Acute and Cumulative Soccer Injuries

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athletic soccer player kicking ball on soccer pitch

Although many soccer injuries involve the legs and lower extremities, other body areas are susceptible to injury/s as well. Acute or cumulative is how soccer injuries are generally described. Acute injuries are traumatic. They are usually caused by a slip, trip, and fall, getting hit, and crashing into other players. Cumulative injuries involve repetitive stress on a muscle, joint, or connective tissue. This triggers progressive aches, pain, and physical impairment that gets worse with time. Understanding how and why they happen is the first step in injury prevention. The more common injuries experienced among soccer athletes include.

Concussion

This is a form of mild traumatic brain injury mTBI caused by a sudden hit/impact to the head. Players are trained to head the ball; however, concussions can happen if not ready for impact or heading at an awkward position.

Ankle Sprains

Ankle sprains are when there is stretching and tearing of ligament/s that surround the ankle joint.

Lateral ankle sprains or outside of the ankle can happen when a player kicks the ball with the top of the foot.
A medial ankle sprain or inside of the ankle can happen when the toes are turned out when the foot is flexed up.

Achilles Tendonitis

This is a chronic injury that occurs from overuse with pain in the back of the ankle. Players are constantly performing repetitive and sudden movements that, over time, can cause this type of injury.

Achilles Tendon Rupture

A rupture involves a partial or complete tear of the Achilles tendon. Often players say with a popping sound. This happens when players perform fast, explosive movements. Rapid stopping, starting, shifting, jumping can all contribute.

Groin Pull/Strain

This is a type of strain that happens when the inner thigh muscles are stretched beyond their limit. As a result, a player can pull the groin when kicking and/or resistance from an opponent trying to take the ball or kick in the opposite direction.

Hamstring Injury

These injuries involve the three back muscles of the thigh and can vary from minor strains to complete ruptures/tears. This comes from running, sprinting, jumping, and stopping, leading to these types of injuries.

Iliotibial Band Syndrome

This is an overuse/repetitive injury that involves a tendon known as the IT band. This is the connective tissue that runs along the outside of the thigh. Constant running can create friction as the band gets pulled along the outside of the knee, which can cause tendonitis.

Plantar Fasciitis

This causes foot pain caused by inflammation of the tissue bands that run from the heel to the toes. Several factors can cause the condition. This could be players using inappropriate or not correctly fitting shoes, shoes that do not provide proper arch support or playing on a hard surface.

Calf Muscle Pull

This is when one of the muscles of the lower leg gets pulled from the Achilles tendon. Again, quick and spontaneous sprinting, running, or jumping is usually the cause.

Knee Injuries

The most common soccer injuries are those that involve the knee. This is because of the stopping and shifting directions quickly and suddenly. The explosive, spontaneous movements place extreme stress on the knees and the supporting ligaments. When the stress goes beyond the ligament’s limits, it can cause a sprain or tear in the joint. When there is an injury to the knee/s, it is diagnosed using a grading scale.

Grade 1 Mild sprain
Grade 2 Partial tear
Grade 3 Complete tear

Runner’s Knee

Patellofemoral pain syndrome, also known as runner’s knee, is a condition where the cartilage under the kneecap gets damaged from an injury or overuse. This happens when there is a misalignment in the knee and/or strained tendons.

ACL Injury

The anterior cruciate ligament or ACL is at the front of the knee. These are the most common knee injuries. This is because the ligaments are less retractable than muscles or tendons. And those in the knees are highly vulnerable to damage.

Cruciate Ligament Injury

This type of injury does not always cause pain but often causes a popping sound when it happens. Pain and swelling develop within 24 hours. This is followed by the loss of range of motion and tenderness around and along the joint.

Meniscus Injury

The Meniscus involves a C-shaped piece of cartilage that cushions the space between the femur and the shin bone. These tears are painful and are often the result of twisting, pivoting, decelerating, or quick/rapid impact.

Shin Splints

The term describes a variety of painful symptoms that develop in the front of the lower leg. This often happens from over/intense training, or the training gets changed. Players can also develop shin splints from training while not using appropriate shoes.

Stress Fractures

These types of fractures are usually the result of overuse or repeated impact on a bone. The result is severe bruising or a slight crack in the bone.

Tendonitis

When tendons get inflamed, it is referred to as tendonitis. This comes with repetitive overuse but can also develop from a traumatic injury that causes micro-tears in the muscle fibers.

Soccer Injuries Prevention

Many of these injuries result from overuse, overtraining, improper conditioning, and/or not warming up properly. Here are few tips to help reduce the risk.

Warm-up for at least 30 minutes before playing

Pay special attention to stretching the:

Groin
Hips
Hamstrings
Achilles’ tendons
Quadriceps

Wear protective gear

This includes:

Mouthguards
Shin guards
Kinesio tape
Ankle supports
Eye protection
Ensure they are correctly sized and maintained.

Check the field

Check for anything that could cause injury/s. This includes:

Holes
Puddles
Broken glass
Stones
Debris

Avoid playing in bad weather

Or immediately after heavy rain when the field is especially slick and muddy.

Allow enough time to heal after an injury.

This also goes for minor soccer injuries. Trying too fast to get back increases the risk of worsening the injury, re-injury, and/or creating new injuries.

Body Composition

Athletes and Carb Loading

Carb loading is a strategy that athletes use.

Endurance athletes

Utilize carb-loading to help them increase energy storage for long runs, bike rides, swims, etc. When timed effectively, carb-loading has been shown to increase muscle glycogen, leading to improved performance.

Bodybuilders and fitness athletes

Use carbo-loading to build size and mass before competitions. The timing and efficacy of carb-loading vary from person to person. Make sure to experiment before the next big competition.

References

Fairchild, Timothy J et al. “Rapid carbohydrate loading after a short bout of near maximal-intensity exercise.” Medicine and science in sports and exercise vol. 34,6 (2002): 980-6. doi:10.1097/00005768-200206000-00012

Kilic O, Kemler E, Gouttebarge V. The “sequence of prevention” for musculoskeletal injuries among adult recreational footballers: A systematic review of the scientific literature. Phys Ther Sport. 2018;32:308-322. doi:10.1016/j.ptsp.2018.01.007

Lingsma H, Maas A. Heading in soccer: More than a subconcussive event?. Neurology. 2017;88(9):822-823. doi:10.1212/WNL.0000000000003679

Pfirrmann D, Herbst M, Ingelfinger P, Simon P, Tug S. Analysis of Injury Incidences in Male Professional Adult and Elite Youth Soccer Players: A Systematic Review. J Athl Train. 2016;51(5):410–424. doi:10.4085/1062-6050-51.6.03

Anterior Pelvic Tilt Downward Posture Hip and Back Pain

By

Dr. Alex Jimenez

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Fit girl doing stretching exercies for legs

APT is short for anterior pelvic tilt. APT is when the pelvis tilts more down than forward, which can cause strain on the surrounding muscles and the spine to hold the torso up. The body’s own anatomical structure causing the condition and/or part of a bad habit that an individual has grown accustomed to. This can be from injury/s, back, and/or hip pain causing an individual to take on awkward postures to compensate for the discomfort and try and avoid it. However, these unhealthy postures cause their own set of musculoskeletal problems. Addressing this form of poor posture can help reduce and alleviate low back and hip pain and prevent further injuries. Chiropractic can pinpoint an anterior pelvic tilt and fix it.

Table of Contents

Anterior Pelvic Tilt

What happens is the pelvis becomes tilted or rotated forward. Place the hands, specifically the fingertips, on the hips. There are bone ridges. These are the iliac crests. If they’re facing more toward the ground than directly forward, this could be an anterior pelvic tilt. It usually happens when the hip flexors become tight and pull the pelvis down. Another contributor is the glute and hamstring muscles have weakened and are not strong enough to counteract the forward pulling. This can be caused by sitting for long periods, poor posture, and for women who wear high heels regularly. These contribute to tightening the hip flexors and the glutes, hamstrings, and core muscles.

An anterior pelvic tilt causes an increase in the curve of the lower back. It can feel like the hip flexors are tightening up. It typically affects the lower back at the lowest two levels, which are L4-5 and L5-S1. There can be long-term issues if an anterior pelvic tilt is left untreated. The spine becomes more vulnerable to disc issues that can include:

Compressed degenerative disc
Disc tears, aka annular tears
Disc bulges
Herniation

Exercises

An anterior pelvic tilt is a repairable condition. Several exercises can help loosen/relax the hip flexors and strengthen the core and posterior muscle chain. This in addition to walking and reducing wearing high heels regularly. A few exercises for anterior pelvic tilt.

The Tail Tuck

This is literally trying to tilt the tailbone forward, like tucking in an imaginary tail. This can be done for 10-12 reps and up to 3 times.

