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Hamstring Syndrome Relief: Understanding Your Pain

By
Dr. Alex Jimenez
-
Physiotherapy doctor assisting elderly patient with leg exercise in clinic

Individuals dealing with pain in the buttocks and in the back of the thigh, along with numbness and tingling down to the bottom of the foot, may be experiencing hamstring syndrome, a condition caused by pressure on the sciatic nerve. What is the recommended treatment?

Hamstring Syndrome Relief: Understanding Your Pain

Hamstring-Syndrome Relief

The hamstrings are three muscles in the back of the thigh, extending from the pelvis or upper thigh across the back of the knee to the leg. This muscle group is important for bending the knee, straightening the hip, and stabilizing the knee. The sciatic nerve is a large nerve that runs from the lower back down the legs. It usually passes near or through these muscles, and the pelvis then runs under these muscles in the thigh. Hamstring syndrome refers to pain in the buttock and back of the thigh, often radiating down the leg, caused by compression or irritation of the sciatic nerve at the hamstring-insertion point on the ischial tuberosity, typically due to tight or scarred tissue. (Sakari Orava, 1997)

Pain Location

The pain is primarily felt in the buttock and back of the thigh, sometimes extending down the leg. It’s characterized by pressure on the sciatic nerve, which runs through the buttock and into the back of the thigh, where it supplies the hamstring muscles. (Kaiser Permanente, 2024)

Mechanism

This pressure can occur due to: (Sakari Orava, 1997) (Kaiser Permanente, 2024)

Fibrotic Bands

  • Tight, tendon-like, or scarred bands of tissue at the hamstring’s insertion point/ischial tuberosity can irritate the sciatic nerve.

Compression

  • These bands can compress the nerve, especially when sitting or during activities that involve hip flexion and knee extension.

Traction

  • The sciatic nerve can also be stretched or irritated by the hamstring tendons.

Symptoms

  • Pain in the buttock and back of the thigh may radiate down the leg.
  • Pain that is worse when sitting, stretching the hamstrings, or during activities like running. (Puranen J. & Orava S. 1988)
  • Numbness or tingling in the back of the leg

Differential Diagnosis

It’s important to differentiate hamstring syndrome from other conditions that could be causing similar symptoms, including:

  • Piriformis syndrome
  • Ischiogluteal bursitis
  • Hamstring muscle strains

Treatment

Hamstring syndrome relief may consist of the following:

Conservative

  • Initial treatment focuses on rest, ice, stretching, and over-the-counter pain relievers.

Physical Therapy

Injections

  • In some cases, injections with cortisone and numbing medicine may be used to reduce nerve inflammation and pain. (Lower Limb Surgery, 2024)

Surgery

  • In severe cases, surgery may be necessary to release the compressing bands and free the sciatic nerve. (Lower Limb Surgery, 2024)

Injury Medical Chiropractic & Functional Medicine Clinic

Talk to a healthcare provider about what interventions would help the most. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.

Sciatica: Causes, Symptoms and Tips

References

Orava, Sakari. (1997). Hamstring syndrome. Operative Techniques in Sports Medicine, 5(3). doi.org/https://doi.org/10.1016/S1060-1872(97)80035-4.

Kaiser Permanente. (2024). Hamstring Syndrome: Care Instructions. healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.hamstring-syndrome-care-instructions.abr3618

Puranen, J., & Orava, S. (1988). The hamstring syndrome. A new diagnosis of gluteal sciatic pain. The American Journal of Sports Medicine, 16(5), 517–521. doi.org/10.1177/036354658801600515

Zion Physical Therapy. (2023). Hamstring Tendinitis Vs. Hamstring Syndrome. www.zionpt.com/post/hamstring-tendinitis-vs-hamstring-syndrome

Lower Limb Surgery. (2024). Hamstring Syndrome. www.lowerlimbsurgery.com/hamstring syndrome#:~:text=General%20Treatment%20Considerations,%E2%80%8B

Tofu: A Versatile Ingredient in Your Kitchen

By
Dr. Alex Jimenez
-

Find out everything you need to know about tofu, from cooking tips to nutritional advantages to heart health.

Introduction

Eating a healthy diet is essential for improving one’s health and well-being since it feeds the body and gives the musculoskeletal, cardiovascular, and gastrointestinal systems—to mention a few—extra nutrients. Pain and discomfort may be avoided by making minor dietary adjustments that reduce the overlapping risk profiles that environmental variables might produce. Making minor dietary adjustments may also assist in increasing protein intake, which will support the development of the musculoskeletal system and lessen cardiovascular problems. Tofu is a very flexible and nutrient-dense protein. This article will discuss the many forms of tofu, their nutritional content, cardiovascular health benefits, and how to include them in a balanced diet.

 

What Is Tofu?

Made from a soybean slurry and pressed into a solid block, tofu or bean curd is a century-old food from China that has become a staple in East Asia. This versatile food has become a staple source of protein that is becoming more popular globally due to its cooking adaptability and impressive nutritional profile. Tofu comes from soybean seeds as it is bioactive, consisting of soaking, draining, and grinding to a gelatinous block filled with abundant beneficial lipids. Bioactive compounds become a great source of plant-based protein for many individuals. (Dang et al., 2023)

 

Nutritional Value of Tofu

Since tofu is a great meat alternative for those seeking a plant-based or low-saturated-fat diet as a typical 0.25 block of firm tofu with a serving of 116 grams provides:

  • Protein: 9g
  • Calories: 88
  • Fat: 6g
    • Saturated Fat: 0.8g
  • Carbohydrates: 2.2g
    • Dietary Fibers: 0.3g
  • Sodium: 8g
  • Potassium: 140mg
  • Iron: 34% DV (Daily Value)
  • Calcium: 40% DV (Daily Value)
  • Magnesium: 8% DV (Daily Value)
  • Vitamin B6: 5% DV (Daily Value)

Additionally, the soybean from which tofu is made is a legume that contains no cholesterol, is low in saturated fats, and contains all eight essential amino acids (Montgomery, 2003), making it very appealing to cardiovascular patients.

The Healing Diet: Combat Inflammation & Embrace Wellness- Video

The Healing Diet: Combat Inflammation, Embrace Wellness | El Paso, Tx (2023)

Tofu & Cardiovascular Health

Many do not realize that tofu will benefit cardiovascular health when incorporated into their protein intake. By incorporating tofu into a cardiovascular diet, many will notice lower LDL (low-density lipoprotein) cholesterol. This is due to the hypocholesterolemic effects of the soy protein in tofu. (Messina, 2016) Additionally, tofu has isoflavones that can promote cell proliferation in the body while acting as an antioxidant that can exert anti-inflammatory properties. (Rizzo et al., 2023) Some of the potential benefits of incorporating tofu to support cardiovascular health include:

  • Rich with healthy heart fats
  • Reduce cholesterol
  • Provides support to blood pressure
  • Weight management

Additionally, with its associated phytochemicals, tofu can help improve lipid profiles when people substitute animal protein with soy to reduce cardiovascular diseases like coronary heart disease and control blood cholesterol levels. (Erdman, 2000)

 

Types of Tofu

Now, for individuals trying to figure out how to incorporate tofu into various cooking methods and different recipes since it comes in a variety of textures:

  • Silken Tofu: Silken tofu has a soft and creamy texture, ideal for smoothies, dressings, or desserts.
  • Soft Tofu: Soft tofu is slightly firmer than silken and similar to Jello. It works well in soups or scrambles.
  • Firm Tofu: Firm tofu holds its shape well; perfect for stir-fries, grilling, or baking.
  • Extra-Firm Tofu: Extra-firm tofu is dense and chewy, perfect for recipes that require a desired meatier texture, and best for frying.
  • Fermented Tofu: Fermented tofu is a preserved, tangy tofu used as a condiment or flavor enhancer in food dishes.

 

Is Tofu A Good Protein Source?

Tofu can be an excellent alternative to animal protein for vegans or vegetarians looking to reduce their meat intake. Many individuals can incorporate tofu as part of their diet for protein intake to maintain muscle strength and repair due to its essential amino acids that the body needs to function throughout the day.

 

Adding Tofu Into A Diet?

Tofu is incredibly adaptable as part of a person’s diet as it can absorb the flavors of the ingredients it’s cooked with. Tofu can be boiled, fried, or steamed into healthy dishes while allowing the individual to think more about their nutrition and encouraging them to consider the changes to incorporate in their food habits. (Eze et al., 2018)

 

Final Thoughts

More than simply an animal protein alternative, tofu is a heart-smart, nutrient-dense food that may benefit cardiovascular health and be included into a variety of diets. A lot of folks who are thinking about increasing their protein intake may include tofu in their meals. With its isoflavones, vital amino acids, and cardiovascular health support, this could be the answer to living a healthier lifestyle and eating better.

 

Injury Medical & Functional Medicine Clinic

We associate with certified medical providers who understand the importance of assessing individuals dealing with cardiovascular issues and are looking for natural alternatives to incorporate plant-based foods into a healthy diet. When asking important questions to our associated medical providers, we advise patients to incorporate tofu into their diet to reduce the effects of cardiovascular disorders related to the body. Dr. Alex Jimenez, D.C., uses this information as an academic service. Disclaimer.

References

Dang, Y., Ren, J., Guo, Y., Yang, Q., Liang, J., Li, R., Zhang, R., Yang, P., Gao, X., & Du, S. K. (2023). Structural, functional properties of protein and characteristics of tofu from small-seeded soybeans grown in the Loess Plateau of China. Food Chem X, 18, 100689. doi.org/10.1016/j.fochx.2023.100689

Erdman, J. W., Jr. (2000). AHA Science Advisory: Soy protein and cardiovascular disease: A statement for healthcare professionals from the Nutrition Committee of the AHA. Circulation, 102(20), 2555-2559. doi.org/10.1161/01.cir.102.20.2555

Eze, N. M., Okwume, U. G., Eseadi, C., Udenta, E. A., Onyeke, N. G., Ugwu, E. N., Akubue, B. N., Njoku, H. A., & Ezeanwu, A. B. (2018). Acceptability and consumption of tofu as a meat alternative among secondary school boarders in Enugu State, Nigeria: Implications for nutritional counseling and education. Medicine (Baltimore), 97(45), e13155. doi.org/10.1097/MD.0000000000013155

Messina, M. (2016). Soy and Health Update: Evaluation of the Clinical and Epidemiologic Literature. Nutrients, 8(12). doi.org/10.3390/nu8120754

Montgomery, K. S. (2003). Soy protein. J Perinat Educ, 12(3), 42-45. doi.org/10.1624/105812403X106946

Rizzo, J., Min, M., Adnan, S., Afzal, N., Maloh, J., Chambers, C. J., Fam, V., & Sivamani, R. K. (2023). Soy Protein Containing Isoflavones Improves Facial Signs of Photoaging and Skin Hydration in Postmenopausal Women: Results of a Prospective Randomized Double-Blind Controlled Trial. Nutrients, 15(19). doi.org/10.3390/nu15194113

Disclaimer

Bread Crumbs: Tips for Substituting in Recipes

By
Dr. Alex Jimenez
-
Brunette woman streaming a cooking class with some homeade recipes from her kitchen

When you don’t have breadcrumbs or want to try something else, what are healthy substitutes for breadcrumbs that may yield similar results without sacrificing flavor or texture?

