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Achieving Optimal Alignment: Pilates Neutral Spine Explained

Sport. Woman exercise in the gym

For individuals wanting to try Pilates for BACK PAIN and exercise, can learning how to find their neutral spine help improve flexibility and increase the range of motion in the joints?

Achieving Optimal Alignment: Pilates Neutral Spine Explained

Pilates Neutral Spine

Pilates is a functional exercise modality emphasizing core stability, which is fundamental to developing a balanced body. The exercises strengthen the muscles, improve flexibility, and increase the range of motion in the joints. (Kloubec J. 2011) It is considered a functional fitness method because its principles work to establish more graceful, efficient movements from everyday life, such as improving posture. Pilates has shown its effectiveness in that it is often used in physical therapy and rehabilitation settings. (Byrnes, K., Wu, P. J., and Whillier, S. 2018) However, knowing how to find the neutral spine is essential for performing various Pilates exercises correctly. (Barbosa, A. C. et al., 2018) This subtle adjustment during practice may help prevent injury and increase overall performance. A neutral spine is the natural position of the spine when all three curves:

  • Cervical (neck)
  • Thoracic (middle)
  • Lumbar (lower)
  • Are active and in healthy alignment.

This is the strongest position for the spine when standing or sitting, allowing the body to move more naturally.


The following exercise can help find the Pilates neutral spine.

Basic Position

  • Lie on the back with knees bent and feet flat on the floor.
  • Ensure the legs are parallel to the hips, knees, heels, and toes.
  • Let the arms rest at your sides.


  • Relax the body, including the shoulders, neck, and jaw.
  • Allow the back to melt into the floor.
  • The rib cage will drop when the lower ribs are released to the floor.

Breathe Deep

  • Inhale all the way into the body, allowing it to move into the back and sides of the rib cage and all the way to the pelvis.

Pelvic Tilt

  • Exhale and use the abdominals to press the lower spine into the floor in a pelvic tuck. (Eickmeyer S. M. 2017)
  • Inhale to release.
  • Exhale and pull the lower spine off the floor, creating a pelvic tilt.
  • Inhale to release.

Pilates exercises don’t use excess energy or tension. Proper alignment and a neutral spine position can ensure that tension is released and excess energy is not exerted. (Byrnes, K., Wu, P. J., and Whillier, S. 2018) When performing the exercise, ensure that the shoulders, neck, and legs are relaxed and not involved in the movement.

When Exercising

Once a neutral spine is achieved, the goal is to maintain this spinal position during the exercises and when changing positions.

  • Start by lifting the right leg and placing it back down without letting the hips move.
  • Then, repeat the motion with the left leg.
  • Engage the abdominal muscles to help stabilize the pelvis, keeping it from moving and maintaining a neutral spine.
  • Repeat this process with each leg.
  • Once each leg can be lifted easily, test with both legs.
  • Exhale deeply and lift the legs while keeping the core and pelvis stable.
  • Then, lower them back down.
  • When performing this progression, there may be a want to release the abs and let the back arch.
  • This will cause a tuck and tilt position away from the neutral spine position.
  • If this progression is difficult, keep practicing until you can maintain a neutral spine.
  • Once this basic progression feels easy, try additional progressions and positioning.

Visualization Tips

Most people have their spines in one of two positions: tucked or tilted. A neutral spine requires individuals to be in between, with the lower abdominals flat and the lower spine’s natural curve slightly off the floor. The following visualization can help establish a neutral spine.

Balanced Pelvic Placement

  • Imagine a cup of water sitting on the lower abdomen, a couple of inches below the belly button.
  • Allow the abdominal muscles to drop toward the spine, flattening the belly.
  • You don’t want the water to spill, so the pelvis cannot be tipped forward or tucked under.

Body Scan Meditation

  • Once the body is relaxed with a balanced alignment on the floor.
  • Allow breathing to become deep and full and the abdominals to drop toward the floor.
  • The natural neck and lower spine curves should be off the floor.
  • Ensure the lower spine is not pressed into the floor, as this indicates a pelvic tilt.

If there is any discomfort or pain when working to increase endurance, seek advice from a healthcare professional. Injury Medical Chiropractic and Functional Medicine Clinic uses an integrated approach to treating injuries and chronic pain syndromes. It offers personalized care plans that improve ability through flexibility, mobility, and agility programs to relieve pain. Our providers use an integrated approach to create personalized care plans for each patient, including Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine principles. Our goal is to relieve pain naturally by restoring health and function to the body. If other treatment is needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments.

Is Motion Key to Healing?


Kloubec J. (2011). Pilates: how does it work and who needs it?. Muscles, ligaments and tendons journal, 1(2), 61–66.

Byrnes, K., Wu, P. J., & Whillier, S. (2018). Is Pilates an effective rehabilitation tool? A systematic review. Journal of bodywork and movement therapies, 22(1), 192–202. doi.org/10.1016/j.jbmt.2017.04.008

Barbosa, A. C., Vieira, E. R., Silva, A. F., Coelho, A. C., Martins, F. M., Fonseca, D. S., Barbosa, M. A., & Bordachar, D. (2018). Pilates experience vs. muscle activation during abdominal drawing-in maneuver. Journal of bodywork and movement therapies, 22(2), 467–470. doi.org/10.1016/j.jbmt.2017.05.002

Eickmeyer S. M. (2017). Anatomy and Physiology of the Pelvic Floor. Physical medicine and rehabilitation clinics of North America, 28(3), 455–460. doi.org/10.1016/j.pmr.2017.03.003

The Importance of Endurance in Everyday Life

Cycle spinning, fitness and applause of a coach with motivation for cycling gym training. Sports co.

Can increasing endurance help individuals who want to improve their physical abilities or extend the time they perform these activities?

The Importance of Endurance in Everyday Life


Individuals tend to think of endurance in terms of exercise and fitness, such as running, biking, swimming, and strength training. While this is true, endurance is involved in nearly every task we perform. For example, an individual has to have enough endurance to complete a full day of activities. This includes:

  • Carpooling the kids
  • Professional responsibilities
  • Home chores
  • Preparing dinner
  • Helping out kids with homework, etc.

Nearly every activity requires some level of endurance, which means the ability to maintain activity for an extended period of time. When endurance begins to wane, it usually results from not performing certain activities regularly. The body gets used to daily routines and activities. When it stops engaging in certain activities, like walking and exercising regularly, endurance slowly declines, and the ability to perform at the same caliber.

What Is It?

Endurance is an ability that is acquired after extensive physical and mental training. Physiological and psychological factors reinvigorate individuals to continue doing what they are doing longer. Factors include:


  • Individuals who didn’t sleep well the night before or are worn out may have difficulty following through with certain activities that require extensive output or stamina.

Fitness Levels

  • Current fitness levels are also a predictor of endurance.
  • How physically fit an individual is, coupled with their level of training, will impact endurance abilities.
  • Genetics is another factor, as everybody has different muscle fibers that can influence physical capabilities. While research shows that individuals can gradually alter the amount of these fibers, it also emphasizes the role of genetics in determining one’s muscle makeup. (de Souza, E. O. et al., 2014)

Individuals who constantly challenge themselves mentally and physically are continually building endurance.

Endurance and Stamina Difference

Endurance is often used interchangeably with stamina. However, the two are very different.

  • Stamina refers to how long an individual can perform a certain activity at maximum capacity or without getting tired.
  • Endurance revolves around an individual’s ability to perform a certain activity without performing at maximum capacity.


Endurance can be divided into classifications defined by type. Here are the main types of endurance in physical fitness and what they mean.


  • Cardiovascular endurance is the stress an individual’s heart can take during physical activity.
  • When building cardiovascular endurance, the body becomes more efficient at pumping blood while performing a specific activity.
  • Individuals with more cardiovascular endurance can sustain longer and more intense overall training.


  • Muscular endurance is the length of time muscles can continue to contract enough to allow the body to finish a certain activity.
  • An individual lacking in muscular endurance will succumb faster to excess lactic acid build-up, causing cramps.
  • An individual with significant muscular endurance can lift a weight for more repetitions before failure.


  • Anaerobic means without oxygen, so anaerobic endurance refers to how long a muscle can continue working at a certain physical level without much or any oxygen.
  • Weightlifting is a great example of this.
  • Anaerobic exercise tends to be shorter in duration but more intense than aerobic exercise, like swimming or cycling.


Through endurance training, individuals can improve their ability to carry out certain activities longer. Recommendations for how to improve include.

Interval Training

Interval training, or high-intensity interval training, involves increasing the intensity of the workout for a short period of time.

  • If running, intentionally push the pace harder than normal for 20-second intervals.
  • Followed by a slower recovery pace for about a minute.
  • This increases endurance and improves insulin sensitivity.
  • Pedaling on an air bike is another recommended activity to build strength and endurance.

Rest Less Between Sets

  • Resting in between certain types of physical activity is beneficial, it can also lower heart rate and endurance threshold.
  • Taking less rest between workout sets so that the heart rate stays elevated increases endurance with each workout.

Perform a Few More Reps On Each Set

  • Whatever the type of exercise being done, one way to enhance endurance is to add one more rep, one more mile, or a few more minutes to the fitness schedule.
  • The body will slowly adapt to that level, making it the new norm.

Increase Core Strength

  • No matter the workout—running, swimming, cycling, or weight lifting—it’s important to focus on strengthening the core. This will help improve endurance in any activity and prevent injuries.

Individuals having trouble taking their workouts to the next level and feeling that their endurance has flattened should consider enlisting the help of a certified personal trainer. If there is any discomfort or pain when working to increase endurance, seek advice from a healthcare professional. Injury Medical Chiropractic and Functional Medicine Clinic uses an integrated approach to treating injuries and chronic pain syndromes. It offers personalized care plans that improve ability through flexibility, mobility, and agility programs to relieve pain. Our providers use an integrated approach to create personalized care plans for each patient, including Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine principles. Our goal is to relieve pain naturally by restoring health and function to the body. If other treatment is needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments.

Unlocking Athletic Potential


de Souza, E. O., Tricoli, V., Aoki, M. S., Roschel, H., Brum, P. C., Bacurau, A. V., Silva-Batista, C., Wilson, J. M., Neves, M., Jr, Soares, A. G., & Ugrinowitsch, C. (2014). Effects of concurrent strength and endurance training on genes related to myostatin signaling pathway and muscle fiber responses. Journal of strength and conditioning research, 28(11), 3215–3223. doi.org/10.1519/JSC.0000000000000525

The Inner Core: Nucleus Pulposus and Spinal Discs

Asian senior care nurses and grandmothers provide caring support to elderly women

Can understanding the nucleus pulposus help in body positioning and prevention for individuals wanting to practice spinal hygiene and protect their discs from injury?

