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Exploring Electrolyte Chewing Gum: What You Need to Know

By
Dr. Alex Jimenez
-
Orange slice, a handful of bubblegums and a pack of gum tablets on a colorful background. High quality photo

Can electrolyte chewing gum help physically active individuals, fitness enthusiasts, and athletes experiencing extreme heat and dehydration?

Exploring Electrolyte Chewing Gum: What You Need to Know

Electrolyte Chewing Gum

Electrolyte powder mix and drinks have been marketed as efficient and time-saving for fast-paced lives. Now, electrolytes are in chewing gum form. These gums work by activating salivary glands and making the mouth water. Manufacturers claim the gum’s sour taste makes the mouth water, quenches thirst, and replenishes some electrolytes. Some brands don’t list the percentages or amounts of ingredients, making determining each gum’s electrolyte content difficult. However, electrolyte chewing gum is designed to eliminate feelings of thirst and is not meant to hydrate the body. This can be dangerous because it gives the individual a false sense of hydration. When the thirst mechanism is impaired, an individual may not drink enough fluids, leading to dehydration. The Food and Drug Administration has not studied the effectiveness of electrolyte gum.

Signs The Body Is Not Getting Enough Electrolytes

Electrolyte deficiency can result from insufficient fluids or excessive sweating (National Library of Medicine, 2024). Signs that the body is not getting enough electrolytes can vary because the body needs each electrolyte for specific functions. The symptoms can range from neurological symptoms such as headaches and seizures in the case of low sodium to muscle cramps and weakness when there are low potassium levels. (National Library of Medicine, 2023) (National Library of Medicine, 2023) However, individuals can still have electrolyte imbalances even if they do not have symptoms. This is why proper hydration and intake of electrolytes through water and food are important.

Ingredients

The ingredients listed on electrolyte chewing gum include:

  • Sugar
  • Gum base
  • Corn syrup
  • Citric acid
  • Glycerin
  • Natural flavors
  • Soy lecithin
  • Artificial sweeteners
  • Artificial color
  • Electrolytes in sodium citrate and potassium citrate

However, gum brands fail to include the percentages of the ingredients, making it hard to figure out the actual electrolyte content. The amount can determine their effectiveness. Given their size, estimates point to very little electrolyte content, possibly around 10 milligrams of sodium per piece, which is insufficient to hydrate the body.

Rehydrating the Body

Food and fluids are reliable sources of electrolytes that the body can absorb. Sources include:

  • Fruits like bananas and oranges contain potassium and magnesium.
  • Vegetables also contain potassium and magnesium.
  • Dairy for calcium.

Electrolyte supplements are generally unnecessary if you eat a balanced diet. However, these products could be useful during exercise, especially for their sodium content (National Library of Medicine, 2024). When exposed to the heat, consider a rehydration solution like sports drinks or making your own. The presence of sugar increases the absorption of sodium by the intestine. Sugar in electrolyte solutions does not add calories; it helps the intestine absorb the sodium faster and holds water in the bloodstream, helping maintain blood pressure. While chewing a piece of electrolyte gum might make it easy to get balanced electrolytes, it is not enough to replenish the body. Individuals who need more electrolytes should talk to their healthcare provider about the best way to meet their body’s needs. They may recommend drinks or powders specially formulated to provide an electrolyte boost.

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop highly effective treatment plans through an integrated approach for each patient and restore health and function to the body through nutrition and wellness, functional medicine, acupuncture, Electroacupuncture, and integrated 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.

Balancing Body and Metabolism

References

National Library of Medicine, MedlinePlus. (2024). Fluid and electrolyte balance. Retrieved from medlineplus.gov/fluidandelectrolytebalance.html

National Library of Medicine, MedlinePlus. (2023). Low blood sodium. Retrieved from medlineplus.gov/ency/article/000394.htm

National Library of Medicine MedlinePlus. (2023). Low blood potassium. Retrieved from medlineplus.gov/ency/article/000479.htm

Understanding the Role of Supportive Digestive Organs

By
Dr. Alex Jimenez
-
Woman holding illustration. Professional medical worker in white coat is in the office.

For individuals looking to improve their gut health, can learning about the supportive digestive organs help with how digestion works and how it can be affected by inflammatory bowel disease/IBD?

Understanding the Role of Supportive Digestive Organs

Supportive Digestive Organs

Most people are familiar with food movement from the mouth through the esophagus, stomach, small intestine, and large intestine. However, digestion begins in the mouth with the formation of saliva, and the supportive digestive organs provide the necessary fluids to digest food and used by the body. The digestive tract runs from the mouth to the anus in one long, continuous tube. Several supportive digestive organs assist digestion but are not considered part of the digestive tract, including the salivary glands, pancreas, liver, and gallbladder.

Salivary Glands

The salivary glands produce saliva passed through ducts and into the mouth. Saliva is a clear liquid containing various substances important for digestion and the beginning of the food breakdown process (National Institute of Diabetes and Digestive and Kidney Diseases, 2017). Saliva is important to digestion because it aids chewing, contains antibodies, and helps keep the mouth clean. Infections, mumps, obstructions, Sjogren’s syndrome, and cancer are diseases and conditions that can affect the salivary glands.

Pancreas

Behind the stomach is the pancreas, which is important to digestion because it is where digestive enzymes and hormones are produced. Digestive enzymes help break down food (National Institute of Diabetes and Digestive and Kidney Diseases, 2017). The pancreas also creates Insulin, a hormone that helps balance blood sugar levels. Individuals with Type 1 diabetes are unable to make insulin and need insulin shots to balance sugar levels. Individuals with Type 2 diabetes also need insulin because their body is either resistant to insulin or their pancreas does not respond correctly. (American Diabetes Association, 2024) Glucagon is another hormone produced in the pancreas to raise blood sugar when the levels are very low. For individuals who have diabetes, glucagon can increase blood sugar levels too high. Insulin and glucagon work together to regulate blood sugar. (American Diabetes Association, 2024) Some diseases and conditions affecting the pancreas include pancreatitis, cancer, and cystic fibrosis.

Liver

The liver is one of the largest organs. Its functions include creating bile, storing nutrients and glycogen, converting toxins into harmless substances, and/or enabling their removal. Bile is passed through ducts that run from the liver to the duodenum of the small intestine. Blood circulates through the digestive tract and liver, where vitamins and nutrients are processed and stored (Johns Hopkins Medicine, 2024). The liver is also the body’s detox organ, helping remove byproducts produced by alcohol and medications. The liver also helps break down old or damaged blood cells and produces substances to help with blood clotting. (Johns Hopkins Medicine, 2024) Diseases and conditions of the liver include cirrhosis, hepatitis, hemochromatosis, and cancer.

Gallbladder

The gallbladder is a much smaller organ located just under the liver. This supportive digestive organ stores bile after it is made in the liver. After eating, the small intestine releases a special hormone called cholecystokinin, which prompts the gallbladder to send bile through ducts and into the small intestine. Once in the small intestine, the bile breaks down the fat from the food. Conditions that can affect the gallbladder include gallstones. Surgery to remove the gallbladder, known as a cholecystectomy, is common. Some individuals may initially need to make adjustments to their diet after surgery. (Johns Hopkins Medicine, 2024)

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop highly effective treatment plans through an integrated approach for each patient and restore health and function to the body through nutrition and wellness, functional medicine, acupuncture, Electroacupuncture, and integrated 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.

Healthy Diet and Chiropractic

References

National Institute of Diabetes and Digestive and Kidney Diseases. Dis (2017). Your digestive system & how it works. Retrieved from www.niddk.nih.gov/health-information/digestive-diseases/digestive-system-how-it-works

American Diabetes Association. (2024). About diabetes: common terms. diabetes.org/about-diabetes/common-terms

Johns Hopkins Medicine. (2024). Liver: anatomy and functions. www.hopkinsmedicine.org/health/conditions-and-diseases/liver-anatomy-and-functions

Johns Hopkins Medicine. (2024). Cholecystectomy. www.hopkinsmedicine.org/health/treatment-tests-and-therapies/cholecystectomy

Plantaris Muscle Tear: Symptoms, Diagnosis, and Recovery

By
Dr. Alex Jimenez
-
Physiotherapist massaging male patient with injured calf. Sports injury treatment.

Individuals who engage in sports and physical activities that involve lunging forward while running or jumping can sustain a plantaris muscle injury. Can understanding the anatomy of the back of the leg and the symptoms help diagnose and treat plantar muscle injuries?

Plantaris Muscle Tear: Symptoms, Diagnosis, and Recovery

Plantaris Muscle

The plantaris muscle is a long, narrow muscle in the calf that runs along the back of the leg. It’s part of the Triceps Surae, a group of muscles in the calf that, along with the gastrocnemius and soleus muscles, makes up the bulk of the back of the leg. It is located in the superficial posterior compartment of the leg. Strains or tears of the plantaris muscle at the back of the leg can cause pain and swelling, similar to a calf strain or Achilles tendon tear. Individuals may feel immediate pain, cramping, and other symptoms.

Anatomy

The gastrocnemius and soleus muscles are the major muscles, with the soleus located deeper in the leg. Together, they form the Achilles tendon, which blends into a tendon in the back of the heel and attaches to the heel bone/calcaneus. When the calf muscles contract, they point the foot downward, propelling the body forward when walking, running, and sprinting. The plantaris muscle and tendon sit more or less in the center of the calf, between the two heads of the gastrocnemius. Around 7% to 20% of the population are born without plantaris muscles. There are variations, such as having a double- or triple-headed plantaris muscle. (Olewnik Ł. et al., 2020) However, individuals that do not have the muscle or have a variation have not been shown to affect long-term or short-term mobility.

Symptoms

Plantaris muscle ruptures are the most common injury and occur often during running or jumping. (Spang C. et al., 2016) Many who sustain this injury are athletes who have to lunge forward. Common symptoms include:

  • Sudden onset pain behind the calf.
  • Swelling of the calf muscle.
  • Muscle knots or myofascial trigger points of the calf muscle.
  • Swelling and bruising in the back of the calf area.
  • Cramping in the calf muscle.
  • Spasm sensations of the calf muscle.
  • Symptoms of a plantaris muscle strain are less severe, with the common signs being tightness and pain during and after physical activity.

Diagnosis

Plantaris muscle tears differ from Achilles tendon tears because the foot can be pointed downward following the rupture, whereas an Achilles tear cannot. Plantaris ruptures can also be confused with a blood clot in the large veins of the calf, called deep vein thrombosis/DVT. (Rohilla S. et al., 2013) Tests like MRI or ultrasound can be performed to confirm or exclude a plantaris rupture. Both can be useful for verifying whether the injury is a strain or tear and identifying other possible causes of calf pain.