Plank

Core-strengthening exercises can help with all types of back and hip problems. If possible, do the exercises in front of a mirror to ensure no arching of the back or the butt sticking out. If it is too difficult on the hands, go to the elbows. If there are wrist or shoulder issues, planks can be done on a raised surface, like a table or couch. Hold as long as possible, maintaining proper form. Start with 10-30 seconds and build up to minutes.

Strengthening the Glutes

It is recommended to strengthen the glute muscles. This can be done with exercises like clams or side-stepping with resistance bands. For clams, lie on the side and raise each leg up and down 10-12 times, up to 3 sets. For side-stepping, place resistance bands around the ankle/shin area and step to the side for 8-10 steps. Then go the other direction for the same number of steps. Repeat up to 3 sets.

Hip Flexor Stretch

Lunge forward while standing or lunge and kneel with the other leg on the ground. Then move the torso back a little and engage the core to stretch the hip flexors in the front of the thigh/pelvis area. Hold for 30 seconds, then release. Repeat 3-5 times per leg.

Lifestyle

These exercises can help, but if there is no progress around a month, contact a qualified chiropractor or physical therapist for further instruction and supervision. Also, if any neurological symptoms present like:

Sciatica
Shooting pain
Numbness
Tingling
Weakness
See a doctor as soon as possible.

Fixing posture-related problems require individuals to learn to be posture aware along with making some lifestyle adjustments. One way to do these exercises is to tack them onto a workout. Also, set reminders on a calendar to get up, stretch, and move around if sitting most of the day.

Body Composition Health

Difference between Processed sugar and Natural sugar

There are different types of sugar. There are natural sugars that are found in:

Fruits
Vegetables
Nuts
Whole grains
Beans

All sugar is broken down into glucose. However, foods that contain natural sugar are also rich in nutrients, including:

Vitamins
Minerals
Fiber
Protein
All which the body requires for optimal health.

Natural sugar does not lead to excess sugar intake; it happens with processed sugar. Processed sugar is extracted from sugarcane or sugar beet and is normally found as sucrose. This is present in cakes, cookies, cereal, and beverages. Processed sugar is also hidden in foods that are not sweet, like:

Microwave meals
Spaghetti sauce
Low-fat yogurt
Ketchup
Sports drinks

Foods that contain processed sugar are an energy source, but they contain little or no nutrients and can cause blood sugar levels to spike. In addition, consuming too much sugar is linked to an increased risk of:

Diabetes
Accelerated aging
Weight gain

Research has found that added sugar contributes to around 17% of the total calorie intake for adults. The recommended daily amount of calories from added sugar is 10%.

References

Azaïs-Braesco, Véronique et al. “A review of total & added sugar intakes and dietary sources in Europe.” Nutrition journal vol. 16,1 6. 21 Jan. 2017, doi:10.1186/s12937-016-0225-2

Centers for Disease Control and Prevention (CDC). (May 2020) “Acute Low Back Pain” www.cdc.gov/acute-pain/low-back-pain/index.html

National Institute of Neurological Disorders and Stroke. (March 2020) “Low Back Pain Fact Sheet” www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Low-Back-Pain-Fact-Sheet

Orlando Health. (2019) “Bad Posture Often to Blame for Chronic Pain and Health Issues, But Survey Finds Too Few Americans Are Concerned” www.orlandohealth.com/content-hub/bad-posture-often-to-blame-for-chronic-pain-and-health-issues

Re-Energize From Lack of Energy and Fatigue With Bio-Chiropractic

By

Dr. Alex Jimenez

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chiropractor massaging neck of man lying on towel in hospital

Re-energize from a lack of energy and fatigue with Bio-chiropractic. Millions of individuals struggle to get through the day or night depending on work/school schedules because of deficient energy levels that result in fatigue. Unfortunately, many begin taking over the counter or prescription medication, drinking coffee or highly caffeinated/energy beverages, or taking days off to catch up on rest. There is a wide range of high-sugar and caffeine energy products to help with fatigue. But, research has shown how overconsumption of these products can contribute and/or cause:

High blood pressure
Cardiovascular disease
Diabetes
When a tired body takes in caffeinated energy, it is only for a temporary energy boost.
Energy products can mask the fatigue causation. This could be a disease, a type of condition, or an overlapping of causes.

Table of Contents

Nervous System

The nervous system is the body’s life energy source. It is responsible for facilitating millions of functions that occur throughout the body every day. These include:

Movement
Digestion
Hormone regulation
Heartbeat
The health of the vital organs

What often happens is that:

Poor posture
Accidents
Injuries
Birth trauma
Shifts the spine out of alignment, placing added pressure on the delicate nerves in the neck and back.

The compression causes nerve interference that disrupts optimal nerve energy flow from reaching the organs. This leads to:

Fatigue
Pain
Organ dysfunction
Eventually disease

Bio-Chiropractic

Bio-Chiropractic is a scientific and researched based form of musculoskeletal corrective care. It aims to unblock nerve interference through the proper realignment of the spine, returning it to its proper curvature. As a result, many individuals under chiropractic care report immediate relief from neck or back pain, along with a vibrant, energized feeling, and with time their overall health improves.

Body Composition Feedback

Malnutrition

Malnutrition can be defined as a deficiency, excess, or imbalance in an individual’s intake of energy and nutrients. Protein-energy deficiency is a common form of malnutrition. It is a health condition that can have immediate/negative effects on body composition. This deficiency causes damage to skeletal muscle mass as the body progresses into starvation mode, breaking down its own protein stored in the muscles for fuel.

Micronutrient deficiency is a lack of nutrients like minerals and vitamins. These support important functions like cell regeneration, the immune system, and eyesight. Common examples are iron and/or calcium deficiencies. Micronutrient deficiency has the greatest impact on the body’s physiological functions/processes. They can occur at the same time that protein-energy deficiency is happening overlapping each other. Nutritional deficiencies can impact processes like:

Building and repairing muscle
Protein-energy deficiency has a more pronounced effect on body composition, as lowered protein intake can lead to increased losses in muscle mass.
The American Society for Parenteral and Enteral Nutrition or ASPEN defines several factors of malnutrition and nutritional deficiencies that include:
Insufficient energy intake
Non planned weight loss
Diminished physical function like handgrip strength and physical performance
Serious medical conditions that result from fluid accumulation

References

Berkson, D L. “Osteoarthritis, chiropractic, and nutrition: osteoarthritis considered as a natural part of a three-stage subluxation complex: its reversibility: its relevance and treatability by chiropractic and nutritional correlates.” Medical hypotheses vol. 36,4 (1991): 356-67. doi:10.1016/0306-9877(91)90010-v

Jensen, Gordon L et al. “Recognizing malnutrition in adults: definitions and characteristics, screening, assessment, and team approach.” JPEN. Journal of parenteral and enteral nutrition vol. 37,6 (2013): 802-7. doi:10.1177/0148607113492338

Oakley, Paul A et al. “Restoring lumbar lordosis: a systematic review of controlled trials utilizing Chiropractic Bio Physics^® (CBP^®) non-surgical approach to increasing lumbar lordosis in the treatment of low back disorders.” Journal of physical therapy science vol. 32,9 (2020): 601-610. doi:10.1589/jpts.32.601

I Threw Out My Back, What That Means

By

Dr. Alex Jimenez

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I threw my back out. Most of us have heard and possibly experienced throwing our backs out. But, what does throwing out your back really mean? Find out from our experts. When talking about throwing one’s back out, it’s usually a result of twisting, turning, coughing, sneezing, or lifting incorrectly. The medical equivalent to this injury is an ankle sprain. It can be excruciating, individuals might not see or feel a tear, but the ligaments have been injured, causing inflammation and pain. The same thing can happen to the spine.

Table of Contents

What it means when you throw out your back.

Most experience acute pain in the lower region of their backs. Individuals can throw out their back at any age doing all kinds of activities. These can range from:

Changing a tire
Moving lifting boxes, going upstairs, etc
House chores/tasks
Gardening
Sports
Working out
Bending over to pick up an object

It is more common as individuals age. This is when individuals notice how they could take a serious injury and walk away when they were young. However, with age, something like a cough or sneeze could cause the back to become sprained. When the ankle is sprained, it is immobilized to allow it to rest and heal.

However, it is not as easy to immobilize the spine as large muscles in the back around the spine. Any time tissue is injured, the muscles automatically spasm to act as a splint. These spasms usually tend to be the worst part when back pain presents. This is because the back muscles are large; they cause intense inflammation and pain when they spasm. Combined with this, the back can feel like it is stuck, significantly decreasing the range of motion. This type of injury can take a couple of days to reduce and up to two to six weeks to return to normal function.

This is what is really happening

The majority of the time, what has happened is there is a small ligament strain or an annular tear, which is a tear in the ligament that connects the vertebra to the disc. When standing upright and lifting properly, the disc/s work like hydraulics.