Bread Crumbs: Tips for Substituting in Recipes

Bread Crumbs

Various recipes call for bread crumbs. Adding bread crumbs to sauces and other dishes helps bind and thicken wet ingredients while sprinkling bread crumbs on top of casseroles can add a crispy, crunchy texture. Individuals who follow low-carb or gluten-free meal plans or those with allergies to wheat may choose to avoid bread crumbs and dishes made with them. Wheat-free substitutes can replace bread crumbs in recipes with similar results, though the recipe may vary slightly.

Why Use Substitutes?

Individuals with food allergies or dietary restrictions may seek a substitute for bread crumbs since they may contain common allergens like wheat and gluten. Wheat is among the most common food allergies in the U.S. (Asthma and Allergy Foundation of America, 2022)

For those with allergies or sensitivities, gluten- and wheat-free bread crumbs are available to purchase at some stores, and some use alternatives out of preference. Crushing different varieties of chips, crackers, and pretzels can be used instead of bread crumbs, adding a unique flavor and texture. However, these substitutes may not be an option for recipes that call for bread crumbs to bind or thicken wet ingredients.

Nutrition

Nutrition information for 1 ounce (28.35 grams) of unseasoned bread crumbs. (USDA, FoodData Central, 2018)

  • Calories – 112
  • Fat – 1.5 grams
  • Sodium – 208 milligrams
  • Carbohydrates – 20.4 grams
  • Fiber – 1.28 grams
  • Sugars – 1.76 grams
  • Protein – 3.8 grams

Bread products like bread crumbs can be part of a balanced diet. Guidelines recommend between 3 and 5 servings of whole grains daily for adults, including whole-wheat bread. (United States Department of Agriculture, 2025)

  • The main macronutrient in bread crumbs is carbohydrates.
  • Bread crumbs are usually consumed in small amounts because they are not the main ingredient.

Substitutes

Rolled Oats or Oat Flour

Oats and oat flour are often used as gluten-free alternatives to wheat in baking. Oats by weight are:

  • Lower in calories
  • Provide more complex carbohydrates.
  • They are a richer source of dietary fiber than bread crumbs.

Like regular flour, oats can be a binder in meat-based recipes. For example, if a recipe for meatloaf or meatballs calls for bread crumbs, rolled oats or oat flour can be successfully substituted.

Ensure the oats are gluten-free for individuals with gluten allergies, celiac, or gluten sensitivity. Though oats are inherently gluten-free, they may be processed on shared equipment and exposed to cross-contamination.

Cornflakes

  • Cornflakes can also add a crunchy texture to baked recipes. While corn is inherently gluten-free, cornflakes may not be. For individuals who have allergies or sensitivities, ensure you use gluten-free cornflakes. To use cornflakes, crunch them up by adding them to a ziplock bag and pressing them on the outside.

Nuts

  • Try nuts like almonds, walnuts, pecans, and cashews to add crunch and nutrients to a recipe. They are rich in healthy fats, protein, vitamins, and minerals. Plain nuts are also gluten-free, but roasted nuts may contain a wheat-based coating. Be sure to read the labels before using them.

Seeds

  • Seeds are a nutritious substitute.
  • They offer a different crispy, crunchy texture.

Shredded Coconut

Shredded or desiccated coconut can be used for sweet or rich recipes. It is perfect for adding to baked goods, especially gluten-free varieties. The recipe may need to be adjusted slightly because coconut has more moisture than regular bread crumbs. Do a small sample first to see how the coconut works in the recipe.

Injury Medical Chiropractic & Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop highly effective treatment plans through an integrated approach for each patient and restore health and function to the body through nutrition and wellness, functional medicine, acupuncture, electroacupuncture, and integrated medicine protocols. We focus on what works for you to relieve pain, restore function, prevent injury, and mitigate issues through adjustments that help the body realign itself. The clinic can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

Hypertension? There’s a Diet for That

References

Asthma and Allergy Foundation of America. (2022). Food allergies. aafa.org/allergies/types-of-allergies/food-allergies/

United States Department of Agriculture, FoodData Central. (2018). Bread crumbs, dry, grated, plain. Retrieved from fdc.nal.usda.gov/food-details/174928/nutrients

United States Department of Agriculture. Dietary Guidelines for Americans 2020-2025. (2020). Dietary Guidelines for Americans, 2020-2025. Retrieved from www.dietaryguidelines.gov/sites/default/files/2021-03/Dietary_Guidelines_for_Americans-2020-2025.pdf

Leg Cramp Causes You Need to Know

By
Dr. Alex Jimenez
-
foot injury joint pain treatment light background. High quality photo

Can understanding how leg cramps feel, their causes, and prevention help individuals with treatment options?

Leg Cramp Causes You Need to Know

Leg Cramp Causes

A leg cramp is an involuntary contraction of the muscles in the leg, typically the calf muscle. It causes a sudden, sharp, and painful tightening of the muscle. They commonly occur from

  • Dehydration
  • Muscle overexertion
  • They can be a symptom of an underlying health condition, such as type 2 diabetes or kidney failure.
  • They can also be a side effect of certain medications.

Sensation

Leg cramps typically cause sudden, severe pain in the affected muscle. Individuals may also feel a hard knot or twitching of the muscle. The calf muscles are the most common site. (Harvard Health Publishing, 2024)

Causes

The underlying cause of leg cramps isn’t always known. However, work, lifestyle factors, and medical conditions can play a role. Common causes include:

  • Muscle fatigue from overuse
  • Electrolyte imbalances (e.g., potassium, magnesium)
  • Dehydration
  • Poor circulation
  • Nerve damage
  • Certain medications (e.g., statins, diuretics)

Lifestyle Risk Factors

Certain lifestyle factors and other physical characteristics can increase the risk of leg cramps and can include: (Harvard Health Publishing, 2024) (National Library of Medicine, 2020)

  • Age (those 60 and over are affected more often than younger individuals)
  • Exercising in a hot environment
  • Exercising for extended periods
  • Obesity
  • Pregnancy

Medical Factors

Leg cramps are also associated with certain medical conditions and treatments for illness. Examples include: (Maughan R. J. & Shirreffs S. M. 2019) (Garrison, S. R. et al., 2020)

  • Pinched nerves in the lower back
  • Decreased blood circulation in the legs
  • Spinal cord injury
  • Certain medications (such as statins and diuretics)
  • Allergies
  • Gastrointestinal disease (digestive tract disorders)
  • Cardiovascular disease
  • Liver failure
  • Cancer
  • Dialysis – treatment to remove excess fluid from the blood when kidneys fail.
  • Respiratory diseases of the lungs and airways
  • Amyotrophic lateral sclerosis (ALS, or Lou Gehrig’s disease, a neurological condition affecting the brain, nerves, and muscles)

Self-Care

Leg cramps often go away on their own after a few minutes. However, other self-care can help. Recommendations: (Harvard Health Publishing, 2024)

Change Body Positions

  • Moving can help relieve tension and pain.
  • If the leg cramps happen at night, stand up and take a few steps.

Massage

  • Gently rubbing the cramped muscle can help it relax.

Stretch

  • Stretching the cramping muscle can help it relax.

Apply Heat

  • If the leg cramp lasts more than a few minutes, apply a heating pad or take a warm shower to increase blood circulation to and around the muscle to help it relax.

Treatment

There are no medications specifically for treating leg cramps. However, if symptoms are caused by another medical condition, treating the underlying condition might help reduce cramp frequency. Dehydration or low electrolytes can cause leg cramps; in these cases, drinking water or electrolyte-infused beverages can help. If cramps are related to overexercising, consider reducing the intensity of your activity or exercising in a cooler environment. (Maughan R. J. & Shirreffs S. M. 2019) Magnesium supplements are usually marketed to relieve muscle cramps; they are not proven to alleviate them. (Garrison, S. R. et al., 2020)

Exercises and Stretches

It is important to know which muscle to target when stretching the leg. If the cramp does not resolve after the first stretch attempt, try again.

Hamstring Muscle

Pain in the back of the thigh. Here’s how to stretch the hamstrings (American Academy of Orthopaedic Surgeons, 2018)

  • Lie on your back.
  • Bend both knees and rest your feet on the ground or mattress if the cramp occurs at night.
  • On the leg that is cramping, bring the knee toward your chest.
  • Interlock the fingers behind your knee.
  • Slowly straighten the knee and pull your leg toward your head until you feel a stretching sensation along the back of the thigh.
  • Hold for 30 to 60 seconds.

Calf Muscle

The calf muscle is the most common for leg cramps. To stretch the calf muscle (American Academy of Orthopaedic Surgeons, 2018)

  • Stand facing a wall.
  • Place palms flat against the wall at shoulder height.
  • Step the cramping leg away from the wall around 12 to 18 inches.
  • Keep your heels flat on the floor.
  • Keeping the back leg straight, bend the front knee slowly and lean forward until you feel a stretch along the calf.
  • Hold for 30 to 60 seconds.

Prevention

They can’t always be prevented. However, if they are related to dehydration or other lifestyle factors, individuals may be able to prevent them from occurring or decrease the frequency. Try the following: (Harvard Health Publishing, 2024)

  • Drink plenty of water.
  • Stretch the leg muscles before you go to bed.
  • Try drinking a beverage with electrolytes for longer workouts or activities in hot weather.
  • Warm up before exercise, such as with a slow jog, before getting into more intense exercises.
  • Properly cool down after a workout.
  • Stretch the leg muscles before and after exercising.
  • Maintain a healthy body weight.

Contact a Healthcare Provider

Leg cramps can sometimes signify something more serious than a Charley horse. See a healthcare provider if any of the following symptoms present (National Library of Medicine, 2020)

  • Change in skin color, including redness or a deeper tone than normal
  • Cramps that last more than a few minutes or occur frequently
  • Muscle weakness
  • Severe pain from the cramps
  • Swelling
  • Warm skin

Injury Medical Chiropractic & Functional Medicine Clinic

Talk to a healthcare provider about leg cramps to learn what interventions would help the most. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.

Is Motion Key to Healing?

References

Harvard Health Publishing. (2024). How to get rid of muscle cramps in your legs. www.health.harvard.edu/pain/how-to-get-rid-of-muscle-cramps-in-your-legs

National Library of Medicine. (2020). Muscle cramps. Retrieved from medlineplus.gov/musclecramps.html

Maughan, R. J., & Shirreffs, S. M. (2019). Muscle Cramping During Exercise: Causes, Solutions, and Questions Remaining. Sports Medicine (Auckland, N.Z.), 49(Suppl 2), 115–124. doi.org/10.1007/s40279-019-01162-1

Garrison, S. R., Korownyk, C. S., Kolber, M. R., Allan, G. M., Musini, V. M., Sekhon, R. K., & Dugré, N. (2020). Magnesium for skeletal muscle cramps. The Cochrane database of systematic reviews, 9(9), CD009402. doi.org/10.1002/14651858.CD009402.pub3

American Academy of Orthopaedic Surgeons. (2018). Knee conditioning program. orthoinfo.aaos.org/en/recovery/knee-conditioning-program/

Antinutrients: Understanding Plant Compounds

By
Dr. Alex Jimenez
-
Sport and vitamins for immunity. Happy black woman doctor holding orange and barbell in clinic, posing at her workplace, free space

Can understanding antinutrients and the importance of a balanced diet help individuals get the most out of their foods?

