20.4mg
Manganese: 0.17mg – 0.582mg
Zinc: 0.046mg – 0.294mg
Riboflavin: 0.008mg – 0.254mg

Similarities

Honey and maple syrup are similar liquid sweeteners nutritionally. Both contain no substantial amount of fat or protein, with carbohydrates from sugar supplying all their calories. Both also contain some micronutrients and antioxidants. Research has revealed promising levels of antioxidants in honey (Schramm, D. D. et al., 2003) and maple syrup (Li, L., and Seeram, N. P. 2011) that could contribute to reducing oxidative stress, a key component in preventing some chronic diseases.

Differences

The nutrition differences between maple syrup and honey are more significant. Although a tablespoon of honey has only eight more calories than maple syrup, this can add up depending on the amount used. In a quarter cup, honey contains 32 more calories than maple syrup or 128 more calories in 1 cup. The carbohydrate count of maple syrup and honey is similar, but there is a difference of one teaspoon of added sugar. Honey and maple syrup are not identical in micronutrient levels. Honey contains small amounts of vitamins C and B, but individuals would have to consume a lot of honey to receive the benefits. In 100 grams, around five tablespoons of honey, individuals receive about 1% of the RDA for vitamin C. Maple syrup is a healthy source of manganese, riboflavin, and zinc.

Health Benefits

Honey Health Benefits

Honey’s antioxidants help clean cells of damaging free radicals. It can also be used as food and medicine during cold and flu season. Research has shown that a spoonful could be a more effective treatment for a cough than over-the-counter medications. (Oduwole, O. et al., 2018) Those with allergies may want to consider visiting a local beekeeper. While inconclusive, some studies (Asha’ari, Z. A. et al., 2013) have found that eating local raw honey can help improve seasonal allergy symptoms.

Maple Syrup Health Benefits

Maple syrup offers health benefits, particularly because it contains high amounts of manganese and riboflavin. Manganese is a trace mineral the body does not need very much of but does need to operate efficiently. It is essential to bone and tissue formation, blood clotting, proper immune response, and sexual function. Riboflavin helps create usable energy from food and could help prevent cancer and migraines. (National Institutes of Health Office of Dietary Supplements, 2022) Maple syrup also offers benefits for individuals with certain chronic health conditions. Its lower glycemic index makes it recommended for those with diabetes or other blood sugar conditions. Because of the type of sugar it contains, those with irritable bowel syndrome/IBS may be able to digest maple syrup better than honey. Maple syrup and honey both contain simple sugars; however, fructose in honey may not be digested as well in individuals with IBS who need a low FODMAP diet.

Preparation and Cooking

Honey and maple syrup have distinctive flavors, so the individual can choose where and when to use each. Maple syrup has a more earthy, woodsy taste, while honey has floral hints and a thicker texture. Honey does well in salad dressings and marinades, where it can cling to other foods, whereas maple syrup blends easily in baked goods. Both work well in various food preparations. Rules of thumb for using honey and maple syrup include:

Both can be used in place of sugar as long as the liquid in the recipe is adjusted.
For every cup of sugar replaced by honey or maple syrup, decrease other liquid ingredients by three to four tablespoons.
Scaling back a little is recommended if using either as a substitute for table sugar.
Both maple syrup and honey are sweeter than sugar; replacing sugar requires only three-fourths of either.

Lifestyle and Safety

Sometimes, when to use honey and maple syrup has nothing to do with nutrition or taste. Vegans, for example, often choose not to consume honey because it’s an insect by-product. A vegan lifestyle may prefer maple syrup, which is 100% plant-based. Parents of infants under one should keep honey off the menu. Honey can contain small amounts of the bacteria Clostridium botulinum, which can cause botulism poisoning in babies; for babies under 12 months old, maple syrup or other sweeteners are recommended in baked goods or cooked meals. However, while honey can be harvested almost anywhere honeybees live, maple syrup is native only to a small region of eastern North America, and obtaining the syrup may not be possible.

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References

U.S. Department of Agriculture, FoodData Central. (2018). Syrups, maple. Retrieved from fdc.nal.usda.gov/fdc-app.html#/food-details/169661/nutrients

U.S. Department of Agriculture, FoodData Central. (2018). Honey. Retrieved from fdc.nal.usda.gov/fdc-app.html#/food-details/169640/nutrients

Schramm, D. D., Karim, M., Schrader, H. R., Holt, R. R., Cardetti, M., & Keen, C. L. (2003). Honey with high levels of antioxidants can provide protection to healthy human subjects. Journal of agricultural and food chemistry, 51(6), 1732–1735. doi.org/10.1021/jf025928k

Li, L., & Seeram, N. P. (2011). Further investigation into maple syrup yields 3 new lignans, a new phenylpropanoid, and 26 other phytochemicals. Journal of agricultural and food chemistry, 59(14), 7708–7716. doi.org/10.1021/jf2011613

Oduwole, O., Udoh, E. E., Oyo-Ita, A., & Meremikwu, M. M. (2018). Honey for acute cough in children. The Cochrane database of systematic reviews, 4(4), CD007094. doi.org/10.1002/14651858.CD007094.pub5

Asha’ari, Z. A., Ahmad, M. Z., Jihan, W. S., Che, C. M., & Leman, I. (2013). Ingestion of honey improves the symptoms of allergic rhinitis: evidence from a randomized placebo-controlled trial in the East coast of Peninsular Malaysia. Annals of Saudi medicine, 33(5), 469–475. doi.org/10.5144/0256-4947.2013.469

National Institutes of Health Office of Dietary Supplements. (2022). Riboflavin: Fact sheet for health professionals. Retrieved from ods.od.nih.gov/factsheets/Riboflavin-HealthProfessional/