When individuals bend over not using their legs, the back part of the spine widens/opens up, and instead of a hydraulic effect, it becomes a cantilever structure. Bending and twisting compound the pressure across the disc. Prevention is key and by using the legs and keeping the back straight, let the hydraulic system do its natural job.

Misconceptions

Chiropractors specialize in difficult to treat musculoskeletal pain conditions. The term threw out one’s back is similar to the knee, arm, shoulder being blown out. The terminology can create fear associated with the idea of throwing something out of place, especially when it comes to the spine. When individuals come in with back pain, they can become fearful of what will be found. These include:

What has happened to my spine?
Is it going to get better?
Is this going to be a life-long injury?
Will I be able to walk normally?

Through research, doctors now know that fear is an inflammatory response. Therefore, when individuals become fearful, their immune system kicks in, causing the pain to worsen.

Treatment

A few things have been proven to work well, along with seeing a doctor, spine specialist, or chiropractor.

Ice and heat

It depends on individual preference. Ice reduces inflammation and pain, and the heat helps to get the blood flowing in and around the area to help heal the injury.

Abdominal support

An abdominal corset is a stretchy band that is worn around the lower mid-section. The abdominal muscles supply support for the lower body. The corset can help take some of the weight off of the spine to help ease discomfort and pain.

Anti-inflammatories

Advil or a prescription Ibuprophen from a physician is better than narcotics. However, if narcotic medications are necessary, they should be short-term, a few days to a week. In addition, individuals need to show caution as they can cause constipation, making back pain even worse.

Chiropractic and Physical Therapy

Seeing a chiropractor and physical therapist can help heal the injury faster. They will strengthen the spinal muscles and educate the individual on stretches, exercise, posture, anti-inflammatory diet for optimal spinal health. Individuals usually take two to six weeks to heal completely. However, individuals should still be able to do most physical activities once the spine injury heals. Maintaining the back muscles can be achieved with regular exercise, lifting correctly with the legs, and not over-twisting and over-reaching are important elements to prevent back injuries.

Body Composition Analysis

Summer Heat and The Body

How the body reacts to extreme heat. It is a process known as thermoregulation, where the body strives to maintain a temperature between 97.7 to 99.5 degrees Fahrenheit. The hypothalamus, a gland in the brain, is in charge of managing the core temperature. If outside weather is extreme, causing a change in the body’s core temperature, the hypothalamus triggers a specific process to heat or cool the body back to the normal range. When the hypothalamus registers that the body’s core temperature is rising because it’s sweltering outside, it kicks in.

To remove the extra heat, the hypothalamus increases circulation, moving the blood toward the surface, dilating blood vessels so that the heat can dissipate through the skin. When this happens, the veins can protrude, and the skin flushes. Along with increased circulation, the hypothalamus also activates the sweat glands. The evaporation of the water released onto the skin cools the body down, reducing temperature. Finally, the thyroid is activated to lower heat created through the metabolic processes.

References

Disc tears: Stat Pearls. (11/17/2020).” Annular Disc Tear.” ”https://www.statpearls.com/ArticleLibrary/viewarticle/17615

Fear and Pain: Journal of Pain Research. (2018). “Assessments of Pain-Related Fear in Individual with Chronic Pain Conditions.” www.ncbi.nlm.nih.gov/pmc/articles/PMC6280906/

Mittinty, Manasi M et al. “Assessment of pain-related fear in individuals with chronic painful conditions.” Journal of pain research vol. 11 3071-3077. 30 Nov. 2018, doi:10.2147/JPR.S163751

Different Individuals Different Sciatica Treatment Approaches

By

Dr. Alex Jimenez

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Millennial African American guy suffering from back pain, leaning on sofa, cannot walk at home. Healthcare concept — Millennial African American guy suffering from back pain, leaning on sofa, cannot walk at home. Young black man having injury or trauma, needing rehabilitation. Healthcare concept

Living with sciatica can be debilitating and exhausting. Find out how different individuals reduced their pain from this condition. Sciatica has different treatment options. It is often a matter of trial and error to find a treatment/therapy that works for the individual. These include:

Physical therapy
Medication
Chiropractic
Injections
Acupuncture
Surgery

Different individuals with sciatica share what works for them. Here are their stories.

Table of Contents

Rudy Found Relief With Self Care

A bad fall left Rudy, a graphic designer, with a broken pelvis and broken foot. I was in the hospital for a few days, and when I came home, I noticed I was hobbling. I had developed sciatica. I was in a lot of pain but decided to try the treatment that had helped me manage chronic migraines. This was yoga. Specifically, it was hot yoga sessions that, despite the pain, worked. However, for others, he recommends not staying still. The body can’t stay stagnant with no movement.

Rudy follows a plant-based diet. Eating right has helped significantly. He starts the day with a green smoothie and sips one throughout the day. This reduces inflammation and pain. His stress would also contribute to the pain. Anything felt from a pain perspective becomes amplified when in a sad, frustrated, confused mood. Rudy’s advice is to get the body moving. And follow a plant-based anti-inflammation diet.

Medication and a Topical Pain Balm Work For Jose

Jose, 66, figured how his sciatica developed was when he decided to insulate the garage. I was bending, twisting, turning, and contouring my body every which way. A week after the job, I developed excruciating pain that got worse over the following weeks. I would jolt out of bed at 2-3 in the morning with severe pain. My doctor gave me steroids that didn’t do anything. I could barely sit down and had to go through a careful method of getting into a chair. I was prescribed Vicodin – hydrocodone/acetaminophen. I took them for a week and a half.

The pain went away, but it came right back as soon as I stopped taking the meds. The meds were only masking the pain. I decided only to use it when the pain was excruciating. This was because I was worried about addiction. I tried chiropractic, massage, acupuncture, cupping, and physical therapy. Unfortunately, I was not feeling any real relief. Then I went to a pain management doctor, who ordered an X-ray and an MRI.

The doctor informed me that my spine was in great shape. The pain management doctor gave me a piriformis injection and, later, an epidural steroid injection. There were still no positive results. My primary care doctor prescribed gabapentin. This is an anti-epilepsy medication that has been shown to help some cases of back pain. Most of the major pain is gone, and I’m pretty sure it’s from the gabapentin along with weekly deep massage sessions. I also use CBD cream with arnica. Movement is important; during the day, I make sure to stand up and walk around.

Epidural Injections Work For Isabel

Isabel has chronic pain. This comes from arthritis, migraines, and fibromyalgia. Sciatica developed as a result of these conditions. Soon she couldn’t get into the car or even empty the dishwasher without going through excruciating pain. Nerve ablation or physical therapy was ineffective at relieving the pain. Then my doctor suggested getting an epidural injection. This is not the same type of injection as when having a baby. It is not the same at all. The injection includes a steroid medication called a corticosteroid that is an anti-inflammatory, along with an anesthetic. I tried it and got some relief, but the pain came back. However, after a month and a half, I began to feel more relief. The pain is not completely gone. I do feel better, but there is still some pain. My doctor told me that patients are all different and require different amounts of medication and time to work.

Surgery Gave Pablo His Life Back

Pablo, 50, is no stranger to back pain or back surgery. After living with chronic back pain from a roll-over auto accident, Pablo underwent a laminectomy. A doctor removed a portion of the vertebra in 1998 and spinal fusion in 2004 that fused the discs from L5 to S1. Life was going well until I was laid off from my desk job. I started working at a warehouse doing light work, but I would still help lift moderate/heavy bags, boxes, etc. I just pushed through the pain, thinking it was a strain that would go away.

However, during the last six months, the pain was so bad I had to stop working. I needed a cane to get out of a chair. Friends and family told me I was walking like a 90-year-old. I also lost feeling in a couple of my toes. In 2021 I had another fusion and had a broken screw from my earlier fusion repaired. The surgery went well, and they said as long as I don’t do any heavy lifting, I should be alright. Although there is still pain, it is much less than it was before the surgery. My doctor recommended a new desk job and a physical therapy rehabilitation, stretching, and strengthening program.

Body Composition

Calories burned from 10,000 steps

Estimations of how many calories are burned from exercises like walking or running depends on how heavy an individual is. Heavier people use more energy to move than lighter people. Estimates revolve around 100 calories burned per mile for a 180-pound person. 10,000 steps comes to around roughly 5 miles. Assuming an individual weighs 180 pounds means 100 calories x 5 miles equals 500 calories. Over a week, it becomes 3,500 calories. However, lighter or heavier individuals will burn less or more calories while walking the same number of steps or distance.