The Inner Core: Nucleus Pulposus and Spinal Discs

Nucleus Pulposus

The spinal discs are located between the spine’s vertebrae and are the body’s natural impact and shock absorbers. Within the disc is the nucleus pulposus, which plays a major role in providing the spine with shock absorption during movement. (Zhou Z. et al., 2014) The discs have a tough outer portion and a soft inner core. They are the:

Annulus Fibrosus

  • The annulus fibrosus is the outer portion of the disc.(Nosikova, Y. S. et al., 2012)
  • It forms the tough circular exterior and comprises concentric sheets of collagen fibers or lamellae surrounding the inner core.
  • It has cartilaginous endplates that firmly attach to the vertebrae above and below.

Nucleus Pulposus

  • The nucleus pulposus is the inner core soft filling of the discs.
  • It contains a network of fibers suspended in a mucoprotein gel with a water base to maintain strength and pliability.
  • The near-liquid consistency makes it responsive to movement to handle the body’s axial load.
  • It helps maintain spinal suspension to prevent pressure on the bones and prevent bone-to-bone contact, reducing the potential for injuries and pain.

Shock Absorber

Each intervertebral disc is a shock-absorbing cushion, with the nucleus pulposus providing shock-absorbing properties (Zhou Z. et al., 2014). The intervertebral discs move as the body moves. For example, when arching the back, the disc moves forward slightly, and when twisting, the disc twists as well.

Spinal Action

The intervertebral disc supports spinal movements. When bending, twisting, arching, or tilting the spine, the nucleus pulposus swivels to accommodate these actions. These repeated spinal actions, which occur throughout the day and night, contribute to shifting positions while sitting, working, playing sports, carrying groceries, performing house chores, etc. An example is bending forward to pick something up. This action involves forward spinal flexion, which is bending the spine forward, flattening, or rounding. When bending using flexion, the spinal bones come closer together, pushing the nucleus pulposus toward the back.


The disc can be pushed too far back with persistent or excessive spinal flexion. If the fibers of the annulus fibrosus become weak, they can tear, causing the nucleus pulposus to leak out and disc herniation. Generally, the nucleus pulposus will leak to the side and back; however, this corresponds to the location of the very sensitive nerve root/s with which it can come into contact, causing pain and other symptoms. The most common causes of disc herniation are degenerative wear and tear changes of the disc and trauma. Disc degeneration occurs as the body ages; it weakens the annulus fibers, allowing the nucleus pulposus to distend, bulge, or herniate.


Disc degeneration occurs with age but can also occur with injuries to the area. In young individuals, the nucleus pulposus is mostly water. For this age group, a herniation from trauma is more likely than in older individuals. (Ucar, D. et al., 2021) But as the body ages, the discs, especially the nucleus pulposus, begin to dry out. This dehydration leads to a significant loss of disc height. (UCLA Health, 2024) By age 60 or 70, the discs may be composed entirely of fiber, which can cause the shock absorption function not to work and disappear.

Chiropractic therapy is among the more conservative treatment options for a herniated disc and may be tried first before proceeding with more invasive treatments. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution that fully benefits the individual to get back to normal.

The Science of Functional Healing


Zhou, Z., Gao, M., Wei, F., Liang, J., Deng, W., Dai, X., Zhou, G., & Zou, X. (2014). Shock absorbing function study on denucleated intervertebral disc with or without hydrogel injection through static and dynamic biomechanical tests in vitro. BioMed research international, 2014, 461724. doi.org/10.1155/2014/461724

Nosikova, Y. S., Santerre, J. P., Grynpas, M., Gibson, G., & Kandel, R. A. (2012). Characterization of the annulus fibrosus-vertebral body interface: identification of new structural features. Journal of anatomy, 221(6), 577–589. doi.org/10.1111/j.1469-7580.2012.01537.x

Ucar, D., Duman, S., Bayram, Y., & Ucar, B. Y. (2021). Extruded disc herniations are experienced earlier by inactive young people in the high-tech gaming era. Journal of medicine and life, 14(3), 402–407. doi.org/10.25122/jml-2021-1059

UCLA Health. (2024). Degenerative disc disease (Conditions Treated, Issue. www.uclahealth.org/medical-services/neurosurgery/conditions-treated/degenerative-disc-disease

Recognizing HIV: A Clinical Perspective

How do healthcare professionals provide a clinical approach to recognizing HIV for individuals in pain and providing relief?


The human body has dealt with various environmental factors, injuries, and pathogens that can cause issues to the body system. As many individuals are always on the go from one location to another, being healthy is extremely important. Making time to make an appointment for a person’s health and well-being is extremely important, as many people have experienced comorbidities and overlapping risk profiles that are causing them pain. When individuals experience onset issues of fatigue, muscle and joint pain, or immune disorders, many healthcare professionals must assess the situation and ask the individuals when they experienced these overlapping risk profiles and how they affect their daily activities. One of the overlapping risk profiles that seems to affect the body is a viral infection known as Human Immunodeficiency Virus or HIV. This can get many healthcare professionals to come up with a personalized treatment plan to reduce these overlapping risk profiles and educate the individual on what to do to manage HIV symptoms. Today’s article looks at how HIV can impact a person, their symptoms, and non-surgical treatments to manage HIV. We discuss with certified associated medical providers who consolidate our patients’ information to assess the effects of HIV and its associated symptoms. We also inform and guide patients on how to be aware of the impact of HIV and ask their associated medical providers intricate questions to integrate a customized treatment plan to incorporate multiple non-surgical therapies to manage the symptoms. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer.


What Is HIV?


Do you constantly feel tired even after taking a good night’s rest? Do you feel your throat being sore without the flu symptoms? Or are you experiencing muscle and joint pain in different locations of your body? Worldwide, many individuals have often experienced these symptoms from a viral infection known as Human Immunodeficiency Virus or HIV. HIV belongs to the retroviridae family, which targets the body’s immune system, especially the CD4+ T cells. The CD4+T cells play an important role in the body’s immune response, but when HIV starts to deplete the receptors and terminate the host cells. (Masenga et al., 2023) This causes individuals to have acute stages of HIV and, if not treated immediately, can lead to the progression of severe stages. However, how do individuals contract HIV? Well, the most common mode is through unprotected sexual intercourse, sharing needles, or through maternal-infant exposure, which diminishes the T-helper cell population and, over time, can increasingly weaken the immune system. (van Heuvel et al., 2022) This causes many individuals to develop various symptoms from HIV that can vary, depending on the severity and the progression stages of the virus. 


The Symptoms

Now, for the progression of HIV to infect the body’s immune system and cause various symptoms to affect the individual, many healthcare professionals have to look at the process of the host’s exosomes and their correlation role with HIV. The generational process of exosomes causes overlapping risk profiles with the viral assembly of HIV as exosomes can transport the virus from the infected cells to the uninfected cells of the body by helping it regulate the host’s immune response to the virus infection. (Chen et al., 2021) To that point, it can lead to the progression of several stages of HIV and its associated symptoms. When a person is dealing with an HIV infection in its acute stages, the symptoms can be mild and easily mistaken for a common viral infection. Some of the symptoms can include:

  • Muscle aches
  • Joint pain
  • Difficulty falling asleep
  • Fatigue 
  • Neuropathy
  • Shortness of breath
  • Swollen glands

This is because the inflammatory cytokines from the immune system are heightened and influenced by HIV. When inflammatory cytokines become associated with HIV, symptoms have a huge impact on an individual’s life, causing them to be miserable. (Schnall et al., 2020) Additionally, when HIV is in a clinical latency stage, the virus is less active but can still replicate without exhibiting any symptoms in the body. However, when HIV progresses to its severe stage, it can lead to the development of AIDS. Luckily, treatment advancements to treat HIV from its acute stages can help manage the associated symptoms. 


The Non-Surgical Approach To Wellness- Video

The Non-Surgical Approach to Wellness with Chiropractic Care | El Paso, Tx (2024)

Non-Surgical Treatments For HIV


When it comes to treating HIV, non-surgical treatments can help manage its associated symptoms while dramatically improving the life expectancy and quality of life of the individual who is affected by the virus. For non-surgical treatments, the main goal is to diagnose HIV as early as possible and to assess the situation by coming up with new and innovative HIV testing initiatives to increase the frequency and prevention of HIV in both clinical and non-clinical settings. (Delaney & DiNenno, 2021) Below are some non-surgical treatments to manage HIV.


Antiretroviral Treatments

Now, some of the non-surgical treatments to manage HIV is by taking antiretroviral therapy. This allows the individual with HIV to be more mindful of taking antiretroviral medications daily, which then helps improve sustained viral suppression of HIV and provides effective strategies of therapeutic approaches to enhance antiretroviral activities. (Huerta, 2020) Additionally, the primary goal of antiretroviral therapy is to reduce the HIV load to an undetectable level, keep the immune system functioning, and prevent the progression development of AIDS.


Lifestyle Adjustments

While living with HIV today is vastly different from decades past, thanks to significant medical advancements. Many individuals can go to their healthcare providers for an early diagnosis and effective treatment to live long and healthy lives. Awareness, education, and staying proactive with health checks remain key in the fight against HIV and its progression. Additionally, proper nutrition, regular exercise, and mental health support are also crucial for people living with HIV, helping to boost the immune system and manage symptoms. At the same time, regular visits to a healthcare provider for blood tests are essential to monitor the effectiveness of ART and adjust the treatment regimen as needed to live a healthier life.



Chen, J., Li, C., Li, R., Chen, H., Chen, D., & Li, W. (2021). Exosomes in HIV infection. Curr Opin HIV AIDS, 16(5), 262-270. doi.org/10.1097/COH.0000000000000694

Delaney, K. P., & DiNenno, E. A. (2021). HIV Testing Strategies for Health Departments to End the Epidemic in the U.S. Am J Prev Med, 61(5 Suppl 1), S6-S15. doi.org/10.1016/j.amepre.2021.06.002

Huerta, L. (2020). Editorial: Anti-infective 2020: HIV-From pathogenesis to treatment. Curr Opin Pharmacol, 54, x-xii. doi.org/10.1016/j.coph.2020.12.001

Masenga, S. K., Mweene, B. C., Luwaya, E., Muchaili, L., Chona, M., & Kirabo, A. (2023). HIV-Host Cell Interactions. Cells, 12(10). doi.org/10.3390/cells12101351

Schnall, R., Jia, H., & Reame, N. (2020). Association Between HIV Symptom Burden and Inflammatory Cytokines: An Analysis by Sex and Menopause Stage. J Womens Health (Larchmt), 29(1), 119-127. doi.org/10.1089/jwh.2019.7749

van Heuvel, Y., Schatz, S., Rosengarten, J. F., & Stitz, J. (2022). Infectious RNA: Human Immunodeficiency Virus (HIV) Biology, Therapeutic Intervention, and the Quest for a Vaccine. Toxins (Basel), 14(2). doi.org/10.3390/toxins14020138



The Importance of Early Treatment for Muscle Contracture

Happy physiotherapist supporting patient with stiffener on the leg

Can physical therapies help relieve muscle contractures in individuals who have endured prolonged bed rest, inactivity, or lack of use of certain muscle groups?

