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Sciatic Nerve Branches

By
Dr. Alex Jimenez
-

The sciatic nerve is formed through a combination of motor and sensory fibers based on the spinal nerves of the lower back L4 to S3, known as the lumbosacral plexus. It is the largest and longest nerve in the human body and about as wide as an adult thumb. It begins at the base of the spine, runs along the back of each leg, and ends at the foot supplying the areas with fresh blood and nutrients. There are sciatic nerve branches that consist of primary branches and smaller branches.

Sciatic Nerve Branches

Sciatic Nerve Branches

  • The nerve splits into two main branches near the back of the knee called the popliteal fossa.
  • This fossa is located slightly above the joint behind the knee.
  • The popliteal fossa is a diamond-shaped space that acts as the conduit for the blood vessels and nerves.

Primary branches

From the popliteal fossa:

  • The tibial nerve continues down the back of the calf to the heel and bottom of the foot.
  • The common peroneal nerve, aka common fibular nerve, travels sideways along the outer part of the knee to the outer border of the lower leg and foot.
  • Both nerves convert into small sensory nerves in the calf that supply the outer side of each foot.
  • These sensory nerves are called sural nerves.

Collateral branches

The sciatic nerve breaks off into smaller branches, known as collaterals, that include:

  • These are muscle branches that supply the muscles in the thigh, including the hamstring group and the adductor magnus muscles along the inner thigh.
  • Other small branches supply the leg and foot muscles.
  • Articular branches supply the back of the hip joint, the back and side of the knee joint.

The sciatic nerve does not supply structures in the buttocks; however, pain commonly radiates/spreads into this area when the nerve is impaired, impinged, and inflamed.

Blood Supply

The delivery of nutrients to the sciatic nerve is done through blood vessels that also contribute to the nerve’s function. Any interruption of blood flow to the sciatic nerve can cause pain and dysfunction. The sciatic nerve and the sciatic nerve branches receive their blood supply from two sources that include:

  • The extrinsic system is made up of nearby arteries and veins.
  • The intrinsic system includes arteries and veins that run along the nerve and are embedded deep in a sheath known as the epineurium of connective tissue that envelops the nerve.
  • The intrinsic blood supply can be affected by conditions like diabetes, which can contribute to symptoms associated with diabetic neuropathy.
  • Both systems connect at various junction points.

Nerve Function

The combination of sensory and motor fibers that make up the sciatic nerve provides the essential functions in the lower limbs allowing the body to:

  • Stand
  • Walk
  • Run
  • Climb
  • Lift

A healthy sciatic nerve is well protected around the low back and buttock muscles where it starts, and it cannot be palpated or felt by touching or pressing on the area. When the nerve gets inflamed, injured, or pinched, the leg can feel stiff and inflexible when trying to move and can lead to pain, weakness, and tingling in the lower back, buttock, leg/s, and feet.

Anatomical Variations of the Nerve

Individuals can have variations in the anatomical structure of the sciatic nerve. These variations are considered normal, but they can increase the risk of developing sciatica brought on by impingement, entrapment, or irritation of the nerve root/s. Variations in sciatic nerve branches include:

  • The nerve divides above the piriformis muscle; one portion passes through the piriformis, with the other portion exiting the pelvis below the muscle. This is the most common variation.
  • The nerve divides above the piriformis muscle; one portion passes through the piriformis, with the other portion exiting the pelvis above the muscle.
  • The nerve divides above the piriformis, with one portion traveling in front while the other travels behind it.
  • Undivided sciatic nerve exits through the piriformis muscle.
  • Undivided sciatic nerve exits from behind the top part of the piriformis.
  • Around 10% of individuals have a nerve that divides above the popliteal fossa and does not merge but courses down in two separate branches.

The sciatic nerve and the sciatic nerve branches are significant components of the body. It supplies motor functions to move the legs and feet and provides sensory functions along the nerve path. Keeping the sciatic nerve healthy is key in helping to prevent back and spinal issues. Chiropractic can help realign the sciatic nerve and educate on maintaining the nerve’s health.

Body Composition

Fitness Motivation

New workout routine

Individuals that don’t feel like returning to previous workout routines are recommended to try out other fitness options. If the gym isn’t cutting it or there is burnout with the current routine, switch things up. This can include:

  • Virtual group classes.
  • 1-on-1 personal training.
  • Outdoor activities.
  • All are valid options to explore if in a rut with the current routine.
  • The important thing is to find what works for you.

Allow the body to rest

Individuals may want to push it to the limit to get back into shape, but rest days are essential for healthy muscle development and improved performance.

  • Noticing the body is more sore and exhausted after a workout is an indication that the body needs rest. This also includes:
  • Maintaining proper hydration.
  • Stretching out the muscles regularly.
  • Taking days off from exercising are necessary to:
  • Prevent muscle fatigue.
  • Reduce the risk of injury.
  • Allow for adequate muscle recovery.

Long term commitment is key

It can be discouraging to commit to a workout schedule only to notice minor changes to strength and fitness.

  • However, small improvements do accumulate over time.
  • Small increases over time can have a huge impact on overall strength and fitness.
  • Keep the bigger picture in mind to remain positive.
References

Davis D, Vasudevan A. Sciatica. [Updated 2019 Feb 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK507908/

Barral J, Croibier A. Manual Therapy for the Peripheral Nerves. Elsevier Health Sciences; 2007.

Ryan MM, Jones HR Jr. Mononeuropathies. In: Neuromuscular Disorders of Infancy, Childhood, and Adolescence. Elsevier; 2015:243-273. doi:10.1016/b978-0-12-417044-5.00014-7

Cold Weather Muscle Spasms, Cramps

By
Dr. Alex Jimenez
-
Osteopathic assistant cracking back and shoulder bones for senior woman at chiropractic consultation. Chiropractor giving assistance to elder patient for recovery and rehabilitation

Muscle spasms also referred to as muscle cramps, are painful contractions and tightening of the muscles. They are common, involuntary, and unpredictable. Temperature drops and cold weather can cause the muscles and joints to contract and tighten, leading to spasms and pain. Chiropractic, physical therapy massage, exercises, stretching, and an anti-inflammatory diet can bring relief and help strengthen the muscles to prevent future episodes.

Cold Weather Muscle Spasms, Cramps

Muscle Spasms

Spasms are common and can affect any of the muscles. They can involve part of a muscle, all of a muscle, or several muscles in a group. Spasms occur when the muscle/s involuntary and forcibly contract uncontrollably and are unable to relax. The most common sites for muscle spasms include:

  • Hands
  • Arms
  • Abdomen
  • Back
  • Legs
  • Thighs
  • Calves
  • Thighs
  • Feet

How Cold Affects the Muscles

As the weather gets colder, this causes the muscles in the body to lose heat, causing them to contract. As a result, the muscles and joints become tighter, stiffer, and decrease mobility and range of motion. This forces the muscles to work harder than usual to compensate. This can increase the fatigue of the muscles, leading to more prolonged bouts of pain and discomfort after physical activity, movement, exercise, etc.

Symptoms and Causes

A cramp can last a few seconds or last up to 15 minutes. During a muscle spasm, the following may be experienced:

  • Twitching in the muscle.
  • Pain in the muscle.
  • Throbbing.
  • Hardness and/or stiffness.
  • The muscles appear physically distorted.

Because the muscles have to work harder, the cold weather can increase muscle spasms. One of the most common causes of muscle spasms is overuse and fatigue. However, exact causes vary from person to person. Some experts believe that one or more of the following contribute to the spasms/cramps, and they include:

  • Dehydration.
  • Stress.
  • Not stretching the body regularly.
  • Muscle fatigue.
  • Restricted blood circulation.
  • Involuntary nerve discharge/s.
  • Over-exercising.
  • Exercising in the heat.
  • Exhaustion of salts and minerals:
  • Potassium
  • Magnesium
  • Calcium

Possible causes for leg cramps at night or nocturnal leg cramps specifically include:

  • Sitting for too long without moving around to keep circulation healthy.
  • Sitting with unhealthy posture.
  • Overusing the muscles.
  • Standing or working on hard floors.

Dealing With The Cold

One way to deal with the cold is to warm up before any physical activity. Taking a few minutes to get the heart rate up can increase the blood flow and flexibility of the muscles. This will ensure the muscles are functioning correctly and avoid the need to work harder to stop spasms. When a cramp strikes, there are a few steps to try to alleviate the spasm:

  • Stretching the affected area.
  • Massaging the affected area manually with a massage roller, percussive massager.
  • Stand up.
  • Move around.
  • Apply heat or ice.
  • A warm bath, shower with massage setting if possible.
  • Ibuprofen and acetaminophen.
  • Vitamin B12 complex can help prevent cramps.

Body Composition

Getting Back To Fitness

Get back into regular exercising with a few tips for making the transition as smooth as possible.

Start Slow

  • Don’t try to jump back into exercise in attempting to crush out a challenging workout.
  • Commit to a few light workouts a week that integrate stretching pre and post-exercise.
  • Over-exerting the body increases the risk of injuries, motivation loss, and prolonged exhaustion.

Create a Workout Schedule That Works For You

  • Routines and habits can help stay on track.
  • Build a sustainable exercise routine to stay focused and committed.
  • Find times that work.
References

American Academy of Orthopaedic Surgeons. Muscle Cramp. (orthoinfo.aaos.org/topic.cfm?topic=A00200) Accessed 3/1/2021.

American Association of Osteopathy. Muscle Cramp—A Common Pain. (www.osteopathic.org/osteopathic-health/about-your-health/health-conditions-library/general-health/Pages/muscle-cramp.aspx) Accessed 3/1/2021.