Treatment

Treatment is typically non-surgical. While the injuries can cause pain and disability, the symptoms almost always resolve with conservative treatments and therapies. Rest, ice, compression, and elevation are the first line used and may be all that is needed for a muscle strain. Short-term use of NSAIDs may be recommended for a strain or tear to reduce pain and inflammation. (Morelli K. M. et al., 2018) If the pain is profound or there is a tear, patients may require short-term immobilization or the use of a crutch for the pain to subside. With the assistance of a physical therapist, sports chiropractor, and athletic trainer, gradual increases in mobility and strength can be obtained. Symptoms usually gradually resolve over several weeks. Full recovery may take up to eight weeks, depending on the severity of the injury.

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop customized treatment programs through an integrated approach to treating injuries and chronic pain syndromes, improving flexibility, mobility, and agility, relieving pain, and helping individuals return to normal activities. If other treatments are needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments.

Control Foot Motion with Custom Orthotics

References

Olewnik, Ł., Zielinska, N., Karauda, P., Tubbs, R. S., & Polguj, M. (2020). A three-headed plantaris muscle: evidence that the plantaris is not a vestigial muscle?. Surgical and radiologic anatomy : SRA, 42(10), 1189–1193. doi.org/10.1007/s00276-020-02478-8

Spang, C., Alfredson, H., Docking, S. I., Masci, L., & Andersson, G. (2016). The plantaris tendon: a narrative review focusing on anatomical features and clinical importance. The bone & joint journal, 98-B(10), 1312–1319. doi.org/10.1302/0301-620X.98B10.37939

Rohilla, S., Jain, N., & Yadav, R. (2013). Plantaris rupture: why is it important?. BMJ case reports, 2013, bcr2012007840. doi.org/10.1136/bcr-2012-007840

Morelli, K. M., Brown, L. B., & Warren, G. L. (2018). Effect of NSAIDs on Recovery From Acute Skeletal Muscle Injury: A Systematic Review and Meta-analysis. The American journal of sports medicine, 46(1), 224–233. doi.org/10.1177/0363546517697957

Managing Posterolateral Corner Injuries: Treatment and Recovery

By
Dr. Alex Jimenez
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Physiotherapist examining his patients knee in clinic

Individuals who have sustained trauma to the knee area from work, physical activity, or a motor vehicle collision can experience significant pain and mobility impairment. Can physical therapy help heal and strengthen the PLC?

Managing Posterolateral Corner Injuries: Treatment and Recovery

Posterolateral Corner Knee Injury

The posterolateral corner, or PLC, comprises muscles, tendons, and ligaments in the back of the knee that help support and stabilize the outside region. The primary role of the PLC is to prevent the knee from excessive amounts of rotation or bowing/turning outward. (Chahla J. et al., 2016) Posterolateral corner injuries can cause significant pain and can dramatically impact an individual’s ability to walk, work, or maintain independence. Treatment options will depend on the severity of the injury.

The Posterolateral Corner

The posterolateral corner comprises multiple structures that support and stabilize the outside of the knee. The structures are subdivided into primary and secondary stabilizers. The primary group includes:

  • Lateral collateral ligament- LCL
  • Popliteofibular ligament – PFL
  • Popliteus tendon

The secondary stabilizers include:

  • The lateral capsule of the knee.
  • Coronary ligament.
  • Fabellofibular ligament.
  • Lateral gastrocneumius tendon.
  • The long head of the biceps femoris.
  • Iliotibial/IT band (Chahla J. et al., 2016)

The primary role is to prevent the knee from excessively turning outward, so the grouping provides secondary assistance in preventing the lower leg bone/tibia from shifting forward or backward on the thighbone/femur. Occasionally, one or several posterolateral corner structures can be sprained, strained, or torn.

How Injury Occurs

An injury occurs when a direct blow to the inner portion of the front of the knee causes the leg to bow outward. A posterolateral corner injury may also be sustained without contact, for example, if the knee hyperextends or buckles away from the other leg into a varus/bow leg position. Because the knee usually moves during a PLC, concurrent sprains or tears to the anterior cruciate ligament/ACL or posterior cruciate ligament/PCL are also common. (Chahla J. et al., 2016) Other situations that can also cause PLC injuries include automobile crashes and falls from elevated surfaces. (Shon O. J. et al., 2017) When this type of trauma causes a posterolateral corner injury, bone fractures are also common.

Symptoms

Depending on the severity of the injury, multiple symptoms may be present, including:

  • Difficulty walking or climbing stairs due to instability. (Shon O. J. et al., 2017)
  • Numbness or tingling in the lower leg.
  • Pain, swelling, bruising, and hardening in the knee and surrounding area.
  • Outward bowing position of the affected knee when standing.
  • Foot drop presents on the injured side. (Chahla J. et al., 2016)

For individuals who suspect that they have sustained a PLC injury or have any of the symptoms listed, it is critical to be seen by an orthopedic specialist or emergency room physician. A healthcare provider will properly evaluate the leg and develop the appropriate treatment.

Diagnosis

Diagnosis begins with a comprehensive examination. In addition to looking for the symptoms noted, a healthcare provider will move the legs in different directions to assess for any instability. The dial test may be performed, which involves having the patient lie on their stomach while the healthcare professional assesses the side-to-side rotation in the leg to check for excessive motion. (Shon O. J. et al., 2017) Imaging is frequently ordered to determine which anatomical structures are affected more accurately. X-rays can help rule out concurrent fractures and check for excessive laxity in the knee area. MRIs are also useful for visualizing the various tendons and ligaments, helping the healthcare provider look closely at any sprains or tears that may have occurred. However, MRIs may be less accurate in diagnosing PLC injuries after 12 weeks, so they should be obtained as soon as possible. Based on this evaluation, the injury may be classified using the following system (Shon O. J. et al., 2017)

Grade 1

  • 0 to 5 degrees of rotational or varus/bowing instability.
  • Incompletely torn posterolateral corner.

Grade 2

  • 6 to 10 degrees of rotational or varus/bowing instability.
  • Incompletely torn posterolateral corner.

Grade 3

  • Eleven or more degrees of rotational or varus/bowing instability.
  • Completely torn posterolateral corner.

Treatment

The care received after a posterolateral corner injury can vary depending on the structures involved and the overall severity.

Nonsurgical

Nonsurgical treatment is typically reserved for isolated grade 1 or 2 PLC injuries. (Shon O. J. et al., 2017) Depending on which structures are affected, a stabilizing brace may be worn, and crutches are often needed to decrease the strain on the knee. Physical therapy is also commonly prescribed and focuses on the following goals:

  • Gradually reducing crutch use.
  • Improving balance and stability.
  • Improving walking patterns.
  • Regaining the range of motion in the knee.
  • Strengthening the leg muscles.
  • Gradually reintroducing specific movements like running and jumping.

Surgery

Non-surgical treatment tends not to work with grade 3 injuries. If surgery is not performed, individuals may also suffer from chronic knee instability or develop long-term osteoarthritis. (Chahla J. et al., 2019) Surgical treatment is often recommended for grade 3 injuries. The damaged primary stabilizers are surgically reconstructed using a graft from another body region. Surgical repairs may also be performed on any secondary stabilizers to improve stability. (Chahla J. et al., 2019) Any other ligament injuries, such as ACL, PCL, or concurrent fractures, will also be addressed. Following the procedure, individuals immobilize their knee with a brace and do not place weight on the affected leg to protect the surgical area. Depending on the surgeon’s recommendations, this can last six weeks or more. Physical therapy is also initiated after a surgical procedure. Though rehabilitation progresses slowly, the goals are often the same as when treating milder PLC injuries. Returning to work, sports, and/or physical activity after surgery may take six months of therapy or more. (Shon O. J. et al., 2017)

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop a personalized treatment program through an integrated approach to treat injuries and chronic pain syndromes, improve flexibility, mobility, and agility, relieve pain, and help individuals return to normal activities. If other treatments are needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments.

Knee Injury Rehabilitation

References

Chahla, J., Moatshe, G., Dean, C. S., & LaPrade, R. F. (2016). Posterolateral Corner of the Knee: Current Concepts. The archives of bone and joint surgery, 4(2), 97–103.

Shon, O. J., Park, J. W., & Kim, B. J. (2017). Current Concepts of Posterolateral Corner Injuries of the Knee. Knee surgery & related research, 29(4), 256–268. doi.org/10.5792/ksrr.16.029

Chahla, J., Murray, I. R., Robinson, J., Lagae, K., Margheritini, F., Fritsch, B., Leyes, M., Barenius, B., Pujol, N., Engebretsen, L., Lind, M., Cohen, M., Maestu, R., Getgood, A., Ferrer, G., Villascusa, S., Uchida, S., Levy, B. A., Von Bormann, R., Brown, C., … Gelber, P. E. (2019). Posterolateral corner of the knee: an expert consensus statement on diagnosis, classification, treatment, and rehabilitation. Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 27(8), 2520–2529. doi.org/10.1007/s00167-018-5260-4

Levator Scapulae Muscles: A Key Player in Shoulder Blade Mobility

By
Dr. Alex Jimenez
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Male chiropractor works with a patient in a rehabilitation center, he gives him a massage

The levator scapulae muscles could be overstretched for individuals experiencing upper back, shoulder, and neck pain. Can physical therapies help relieve pain and retrain the muscles to function properly?

Levator Scapulae Muscles: A Key Player in Shoulder Blade Mobility

Levator Scapulae Muscles

The levator scapulae muscles stretch along the spine across the upper back and neck. They originate from the cervical vertebrae C1 to C4 and attach to the inside top edge of the scapula. (Chotai P. N. et al., 2015) They elevate the shoulder blades, tilt the head, and work with other muscles to stabilize the spine and influence neck motion and upper back posture. The shoulder blade/scapula is the flat, triangular-shaped bone that sits on top of the upper part of the rib cage. Where the levator scapulae attaches, the muscles raise the shoulder blade, a movement called elevation, and indirectly rotates the scapula’s bottom tip downward towards the spine. These shoulder blade movements are part of the shoulder joint’s larger flexion and abduction movements.

  • Flexion occurs when moving the arm forward and up, and abduction occurs when moving the arm out to the side.
  • The levator scapulae muscles contract during flexion and/or abduction,
  • The muscles also contract when moving the neck in side bending, lateral flexion, rotation, or twisting.