The Importance of Early Treatment for Muscle Contracture

Muscle Contracture

A muscle contracture, or contracture deformity, is caused when a muscle loses elasticity. This causes permanent shortening and tightening of muscle fibers, which reduces flexibility and makes movement difficult. Muscles that cannot move and stretch cause the surrounding joints to lose mobility and develop pain symptoms. When trying to stretch the contracted muscle, the individual will feel the muscle become very rigid, which can increase pain. (Lieber, R. L., and Fridén, J. 2019) Delaying treatment can potentially cause irreversible and chronic symptoms.

Commonly Affected Muscles

Flexor muscles bend the joints and are those most affected by contractures. The stiffening and tightening prevent the body parts from moving out and away. The most common include:

Wrist and Finger Flexors

  • Muscle groups that bend the wrist and fingers.


  • The primary elbow flexor that bends the arm.

Gastrocnemius and Soleus

  • The calf muscles which allow the ankle to point the foot/plantarflexion.


  • A group of three muscles behind the thigh that bend the knee.


The permanent shortening of muscle fibers and changes in muscle structure cause muscle contractures or stiffer-than-normal tissue that is difficult to stretch. Sarcomeres are structural units of muscles that cause fibers to contract.

With contractures, the sarcomeres overly lengthen when the muscle fibers tighten. This increase in sarcomere length prevents the muscle from contracting normally, resulting in weakness. Muscle fibers are encased in an extracellular matrix, a mesh composed of collagen and other proteins that help transmit force and provide muscle contraction. Muscle contractures cause the amount of collagen within the extracellular matrix to increase, causing a stiffening of fibers that restricts movement. (Lieber, R. L., and Fridén, J. 2019)

Muscle contractures also form from decreased satellite cells. Satellite cells are specialized stem cells that can rebuild muscle and are necessary for muscle regeneration and repair. Without the proper amount of satellite cells, other cells like fibroblasts significantly increase in the muscle tissue, causing the fibers to become stiff and fibrotic or more fibrous. These changes to the sarcomeres, collagen within the extracellular matrix, and decreased satellite cells all result from conditions in which neurological input to the brain and spinal cord muscles becomes reduced. This is caused by lack of use, injury, or neurological and neuromuscular conditions. (Lieber, R. L., and Fridén, J. 2019)

Cerebral Palsy

Contractures often occur from upper motor neuron lesions, which prevent signals from the brain and spinal cord from reaching the motor neurons that control muscle contraction. When these signals are weakened or blocked, muscles become stiff and weak from lack of stimulation. (Lieber, R. L., and Fridén, J. 2019)

Cerebral palsy is a group of disorders affecting mobility caused by an upper motor neuron lesion that is present at birth and is the most common motor disability in children. It causes:

  • Cognitive impairment
  • Decreased muscle strength
  • Problems with movement, coordination, and functional motions.

Because cerebral palsy prevents the muscles of the legs from being sufficiently stimulated, contractures commonly develop in the hips, knees, and ankles.  Individuals can have a 75% decrease in satellite cells to repair muscle tissue and prevent muscle fibrosis or stiffening. Specific genes linked to collagen production are also altered, causing irregular changes to the extracellular matrix of muscles. (Lieber, R. L., and Fridén, J. 2019)

Muscular Dystrophy

Muscular dystrophy is a group of inherited neuromuscular disorders characterized by muscle weakness and wasting. Deficient nerve supply to muscles causes them to become stiff and tight, inhibiting the functional range of motion needed to move joints and activate muscles to move. Clinical research suggests that individuals with muscular dystrophy have decreased levels of satellite cells to repair, increasing the risk of developing muscle contracture. (Lieber, R. L., and Fridén, J. 2019)

Disuse-induced Muscle Wasting or Disuse Atrophy

When muscles are not used for some time because of hospitalization, prolonged bed rest, or immobilization from wearing braces, splints, or casts after injuries, the blood circulation and electrical signaling from nerves to muscles decreases. This results in weakness, increased muscle tightness and stiffness, and muscle wasting/atrophy. Over time, stiff and tight muscles can progress to contractures that become extremely difficult to stretch.

Trauma or Injury

Muscle or tendon injuries can cause contractures as scar tissue develops, joining muscle fibers and joints together. This can significantly restrict movement. Large burns can also cause skin, muscles, and joint contractures. The range of motion can become significantly limited, and the changes can become irreversible if not aggressively treated.

Other Causes

Other forms of upper motor neuron lesions that can cause contractures because of weak or blocked electrical input to muscles as a result of brain or spinal cord damage include:

  • Stroke
  • Traumatic brain injuries
  • Spinal cord injuries (Lieber, R. L., and FridĂ©n, J. 2019)
  • Neuromuscular disorders like spinal muscular atrophy – SMA.
  • Conditions that cause inflammation and joint stiffening, like juvenile rheumatoid arthritis.
  • A history of diabetes also increases the risk of developing contractures affecting finger flexors, like Dupuytren’s contractures and stenosing tenosynovitis
    or trigger finger. (Lieber, R. L., and Fridén, J. 2019)


Symptoms include:

  • Extremely stiff and tight muscles resistant to stretching.
  • Pain from the inability to stretch.
  • Loss of range of motion.
  • Impaired joint mobility.
  • Severe contractures can interfere with the functional range of motion needed to move joints to complete normal tasks and movements, such as standing up from a chair and walking.


Physical Therapy


Regular exercise can:

  • Reduce joint stiffening and muscle tightening.
  • Help maintain joint mobility and range of motion.
  • Improve blood circulation and muscle activation. (Lieber, R. L., and FridĂ©n, J. 2019)

Braces and Splints

  • Specialized braces or splints can be custom-made to fit different body parts.
  • These provide a prolonged low-intensity stretch over a period of time to increase muscle length.
  • Once the muscle has stretched, a new brace or splint may be needed to adjust to the increased range of motion. (Lieber, R. L., and FridĂ©n, J. 2019)


In severe cases where muscle contractures limit the functional range of motion needed for activities of daily living or ADLs, surgical release of the contracted tissue may be recommended. This surgery can improve functional movements like walking, getting in and out of bed, and standing up from chairs. The tight muscles can be surgically cut, and the tendons can be lengthened to allow more mobility. (Lieber, R. L., and Fridén, J. 2019)

The causes of muscle contracture are not always avoidable, but various treatment options are available to help loosen up tight muscles and preserve or restore the range of motion. It’s important to move daily and stretch common areas like the fingers, arms, and legs to reduce the risk of muscle tightness and prevent contractures from developing. It is imperative to seek medical treatment for severe contractures resulting from neuromuscular disorders, including physical and occupational therapy, to prevent contractures from worsening and regaining as much functional range as possible.

Injury Medical Chiropractic and Functional Medicine Clinic uses an integrated approach personalized to the individual that focuses on what works for them and treats injuries and chronic pain syndromes through personalized care plans that improve ability through flexibility, mobility, and agility programs to relieve pain. Our providers use an integrated approach to create personalized care plans for each patient, including Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine principles. Our goal is to relieve pain naturally by restoring health and function to the body. If other treatment is needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments.

Chiropractic Treatment for Cerebral Palsy


Lieber, R. L., & FridĂ©n, J. (2019). Muscle contracture and passive mechanics in cerebral palsy. Journal of applied physiology (Bethesda, Md. : 1985), 126(5), 1492–1501. doi.org/10.1152/japplphysiol.00278.2018

Discover the Health Benefits of Kimchi

Homemade kimchi in a glass jar, traditional Korean cuisine. Black background. Top view. Copy space.

Can kimchi benefit individuals trying to incorporate more fermented foods into their diet?

Discover the Health Benefits of Kimchi


Kimchi is a flavorful and nutritious food packed with nutritious vegetables. It is high in vitamin C, vitamin A, and iron. It is made of salted, fermented vegetables and typically served as a side dish that starts with cabbage as the base. Other varieties use different vegetables, like radish, cucumber, and onion. It has minimal calories, a low carb count, zero fat, and health benefits like an abundance of probiotics from its fermentation process.


Kimchi is an excellent source of vitamin C and vitamin A. A typical half-cup of kimchi is 85 grams and provides the following. (U.S. Department of Agriculture. 2017)

  • Calories – 20
  • Fat – 0g
  • Sodium – 290 milligrams
  • Carbohydrates – 4 grams
  • Fiber – 1 grams
  • Sugars – 2 grams
  • Protein – 1 grams
  • Vitamin C – 18 milligrams
  • Iron – 1.08 milligrams
  • Vitamin A – 375 micrograms
  • Calcium – 40 milligrams


  • A half-cup serving provides 20 calories, about 53% of which are carbohydrates, 21% are protein, and 26% are fat.


  • Kimchi comprises 4 grams of carbohydrates per serving, with 1 being fiber.
  • However, many kimchi recipes add sweeteners, like honey or fruit juice, to balance the sourness.
  • More sweeteners means more carbohydrates.


  • Because it is primarily vegetables, it is naturally fat-free.


  • Kimchi isn’t exactly a protein-power player.
  • A half-cup serving provides just 1 gram of plant-based protein from veggies.
  • However, recipes that include seafood like shrimp or squid will contain higher amounts of this macronutrient.

Vitamins and Minerals

  • Vitamins and minerals vary depending on the vegetables used.
  • A Napa cabbage-based kimchi includes abundant vitamins C and K and smaller amounts of iron, calcium, copper, and potassium.
  • A recipe with carrots will contain significant vitamin A.
  • A recipe with radishes will supply folate, potassium, and riboflavin.
  • All varieties are made with salt, so sodium is a mineral to watch.
  • A half-cup serving may provide nearly 300 milligrams or 13% Daily Value of sodium.


Kimchi is a versatile food that can provide health benefits.


  • The lactic acid that ferments the cabbage also provides healthy gut bacteria.
  • Consuming probiotics through kimchi promotes healthy digestion and helps alleviate constipation problems. (Higashikawa, F. et al., 2010)

Compatible with Special Diets

  • With simple plant-based ingredients it can be suitable for specialized diets.
  • It suits vegan, vegetarian, low-carb, gluten-free, and dairy-free diets.