Chiropractic Care For Individuals Post Back Surgery or Spinal Fusion

By

Dr. Alex Jimenez

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Physiotherapist doing manual treatment — Professional senior physiotherapist doing manual treatment to a men's thoracic spine in the cabinet of rehabilitation clinic

Individuals that go through severe low back pain caused by degeneration, herniated discs, vehicle, personal, work, and sports injuries, surgery, or spinal fusion is usually a last resort if non-invasive treatments fail to provide relief or not enough relief. Patients try to avoid spinal fusion because it can be an intense experience and requires a year-long recovery period. Unfortunately, individuals still experience discomfort and pain after surgery. Do individuals want to know what other treatment options are available, including chiropractic care?

Doctors will inform post-op patients of the risks involved with chiropractic therapy. However, chiropractic medicine can bring natural pain relief after surgery. Chiropractic treatment requires that an individual be adequately or fully healed before beginning a personalized treatment plan. At Injury Medical Chiropractic and Functional Medicine Clinic, we consult patients post-surgery about the effectiveness of rehabilitation spinal adjustments and physical therapy massage.

Table of Contents

Wait Time After Surgery

Spinal fusion surgery involves removing the discs between two or more vertebrae and fusing the bones with metal screws and plates. The objective is to correct conditions like herniated discs and degenerative diseases by immobilizing the spine in that area. It can take at least three months for the vertebrae to fuse for a fully immobilized graft. Once the graft is complete, a few months of physical therapy are recommended to loosen/stretch and strengthen the muscles around the graft. Initial recovery combined with physical therapy typically takes a full year for a complete recovery.

It is during recovery where it can be difficult and for discomfort and pain to present. The reason is patients are recommended to avoid any twisting, bending, over-reaching motions, or the graft could break. This can make an individual take on awkward poses/postures, flexing and contracting muscles incorrectly, causing strain. The result is added discomfort and/or pain.

How Chiropractic Helps

Spinal fusion is not guaranteed to alleviate an individual’s back pain completely. But many do experience discomfort or pain post-surgery. This could be for a little while or longer, depending on their condition or injuries. Fortunately, chiropractic treatment can help bring pain relief through mobilization, manipulation, and massage techniques. Manipulations’ objective is to adjust and/or realign the bones of the spine and other areas of the body. Because of the intricacy of spinal manipulations, many who have undergone back or spinal fusion surgery are hesitant to seek chiropractic treatment. Discuss possible chiropractic care with your physician to determine if the surgical graft is strong enough to withstand spinal manipulations. If the graft is adequately/fully healed and your physician believes it can endure mild adjustments, reach out to a chiropractor to discuss a customized treatment plan.

Body Composition Testing

Poor Leg Skeletal Muscle Mass

The gluteal muscles or buttock muscles are the largest muscle group in the body. Individuals can start losing bone density by their 30s. This increases the risk of injury and further bone density loss. Bone density loss is a natural process, but the process can be accelerated for individuals with under-developed skeletal muscle mass. The health of muscles and bones are closely linked. Researchers found that individuals with less muscle mass than average for their height tended to have narrower and thinner bones. This resulted in limited lower bending strength.

Decreased muscle mass was shown to be linked to balance problems and increased risk of falls. There is a higher prevalence of sarcopenia or muscle wasting for patients with hip fractures and a reduction of leg muscle mass. The combination of:

Low muscle mass
Low bone density
Hip fractures
It can have lifelong consequences

References

Fernandez, Matthew et al. “Surgery or physical activity in the management of sciatica: a systematic review and meta-analysis.” The European spine journal: official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society vol. 25,11 (2016): 3495-3512. doi:10.1007/s00586-015-4148-y

Keller, Glenda. “The effects of massage therapy after decompression and fusion surgery of the lumbar spine: a case study.” International journal of therapeutic massage & bodywork vol. 5,4 (2012): 3-8. doi:10.3822/ijtmb.v5i4.189

O’Shaughnessy, Julie et al. “Chiropractic management of patients post-disc arthroplasty: eight case reports.” Chiropractic & osteopathy vol. 18 7. 21 Apr. 2010, doi:10.1186/1746-1340-18-7

Perrucci, Rachel M, and Christopher M Coulis. “Chiropractic management of post-spinal cord stimulator spine pain: a case report.” Chiropractic & manual therapies vol. 25 5. 6 Feb. 2017, doi:10.1186/s12998-017-0136-0

Szulc, Pawel et al. “Low skeletal muscle mass is associated with poor structural parameters of bone and impaired balance in elderly men–the MINOS study.” Journal of bone and mineral research: The American Society for Bone and Mineral Research vol. 20,5 (2005): 721-9. doi:10.1359/JBMR.041230

Lower/Lumbar Back Total Disc Replacement or Fusion Options

By

Dr. Alex Jimenez

-

Showing x-ray to patient — Young radiologist showing x-ray image to her aged patient and giving recommendations about treatment

Many doctors/surgeons rely on the widely adopted lumbar spinal fusion. However, experts have asserted that lumbar total disc replacement or TDR should be made available and increased for treating degenerative disc disease and other spinal conditions. Individuals interested in total disc replacement, the ability to have it done, and if insurance will pay? What to know about TDR and fusion before deciding and moving forward.

Table of Contents

Total Disc Replacement

Spinal fusion has been the traditional approach for relieving lower back pain. In this procedure, a bone graft is inserted between two or more vertebrae. This eliminates movement that causes pain or could be dangerous to the individual. Total disc replacement demands more on a technical level than spinal fusion. However, the worn-out, injured, or damaged disc is fully replaced, even a completely degenerated disc, with a metal and/or plastic one. Benefits from lumbar TDR surgery include:

Shown to be a safe procedure with minimal complications
Significant improvement in health and quality of life
High rates of successful outcomes
Mobility is preserved

Who Needs Disc Replacement?

Low back problems affect more than a third of the population. This can come from:

Personal
Work
Sports
Automobile injuries
Aging
All are risk factors

Fusion or Total disc replacement

Fusion reduces and eliminates motion around the affected area which also changes with the spine’s mechanics. It can also place increased stress on the surrounding segments. However, the lack of motion is to eliminate the pain. Total disc replacement does increase mobility, but it can’t fully relieve the pain. It can relieve pain generated from the disc but not from other causes. TDR has been shown to:

Provides motion preservation
Reduces staying at the hospital
Provides long-term durability
Lower reoperation rates compared to fusion

Total disc replacement issues:

The procedure is more time-consuming
A lot of time making decisions
A lot of time preparing

An example could be the patient has a narrow disc space. Looking at the X-rays of the discs above and below, the surgeon has to make sure they choose the right size. Next, the narrow space needs to be mobilized back to a normal height that cannot be too high or too short. Finally, the surgeon has to make sure that the disc is anchored and fits properly.

Why Surgeons Still Choose Fusion?

Despite the benefits, there are reasons why surgeons still choose fusion.

There are strict rules as to when TDR can be used. This means insurers are prone only to approve fusion procedures.
The surgical technique is challenging. TDR surgery is a highly demanding procedure. As a result, many doctors specializing in fusion for 20 years or more can be reluctant to perform the procedure.
Complications and revision surgeries. Reoperations are sometimes necessary, but this happens in both fusion and TDR.

Individual Needs

Fortunately, most individuals with lower back problems never need total disc replacement. And those that do have severe pain/conditions are recommended to try non-invasive/surgical treatment. This ranges from:

Chiropractic
Physical therapy
Massage

Imaging and lab tests will be required.

However, if an operation is necessary, ask questions about both procedures. For example, if a surgeon insists that fusion is the only option, ask why total disc replacement is not an option?

Body Composition Testing

Protein and Weight Loss

Protein is one of three basic macronutrients found in food. Proteins are made up of smaller units called amino acids. There are 22 amino acids, with 9 of these being essential. This means the body needs them, as the body cannot produce them. These essential amino acids can be obtained by eating protein-rich foods like:

Eggs
Meat
Fish
Vegetarian/vegan options include:
Nuts
Seeds
Beans
Tofu

Generally, all the essential amino acids cannot be obtained from just one food. Therefore it is recommended to eat a variety of animal and plant-based proteins. Protein is in almost every structure and function of the body.

Antibodies

These proteins fight off any infections, bacteria, etc.

Repair, maintenance, and structural

Proteins are the building blocks of the body’s muscles, bones, skin, and hair.

Hormones

Chemical messenger proteins are how cells and organs communicate. For example, Growth Hormone affects muscle gain and fat loss.

Enzymes

Not all proteins are enzymes; however, all enzymes are proteins. These proteins are catalysts or starters for chemical reactions in the body.

Transportation and storage

Some proteins carry molecules where they are needed. For example, hemoglobin or the red blood cells carry oxygen to cells, then transport carbon dioxide away.

Not getting enough protein in one’s diet can have serious consequences on the body’s health. Without enough protein, the muscles can begin to atrophy or waste away, taking Lean Body Mass, strength, and energy away as well.