Antinutrients: Understanding Plant Compounds

Antinutrients

Antinutrients are compounds in some plant foods that can reduce the body’s ability to absorb and use certain nutrients. (Petroski W., & Minich D. M. 2020) The purpose of these compounds is to protect the plants from infections and insects, which benefits the plant. It can also lower the human body’s ability to absorb nutrients properly. They are found in many grains, legumes, seeds, nuts, fruits, and vegetables. Plant-based foods high in antinutrients have beneficial nutrients, such as antioxidants, fiber, and other vitamins and minerals, and have been associated with a lower risk of chronic disease. The antinutrients may prevent the digestion and absorption of some minerals and have other negative effects that include:

  • Altered gut function
  • Increased inflammation
  • Endocrine disruption
  • Increased risk of calcium kidney stones

Common Types

Some of the main antinutrients of concern include phytates, lectins, oxalates, tannins, and phytoestrogens.

Phytates (phytic acid)

Lectins

  • They are found in nearly all foods, notably legumes and grains.
  • Lectins are proteins that bind to carbohydrates.
  • They can be harmful in high amounts or when high-lectin foods, such as beans, lentils, and wheat, are consumed raw. (Adamcová A., Laursen K. H., & Ballin N. Z. 2021)

Oxalates

  • They are found in various plant foods, including fruits, vegetables, nuts, and grains. (Mitchell T. et al., 2019)
  • Oxalates bind to certain minerals, such as calcium-forming calcium oxalate.

Tannins

  • They are found in many plant foods, such as legumes, cereal grains, nuts, cacao, leafy and green vegetables, coffee, and tea. (Ojo M. A. 2022)
  • Tannins are antioxidant-phenolic compounds that can reduce the absorption of some minerals and proteins in the body.

Phytoestrogens

  • They are found in various plant foods, such as fruits, vegetables, legumes, nuts, and seeds.
  • These estrogen-like compounds have many health benefits but may also act as endocrine disruptors (interfering with hormones). (Petroski W., & Minich D. M. 2020)

Effects on the Body

Antinutrient compounds typically bind to minerals or other nutrients, which inhibits digestion and absorption. For example,

Advantages and Disadvantages

Plant foods have long been associated with improved health and a decreased risk of some chronic diseases, such as heart disease, diabetes, cancer, stroke, and others. (Craig W. J. et al., 2021) For most, the effects of antinutrients are not of major concern after processing and cooking. The benefits and drawbacks of consuming foods high in antinutrients include: (Petroski W., & Minich D. M. 2020)

Benefits

  • Some antinutrients act as antioxidants.
  • Some have cancer-fighting abilities.
  • Some may increase immune system function.
  • They are often sources of dietary fiber and other beneficial nutrients.

Drawbacks

  • It may be difficult for some individuals to digest.
  • Phytoestrogens may behave like endocrine disruptors.
  • High amounts of oxalates can contribute to kidney stones.
  • It may decrease the absorption of some minerals.

Foods

Plant foods are the highest in antinutrient compounds, including (Petroski W. & Minich D. M. 2020)

  • Coffee
  • Some teas
  • Cacao
  • Grains
  • Nuts, such as cashews, hazelnuts, and almonds
  • Legumes, such as beans, peas, peanuts, lentils and soybeans
  • Seeds like flaxseeds, sunflower seeds, and sesame seeds
  • Fruits and vegetables include apples, stone fruits, some berries, dark leafy greens, and potatoes.

Reducing Intake

Processing and cooking foods high in antinutrients can help reduce the amount of antinutrient compounds (Petroski W. & Minich D. M., 2020) (Harvard T.H. Chan School of Public Health, 2022)

  • Soaking and sprouting
  • Fermentation
  • Cooking methods to minimize antinutrient content, like boiling, steaming
  • Autoclaving – a cooking process that uses high pressure and heat to cook and sterilize food.
  • Peeling the skins of fruits and nuts is effective for reducing tannins.
  • Combining foods to enhance nutrient absorption.
  • For example, pairing high-oxalate foods with high-calcium foods.

Combining different cooking and processing methods can completely degrade and reduce many antinutrient compounds. The exception is phytoestrogens, where boiling, steaming, and fermentation can increase antinutrients. (Petroski W. & Minich D. M., 2020)

Balancing Nutrition

The Dietary Guidelines for Americans recommend consuming nutrient-dense foods across all food groups. (U.S. Department of Agriculture, 2020)

  • Including various foods in one’s diet will help ensure one gets a diverse range of nutrients to fuel the body properly.
  • When consuming high-antinutrient foods, use processing and cooking methods known to reduce antinutrient compounds.
  • Think about making balanced food pairings to optimize nutrient absorption and minimize antinutrient intake.

For example, combining foods high in vitamin C with foods containing iron in the same meal or snack can enhance iron absorption, opposing the antinutrient activity of phytates. (National Institutes of Health Office of Dietary Supplements, 2024)

Injury Medical Chiropractic & Functional Medicine Clinic

Individuals concerned about antinutrients in their diet and who want individualized advice on how to get the most out of the food they eat should consider consulting with a registered dietitian nutritionist or another healthcare professional. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution.

Smart Choices, Better Health

References

Petroski, W., & Minich, D. M. (2020). Is There Such a Thing as “Anti-Nutrients”? A Narrative Review of Perceived Problematic Plant Compounds. Nutrients, 12(10), 2929. doi.org/10.3390/nu12102929

Gupta, R. K., Gangoliya, S. S., & Singh, N. K. (2015). Reduction of phytic acid and enhancement of bioavailable micronutrients in food grains. Journal of food science and technology, 52(2), 676–684. doi.org/10.1007/s13197-013-0978-y

Adamcová, A., Laursen, K. H., & Ballin, N. Z. (2021). Lectin Activity in Commonly Consumed Plant-Based Foods: Calling for Method Harmonization and Risk Assessment. Foods (Basel, Switzerland), 10(11), 2796. doi.org/10.3390/foods10112796

Mitchell, T., Kumar, P., Reddy, T., Wood, K. D., Knight, J., Assimos, D. G., & Holmes, R. P. (2019). Dietary oxalate and kidney stone formation. American journal of physiology. Renal physiology, 316(3), F409–F413. doi.org/10.1152/ajprenal.00373.2018

Ojo, M. A. (2022). Tannins in Foods: Nutritional Implications and Processing Effects of Hydrothermal Techniques on Underutilized Hard-to-Cook Legume Seeds-A Review. Preventive nutrition and food science, 27(1), 14–19. doi.org/10.3746/pnf.2022.27.1.14

Craig, W. J., Mangels, A. R., Fresán, U., Marsh, K., Miles, F. L., Saunders, A. V., Haddad, E. H., Heskey, C. E., Johnston, P., Larson-Meyer, E., & Orlich, M. (2021). The Safe and Effective Use of Plant-Based Diets with Guidelines for Health Professionals. Nutrients, 13(11), 4144. doi.org/10.3390/nu13114144

Harvard T.H. Chan School of Public Health. (2022). Are anti-nutrients harmful? nutritionsource.hsph.harvard.edu/anti-nutrients/

U.S. Department of Agriculture. (2020). Dietary Guidelines for Americans, 2020-2025. Retrieved from www.dietaryguidelines.gov/sites/default/files/2021-03/Dietary_Guidelines_for_Americans-2020-2025.pdf

National Institutes of Health Office of Dietary Supplements. (2024). Iron. Retrieved from ods.od.nih.gov/factsheets/Iron-HealthProfessional/

Enhancing Your Health With Chiropractic Care & Gua-Sha

By
Dr. Alex Jimenez
-

Discover the synergy of gua-sha and chiropractic care for holistic health benefits that can transform your wellness routine.

Introduction

When it comes to many individuals dealing with musculoskeletal pain, it can be due to many environmental factors that can affect the body. Excessive movement can affect different body areas, from overly stressful days to injuries. Some of the more common musculoskeletal issues are neck, shoulder, and back pain. These muscle issues can cause referred pain to the upper and lower extremities while causing the affected muscles to become tight and stiff. When individuals are experiencing musculoskeletal pain, many can incorporate non-surgical treatments to not only relax the body but also reduce the overlapping symptoms of musculoskeletal pain affecting the muscles. One of the most underutilized and effective tools that can help relax the affected muscles is Gua Sha therapy.

 

What is Gua-Sha?

Gua Sha is a traditional healing technique incorporating a smooth-edged tool made from either jade, rose quartz, or metal to scrape the skin gently. This technique has been used regularly in China and Southeast Asia and has therapeutic properties to restore the body’s chi or energy. “Gua Sha” means scraping stagnant blood to increase circulation beneath the skin. Thus enhancing the immune surveillance function of the affected muscle. (Chu et al., 2021) GuaSha therapy can be a powerful therapeutic tool for reducing inflammation in soft tissues, improving mobility within the extremities, and relieving muscle pain.

 

How Gua-Sha Helps With Musculoskeletal Pain

Now, when it comes to individuals dealing with musculoskeletal pain, it is often associated with overuse, repetitive movements, injuries, poor posture, or chronic conditions. When these environmental factors start to cause musculoskeletal pain, it can affect different body areas, especially the neck, shoulders, and back. These common areas of musculoskeletal pain can cause localized or referred pain that causes the muscles, fascia, and ligaments to be pain generators due to overuse, leading to myofascial pain and muscle trigger points. (Knezevic et al., 2021) Gua Sha therapy can address these root musculoskeletal causes by:

  • Breaking up fascia adhesions and scar tissue within the soft tissues
  •  Gua Sha can reduce inflammation in the affected area by improving muscle microcirculation.
  • Help stimulate the parasympathetic nervous system, providing pain relief
  • Releasing muscle tension and myofascial trigger points in the upper and lower extremities
  • Helps to enhance lymphatic drainage, thus reducing swelling and stagnation

In short, Gua Sha can help remove du meridian obstructions, replenish the body’s energy, remove blood stasis, and promote blood circulation for natural healing. (Wang et al., 2020)

 

Discovering the Benefits of Chiropractic Care- Video

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

Gua-Sha & Chiropractic Care: A Powerful Combination

When individuals are experiencing musculoskeletal issues within their upper and lower extremities correlated with environmental factors, many will often seek non-surgical treatment for their pain. Some non-surgical treatments, like chiropractic care, can benefit the musculoskeletal system. Chiropractic care emphasizes diagnosing and managing musculoskeletal disorders that use mechanical and manual spinal manipulation. (Trager et al., 2024) Combined with Gua Sha, it can be more effective in promoting healing properties since chiropractic care helps restore joint mobility and realign the spine. Gua-Sha helps break down or scrape the surrounding tissues. For chiropractors, incorporating the Graston technique (another form of Gua Sha) utilizes specialized instruments to modify the affected body area structure and composition of soft tissue. This then enhances fascia mobility while addressing tissue adhesions. (Deshmukh & Phansopkar, 2023)

 

The Benefits of Chiropractic Care & Gua-Sha

One of the advantages of chiropractic care is that it reduces discomfort in the muscles, joints, bones, and connective tissues by helping people maintain normal musculoskeletal alignment. (Chu and others, 2023) Benefits of gua sha that may be used either by itself or in conjunction with chiropractic adjustments include:

  • Relief of shoulder, back, and neck discomfort
  • Increase the muscles’ flexibility and range of motion.
  • Reduction of inflammation in the afflicted muscle
  • Speeds up the body’s recuperation

The underlying problems impacting the whole kinetic body chain may be addressed with Gua-Sha and chiropractic adjustments as part of the individual’s personalized treatment plan. Gua Sha is used by chiropractors either before or after a chiropractic adjustment to promote mobility, decrease guarding, restore tissue function and flow, and boost the therapy’s efficacy. Consequently, this facilitates both functional musculoskeletal mobility and long-term recovery.