Herzberg J. Stevermer J. Treatments for Nocturnal Leg Cramps. (www.aafp.org/afp/2017/1001/od3.pdf) Am Fam Physician 2017;96(7):468-469. Accessed 3/1/2021.

Young G. Leg Cramps. (www.ncbi.nlm.nih.gov/pmc/articles/PMC4429847/) BMJ Clin Evid 2015; May 13;1113. Accessed 3/1/2021.

Neuromuscular Massage For Muscular Pain

By
Dr. Alex Jimenez
-
Physiotherapist treats man spine and back with massaging percussion device. Rehabilitation therapy

A neuromuscular massage is a form of manual massage used to release strained muscles. Strained areas are also known as trigger points that tend to be the cause of muscular pain symptoms. Trigger points are small areas of the muscle that contract the tissue. The lack of blood and nutrients in these areas causes an inability for the muscles to relax. The area becomes hypersensitive, causing fatigue, weakness, inflammation, and pain. Trigger points can lead to referred pain in which other areas of the body experience sensations of pain, tingling or numbness.

Neuromuscular Massage For Muscular Pain

Neuromuscular Massage

Neuromuscular massage treatment involves applying alternating levels of concentrated pressure on the trigger point/s done through manual and instrument manipulation. Neuromuscular therapy is also called trigger point myotherapy. The American Academy of Pain Management recognizes this form of treatment as an effective treatment for pain caused by soft tissue injury.

Deep Tissue Massage

A deep tissue massage is generally used to address muscle aches and pains and is administered on an on-off basis. Neuromuscular manual therapy techniques are specialized and designed to correct pain and movement dysfunction by treating:

Problems are usually caused by:

  • Specific trauma
  • Repetitive movements
  • Unhealthy posture

Neuromuscular massage is considered an ongoing treatment.

Massage Reduces Pain

Muscles, when spasming, are painful to the touch. The pain is caused by ischemic muscle tissue. Ischemia means the muscle is lacking proper blood flow because of the spasm. This causes adverse effects because the muscles are not receiving enough blood; the muscles also do not receive enough oxygen.

  • The lack of oxygen causes the muscles to produce lactic acid.
  • The lactic acid causes the muscles to feel sore following physical activity.

Neuromuscular massage therapy relaxes the muscles releasing the lactic acid, allowing the muscles to receive enough blood and oxygen. Neuromuscular therapy can feel painful at first, but the pressure of the massage will alleviate the muscle spasm/s. It is crucial to communicate with the chiropractor and massage therapist about the pressure – whether it is too much, too little, feels better, feels worse, etc. Massage therapy pressure should never be overly painful. Individuals often describe the pressure as good pain, where they can feel the difference. Following a neuromuscular massage, the soreness should fade after twenty-four to thirty-six hours. The tight muscles should remain relaxed for four to fourteen days, depending on activities and stress levels.

Massage Treatment

Medical issues and conditions for which neuromuscular massage can treat include:

  • Tendonitis
  • Headaches
  • Temporomandibular joint pain – TMJ disorders
  • Jaw pain
  • Carpal tunnel
  • Upper back pain
  • Low back pain
  • Sciatica
  • Hip pain
  • Knee pain
  • Iliotibial band syndrome
  • Calf cramps
  • Plantar fasciitis

Neuromuscular Massage Benefits

Individuals who undergo neuromuscular massage therapy can experience the following benefits:

  • Reduced and/or complete elimination of pain.
  • Increased blood circulation.
  • Body toxin release.
  • Increased flexibility and strength.
  • Better movement.
  • Improved posture.
  • Balanced musculoskeletal and nervous systems.
  • Increased energy and vitality.

Body Composition

Fatigue

When it comes to getting fit, remember it is a long-distance marathon, not a quick sprint. Whether physical, mental, or a combination, fatigue is a common obstacle for successfully reaching health goals. Physical fitness requires energy:

  • Energy for work or school.
  • Energy to set up the gear or get to the gym.
  • Energy for the workout.
  • Energy to prepare regular healthy meals.

Combined with the pressures of everyday life can make it a challenge to work out consistently. The objective is to make gradual changes rather than significant immediate changes. This will help prevent/avoid early burnout and help lead to maintaining healthy habits. One tip could be scheduling the workouts and meal prep time for the day or week when most active. For example, knowing that after work or school, the body can’t take a workout and needs to crash at the end of the day, set up the exercise for the morning or afternoon. And once the workouts become a routine, energy levels will improve, allowing for more activity.

References

Bervoets, Diederik C et al. “Massage therapy has short-term benefits for people with common musculoskeletal disorders compared to no treatment: a systematic review.” Journal of physiotherapy vol. 61,3 (2015): 106-16. doi:10.1016/j.jphys.2015.05.018

Field, Tiffany. “Massage therapy research review.” Complementary therapies in clinical practice vol. 24 (2016): 19-31. doi:10.1016/j.ctcp.2016.04.005

Furlan, Andrea D et al. “Massage for low-back pain.” The Cochrane database of systematic reviews,9 CD001929. 1 Sep. 2015, doi:10.1002/14651858.CD001929.pub3

Qaseem, Amir et al. “Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians.” Annals of internal medicine vol. 166,7 (2017): 514-530. doi:10.7326/M16-2367

Sports Hernia: Core Muscle Injury

By
Dr. Alex Jimenez
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Calm. Young muscular caucasian woman practicing in gym with the weights. Athletic female model doing strength exercises, training her lower body, legs. Wellness, healthy lifestyle, bodybuilding.

A sports hernia is a soft tissue injury that happens in and around the groin area. It is a strain or tear of any soft-tissue muscles, tendons, or ligaments in the lower abdomen or groin area. It usually happens during physical sports activities that require fast, quick, sudden changes of direction and/or intense twisting movements. Despite its name, a sports hernia is not a hernia in the classic sense. The condition’s proper term is athletic pubalgia. However, a sports hernia can lead to an abdominal hernia. The condition can happen to both men and women.

Sports Hernia: Core Muscle Injury

Anatomy

The soft tissues most affected by sports hernias are the oblique muscles in the lower abdomen, along with the tendons that attach the oblique muscles to the pubic bone, are the most at risk. In many cases, the tendons that attach the thigh muscles to the pubic bone or adductors are also stretched or torn.

Core Muscle Injury

A core muscle injury is when the deep layers of the abdominal wall weaken or tear. This can cause nerve irritation and contribute to uncomfortable symptoms of numbness or tingling. The most common causes include:

  • Planting the feet and turning or twisting with maximum force.
  • Constant repetitive hip and pelvic twisting motions.
  • Imbalances between the hip and abdominal muscles can also, over time, cause overuse injuries.
  • Weakness in the abdominals and improper or no conditioning can also contribute to injuries.
  • Aggressive abdominal exercises can cause and/or aggravate a core muscle injury.

Symptoms

  • Chronic groin pain is the primary symptom of a core muscle injury.
  • Sharp groin pain with exertion.
  • Basic movements like sitting down or getting out of bed can also present with pain or discomfort.
  • Pain on one side of the groin.
  • Pain or numbness that radiates into the inner thigh.
  • Pain when coughing or sneezing.
  • Tenderness or pressure on the lower abdominal area.
  • Pain decreases with rest.

Diagnosis

A doctor will discuss symptoms and how the injury occurred. They will run a series of strength tests like a sit-up or trunk flex against resistance. If it is a sports hernia, there will be tenderness in the groin or above the pubis, along with discomfort and pain. Further tests will include MRI, ultrasound, or X-rays to rule out hip, low back, or pelvis injuries to confirm a core muscle injury.

Non-Surgical Treatment

Rest

  • In the first 7 to 10 days after the injury resting and icing the area is recommended.
  • If there is a bulge in the groin, compression or a wrap can help relieve symptoms.

Chiropractic and Physical therapy

  • Two weeks after the injury, chiropractic adjustments and physical therapy exercises are recommended to improve strength and flexibility in the abdominal and inner thigh muscles.
  • For most cases, 4 to 6 weeks of chiropractic and physical therapy will resolve any pain and allow the individual to return to their exercise or sports activity.

Anti-inflammatory Medications

  • A doctor could recommend non-steroidal anti-inflammatory medications to reduce swelling and pain.
  • If the symptoms persist over a prolonged period, a doctor may suggest a cortisone injection.

If the pain comes back when resuming the physical activities, surgery could be needed to repair the torn tissues.

Surgical Treatment

Repairing the torn tissues can be done with a traditional open procedure that involves one long incision or a minimally invasive endoscopic procedure. In an endoscopy, the surgeon makes smaller incisions and uses a small camera, called an endoscope, to see inside the abdomen. The results of traditional and endoscopic procedures are the same. Most individuals can return to sports and physical activities 6 to 12 weeks after surgery.

Body Composition

Muscle Gain

Individuals can’t lose fat forever. At some point, they need to work on developing muscle or work to preserve the muscle that is already present. This requires a different diet and exercise plan than one designed for fat loss. Instead of getting the body into a catabolic state, the body needs to be in an anabolic state where the body builds tissue instead of breaking it down. To build muscle, the body needs resources meaning proper nutrition and sufficient protein intake to increase muscle mass. Maintaining an energy surplus of around 15% is appropriate for developing musculature, meaning a moderately active individual with a BMR of 1,600 calories would want to their intake to about 2,852 calories a day.