Immune System Support

Decrease Inflammation

  • Researchers isolated a compound in kimchi called HDMPPA – 3-(4′-hydroxyl-3′,5′-dimethoxyphenyl) propionic acid
    and studied its interaction with inflammatory proteins.
  • They discovered that HDMPPA counteracted the proteins’ inflammatory effect.
  • It is not enough to conclude that kimchi readily reduces inflammation, but further research could help confirm its ability. (Jeong, J. W. et al., 2015)

Improve Asthma Symptoms

  • A study of Korean adults with asthma found that the more kimchi they consumed, the less likely they were to experience an asthma attack.
  • Further research is needed, but the results are promising. (Kim, H. et al., 2014)


  • Commercial and home-prepared kimchi is often free of all top eight food allergens—but check ingredient labels to be sure.
  • Some preparations, for example, may contain fish sauce, shrimp, or shrimp paste, which are a no-go for those with a fish or shellfish allergy.

Adverse Effects

  • Kimchi may have adverse effects on some individuals depending on its preparation.
  • It could be high in sodium, which may not be recommended for individuals on a heart-healthy or sodium-restricted diet.
  • With high levels of probiotics, it could cause bloating or an upset stomach.
  • Individuals sensitive to strong flavors may not enjoy the taste.


Traditionally, kimchi is made from cabbage, but a wide variety of vegetables can be substituted for or combined with recipes that use alternative vegetables, spices, or other additions. Some recipes include fish or meat to turn it inta a main dish. Water kimchi is a soup version served in broth. But what makes kimchi is its base of fermented vegetables.

Storage and Safety

Fermentation can be tricky when it comes to food safety. Store-bought or homemade kimchi properly canned in a sterilized jar can be kept at room temperature for up to a week after opening. Stored in the refrigerator, it will stay fresh for three to six months. The beneficial bacteria working and fermentation process is ongoing, making the taste increasingly sour and texture mushier over time. This does not mean the jar has gone bad as long as it has no odd smell or mold.


The process is not that complex.

  • Select a recipe with vegetables like cabbage, radish, and carrots.
  • Slice the vegetables into chunks and rub with salt.
  • Leave the vegetables in salt; some recipes include water for several hours to allow fermentation.
  • Drain the excess water, then add flavoring ingredients like sweeteners and spices.
  • Serve as a side dish with fried rice or noodles, or make it a main course by adding fish, meat, or tofu.

Injury Medical Chiropractic and Functional Medicine Clinic focuses on and treats injuries and chronic pain syndromes through personalized care plans that improve ability through flexibility, mobility, and agility programs to relieve pain. Our providers use an integrated approach to create personalized care plans for each patient, to restore health and function to the body through Nutrition and Wellness, Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine protocols. If the individual needs other treatment, they will be referred to a clinic or physician best suited for them, as Dr. Jimenez has teamed up with the top surgeons, clinical specialists, medical researchers, nutritionists, and health coaches to provide the most effective clinical treatments.

The Healing Diet


U.S. Department of Agriculture. FoodData Central. (2017). Kimchi. Retrieved from fdc.nal.usda.gov/fdc-app.html#/food-details/516912/nutrients

Higashikawa, F., Noda, M., Awaya, T., Nomura, K., Oku, H., & Sugiyama, M. (2010). Improvement of constipation and liver function by plant-derived lactic acid bacteria: a double-blind, randomized trial. Nutrition (Burbank, Los Angeles County, Calif.), 26(4), 367–374. doi.org/10.1016/j.nut.2009.05.008

Olivares, M., Paz Díaz-Ropero, M., Gómez, N., Sierra, S., Lara-Villoslada, F., Martín, R., Miguel Rodríguez, J., & Xaus, J. (2006). Dietary deprivation of fermented foods causes a fall in innate immune response. Lactic acid bacteria can counteract the immunological effect of this deprivation. The Journal of dairy research, 73(4), 492–498. doi.org/10.1017/S0022029906002068

National Institutes of Health Office of Dietary Supplements. (2021). Vitamin C: Fact sheet for health professionals. Retrieved from ods.od.nih.gov/factsheets/VitaminC-HealthProfessional/

Jeong, J. W., Choi, I. W., Jo, G. H., Kim, G. Y., Kim, J., Suh, H., Ryu, C. H., Kim, W. J., Park, K. Y., & Choi, Y. H. (2015). Anti-Inflammatory Effects of 3-(4′-Hydroxyl-3′,5′-Dimethoxyphenyl)Propionic Acid, an Active Component of Korean Cabbage Kimchi, in Lipopolysaccharide-Stimulated BV2 Microglia. Journal of medicinal food, 18(6), 677–684. doi.org/10.1089/jmf.2014.3275

Kim, H., Oh, S. Y., Kang, M. H., Kim, K. N., Kim, Y., & Chang, N. (2014). Association between kimchi intake and asthma in Korean adults: the fourth and fifth Korea National Health and Nutrition Examination Survey (2007-2011). Journal of medicinal food, 17(1), 172–178. doi.org/10.1089/jmf.2013.3013

How the Thoracolumbar Fascia Impacts Back Health

Chiropractor forms correct posture for a young patient, classes take place in the gym

Can the thoracolumbar fascia cause or contribute to lower back pain and inflammation?

How the Thoracolumbar Fascia Impacts Back Health

Thoracolumbar Fascia

Tissue behind the spinal column, positioned at both the lower back and mid-back levels, is connected to the thoracolumbar fascia, also called the lumbodorsal fascia or LF. The fascia is a thick connective tissue that covers and supports all the body’s muscles, bones, tendons, ligaments, and organs. The fascia also contains nociceptive nerve endings, also known as free nerve endings, that arise from the central nervous system, i.e., the brain and spinal cord, which may be responsible for some forms of back pain and stiffness caused by injury or inflammation.


The thoracolumbar fascia is divided into three layers:

  1. Back or posterior layer.
  2. Middle layer
  3. Front or anterior layer. (Willard, F. H. et al., 2012)

Many of the back muscles attach to the thoracolumbar fascia. The erector spinae muscle group, known as the paraspinals, runs longitudinally down the spine. They are attached to the thoracolumbar fascia and the bony spine. The lumbar part of the posterior layer of the thoracolumbar fascia extends from the lowest rib to the top of the hip bone or the iliac crest. On the same path, it connects with the transverse abdominal muscle. The thoracolumbar fascia connections help bridge the back muscles to the abdominal wall muscles. The latissimus dorsi, a large back muscle that bears and moves the body’s weight with the arms and shoulders, is also connected to the thoracolumbar fascia, with the fibers extending outward from the fascia. The front part of the thoracolumbar fascia, or anterior layer, covers a muscle called the quadratus lumborum. This muscle bends the trunk to the side, helps maintain a healthy posture, and is often focused on muscle-related lower back pain.

What the Fascia Does

The thoracolumbar fascia, examined from the back of an anatomical drawing or diagram, is diamond-shaped. Its shape, large size, and central location uniquely position it to unify and synchronize the upper body’s movements with the lower body’s. The fascia’s fibers are very strong, enabling the tissue sheath to lend support (Willard, F. H. et al., 2012) . The tissue is also flexible, enabling it to help circulate forces of movement and contralateral movements as the back muscles contract and relax. An example is walking.

Back Pain

Scientists and doctors don’t know for sure, but it’s possible that the thoracolumbar fascia may contribute to lower back pain. A study found that the fascia may generate back pain based on: (Wilke, J. et al., 2017)

  • Sustaining micro-injuries and/or inflammation, which are often related, may cause signal changes in the free nerve endings in the fascia. Nerve endings acquire information from the outer areas of the body, like skin and other fascia, and relay it back to the central nervous system. The theory is that when the fascia close to the skin becomes injured, damaged, and/or backed up with inflammatory chemicals and substances, it is communicated as pain and other sensations back to the brain and spinal cord.
  • After a back injury, tissues tighten and stiffen. Some studies of patients with back pain noted alterations in their thoracolumbar fascia.
  • Injuries tend to stimulate nerves, which can lead to increased sensitivity.

Injury Medical Chiropractic and Functional Medicine Clinic focuses on and treats injuries and chronic pain syndromes through personalized care plans that improve ability through flexibility, mobility, and agility programs to relieve pain. Our providers use an integrated approach to create personalized care plans for each patient, including Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine principles. Our goal is to relieve pain naturally by restoring health and function to the body. If other treatment is needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments.

Sciatica, Causes, Symptoms, and Tips


Willard, F. H., Vleeming, A., Schuenke, M. D., Danneels, L., & Schleip, R. (2012). The thoracolumbar fascia: anatomy, function and clinical considerations. Journal of anatomy, 221(6), 507–536. doi.org/10.1111/j.1469-7580.2012.01511.x

Wilke, J., Schleip, R., Klingler, W., & Stecco, C. (2017). The Lumbodorsal Fascia as a Potential Source of Low Back Pain: A Narrative Review. BioMed research international, 2017, 5349620. doi.org/10.1155/2017/5349620

Understanding Wrestling Injuries: Common Types and Prevention

Men, wrestling and competition in a ring, mat or athlete winning in a tournament, match or training.

For wrestling athletes or those thinking about getting into the sport, can knowing about common injuries help in rehabilitation and prevention?

Understanding Wrestling Injuries: Common Types and Prevention

Wrestling Injuries

Wrestling is an intense and demanding sport. Studies have found that football and wrestling are the two high school sports with the highest risk of serious injury to athletes (Center for Injury Research and Policy, 2009). The injury rate for college wrestlers is 9 injuries per 1,000 athlete exposures. (Kroshus, E. et al., 2018) While most wrestling injuries include strains and sprains, there can also be serious traumatic and unusual injuries. Using proper safety gear and learning correct techniques can significantly reduce the risk of injuries. The majority occur during competition.


The most common wrestling injuries are similar to those in other sports and include:

Muscle Soreness

  • Muscle soreness that is experienced 12 to 48 hours after an intense workout or competition.
  • Resting is often all that is needed to recover.

Bruises and Contusions

  • Sparring, take-downs, and hard landings can result in various bruises and contusions.

Sprains and Strains

  • Rest, ice, compression, and elevation are recommended to treat sprains and strains immediately.

Ankle Sprains

  • Ankle sprains occur when surrounding ligaments stretch and tear around the joint.

Wrist Sprains

  • Typically, it occurs when stretching or tearing the ligaments.
  • Falling or landing on the hands is a common cause.

Overtraining Syndrome

  • Frequently occurs in athletes who train beyond the body’s ability to recover.


  • When trying to make weight, dehydration can be a serious health problem that many wrestlers experience.

Other Injuries

Other injuries common in wrestling:

  • Wrist tendinitis
  • Finger fractures
  • Iliotibial band syndrome
  • Meniscus tears
  • Groin pull
  • Hamstring pull or tear
  • Pulled calf muscle
  • Achilles tendonitis
  • Achilles tendon rupture
  • Clavicle/Collarbone fracture
  • Concussion


The forcing of a joint beyond its normal range of motion is the most common cause of serious injuries. The most serious wrestling injuries affect the neck, shoulder, elbow, and knee and include:


  • The cervical vertebrae are often forced into vulnerable positions during various techniques and movements, which can result in a neck injury. Common types include:
  • Neck Strain
  • Whiplash
  • Cervical Fracture


  • A combination of leverage and twisting causes most upper body and shoulder injuries during competition. Types of shoulder injuries include:
  • Rotator cuff injury
  • Shoulder separation
  • Shoulder dislocation

Elbow Dislocation

  • Elbows are under tremendous strain when maneuvering.
  • Dislocations of the radial head are often related to the athlete bracing for a fall on an outstretched arm during take-downs.