 

Common Gua-Sha Uses In Musculoskeletal Care

The mild, non-invasive technique of gua sha treatment is useful for some ailments and may be tailored to each patient’s tolerance and recovery requirements. That comprises:

  • Persistent lower back or neck discomfort
  • Muscle-related pain syndrome
  • The syndrome of carpal tunnel
  • Achilles and tennis elbow are examples of tendinitis.
  • Fascia plantaris
  • Scarring or stiffness after surgery
  • Headaches caused by tension and TMJ dysfunction

Gua Sha treatment has several positive benefits on the musculoskeletal system, but it may not be appropriate for everyone who has a history of bleeding or has certain skin or vascular issues. A suitable, individualized treatment strategy for such problems must be discussed with the patient’s affiliated healthcare professionals.

 

Conclusion

People who are seeking holistic, non-pharmacological therapy for musculoskeletal pain brought on by environmental causes may include Gua Sha in their personalized chiropractic treatment regimen. This combination can improve soft tissue health and promote appropriate spinal alignment, lowering the likelihood that musculoskeletal diseases may recur. Once people begin to think about their health and well-being, they will have a whole team to support them on their path to wellness and pain relief using Gua Sha treatment and chiropractic adjustments.

Injury Medical & Functional Medicine Clinic

We associate with certified medical providers who understand the importance of assessing individuals dealing with musculoskeletal pain by incorporating Gua-Sha and chiropractic care. When asking important questions to our associated medical providers, we advise patients to utilize Gua-Sha combined with chiropractic care to reduce musculoskeletal pain and restore soft tissue mobility in the extremities. Dr. Alex Jimenez, D.C., uses this information as an academic service. Disclaimer.

References

Chu, E. C., Lin, A. F. C., & Chu, V. (2023). The Inclusion of Chiropractic Care in the Healthy China Initiative 2030. Cureus, 15(8), e43068. doi.org/10.7759/cureus.43068

Chu, E. C. P., Wong, A. Y. L., Sim, P., & Kruger, F. (2021). Exploring scraping therapy: Contemporary views on an ancient healing – A review. J Family Med Prim Care, 10(8), 2757-2762. doi.org/10.4103/jfmpc.jfmpc_360_21

Deshmukh, N. S., Jr., & Phansopkar, P. (2023). Effect of the Graston Technique and Cupping Therapy on Pain and Functions in Individuals With Medial Tibial Stress Syndrome: A Randomized Clinical Trial. Cureus, 15(11), e48246. doi.org/10.7759/cureus.48246

Knezevic, N. N., Candido, K. D., Vlaeyen, J. W. S., Van Zundert, J., & Cohen, S. P. (2021). Low back pain. The Lancet, 398(10294), 78-92. doi.org/10.1016/s0140-6736(21)00733-9

Trager, R. J., Bejarano, G., Perfecto, R. T., Blackwood, E. R., & Goertz, C. M. (2024). Chiropractic and Spinal Manipulation: A Review of Research Trends, Evidence Gaps, and Guideline Recommendations. J Clin Med, 13(19). doi.org/10.3390/jcm13195668

Wang, Y. W., Xi, Z. W., Pu, B., Chen, G. Y., Ma, Y. F., Liu, D. L., & Xu, X. (2020). Gua sha therapy for chronic low back pain: A protocol for systematic review. Medicine (Baltimore), 99(40), e20606. doi.org/10.1097/MD.0000000000020606

Disclaimer

Back Pain When Walking: Understanding the Symptoms

By
Dr. Alex Jimenez
-
Complex examination and treatment of back pain with examination and MRI of spine in neurological spine disorders clinic

For individuals with lower back pain when walking, could they have injured a muscle or have an underlying condition affecting the joints, ligaments, or nerves?

Back Pain When Walking: Understanding the Symptoms

Back Pain When Walking

Lower back pain when walking can occur for a variety of reasons. It can result from poor posture, injuries, muscle fatigue, or an underlying condition. Specific injuries, like muscle strains, can affect the ligaments in the spine and cause pain. Muscles that have not been used often can result in fatigue and pain. Specific health conditions, such as degenerative disc disease, spinal stenosis, herniated discs, sciatica, or even sacroiliac joint dysfunction, can cause lower back pain. Factors like overexertion or improper gait can exacerbate it.

Muscle Issues

Muscle strains, ligament sprains, or fatigue can cause lower back pain when walking. Pain can occur after walking or come on gradually from wear and tear without an apparent cause, as follows (American Association of Neurological Surgeons, 2024)

Strains

  • Occur when the fibers in the back are overstretched or torn.
  • Pain from muscle strains is usually worse during activity and better when resting.

Sprains

  • It occurs when the ligaments that connect bone to bone become detached.
  • If the muscles do not adequately support the spine, the spinal joints absorb more pressure, which can lead to injury to the spinal ligaments.

Fatigue

  • It can happen from overexertion and lead to lower back pain when walking.
  • It could occur when walking longer than the body is used to, on uneven surfaces that make the muscles work harder to help maintain balance, or climbing hills that cause you to lean forward while walking.

Degenerative Disc Disease

  • Between each vertebra is a disc that provides cushioning between the bones.
  • As the disc wears down, surrounding muscles, ligaments, joints, and nerves in the spine absorb more pressure, causing damage.
  • Degenerative disc disease is a wear-and-tear condition that becomes more common as individuals age and is a common cause of lower back pain.
  • Healthcare providers recommend walking as a low-impact activity for individuals with the disease. However, if the condition is more severe, individuals could experience pain from this exercise, especially when walking on hard surfaces. (Hospital for Special Surgery, 2024)

Sciatica

Sciatica pain occurs when a nerve exiting the spine in the lower back becomes compressed or pinched. It is a common symptom of a herniated disc, in which a disc moves out of place and puts pressure on nearby nerves. In addition to lower back pain, sciatica can cause pain in the hip, the back of the thigh, and down the leg. Sciatica can also cause: (American Academy of Orthopaedic Surgeons, 2021)

  • Numbness
  • Tingling
  • Muscle cramps
  • Leg muscle weakness

Healthcare providers often recommend walking as a safe form of physical activity for individuals with sciatica. However, individuals should avoid twisting or bending forward. (American Academy of Orthopaedic Surgeons, 2021) To decrease pain, avoid walking on uneven surfaces or uphill.

Lumbar Spinal Stenosis

  • Spinal stenosis is a wear-and-tear condition that often affects the lumbar spine/five vertebrae in the lower back.
  • It causes the space surrounding the spinal cord to narrow.
  • Sometimes, the narrowing can add pressure on the nerves, resulting in numbness, tingling, and weakness in the legs. (American Academy of Orthpaedic Surgeons, 2021)
  • Lumbar spinal stenosis typically causes pain when standing upright, including when walking.
  • Many with this condition find that leaning slightly forward helps to reduce the pain by opening up the compressed areas.

Hyperlordosis

Lordosis describes the normal curve in the spine in the lower back. However, when this curve is exaggerated, it causes hyperlordosis or swayback. (American Academy of Orthopaedic Surgeons, 2020) Hyperlordosis affects the range of motion, putting abnormal pressure on the muscles, ligaments, and joints. It also reduces the spine’s ability to absorb shock correctly when walking, leading to pain. (Cedars-Sinai, 2025)

Prevention Strategies

Individuals can take steps to reduce their risk of lower back pain when walking, even if they’ve been diagnosed with a condition that can potentially cause this symptom. Walking can decrease chronic low back pain for some. (Suh J. H. et al., 2019) As with any new exercise program, check with a healthcare provider to ensure that walking for exercise is appropriate for the injury, condition, or disease and is safe. Recommended tips: (Harvard Health Publishing, 2015)

  • Wear shoes made for walking.
  • Perform gentle lower back stretches before walking.
  • Start slowly by walking for a few minutes, then gradually increase the time.
  • Walk on a smooth surface, such as a sidewalk or athletic track, or indoors, such as in a shopping center or mall.
  • Warm up and cool down by walking slowly at the beginning and end of the walk.
  • This allows the back and leg muscles to warm up before exercise and recover afterward.
  • Walk at a slow to moderate pace/speed that allows one to converse.
  • Standing up straight while walking or standing upright reduces pressure on the lower back.

Alternative Exercise

If there is still back pain when walking, it might not be an appropriate exercise for the individual and/or how their condition presents symptoms. Alternate activities can include: (Hospital for Special Surgery, 2023)

Elliptical Trainer

  • This exercise keeps the feet in contact with the pedals, putting less shock-absorbing pressure on the spine than walking.

Recumbent Biking

  • will keep the back upright, which is recommended if there is more pain when bending forward.

 Upright Stationary Biking

  • This is recommended if the back pain improves when bending forward.

Walking In A Pool

  • This activity provides benefits while reducing pressure on the spine.
  • To target different muscles, try walking laps in waist-deep water in multiple directions (forward, backward, and side to side).

Water Aerobics

  • This activity provides cardiovascular health benefits with decreased pressure on the back.

Injury Medical Chiropractic & Functional Medicine Clinic

See a physical therapist for a personalized exercise program to reduce back pain and appropriate for your condition. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.