References

Hoffman, Jay R et al. “Effect of protein intake on strength, body composition and endocrine changes in strength/power athletes.” Journal of the International Society of Sports Nutrition vol. 3,2 12-8. 13 Dec. 2006, doi:10.1186/1550-2783-3-2-12

Larson, Christopher M. “Sports hernia/athletic pubalgia: evaluation and management.” Sports health vol. 6,2 (2014): 139-44. doi:10.1177/1941738114523557

Poor, Alexander E et al. “Core Muscle Injuries in Athletes.” Current sports medicine reports vol. 17,2 (2018): 54-58. doi:10.1249/JSR.0000000000000453

Thorborg, Kristian et al. “Clinical Examination, Diagnostic Imaging, and Testing of Athletes With Groin Pain: An Evidence-Based Approach to Effective Management.” The Journal of orthopedic and sports physical therapy vol. 48,4 (2018): 239-249. doi:10.2519/jospt.2018.7850

Tyler, Timothy F et al. “Groin injuries in sports medicine.” Sports health vol. 2,3 (2010): 231-6. doi:10.1177/1941738110366820

Job Related Back Injury

By
Dr. Alex Jimenez
-
Back view of a young luggage handler suffering from backache caused by lifting heavy suitcases

Any job-related back injury can significantly complicate an individual’s life. Dealing with the pain, trying to figure out how to get things done while in recovery, and workers’ compensation to protect individuals who are injured on the job, getting them healthy without the stress of worrying about losing money from missing work.

Job Related Back Injury

Job-Related Injury

According to the Occupational Safety and Health Administration or O.S.H.A, a job-related injury is one that either contributed to or is caused by something in the work environment that injures an individual or exacerbates/worsens a previous injury. This is a general overview of the definition, and there are some exceptions. For example, being at the place of work as a general public citizen and not working when an injury happens will not be covered. If not sure whether a back injury is job-related, it’s better to be cautious and report the incident as soon as it happens.

Common Back Injuries

Back injuries are the most common job-related injuries. Back injuries are the number one reason individuals cannot work, whether they hurt their back at home or on the job. The Bureau of Labor Statistics found that nearly 40% of all musculoskeletal injuries that resulted in lost workdays were because of back injuries. The most common back injuries include:

  • Sprains
  • Strains
  • Herniated Discs
  • Whiplash
  • Spinal Cord Injuries
  • Vertebral Fractures

Compensation

Every state’s workers’ compensation program is different; however, the basic components are the same throughout. This means that if a workers’ compensation claim is approved and an individual cannot work because of their injury, they can expect to receive a regular base salary during treatment, rehabilitation, and recovery. Individuals also continue to receive medical coverage through the company, while the workers’ compensation fund should pay for treatment and diagnostics related to the injury.

When A Back Injury Occurs at Work

When a back happens at work, inform the employer as soon as possible. Do not be embarrassed or feel as it is not a big deal to seek workers’ compensation.  It is an insurance program for both the individual and the employer. An employer pays into the state’s workers’ compensation program for limited liability when employees get injured. Individuals don’t pay for the program, but it protects the individual in case something happens.

Letting an injury go untreated might not be anything at first, but months and years later, it can come back and be worse than when it first happened, causing greater damage, added medical costs, and procedures that the individual has to pay for out of their pocket. 

Once an individual knows they have a back injury, it is recommended to seek treatment as soon as possible to prevent worsening the injury or create new ones and develop a treatment, rehabilitation, and strengthening program. If an individual needs emergency care, tell the doctors about the work injury and precisely what happened. Emergency medical care should be sought out when:

  • There is a loss of function in any of the limbs.
  • There is a persistent numbness with the back pain.
  • There is nausea, dizziness, or vomiting after the injury.
  • There is a fever with back pain.
  • Loss of consciousness.
  • Loss of bowel or bladder control.

If the injury is not immediate and progresses gradually, but suspect that it is from work, it should be reported and examined by a medical professional.

Treatment

Proper treatment for a back injury depends on the severity of the injury. Those that prefer non-invasive, medication-free treatment are able to recover with chiropractic or physical therapy. Chiropractic doctors are experts in the spine and the musculoskeletal system. Chiropractic treatment is safe, proven, and can help relieve the pain, restore function, to get back to work safely.

Body Composition

Resistance Exercise

Resistance workouts are made to stress the muscles resulting in muscle gain. Resistance exercise makes the body adapt by growing the muscles to make them more capable of handling intense forces without strain. The stress of resistance exercise causes the muscle fibers to tear at the cellular level. Then, special muscle cells, known as satellite cells, jump into action to repair, rebuild, and grow the muscle. These types of exercises include high-intensity workouts or compound exercises that increase muscle growth. However, there needs to be a healthy balance between workouts and rest to support healthy hormone levels and maximize muscle gain.

Hormones

There are three primary hormones that stimulate muscle hypertrophy. They are:

  • Insulin-like growth factor 1 IGF-1
  • Growth hormone GH
  • Testosterone

Muscle protein synthesis is a critical process in muscle hypertrophy and happens after weight training. The hormones signal to the muscle to repair and rebuild after workout sessions. GH is released in high quantities during sleep, which is why proper sleep is needed to help reach body composition goals. When nutrition, workouts, and hormonal effects are combined, muscle-building happens. Figuring out the right balance is essential for reaching health goals.

References

Burton, A K, and E Erg. “Back injury and work loss. Biomechanical and psychosocial influences.” Spine vol. 22,21 (1997): 2575-80. doi:10.1097/00007632-199711010-00021

www.osha.gov/laws-regs/regulations/standardnumber/1904/1904.5

www.bls.gov/opub/ted/2018/back-injuries-prominent-in-work-related-musculoskeletal-disorder-cases-in-2016.htm

Marjorie L Baldwin, Pierre Côté, John W Frank, William G Johnson, Cost-effectiveness studies of medical and chiropractic care for occupational low back pain: a critical review of the literature, The Spine Journal, Volume 1, Issue 2, 2001, Pages 138-147, ISSN 1529-9430, doi.org/10.1016/S1529-9430(01)00016-X.(https://www.sciencedirect.com/science/article/pii/S152994300100016X)

Randall, Sara. “1. Avoiding back injury.” The practicing midwife vol. 17,11 (2014): 10, 12-4.

Taking It Slow After Spine Surgery

By
Dr. Alex Jimenez
-
Man exercising on the decompression simulators with trainer during the spine treatment at the rehabilitation gym

Taking it slow after spinal surgery is recommended to optimize a full recovery. What usually happens is that an individual starts feeling normal/better, so they begin to engage in a few daily activities. Then pain presents, letting the individual know that they have done too much too soon. The pain does not necessarily signal re-injuring the area, but recovery should be treated seriously. More than 50% of patients have successful spine surgery, but repeat surgeries do not tend to be quite as effective. Doing too much too early during recovery can result in severe re-injury or creating new injuries. So when can an individual get back to everyday life?

Taking It Slow After Spine Surgery

Surgery Recovery

Recovery after back surgery is different for everyone. Low back lumbar fusion surgeries usually require more recovery time than lumbar non-fusion surgeries, like:

  • Laminectomy – when the lamina portion of a vertebra is removed.
  • Microdiscectomy – the removal of abnormal disc material
  • Cervical spine surgeries.

Individuals who have undergone a procedure where two or more vertebrae have been surgically fused should expect a longer recovery. A typical timeline for lumbar fusion usually involves around three months. What happens is individuals want to get up and move, doing household activities almost immediately because they feel so good, but this is because of the pain medications. Strong pain medication use ends by four to six weeks. It is not until after 12 weeks or three months with post-operative chiropractic rehabilitation and physical therapy that individuals are encouraged to engage in specific physical activities that will optimize the healing process.

Taking It Slow With Certain Activities

Specific activities should not be engaged in after lumbar fusion surgery, as it requires a higher level of caution during recovery.

No Bending, Lifting, and Twisting

Bending, lifting, and twisting all require the direct use of the back muscles. Performing these movements can cause serious damage and hinder proper healing. Therefore it is recommended not to bend, lift, or twist for six weeks.

No Taking Baths or Swimming

Taking showers can be done right away with protective plastic or a sponge bath for a few days after surgery, but it is advised not to take baths or go swimming for three weeks.

No Cardiovascular Exercise

While the back may be feeling better after the spine surgery, cardiovascular exercise is not recommended for at least six to 12 weeks as it is too strenuous on the back. Light walking is fine, but the doctor and a chiropractor and physical therapist will develop a controlled, progressive exercise program for the individual. The program usually starts between 6 weeks and three months after surgery. This can include working out on an elliptical machine, a stationary bike, or easy treadmill walking.

Listening to The Body

The doctor will be clear about what can and can’t be done immediately following back surgery. Therefore it is crucial to follow the instructions to avoid any complications and listen to the body. Don’t push through activity or try taking on too much. Give the body and spine time to heal, taking it slow. There is time to get back to normal activities, but if re-injury or new injuries occur, rehabilitation/recovery could become the regular activity.

Body Composition

Malnutrition

Malnutrition is defined as deficiencies, excesses, or imbalances in an individual’s energy intake and/or nutrients. Protein-energy deficiency is one of the most common forms of malnutrition, and this health condition has an immediate and negative impact on body composition. The deficit wreaks havoc on skeletal muscle mass as the body progressively goes into starvation mode, breaking down the protein stored in the muscle for fuel.

Micronutrient deficiency is a lack of minerals and vitamins that support vital bodily processes like cell regeneration, immune system health, and eyesight. Common examples include iron or calcium deficiencies. Micronutrient deficiency has the most significant impact on normal physiological functions, processes and can happen in conjunction with a lack of protein-energy. This is because most micronutrients are obtained from food. Nutritional deficiencies of specific micronutrients can affect processes like building and repairing muscle; protein deficiency has a more pronounced effect on body composition because lowered protein intake can lead to muscle mass loss. Malnutrition and nutritional deficiencies in adults include:

  • Not enough energy to get through the day.
  • Unintended weight loss.
  • Physical function, including handgrip strength and physical performance, diminishes.
  • Serious medical conditions can result from fluid accumulation like edema.
References

Daniell, James R, and Orso L Osti. “Failed Back Surgery Syndrome: A Review Article.” Asian spine journal vol. 12,2 (2018): 372-379. doi:10.4184/asj.2018.12.2.372

Kinesthesia: Body Sense Positioning

By
Dr. Alex Jimenez
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Delivery man suffering from the back ache while moving the couch in the apartment

Kinesthesia is the body’s ability to sense movement, position, action, and location, also known as proprioception. An example is when moving the arm, the brain and body are aware that the arm has moved. When dealing with chronic back pain, individuals are unable to function normally with regular everyday movements causing discomfort.