  • Most knee injuries occur to the ligaments of the knee joint.
  • These include anterior and posterior cruciate ligament or ACL/PCL injuries.


Wrestling requires flexibility, strength, and proper technique to prevent injury, combined with thorough instruction and coaching and following basic safety precautions. Some tips include.

Safety Gear

  • Wear appropriate headgear and mouthguards during practices, meets, and tournaments.

Improving Joint Flexibility

  • Wrestlers with a high degree of shoulder flexibility have fewer injuries.
  • The flexibility of the lower back, hamstrings, elbows, and cervical spine should also be worked on.​

Gain or Lose Weight Safely

  • Avoid dramatic weight loss and weight-gaining strategies by maintaining healthy nutrition and hydration during the season.

Avoiding Dangerous Holds and Slam Moves

  • Safe wrestling techniques need to be followed as these can generate severe injuries.

Regardless of how common or seemingly not serious an injury or medical condition is, it’s important to rest and recover and tell a coach and health care professional, as some injuries and conditions can become serious if left untreated. Injury Medical Chiropractic and Functional Medicine Clinic focuses on and treats injuries and chronic pain syndromes through personalized care plans that improve ability through flexibility, mobility, and agility programs to relieve pain. Our providers use an integrated approach to create personalized care plans for each patient, including Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine principles. Our goal is to relieve pain naturally by restoring health and function to the body. If other treatment is needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments.

Perseverance and Power


Nationwide Children’s Hospital. (2024). Center for Injury Research and Policy. www.nationwidechildrens.org/research/areas-of-research/center-for-injury-research-and-policy

Kroshus, E., Utter, A. C., Pierpoint, L. A., Currie, D. W., Knowles, S. B., Wasserman, E. B., Dompier, T. P., Marshall, S. W., Comstock, R. D., & Kerr, Z. Y. (2018). The First Decade of Web-Based Sports Injury Surveillance: Descriptive Epidemiology of Injuries in US High School Boys’ Wrestling (2005-2006 Through 2013-2014) and National Collegiate Athletic Association Men’s Wrestling (2004-2005 Through 2013-2014). Journal of athletic training, 53(12), 1143–1155. doi.org/10.4085/1062-6050-154-17

Best Stretches for Plantar Fasciitis Relief and Recovery

Can various stretches can help relieve individuals with plantar fasciitis to reduce foot pain and restore gait function?


As human beings, we are constantly on the move, and our feet are the ones that take a toll after a long day. The feet have various muscles, ligaments, tendons, and soft tissues that help protect the joints and provide stability. The feet are part of the lower body extremities that aid in mobility and strength of the upper body. When many individuals are constantly on their feet, the muscles and ligaments become overworked and can develop into pain-like issues. Most of the time, it is just muscle aches and pain; however, when repetitive motions start to cause more problems on the feet, it can lead to micro tears in the foot’s fascia. This, in turn, can lead to the development of plantar fasciitis, affecting a person’s gait ability. Today’s article looks at how plantar fasciitis affects gait function and how various stretches can help alleviate plantar fasciitis. We discuss with certified associated medical providers who consolidate our patients’ information to assess plantar fasciitis and its associated comorbidities. We also inform and guide patients on various stretches for plantar fasciitis and ask their associated medical providers intricate questions to integrate a customized treatment plan to incorporate multiple stretches to reduce the pain-like symptoms correlated with it. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer.


How Plantar Fasciitis Affects Gait Function

Do you feel like you are walking crooked from one location to another? Do you feel a stabbing pain when you take your first steps? Or do you feel constant pain in your feet while you are resting? As stated earlier, many individuals are constantly on their feet and have dealt with some pain that can affect their quality of life. Since the feet are part of the lower body extremities, a person experiencing a lot of pain in their heels can lead to a chronic musculoskeletal condition known as plantar fasciitis. The plantar fascia plays a huge part in the human body as it helps with the normal biomechanics of the foot, supports the arch, and provides shock absorption when a person is stepping. (Buchanan et al., 2024) When a person has been doing repetitive motions on their feet, it can lead to the development of plantar fasciitis. Plantar fasciitis is a common musculoskeletal disease that causes chronic degenerative changes in the plantar fascia. This musculoskeletal disease is also associated with mechanical factors such as repetitive stress and weight bearing that can lead to microtears in the muscle fibers. (Tseng et al., 2023) That point causes many individuals to have gait issues and other comorbidities.



Some risk factors correlated with plantar fasciitis are decreased ROM in plantarflexion and increased tensile load, which can cause many individuals to have gait issues while walking. (Hamstra-Wright et al., 2021) Since many individuals rely on walking and are experiencing pain from plantar fasciitis, not only their gait function is being affected, but the surrounding muscles in the legs are also affected. Pain symptoms like intrinsic muscle weakness, reduced muscle strength on the legs and dorsiflexion, leg length discrepancy, and arch deformity can increase the chances of plantar fasciitis developing. (Khammas et al., 2023) This can cause many individuals to have gait dysfunction since the pain can be unbearable. Additionally, when people deal with plantar fasciitis, they shift their weight to one side of their bodies to reduce the pain and allow their secondary muscles to take on the unnecessary weight load. Luckily, there are ways to minimize the pain-like effects of plantar fasciitis and help restore a person’s gait function.


What is Plantar Fasciitis?-Video

What is Plantar Fasciitis? | El Paso, Tx (2023)

Effective Stretches To Alleviate Plantar Fasciitis


When it comes to reducing plantar fasciitis, many individuals seek various treatments to reduce the pain-like symptoms causing their gait dysfunction. Many individuals seek non-surgical and surgical treatments to find the right solution for their plantar fasciitis. Depending on the severity of the pain affecting their feet, the main objective is to reduce tissue compressive load and provide a personalized treatment plan to educate and treat plantar fasciitis. (Morrissey et al., 2021) One of the best ways to reduce the pain from plantar fasciitis is by incorporating various stretches. Various stretches for plantar fasciitis can be effective as they can help relieve pain and enhance muscle strength in the extrinsic and intrinsic foot muscles. (Boonchum et al., 2020) Below are some stretches that many people dealing with plantar fasciitis can do at home to relieve the pain.


Towel Stretch

This simple stretch is perfect for the morning, especially before taking your first steps.

How to do it:

  • Sit alongside the bed with your legs straight in front of you.
  • Loop a towel around the ball of the feet and hold each end with your hands.
  • Pull the towel towards you while trying to keep the knees straight until you feel a stretch along the bottom of your foot and calf.
  • Hold the position for 15 to 30 seconds.
  • Repeat 2-3 times for each foot.


Calf Stretches

Tight calf muscles can exacerbate plantar fasciitis. Stretching your calves can relieve the pressure on your plantar fascia.

How to do it:

  • Stand near a wall with one foot back and one foot in front of you.
  • Keep your back heel on the ground and bend your front knee until you feel a stretch in the back leg’s calf muscle.
  • Hold for about 30 seconds and switch.
  • Repeat 2-3 times for each leg.


Plantar Fascia Stretch

Directly stretching the plantar fascia can help alleviate pain and improve foot function.

How to do it:

  • Sit with your affected foot and place it over the opposite side.
  • Use your hand to pull your toes back towards the shin until you feel a stretch along the arch of your foot.
  • Hold the stretch for at least 15 seconds and repeat the stretch three times.


Achilles Tendon Stretch

This stretch helps both the calf muscles and the plantar fascia.

How to do it:

  • Stand with your affected foot behind you.
  • Keep your heel down and bend your knee slightly.
  • Hold the position for 15-20 seconds, then relax.
  • Repeat 2-3 times for each leg.


Marble Pickup

Strengthening the muscles around your foot can also support the healing process.

How to do it:

  • Sit in a chair
  • Then, place 20 marbles and a bowl on the floor before your feet.
  • Use your toes to pick up one marble and place it into a bowl one at a time.
  • Repeat until you have all the marbles in the bowl.



Boonchum, H., Bovonsunthonchai, S., Sinsurin, K., & Kunanusornchai, W. (2020). Effect of a home-based stretching exercise on multi-segmental foot motion and clinical outcomes in patients with plantar fasciitis. J Musculoskelet Neuronal Interact, 20(3), 411-420. www.ncbi.nlm.nih.gov/pubmed/32877978


Buchanan, B. K., Sina, R. E., & Kushner, D. (2024). Plantar Fasciitis. In StatPearls. www.ncbi.nlm.nih.gov/pubmed/28613727

Hamstra-Wright, K. L., Huxel Bliven, K. C., Bay, R. C., & Aydemir, B. (2021). Risk Factors for Plantar Fasciitis in Physically Active Individuals: A Systematic Review and Meta-analysis. Sports Health, 13(3), 296-303. doi.org/10.1177/1941738120970976

Khammas, A. S. A., Mahmud, R., Hassan, H. A., Ibrahim, I., & Mohammed, S. S. (2023). An assessment of plantar fascia with ultrasound findings in patients with plantar fasciitis: a systematic review. J Ultrasound, 26(1), 13-38. doi.org/10.1007/s40477-022-00712-0

Morrissey, D., Cotchett, M., Said J’Bari, A., Prior, T., Griffiths, I. B., Rathleff, M. S., Gulle, H., Vicenzino, B., & Barton, C. J. (2021). Management of plantar heel pain: a best practice guide informed by a systematic review, expert clinical reasoning and patient values. Br J Sports Med, 55(19), 1106-1118. doi.org/10.1136/bjsports-2019-101970

Tseng, W. C., Chen, Y. C., Lee, T. M., & Chen, W. S. (2023). Plantar Fasciitis: An Updated Review. J Med Ultrasound, 31(4), 268-274. doi.org/10.4103/jmu.jmu_2_23


Overcoming Neuropathic Gait: Treatment Options

Can physical therapies help treat a high steppage gait from injury or medical conditions and restore normal gait patterns for individuals who have or are developing one?

Overcoming Neuropathic Gait: Treatment Options
Walking or gait anthropometric analysis on a treadmill

Neuropathic Gait

Neuropathic gait, aka equine or high steppage gait, is a type of walking abnormality that causes individuals to raise their hips to lift their legs higher than normal. It occurs when individuals have a foot drop or ankle equinus due to loss of dorsiflexion. As a result, the foot hangs with the toes pointing down, causing the toes to drag while walking. The foot may appear floppy when it drops. Foot drop is caused by weakness or paralysis of the anterior tibialis muscle in front of the shin bone. The anterior tibialis muscle contracts to help flex the foot and ankle while walking, ensuring the foot clears the floor and doesn’t drag. Individuals with anterior tibialis weakness or paralysis may have a neuropathic gait and excessively bend the hip and knee while stepping forward, lifting their leg high off the floor to clear the foot to avoid tripping. A physical therapy team can help with a high steppage gait pattern after illness or injury.