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. In addition, we provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

phone: 915-850-0900

Licensed in: Texas & New Mexico*

References

Salzmann, Stephan N et al. “Lumbar disc replacement surgery-successes and obstacles to widespread adoption.” Current reviews in musculoskeletal medicine vol. 10,2 (2017): 153-159. doi:10.1007/s12178-017-9397-4

Hopkins overview of Lumbar TDR (for consumers) www.hopkinsmedicine.org/health/treatment-tests-and-therapies/lumbar-disk-replacement

“Comparison of Lumbar Total Disc Replacement With Surgical Spinal Fusion for the Treatment of Single-Level Degenerative Disc Disease: A Meta-Analysis of 5-Year Outcomes From Randomized Controlled Trials”, Zigler J, et al., Global Spine Journal, June 2018, PMC602295 www.ncbi.nlm.nih.gov/pmc/articles/PMC6022955/

“Overview of Lumbar TDR” (for consumers); Johns Hopkins Medical Center www.hopkinsmedicine.org/health/treatment-tests-and-therapies/lumbar-disk-replacement

Summer Heat Can Affect Joints and Movement

By

Dr. Alex Jimenez

-

Senior man at the gym suffering from pain in knee

Although it is not officially summer, the past few weeks sure feels like it. Especially for those with joint discomfort and pain. As the body ages, individuals may notice their joints have some mobility/flexibility issues in the summer heat. Again, the heat and humidity are the culprits. The hotter it is, the more the body is susceptible to inflammation and swelling. The more prone an individual’s body is to swelling, the more pain can present. Barometric pressure can also have some form of impact on joint health. The pressure changes can cause the joints to become more sensitive. When the pressure changes, individuals often speak of their joints feeling tighter combined with stiffness, leading to a cycle of swelling and pain.

Table of Contents

Joint Anatomy

Whether it’s the hip, knee, elbow, or hand, all of the body’s joints have fluid in them. It is a gel-like substance known as synovial fluid. This is what lubricates the joints and keeps them functioning smoothly. However, the temperature and humidity levels can change the thickness of the fluid in the joints. This means that the synovial fluid can become inflamed with the weather changes. This is a symptom when the joints begin to feel like they cannot move and/or are becoming stiff. Joint inflammation can become more common and chronic as the body gets older.

Weather and the joints

The summer heat and humidity can affect the joint because:

The tendons, ligaments, and muscles expand in this type of weather
The heat can restrict individuals from moving around. Non-use stiffens the joints
Joints that have worn down cartilage could have exposed nerves that are reacting to the temperature changes
Humidity causes the body to lose water by sweating. This can reduce the fluid around the joints leading to stiffness, immobility, and pain.

However, not everyone has joint problems in the summer heat. Many have joint issues when it’s cold, damp, or raining. Other’s are at their best in cool, dry weather. It depends on an individual’s body and how their joints react when the temperature changes.

Maintaining joint health for the summer heat

When joint discomfort or pain presents in the summer, there are a few easy ways to gain relief.

Properly Hydrate the Body

Water and sports drinks maintain the fluid levels in the body, specifically, it keeps the joints moving. One way to hydrate the body can be achieved by eating healthy fruits and vegetables. Water-rich fruits and vegetables include:

Watermelon
Oranges
Strawberries
Tomatoes
Cucumbers
Spinach
Celery

Over-The-Counter pain ointments and creams

Arthritis and anti-inflammatory creams/ointments can ease joint pain by allowing more blood circulation in the affected areas.

Dressing for the heat

Wear loose, natural fiber, breathable clothing that allows the body to move freely while maintaining a cool temperature.

Relax in the air conditioning

Get into the air conditioning. The cool air can help reduce joint inflammation.

Get in the Water

Swimming or just wading through doing some light exercise in the water cools the body’s core. In addition, the buoyancy of the water relieves pressure on the joints.

Body Composition Testing

Body Water

The body is made up of as much as 2/3’s water. Even though much of the body is made up of water, the percentage of body composition changes based on functional needs. Essential functions of water include:

Water is the building block to almost every cell in the body
It regulates the body’s temperature through sweating and respiration
Carbohydrates and proteins for energy are transported via the water in the blood
Water assists in the removal of metabolic waste through urination
It is part of the shock-absorbing system that protects the brain and spinal cord
Water is part of the saliva and fluid that lubricates the joints

The amount of water in the body depends on various factors. This includes:

Age
Gender
Physical activity
It is referred to as Total Body Water or TBW.

TBW is constantly changing with gains and losses of fluid in healthy adults. The body can detect irregularities and compensate for losses and/or gains to make sure that the systems are balanced.

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. In addition, we provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Morton, Darren, and Robin Callister. “Exercise-related transient abdominal pain (ETAP).” Sports medicine (Auckland, N.Z.) vol. 45,1 (2015): 23-35. doi:10.1007/s40279-014-0245-z

Peeler, Jason et al. “Managing Knee Osteoarthritis: The Effects of Body Weight Supported Physical Activity on Joint Pain, Function, and Thigh Muscle Strength.” Clinical journal of sports medicine: official journal of the Canadian Academy of Sports Medicine vol. 25,6 (2015): 518-23. doi:10.1097/JSM.0000000000000173

Quick, D C. “Joint pain and weather. A critical review of the literature.” Minnesota medicine vol. 80,3 (1997): 25-9.

Timmermans, Erik J et al. “The Influence of Weather Conditions on Joint Pain in Older People with Osteoarthritis: Results from the European Project on OSteoArthritis.” The Journal of rheumatology vol. 42,10 (2015): 1885-92. doi:10.3899/jrheum.141594

Chiropractic Treatment and Adjustment Schedule

By

Dr. Alex Jimenez

-

A proper diagnosis goes a long way. Treatment and recovery can happen relatively quickly or broken up into parts, phases, and sessions, as part of a treatment and rehabilitation plan. This depends on the individual, their age, underlying conditions, and the severity of their injury/s. It is not uncommon to have a treatment schedule that could be weeks/months long. This can be tough on individuals with limited abilities and/or a slow progressive rehab to get back to normal. It is arduous, but to achieve optimal healing and health, it is expected.

Chiropractic medicine is no different. It’s non-invasive compared to surgery but not as immediate as medication/s. This places it in between. Recovery timelines can vary significantly based on the nature of the condition, the patient, their injury/s, and everything attached. Most chiropractic treatment and adjustment plans are scheduled according to the individual’s injury and/or condition. Every case is different, meaning that treatment could be a couple of sessions for an individual with mild sciatica to a few weeks or months for more severe injuries/conditions. Most want to know why chiropractors execute these plans over weeks and months.

Table of Contents

The Body Needs To Get Used To The Adjustments

One reason for an extended adjustment schedule is to prevent adjustment shock. Adjustment shock often presents through soreness and tenderness, and there could be a feeling of soreness when sitting or standing or difficulty when trying to move with a normal range of motion. This happens when trying to heal the body too much and too fast. Trying to perform massive chiropractic adjustments without preparing the body could worsen and/or create further injury/s.

For example, correcting severe lordosis requires repositioning the spine’s curvature through properly planned out adjustment sessions. If a chiropractor tries to adjust/align the spine into place over a few days, this would be extremely uncomfortable and more than likely painful for the individual. Plus, there is a lack of musculoskeletal support from the rest of the body that is needed to make sure that the adjustments/changes take hold and are maintained. A chiropractor wants to avoid these issues to focus on getting the individual back to proper health.

Preparing The Body With A Solid Foundation

Chiropractic manipulations and adjustments need time to settle in, ensuring that they take hold and not shift back to the incorrect position. Spinal problems are not solved overnight. This means that the causes of misalignment will remain for a period as the treatment/adjustment process begins. A spaced-out schedule ensures that the adjustments are made accordingly to strengthen the spine through the process. This enables adjustments and the body to develop the necessary support system and prevent any negative re-shifting. As time goes on, the adjustments achieve total realignment, restoring the positive curvature that can be maintained.

Schedule Benefits

Finally, the step-by-step nature of a chiropractic adjustment schedule enables the treatment team to check the status of an adjustment plan. If radiological imaging shows changes, setbacks, or new issues arise, the treatment plan and schedule can be changed and adapted accordingly.

Body Composition Testing

Too Much Alcohol Can Slow Recovery From Tissue Injuries

Alcohol is often associated with celebrations, anniversaries, etc. But drinking too much can damage the immune system. Too much alcohol contributes to organ damage, specifically the liver. However, it is known to slow down recovery from tissue injuries, as well. Moderate drinking is defined as drinking up to 1 drink a day for women and up to 2 a day. Exceeding the recommended intake disrupts the immune pathways and impairs the body’s ability to fight off infections. Alcohol-related immune system damage has been associated with the development of certain types of cancer, including head and neck cancers among alcohol users. Before thinking that this is a problem that only affects chronic alcohol users, acute binge drinking can also severely impair the body’s immune system.