Chronic back pain can make an individual feel like a stranger in their body, altering their perception. Tension develops throughout the body due to the pain, causing tightness and positional adaptations that are unfamiliar, awkward, and unhealthy for the musculoskeletal system. These body positioning changes continue while the individual is unaware of what they are doing, causing further strain and injury.

Kinesthesia: Body Sense Positioning

Kinesthesia

Kinesthesia is essential for overall coordination, balance, and posture as long as the movements are done correctly with proper form. Chronic back pain can affect kinesthesia differently. Individuals can misjudge and estimate that their bodies’ ability to lift, carry, or open something is more complicated or easier than it is. This can exceed the body’s tolerances, causing:

  • Strains
  • Sprains
  • Severe injuries

Once the back starts to hurt, this causes the individual’s sense of kinesthesia to compensate for the pain. As a result, individuals may knowingly or unknowingly attempt to carry out uncoordinated, awkward movements and positions, making things worse.

Motor Control

Motor control is the ability to control movement. When experiencing back pain, individuals adjust their motor control to avoid specific movements that cause back pain. Motor control adaptations and kinesthesia involve body positioning and heightened responsiveness to stimuli, like muscle spasms. Even moderate back pain can cause awkward and dangerous responses causing individuals to overcompensate or become too cautious, worsening or creating new injuries in the process. The body is performing movements that do not follow proper form, even though an individual thinks they are protecting themselves.

Building Healthy Proprioception

A recommended strategy for building kinesthesia to benefit the back and the rest of the body is yoga. Yoga helps build bodily sensory awareness. It trains the body when sending significant signals from the muscles, joints, and tendons back to the proprioceptive centers in the brain. This happens immediately and increases over time.

Yoga Poses

Creating positive awareness of the body’s movements will help relieve back pain as the body learns to feel, understand, and control the muscles. Here are a few poses to help, along with video links.

Reclining Hand-to-Big-Toe Pose

  • Lie with the back flat on the floor.
  • Grasp the big toe, foot, or ankle in both hands, or use a yoga strap or towel if you cannot reach the toes.
  • Hold the pose as long as possible while comfortable.
  • Repeat steps two and three on the other side.
  • Perform twice a day.
  • This pose stretches the lower back muscles, prevents spasms, and alleviates pain.
  • Avoid this pose if you have a herniated disc or retrolisthesis.

Bridge Pose

  • Lie flat on the floor with knees bent.
  • Arms bent on the floor.
  • Press down on the elbows and feet to raise the torso off the floor.
  • Hold and Repeat 4 to 5 times
  • Perform daily to relieve herniated disc, retrolisthesis, and vertebral fracture pain.
  • Avoid this pose if dealing with spinal stenosis, anterolisthesis, facet syndrome, or quadratus lumborum spasm.

Lord of the Fishes Pose

Body awareness is critical, but if an individual moves in a way that’s not natural to the body, it can cause injury. Kinesthesia and healthy posture can help avoid back pain and other health issues. A professional chiropractor can alleviate back pain, educate on proper form and recommend specific stretches and exercises to strengthen the body to prevent injury.

Body Composition

Magnesium

Magnesium supports a healthy immune system. It helps maintain:

  • Healthy bone structure
  • Muscle function
  • Insulin levels

Magnesium assists the body with ATP energy metabolism and acts as a calcium blocker. This reduces cramping and aids in muscle relaxation after physical activity/exercise. Magnesium is essential in biochemical reactions in the body. A slight deficiency can lead to an increased risk of cardiovascular disease and a higher risk of insulin resistance. Many magnesium-rich foods are high in fiber, like:

  • Dark leafy greens
  • Nuts
  • Legumes
  • Whole grains

Studies have shown that consuming a diet rich in Magnesium also provides a higher intake of dietary fiber. Dietary fiber aids in:

  • Digestion
  • Helps control weight
  • Reduces cholesterol
  • Stabilizes blood sugar

The best sources of Magnesium include:

  • Spinach, swiss chard, and turnip greens
  • Almonds and cashews
  • Flax, pumpkin, and chia seeds
  • Cocoa

References

Meier, Michael Lukas et al. “Low Back Pain: The Potential Contribution of Supraspinal Motor Control and Proprioception.” The Neuroscientist: a review journal bringing neurobiology, neurology and psychiatry vol. 25,6 (2019): 583-596. doi:10.1177/1073858418809074

Tong, Matthew Hoyan et al. “Is There a Relationship Between Lumbar Proprioception and Low Back Pain? A Systematic Review With Meta-Analysis.” Archives of physical medicine and rehabilitation vol. 98,1 (2017): 120-136.e2. doi:10.1016/j.apmr.2016.05.016

Wang, Jinsong, et al. “Dietary magnesium intake improves insulin resistance among non-diabetic individuals with metabolic syndrome participating in a dietary trial.” Nutrients vol. 5,10 3910-9. 27 Sep. 2013, doi:10.3390/nu5103910

Psoriatic Arthritis Knee Pain

By
Dr. Alex Jimenez
-
Orthopedic nurse helping patient with knee injury for physical recovery at clinic. Chiropractor doing osteopathy consultation to retired man with leg muscle pain to relieve pressure

Psoriatic arthritis can develop in individuals who have psoriasis, affecting various joints, especially the knees. Psoriasis is a skin condition that causes skin cells to build up and form patches of itchy, dry skin known as plaques. Psoriatic arthritis is a long-term inflammatory disease that can cause inflammation, stiffness, and pain. Symptoms can progressively worsen over time without treatment. Early diagnosis is vital to minimize damage to the joints and slow the condition’s progress with treatment.

Psoriatic Arthritis Knee Pain

Psoriatic Arthritis

Psoriatic arthritis symptoms like stiffness and swelling can present differently from person to person. For example, some individuals with psoriatic knee arthritis will experience stiffness or pain in one knee, while others experience symptoms in both knees. Psoriatic arthritis in the knee can also cause swelling in the surrounding:

  • Ligaments
  • Tendons
  • Synovial membranes
  • Symptoms can also present in the:
  • Elbows
  • Feet
  • Hands

Symptoms

Symptoms usually begin between the ages of 30 and 50. Common symptoms include:

  • Stiffness after resting or sleeping.
  • Swelling.
  • Inflammation in the knee and surrounding area.
  • Warm or hot skin on the knee from the inflammation.
  • Pain in and around the joints, tendons, or ligaments.
  • Joint sticking, difficulty moving, or reduced range of motion.

Other symptoms include:

  • Back pain
  • Fatigue
  • Pain and redness in the eyes
  • Swollen fingers or toes
  • Difficulty walking from pain in the feet or Achilles tendon.
  • Nail pitting or separation.

The severity of psoriasis does not determine psoriatic arthritis symptoms. Symptoms can go through a pattern of relapses and remissions. Individuals can have a sudden attack where symptoms get worse over a short time. After the flare-up, symptoms can improve as the condition goes into remission. Symptoms may not present for a long time until another flare-up. For example, an individual may have severe psoriasis but only mild psoriatic arthritis.

Causes

Psoriatic arthritis develops when the body’s immune system mistakenly attacks healthy cells and tissues. The faulty immune response causes the body to quickly generate new skin cells that stack on top of each other forming plaques. When the condition affects the joints, it leads to inflammation. While there is no apparent cause for psoriatic arthritis, researchers have found connections to genetics and the environment, as well as, individuals with close relatives that have psoriatic arthritis could be more likely to develop the condition. Other factors that could influence the development include:

  • Severe psoriasis
  • Traumatic injury/s
  • Obesity
  • Nail disease
  • Smoking

The condition can happen at any age, but according to the National Psoriasis Foundation, most individuals first notice symptoms about ten years after their psoriasis begins. However, only 30% of individuals with psoriasis develop psoriatic arthritis.

Diagnosis

Doctors use imaging tools to diagnose psoriatic arthritis in the knee. They will use:

  • MRI
  • X-rays
  • Ultrasound
  • To help them check for irregularities or signs of inflammation in the joint and surrounding tissues.
  • Additional tests are used to rule out other common forms of arthritis like rheumatoid and osteoarthritis.
  • Blood tests check for inflammation and specific antibodies.
  • In some cases, a small amount of fluid from the joint is taken to help eliminate the possibility of other underlying conditions like an infection.

Treatment

There is currently no cure for psoriatic arthritis, but treatments are being developed and show promise for long-term management. Current treatments focus on managing symptoms and improving the quality of life for the individual.

Biologics

Biologic medications like tumor necrosis factor or TNF inhibitors are recommended as the first-line therapy for most individuals with a new diagnosis of psoriatic arthritis. These meds help block TNF, which plays a crucial role in inflammation. They have shown to be effective at reducing the severity of symptoms and the frequency of flare-ups. Biologics can cause unwanted side effects, especially in individuals that experience frequent infections and need routine monitoring.

Small Molecule Medications

Individuals that cannot use biologic medications may be recommended a new class of medication called oral small molecules or OSMs. Examples include apremilast – Otezla and tofacitinib – Xeljanz.