Beyond Adjustments: Chiropractic and Integrative Healthcare

References

American Association of Neurological Surgeons. (2024). Low back strain and sprain. www.aans.org/patients/conditions-treatments/low-back-strain-and-sprain/

Hospital for Special Surgery. (2024). Degenerative disc disease. www.hss.edu/condition-list_degenerative-disc-disease.asp

American Academy of Orthopaedic Surgeons. (2021). Sciatica. orthoinfo.aaos.org/en/diseases–conditions/sciatica

American Academy of Orthpaedic Surgeons. (2021). Lumbar spinal stenosis. orthoinfo.aaos.org/en/diseases–conditions/lumbar-spinal-stenosis/

American Academy of Orthopaedic Surgeons. (2020). Spine basics. orthoinfo.aaos.org/en/diseases–conditions/spine-basics/

Cedars-Sinai. (2025). Swayback (lordosis). www.cedars-sinai.org/health-library/diseases-and-conditions/s/swayback-lordosis.html

Suh, J. H., Kim, H., Jung, G. P., Ko, J. Y., & Ryu, J. S. (2019). The effect of lumbar stabilization and walking exercises on chronic low back pain: A randomized controlled trial. Medicine, 98(26), e16173. doi.org/10.1097/MD.0000000000016173

Harvard Health Publishing. (2015). 5 tips for getting started with a walking program. www.health.harvard.edu/exercise-and-fitness/get-started

Hospital for Special Surgery. (2023). Best types of exercise for back pain. www.hss.edu/article_best-exercise-lower-back-pain.asp

Post-Surgery Leg Strengthening to Regain Mobility

By
Dr. Alex Jimenez
-
Young physiotherapist examining customer's leg while colleague noting in clipboard at hospital

What are some leg-strengthening exercises that will expedite recovery for athletes and physically active individuals who have undergone leg surgery?

Post-Surgery Leg Strengthening to Regain Mobility

Post Surgery Leg Strengthening

Leg muscles may weaken after hip, knee, ankle, or foot surgery. This happens because those muscles are not used as much during recovery. Gaining back strength and muscle endurance after an injury or surgery is an important step in recovery. Leg exercises can help regain mobility and prevent complications like blood clots and pressure sores after surgery or an injury, which is why engaging in post-surgery leg strengthening is important once the doctor gives the ok.

Benefits

Post-surgery leg strengthening exercises have several benefits, including

  • Rebuilds strength and confidence
  • Retraining for optimal mobility and flexibility
  • Prevents pressure sores
  • Prevents blood clots

When the leg muscles are contracted, they move blood like a pump, maintaining proper circulation. Moving in a bed after surgery also helps prevent pressure sores from forming and blood clots. A physical therapy team will determine the right leg exercises for each individual and their injury/condition. This is an important step when moving forward after surgery. (Hoogeboom T. J. et al., 2014)

Starting Out

The first exercises should target all the major muscles of the leg. (Madara K. C. et al., 2019)

Gluteal Sets

This isometric exercise means the muscles contract while no motion occurs at the hip joints. To perform:

  • Lie on your back and tighten your buttock muscles.
  • Hold the muscles tight for 5 seconds, then relax.
  • Repeat 10 or 15 times.
  • Gluteal sets can be done several times per day.

Heel Slide

Heel slides can help regain strength in the major muscles of the leg. To perform:

  • Lie on your back.
  • Bend the knee of the surgical leg and slowly slide the heel toward your butt.
  • Slide as far as possible and hold for 5 seconds.
  • Slowly return to the starting position and repeat.

Short Arc Quad

The short arc quad, or SAQ, is a simple way to get the quadricep muscles working. To perform:

  • Lie on your back with a towel roll, small ball, or something similar under the knee.
  • Slowly straighten the knee.
  • Tighten the quad muscle on the top of the thigh.
  • Hold for 3 seconds, then relax.
  • Repeat 10 to 15 times.

Quad Set

This exercise helps get the quad muscles working. It also helps control the position of the kneecap. To perform:

  • Lie on your back.
  • Place a small towel roll under the knee.
  • Try to press the back of the knee flat against the floor.
  • Hold for 10 seconds and release.
  • Repeat 10 to 15 times.

Individuals can complete quad sets bilaterally or with both knees simultaneously. This makes the stronger leg help strengthen the weaker side.

Straight Leg Raise

To perform:

  • Lie on your back.
  • Lift your leg straight off the floor until it is at the height of the opposite bent knee.
  • Hold for 10 seconds and slowly lower.
  • Repeat 10 to 15 times.

Be sure to keep the knee straight for the entire exercise. Keep the opposite knee bent for comfort. To ensure the knee is straight, individuals can complete a quad set first and then the straight leg raise. The exercise can be more challenging by increasing repetitions or adding a 2- to 3-pound ankle weight on the thigh. For even more challenge, add the ankle weight to the ankle.

Hamstring Strengthening

Working out the hamstrings after injury or surgery is important. The hamstring muscles bend the knee and extend the hip backward. To perform:

  • Lie on your stomach.
  • Bend one knee to raise the lower limb straight in the air.
  • Hold for 5 seconds and lower slowly.
  • Repeat 10 to 15 times.

Once the exercise is easy to do, increase the repetitions to 30. Individuals can also try adding a 2- to 3-pound ankle weight.

Physical therapy can help individuals regain mobility after injury or surgery. A therapist may prescribe exercises as part of an at-home exercise program. Over time, progress will go from simple exercises to more challenging ones to improve balance and mobility. (Madara K. C. et al., 2019)

Injury Medical Chiropractic & Functional Medicine Clinic

Before starting this or any other exercise program, consult a doctor and a physical therapist to find the right exercises for your situation. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.

Are You Recovering From Ankle Sprains?

References

Hoogeboom, T. J., Dronkers, J. J., Hulzebos, E. H., & van Meeteren, N. L. (2014). Merits of exercise therapy before and after major surgery. Current opinion in anaesthesiology, 27(2), 161–166. doi.org/10.1097/ACO.0000000000000062

Madara, K. C., Marmon, A., Aljehani, M., Hunter-Giordano, A., Zeni, J., Jr., & Raisis, L. (2019). PROGRESSIVE REHABILITATION AFTER TOTAL HIP ARTHROPLASTY: A PILOT AND FEASIBILITY STUDY. International Journal of Sports Physical Therapy, 14(4), 564–581.

Personal TENS: A Portable Solution for Pain

By
Dr. Alex Jimenez
-
Senior Woman Doing Wrist Joint Physical Therapy with Conductive TENS Electrode Sock, Transcutaneous Electrical Nerve Stimulation

For individuals managing chronic pain conditions, can incorporating a personal TENS device help?

Personal TENS: A Portable Solution for Pain

Personal TENS Device

Almost all physical therapy, chiropractic, acupuncture, and massage clinic healthcare providers offer TENS (transcutaneous electrical nerve stimulation) therapy. Individuals can buy a TENS unit for on-the-go and home care use. A personal TENS unit is a small, battery-powered device that uses low-voltage electrical currents delivered through electrodes placed on the skin to help relieve pain.

How It Works

TENS units work by stimulating nerve fibers in pain, which can help block pain signals from reaching the brain or by stimulating the release of endorphins, the body’s natural pain-killing chemicals.

Uses

TENS units are used to treat a variety of conditions, including:

  • Arthritis
  • Muscle cramps
  • Neck pain
  • Back pain
  • Pelvic pain
  • Knee pain
  • Osteoarthritis
  • Fibromyalgia
  • Tendinitis
  • Bursitis
  • Diabetes-related neuropathy
  • Pelvic pain from periods or endometriosis

Features

Portability

  • TENS units are small, lightweight, and portable, making them convenient for home or on the go. It can be held in a pocket or clipped to a belt. (National Health Service UK, 2025)

Electrodes

  • The unit is connected to a series of electrodes placed on the skin to deliver the electrical charge.

Adjustable Settings

  • Many TENS units allow users to adjust the electrical pulses’ intensity, frequency, and duration.

Benefits

Non-Invasive

  • TENS therapy is a non-invasive method for relieving pain.

Drug-Free

  • It can provide pain relief without the need for medication.

Convenient

  • TENS units are small, portable, and relatively discrete.

Precautions

Consult a healthcare provider before using a TENS device to ensure its safety for you and your injury/condition. The treatment should not be used for individuals who are pregnant, have epilepsy, poor sensation, a heart problem, a pacemaker, or another electrical or metal implant in their body. (National Health Service UK, 2025) The electrodes should not be placed on certain areas of the body, including (Teoli D, Dua A, An J. 2025)

  • Head
  • Eyes
  • Mouth
  • Front of the Neck
  • Chest and upper back at the same time
  • Numb areas
  • Broken skin
  • Tumors

There is a minor risk of skin irritation, particularly if allergic to the adhesive pads.

Effectiveness

Researchers are still determining how effective TENS units are for relieving and reducing pain. A study found that TENS was effective in relieving pain for patients with fibromyalgia. (Dailey D. L. et al., 2013) Another study suggested that TENS may improve bone pain for cancer patients, but the results were inconclusive because of the limited number of randomized trials. (Vance C. G. et al., 2014)

Research suggests that some factors can impact the effectiveness of the intervention. Varying the intensity and frequency may help it be more effective so the body doesn’t develop a tolerance to it. In addition, using the electrodes in areas that are acupuncture points may help to reduce pain. While further study is needed, TENS is considered a safe pain-relief option for many conditions because it’s non-invasive and doesn’t require medication. (Vance C. G. et al., 2014)

Injury Medical Chiropractic & Functional Medicine Clinic

Individuals interested in trying a personal TENS unit should consult their healthcare provider. They may be able to refer them to a physical therapist, who can show them which type and how to use it for their particular condition. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.

Don’t Ignore Post-Accident Pain

References

National Health Service UK. (2025). TENS (transcutaneous electrical nerve stimulation). www.nhs.uk/conditions/transcutaneous-electrical-nerve-stimulation-tens/

Teoli, D., Dua, A., & An, J. (2025). Transcutaneous Electrical Nerve Stimulation. In StatPearls. www.ncbi.nlm.nih.gov/pubmed/30725873

Dailey, D. L., Rakel, B. A., Vance, C. G. T., Liebano, R. E., Amrit, A. S., Bush, H. M., Lee, K. S., Lee, J. E., & Sluka, K. A. (2013). Transcutaneous electrical nerve stimulation reduces pain, fatigue, and hyperalgesia while restoring central inhibition in primary fibromyalgia. Pain, 154(11), 2554–2562. doi.org/10.1016/j.pain.2013.07.043

Vance, C. G., Dailey, D. L., Rakel, B. A., & Sluka, K. A. (2014). Using TENS for pain control: the state of the evidence. Pain management, 4(3), 197–209. doi.org/10.2217/pmt.14.13

Modern Clinical Approach Strategies For Reproductive Health & Sexual Wellness

By
Dr. Alex Jimenez
-

Uncover how a clinical approach to reproductive health can guide effective treatment and support for reproductive challenges.

Reproductive Health

As their menstrual cycles increase or decrease in frequency, many women may see physical changes that may impact their reproductive health. Each woman will experience menopause differently, with varying symptoms, while monthly alterations might last anywhere from one to three years.