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Holt, Kelly, et al. “The effects of a single session of chiropractic care on strength, cortical drive, and spinal excitability in stroke patients.” Scientific Reports vol. 9,1 2673. 25 Feb. 2019, doi:10.1038/s41598-019-39577-5

Iben, Axén, et al. “Chiropractic maintenance care – what’s new? A systematic review of the literature.” Chiropractic & manual therapies vol. 27 63. 21 Nov. 2019, doi:10.1186/s12998-019-0283-6

Mior, Silvano et al. “Chiropractic services in the active-duty military setting: a scoping review.” Chiropractic & manual therapies vol. 27 45. 15 Jul. 2019, doi:10.1186/s12998-019-0259-6

Pasala, Sumana et al. “Impact of Alcohol Abuse on the Adaptive Immune System.” Alcohol research: current reviews vol. 37,2 (2015): 185-97.

Low Levels of Choline Can Contribute To Muscle Cramps

By

Dr. Alex Jimenez

-

Female athlete injured on athletic run training - Male coach taking care on woman having fatigue cramps - Sport team concept with young sporty people facing mishaps casualties - Contrast filter

Muscle cramps are sudden and involuntary contractions of one or more of the body’s muscles. They often occur at night or at any moment stopped by a sudden Charley horse. These cramps can cause severe pain, making it impossible to move and use the affected muscle/s. They are usually brought on from:

Long periods of exercise
Physical labor
Hot weather
All can lead to muscle cramps.
There are medications and certain conditions that can cause muscle cramping. Muscle cramps can be treated at home with self-care.

Table of Contents

Affected by muscle cramps

Muscle cramps are common and can happen to anyone, but often occur to:

Indoor/outdoor physical work employees
Pregnant women
The elderly
Infants
Individuals that are overweight
Athletes

Cramping Up

Muscle cramps can be a symptom of a variety of medical issues. It is typically dehydration and muscle strain from overworking/exercising the muscles, but it can also be a sign of medical conditions like:

Poor circulation
Mineral depletion low levels of magnesium, calcium, potassium, and choline
Diuretics
Low electrolyte levels
Nerve disorders are rare cases, but a pinched nerve or spinal cord injury can cause nerve compression that can lead to cramping
Tight muscles, this comes from inactivity and not stretching the body causes the muscles to contract involuntarily
Hypothyroidism, a thyroid gland that is less active than normal can cause cramps
Liver disease

Muscle cramps can make daily activities difficult if not impossible to perform. They often happen at night affecting proper sleep. This can lead to:

Pain hangover
Grogginess
Fogginess
Cautious body behavior – as an individual wants to avoid pain and more cramping they begin to watch how they:
Step
Reach
Bend
Move
So as not to cause discomfort, pain, and further cramping, they develop awkward body positions that create more health problems from improper body posture.

Muscle cramps can happen to any muscle of the body. However, they present most often in the:

Abdomen
Ribs
Legs
Feet
Hands
Arms

Symptoms

This is usually sudden, sharp pain. Individuals can also feel or see a lump of muscle tissue under the skin.

When to see a professional

They usually go away on their own not requiring medical care. However, seek medical attention if the cramps:

Are causing severe discomfort and pain
Severe swelling, redness, or changes in skin tone
Muscle weakness is present
They are occurring frequently
They do not improve with self-care
There is no connection with an obvious cause, like intense physical activity/exercise

Mineral Depletion

Choline is a nutrient that just as important but not as well known as B vitamins. Choline has a fundamental role in muscle physiology and low levels could be a cause/contributor of muscle cramping. Choline is well-known for its function as part of the neurotransmitter acetylcholine. This is a chemical messenger that transmits signals between nerve cells and muscles. Acetylcholine is the physiological link that tells the muscles to contract. This is where medications can interfere with the messaging system.

Most believe that muscle cramps are caused by magnesium deficiency. This is true, but magnesium is not the only nutrient that could present with muscle issues. Choline regulates intracellular calcium and muscle contraction. This is what helps bind calcium proteins to muscle receptors. Choline keeps minerals like calcium available to the muscles so they can use it instantly when they need to contract. For individuals with skeletal muscle issues, which can be muscle cramping, general soreness, or another type of issue, testing for choline status could be the key.

Prevention and Relief

Home self-care for prevention and relief includes:

Heat or ice application to the muscle/s and affected areas
Avoiding caffeine
Drink plenty of water before and during physical activities, indoor/outdoor work, exercise
Self-massaging the cramped muscle/s
Stretching before and after physical activities
Nightly stretching before bed
Chiropractic maintenance

Body Composition Testing

Disclaimer

The information herein is not intended to replace a one-on-one relationship with a qualified health care professional, licensed physician, and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the musculoskeletal system’s injuries or disorders. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request. We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, CTG*
email: coach@elpasofunctionalmedicine.com
phone: 915-850-0900
Licensed in Texas & New Mexico

References

American Osteopathic Association. Muscle Cramp. Accessed 12/10/2019.

Merck Manual. Muscle Cramps. Accessed 12/10/2019.

Miller, Timothy M, and Robert B Layzer. “Muscle cramps.” Muscle & nerve vol. 32,4 (2005): 431-42. doi:10.1002/mus.20341

Nutrients, July 202

Vitamin B12 and Shoulder Injuries

By

Dr. Alex Jimenez

-

attentive african american doctor touching injured shoulder of young sportsman

Vitamin B12 and Shoulder Injuries. Most shoulder injuries involve the muscles, ligaments, and tendons. Individuals that perform repetitive arm motions/movements constantly lift objects as part of their job, and athletes that use their arms repetitively have an increase in developing/experiencing shoulder injuries and problems. Shoulder injuries are commonly caused by physical activities that involve:

Excessive motions
Repetitive motions
Overhead motions
Sports like swimming, tennis, pitching, and weightlifting involve these repetitive arm/shoulder motions contributing to shoulder injuries.
Injuries can also be brought on by everyday activities like washing/painting walls, hanging curtains/plants, and gardening.

Table of Contents

Shoulder Injury Symptoms

There are a few ways to analyze the situation of discomfort and/or pain in and around the shoulder.

Is there stiffness in or around the shoulder?
Can you rotate the arm through the normal range of active movement?
Does the shoulder feel like it could pop out or slide out of its socket?
Is there a lack of strength in the shoulder for normal daily activities?

If yes was an answer to any of these questions, individuals should consult an orthopedic surgeon and/or chiropractor for assistance determining the problem and its severity.

Injury Categories

Individuals often underestimate the extent of an injury and usually push/play through the discomfort and pain. This is how powerful the brain is as it ignores steady pain, weakness, or limitation of joint motion. Shoulder injuries and problems are grouped into the following categories.

Instability

This is when a shoulder joint moves/shifts or is forced out of its normal position. This is called instability and can result in the dislocation of the joints in the shoulder. Individuals will experience pain when raising their arms. It can feel as if the shoulder is slipping out.

Impingement

Impingement is caused by excessive rubbing/friction of the muscles against the top part of the shoulder blade, known as the acromion. Impingement can happen during physical activities that require excessive overhead arm motion. Medical examination and care are recommended for inflammation, which could lead to a more serious injury.

Injuries

Bursitis

The bursa is the fluid-filled sac that cushions the joints. These can become swollen and irritated from repetitive motions, falls, or other injuries. Individuals will notice the pain most when moving/rotating the shoulder.

Cartilage tear

The cartilage – the rubbery padding that goes around the rim of the shoulder joint can get damaged from repetitive motions, overextending, falls, or intense force to the shoulder. With this type of injury, individuals feel pain when reaching overhead, weakness, and/or catching, locking, and grinding feelings.

Rotator cuff tear

The rotator cuff consists of muscles and tendons that hold the arm in place and allow lifting the arm up and overhead. It can get damaged through overuse, falls, and regular wear and tear with age. Pain often presents at night when lifting objects, and there could be a cracking sound when trying to move or rotate.

Frozen shoulder

This condition limits the joint’s movement. Abnormal bands of tissue called adhesions build up in the joint and restrict movement. The shoulder can freeze up from not using it. This could be because pain or surgery causes an individual to use it less. This is when adhesions begin to build up.

Separation

This injury affects the joint where the collarbone and shoulder blade join. It is known as the acromioclavicular or AC joint. A fall or hard impact can tear the ligaments that hold it together. If the collarbone gets pushed out of place, a bump forms/develops on top of the shoulder.

Fracture

A bone can break or crack from a vehicle accident, fall, or takes a hard hit. The most common fractures are to the clavicle – collarbone and the humerus – arm bone closest to the shoulder. This type of injury causes a great deal of pain and bruising. If the collarbone is broken, the shoulder can sag with the inability to lift the arm.