Disease-modifying Antirheumatic Drugs

Disease-modifying antirheumatic drugs – DMARDs are a long-term option. They are used to slow the progression of psoriatic arthritis, and examples include methotrexate and cyclosporine. DMARDs work best when an individual begins taking them as early as they can take time to work. However, individuals are encouraged to continue taking them, even if symptoms do not improve right away.

Easing Inflammation

A doctor may prescribe nonsteroidal anti-inflammatory drugs – NSAIDs and corticosteroid injections when knee symptoms flare-up. These are short-term treatments that provide immediate relief, as long-term use can lead to side effects. Individuals can find relief with combined self-care that includes:

  • Taking over-the-counter NSAIDs like ibuprofen/Advil or naproxen/Aleve.
  • Applying ice and heat packs.
  • Gentle exercise to promote a full range of motion.
  • Gentle stretching or yoga can help relax tight muscles.
  • Chiropractic.
  • Acupuncture.
  • Therapeutic Massage.
  • Anti-inflammatory diet.
  • Electrical stimulation.

Chiropractic treatment can help to:

  • Relieve soreness.
  • Prevent muscle spasms.
  • Realign joints.
  • Improve mobility.

However, chiropractic is not the primary treatment for arthritis but is intended to be used in combination to relieve pain, loosen and stretch the muscles and balance the body.

InBody

Strength, Balance, and Improved Body Composition

Functional fitness is the ability to move comfortably every day. The benefits of physical activity also contribute to improved body composition. Working to reach a certain level of functional fitness can help the aging process that has been shown to reduce metabolic rate. Inactivity is why individuals lose Lean Body Mass as they age, leading to increased body fat. Lean Body Mass contributes to the body’s overall Basal Metabolic Rate or BMR, also known as metabolism. This is the number of calories the body needs to support essential functions. Everyone is encouraged to engage in strength training or resistance exercises, but specifically older adults. This can help regain muscle loss which can lead to an increase in lean body mass. The increase in Lean Body Mass increases BMR, which helps prevent fat gain.

References

Chang, K. L., et al. (2015). Chronic pain management: Nonpharmacological therapies for chronic pain [Abstract]. www.ncbi.nlm.nih.gov/pubmed/25970869

Chiropractic care for arthritis. (n.d.). arthritis.org/health-wellness/treatment/complementary-therapies/physical-therapies/chiropractic-care-for-arthritis

Chiropractic: In-depth. (2019). nccih.nih.gov/health/chiropractic-in-depth

How to achieve remission in psoriatic arthritis. (n.d.). arthritis.org/diseases/more-about/how-to-achieve-remission-in-psoriatic-arthritis

Living with psoriatic arthritis. (n.d.). psoriasis.org/living-with-psoriatic-arthritis/

Sankowski, A. J., et al. (2013). Psoriatic arthritis. www.ncbi.nlm.nih.gov/pmc/articles/PMC3596149/

Photobiomics and Gut Health: Part 2 | El Paso, TX (2021)

By
Dr. Alex Jimenez
-
Woman on blurred background using digital x-ray of human intestine holographic scan projection 3D rendering

Introduction

The previous article talked about how photobiomodulation or low laser therapy can help improve the gut microbiome. Today’s article gives an in-depth look at how photobiomics can provide the therapeutic potential to the gut. When it comes to the gut, an individual must take care of it. Supplying it with wholesome, nutritional food feeding the good bacteria will provide outstanding results like more energy throughout the day, the feeling of being full, weight loss, and healthy brain function. By eating these nutritional foods, the body can feel good; however, when harmful bacteria come into play and starts attacking the gut, it causes the gut microbiome to have all sorts of problems that can turn into chronic pain. Some of the ailments can be leaky gut, IBS, and inflammation, to name a few. When these harmful pathogens affect the gut, it can cause the body not to function correctly and dampen a person’s ability to go about their everyday life.

Photobiomodulation Works With The Gut

 

 

So how does photobiomodulation work with the gut microbiota? Research studies show that when photobiomics are being applied to the gut, the low laser wavelength can help rebalance what is happening to the gut and maintain diversity in the gut microbiota. It can sustain a healthy production of vital metabolites, and the diversity can help the gut from getting many harmful bacteria from causing too much trouble in the gut. Not only that, but photobiomodulation therapy affecting the gut, directly and indirectly, gives it a mimicry of the circadian clock from the brain. Since the brain and gut are connected with the brain giving signals to the gut microbiota to regulate and produce the bacterial metabolites.

 

The Brain-Gut Connection

 

 

The brain and gut connection is more of consistent bidirectional communication between the brain and gut. Studies show that the gut and brain connection ensures the proper maintenance of gastrointestinal homeostasis and has multiple effects on motivation and cognitive functions in the body. When inflammation comes to play in the gut; however, it can affect the gut to not work properly and disrupt the signals it is receiving from the brain and vice versa. When there is a disruption in the bacterial diversity in the gut, it can decrease the brain’s circadian rhythm. The disruption of the bacterial diversity of the gut can even reduce vitamin D absorption in the gastrointestinal tract, causing inflammation and heightening the effects of autoimmune properties that the body is experiencing.

 

Vitamin D and Photobiomics

 

 

Studies have shown that vitamin D plays an essential role in bone health and regulating gastrointestinal inflammation. This is huge since vitamin D has anti-inflammatory properties and can dampen the effects of Crohn’s disease, ulcerative colitis, and IBD or inflammatory bowel diseases. Vitamin D has many beneficial properties since it can help improve the body’s immune system and has anti-inflammatory properties. Anyone who takes vitamin D in supplement form or food form as part of their daily ritual will notice that they have more energy in their system and feel good overall. That is because vitamin D can modify the integrity of the epithelial cell in the gut and increase the composition and immune response to the gut microbiome. When vitamin D and photobiomics are combined, it can restore the vitamin D receptors in the gut and cause improvements to body immunity and bone health and dampen the inflammatory effects that were causing harm to the body.

 

The Vagus Nerve

 

 

Another unique fact that photobiomodulation can help is that it can improve low vagus nerves in the brain. Since the brain and gut are connected, it shows that photobiomics can help the brain by decreasing the inflammation receptors that are disrupting the brain-gut connection and causing problems to the body. The vagus nerve is a part of this connection since it sends the information back and forth from the brain to the gut. Studies show that the vagus nerve is represented as the main component of the parasympathetic nervous system. This means that the vagus nerve can oversee many crucial bodily functions, including sending information between the brain and gut. Not only that, but the vagus nerve represents an essential link to neurological and inflammatory responses to the body. When inflammation affects the gut and the vagus nerves, it can disrupt the signals to the brain, causing the inflammation to become worse and hurting the body. Treatments like photobiomodulation can target the vagus nerve and help increase the vagal tone in the body and inhibit cytokine productions. 

 

The 4 R’s

 

 

When the body is being affected by inflammation, treatments can help the body feel a bit better and start recovering. With photobiomodulation therapy and natural foods that are beneficial to the gut can bring the balance of a healthy lifestyle back to a person. For a better gut, doctors have recommended the 4’s for gut health.

 

The First R: Remove

REMOVE– Removing foods that a person has a food sensitivity or allergic reaction to can help dampen the effects of inflammation to the gut. These can be common foods like dairy and wheat or processed food containing high fats and added sugars.

 

The Second R: Replace

REPLACE– By replacing processed food with wholesome, nutritional food that is chalked up with the necessary vitamins and minerals can give the body more energy and put the person in a good mood. Thus, helping the gut produce more enzymes to digest the nutritional foods.

 

The Third R: Reinoculate

REINOCULATE– Adding prebiotics and probiotics into your recovery process can help improve the beneficial bacteria in the gut. Fermented food is a great way to get the necessary probiotics and prebiotics into the gut.

 

The Fourth R: Repair

REPAIR– Eating certain food that can help repair the gut lining in the gut microbiota ensures that inflammation won’t flare up due to gut stress. Adding fermented foods, butyric acid, L-glutamine, and aloe vera into a person’s diet is excellent in gut repair.

 

Conclusion

Overall, gut health is essential to the human body as it helps the body function properly. With the help of photobiomodulation, it can help the recovery process. Since photobiomics are still providing excellent results to treat patients with inflammation, it is necessary to combine whole, nutritional foods and the proper supplements into the everyday lifestyle so the body doesn’t have specific ailments like inflammation. This new combination has opened the doors to many new avenues of effective treatments for inflammation and improving overall body health and wellness.

 

References:

Breit, Sigrid, et al. “Vagus Nerve as Modulator of the Brain-Gut Axis in Psychiatric and Inflammatory Disorders.” Frontiers in Psychiatry, Frontiers Media S.A., 13 Mar. 2018, www.ncbi.nlm.nih.gov/pmc/articles/PMC5859128/.

 

Carabotti, Marilia, et al. “The Gut-Brain Axis: Interactions between Enteric Microbiota, Central and Enteric Nervous Systems.” Annals of Gastroenterology, Hellenic Society of Gastroenterology, 2015, www.ncbi.nlm.nih.gov/pmc/articles/PMC4367209/.

 

Craig, Ian. “The 4 R’s of Gut Health.” The Nutritional Institute, 28 May 2018, thenutritionalinstitute.com/resources/blog/292-the-4-r-s-of-gut-health.

 

Silverman, Robert G. “Photobiomics: A Look to the Future of Combined Laser and Nutrition Therapy.” Chiropractic Economics, 5 Oct. 2021, www.chiroeco.com/photobiomics/.

 

Tabatabaeizadeh, Seyed-Amir, et al. “Vitamin D, the Gut Microbiome and Inflammatory Bowel Disease.” Journal of Research in Medical Sciences: The Official Journal of Isfahan University of Medical Sciences, Medknow Publications & Media Pvt Ltd, 23 Aug. 2018, www.ncbi.nlm.nih.gov/pmc/articles/PMC6116667/.