When there are hormonal changes related to reproductive health, some of the symptoms may include:

  • Restless nights
  • Weight variations
  • Muscle and joint discomfort and exhaustion

Women who are coping with hormonal changes related to their reproductive health also experience physical sensations that resemble pain. Hormones, the body, and the spinal structure all change with age. Low back pain may result from overlapping risk profiles for the musculoskeletal system and reproductive health caused by a variety of environmental variables that impact the body. Many people who suffer from low back pain, particularly women, relate it to a variety of variables, such as different menstrual cycles and greater pain sensitivity. (Chen and colleagues, 2024)

 

Hormone Replacement Therapy

Hormone replacement Therapy or HRT is a treatment that can be used to treat some of the symptoms of hormonal changes associated with reproductive health by replacing hormones that are at a lower level. For females, low estrogen and progesterone levels can affect neuroprotective receptors in the brain, causing symptoms of inflammation and stress to impact the body. (Hwang et al., 2020) For males, low testosterone levels can cause skeletal muscle mass and strength reduction, decreased bone mineral density, and sexual dysfunction. (Barone et al., 2022) So, for males and females, taking HRT can help replenish the lost hormones in their bodies and reduce the overlapping pain symptoms.

 

Andropause & Menopause

When a woman between the ages of mid-40s and mid-50s deals with changes in their menstrual cycle, it is known as menopause. When a woman goes through menopause, it is a transition period where the woman’s ovaries stop releasing eggs, and their hormone levels of estrogen and progesterone decrease, thus ceasing a woman’s menstruation cycle. Within that time frame during menopause, most women will experience weight gain and have an increase of peripheral fat stored in the hips, glutes, and around the abdominals. (Ko & Kim, 2020) This extra weight around the abdominals and hips can lead to the development of musculoskeletal issues like back pain.

 

While males have the capability of reproduction throughout their lives after puberty, when they begin to age, they produce low testosterone levels and fewer sperm. Additionally, a majority of men can experience low levels of testosterone hormones as they start to notice a decreased libido, body hair loss, loss of muscle mass, and breast enlargement. This is known as andropause, where, like menopause in women, the testosterone hormone levels are lowered. Luckily, low testosterone levels can be tested, allowing males to be treated with testosterone replacement therapy. Testosterone replacement therapy can provide beneficial results by replenishing testosterone levels associated with reducing symptoms of decreased libido, improving skeletal muscle function, and restoring bone mineral density. (Barbonetti et al., 2020)

 

Testosterone Deficiency In Men- Video

*TESTOSTERONE DEFICIENCY* in men | El Paso, Tx (2021)

Surgical & Non-Surgical Interventions

Many middle-aged adults would discuss with their partners about not wanting to have children or are finished having children. When it comes to interventions such as this, many choose surgical or non-surgical procedures. Females can have a surgical procedure known as tubal ligation. This procedure has the fallopian tubes either cut, tied, or removed to prevent pregnancy while still having their menstrual cycle until menopause, so there is no impact on the hormones. For males, they can go through a surgical procedure known as a vasectomy so that the vas deferens are cut and sealed. Both methods are 99% effective in preventing pregnancy. These outpatient procedures have different state laws and safeguards regarding sterilization surgery.

 

However, not many people will go on the surgical route to prevent surgery and will go on the non-surgical route. Many people will utilize birth control methods like birth control medication, condoms, and natural cycle planning. For women, many will incorporate hormonal birth control medication as part of their routine in preventing pregnancy. Some of the added benefits for women who are taking contraceptives include: (Allen et al., 2013)

  • Restoring menstrual regularity
  • Improving vasomotor symptoms
  • Preventing bone mineral density decline

 

Sex Changes In Middle Adulthood

A significant aspect of people’s life at any age, sexual activity is practiced by many via communication and wholesome partnerships. Many happy couples find that closeness helps them express their needs and desires. Adults also experience sexual changes that are connected to their reproductive health as they become older. Due to the common vaginal walls being thinner and the vagina becoming shorter and narrower, many women may experience discomfort in the pelvic area, which is caused by decreased lubrication.

Men also experience changes in erection performance as they age, particularly if they have health and wellness-related comorbidities. For older men, erectile dysfunction, or ED, which is characterized by trouble achieving an erection, is one of the most prevalent alterations. (Leslie & Sooriyamoorthy, 2025) When environmental circumstances cause risk profiles to coincide, ED may develop as a symptom. Fortunately, there are methods for treating ED that include altering one’s lifestyle and taking care of interpersonal or psychological problems. (Lowy & Ramanathan, 2022) Men may find it challenging to talk about it with their physicians, but it is crucial for their overall health and welfare.

 

Final Thoughts

In terms of sexual and reproductive health, many people who suffer from discomfort and musculoskeletal problems might benefit from a personalized treatment plan. Adding a different routine, such as eating more vegetables and lean meats, exercising for 30 minutes, or getting a wellness check-up, can help manage pain-like symptoms related to environmental factors and support an individual on their health journey. Even small changes to a routine can have long-term benefits.

 

Injury Medical & Functional Medicine Clinic

We associate with certified medical providers who understand the importance of assessing individuals dealing with reproductive and sexual health associated with body pain. When asking important questions to our associated medical providers, we advise patients to implement various approaches to their reproductive and sexual health associated with their pain. Dr. Alex Jimenez, D.C., utilizes this information as an academic service. Disclaimer.

References

Allen, R. H., Cwiak, C. A., & Kaunitz, A. M. (2013). Contraception in women over 40 years of age. CMAJ, 185(7), 565-573. doi.org/10.1503/cmaj.121280

Barbonetti, A., D’Andrea, S., & Francavilla, S. (2020). Testosterone replacement therapy. Andrology, 8(6), 1551-1566. doi.org/10.1111/andr.12774

Barone, B., Napolitano, L., Abate, M., Cirillo, L., Reccia, P., Passaro, F., Turco, C., Morra, S., Mastrangelo, F., Scarpato, A., Amicuzi, U., Morgera, V., Romano, L., Calace, F. P., Pandolfo, S. D., De Luca, L., Aveta, A., Sicignano, E., Trivellato, M.,…Crocetto, F. (2022). The Role of Testosterone in the Elderly: What Do We Know? Int J Mol Sci, 23(7). doi.org/10.3390/ijms23073535

Chen, D., Zhou, J., Lin, C., Li, J., Zhu, Z., Rao, X., Wang, J., Li, J., Chen, H., Wang, F., Li, X., Gao, M., Zhou, Z., Xi, Y., & Li, S. (2024). A causal examination of the correlation between hormonal and reproductive factors and low back pain. Front Endocrinol (Lausanne), 15, 1326761. doi.org/10.3389/fendo.2024.1326761

Hwang, W. J., Lee, T. Y., Kim, N. S., & Kwon, J. S. (2020). The Role of Estrogen Receptors and Their Signaling across Psychiatric Disorders. Int J Mol Sci, 22(1). doi.org/10.3390/ijms22010373

Ko, S. H., & Kim, H. S. (2020). Menopause-Associated Lipid Metabolic Disorders and Foods Beneficial for Postmenopausal Women. Nutrients, 12(1). doi.org/10.3390/nu12010202

Leslie, S. W., & Sooriyamoorthy, T. (2025). Erectile Dysfunction. In StatPearls. www.ncbi.nlm.nih.gov/pubmed/32965924

Lowy, M., & Ramanathan, V. (2022). Erectile dysfunction: causes, assessment and management options. Aust Prescr, 45(5), 159-161. doi.org/10.18773/austprescr.2022.051

Disclaimer

Pulled Muscle Guide: Recovery and Prevention Tips

By
Dr. Alex Jimenez
-
Mixed race woman physiotherapist with her mature female patient during spine and back rehabilitation

What are the recommendations for a pulled muscle injury to fully recover?

Pulled Muscle Guide: Recovery and Prevention Tips

 

Pulled Muscle Recovery Time

A pulled muscle, medically known as a strain, occurs when muscle fibers are stretched too far and sometimes tear. A pulled muscle injury typically starts to heal within days. Mild injuries can heal completely in one to three weeks, but more serious strains or tears, depending on the severity, can take six to 12 weeks or longer. (Fernandes T. L., Pedrinelli A., & Hernandez A. J. 2015)  Rest, hydration, healthy foods, and slowly returning to activity can help expedite healing time.

Timeline

The timeline for recovering from a pulled muscle depends on the injury’s severity.

Pulled muscles are typically categorized into three grades based on the degree and size of pulled muscle fibers, as follows (Hospital for Special Surgery, 2024)

Grade 1 (mild)

  • Heals in a few days.
  • A microscopic tear or stretch in the muscle fiber.
  • It might feel sore, but you can still use the muscle.

Grade 2 (moderate)

  • Heals in four to six weeks.
  • A partial tear in the muscle causes noticeable pain and swelling, making it harder to move or use the injured muscle.

Grade 3 (severe)

  • Heals in several months
  • This type of muscle strain causes a complete tear, also known as a rupture.
  • It results in intense pain, significant swelling, and inability to use the muscle.
  • Surgery may be required in some cases.
  • Larger muscles, such as the hamstrings and quadriceps, may take longer to heal than smaller muscles due to their increased size and greater weight-bearing loads.

Body Parts More Susceptible To Injury

The following are more susceptible to muscle strains, pulls, or tears (Nölle L. V. et al., 2022)

  • Neck – levator scapulae and trapezius
  • Shoulders – rotator cuff muscles
  • Lower back – erector spinae
  • Groin – adductors
  • Front of the thigh – quadriceps
  • Behind the thigh – hamstrings
  • Calves – gastrocnemius and soleus

Healing Stages and Factors

Pulled muscles heal in three predictable stages, though the timing and progression may vary by individual and injury severity (Baoge L. et al., 2012).

Inflammatory Stage (zero to three days)

  • When pulling a muscle, the body reacts instantly with an inflammatory response that may include swelling, redness, bruising, and pain.
  • Rest is important during this stage to prevent the injury from getting worse.

Repair Stage (three to 21 days)

  • Damaged muscle fibers are repaired and regrow during this stage.
  • Collagen fills in any tears to rebuild damaged muscle tissue.
  • Gentle movement and easy activity can help the fibers line up properly and reduce stiffness.
  • Start slowly moving a pulled muscle as soon as possible, but avoid too much activity too soon, as it can delay and prolong healing.

Remodeling Stage (three weeks to one year)

  • Repaired tissue gets stronger and adapts to regular movement.
  • Scar tissue may form.
  • Gradually adding more activity, stretching, and strengthening exercises helps treat a pulled muscle and return to full strength and function but should be done carefully to avoid re-injury.

Faster Healing

To help speed up recovery from a pulled muscle, try these simple strategies: (Baoge L. et al., 2012) (Laumonier T. & Menetrey J. 2016)

Rest

  • Avoid activities that cause pain, but move the muscle gently to prevent stiffness.
  • Prolonged rest can slow healing, so maintain a balance between rest and exercise.

Ice

  • Add ice for 10–20 minutes for the first 48 hours to reduce swelling and pain.
  • Ice helps control inflammation by limiting blood flow to the injured area.

Compression

  • Use compression stockings or wrap the injured part in bandages to help reduce swelling.
  • Ensure the binding is not too tight so circulation is not cut off.

Elevation

  • Raise the injured area above heart level throughout the day.
  • This helps reduce swelling by allowing fluids to drain away from the injury site.

Heat

  • After the first two to three days, heat therapy increases blood circulation and improves flexibility, helping the muscle heal.