Vitamin B12

Rotator cuff injuries involve dysfunctional and/or damaged connective tissue. This could be from impaired collagen synthesis. Vitamin B12 helps combat inflammation and plays a significant role in collagen formation. Low vitamin B12 status can be directly linked to pro-inflammatory cytokines. This means that a lack of vitamin B12 increases inflammation.

Researchers followed a group of individuals to determine if their vitamin B12 levels correlated with an increased risk of a rotator cuff tear. To begin the study, levels of vitamin B12 were measured along with other nutrients that included:

Vitamin D
Zinc
Calcium
Magnesium
Folate

Homocysteine and blood sugar biomarkers were also measured, associated with B12 metabolism. Homocysteine is a metabolite that builds up in the blood when specific nutrients, like B12, folate, or B6, become deficient. Elevated levels of homocysteine can be harmful and cause damage to blood vessels and brain tissue when not detoxified properly. In the study, the homocysteine levels did not differ between the groups, but vitamin B12 levels were significantly different.

The patients that were included were a healthy group that did not have any rotator cuff injury during the study.
The second group experienced a rotator cuff tear that required surgery during the study.
Only vitamin B12 and vitamin D differed with the various nutrients measured, with the B12 and D being lower in the shoulder injury group.
Specifically, the B12 levels in the healthy group were 627 pg/mL compared to 528 pg/mL in the injured group. This was a 16% decrease.

These subclinical deficiencies are usually missed with traditional serum testing, which is why functional nutritional testing is clinically recommended.

Body Compositional Testing

American Society for Surgery of the Hand: Shoulder Pain.

American Academy of Family Physicians: Shoulder Pain.

BMC Musculoskeletal Disorders, April 2021

Cleveland Clinic: Rotator Cuff Tendonitis Shoulder Tendinitis.

Monica, James, et al. Acute Shoulder Injuries in Adults. American family physician vol. 94,2 (2016): 119-27.

OrthoInfo: Shoulder Pain and Common Shoulder Problems, Rotator Cuff and Shoulder Conditioning Program.

Knee Injuries, Surgeries, and Vitamin D Status

By

Dr. Alex Jimenez

-

Knee Injuries, Surgeries, and Vitamin D Status. The knee joint is one of the largest and complex joints. It connects the thigh bone to the shinbone, which has a very important role in:

Supporting the body’s weight
Facilitating movement
Allowing the ability to bend the knee

Because of the complexity of the knee joint, it is highly susceptible to injuries. The most common injuries include tears in the:

Ligaments
Tendons
Cartilage
The kneecap itself can be fractured and/or dislocated.

Table of Contents

Tears

Meniscal Tears

The meniscus is the cartilage between the knee joint that absorbs the impact/shock when running, playing sports, yard work, hiking, bicycling, etc. It cushions the joint and maintains stability.

Meniscus tears are common in sports that have a lot of jumping, starting/stopping quickly, changing direction suddenly, like volleyball, basketball, tennis, soccer, football. This is when the meniscus tears. Surgery can be required, depending on the severity/extent of the injury and tear.

Tendon Tears

The patellar tendon works with the knee muscles in the front of the thigh to straighten the leg. Tears in the patellar tendon are common among middle-aged individuals and those that participate in running or jumping sports.

A complete tear is considered a disabling injury that requires surgery for full functional recovery.
Fortunately, most tears are partial and require rest and chiropractic/physical therapy to heal.

Dislocation

Knee dislocations happen when the knee bones shift out of position. This can happen after a fall, car crash, or high-speed impact. It can also be caused by twisting the knee while the foot stays planted. Dislocations require relocation. However, sometimes a dislocated kneecap corrects itself and returns to the proper position. Other cases can require a mild sedative to allow a doctor to relocate the knee. Dislocations generally take around six weeks to fully heal.

Anterior Cruciate Ligament – ACL Injury

The anterior cruciate ligament or ACL is knee tissue that joins the upper and lower leg bones and maintains the knees’ stability. The ACL can be torn if the lower leg over-extends forward or if the leg gets twisted. ACL injuries are common knee injuries and account for around 40% of sports-related injuries. These injuries can range from a small tear in the ligament to a severe injury where the ligament tears completely or gets separated from the bone. Treatment depends on the severity of the injury. Depending on various factors including the severity of the tear, surgery could be required.

Knee Surgery

For most cases, surgery is done using arthroscopy technology. This procedure uses small incisions to insert a camera and surgical instruments into the joint. Usually, two or three incisions are needed with recovery time being quicker than large incision surgery where the whole knee is opened. Minimally invasive arthroscopic surgery is preferred by sports medicine experts. With this procedure:

There is no need to cut the tendons or muscles
Bleeding is reduced
Small incisions decrease scarring
Recovery time is shorter

However, sometimes a large incision is required for complex surgical techniques. Common knee surgery procedures include:

Arthroscopy Surgery

This method allows the ability to see inside the knee joint. The procedure is often recommended for:

Diagnosis
Minor repairs to ligaments and/or tendons
Cartilage or bone that needs to be removed

Total Knee Replacement

A full knee replacement is known as arthroplasty. When the joint is damaged beyond repair from injury or disease, an implant is placed in the knee joint restoring function. A small amount of cartilage and bone from the shinbone and thigh bone gets removed for perfect placement of the new knee joint.

Revision Knee Replacement

Most knee replacements last around 15 – 20 years. For individuals that have knee replacement early, then a new operation for new implants could be required. Here, the surgeon removes the original prosthesis and replaces it with a new one.

Partial Knee Replacement

Some knee injuries do not require complete replacement. Here, only the worn-out portion of the joint is replaced. As an example, the cartilage that has been lost in an area of the knee can be repaired with a partial replacement.

Vitamin D Status

A study on athletes that underwent ACL surgery looked at their vitamin d status and how it affected their recovery.

The research concluded that vitamin D status had no effect on surgery outcomes.
However, those with the lowest vitamin D status had three times the failure rate than those with higher vitamin D
The average age of the individuals was around twenty-four and were healthy athletes.

Each of the patients in this study had their vitamin levels measured before the operation and were grouped based on their vitamin D status:

Group 1 vitamin D below 20 ng/mL – considered deficient
Group 2 vitamin D between 20-30 ng/mL – considered low but in a technical range
Group 3 vitamin D above 30 ng/mL – considered sufficient, but not optimal

All were followed for two years with their surgery recovery being measured with two systems.

The Lysholm score, which is a 100 point scoring system that looks at an individual’s knee functions that include:

Mechanical locking
Instability
Pain
Swelling
Stair climbing
Squatting

The WOMAC score is a scoring system that measures:

Physical function
Pain
Stiffness
This can be for knee and hip replacement

After 2 years, the Lysholm score and the WOMAC scores were similar.

However, there was a difference in the graft failure rate which was about 6% in group 1 with the lowest vitamin D and around 2% in groups 2 and 3. This shows that the lowest vitamin D status has three times the failure rate compared with those that had increased vitamin D levels. Vitamin D is a known anti-inflammatory with metabolic functions that are documented. Therefore, vitamin D does improve surgical success and recovery in healthy athletes.

Body Composition

Disclaimer

The information herein is not intended to replace a one-on-one relationship with a qualified health care professional, licensed physician, and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the musculoskeletal system’s injuries or disorders. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request. We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, CTG*
email: coach@elpasofunctionalmedicine.com
phone: 915-850-0900
Licensed in Texas & New Mexico

References

Brambilla, Lorenzo, et al. “Outcome of total hip and total knee arthroplasty and vitamin D homeostasis.” British medical bulletin vol. 135,1 (2020): 50-61. doi:10.1093/bmb/ldaa018

European Journal of Orthopedic Surgery and Traumatology, January 2021

Zhang, Hao et al. “Vitamin D Status and Patient Outcomes after Knee or Hip Surgery: A Meta-Analysis.” Annals of nutrition & metabolism vol. 73,2 (2018): 121-130. doi:10.1159/000490670

The Difference Between Muscle Mass and Lean Body Mass

By

Dr. Alex Jimenez

-

Young strong male and female fitness models outdoors in beautiful landscape. Man and woman running in park

There are different types of muscle from a biological perspective, however, there is no such thing as lean muscle. Lean suggests the absence of body fat. But the fact is that all muscle is lean muscle. It is important to build muscle mass as the body ages, however, it is more important to build lean body mass. Here is the difference.

Table of Contents

Lean Body Mass

Lean Body Mass is the total weight of an individual’s body minus all the weight from the fat mass.

Lean Body Mass (LBM) = Total Weight – Fat Mass

Lean Body Mass includes the weight of the:

Skin
Body Water
Bones
Organs
Muscle Mass

Because Lean Body Mass consists of various components, any change in the weight of these areas is recorded as changes in lean body mass. However, the weight of the body’s organs will not change. Bone density does decrease with time and age, but will not significantly affect the weight of lean body mass. With lean body mass, 2 areas of focus include:

Body water
Muscle mass

Lean Muscle

Sometimes, individuals use the term lean muscle referring to the shape of the muscles. However, both types of muscle are lean and fat-free.