Disclaimer

Video Gaming Injuries

By
Dr. Alex Jimenez
-
Happy young couple after winning at video games on television sitting on couch at night.

Video gaming has grown to over 150 million individuals in the United States playing. Around 60% of Americans play video games every day, with the average gamer being 34 years old. Playing video games for an extended amount of time takes a toll on the body. Individuals are experiencing the same kind of pains and aches from sitting and standing all day at work or school. Sitting positions, holding the controllers, and the different accessories can impact the nerves, muscles, and Posture. E-sports professionals understand the physical toll their bodies take with constant practice, tournaments, clinics, etc. They do cardiovascular conditioning, strength train, and stretch to improve their gaming abilities and also take into account:

  • The correct sitting position.
  • Ergonomic chairs.
  • Screen height.
  • Ergonomic controllers.
  • Hand/wrist supports.
  • Take regular breaks.

Taking steps can prevent strain, injuries and minimize the risk of long-term damage. If strain and injuries are present, professional chiropractic treatment can help alleviate the pain, rehabilitate/strengthen the muscles, ligaments, tendons, and recommend exercises and stretches.

Video Gaming Injuries

Video Gaming Posture

Proper Posture is vital to maintaining spinal as well as overall health. Poor Posture is the most common cause of back and neck pain.

Video Gaming Positions

Common gaming positions include the couch slouch where the gamer is slumped back into the couch with their feet up. This can lead to low back pain and sciatica. The full-on position is where the individual leans forward, elbows on their knees, head tilted forward, and staring up at the screen. Hours in these positions cause the neck, back, and other body areas to stiffen, generating soreness from the restricted movement. Many gamers use ergonomic gaming chairs. They have found that using the gaming chair improves Posture, eliminating the forward head and rounded shoulders. Gaming chairs can provide the health benefit of sitting correctly, reducing and eliminating neck and back tension or strain.

Injuries and Health Issues

Common musculoskeletal issues caused by excessive gaming and lack of movement include:

  • Eyestrain
  • Headaches
  • Neck pain
  • Elbow, arm, wrist  pain
  • Thumb pain
  • General hand pain
  • Carpal tunnel syndrome
  • Postural stress
  • Back pain

Chiropractic Treatment

Shoulder Massage

The intensity of gaming can cause the shoulders to tense up and stiffen. When using the controller, the shoulders can slightly lift, building up lactic acid, interrupting blood circulation, causing an accumulation of unwanted toxins inflaming trigger points. A chiropractic massage will release tightened muscles, provide relaxation, and increase the blood flow.

Hand and Wrist Treatment

The most used body parts for video games include the hands and wrist. Individuals grip the controllers or constantly use the keyboard and mouse. No matter what form of input is used, prolonged use can cause hand and wrist injuries. Injuries include:

  • Inflammation
  • Hand muscle aches

Chiropractic focuses on specific areas to help treat the body through a hand and wrist massage. Advanced techniques include electrical muscle stimulation to help stimulate and loosen the muscles. A chiropractor will recommend stretches and exercises, and hand/wrist supports, guards, or special gloves to alleviate muscle pains while still playing.

Neck and Back Adjustments

Poor posture can result in a misaligned spine or back muscle spasms. During extended game sessions, pain and fatigue can begin to present. A chiropractic adjustment can realign the muscles and set them back in place. The tissue surrounding the neck may thicken and focus on a specific area. Leaning too far forward or using a heavy gaming headset can result in a forward head posture placing a constant strain on the neck. Chiropractic adjustments will loosen the tissue and release any tension. Stretches and exercises will be recommended as well.

Recommendations

  • Set up the gaming station correctly.
  • The monitor or TV should be directly in front and around eye level, taking the strain off the neck.
  • Support the low back by maintaining the normal curve known as lordosis.
  • Use a lumbar support pillow or a small pillow behind the low back to prevent strain and pain.
  • Take frequent breaks every hour, take 10 minutes to get up, walk around, and stretch.
  • Physical activity/exercise 30-60 minutes a day to improve health.
  • Healthy diet

Body Composition

Body Composition

Body composition refers to how various substances in the body are proportioned. A few examples of the components that make up the body include:

  • Water
  • Protein
  • Fat
  • Minerals

All of these components generate balance in the body. When individuals exercise, they begin to notice changes in their body composition. For individuals that exercise regularly, it is vital to track weight gain, weight loss, and changes in body composition. This is to ensure that they aren’t losing muscle mass. As individuals exercise, muscle fibers are torn. During the recovery process, muscles are rebuilt. Overtraining can lead to muscle mass reduction because the body cannot catch up and rebuild the number of muscle fibers, eventually leading to lost muscle.

References

Emara, Ahmed K et al. “Gamer’s Health Guide: Optimizing Performance, Recognizing Hazards, and Promoting Wellness in Esports.” Current sports medicine reports vol. 19,12 (2020): 537-545. doi:10.1249/JSR.0000000000000787

Geoghegan, Luke, and Justin C R Wormald. “Sport-related hand injury: a new perspective of e-sports.” The Journal of hand surgery, European volume vol. 44,2 (2019): 219-220. doi:10.1177/1753193418799607

McGee, Caitlin, et al. “More Than a Game: Musculoskeletal Injuries and a Key Role for the Physical Therapist in Esports.” The Journal of orthopedic and sports physical therapy vol. 51,9 (2021): 415-417. doi:10.2519/jospt.2021.0109

McGee, Caitlin, and Kevin Ho. “Tendinopathies in Video Gaming and Esports.” Frontiers in sports and active living vol. 3 689371. 28 May. 2021, doi:10.3389/fspor.2021.689371

Zwibel, Hallie et al. “An Osteopathic Physician’s Approach to the Esports Athlete.” The Journal of the American Osteopathic Association vol. 119,11 (2019): 756-762. doi:10.7556/jaoa.2019.125

Photobiomics and Gut Health: Part 1 | El Paso, TX (2021)

By
Dr. Alex Jimenez
-

Introduction

The body has a variety of functions that work simultaneously to make sure that it’s working correctly. From the musculoskeletal system all the way to the endocrine system, the body has good bacteria that cause each system to work as it should be. However, sometimes an injury or autoimmune factor comes to play when it affects the body, causing a person to feel pain or not function properly. Many remedies and treatments can help the body by dampening the harmful effects that trigger various problems like inflammation, IBS, leaky gut, and much more. One of the treatments that physicians have used to help patients is photobiomodulation or low laser therapy.

 

Photobiomodulation Explained

 

Low laser therapy or photobiomodulation is when the body is exposed to a cold laser in the affected area. The laser wavelength targets the area through the skin to the mitochondrial. Studies have shown that photobiomodulation mechanics can help the body at the molecular, cellular, and tissue-based level causing therapeutic relief. When exposed through treatment, the laser wavelength can help give the injured area of the body relief that can last for hours to months with regular treatment. 

Photobiomodulation Benefits

 

Another study found that photobiomodulation can heal and stimulate body tissue, thus relieving pain and inflammation, causing the microbiome to alter in the body. The study also mentions that photobiomics can indirectly affect the microbiome and cause harmful bacteria or inflammation to halt, causing the body to boot its immune system. One study has even found that even though photobiomodulation has been widely accepted to treat low-back pain, it can be highly effective when modulating the gut microbiome. This means that when photobiomodulation and nutritional therapy are combined, they can help treat gut issues, low vagal tone, and autoimmunity in the body.

 

The Gut System

 

The gut microbiome is one of the important biomes in the body that plays a huge role. The gut microbiota can help the body internally by regulating its metabolism and protecting itself from harmful pathogens; thus, a healthy gut flora is mainly responsible for an individual’s overall health. Studies have shown that the gut microbiota comprises two significant phyla, which are Bacteroidetes and Firmicutes. The study also mentions that a normal gut microbiome can help maintain the structural integrity of the gut mucosal barrier, immunomodulation, and metabolize xenobiotics.

The Microbiome of the Gut

 

Since the gut microbiome makes sure that the body is healthy, sometimes unwanted pathogens can affect the gut, disrupting the body. Studies show that the gut microbiota can ensure homeostasis while recognizing bacterial epitopes in intestinal epithelial and the mucosal immune cells. But when harmful bacterias invade the gut, either by food sensitivity or autoimmune factors, the gut takes a heavy toll, causing the body to feel unwell. These factors can cause body inflammation, leaky gut, or IBS, thus making the individual feel pain if it’s not treated, causing more problems.

 

Conclusion

Overall, doctors using photobiomodulation on the gut is beneficial in the overall wellness of the body. The photobiomics have proven extraordinary therapeutic effects by targeting the inflamed area and improving the area by raising the antibodies to combat the inflammation and reducing gastrointestinal wall damage. By utilizing photobiomodulation and natural food therapy together, the body can recover quickly and achieve overall wellness.

 

References:

Hamblin, Michael R. “Photobiomodulation or Low-Level Laser Therapy.” Journal of Biophotonics, U.S. National Library of Medicine, Dec. 2016, www.ncbi.nlm.nih.gov/pmc/articles/PMC5215795/.

 

Jandhyala, Sai Manasa, et al. “Role of the Normal Gut Microbiota.” World Journal of Gastroenterology, U.S. National Library of Medicine, 7 Aug. 2015, pubmed.ncbi.nlm.nih.gov/26269668/.

 

Liebert, Ann, et al. “‘Photobiomics’: Can Light, Including Photobiomodulation, Alter the Microbiome?” Photobiomodulation, Photomedicine, and Laser Surgery, Mary Ann Liebert, Inc., Publishers, Nov. 2019, www.ncbi.nlm.nih.gov/pmc/articles/PMC6859693/.