Conditions that can cause anterior tibialis weakness or paralysis and a high steppage gait pattern include:


Peroneal Nerve Injury

Multiple Sclerosis


A primary healthcare provider may refer a physical therapy team to help correct the neuropathic gait pattern.


Treatment can involve various therapies that focus on the anterior tibialis muscle.

  • Targeted ankle exercises can help strengthen the muscle.
  • Calf stretches can help maintain the ankle’s range of motion.
  • Gait training exercises.
  • Balance exercises will help improve overall proprioception, or the sense of the body’s position and movement.
  • Neuromuscular electrical stimulation, or NMES, can help improve the function of the muscle. (Hollis, S., McClure, P. 2017)
  • The electrical stimulation artificially contracts the muscle to restore proper function.
  • For anterior tibialis weakness caused by sciatica, back decompression exercises may be prescribed to relieve pressure off the sciatic nerve.
  • The exercises release the nerve to restore normal signal transmission up and down the nerve in the lower back.
  • Neuromuscular electrical stimulation may also be used to help improve muscle function.

Assistive Walking Devices

A therapist may suggest using an assistive device to help the patient walk properly. This could include a wheeled walker or a quad cane. A temporary solution to anterior tibialis weakness is to elevate the foot while walking with an elastic band. Tie a band around the leg below the knee and secure it around the ball of the foot. When swinging the leg forward, the band pulls the foot up. Using it as a temporary solution may help maintain safe mobility. Sometimes, paralysis of the anterior tibialis muscle can become permanent. In this case, individuals may benefit from a special brace called an ankle-foot orthosis. The brace helps to lift the foot and toes off the ground.

For individuals concerned about losing their balance and falling, there are ways to improve walking patterns to stay safe. A healthcare provider may recommend physical therapy to correct gait, strengthen the anterior tibialis muscle, improve balance, and educate on injury prevention. Individuals should discuss symptoms and conditions with a primary physician, healthcare provider, or specialist to guide them in the right direction and determine the best treatment.

Injury Medical Chiropractic and Functional Medicine Clinic uses an integrated approach personalized to the individual that focuses on what works for them and treats injuries and chronic pain syndromes through personalized care plans that improve ability through flexibility, mobility, and agility programs to relieve pain. If other treatment is needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments.

Control Foot Motion and Posture


McCabe, F. J., & McCabe, J. P. (2016). An Unusual Presentation of Right-Sided Sciatica with Foot Drop. Case reports in orthopedics, 2016, 9024368. doi.org/10.1155/2016/9024368

Johns Hopkins Medicine. (2024). Peroneal nerve injury. www.hopkinsmedicine.org/health/conditions-and-diseases/peroneal-nerve-injury

Kaykisiz, E. K., & Unluer, E. E. (2017). An Unexpected Reason for Isolated Foot Drop: Acute Stroke. Pakistan journal of medical sciences, 33(5), 1288–1290. doi.org/10.12669/pjms.335.13593

Taylor, P. N., Wilkinson Hart, I. A., Khan, M. S., & Slade-Sharman, D. E. (2016). Correction of Footdrop Due to Multiple Sclerosis Using the STIMuSTEP Implanted Dropped Foot Stimulator. International journal of MS care, 18(5), 239–247. doi.org/10.7224/1537-2073.2015-038

Hollis, S., & McClure, P. (2017). Intramuscular Electrical Stimulation for Muscle Activation of the Tibialis Anterior After Surgical Repair: A Case Report. The Journal of orthopaedic and sports physical therapy, 47(12), 965–969. doi.org/10.2519/jospt.2017.7368

How to Reduce TMJ Pain with Stretching Exercises

Can various stretches provide beneficial results for individuals experiencing TMJ pain by providing relief to the jaw?


Many individuals use their jaws to communicate with one another, eat delicious food, and express themselves. The jaw is part of the upper extremities as it has five muscles that allow it to function when the mouth is opening or closing, chewing, and moving from side to side. When common motor functions like yawning, chewing, or speaking produce loud pops or clicks, it can become very painful and more often lead to temporomandibular joint dysfunction or TMJ. TMJ is a joint disorder that can affect a person’s ability to use their jaws properly and can lead to visceral-somatic disorders that can affect the upper extremities, causing them to be miserable. Luckily, many individuals can incorporate various stretches to reduce the impact of TMJ and help relax the stiff muscles around the jaw. Today’s article looks at the effects of TMJ, how various stretches can effectively reduce TMJ, and how additional non-surgical treatments can relieve TMJ pain. We discuss with certified associated medical providers who consolidate our patients’ information to assess pain-like issues associated with TMJ. We also inform and guide patients on various stretches for TMJ and ask their associated medical providers intricate questions to integrate a customized treatment plan to reduce the pain-like issues affecting their jaws. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer.


The Effects of TMJ

Do you feel stiffness in your jaw after clenching for an extended period? Do you hear excessive loud clicks when opening or closing your jaw? Or do you think your jaw is locking up constantly, making it difficult to open or close your mouth? When many individuals start to feel pain around their jaws excessively, many would often think that it could be tooth pain, but in actuality, it is the temporomandibular joint that is causing the issues. Temporomandibular joint disorder, or TMJ, can be developed through various causes that can impact a person’s jaw and can lead to pain and discomfort. Mechanical factors like jaw injuries, arthritis, teeth clenching, and grinding can cause excessive or unbalanced joint loading to the jaw, which can progress the development of TMJ. (Cardoneanu et al., 2022) When dealing with TMJ, pain can lead to symptoms of tenderness around the joint area of the jaw, difficulty chewing, ear pain, and stiffness.



At the same time, the effects of TMJ pain are often characterized by localized discomfort, as TMJ is a multifactorial musculoskeletal and neuromuscular disorder that can be difficult to diagnose. (Alolayan et al., 2022) This is because of how many individuals chew their foods on one side, which can lead to its development. When the masseter muscles of the jaw begin to overload on the TMJ, it can initiate remodeling on the non-working side of the jaw and cause the pain to flourish over time. (Santana-Mora et al., 2013) However, when dealing with TMJ pain, many individuals can seek out various treatment options that can reduce muscular impairment and disc displacement from the jaw and help improve the mandibular range of motion. (Brighenti et al., 2023) 


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The Science of Motion "Chiropractic Care" | El Paso, Tx (2024)

Why Stretching Helps With TMJ


When it comes to reducing TMJ pain, many individuals can seek out non-surgical treatments to reduce the overlapping pain symptoms and restore jaw function. Some of the main objectives that many pain specialists can take into account when dealing with TMJ pain are reducing reflex masticatory muscle pain and helping increase TMJ function through various treatments that can have a positive impact on the jaw. (Ferrillo et al., 2022) Some non-surgical treatments include multiple stretches to help relax the surrounding muscles and jaw and alleviate the tension and discomfort associated with TMJ. 


Effective Stretches For TMJ Relief

Stretching can be part of a person’s personalized treatment plan to reduce TMJ pain and its associated comorbidities. Stretching and strengthening exercises can positively affect pain while improving the range of TMJ movement and helping many individuals restore their jaw motor function (Byra et al., 2020). Below are some of the stretches that can help reduce TMJ pain and relax the jaw muscles. 


Relaxed Jaw Exercise

  • How to Do It: Place the tongue gently on the roof of the mouth behind the upper front teeth. This allows the teeth to come apart while relaxing the jaw muscles.
  • Benefits: This exercise helps relax the jaw and ease muscle tension.


Partial Goldfish Exercises

  • How to Do It: Place the tongue gently on the roof of the mouth and one finger in front of the ear where the TMJ is located. Place your middle finger on your chin. Drop your lower jaw halfway and close. Perform this exercise six times in one set.
  • Benefits: This stretch helps target the jaw’s range of motion and reduce joint stiffness.


Full Goldfish Exercises

  • How to Do It: Similar to the partial opening, but open your mouth fully this time.
  • Benefits: This stretch helps enhance the full range of motion and reduce joint stiffness.


Chin Tucks

  • How to Do It: Sitting upright in a chair, pulling your chin straight back, creating a “double chin.” Hold for three seconds, and then release.
  • Benefits: This exercise helps strengthen the neck muscles, improves posture, and reduces strain on the jaw.


Additional Tips To Reduce TMJ

Along with these stretches, additional tips for managing and reducing TMJ by avoiding excessive jaw movements and applying hot/cold packs to reduce any residual inflammation correlating with TMJ. When people with TMJ start incorporating non-surgical treatments and stretches to relieve the pain, it can help increase the mandibular active range of motion and provide beneficial relief. (Urbanski et al., 2021) This, in turn, allows many people with TMJ pain to be more mindful of the body and make small changes in their health and well-being.



Alolayan, A., Alsayed, S. S., Salamah, R. M., Ali, K. M., Alsousi, M., & Elsayed, S. (2022). Temporomandibular joint (TMJ) disorders prevalence and awareness of appropriate clinical practices, among Al-Madinah community in Saudi Arabia. F1000Res, 11, 395. doi.org/10.12688/f1000research.104272.2

Brighenti, N., Battaglino, A., Sinatti, P., Abuin-Porras, V., Sanchez Romero, E. A., Pedersini, P., & Villafane, J. H. (2023). Effects of an Interdisciplinary Approach in the Management of Temporomandibular Disorders: A Scoping Review. Int J Environ Res Public Health, 20(4). doi.org/10.3390/ijerph20042777

Byra, J., Kulesa-Mrowiecka, M., & Pihut, M. (2020). Physiotherapy in hypomobility of temporomandibular joints. Folia Med Cracov, 60(2), 123-134. www.ncbi.nlm.nih.gov/pubmed/33252600

Cardoneanu, A., Macovei, L. A., Burlui, A. M., Mihai, I. R., Bratoiu, I., Rezus, II, Richter, P., Tamba, B. I., & Rezus, E. (2022). Temporomandibular Joint Osteoarthritis: Pathogenic Mechanisms Involving the Cartilage and Subchondral Bone, and Potential Therapeutic Strategies for Joint Regeneration. Int J Mol Sci, 24(1). doi.org/10.3390/ijms24010171

Ferrillo, M., Giudice, A., Marotta, N., Fortunato, F., Di Venere, D., Ammendolia, A., Fiore, P., & de Sire, A. (2022). Pain Management and Rehabilitation for Central Sensitization in Temporomandibular Disorders: A Comprehensive Review. Int J Mol Sci, 23(20). doi.org/10.3390/ijms232012164

Santana-Mora, U., Lopez-Cedrun, J., Mora, M. J., Otero, X. L., & Santana-Penin, U. (2013). Temporomandibular disorders: the habitual chewing side syndrome. PLOS ONE, 8(4), e59980. doi.org/10.1371/journal.pone.0059980

Urbanski, P., Trybulec, B., & Pihut, M. (2021). The Application of Manual Techniques in Masticatory Muscles Relaxation as Adjunctive Therapy in the Treatment of Temporomandibular Joint Disorders. Int J Environ Res Public Health, 18(24). doi.org/10.3390/ijerph182412970


Enhancing Muscle Function with Electrical Muscle Stimulation

An elderly female patient is using electrical stimulation therapy TENS on her back

Can incorporating electrical muscle stimulation help control pain, strengthen muscles, increase physical function, retrain lost movements, and/or manage inflammation for individuals experiencing neck and back pain?