Eat Healthy

  • Get enough protein for muscle repair.

Maintain Hydration

  • Drink plenty of water to help with circulation and muscle lubrication.

Massage and Physical Therapy

  • These hands-on interventions can improve circulation, help reduce scar tissue, and restore range of motion.

Over-the-counter Medications

  • If needed, over-the-counter nonsteroidal anti-inflammatory medications like Advil or Motrin (ibuprofen) and Aleve (naproxen sodium) can help with pain and swelling.
  • Only use as directed.

These steps can help promote faster healing and expedite returning to normal daily activities.

When to Resume Normal Activity

Individuals may need one to two weeks to recover before resuming normal activity for mild strains. However, for more severe injuries, it could take four to six weeks or longer to return to all daily activities. (Harvard Health Publishing, 2023) It’s essential to gradually return to daily activities to avoid reinjury, which can delay and prolong healing. Follow these recommendations to recover from a pulled muscle safely and quickly (Kraemer W., Denegar C., & Flanagan S. 2009)

  • Once the pain has subsided, the swelling has decreased, and the muscle feels better, start with low-impact exercises.
  • Slowly resume normal activities, avoiding overexerting the injured area.
  • Gradually increase activity levels and stop if there is any pain.
  • Avoid strenuous activities that place excessive stress on the injured muscle until the muscle is completely healed.

Contact a Healthcare Provider

While most pulled muscles heal with home care, seek medical attention if: (Penn Medicine, 2023)

  • Pain persists or worsens after seven to 10 days.
  • This can indicate a more serious injury, such as a severe torn muscle.
  • Significant pain, loss of motion and strength, and swelling disrupt daily activities or show signs of worsening despite rest and self-care.
  • It is difficult to move the affected area, or the muscle cannot bear weight, suggesting a more severe injury.
  • There are signs of infection, including redness, warmth, increased swelling, or fever, especially if the skin is cut or broken near the injured area.
  • There is unusual bruising or a visible deformity, which could indicate a bone fracture requiring professional evaluation.

A healthcare provider may recommend imaging studies, such as MRI, ultrasound, or X-rays, to assess the extent of the injury, rule out fractures, or check for muscle tears.

Injury Medical Chiropractic & Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.

Say Goodbye to Pain with Chiropractic Care

References

Fernandes, T. L., Pedrinelli, A., & Hernandez, A. J. (2015). MUSCLE INJURY – PHYSIOPATHOLOGY, DIAGNOSIS, TREATMENT, AND CLINICAL PRESENTATION. Revista brasileira de ortopedia, 46(3), 247–255. doi.org/10.1016/S2255-4971(15)30190-7

Hospital for Special Surgery. J. N. R., MD. (2024). Muscle Strain: Causes, Symptoms, Treatment. www.hss.edu/conditions_muscle-strain.asp

Nölle, L. V., Mishra, A., Martynenko, O. V., & Schmitt, S. (2022). Evaluation of muscle strain injury severity in active human body models. Journal of the mechanical behavior of biomedical materials, 135, 105463. doi.org/10.1016/j.jmbbm.2022.105463

Baoge, L., Van Den Steen, E., Rimbaut, S., Philips, N., Witvrouw, E., Almqvist, K. F., Vanderstraeten, G., & Vanden Bossche, L. C. (2012). Treatment of skeletal muscle injury: a review. ISRN orthopedics, 2012, 689012. doi.org/10.5402/2012/689012

Laumonier, T., & Menetrey, J. (2016). Muscle injuries and strategies for improving their repair. Journal of Experimental Orthopaedics, 3(1), 15. doi.org/10.1186/s40634-016-0051-7

Harvard Health Publishing. (2023). Muscle strain. www.health.harvard.edu/staying-healthy/muscle-strain-a-to-z

Kraemer, W., Denegar, C., & Flanagan, S. (2009). Recovery from injury in sport: considerations in the transition from medical care to performance care. Sports Health, 1(5), 392–395. doi.org/10.1177/1941738109343156

Penn Medicine. (2023). Strains. www.pennmedicine.org/for-patients-and-visitors/patient-information/conditions-treated-a-to-z/strains

Enzymes and Health: Importance of Balance

By
Dr. Alex Jimenez
-
Professional, confident, and supportive collaboration for healthcare wellness.

Enzymes’ function is to help trigger bodily processes ranging from digestion to blood clotting to growth. What is the best way to support enzyme production?

Enzymes and Health: Importance of Balance

Enzymes

Enzymes are proteins that act as biological catalysts. They cause and speed up crucial chemical reactions and help the body complete necessary chemical reactions. They are vital for many biological processes, including digestion, metabolism, and molecule building and breaking down. This includes breaking down food, facilitating growth, and forming blood clots. Too little of a certain type can lead to serious health implications like a fatal buildup of toxins. Individuals missing a certain kind of enzyme or having too little of it can develop serious health conditions.

Function

They help speed up chemical reactions in the body (National Human Genome Research Institute, 2025). They facilitate chemical reactions in everything from digesting food to muscle growth. Enzymes facilitate this by binding to a cell, creating the reactions needed. With enzyme binding, chemical reactions can occur without destroying the cell. (Nemours KidsHealth, 2023) Each cell in the body has thousands of enzymes to help facilitate all the complex reactions to maintain health. (National Human Genome Research Institute, 2025)

Factors Affecting Production

In healthy individuals, the body produces the enzymes it needs. However, metabolic disorders can occur if the body does not produce enough of a certain type. (Kennedy Krieger Institute, 2025) These disorders can be serious and are usually caused by a genetic malfunction that impacts production.

Types

There are thousands of different types. Digestive enzymes, for example, aid in the breakdown of food and convert it into energy. Common enzymes that are critical for health include (Nemours KidsHealth, 2023)

Amylase

  • Digestive helps break down starches.

Aspartate aminotransaminase (AST) and Alanine Aminotransaminase (ALT)

  • Help the liver convert sugar into energy.

Creatine Kinase (CK)

  • Helps muscles create energy.

DNA Polymerase

  • Facilitates growth by allowing DNA to duplicate.

Glucose-6-Phosphate Dehydrogenase

  • Keeps red blood cells healthy by preventing damage to the cell.

Lipase

  • A digestive enzyme that helps break down fats and oils.

Protease

  • Digestive helps break down proteins.

Thrombin

  • Causes blood to clot.

Deficiencies

If the body doesn’t make enough of a certain enzyme, it cannot undergo the bodily processes that the enzyme helps facilitate. This can lead to a variety of symptoms. Some are minor, like not being able to eat lactose. Others are serious, like developmental delays caused by the build-up of toxins. (Kennedy Krieger Institute, 2025) Usually, these deficiencies are caused by genetics.

Types

There are various deficiencies. Some are very rare, while others can lead to conditions such as: (Nemours KidsHealth, 2023)

Lactose Intolerance

  • This is caused by not having enough of the enzyme that breaks down lactose, a sugar found in milk, leading to gas and bloating.

Tay-Sachs Disease

  • An often fatal disease caused by a missing hexosaminidase, which is responsible for breaking down fats

Gilbert’s Syndrome

  • This is caused by a missing enzyme that removes waste product (bilirubin) from the blood, leading to bilirubin buildup and
  • Jaundice or yellowing of the skin and whites of the eyes

Galactosemia

  • This leads to slow growth and trouble gaining weight, which is caused by the missing galactose-1-phosphate uridylyltransferase (GALT), which helps break down a sugar called galactose.

Phenylketonuria (PKU)

  • This is caused by having too little phenylalanine hydroxylase, which breaks down a protein called phenylalanine, causing brain damage.

Morquio Syndrome

  • This is caused by having too few enzymes that break down glycosaminoglycans, a type of sugar molecule.
  • This leads to bone and growth abnormalities.

Wilson’s Disease

  • A liver disease is caused by a missing protein that helps break down copper in the body.

Enzyme Production Support

Eat a healthy, well-balanced diet of fruits and vegetables to support enzyme production. Avoid processed foods, especially those that are very fatty (Johns Hopkins Medicine, 2025). The body produces all the necessary enzymes unless the individual has a genetic condition. Supplements aren’t usually required, but they can help with lactose intolerance or digestion in cystic fibrosis patients. (Nemours KidsHealth, 2023)

One supplement type, pancreatic enzyme replacement therapy (PERT), is available. PERT is an FDA-regulated prescription medication prescribed to patients with serious illnesses such as cystic fibrosis. (U.S. Food and Drug Administration, 2019)

Injury Medical Chiropractic & Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.

Chiropractic Care and Metabolism: The Hidden Link

References

National Human Genome Research Institute. (2025). Enzyme. Retrieved from www.genome.gov/genetics-glossary/Enzyme

Nemours KidsHealth. (2023). Enzymes. kidshealth.org/en/parents/enzymes.html

Kennedy Krieger Institute. (2025). Metabolic disorders. www.kennedykrieger.org/patient-care/conditions/metabolic-disorders

Johns Hopkins Health. (2025). Digestive enzymes and digestive enzyme supplements. www.hopkinsmedicine.org/health/wellness-and-prevention/digestive-enzymes-and-digestive-enzyme-supplements#:~:text=You're%20better%20off%20building,your%20diet,%20especially%20fried%20foods.

U.S. Food and Drug Administration. (2019). FDA approves new breakthrough therapy for cystic fibrosis. Retrieved from www.fda.gov/news-events/press-announcements/fda-approves-new-breakthrough-therapy-cystic-fibrosis

Cupping as Alternative Medicine for Pain Relief

By
Dr. Alex Jimenez
-
Physiotherapist placing vacuum cups on woman's back during cupping therapy session

For individuals experiencing musculoskeletal pain symptoms like lower back pain and shoulder pain, can incorporating cupping therapy help bring relief and manage pain?

Cupping as Alternative Medicine for Pain Relief

Cupping Therapy

This ancient treatment is gaining public acceptance, and awareness has heightened, with various individuals and athletes being seen with round marks on their shoulders and backs. It is a pain treatment that, like acupuncture, comes from traditional Chinese medicine, or TCM. The therapy involves placing glass, silicone, or bamboo cups on the skin to create suction. The treatment is an alternative medicine technique used to relieve musculoskeletal pain. The suction is believed to promote healing (Cleveland Clinic, 2023)

Increasing Blood Circulation

  • The suction draws blood to the area, which can help reduce inflammation and promote healing.

Releasing Muscle Tension

  • The suction can stretch and pull on muscles, which can help relieve pain and tightness.

Breaking Up Adhesions

  • The suction can help break up scar tissue and adhesions that can cause pain and restricted movement.

Detoxifying the Body

  • Some practitioners believe that cupping can help remove toxins from the body.

It is typically performed by a trained practitioner who places the cups on the skin and leaves them in place for several minutes. The cups can be placed on various body areas, including the back, neck, shoulders, and legs. (Cleveland Clinic, 2023)

Benefits

  • Pain relief, especially for muscle and joint pain
  • Reduced inflammation
  • Improved circulation
  • Increased range of motion
  • Detoxification

Procedure

The medical practice involves creating skin suction using glass, ceramic, or plastic cups. How it’s done:

Preparation

  • The practitioner cleans the area where the cups will be placed.
  • They may apply oil or massage cream to the skin for easier movement of the cups.