Symptoms

Neck and shoulder pain are common problems for office workers, truck drivers, and others who sit most of the day for their jobs. It can worsen when there is no spinal support for maintaining correct alignment. Poorly designed work chairs may contribute to chronic muscle tension and spasms, plus they may contribute to muscle weakness. One of the primary functions of the levator scapulae muscles is to keep the shoulder blade in a position that supports a vertical alignment of the head and to prevent forward head posture. (Yoo W. G. 2018)

However, the shoulder blade is an extremely movable bone. Maintaining stability and correct neck posture is not easy. The levator scapulae muscles may not be strong enough to keep the shoulder blade where it’s supposed to be for healthy posture, and instead, they become overstretched. When muscles are overstretched, they often become taut to try to maintain some form of stability. It can feel like muscle tension because the muscles shorten, but there is a difference. The situation can worsen if one slouches, has no lumbar support, and/or the desk or steering wheel is too high or too low, which may force the shoulder blade upward or downward.

Pain Relief

The levator scapulae muscles are two of several shoulder muscles that may contribute when neck pain presents. This is why a qualified, licensed health professional should diagnose any pain or dysfunction in the area. Physical therapy can help get the body back on track. (Yoo W. G. 2018) Treatment may consist of restoring muscle strength and flexibility in the shoulder, neck, and upper back muscles and developing better posture habits. Physical therapy exercises, particularly those that address upper back posture, can help reduce the stress placed on the levator scapulae muscles and can help decrease kyphosis, often a precursor to forward head posture. Stretching, strengthening, and posture lessons will help relieve pain and increase the physical functioning of the upper body. Other tips for avoiding and relieving muscle pain include:

  • Stretching regularly by gently rotating the neck and shoulders.
  • Applying heat to promote relaxation.
  • Regular massage therapy.
  • Adjusting chairs and/or monitor height to align with a straight line of sight.
  • Not carrying heavy bags, especially on one shoulder.
  • Avoiding side sleeping without proper head support.

Injury Medical Chiropractic Clinic

Visiting a chiropractic and physical therapy team can help treat injuries and chronic pain syndromes, relieve pain, resolve musculoskeletal issues, and prevent future symptoms. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop a personalized care program for each patient through an integrated approach to help return to normal and optimal function. If other treatments are needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments.

The Natural Way to Heal: Non-Surgical Chiropractic Care for Pain Relief

References

Chotai, P. N., Loukas, M., & Tubbs, R. S. (2015). Unusual origin of the levator scapulae muscle from mastoid process. Surgical and radiologic anatomy : SRA, 37(10), 1277–1281. doi.org/10.1007/s00276-015-1508-6

Yoo W. G. (2018). Effects of thoracic posture correction exercises on scapular position. Journal of physical therapy science, 30(3), 411–412. doi.org/10.1589/jpts.30.411

A Complete Guide to Managing Piriformis Syndrome

By
Dr. Alex Jimenez
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Chiropractor working on young woman spine while female patient lies on massage table

For individuals experiencing piriformis syndrome. Can knowing the causes and what it feels like help in diagnosis and treatment?

A Complete Guide to Managing Piriformis Syndrome

Managing Piriformis Syndrome

Piriformis syndrome is where spasms occur in the piriformis muscle located in the buttocks. These muscle spasms can cause pain and numbness in the buttocks and the back of the leg. (Cedars Sinai, 2022)

What Is It?

Piriformis syndrome is an irritation of the sciatic nerve from the piriformis muscle. Although the piriformis muscle is small compared to other muscles around the hip and thigh, it supports the hip joint’s external rotation or turning out. The sciatic nerve supplies the lower extremities with motor and sensory functions. The piriformis tendon and sciatic nerve cross each other behind the hip joint in the deep buttock. Both are about one centimeter in diameter. The piriformis muscle spasms can irritate the sciatic nerve, causing sciatica symptoms. (Cedars Sinai, 2022)

Triggers

A piriformis syndrome diagnosis means the piriformis tendon binds or spasms around the sciatic nerve, causing irritation and symptoms. Many doctors and specialists support the theory that when the piriformis muscle and its tendon tighten, this can cause compression and pinch the nerve. This can decrease blood circulation and irritate the nerve due to pressure. (Cass S. P. 2015) Many doctors also believe that piriformis syndrome occurs from anatomic variation of the muscle and tendon. It is thought this muscle-tendon variation irritates the nerve in some, leading to sciatica symptoms.

How It Feels

Common signs and symptoms experienced include (Cass S. P. 2015)

  • Pain in the buttocks.
  • Pain behind the hip.
  • Electric shock pains traveling down the back of the lower extremity.
  • Numbness in the lower extremity.
  • Tenderness with pressure that often causes pain when sitting.
  • Some develop symptoms abruptly, while others gradually increase in symptoms in the back of their thighs.

Most who are diagnosed with piriformis syndrome are generally active individuals who experience increasing difficulty with certain types of physical activity.

Testing

There are no specific tests that accurately diagnose piriformis syndrome. Doctors will order tests, including MRI and nerve conduction studies. Because it can be difficult to diagnose, there are likely many misdiagnosis cases. This means that some with the condition don’t have a piriformis diagnosis. In addition, some with vague hip pain may receive this diagnosis even if they don’t have the condition. (Cass S. P. 2015) An injection is often administered into the piriformis muscle when the diagnosis is uncertain. (Jankovic D. et al., 2013) Performing an injection can help determine the specific location of the discomfort. When an injection is given into the piriformis muscle or tendon, it is administered by ultrasound guidance to ensure the needle delivers medication to the correct location. (Bardowski E. A., and Byrd J. W. T. 2019)

Differential Diagnosis

Some other conditions with buttock pain can have similar symptoms. Other causes can include:

  • Radiculopathy/Sciatica
  • Herniated discs
  • Hip bursitis
  • Spinal stenosis

The diagnosis of piriformis syndrome is given when these diagnoses are eliminated as possible causes of pain.

Treatment

Managing piriformis syndrome is quite general, and it is often difficult to recover from. Common treatment and management suggestions include the following. (Jankovic D. et al., 2013)

Rest

  • Avoiding activities that cause symptoms for at least a few weeks.

Physical Therapy

  • Focuses on stretching and strengthening the hip rotator muscles.

Anti-inflammatory Medication

  • To decrease inflammation around the tendon.

Deep Massage

  • Used to relax the piriformis muscle and help release the compressed nerve.

Cortisone Injections

  • It can help decrease inflammation and swelling.

Botulinum Toxin Injection

  • It can paralyze the piriformis muscle to reduce pain and discomfort.

In severe cases, surgery can be performed to loosen the piriformis tendon, known as a piriformis release (Cass S. P. 2015). This surgical procedure is recommended when conservative treatments have been tried for at least six months and other causes of pain have been evaluated and ruled out. Recovery takes several months.

The goal of managing piriformis syndrome is to improve the range of motion and flexibility around the hip and diminish inflammation around the sciatic nerve. Working with a professional chiropractic team can help relieve pain, return individuals to normal function, and expedite healing. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop a customized treatment program through an integrated approach to treating injuries and chronic pain syndromes, improving flexibility, mobility, and agility. If other treatments are needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments.

Piriformis Syndrome Treatment Chiropractor

References

Cedars Sinai. Sinai, C. (2022). Piriformis syndrome. www.cedars-sinai.org/health-library/diseases-and-conditions/p/piriformis-syndrome.html

Cass S. P. (2015). Piriformis syndrome: a cause of nondiscogenic sciatica. Current sports medicine reports, 14(1), 41–44. doi.org/10.1249/JSR.0000000000000110

Jankovic, D., Peng, P., & van Zundert, A. (2013). Brief review: piriformis syndrome: etiology, diagnosis, and management. Canadian journal of anaesthesia = Journal canadien d’anesthesie, 60(10), 1003–1012. doi.org/10.1007/s12630-013-0009-5

Bardowski, E. A., & Byrd, J. W. T. (2019). Piriformis Injection: An Ultrasound-Guided Technique. Arthroscopy techniques, 8(12), e1457–e1461. doi.org/10.1016/j.eats.2019.07.033

Living with Annular Fissure: Lifestyle Changes and Medical Care

By
Dr. Alex Jimenez
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Shot of a young female doctor showing a patient a digital x-ray in an office.

An annular fissure is caused by age-related changes to the spine, which often do not cause symptoms but can cause back pain. Can understanding the causes help individuals manage lower back pain and help healthcare providers develop an effective treatment program?

Living with Annular Fissure: Lifestyle Changes and Medical Care

Annular Fissure

An annular fissure is a discogenic condition that affects the spine and can cause lower back pain. Also called an annular tear, it’s usually a wear-and-tear condition that happens over time rather than a condition caused by trauma. It usually happens when the fibers that make up the annulus or the tough outer covering of the intervertebral disc break or separate. To manage it, healthcare providers may recommend:

  • Making lifestyle changes.
  • Staying aware of how you go about daily activities and take steps to make adjustments, such as being mindful of unhealthy posture.
  • Start doing exercises that help make the back stronger.
  • Medical care if pain and other symptoms need to be managed.

Symptoms

Lower back pain may be a sign of an annular fissure, or there may be no symptoms. Symptoms can include:

  • Pain
  • Weakness
  • Numbness
  • Electrical sensations travel down one leg or arm if a cervical/neck tear is present.
  • Numbness and weakness may be caused by the nerves getting irritated or compressed near an annular tear. (Stadnik, T. W. et al., 1998)
  • These symptoms can also be similar to a herniated disc, which can be a complication of an annular fissure.
  • However, studies have shown that annular tears and herniated discs often go unnoticed because they have few obvious symptoms. (Jarvik, J. G. et al., 2005)

Annulus Function

The annulus comprises several layers of tough fibers/fibrocartilage that surround, contain, and protect the soft, liquid nucleus inside the disc. The layers of the annulus fibrosus crisscross to provide support. The nucleus is a shock absorber cushions the body’s weight on the spinal joints when sitting, standing, or moving. Its strength also allows the disc to buffer the jolts and jars it experiences. It also helps maintain the integrity of the intervertebral joint by supporting the space between the two vertebrae. When an annular fissure occurs, the fibers separate or tear off from insertion on the nearby spinal bone. A fissure can also be a break in the fibers of one or more layers. (Jarvik, J. G. et al., 2005)

Causes

An annular tear is not the standard term medical professionals use to describe or diagnose a fissure because the word tear suggests that trauma has led to the separation or break in the fibers. While an injury can cause an annular fissure, it’s usually caused by long-term wear and tear. (Guterl, C. C. et al., 2013) The tears are typically caused by age-related degenerative changes in the disc, which can also lead to degeneration in other areas of the spine. Wear and tear are caused by annular fissures due to an individual’s daily living habits, such as sitting, standing, walking, climbing stairs, and performing other routine movements.