Enhancing Muscle Function with Electrical Muscle Stimulation
Female doctor placing myostimulation physical therapy equipment on patient’s back

Electric Muscle Stimulation

Electrical muscle stimulation or E-stim is a physical therapy used to reactivate the muscles’ ability to contract. E-stim uses devices that transmit electrical impulses through the skin to target nerves and/or muscles. The most common forms include

  • Transcutaneous electric nerve stimulation, or TENS, is the most well-known type of electrical stimulation that offers devices that can be used at home or on the go.
  • Electrical muscle stimulation or EMS.
  • In physical therapy, E-stim stimulates muscles to contract, strengthening them and encouraging blood circulation.
  • Blood circulation can directly affect the condition of muscle tissue.
  • Electrical muscle stimulation is also used in spinal cord injury and other neuromuscular conditions. (Ho, C. H. et al., 2014)


During treatment, electrodes are hooked to an electric stimulation machine and placed around the affected neck or back area.

  • The electrodes will be placed on the skin for most neck or back injuries.
  • The placement of the electrodes depends on the reason for treatment and the depth or superficiality of the electrical stimulation.
  • The electrodes are often placed near a motor point of a muscle to ensure the correct contraction.
  • The therapist will adjust the controls of the stimulation machine to achieve thorough muscle contraction with minimal discomfort.
  • Stimulation can last 5 – 15 minutes, depending on the treatment plan and injury severity.

Spinal Joint Stabilization

Activation of the muscles may help increase spinal joint stability, improving problems with spinal instability. (Ho, C. H. et al., 2014) Electric muscle stimulation is thought to enhance the exercise program a therapist prescribes to help maintain joint stability. Electrical stimulation may also help build muscle strength and endurance. (Veldman, M. P. et al., 2016) Muscle endurance is the repetitions a muscle can contract before it fatigues.

Healing and Pain Management

Electric muscle stimulation therapy can enhance tissue healing and help manage inflammation by reducing swelling and increasing circulation. It can reduce pain sensations by blocking nerve transmission at the spinal cord. (Johnson, M. I. et al., 2019) A healthcare professional may suggest a TENS or take-home electric stimulation unit to manage symptoms. (Johnson, M. I. et al., 2019)


Interdisciplinary therapies tailored to an individual’s specific back or neck pain have been found to provide positive results. Exercise, yoga, short-term cognitive behavioral therapy, biofeedback, progressive relaxation, massage, manual therapy, and acupuncture are recommended for neck or back pain. (Chou, R. et al., 2018) Taking non-steroidal anti-inflammatory medications may also help. Electrical muscle stimulation could be an effective neck or back treatment.

Individuals unsure whether they need or would benefit from electrical should discuss symptoms and conditions with a primary physician, healthcare provider, or specialist to guide them in the right direction and determine the best treatment. Injury Medical Chiropractic and Functional Medicine Clinic focuses on what works for the patient and strives to better the body through researched methods and total wellness programs. Using an integrated approach, we treat injuries and chronic pain syndromes through personalized care plans that improve ability through flexibility, mobility, and agility programs personalized to the individual to relieve pain. If other treatment is needed, Dr. Jimenez has teamed up with the top surgeons, clinical specialists, medical researchers, and premier rehabilitation providers to provide the most effective treatments.

Thoracic Spine Pain


Ho, C. H., Triolo, R. J., Elias, A. L., Kilgore, K. L., DiMarco, A. F., Bogie, K., Vette, A. H., Audu, M. L., Kobetic, R., Chang, S. R., Chan, K. M., Dukelow, S., Bourbeau, D. J., Brose, S. W., Gustafson, K. J., Kiss, Z. H., & Mushahwar, V. K. (2014). Functional electrical stimulation and spinal cord injury. Physical medicine and rehabilitation clinics of North America, 25(3), 631–ix. doi.org/10.1016/j.pmr.2014.05.001

Veldman, M. P., Gondin, J., Place, N., & Maffiuletti, N. A. (2016). Effects of Neuromuscular Electrical Stimulation Training on Endurance Performance. Frontiers in physiology, 7, 544. doi.org/10.3389/fphys.2016.00544

Johnson, M. I., Jones, G., Paley, C. A., & Wittkopf, P. G. (2019). The clinical efficacy of transcutaneous electrical nerve stimulation (TENS) for acute and chronic pain: a protocol for a meta-analysis of randomised controlled trials (RCTs). BMJ open, 9(10), e029999. doi.org/10.1136/bmjopen-2019-029999

Chou, R., CĂŽtĂ©, P., Randhawa, K., Torres, P., Yu, H., Nordin, M., Hurwitz, E. L., Haldeman, S., & Cedraschi, C. (2018). The Global Spine Care Initiative: applying evidence-based guidelines on the non-invasive management of back and neck pain to low- and middle-income communities. European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 27(Suppl 6), 851–860. doi.org/10.1007/s00586-017-5433-8

Non-Invasive Therapies for Musculoskeletal Trigger Points

Can individuals dealing with musculoskeletal trigger points seek non-surgical treatments to reduce pain in their extremities?


The musculoskeletal system has various muscles, tendons, ligaments, and soft tissues that allow the lower and upper extremities to function in multiple tasks that the person is doing. From physical activities to relaxing or just doing errands, the musculoskeletal system has a wonderful relationship with all the various body systems. It helps protect the vital organs from environmental factors and injuries. However, when environmental factors or injuries affect the body, many overlapping risk profiles affect the upper and lower quadrants, thus affecting the muscles and the soft tissues. When the musculoskeletal system starts to feel symptoms of pain and discomfort, it can cause visceral-somatic referred pain in different body locations and cause the development of trigger points in the muscle tissues. This causes the individual to be in excruciating pain and discomfort and is seeking treatment to reduce the pain-like symptoms. Today’s article gives us an understanding of musculoskeletal trigger points and how various non-surgical treatments can alleviate musculoskeletal trigger points in the body. We discuss with certified associated medical providers who consolidate our patients’ information to assess pain-like issues affecting their musculoskeletal system that are correlating to trigger point pain. We also inform and guide patients on various non-surgical treatments and ask their associated medical providers intricate questions to integrate a customized treatment plan to reduce musculoskeletal trigger point pain. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer.


Understanding Musculoskeletal Trigger Points

Do you often experience pain in your legs, arms, hands, and feet throughout the day? How often do you experience symptoms of stiffness and discomfort in your neck, shoulder, or back? Or do you feel tingling and numbing sensations in your hands and feet? More often than not, many people who are experiencing these overlapping pain issues in their musculoskeletal system might have trigger points in their muscle fibers. Trigger points are part of a painful musculoskeletal condition known as myofascial pain syndrome. This painful musculoskeletal condition constitutes a hyperirritable spot within the taut band of the musculoskeletal system, causing pain when being compressed. (Lavelle et al., 2007) When a person is dealing with musculoskeletal trigger points, they will often experience referred pain and discomfort, motor dysfunction, and autonomic issues. This is because when many individuals experience pain in the upper or lower muscle quadrants, they deal with referred pain from the affected muscles. When the affected muscles have abnormal tender muscle regions, it can lead to impaired movements associated with the affected muscles in any joint area. (Macdonald, 1980)



Additionally, musculoskeletal trigger points can be identified as latent or active based on the development of where the pain originates from within the musculoskeletal system. To that point, when environmental factors or injuries develop trigger points, pain-like symptoms like muscle stiffness, dysfunction, and restricted range of motion show up when a pain specialist is assessing a person. (Shah et al., 2015) Fortunately, musculoskeletal trigger points are not difficult to treat once the pain source is located in the musculoskeletal system. This is because non-surgical treatments help manage the pain-like symptoms by inactivating the trigger points and restoring the affected resistant muscles to their full range of motion. (Rubin, 1981)


The Non-Surgical Approach To Wellness-Video

The Non-Surgical Approach to Wellness with Chiropractic Care | El Paso, Tx (2024)

Non-Surgical Treatments For Musculoskeletal Trigger Points

When it comes to treating musculoskeletal trigger points, many individuals seek out various treatments to reduce pain-like symptoms. Since musculoskeletal trigger points can range from mild discomfort to severe pain, it can affect a person’s daily activities and cause them to be miserable. Luckily, musculoskeletal trigger points can be reduced through non-surgical treatments. Non-surgical treatments can vary depending on the pain severity of the trigger points in the musculoskeletal system. At the same time, many individuals can have numerous non-surgical therapies as they are customizable, cost-effective, and personalized for the person’s treatment. Below are some non-surgical treatments that can help alleviate musculoskeletal trigger points.


Chiropractic Care


Chiropractic care utilizes mechanical and manual manipulation of the musculoskeletal system and can help reduce the overlapping effects of musculoskeletal trigger points. Chiropractors incorporate various techniques and ischemic pressure to relieve the pain and provide relief. (Vernon & Schneider, 2009) Additionally, chiropractors can locate the trigger points by pressing on the muscle tissue or manipulating the muscle fibers. Chiropractors can also combine massage therapy to relieve trigger points and associated pain symptoms to restore the body to optimal function. This combination can incorporate various techniques to increase blood circulation to the affected muscle, help break down the inflexible scar tissue, and help restore muscle function to the extremities. 



Another form of non-surgical treatment to reduce musculoskeletal trigger points is acupuncture. Acupuncture incorporates solid, thin needles placed on various acupoints in the body by a professional. What acupuncture does is that when the needles are placed in the acupoints of the affected muscle, it can help stimulate the nervous system and help facilitate the body’s natural pain-relieving chemicals to kick-start the healing process. Additionally, when people incorporate acupuncture to reduce musculoskeletal trigger points, the sensory input that is causing them pain is reduced and can provide prolonged relief. (Melzack, 1981)


Lifestyle Adjustments

When it comes to reducing trigger points and combining non-surgical treatments, many individuals dealing with overlapping pain profiles from musculoskeletal trigger points can make lifestyle adjustments to prevent its development. Making small adjustments to a person’s work and living environments can reduce stress from being a co-factor to developing trigger points in the muscle fibers. Other small adjustments like improving posture and employing relaxation techniques like yoga, meditation, or deep breathing exercises can help reduce muscle stress and strain from everyday life. Incorporating non-surgical treatments to reduce and manage musculoskeletal triggers can provide a positive, beneficial result to improve muscle function and allow individuals to live healthier lives. 