 

Sekirov, Inna, et al. “Gut Microbiota in Health and Disease.” Physiological Reviews, U.S. National Library of Medicine, 9 July 2010, pubmed.ncbi.nlm.nih.gov/20664075/.

 

Silverman, Robert G. “Photobiomics: A Look to the Future of Combined Laser and Nutrition Therapy.” Chiropractic Economics, 5 Oct. 2021, www.chiroeco.com/photobiomics/.

 

Disclaimer

Gastrointestinal Stress and Digestion

By
Dr. Alex Jimenez
-
unhappy girl sitting on sofa and suffering from stomach pain

Gastrointestinal stress and digestion issues/problems have become a familiar experience for many individuals. Gastrointestinal issues include:

  • Dyspepsia or indigestion 
  • Bloating
  • Gas
  • General abdominal pain
  • Irritable bowel syndrome IBS
  • Crohn’s Disease
  • Constipation
  • Diarrhea
  • Persistent stomach pains

All of these can deplete the body of nutrients and drain the body’s energy. As a result, individuals can be distracted throughout the day, unable to leave the house, and unable to accomplish regular tasks. Gastrointestinal stress can be caused by a variety of factors, including:

  • Unhealthy diet
  • Interrupted sleep patterns
  • Work/school changes
  • Headaches
  • Medications
  • Fibromyalgia

Digestive issues are commonly associated with poor nutrition, but there could be an underlying cause in the spine and nervous system. Chiropractic can help manage gastrointestinal stress and stomach problems.

Gastrointestinal Stress and Digestion

Spinal Subluxation and Gastrointestinal Stress

The nervous system controls every function that the body performs, including digestion. The spine communicates with the stomach directly. The thoracic mid-back and lumbar low-back regions of the spine are responsible for regulating the rate of how food is physically broken down and digested. A subluxation or spinal misalignment can interfere with vital information transmissions from the brain to the digestive tract compromising digestive function.

Subluxation

Subluxation refers to a misalignment of the vertebrae that can cause health issues with the nerves in the spine, directly affecting digestion. If the vertebrae are out of alignment, this causes a misfire in the signals being sent to the nerves of the digestive system.  This can cause problems for the body absorbing nutrients, vitamins, and minerals from food. Because of this, no matter how healthy the diet is, individuals can still suffer from digestive issues.

Chiropractic

Many individuals deal with stress through meditation, breathing exercises, physical activity/exercise, and diet adjustments.

Lifestyle adjustments help counter the effects of stress, but if the nervous system is blocked from spinal misalignment, disrupting vital nerve flow through the body, specifically the digestive tract, gastrointestinal stress will continue to cause damage and malfunction. Individuals with:

Body Composition

Viscous and Nonviscous Fiber

Another way of classifying fiber is by its viscosity or thickness. Certain types of soluble fiber are thicker and are more likely to form firmer, stickier gels when mixed with water. When digesting food that consists of thick fiber it increases the thickness of the gel substance that passes through the gut. As a result, it reduces appetite because it makes the body feel fuller longer. Viscous fibers include:

The most frequently cited benefits of fiber include:

  • Reduces cholesterol levels
  • Improves glycemic control in type 2 diabetes
  • Improves stool form in constipation and diarrhea directly related to viscosity.

Nonviscous food sources tend not to have these benefits. A recommended strategy is to lean toward foods higher in viscosity.

References

Angus, Katherine et al. “What effect does chiropractic treatment have on gastrointestinal (GI) disorders: a narrative review of the literature.” The Journal of the Canadian Chiropractic Association vol. 59,2 (2015): 122-33.

Qu, Liuxin et al. “Irritable bowel syndrome treated by traditional Chinese spinal orthopedic manipulation.” Journal of traditional Chinese medicine = Chung i tsa chih ying wen pan vol. 32,4 (2012): 565-70. doi:10.1016/s0254-6272(13)60072-2

Walking For A Healthy Back

By
Dr. Alex Jimenez
-
Fit female athlete in sports bra and shorts walking on embankment and checking smart watch during fitness training in city harbor.

Walking for a healthy back. This simple form of exercise can:

  • Trim the waistline.
  • Elevate mood.
  • Reduce the risk of chronic disease.
  • Improve back health.

Chiropractors recommend walking because of the ease of the workout and the health benefits it provides. It is a simple, low-impact exercise that can significantly improve the body’s overall health in a short amount of time. It improves back health by:

  • Strengthening the muscles that support the spine.
  • Improves posture.
  • Facilitates strong circulation.
  • Improves bone strength.

Walking For A Healthy Back

Walking For A Healthy Back

Strengthens Muscles

  • Walking engages all of the muscles which keep the body upright, including the core, leg, and back muscles. Muscle strength increases, providing optimal support of the spine.

Optimize Bone Health

  • Bone is living tissue like the muscles, and exercise stimulates bone the same way as muscle, gradually increasing strength.
  • Studies have found that walking improves bone density and reduces bone loss.
  • Walking also helps reduce the risk of degenerative bone diseases.

Posture Improves

  • Poor posture is one of the most common reasons why individuals have back pain.
  • Poor posture affects mobility and places a significant amount of strain on the back.
  • Walking a few times each week engages and strengthens the back muscles keeping the body straight.

Reduces Weight

  • Many individuals have lower back pain that is caused by excess weight.
  • The added weight causes the front of the body to shift forward, placing additional strain on the lower back.
  • Walking reduces the load on the lower back.

Improves Flexibility and Range of Motion

  • Combined with stretching, walking improves flexibility and range of motion, making it easier to perform everyday activities reducing the risk of back injuries.

Improves Circulation to the Spinal structures

  • Walking improves blood circulation, delivers nutrients to the soft tissues, and removes toxins.

Added Benefits include:

  • Stress relief.
  • Better sleep.
  • Improved skin tone.
  • Lower risk of diabetes.
  • Reduced risk of depression.
  • Improved cardiovascular health that lowers the risk of:
  • High blood pressure.
  • Heart disease.
  • Stroke.

Before Exercising

Before beginning an exercise program, it’s essential to consult a doctor or chiropractor for individuals that have not exercised for a while or are dealing with underlying condition/s. They will educate and recommend how much exercise is appropriate given their current fitness level and overall health. To maximize the benefits of walking and prevent injuries:

Use High-Quality Tennis or Walking Shoes

  • Walking is much more enjoyable and safer when the body is comfortable.
  • Improving comfort levels is by using a pair of high-quality walking shoes or trainers.
  • They will provide proper support, cushioning, and adequate traction.

Maintain Proper Posture

Stay aware of body position when walking. A few key points to keep in mind:

  • Place the heel down first.
  • Then roll through each part of the foot, ending on the point of the toes.
  • Keep the shoulders back and head up.
  • Lift from the hips to reduce the impact on the lower joints.
  • Keep a slight bend in the arms and smoothly swing them back and forth.

Turn Walking Into a Healthy Habit

  • In the beginning, aim for at least 5 to 7 walks each week that last 25 minutes.
  • Speed does not matter as the objective is to get out and walk.
  • Once walking starts turning into a healthy habit with improvements in health, then start walking faster and longer.

Interval Walking

  • Interval walking involves short periods of high-intensity walking followed by a longer period of slow walking.
  • This increases cardiovascular fitness and muscle strength.
  • Begin with a 1-minute interval of fast walking.
  • This is followed by 2 minutes of slower walking.

Take On Easy Obstacles

  • Makes the walks more challenging by walking up or down a hill.
  • Walk over objects like tree stumps or rocks.
  • This increases calorie burn.

Add Hand or Leg Weights

  • Increase workout intensity by adding leg or hand weights.
  • They will help strengthen the arms, shoulders, and upper back.

Body Composition

Building Lean Body Mass

Lean Body Mass is the body’s total weight minus the fat. This includes all the weight of the muscles, organs, and total body water. The best way to develop muscle and Lean Body Mass is to adopt a resistance training program. As stronger muscles are developed, the size and amount of the muscle cells increases. The muscles then require more intracellular water, which allows them to function at optimal levels. As the muscles grow and take in more water, Lean Body Mass increases.

References

Morris, J N, and A E Hardman. “Walking to health.” Sports medicine (Auckland, N.Z.) vol. 23,5 (1997): 306-32. doi:10.2165/00007256-199723050-00004

Nauman, Javaid et al. “Walking in the Fast Lane: High-Intensity Walking for Improved Fitness and Health Outcomes.” Mayo Clinic proceedings vol. 94,12 (2019): 2378-2380. doi:10.1016/j.mayocp.2019.10.020

Vanti, Carla et al. “The effectiveness of walking versus exercise on pain and function in chronic low back pain: a systematic review and meta-analysis of randomized trials.” Disability and rehabilitation vol. 41,6 (2019): 622-632. doi:10.1080/09638288.2017.1410730

The Efficacy of Low Laser Therapy | El Paso, TX (2021)

By
Dr. Alex Jimenez
-

Around the world, pain, especially chronic pain, is widespread to an individual. When the body goes through a tremendous amount of activity, the muscle tissues will rip and tear to strengthen the body for the next activity it overcomes. But when the muscle tissues tear and cause pain to the body, it can take a week or even months for the tissue to recover. Many recovery treatments can help alleviate the pain that a person is in, and one of the recovery treatments that most physicians use is low laser therapy.

 

Low Laser Therapy & Musculoskeletal Pain

 

Doctors have used low laser therapy to help patients alleviate pain and repair muscle tissue in the affected area of the body. Studies have found that the effects of low laser therapy had a positive impact on the treated area. The study showed that the low laser treatment has helped with relieving pain and has promoted tissue repair. The effects of the low laser wavelength have enhanced the healing process by promoting cell proliferation, causing pain relief. One of the efficient ways that low laser therapy is beneficial to the body is to alleviate musculoskeletal pain. 