Treatment

While a large annular fissure is not likely to improve without treatment, a small one could heal independently. However, once an area has torn, it becomes more likely to continue tearing. (Virginia Spine Institute, N.D.) Conservative treatment is usually enough to control pain and symptoms. Physical therapy and anti-inflammatory medication are the first line of treatment. (Cheng, J. et al., 2019) Medication can be over-the-counter or prescription. Physical therapy treatment includes exercises, traction, and other therapies. If these do not help with the symptoms, the provider may suggest a steroid injection to reduce inflammation and pain. It can take three to six months to recover from degenerative disc problems if doing a standard treatment plan that includes rest, low-impact therapy exercises, and anti-inflammatory treatments. (Cheng, J. et al., 2019)

In severe cases, surgery may be recommended, including disc replacement surgery. An annular tear is not a reason to have disc replacement surgery alone; it is only when there are degenerative changes in the vertebral disc that surgery might be necessary. (Yue, J. J. et al., 2012)

Improving Body Alignment

Not paying attention and being aware of how the body performs everyday activities can, over time, set the stage for an annular fissure and other musculoskeletal injuries. However, fixing daily movement and posture habits to prevent injuries can be done through simple adjustments. For example, strengthening the core and back muscles can reduce pressure on the spine and help prevent injuries. (Camp, C. L. et al., 2016) The idea is to improve joint and overall body alignment. Activities can include:

  • Strength training
  • Walking
  • Pilates classes
  • Yoga
  • Tai chi
  • Somatic exercises

These activities help with muscle balance and joint alignment, which are recommended prevention strategies that physical therapists use when working with individuals who need help with spinal problems.

Visiting a chiropractic and physical therapy team can help treat injuries and chronic pain syndromes, relieve pain, resolve musculoskeletal issues, and prevent future symptoms. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop a personalized care program for each patient through an integrated approach to treating injuries, improving flexibility, mobility, and agility to help return to normal and optimal function. If other treatments are needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments.

Back Pain Specialist

References

Stadnik, T. W., Lee, R. R., Coen, H. L., Neirynck, E. C., Buisseret, T. S., & Osteaux, M. J. (1998). Annular tears and disk herniation: prevalence and contrast enhancement on MR images in the absence of low back pain or sciatica. Radiology, 206(1), 49–55. doi.org/10.1148/radiology.206.1.9423651

Jarvik, J. G., Hollingworth, W., Heagerty, P. J., Haynor, D. R., Boyko, E. J., & Deyo, R. A. (2005). Three-year incidence of low back pain in an initially asymptomatic cohort: clinical and imaging risk factors. Spine, 30(13), 1541–1549. doi.org/10.1097/01.brs.0000167536.60002.87

Guterl, C. C., See, E. Y., Blanquer, S. B., Pandit, A., Ferguson, S. J., Benneker, L. M., Grijpma, D. W., Sakai, D., Eglin, D., Alini, M., Iatridis, J. C., & Grad, S. (2013). Challenges and strategies in the repair of ruptured annulus fibrosus. European cells & materials, 25, 1–21. doi.org/10.22203/ecm.v025a01

Virginia Spine Institute. (N.D.). Annular disc tear Understanding the Symptoms, Causes, and Treatments. www.spinemd.com/conditions/annular-disc-tear/

Cheng, J., Santiago, K. A., Nguyen, J. T., Solomon, J. L., & Lutz, G. E. (2019). Treatment of symptomatic degenerative intervertebral discs with autologous platelet-rich plasma: follow-up at 5-9 years. Regenerative medicine, 14(9), 831–840. doi.org/10.2217/rme-2019-0040

Yue, J. J., Telles, C., Schlösser, T. P., Hermenau, S., Ramachandran, R., & Long, W. D., 3rd (2012). Do presence and location of annular tear influence clinical outcome after lumbar total disc arthroplasty? A prospective 1-year follow-up study. International journal of spine surgery, 6, 13–17. doi.org/10.1016/j.ijsp.2011.09.001

Camp, C. L., Conti, M. S., Sgroi, T., Cammisa, F. P., & Dines, J. S. (2016). Epidemiology, Treatment, and Prevention of Lumbar Spine Injuries in Major League Baseball Players. American journal of orthopedics (Belle Mead, N.J.), 45(3), 137–143.

Discover the Amazing Health Benefits of Lemongrass

By
Dr. Alex Jimenez
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lemon grass on a white background

Can incorporating lemongrass into a diet help individuals manage anxiety, colds, fever, inflammation, and insomnia?

Discover the Amazing Health Benefits of Lemongrass

Lemongrass

Lemongrass, or lemongrass or citronella, is a tall grass-like herb commonly used in Southeast Asian cooking. The lower stalks and bulbs of the plant have a fresh, clean, lemony scent that is sometimes added to marinades, teas, curries, and broths. In addition to its flavoring use, lemongrass’s essential oils are used for medicinal purposes, supported by scientific evidence.

Benefits

Lemongrass has been shown to help with common ailments, such as anxiety, colds, fever, inflammation, and insomnia. It can be eaten, rubbed on the skin, or inhaled as an aromatherapy treatment. When taken orally, it is often used to calm stomach discomfort and other gastrointestinal issues, including cramps and vomiting. (DeFilipps, R. A. et al., 2018) When used as a tea, it protects the stomach lining by treating stomach ailments, indigestion, and gastric ulcers. (Khan, Nida. 2020) Lemongrass or oil is applied to the skin to treat headaches and musculoskeletal pain. As an aromatherapy treatment, the oil extract may be inhaled to treat muscle pain, infections, colds, and flu symptoms. Consumed it can help treat:

  • Musculoskeletal pain
  • Sleeplessness
  • Rheumatism
  • Cough
  • Common cold
  • Fever
  • Anxiety
  • Hypertension
  • Diabetes
  • Epilepsy
  • Cancer prevention

However, a few studies support certain lemongrass benefits. Research has suggested that lemongrass oil added to a hair tonic may reduce dandruff. However, more studies are needed to confirm. (Chaisripipat, W. et al., 2015)

Essential Oil

Lemongrass essential oil has been studied and has been found to contain significant bioactive compounds that include:

  • Citral
  • Isoneral
  • Isogeranial
  • Geraniol
  • Geranyl acetate
  • Citronellal
  • Citronellol
  • Germacrene-D
  • Elemol

These compounds contain antifungal, antibacterial, antiviral, anticancer, and antioxidant properties. (Mukarram, M. et al., 2021) Research also shows that essential oils can be therapeutic agents for treating inflammatory skin conditions and help reduce dandruff because of their antimicrobial and anti-inflammatory properties. They can also inhibit the growth of the fungi associated with causing dandruff. (Khan, Nida. 2020)

Nutrition

One tablespoon of fresh lemongrass provides around five calories, most from carbohydrates/fiber and protein. (U.S. Department of Agriculture, 2018) It is a source of fiber, carbohydrates, and vitamins A, B, and C, strengthening the body’s immune system, repairing tissue damage, and promoting cell division. It also contains:

  • Magnesium – Necessary for protein synthesis, glycolysis, and muscle activity,
  • Selenium – Necessary for cognitive function and fertility.
  • Phosphorus – Necessary for DNA/RNA and cell membrane synthesis.
  • Zinc for wound healing, growth, and development. (Khan, Nida. 2020)

Minerals include:

  • Calcium – 3 milligrams
  • Potassium – 34 milligrams
  • Manganese – 0.2 milligrams
  • Magnesium – 2.9 milligrams
  • Iron – 0.4 milligrams

It also provides small amounts of vitamins, including A and C, folate, and niacin. However, lemongrass-flavored oil contains significantly more calories because it usually combines cooking oil with lemongrass extract.

Preparation and Storage

Lemongrass is becoming easier to find in stores. When choosing lemongrass, look for firm green stalks with healthy-looking bulbs attached. Some stores may sell the stalks with a good portion of the top removed. This is fine, as many recipes require using the bottom of the stalk or the bulb. To use lemongrass in teas, soups, broth, or other liquids, crush the stalks’ bottom area to release the aromatic oil. Then, immerse the pieces in the liquid to release the oils. Remove the stalks before eating or drinking the beverage. In other recipes, chopping or mincing the bulb or lower area of the stalks may be necessary before adding to a curry, salad, marinade, or stir-fry. Lemongrass can be wrapped in plastic and refrigerated for two to three weeks or frozen for up to 6 months.

Potential Side Effects

Lemongrass is safe for most when consumed in typical amounts in food. However, some concerns may arise when using it for medicinal purposes.

  • Used topically, lemongrass may cause skin irritation.
  • Additionally, consuming high amounts of lemongrass may cause dizziness, drowsiness, dry mouth, excess urination, and increased appetite. (Memorial Sloan Kettering Cancer Center, 2022)
  • High amounts of essential oil can damage liver and stomach mucous membranes, and excessive tea intake may also affect kidney function. (Memorial Sloan Kettering Cancer Center, 2022)
  • It is recommended that pregnant women should avoid lemongrass.
  • Additionally, individuals undergoing chemotherapy should avoid lemongrass because it may interfere with the actions of some chemotherapeutic agents.

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop a personalized treatment plan through an integrated approach to treating injuries and chronic pain syndromes, improving flexibility, mobility, and agility programs to relieve pain and help individuals return to optimal function. Our providers use an integrated approach to create customized care programs for each patient and restore health and function to the body through nutrition and wellness, 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.

Fighting Inflammation

References

DeFilipps, R. A., & Krupnick, G. A. (2018). The medicinal plants of Myanmar. PhytoKeys, (102), 1–341. doi.org/10.3897/phytokeys.102.24380

Khan, Nida. (2020). Therapeutic benefits of lemongrass and tea tree. Annals of Civil and Environmental Engineering. 4. 027-29. 10.29328/journal.acee.1001022.