Lavelle, E. D., Lavelle, W., & Smith, H. S. (2007). Myofascial trigger points. Anesthesiol Clin, 25(4), 841-851, vii-iii. doi.org/10.1016/j.anclin.2007.07.003

Macdonald, A. J. R. (1980). Abnormally tender muscle regions and associated painful movements. Pain, 8(2), 197-205. doi.org/10.1016/0304-3959(88)90007-3

Melzack, R. (1981). Myofascial trigger points: relation to acupuncture and mechanisms of pain. Archives of Physical Medicine and Rehabilitation, 62(3), 114-117. www.ncbi.nlm.nih.gov/pubmed/6972204

Rubin, D. (1981). Myofascial trigger point syndromes: an approach to management. Archives of Physical Medicine and Rehabilitation, 62(3), 107-110. www.ncbi.nlm.nih.gov/pubmed/6453568

Shah, J. P., Thaker, N., Heimur, J., Aredo, J. V., Sikdar, S., & Gerber, L. (2015). Myofascial Trigger Points Then and Now: A Historical and Scientific Perspective. PM R, 7(7), 746-761. doi.org/10.1016/j.pmrj.2015.01.024

Vernon, H., & Schneider, M. (2009). Chiropractic management of myofascial trigger points and myofascial pain syndrome: a systematic review of the literature. J Manipulative Physiol Ther, 32(1), 14-24. doi.org/10.1016/j.jmpt.2008.06.012


Understanding the Many Benefits of Physical Therapy

Cheerful doctor showing his training plan to trainer on clipboard in front of client at gym

For individuals who are having difficulty moving around due to pain, loss of range of motion, and/or decreased strength, can incorporating working with a physical therapist help relieve pain and restore function?

Understanding the Many Benefits of Physical Therapy
A woman with orthosis working with a physical therapist

Physical Therapy Benefits

Many wonder if they are candidates for physical therapy or if physical therapy can help their injury, ailment, or condition. The answer is yes; most individuals can benefit from physical therapy, whether their condition is a simple ankle sprain or a complex neurological disorder. Physical therapists can help develop pain management treatment strategies and injury prevention. Physical therapy can benefit individuals even if they are not injured; as movement experts, physical therapists can train individuals to help prevent injury and maintain flexibility.

Body Mechanics

Physical therapists work in various settings, including hospitals, nursing homes, sports, and chiropractic clinics. If necessary, they can come to your house after an injury. They work with individuals from all walks of life as a conservative treatment approach to managing, healing, and preventing injuries and disabilities. Physical therapy uses non-invasive tools to help improve total body function. Physical therapy focuses on:

  • Relieving pain
  • Promoting healing
  • Restoring function
  • Restoring movement
  • Facilitation and adaptation for a specific injury.
  • Therapy also focuses on body mechanic training, fitness, and wellness. (Hon, S. et al., 2021)
  • Regardless of age, individuals who have problems with flexibility and mobility may benefit from working with a physical therapist to help them return to optimal function.

Conditions Physical Therapy Can Help Treat

  • Muscle sprains and strains.
  • Work-related injuries.
  • Repetitive motion injuries.
  • Sports-related injuries.
  • Neck pain.
  • Lower back pain.
  • Neuro-rehabilitation – post-stroke and spinal cord or head injury.
  • Arthritis – in one or multiple joints.
  • Mobility problems.
  • Balance issues.
  • Knee, ankle, and foot problems.
  • Shoulder, arm, hand, and wrist injuries and problems.
  • Fractures.
  • Slip and fall accidents and other traumas.
  • Orthopedic conditions.
  • Chronic fatigue.
  • Chronic weakness.
  • Pre and post-surgical conditioning and strengthening.
  • Wound care like diabetic wounds and non-healing traumatic or post-surgical wounds.
  • Pre – during pregnancy and post-partum programs.
  • Fitness and wellness education.
  • Poor cardiovascular endurance.
  • Cardiac rehabilitation.
  • Respiratory problems.
  • Bowel or bladder incontinence.
  • Cancer recovery.

Individuals unsure whether they need or would benefit from physical therapy should discuss their options with a primary physician, healthcare provider, or specialist to guide them in the right direction. Injury Medical Chiropractic and Functional Medicine Clinic focuses on what works for you and strives to better the body through researched methods and total wellness programs. Using an integrated approach, we treat patients’ injuries and chronic pain syndromes through personalized care plans that improve ability through flexibility, mobility, and agility programs personalized to the individual to relieve pain. If other treatment is needed, Dr. Jimenez has teamed up with the top surgeons, clinical specialists, medical researchers, and premier rehabilitation providers to provide the most effective treatments.

Unlocking Vitality


Hon, S., Ritter, R., & Allen, D. D. (2021). Cost-Effectiveness and Outcomes of Direct Access to Physical Therapy for Musculoskeletal Disorders Compared to Physician-First Access in the United States: Systematic Review and Meta-Analysis. Physical therapy, 101(1), pzaa201. doi.org/10.1093/ptj/pzaa201

How to Snack Mindfully at Night for Better Health

Hungry Asian woman taking food out of the fridge in the kitchen at night. Copy space.

Can understanding night cravings help individuals who constantly eat at night plan meals that satisfy and choose nutritious snacks?

How to Snack Mindfully at Night for Better Health

Eating At Night

Snacking after dinner and eating at night is common and not bad; however, snacking mindfully can help one truly enjoy and savor snacks. Consider some of the reasons why you might be hungry or not completely satisfied after dinner. Improving the nutritional value of nighttime snacks can make late-night hunger work toward meeting nutritional needs. Common reasons include:

  • Not meeting the right macronutrient balance during dinner.
  • Not being completely satisfied with dinner.
  • Dehydration.

Macronutrient Profile

Getting the right amount of carbohydrates, fat, and protein during dinner is integral to feeling satisfied. Adults need 130g of carbohydrates, 56g of protein, and 3.7L of water daily. The amount of fat required varies, but monounsaturated and polyunsaturated fats are the most healthy fats to consume, helping the body feel satisfied. Several studies show that eating protein during a meal reduces hunger and decreases cravings. (Kohanmoo, A. et al., 2020)

Unsatisfying Dinner

Another reason individuals eat at night is that they are unsatisfied with dinner. Eating satiating foods can help the mind and body feel full throughout the evening.

  • Satiety is the sense of satisfaction from food.
  • Foods high in fiber and healthy fats are known to help produce satisfaction.
  • When the body is full and satisfied, it produces hormones that signal to the brain there is no need to continue eating.
  • Try to plan healthy meals that are genuinely exciting to eat.
  • Create time to cook and make and eat meals you can genuinely enjoy.


Sometimes, when the body is dehydrated, it can have difficulty distinguishing thirst from hunger. As a result, some may eat in reaction to dehydration. This isn’t always bad, as some foods, specifically water-rich foods like melon and other fruits, can provide hydration. But sometimes, individuals don’t realize they are misreading their body’s thirst for hunger, and they reach for any food. They are still dehydrated, so they keep eating. If hunger persists after dinner, drink a glass of water and wait 20 minutes to see if that impacts hunger.

Maximize Nutrition

Snacking at night is not bad, but it is wise to plan to ensure the body gets the right balance of nutrients.

Satisfy Cravings

Many crave something sweet after dinner or later on. Eating healthy foods that satisfy cravings will help trigger hormones that tell the body it is done eating. Keep your favorite fruits and vegetables for a quick bite to get some sweetness and fiber. Vegetables like red bell peppers and carrots provide sweetness and crunchiness and can be satisfying. One small red pepper provides 100% of the daily recommended Vitamin C in 20 calories. (U.S. Department of Agriculture. Agricultural Research Service. 2018)

Foods that Promote Sleep

The foods chosen can affect sleep. Whole grains, walnuts, cherries, and kiwi increase serotonin and decrease the stress hormone cortisol. Complex carbohydrates contain melatonin, a hormone responsible for feeling sleepy. A whole-grain snack is a healthy choice before going to bed. (Nisar, M. et al., 2019) Some research shows that dark chocolate is rich in magnesium and can help promote deep sleep. However, it also contains caffeine, which can inhibit sleep. If dark chocolate is a favorite, make sure to eat it early enough in the evening.

Alternative Nighttime Routine

Some people eat out of boredom at night. To curb this, individuals in this category should change their routines. Here are a few tips to help adjust nighttime habits.

Healthy After-Dinner Activities

  • Go for a quick walk after dinner. 10 to 20 minutes can help, as physical activity signals the shift from dinner to other evening activities.
  • It also gives the body a chance to feel the fullness sensation.
  • Hobbies and other light meditative activities can help take the mind off eating.

Watch TV Mindfully

  • Many individuals eat more at night because snacking can go on and on in front of the television.
  • Use smart and healthy snacking strategies like portion control.
  • Remember to take a drink of water in between snacking.
  • Stay active – simple chores or activities while watching TV can help avoid overeating.

Rest and Sleep

  • Not getting enough sleep has been linked with increased appetite. (Hibi, M. et al., 2017)
  • Engage in activities to encourage rest.
  • Meditation can help calm down the mind and body.
  • Consider going to bed earlier.

Using an integrated approach, Dr. Jimenez’s Functional Medicine Team aims to restore health and function to the body through Nutrition and Wellness, Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine protocols. We focus on what works for the individual through researched methods and total wellness programs.

Eating Right to Feel Better


Kohanmoo, A., Faghih, S., & Akhlaghi, M. (2020). Effect of short- and long-term protein consumption on appetite and appetite-regulating gastrointestinal hormones, a systematic review and meta-analysis of randomized controlled trials. Physiology & behavior, 226, 113123. doi.org/10.1016/j.physbeh.2020.113123

U.S. Department of Agriculture. Agricultural Research Service. FoodData Central. (2018). Peppers, sweet, red, raw. Retrieved from fdc.nal.usda.gov/fdc-app.html#/food-details/170108/nutrients

Nisar, M., Mohammad, R. M., Arshad, A., Hashmi, I., Yousuf, S. M., & Baig, S. (2019). Influence of Dietary Intake on Sleeping Patterns of Medical Students. Cureus, 11(2), e4106. doi.org/10.7759/cureus.4106

Hibi, M., Kubota, C., Mizuno, T., Aritake, S., Mitsui, Y., Katashima, M., & Uchida, S. (2017). Effect of shortened sleep on energy expenditure, core body temperature, and appetite: a human randomised crossover trial. Scientific reports, 7, 39640. doi.org/10.1038/srep39640