 

 

Musculoskeletal pain is a variety of issues in the body. From muscle pain to fibromyalgia, it can render a person miss out on everyday activities, causing them to miss work or school. Studies have shown that when a patient is going in for low laser therapy, the effects from the laser wavelength can reduce inflammation and edema in the affected area. The studies even show that the laser light effects are photochemical and not thermal. The laser light will trigger a biochemical change in the body, causing the photons from the affected area to be absorbed, thus triggering a chemical change in the area.

 

Efficient Uses of Low Laser Therapy

 

 

Other studies even show that the low laser wavelength triggers chemical alterations and potential biochemical benefits to the human body. This means that if a person is suffering from chronic pain when going for low laser treatment, the laser can relieve chronic pain symptoms and even osteoarthritic conditions. Another efficient use of low laser therapy is that it can suppress the MMP or mitochondrial membrane potential in the DRG neutron while reducing adenosine triphosphate or ATP production in the body. In other words, the effects of low laser therapy can suppress and reduce inflammation receptors in the body, thus causing long-term results that last for years, improving tissue healing.

 

Another efficient way low laser therapy is beneficial is that it can be combined with light exercises as a staple of rehabilitation. Studies have found that the combination of low laser therapy and exercise has merit. When an individual combines stretches and low laser therapy as part of their rehabilitation, the data shows a reduction in pain symptoms and fatigue in the body.

 

Conclusion

 

All in all, the efficient effects of low laser therapy are beneficial by reducing inflammation and damping the pain receptors in the body. Since chronic pain is worldwide and can cause harmful effects to the body, using low laser therapy can dampen the pain receptors. Having low laser therapy treatments as part of their daily regime and light exercises for anyone with chronic pain can get their body moving pain-free. Since the body goes through so much, having low laser therapy is one of the many recovery treatments that can provide long-lasting results and promote overall wellness. 

 

References:

Cotler, Howard B., et al. “The Use of Low Level Laser Therapy (LLLT) for Musculoskeletal Pain.” MOJ Orthopedics & Rheumatology, U.S. National Library of Medicine, 9 June 2015, www.ncbi.nlm.nih.gov/pmc/articles/PMC4743666/.

 

Dima, Robert, et al. “Review of Literature on Low-Level Laser Therapy Benefits for Nonpharmacological Pain Control in Chronic Pain and Osteoarthritis.” Alternative Therapies in Health and Medicine, U.S. National Library of Medicine, 24 Sept. 2018, pubmed.ncbi.nlm.nih.gov/28987080/.

 

Enwemeka, Chukuka S., et al. “The Efficacy of Low-Power Lasers in Tissue … – Medical Laser.” Medical Summus Laser, 2004, medical.summuslaser.com/data/files/77/1585165534_SpHfd8kFyVara63.pdf.

 

Kingsley, J. Derek, et al. “Low-Level Laser Therapy as a Treatment for Chronic Pain.” Frontiers, Frontiers, 19 Aug. 2014, www.frontiersin.org/articles/10.3389/fphys.2014.00306/full.

Trendelenburg Gait

By
Dr. Alex Jimenez
-
Walking or gait anthropometric analysis on a treadmill

A Trendelenburg gait is an abnormal walking gait resulting from a defective or weakened hip abductor. The gluteal musculature is the primary musculature that includes the gluteus medius and gluteus minimus muscles. Weakness in these muscles causes sagging/dropping of the pelvis on the opposite side while walking. There will be a noticeable side-to-side motion if the glutes are too weak to support the body’s weight when walking. It can look as though the individual is limping or missing a step. Individuals can minimize the effects with foot orthotics, core strengthening, chiropractic, and physical therapy.

Trendelenburg Gait

Trendelenburg Gait Causes

This gait often results from straining the hip abductor muscles during physical activity. Exercises specifically for the glutes done improperly are a common cause. When improper exercise form is the cause, the abnormal gait usually goes away as muscle inflammation fades. The gait can also present after total hip replacement surgery, as the procedure requires incisions in the gluteus medius muscle. This can weaken the muscle causing an abnormal gait. Weakness in these muscles can also be caused by:

  • Nerve damage or dysfunction in the nerves that run through the gluteal minimus and medius muscles.
  • Osteoarthritis is a type of arthritis that occurs when joint cartilage starts to wear down.
  • Muscular dystrophy is a condition that causes the muscles and bones to become weak over time.
  • Poliomyelitis is a condition associated with polio that weakens the muscles.
  • Cleidocranial dysostosis is a condition present from birth that can cause your bones to develop improperly.

Symptoms

The walking gait is made up of two phases:

  • Swing – When one leg moves forward.
  • Stance – The other leg stays still and maintains balance.

The main symptom of Trendelenburg gait can be seen when one leg swings forward and the hip drops down and move outward. This is because the hip abductor of the other leg is too weak to support the weight. Individuals may lean back or to the side slightly when walking to maintain balance, or they may lift the foot higher off the ground with each step to avoid losing balance or tripping as the pelvis shifts unevenly.

Diagnosis

Abnormal hip movement during a swing of one or both legs can give a doctor enough evidence to diagnose a Trendelenburg gait. A doctor will observe the individual’s walk in front and behind to get a detailed view. A doctor will also use the Trendelenburg test to diagnose the condition. The doctor will instruct the individual to lift one leg for 30 seconds. If the individual cannot keep the hips parallel with the ground while lifting, it could indicate Trendelenburg gait. X-rays of the hip will be used to identify any causes of weakness in the gluteus minimus or medius.

Treatment Options

Treatment options will depend on the severity and cause of the gait.

Medication

  • If the gait is causing pain, over-the-counter nonsteroidal anti-inflammatory NSAIDs, like ibuprofen or acetaminophen, will help ease symptoms.
  • In severe cases, a doctor may prescribe cortisone injections to help reduce pain.

Foot Orthotics

  • A doctor could also recommend using a foot orthotic in one or both shoes to compensate the hip abductor muscle weakness.

Chiropractic, Physical Therapy, and Exercise

Chiropractic and physical therapy can help adjust, realign, and strengthen the muscles to regain control of the Trendelenburg gait. The chiropractor or physical therapist will move the legs in various directions to help the joints become more accustomed to moving in certain directions and increase muscle strength and resistance. Exercises that can strengthen the hip abductor muscles include:

  • Lie on the side and extend the leg straight out.
  • Lie on the floor and move one leg up, over the other, and back in the opposite direction.
  • Step sideways and onto an elevated surface, then back down again.

Talk with a doctor or chiropractor before beginning any new exercise routine so they can recommend specific exercises and educate on proper form.

Complications

If left untreated, moderate-to-severe cases of Trendelenburg gait can become debilitating, leading to severe complications. These include:

  • Pinched nerves.
  • Sciatica.
  • Pain, stiffness, or grinding in the hips.
  • Loss of range of motion in the hips and gait.
  • Losing the ability to walk, which could require the use of a walker or wheelchair.
  • Paralysis of the lower body.
  • Osteonecrosis or death of bone tissue.

Trendelenburg gait is treatable with special shoes, orthotics, and exercises designed to strengthen the hip abductor muscles. Chiropractic and physical therapy can help limit the condition’s impact on the body’s health, the ability to walk, and reduce the risk of complications.

Body Composition

Heart-Healthy Foods

Citrus

  • The bright and tangy fruits are packed with vitamins and unique plant compounds known as polyphenols that can help lower blood pressure naturally.
  • However, it’s important to note that grapefruit and grapefruit juice could interact with certain prescription medications.

Beans and Lentils

  • Foods high in magnesium, potassium, and fiber can help maintain healthy blood pressure.
  • This is where beans and legumes come in, as they are high in fiber, potassium, and magnesium.
  • Individuals that swapped beans and lentils noticed a lower blood pressure, whether or not they had been diagnosed with hypertension.

Pumpkin Seeds

  • These seeds are packed with potassium, magnesium, and arginine.
  • Arginine is an amino acid used to make nitric oxide, which helps the blood vessels relax and dilate, allowing lower blood pressure.
  • A study found that postmenopausal women who took 3 grams of pumpkin seed oil daily for six weeks saw a significant decrease in their systolic blood pressure.

Garlic

  • Garlic contains nitric oxide, which has been shown to relax blood vessels.
  • Kyolic garlic, in particular, has been shown to help with arterial stiffness and can improve cholesterol levels.
References

Feyh, Andrew et al. “Role of Dietary Components in Modulating Hypertension.” Journal of Clinical & experimental cardiology vol. 7,4 (2016): 433. doi:10.4172/2155-9880.1000433

Gait abnormalities. (n.d.).stanfordmedicine25.stanford.edu/the25/gait.html

Gandbhir, Viraj N., et al. “Trendelenburg Gait.” StatPearls, StatPearls Publishing, 19 August 2021.

Giangarra CE, et al. (2018). Clinical orthopedic rehabilitation: A team approach.sciencedirect.com/science/book/9780323393706

Gilliss AC, et al. (2010). Use of osteopathic manipulative treatment to manage compensated Trendelenburg gait caused by sacroiliac somatic dysfunction.
jaoa.org/article.aspx?articleid=2093879

Maricelli JW, et al. (2016). Trendelenburg-like gait, instability and altered step patterns in a mouse model for limb-girdle muscular dystrophy 2i. DOI:
10.1371/journal.pone.0161984

Mayo Clinic Staff. (2017). Osteoarthritis.mayoclinic.org/diseases-conditions/osteoarthritis/home/ovc-20198248

Michalopolous N, et al. (2016). A personalized monitoring and recommendation framework for kinetic dysfunctions: The Trendelenburg gait. DOI: 10.1145/3003733.3003786

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