Chaisripipat, W., Lourith, N., & Kanlayavattanakul, M. (2015). Anti-dandruff Hair Tonic Containing Lemongrass (Cymbopogon flexuosus) Oil. Forschende Komplementarmedizin (2006), 22(4), 226–229. doi.org/10.1159/000432407

Mukarram, M., Choudhary, S., Khan, M. A., Poltronieri, P., Khan, M. M. A., Ali, J., Kurjak, D., & Shahid, M. (2021). Lemongrass Essential Oil Components with Antimicrobial and Anticancer Activities. Antioxidants (Basel, Switzerland), 11(1), 20. doi.org/10.3390/antiox11010020

U.S. Department of Agriculture. (2018). Lemon grass (citronella), raw. Retrieved from fdc.nal.usda.gov/fdc-app.html#/food-details/168573/nutrients

Memorial Sloan Kettering Cancer Center. (2022). Lemongrass Purported Benefits, Side Effects & More. www.mskcc.org/cancer-care/integrative-medicine/herbs/lemongrass

The Importance of Neurological Physical Therapy for Rehabilitation

By
Dr. Alex Jimenez
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Physiotherapist helping female patient with rehabilitation, balance exercise with bosu ball, woman and doctor during rehab physiotherapy in gym.

Can neurological physical therapy help individuals diagnosed with a recently acquired or chronic neurological condition gain strength and functioning?

The Importance of Neurological Physical Therapy for Rehabilitation

Neurological Physical Therapy

Neurological physical therapy can be extremely beneficial. It aims to restore functional mobility, strength, balance, and coordination in those with neurological conditions that affect their quality of life and ability to move around. It also helps recover from neurological injuries or prevent the progression and worsening of chronic neurological conditions. Depending on the severity of the condition, individuals may receive this therapy as an inpatient or outpatient. Exercise can help improve mobility, increase independence, and decrease the need for assistance, all of which can improve one’s quality of life.

Process

Neurological physical therapy is geared toward treating individuals with conditions affecting the brain and spinal cord, such as stroke, spinal cord injury, and Parkinson’s disease, to help restore mobility and function. The therapy is performed in hospitals, private practice physical therapy clinics, doctors’ offices, rehabilitation facilities, or at a patient’s home. Whether an individual needs inpatient or outpatient physical therapy will depend on the severity of the neurological condition.

  • Newly acquired neurological conditions such as strokes or traumas like spinal cord injuries and traumatic brain injuries or TBIs often require inpatient rehabilitation.
  • Once the patient gains enough strength, coordination, and independence with movements like standing and walking, they can progress to outpatient physical therapy.
  • The patient will undergo a physical exam after a physical therapist has gathered enough information about medical history during the initial evaluation.
  • The therapist will check muscle strength, coordination, range of motion, reflexes, and the muscle tone of the arms and legs. They may also perform neurological tests to examine coordination, such as following moving objects with the eyes, touching the finger to the nose, and rapidly alternating movements.
  • The individual general level of attention, cognition, and sensation will also be assessed to determine if these areas have been affected by the neurological condition. (Cleveland Clinic, 2022)
  • The therapist will then assess the patient’s ability to perform movements called transfers, which are transitions to and from positions such as lying down to sitting up or standing up to sitting.
  • They will note if the patient can perform these movements independently or if they need assistance.
  • The initial evaluation will also include an assessment of balance, quality of gait, and whether the therapist needs to assist.
  • Depending on the severity of the neurological condition, the therapist may provide the patient with or recommend purchasing an assistive device to help walk.

Treatment Sessions

During therapy sessions, patients may receive the following interventions:

Gait Training

  • To improve walking ability, proper instruction on using assistive devices such as canes, walkers, and crutches.

Balance Training

  • To improve static/stationary and dynamic/while moving balance, both sitting unsupported to improve core control and standing upright with or without handheld support.

Therapeutic Activities

  • To improve independence with bed mobility skills like rolling and sitting up from lying down and transfers on and off beds, chairs, and toilets.
  • Therapeutic exercises for stretching and strengthening muscles and improving coordination and motor control.

Endurance Training

  • This can be done with cardiovascular equipment like treadmills, stationary bicycles, and ellipticals.

Vestibular Therapy Interventions

  • Balance exercises with head movements and exercises to treat a common cause of dizziness are used to improve eye movement control.
  • Examples are the Dix-Hallpike and Epley maneuvers.

Conditions

Neurological physical therapy can treat various conditions. Some neurological conditions are progressive, worsening over time, and require regular physical therapy and at-home exercises to maintain optimal health and wellness. Neurological conditions that can be treated with physical therapy include: (Cleveland Clinic, 2022)

  • Strokes – loss of blood supply to the brain.
  • Spinal cord injuries – damage to part of the central nervous system resulting in loss of movement and control.
  • Polyneuropathies –  damage to the peripheral nerves.
  • Traumatic brain injuries – for example, concussions.
  • Cerebral palsy – a group of disorders affecting movement, balance, and posture.
  • Multiple sclerosis – a disabling disease of the brain and spinal cord.
  • Parkinson’s disease – a progressive nervous system disorder.
  • Guillain-Barre syndrome – an autoimmune disease attacking the nerves.
  • Amyotrophic lateral sclerosis/ALS, also known as Lou Gehrig’s disease.
  • Vertigo, including benign paroxysmal positional vertigo or BPPV.

Neurological conditions, like an automobile collision, can occur suddenly or be progressive, such as Parkinson’s. Physical therapy helps those individuals by increasing their use of weakened muscles, improving their motor control, coordination, and balance, and facilitating their independence with daily tasks and movements. Always seek immediate medical attention for any sudden, unexplained muscle weakness. Individuals who experience skeletal muscle weakness should discuss the type and duration of symptoms with their doctor, specialist, physical therapist, or chiropractor, as this might be a sign of a medical condition such as a neuromuscular disorder. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop a personalized treatment program through an integrated approach to treat injuries and chronic pain syndromes, improving flexibility, mobility, and agility, relieving pain, and helping individuals return to normal activities. If other treatments are needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments.

Personal Injury Rehabilitation

References

Cleveland Clinic. (2022). Neurological Exam. my.clevelandclinic.org/health/diagnostics/22664-neurological-exam

Managing Lupus and Sun Sensitivity: Tips and Strategies

By
Dr. Alex Jimenez
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Cheerful attractive brunette young european woman doctor wearing medical uniform white coat and stethoscope posing at clinic or hospital next to window, holding clipboard, smiling at camera

Individuals with the autoimmune disease lupus may be more sensitive to sun exposure. Are there ways to help protect the skin?

Managing Lupus and Sun Sensitivity: Tips and Strategies

Lupus Sun Exposure

Lupus is an autoimmune disease in which the body mistakenly attacks the joints, muscles, and skin. Around 5 million individuals worldwide, and 1.5 million in the United States, have been diagnosed with lupus. The disease is most common in early to mid-adulthood, and 90% develop in women. (Lupus Foundation of America, 2021) For some, the symptoms manifest as joint swelling or muscle soreness. Skin rashes, mottling or red or purple marbled skin, and sun sensitivity are common lupus symptoms. (Medline Plus, 2024) While exposure to UV radiation from natural and artificial light can be damaging to everyone, minimal exposures can cause a flare-up for those with chronic lupus.

UV Radiation

Ultraviolet (UV) light is radiation emitted naturally by the sun. These rays have some health benefits, like the generation of vitamin D, but too much UV exposure can cause health problems. Exposure to too much sun and artificial sources of light can cause: (U.S. Environmental Protection Agency, 2024) (Centers for Disease Control and Prevention, 2024)

  • Sunburn
  • Skin damage
  • Skin cancer
  • Eye damage
  • Cataracts
  • Immune system suppression
  • Certain medications can impact individual sensitivity to the sun and UV radiation.

Sun Exposure

Lupus can increase photosensitivity or immune system reaction to the sun’s rays. This symptom affects 40% and 70% of individuals with lupus. (Lupus Foundation of America, 2021) UV radiation damages cells and alters DNA. However, the damage can be more severe in those with lupus because their cells are more sensitive, and damaged cells are removed from the body more slowly, which can cause an attack on the immune system. (Lupus Foundation of America, 2021)

Symptoms

UV light and certain artificial light sources can trigger reactions in those with lupus. These reactions can happen immediately or develop weeks later and include: (Lupus Foundation of America, 2013)

  • Itching
  • Stinging
  • Burning
  • Joint pain
  • Weakness
  • Fatigue
  • Headaches

Other symptoms of sun exposure triggers are: (Lupus Foundation of America, 2013) (Lupus Foundation of America, 2021)

  • Rashes
  • Skin lesions

Rashes or skin lesions that appear after sun exposure can come and go within hours or days, or they can last for months. (Lupus Foundation of America, 2013) UV light can also cause a lupus flare-up of symptoms, including fatigue, joint pain, tingling, and numbness. (Lupus Foundation of America, 2021)

Protection

Protecting the skin from UV radiation is recommended for everyone, but it is especially important for individuals with photosensitivity from lupus. Some strategies to protect the skin include.

Sunscreen

Applying sunscreen to the skin provides a chemical or physical barrier to UV radiation. (MD Anderson, 2024) Most commercial sunscreens offer a combination of protection:

Physical Barriers

  • These include minerals like titanium dioxide or zinc oxide.
  • The finely ground minerals lay on top of the skin’s surface and reflect UV rays away.

Chemical Absorbers

  • These offer a thin, protective film that absorbs UV rays before they can penetrate the skin.

Proper sunscreen application is crucial, regardless of which type is chosen. The recommended application is to apply a palmful of sunscreen every two hours or more often if it gets wet or sweaty. Look for sunscreens that offer broad-spectrum protection against:

  • Ultraviolet A (UVA) rays
  • Ultraviolet B (UVB) rays
  • A sun protection factor (SPF) of at least 30 is recommended.
  • Sunscreen can expire, so check the expiration dates regularly. (Skin Cancer Foundation, 2020) (MD Anderson 2024)

Protective Clothing

  • Most clothing offers protection against UV radiation.
  • Individuals can purchase clothing or hats with UV-blocking properties or washing products for their clothes to increase their level of UV protection. (American Cancer Society, 2024)
  • Sunglasses are also important against UV radiation, eye damage, and other problems.

Utilize Shade Areas

In the summer, the sun is strongest in most locations between 10 a.m. and 4 p.m. UV rays can pass through windows, and the body is exposed to UV radiation on cloudy days (American Cancer Society, 2024). Avoiding sunlight or other strong sources of UV radiation will help protect the skin. Staying indoors or in shaded areas is the best choice during these hours.