Techniques

Dry

  • The practitioner heats the inside of the cup with a flame or pump, creating a vacuum.
  • The cup is then placed on the skin, which adheres due to the negative pressure.
  • The cup remains on the skin for several minutes, allowing the suction to draw blood and tissue into the cup.

Wet

  • Like the dry technique, the practitioner makes small incisions in the skin before applying the cup.
  • This allows blood to flow into the cup, creating a more intense suction.

Aftercare

  • The cups are removed, and the practitioner may apply pressure to the area to stop bleeding.
  • The patient is advised to avoid strenuous activity and hot showers for a few hours after the treatment.

The benefits of therapy include opening pores, stimulating blood flow, filtration, and balancing energy flow through the body. It’s often combined with massage and acupuncture. (Cleveland Clinic, 2023)

It also aims to alleviate symptoms of systematic diseases like diabetes and hypertension. However, more research is needed to see and fully analyze the effects of the treatment. (Aboushanab T. S., & AlSanad S. 2018)

Risks

The therapy is generally safe when done correctly and by a licensed professional. However, there is some risk of side effects like skin discoloration and scarring. Reports of rare side effects include bleeding inside the skull from cupping on the scalp and anemia from repeated wet techniques. (National Center for Complementary and Integrative Health, 2018) Other side effects can include:

Bruising

  • It can cause temporary bruising at the site of the cups.

Skin Irritation

  • Some people may experience skin irritation or burns from the suction.

Infection

  • There is a small risk of infection if the cups are not properly sterilized.

Who should avoid the therapy?

Those with skin conditions like eczema and psoriasis should avoid cupping, as it may worsen them. (National Center for Complementary and Integrative Health, 2018)

Injury Medical Chiropractic & Functional Medicine Clinic

It is important to consult with a healthcare professional before trying any new treatment, especially if you have any underlying health conditions. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.

Beyond Medicine: The Power of Chiropractic Care

References

Cleveland Clinic. (2023). Cupping Therapy. my.clevelandclinic.org/health/treatments/16554-cupping

Aboushanab, T. S., & AlSanad, S. (2018). Cupping Therapy: An Overview from a Modern Medicine Perspective. Journal of acupuncture and meridian studies, 11(3), 83–87. doi.org/10.1016/j.jams.2018.02.001

National Center for Complementary and Integrative Health. (2018). Cupping. Retrieved from www.nccih.nih.gov/health/cupping

Quadriceps Stretches to Prevent Muscle Tightness

By
Dr. Alex Jimenez
-
Fit, active and strong couple doing a warmup and stretching before a workout at the gym. Sporty boy.

Can stretching quadriceps help relieve stiffness and pain and improve flexibility for individuals with consistently tight quadriceps?

Quadriceps Stretches to Prevent Muscle Tightness

Quadriceps Stretches

Walking, running, biking, and other daily activities can tighten the quadriceps muscles. The quadriceps are four muscles in the front of the thigh that extend the leg and strengthen the knee. Stretching the quadriceps may be a part of a home or gym exercise program or physical therapy treatment to maintain quadricep flexibility. Resting the quadriceps with an exercise program can greatly maximize mobility and prevent injury.

Tight quadriceps may sometimes result from injuries such as patellofemoral stress syndrome or iliotibial band friction syndrome. The quads may also become tight for individuals with spinal stenosis or other related problems with the lower back. (International Sports Sciences Association, 2023) Ely’s test, also known as the Duncan-Ely test, is one way to determine whether your quadriceps are tight. It is a physical examination used to assess the flexibility and potential spasticity of the rectus femoris muscle (a quadriceps muscle) by passively flexing the patient’s knee. Lie on your stomach and try to touch your foot to your buttocks. If you can’t, the rectus femoris, one of the main muscles, may be tight and benefit from quadricep stretches. (Olivencia, O. et al., 2020)

Safety and Precautions

Before trying this or any other exercise program, consult a healthcare provider to ensure exercise is safe for you and your conditions. A professional can help diagnose any overuse injury that might be causing tight quadriceps. Quadriceps stretches will be a little more comfortable after warming up. A few minutes of walking or biking will warm the quadriceps muscles to stretch more easily.

Stretches

To stretch the quadriceps, try the standing, side-lying, and prone quadriceps stretch once fully warmed up and after a workout. Individuals who frequently experience quadriceps tightness should stretch them daily. Incorporate all or some of these stretches into a cool-down or off-day flexibility routine.

Standing Stretch

The standing quadriceps stretch can be done anywhere in the office, gym, or outside. All you need is a place to stand. Here is how:

  • While standing, hold onto a countertop or back of a chair to help with balance.
  • Bend your knee by grasping your ankle.
  • Move your foot toward your buttocks.
  • Gently pull on your ankle to bend your knee as far as possible.
  • Maintain position for 30 seconds.
  • Return to the standing position.
  • Repeat the exercise 3 to 5 times with each leg.
  • Stop stretching if there are any sharp pains.

Side-Lying Stretch

The side-lying quad stretch lengthens the quadriceps. On the floor in a supported position can help focus on the stretch. Here’s how:

  • Lie on your side.
  • Bend the knee of your top leg as far as you can, gently pulling with your hand.
  • Maintain position for 30 seconds.
  • Return to the starting position.
  • Repeat the exercise 3 to 5 more times with each leg.

Prone Stretch

Stretch the quadriceps while lying on your stomach. In this position, the floor helps to stabilize the pelvis, minimizing rocking and maximizing the stretch. To do the stretch:

  • Lie on your stomach.
  • Bend your knee back as far as you are able.
  • Grab your ankle to pull your foot toward your buttocks.
  • Maintain position for 30 seconds.
  • Return to the starting position.
  • Repeat the exercise 3 to 5 more times with each leg.

If you have difficulty reaching your ankle, pull the leg up, wrap a towel or strap around the ankle, and use it to pull. This can help stretch the quadriceps effectively even if you cannot reach the ankle easily.

Injury Medical Chiropractic & Functional Medicine Clinic

Consult a healthcare provider or physical therapist to learn the recommended quadriceps stretches or other strengthening exercises. Keeping the quadriceps healthy will help keep the knees moving and maximize functional mobility. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.

Chiropractic Care For Leg Instability

References

International Sports Sciences Association. (2023). How to Release Tight Quads in 2 Simple Steps. ISSA. www.issaonline.com/blog/post/how-to-release-tight-quads-in-2-simple-steps

Olivencia, O., Godinez, G. M., Dages, J., Duda, C., Kaplan, K., Kolber, M. J., Kaplan, & Kolber (2020). THE RELIABILITY AND MINIMAL DETECTABLE CHANGE OF THE ELY AND ACTIVE KNEE EXTENSION TESTS. International journal of sports physical therapy, 15(5), 776–782. doi.org/10.26603/ijspt20200776

Sleep Cervical Neck Roll: A Solution for Neck Pain

By
Dr. Alex Jimenez
-
Young woman in pajamas feeling pain in neck after sleeping on uncomfortable bed and pillow.

Could making their own cervical neck roll help relieve pain and improve sleep for individuals who have neck pain after sleeping or during sleep?

Sleep Cervical Neck Roll: A Solution for Neck Pain

Sleep Cervical Neck Roll

Neck pain can lead to sleep loss, leading to various health problems. Neck pain and everything that comes with it can limit the ability to work, drive, or sleep normally. A cervical roll may be one way to keep your neck in the optimal position while sleeping. Many with neck pain require extra support from their pillow. A cervical pillow can provide that support.

For individuals who develop neck pain, a visit to a chiropractic physical therapist can help manage symptoms. Treatments and modalities like traction may be necessary to relieve pressure on cervical nerves. (Gudavalli M. R. et al., 2015) Steps to self-manage neck pain may include performing specific neck exercises and maintaining proper posture (Hesby B. B. et al., 2019). Using the right pillow with the right support can help keep the neck in correct alignment, decrease or eliminate neck pain, and get you back to normal activities.

Neck Support During Sleep

The neck comprises seven vertebrae bones, normally forming a slight curve called lordosis. Maintaining a forward curve in the neck is important when treating neck pain, as it can help relieve pressure on spinal discs and nerves. A cervical roll, also known as a neck roll or cervical pillow, is a small pillow placed in the pillowcase that supports the neck while sleeping. The cervical roll provides the right amount of support for the neck and maintains alignment while lying down. (Gross A. R. et al., 2013)

  • Individuals can purchase a cervical roll online or at a store or pharmacy.
  • Individuals can also contact a physical therapist to help them obtain a cervical roll.

Making Your Own

Making a cervical roll is simple to do. Here’s how:

  • Using a hand towel.
  • Fold it in half.
  • Slide the towel into the pillowcase along the lower edge.
  • Be sure the towel is tucked in so it doesn’t slip out.
  • Individuals can place tape around it so it stays in the rolled shape.

The towel roll will also help support the neck when lying on one side or the other, filling in the space between the head and shoulder. Sleeping on the stomach is usually not recommended for neck pain. Exercise and postural correction training are essential components of treatment for neck pain, and finding the right sleeping posture can help quickly eliminate pain. (Harvard Publishing, 2022)

If neck pain persists, worsens, or is accompanied by arm weakness or numbness and tingling, a visit to a healthcare provider may be necessary to assess the cause. A visit to a local chiropractic physical therapist can also help. They can immediately show you how to treat neck pain.

Injury Medical Chiropractic & Functional Medicine Clinic

A cervical roll can give your neck the right support while sleeping. This can help you quickly and safely manage neck pain and return to your previous level of function. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.

The Road To Recovery: Chiropractic Care

References

Gudavalli, M. R., Salsbury, S. A., Vining, R. D., Long, C. R., Corber, L., Patwardhan, A. G., & Goertz, C. M. (2015). Development of an attention-touch control for manual cervical distraction: a pilot randomized clinical trial for patients with neck pain. Trials, 16, 259. doi.org/10.1186/s13063-015-0770-6

Hesby, B. B., Hartvigsen, J., Rasmussen, H., & Kjaer, P. (2019). Electronic measures of movement impairment, repositioning, and posture in people with and without neck pain-a systematic review. Systematic reviews, 8(1), 220. doi.org/10.1186/s13643-019-1125-2

Gross, A. R., Kaplan, F., Huang, S., Khan, M., Santaguida, P. L., Carlesso, L. C., Macdermid, J. C., Walton, D. M., Kenardy, J., Söderlund, A., Verhagen, A., & Hartvigsen, J. (2013). Psychological Care, Patient Education, Orthotics, Ergonomics, and Prevention Strategies for Neck Pain: A Systematic Overview Update as Part of the ICON Project. The open orthopaedics journal, 7, 530–561. doi.org/10.2174/1874325001307010530

Harvard Health Publishing. (2022). Say “good night” to neck pain. www.health.harvard.edu/pain/say-good-night-to-neck-pain

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