Seeing a Healthcare Provider

Lupus treatment varies and changes over time. Individuals with lupus schedule regular appointments with their healthcare provider to review treatment and symptoms, especially after sun exposure. Avoiding sun exposure by seeking shade and wearing sunscreen and protective clothing can help reduce the chances of experiencing a flare-up. Some cases of photosensitivity are mild, while others can require more intense treatments to avoid larger flare-ups.

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop a personalized care plan for each patient through an integrated approach to treating injuries and chronic pain syndromes, improving flexibility, mobility, and agility programs to relieve pain and help return to normal and optimal function. If other treatments are needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments.

Unlocking Pain Relief

References

Medline Plus. (2024). Lupus. Retrieved from medlineplus.gov/lupus.html

Lupus Foundation of America. (2021). Lupus facts and statistics. www.lupus.org/resources/lupus-facts-and-statistics

U.S. Environmental Protection Agency. (2024). Health effects of UV radiation. Retrieved from www.epa.gov/sunsafety/health-effects-uv-radiation

Centers for Disease Control and Prevention. (2024). UV radiation. Retrieved from www.cdc.gov/radiation-health/features/uv-radiation.html?CDC_AAref_Val=https://www.cdc.gov/nceh/features/uv-radiation-safety/index.html

Lupus Foundation of America. (2021). UV exposure: What you need to know. www.lupus.org/resources/uv-exposure-what-you-need-to-know

Lupus Foundation of America. (2013). Research on photosensitivity among people with lupus. www.lupus.org/resources/research-on-photosensitivity-among-people-with-lupus

MD Anderson Center. (2024). How does sunscreen work? www.mdanderson.org/cancerwise/how-does-sunscreen-work.h00-159698334.html

Skin Cancer Foundation. (2020). Ask the expert: Does sunscreen stay effective after its expiration date? www.skincancer.org/blog/ask-the-expert-does-a-sunscreen-stay-effective-after-its-expiration-date/

American Cancer Society. (2024). How do I protect myself from ultraviolet (UV) rays? www.cancer.org/cancer/risk-prevention/sun-and-uv/uv-protection.html

Burn More Fat with Walking: Effective Strategies Revealed

By
Dr. Alex Jimenez
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Young women smiling at each other in sportswear. Running and doing sports with friends.

Can incorporating walking help accomplish health goals for individuals trying to burn fat?

Walking To Burn Calories and Fat

Walking has many wonderful benefits that include:

  • Improving fitness
  • Strengthening bones
  • Easing joint pain
  • Improving mental health

What to know

Taking it easy at first and steadily working on the basics can help individuals reach their health goals. Two keys to burning more fat when walking are:

  1.  Walk with enough speed and intensity to burn fat for energy.
  2. The longer you walk, the more stored fat is burned instead of the sugars for quick bursts of exercise.

While any exercise can burn calories, brisk walking and other aerobic exercises are especially recommended for burning internal abdominal visceral fat. This fat contributes to the waistline and increases the risk of diabetes and heart disease. (Bairapareddy, K. C. et al., 2018)

Fat-Burning Zone

The American Heart Association categorizes brisk walking at a pace of 2.5 miles per hour as a moderate-intensity aerobic activity. (American Heart Association, 2024) The target heart rate for exercising at this level of intensity should be 50% to 70% of an individual’s maximum heart rate. For more vigorous activities, the heart rate should be about 70% to 85% of an individual’s maximum heart rate. (American Heart Association, 2021) Working out at a low to moderate intensity can help burn fat because the body uses stored fat as fuel compared with workouts of higher intensity that depend on carbohydrates. (Carey D. G. 2009)

The heart rate range for this zone varies by age. An age heart rate zone chart can help individuals find the right numbers. While exercising, take your pulse to check your heart rate. Heart rate apps and pulse monitors have been built into activity monitors and smartwatches. While exercising in this zone, breathing is heavier, and there is a feeling of increased exertion and sweating, but individuals should be able to carry on a conversation. (Centers for Disease Control and Prevention, 2022)

  • Beginners should gradually build up walking time and speed.
  • A beginner’s walking plan starts with 15 minutes daily, five days a week, and continued improvement in walking technique.
  • Increase walking time by 5 minutes per session each week.

Increasing Walking Intensity

If the heart rate is still below 60% of the maximum heart rate, individuals need to intensify the workout to burn fat. Ways to do this include:

Adding Distance and Time

Make the walk longer to keep the body working harder and maintain a brisk pace. Adding additional minutes will burn additional stored fat. However, since not everyone has the time, there are other options.

Picking Up The Pace

Even for a short walk, make a goal to perform faster than normal, walking faster using correct posture, arm motion, and a powerful stride. It can help to time the walking route and challenge yourself to complete it faster each time. One study examined individuals walking 3.6 miles per hour, 4.1 mph, and 4.6 mph. Accelerating to 4.6 mph burned more than 50% more calories than going from 3.6 mph to 4.1 mph. (Schwarz, M. et al., 2006)

Adding Intervals

Intervals add intensity and also help increase the overall pace. The strategies above to walk faster incorporate intervals, where individuals increase their speed for a set distance or time, alternating with a slower pace. Research on individuals with diabetes found that those who did interval walking for four months lost six times as much weight as those who walked steadily. (Karstoft K. et al., 2013)

Adding Hills and/or Stairs

Incorporating hills or stair-climbing into some walking sessions helps you stay challenged and makes workouts more intense. If there is no access to outdoor hills or stairs, use a treadmill – start with a slight incline and work up to a steeper one, or get on a stair-stepping machine at the gym. There is no need to walk briskly on hills, as one study showed that walking slowly on an incline was an effective workout that didn’t cause knee joint stress, especially for obese individuals. (Haight, D. J. et al., 2014)

Switch Up Workouts

Mix up different walking workouts like intervals, short and fast walks, and long and moderate walks. Meditative, mindful walks also have stress-reducing benefits that help lower cortisol, which can contribute to weight gain. Individuals who can’t spend 45 continuous minutes walking make the most of the available time. Try and fit in two to four 15-minute walks at a brisk pace. It’s also recommended to include other types of moderate-intensity exercise and activities that include:

  • Bicycle riding on level terrain
  • Water aerobics
  • Using an elliptical trainer
  • Ballroom dancing
  • Gardening
  • Doubles tennis or pickleball

Challenge the body in new ways to burn fat, build muscle, and raise basal metabolic rate. With a boosted metabolism, the body burns more calories all day.

Sample Walking Workout

You can use a treadmill or walk outside. Make sure you have athletic shoes that are flat and flexible and have the proper support and cushioning for a long walk. Wear breathable clothing, which allows freedom of movement and wicks away sweat.

Warmup

  • Start with 5 to 10 minutes of easy walking, increasing speed gradually.
  • The warmup is important to burn stored blood sugar and deplete the ready energy stored in the muscles.
  • This signals the body that a longer exercise session is underway.
  • As a result, the body prepares to burn stored fat.

Pick Up The Speed

  • To burn fat, the body needs to be in the fitness zone, with a heart rate of 60% to 70% of the maximum heart rate.
  • Check heart rate every 10 minutes to stay in the zone.

Stay In The Fitness Zone

  • For 30 to 50 minutes or more.
  • If your heart rate dips, pick up the speed.

Cool Down

  • End with 5 to 10 minutes at an easier pace to cool down.

Injury Medical Chiropractic and Functional Medicine Clinic

Using an integrated approach to treat and prevent injuries and chronic pain syndromes, improve flexibility, mobility, and agility, and help individuals return to normal activities, Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers, trainers, and specialists to develop a personalized fitness program. Each case is different and requires reviewing individual medical history and physical examination to determine the proper training plan. Dr. Jimenez has partnered with top trainers, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments and fitness training plans.

Weight Loss Techniques

References

Bairapareddy, K. C., Maiya, A. G., Kumar, P., Nayak, K., Guddattu, V., & Nayak, V. (2018). Effect of aerobic exercise on echocardiographic epicardial adipose tissue thickness in overweight individuals. Diabetes, metabolic syndrome and obesity : targets and therapy, 11, 303–312. doi.org/10.2147/DMSO.S145862

American Heart Association. (2024). American Heart Association Recommendations for Physical Activity in Adults and Kids. www.heart.org/en/healthy-living/fitness/fitness-basics/aha-recs-for-physical-activity-in-adults

American Heart Association. (2021). Target Heart Rates Chart. www.heart.org/en/healthy-living/fitness/fitness-basics/target-heart-rates

Carey D. G. (2009). Quantifying differences in the “fat burning” zone and the aerobic zone: implications for training. Journal of strength and conditioning research, 23(7), 2090–2095. doi.org/10.1519/JSC.0b013e3181bac5c5

Centers for Disease Control and Prevention. (2022). Measuring Physical Activity Intensity. Retrieved from www.cdc.gov/physicalactivity/basics/measuring/index.html

Schwarz, M., Urhausen, A., Schwarz, L., Meyer, T., & Kindermann, W. (2006). Cardiocirculatory and metabolic responses at different walking intensities. British journal of sports medicine, 40(1), 64–67. doi.org/10.1136/bjsm.2005.020198

Karstoft, K., Winding, K., Knudsen, S. H., Nielsen, J. S., Thomsen, C., Pedersen, B. K., & Solomon, T. P. (2013). The effects of free-living interval-walking training on glycemic control, body composition, and physical fitness in type 2 diabetic patients: a randomized, controlled trial. Diabetes care, 36(2), 228–236. doi.org/10.2337/dc12-0658

Haight, D. J., Lerner, Z. F., Board, W. J., & Browning, R. C. (2014). A comparison of slow, uphill and fast, level walking on lower extremity biomechanics and tibiofemoral joint loading in obese and nonobese adults. Journal of orthopaedic research : official publication of the Orthopaedic Research Society, 32(2), 324–330. doi.org/10.1002/jor.22497

Tips for Maintaining Correct Posture Throughout the Day

By
Dr. Alex Jimenez
-
hardworking handsome doctor with mask stretching his patient during appointment in hospital

For individuals who are feeling back pain, neck pain, or shoulder pain, can using postural techniques help decrease pain and develop strategies to maintain correct posture?

Tips for Maintaining Correct Posture Throughout the Day

Maintaining Correct Posture

Exercise and postural correction are two of the most important strategies to manage pain. (Robin McKenzie, the great spine guru PT, (May S. and Donelson R. 2008) However, it is not easy to maintain correct posture as the day progresses. While working or driving, most of us forget to be mindful of our posture; we slip back into unhealthy habits of sitting slouched, to the side, forward, etc, which often leads to continued pain and movement limitations. Studies on postural correction and its effect on overall back or neck pain levels are limited. (Lederman E. 2011) However, some studies show that a forward-head posture increases stress and load on the neck. (Hansraj K. K. 2014) If an individual has pain that improves with sitting upright, perhaps checking posture as the day progresses could be beneficial. There are ways to start changing posture and maintain the change. First, visit a physical therapist, spine specialist, or chiropractor to learn how to sit or stand to manage posture problems. They can teach individuals how to attain healthy posture and manage their condition. These strategies can then be used to maintain correct posture.

Lumbar Support

A lumbar roll/support is one of the simplest ways to attain and maintain a healthy sitting posture. These specialized pillows can help maintain the forward curve in the lower back. Maintaining the lumbar lordosis curve is essential for keeping stress off the back muscles, joints, and discs. Lumbar support pillows can be found in various stores, office supply stores, or purchased online. A physical therapist PT can help train individuals to use a lumbar roll properly.

Utilize the Slouch Overcorrect Exercise

The slouch overcorrect exercise is a simple maneuver for training the body to find and maintain its neutral position. It involves slowly shifting from a slouched position to an overcorrected postural position. Once posture is overcorrected, a slight relaxation from a fully erect posture will return to sitting properly. Practicing this exercise daily can help train the body to feel the muscles, listen to the body, and maintain proper posture. The muscles have memory, and the more often the body is placed in optimal posture, the muscles memorize their healthy, pain-free positioning.

Kinesiology Tape

Kinesiology tape is a flexible cotton adhesive that facilitates muscle contractions and inhibits muscle spasms and pain. (Han J. T. et al., 2015) Using the tape is a simple way to help facilitate the postural support muscles. The tape can be applied to the middle trapezius and rhomboid muscles to help support the shoulder blades and spine. Kinesiology tape for postural control also gently pulls on the muscles when slouching to remind the individual to sit up or stand straight.

Scapular Stabilization Exercises

A physical therapist or chiropractor can help improve posture through targeted exercises. Strengthening the muscles attached to the shoulder blades can help individuals better control their posture. (Shiravi S. et al., 2019) Exercises like the prone T, I, or Y can help improve the muscles’ neuromuscular recruitment to maintain correct posture.

Use an Alarm

Setting an alarm while working can help train the body to maintain correct posture. Most of us sit at a computer, desk, or workstation with proper posture, but depending on what we’re working on, we eventually slouch, lean to the side, or have a forward head posture. Pretty much all computers and phones have an alarm setting or app. Use the alarm or timer to go off every 20 to 30 minutes. When the alarm rings, look at your posture to recognize what you’re doing, get up and move around to stretch the body, sit and readjust, reset the alarm, and continue working. As you get better at maintaining appropriate posture, you won’t need the alarm anymore, and readjusting will become automatic.

Chiropractic Team

Sitting and standing with unhealthy posture can significantly cause back, neck, and shoulder pain. By visiting a chiropractic and physical therapy team and learning to attain and maintain correct posture, you can quickly relieve pain, resolve musculoskeletal issues, and prevent future pain symptoms. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop a personalized care plan for each patient through an integrated approach to treating injuries and chronic pain syndromes, improving flexibility, mobility, and agility programs to relieve pain and help return to normal and optimal function. If other treatments are needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments.

Scapular Winging In-Depth

References

May, S., & Donelson, R. (2008). Evidence-informed management of chronic low back pain with the McKenzie method. The spine journal : official journal of the North American Spine Society, 8(1), 134–141. doi.org/10.1016/j.spinee.2007.10.017

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

Hansraj K. K. (2014). Assessment of stresses in the cervical spine caused by posture and position of the head. Surgical technology international, 25, 277–279.

Han, J. T., Lee, J. H., & Yoon, C. H. (2015). The mechanical effect of kinesiology tape on rounded shoulder posture in seated male workers: a single-blinded randomized controlled pilot study. Physiotherapy theory and practice, 31(2), 120–125. doi.org/10.3109/09593985.2014.960054

Shiravi, S., Letafatkar, A., Bertozzi, L., Pillastrini, P., & Khaleghi Tazji, M. (2019). Efficacy of Abdominal Control Feedback and Scapula Stabilization Exercises in Participants With Forward Head, Round Shoulder Postures and Neck Movement Impairment. Sports health, 11(3), 272–279. doi.org/10.1177/1941738119835223

Exploring Voluntary Muscles: Their Importance and Function

By
Dr. Alex Jimenez
-
Professional chiropractor or physiotherapist helps to heal a young woman's back. Doctor fixes the patient lying on a couch of a modern rehabilitation clinic Concept of physical rehabilitation.

Skeletal muscles attached to the arms, legs, neck, back, and trunk bones are voluntary and consciously controlled. Weakness or inability to control these muscles can signal a health issue like a neuromuscular disorder or electrolyte imbalance. Can recognizing the symptoms can help healthcare providers develop effective treatment programs?

Exploring Voluntary Muscles: Their Importance and Function

Voluntary Muscles

Voluntary muscles are the skeletal muscles that attach to bones and control movement of the limbs, head, neck, and body under an individual’s conscious control. Skeletal muscles are controlled by neuromuscular signals from the brain that communicate with individual muscle fibers and cause them to contract.

Difference

  • Voluntary muscles are skeletal muscles that contract and relax under conscious control.
  • These muscles attach to bones and regulate movement of the body.
  • Involuntary muscles are not under conscious control.
  • Involuntary muscles involve automatic internal processes needed for survival, like controlling blood vessels and organs like the heart, lungs, and digestive system.
  • They contract and relax automatically and receive signals from the autonomic nervous system, which regulates internal bodily functions.

Voluntary

Voluntary muscles are skeletal muscles that comprise 40% of the body’s weight and 50% to 75% of the body’s proteins. These muscles can convert chemical and mechanical energy to cause voluntary muscle contraction and movement. (Trovato F.M. et al., 2016) Skeletal muscle comprises fascicles or bundled units of multiple muscle fibers or muscle cells. Each muscle fiber consists of a cross-banded structure further divided into myofibrils containing thick myosin and thin actin myofilaments, which give the muscle its stripe appearance, and the structure gives the characteristic striated structure. (Trovato F.M. et al., 2016) Muscle contraction occurs when these myofilaments move closer together, stimulated by the release of the neurotransmitter acetylcholine from nerve cells that communicate with the muscle fiber.

Involuntary

The autonomic nervous system controls involuntary muscles, regulating their contraction and relaxation. This system also controls the activity of organs and blood vessels for essential daily functions, including breathing, circulation, digestion, heartbeat regulation, and urination. Most involuntary muscles are composed of smooth muscles. Smooth muscles do not have the striated structure of skeletal muscles and consist of sheets or layers of smooth muscle cells. When the autonomic nervous system stimulates these muscle cells to contract by releasing hormones or other chemical signals, smooth muscle cells shorten through the movement of actin and myosin myofilaments. Involuntary smooth muscles include the blood vessel walls, diaphragm, intestines, and bladder. (Webb R. C. 2003) One exception of an involuntary muscle is the myocardium, or heart muscle. The myocardium comprises a specialized cardiac muscle cell found only in the heart. Cardiac muscle is striated like skeletal muscle but is controlled by the autonomic nervous system and pacemaker cells, causing it to contract automatically and rhythmically.

Weakened Voluntary Muscles

Skeletal muscle diseases, neuromuscular disorders, and other causes can weaken muscles. Neuromuscular or skeletal muscle disorders affect the nerves that send electrical signals to voluntary skeletal muscles to control movement. When the nerves are damaged, communication between the nerves and muscles becomes disrupted. This can result in significant muscle weakness, atrophy, and loss of function. Most neuromuscular disorders are genetic or caused by issues with the immune system. Nerves communicate with muscles through the release of neurotransmitters at the neuromuscular junction, which is the space between a nerve cell and muscle fiber. Neuromuscular disorders can damage the nerve or the neuromuscular junction. Neuromuscular disorder symptoms can include: (Cleveland Clinic, 2023)

  • Numbness and tingling
  • Muscle weakness
  • Muscle twitches, cramps, or spasms
  • Muscle pain
  • Muscle atrophy
  • Decreased coordination
  • Balance problems
  • Drooping eyelids and double vision from eye muscle weakness.
  • Difficulty swallowing due to weakness of the pharynx.
  • Difficulty breathing due to weakness of the diaphragm.

Common Neuromuscular Disorders

Amyotrophic Lateral Sclerosis – ALS

  • More commonly known as Lou Gehrig’s disease, it is a genetic disorder that results from hardening of the spinal cord.
  • It causes damage to the nerves that control muscles and voluntary movement.

Charcot-Marie-Tooth Disease

  • This is a class of peripheral nerve disorders that cause muscle weakness, atrophy, and loss of sensation, most commonly in the legs and feet.
  • It is a genetic disorder caused by a gene mutation that damages myelin, or the insulating sheath that surrounds all nerves and supports the conduction of electrical signals.

Multiple Sclerosis – MS

  • MS causes degeneration of the myelin sheath surrounding nerves, decreasing the impulses along the nerves to muscles.
  • It can result in muscle weakness, which is often more severe on the dominant side of the body.
  • There are different forms of MS, but the condition is often progressive and gets worse over time if left untreated.

Muscular Dystrophies

  • These are genetic diseases characterized by gradual loss of motor function, muscle weakness and atrophy, walking gait problems, progressive respiratory failure, and cardiomyopathy.
  • There are nine types of muscular dystrophy, all caused by genetic mutations.

Myasthenia Gravis

  • This is an autoimmune disease that causes inflammation throughout the body.
  • An autoimmune disease occurs when the immune system attacks healthy cells by mistake.
  • With myasthenia gravis, the body produces antibodies that attack the receptors for acetylcholine, reducing the body’s ability to contract muscles.
  • This leads to muscle weakness, atrophy, and fatigue.

Myopathies

  • These are diseases of muscles that cause muscle weakness and atrophy.
  • Depending on the type, they may progress and get worse over time.

Electrolyte Imbalances

  • Muscle weakness can result from altered sodium, potassium, calcium, or magnesium levels.

Always seek immediate medical attention for any sudden, unexplained muscle weakness. Individuals who experience skeletal muscle weakness should discuss the type and duration of symptoms with their doctor, specialist, physical therapist, or chiropractor, as this might be a sign of a medical condition such as a neuromuscular disorder. Working with a chiropractic team can help expedite healing. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop a personalized treatment program through an integrated approach to treat injuries and chronic pain syndromes, improving flexibility, mobility, and agility, relieving pain, and helping individuals return to normal activities. If other treatments are needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments.

Chiropractic Massage Therapy

References

Trovato FM, I. M., Conway N, Castrogiovanni P. (2016). Morphological and functional aspects of human skeletal muscle. J Funct Morphol Kinesiol., 1(3), 289-302. doi.org/https://doi.org/10.3390/jfmk1030289

Webb R. C. (2003). Smooth muscle contraction and relaxation. Advances in physiology education, 27(1-4), 201–206. doi.org/10.1152/advan.00025.2003

Cleveland Clinic. (2023). Mitochondrial diseases. my.clevelandclinic.org/health/diseases/15612-mitochondrial-diseases

Homemade Electrolyte Drink: Replenish Your Body Naturally

By
Dr. Alex Jimenez
-
Sports women group, grass and bottle in circle for toast, celebration and diversity with team build.

Replenishing electrolytes and maintaining hydration is essential for individuals who work out, fitness enthusiasts, and those who play recreational or serious sports and want to improve overall health. Can making a homemade sugar-free electrolyte drink help individuals achieve health goals faster?

Homemade Electrolyte Drink: Replenish Your Body Naturally

Homemade Electrolyte Drink

Sports drinks can help replenish the body’s lost electrolytes. Individuals who follow a low-carb diet and exercise or who are on a low-carb diet and get sick need double the added electrolytes. There is evidence that electrolytes are very effective in regulating the body’s fluid balance, especially during and after exercise or illness, and for those on a strict low-carb diet. (Maughan R. J. 1991)

Why More Electrolytes Are Needed

On a low-carb diet, insulin levels drop, so the kidneys retain less sodium. As the body excretes water, important minerals, such as the electrolytes calcium, sodium, magnesium, chloride, and potassium, are also excreted from the body’s system. Therefore, it is important to replenish them to avoid negative symptoms like lightheadedness and dehydration—especially when exercising or ill. (Bostock E. C. S. et al., 2020)

  • Two tablespoons of lemon juice contain almost the same amount of potassium in an 8-ounce sports drink.
  • A pinch of salt supplies 110 milligrams of sodium, the same amount in 8 ounces of a sports drink.

Individuals can make a low-carb homemade electrolyte sports drink. Many sports drinks contain a lot of sugar and other additives. The science behind why many of these drinks contain sugar is that a quick hit of sugar provides glucose for replenishing energy stores. Most individuals benefit from having small amounts of carbohydrates during heavy exercise. However, those who want to avoid sugar might want a sugar-free option to replace fluids and electrolytes.

Basic Recipe

Homemade Electrolyte Drink Mix:

  • 1 cup or 8 ounces of non-carbonated water
  • Two tablespoons of lemon juice
  • A small pinch of salt—a teaspoon contains 2,300 milligrams of sodium, but the body needs 1/20th of a teaspoon.
  • Flavoring and sweetener for taste are optional. Try unsweetened Kool-Aid, Crystal Light Drink Mix, or sugar-free flavored syrups.
  • If avoiding artificial sweeteners, Stevia could be an option.

Sports Drink Ingredients

What goes into most sports drinks and adapting to a low-carb diet?

Water

Water is a primary ingredient, as the goal is to hydrate the body.

Sugar

Sports drinks can contain a lot of sugar, but only about half the sugar of most commercial beverages. For example,

  • A 20-ounce bottle of Gatorade has about 34 grams of sugar.
  • A 20-ounce soda has about 69 grams of sugar.

Sports drinks have less sugar to prevent gastrointestinal cramping during exercise and strenuous physical activity. Although Gatorade contains less sugar than soda, depending on individual health goals, it may not be the best option. Studies of nutritional needs during exercise for those restricting carbohydrates are not extensive. However, it is known that when individuals cut carbs, their bodies switch from primarily using carbohydrates to using fat for energy. This change, known as keto-adaptation, can take two to three weeks. Native populations, like the Inuit, traditionally ate a very low-carbohydrate diet and could maintain vigorous endurance for a long time without ill effects. (Phinney S. D. 2004) This suggests that bodies adapt to using fat for energy during physical activity and exercise over time. However, cutting carbohydrates too much and too soon can lead to symptoms like the keto flu. (Harvard Medical School, 2018). Individuals may need to replace carbohydrates during training for longer, more vigorous workouts, such as running longer than an hour. In addition, what is eaten before and after exercise can also affect physical performance. Working with a registered dietitian, nutritionist, or health coach could be helpful to achieve specific fitness goals.

Electrolytes

Electrolytes are molecules of certain minerals that contain an electrical charge. The nervous system runs on those charges generated by manipulating molecules called ions. (Faber D. S. and Pereda A. E. 2018) Every body function that depends on the nervous system, which includes muscle movement, breathing, digestion, thinking, etc., requires electrolyte activity. Those who exercise strenuously for long periods, individuals who follow a low-carb diet, or those with illness may need extra salt and potassium. Sports drinks contain small amounts of sodium and potassium. A balanced diet will supply plenty of minerals for electrolyte needs for individuals engaged in moderate exercise.

Using an integrated approach to treat and prevent injuries and chronic pain syndromes, improve flexibility, mobility, and agility, and help individuals return to normal activities, Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop a personalized treatment, nutrition, and fitness programs. Each case is different and requires reviewing individual medical history and physical examination to determine the proper and most effective plan.  Dr. Jimenez has teamed up with top trainers, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments and training.

Is Intermittent Fasting the Ultimate Weight Loss Hack?

References

Maughan R. J. (1991). Fluid and electrolyte loss and replacement in exercise. Journal of sports sciences, 9 Spec No, 117–142. doi.org/10.1080/02640419108729870

Bostock, E. C. S., Kirkby, K. C., Taylor, B. V., & Hawrelak, J. A. (2020). Consumer Reports of “Keto Flu” Associated With the Ketogenic Diet. Frontiers in nutrition, 7, 20. doi.org/10.3389/fnut.2020.00020

Phinney S. D. (2004). Ketogenic diets and physical performance. Nutrition & metabolism, 1(1), 2. doi.org/10.1186/1743-7075-1-2

Harvard Medical School, Harvard Health Publishing, Marcelo Campos, M., Contributor. (2018). What is keto flu? Harvard Health Blog. www.health.harvard.edu/blog/what-is-keto-flu-2018101815052

Faber, D. S., & Pereda, A. E. (2018). Two Forms of Electrical Transmission Between Neurons. Frontiers in molecular neuroscience, 11, 427. doi.org/10.3389/fnmol.2018.00427

Choosing the Right Pickleball Footwear: A Guide for Players

By
Dr. Alex Jimenez
-
Couple playing pickleball outdoor at daylight. Outdoor sport leisure activity. Bright blue sky

Proper shoes are highly recommended when playing sports, whether professional or recreational. Can wearing pickleball footwear help increase optimal performance and prevent injuries?

Choosing the Right Pickleball Footwear: A Guide for Players

Pickleball Footwear

Pickleball has become quite popular because individuals of all ages and abilities can play it. Although it is a relatively new sport, it emerged in 1965. (USA Pickleball, 2021) It’s now one of the fastest-growing sports, with over 8 million players nationwide. (Brandon, 2023) The game can be played with most shoes designed for sports, like running or cross-fit shoes. There are shoes specifically for pickleball that improve traction, enhance stability and cushioning, and increase impact absorption. For those getting into the game long-term, investing in high-quality pickleball footwear is a worthwhile investment that can contribute to long-term enjoyment and injury prevention.

The Demands of Pickleball

Like tennis or table tennis, pickleball involves dynamic and fast-paced movements, including lateral strides, pivoting, and quickly changing direction. The body has to move forward, backward, and side to side across the court and pivot. When chasing the ball, to control the shots, produce power, decrease the risk of injury, and change direction while maintaining balance, the feet, body, and shoes must work together to make all this possible. One consideration depends on where the game will be played, whether flat ground or a harder surface. Wearing sneakers or tennis shoes is recommended for flat-ground play, as they provide supportive cushioning and shock absorption. For harder surfaces like concrete or hardwood courts, specialized shoes like those designed for pickleball are recommended.

Benefits

Some of the benefits of investing in pickleball footwear include.

Optimal Traction

Traction is incredibly important in pickleball. Optimal traction can help players execute quick movements, maintain stability, and prevent slips and falls. When looking for the right shoes, consider traction-specific materials like rubber, nylon, and leather. Individuals are most likely to find rubber pickleball shoes because they’re cheaper and commonly used in other outdoor sport-specific shoes, such as soccer. Nylon is more expensive but offers better traction than rubber and is often used in high-tech sneakers because it provides significant shock absorption and long-term durability. Leather is the most expensive material but offers the best grip. Because of its natural look and feel, it is also becoming more popular in sneakers.

Stability and Support

Moving from side to side in a lateral fashion requires players to be on top of their balance and maintain steadiness when making shots. Pickleball shoes are designed to support stability and can help reduce injuries like sprains.

Impact Absorption Cushioning

Pickleball footwear is designed similarly to running shoes, with cushioned comfort and a midsole that offers shock absorption and reduces the impact felt in the joints, including the knees, lower back, and feet. Individuals can find pickleball footwear that utilizes various sports technologies, like gel inserts or responsive foam, which can help cushion and reduce the impact on the joints. When cushioned, the body can maintain more balance, promote positive movement habits, prevent muscular fatigue and joint pain, help reduce overall stress, and allow individuals to play harder without experiencing pain. Long-term benefits result in a stronger, more flexible body.

Proper Fit and Considerations

Make sure that the pickleball shoes fit well and provide adequate support. Measure your feet using a ruler or measuring tape, and have the measurements handy while shopping. Suggestions include:

  • Look for shoes that fit snugly but don’t allow the feet to move around too much during play.
  • Pay attention to arch support.
  • Individuals with high arches should look for shoes with adjustable straps or more supportive materials built into the sole.

Using an integrated approach to treat and prevent injuries and chronic pain syndromes, improve flexibility, mobility, and agility, and help individuals return to normal activities, Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop a personalized fitness program. Each case is different and requires reviewing individual medical history and physical examination to determine the proper training plan.  Dr. Jimenez has teamed up with top trainers, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments if other training is needed.

Custom Foot Orthotics

References

USA Pickleball. (2021). History of the game. usapickleball.org/what-is-pickleball/history-of-the-game/

Mackie, B. Pickleheads. (2024). Pickleball statistics. www.pickleheads.com/blog/pickleball-statistics#h-key-pickleball-statistics

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