The difference between muscle mass and lean muscle

The strict definition of muscle mass is the weight of the muscles of the body. When individuals say they are gaining muscle mass, they typically mean that the muscles look and feel bigger.
Lean muscle mass on the other hand is a term often used when someone is referring to the weight of the muscles, not factoring in the amount of fat that could be present within a muscle.

Combining Lean Gains

Increases in Skeletal Muscle Mass are also an increase in Lean Body Mass. What tends to happen is individuals combine them as lean mass gains or lean gains. However, an increase in Lean Body Mass does not always increase muscle.

This is because body water makes up a significant portion of an individual’s Lean Body Mass. For example, a body composition analysis of a 174-pound male.

98.1 Total Body Water + 35.5 Dry Lean Mass = 133.6 Lean Body Mass

Water makes up more than 55% of total body weight
This is normal for healthy adult males
Lean Body Mass consists of three components, two of which are water.
Everything else grouped together makes up the individual’s Dry Lean Mass.
This includes bone minerals, protein content, etc.

Muscle gains contribute to Lean Body Mass gains, but so does water. The difference is that water levels can fluctuate throughout the day depending on:

Hydration levels
Diet
Physical activity

The muscle tissue itself contains a significant amount of water. Muscle tissue is comprised of up to 79% water. Research has shown that resistance training increases intracellular water in both men and women. This creates an issue when looking at lean gains.

Lean Mass gains can happen quickly, and the increases are mostly body water

Measuring Lean Body Mass and Muscle Mass

What not to do

Don’t try to use a scale to calculate changes in Skeletal Muscle Mass. A popular method used is to estimate muscle gain from the number on the scale and applying fitness websites/magazine tips. The problem with this technique is that estimating progress has many factors that can influence an increase in body weight. These include:

Undigested food or drink
Water retention/glycogen
Water retention/sodium

Most methods of body composition analysis divide the body into Lean Body Mass or Fat-Free Mass/Fat Mass. These include:

Each has its pros and cons with a difference in accuracy, depending on the technique used.

Using A Lean Body Mass Calculator

A lean body mass calculator computes various factors that include:

Height
Weight
Gender
Age

It is the difference between total body weight and body fat weight. However, these calculations are more for helping physicians determine the appropriate amount of prescription medication/s or if an individual will be undergoing anesthesia and not a computation of overall body composition.

Paying Attention to Weight Loss

Paying attention to weight loss is an inaccurate reflection of lean body mass, muscle mass, or lean mass.
Weight loss, or gain, does not reflect overall health and body composition.

Body Fat Percentage

Body fat percentage is different, as far as, the healthy range for men and women. This can provide insights into the overall health of a person.

Key Points

All muscle is lean muscle
Muscle Mass aka Skeletal Muscle Mass
Resistance training/weightlifting workouts combined with added protein will generate a muscle mass percentage increase
Skeletal Muscle Mass is connected with Lean Body Mass
Everyone’s body composition is different, making the proportion of an individual’s skeletal muscle mass to Lean Body Mass unique.
Lean Mass or Lean body mass is the safest term to use to describe gains.

Which Is More Important?

When it comes to tracking muscle gain or fat loss, it all comes down to what tools are being used to measure progress.
If working with just a weight scale, an individual will only know their weight increases or decreases.
This is difficult to see the difference in weight gain from water, muscle, or body fat.
For individuals that want accurate measuring of their muscle gain and assessing their health, then body composition analysis is the key.

Body Composition Difference

Disclaimer

The information herein is not intended to replace a one-on-one relationship with a qualified health care professional, licensed physician, and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the musculoskeletal system’s injuries or disorders. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request. We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, CTG*
email: coach@elpasofunctionalmedicine.com
phone: 915-850-0900
Licensed in Texas & New Mexico

References

Galán-Rioja, Miguel Ángel et al. “Effects of Body Weight vs. Lean Body Mass on Wingate Anaerobic Test Performance in Endurance Athletes.” International journal of sports medicine vol. 41,8 (2020): 545-551. doi:10.1055/a-1114-6206

Köstek, Osman et al. “Changes in skeletal muscle area and lean body mass during pazopanib vs sunitinib therapy for metastatic renal cancer.” Cancer chemotherapy and pharmacology vol. 83,4 (2019): 735-742. doi:10.1007/s00280-019-03779-5

Ribeiro, Alex S et al. “Resistance training promotes an increase in intracellular hydration in men and women.” European journal of sports science vol. 14,6 (2014): 578-85. doi:10.1080/17461391.2014.880192

Ten Haaf, Dominique S M et al. “Protein supplementation improves lean body mass in physically active older adults: a randomized placebo-controlled trial.” Journal of cachexia, sarcopenia and muscle vol. 10,2 (2019): 298-310. doi:10.1002/jcsm.12394

Chiropractic Treatment For Tennis Injuries

By

Dr. Alex Jimenez

-

Tennis is an intense sport that requires strength, agility, flexibility, stamina, endurance, and conditioning. And it’s a great way to stay in shape. However, with all of this intensity is the risk of injuries. Although they are lower compared to other sports injuries, injuries are more cumulative/repetitive based and wear and tear over time type. Tennis injuries can be painful and impair daily life. They can be treated and prevented with chiropractic medicine and strength training. Chiropractic can help the body heal quicker, and address underlying issues that led to the injury. This will help to worsen and prevent re-injury. The most common tennis injuries include…

Table of Contents

Wrist Tendonitis

This is an injury that can happen to beginner players that don’t have a great deal of arm/wrist strength, use a racquet that is too heavy, and begin developing an improper form to compensate. But it can also be caused by repetitive/overusing the wrist instead of the whole arm. Symptoms are chronic stiffness and pain in the area surrounding the wrist joint. Chiropractic sports massage, physical rehabilitation, and learning proper form will help alleviate the pain and prevent worsening or developing new injuries.

Tennis Elbow

Tennis elbow is a condition that is caused by inflammation of the outside muscles in the forearm and tendons. This is usually an overuse injury from all the swinging and hitting, but using the improper technique could also be a cause. Chiropractic adjustments are highly recommended instead of steroid injections and other anti-inflammatories. The adjustments and massage relieve the discomfort and pain by naturally relaxing, stretching, and strengthening the muscles and tendons.

Shoulder Rotator Cuff Tendonitis

The rotator cuff belongs to a group of tendons and muscles that surround the shoulder joint. This allows the shoulder to perform 360-degree arm circles and is what stabilizes the shoulders. Tendonitis happens when the tendons inside the rotator cuff become inflamed. The inflammation causes pain with movement, especially overhead motions decreasing the range of motion in the shoulder. This injury is often caused by serving and hitting overheads with an improper technique. Chiropractic adjusting, heat and ice therapy, and electro-muscular stimulation loosen and stretch the muscles/tendons back to their proper form.

Knee Sprains and Strains

The knee goes through a lot in sports. And tennis is no exception, much like basketball and volleyball with all the jumping, pounding, shifting, twisting, losing balance, or extending beyond the normal range of motion causes injuries that result in:

Pain
Swelling
Bruising
Loss of the ability to move

Chiropractic will help relieve that pain and relax the damaged muscles. It also speeds the healing process by addressing the underlying issues.

Ankle Sprain

An ankle sprain also known as a twisted ankle happens when the ligaments attached to the joint become over-stretched or partially tear. These sprains happen from the:

Quick start and stop movements
Changing direction rapidly
Quick sprints all around the court
Causing the ankle to roll and/or twist.

A chiropractor will realign the ankle and provide physical therapy massage to allow the ligaments to heal properly and faster. Chiropractic treatment will allow the player to return to play quicker and prevent reinjury that if not treated correctly can become chronic. Having the proper personalized treatment plan will ensure the body heals correctly, prevent misalignments, loss of functionality, and/or range of motion.

PUSH Fitness

Aerobic Training

Aerobic exercise is a cornerstone for weight loss. Having the heart rate elevated for a continuous amount of time is the key. This is how calories are burned. Research has found that individuals involved in aerobic training lose more weight overall, including more fat mass than resistance training alone. When combined, aerobic and resistance training individuals gain more fat-free mass, including lean muscle. Aerobics causes the cardiorespiratory system to adapt. Maintaining heart function and health and keeps the body’s energy metabolism system running at optimal levels. Aerobic exercise for fitness and weight loss is a key element of maintaining the body’s health.

Disclaimer

The information herein is not intended to replace a one-on-one relationship with a qualified health care professional, licensed physician, and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the musculoskeletal system’s injuries or disorders. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request. We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, CTG*
email: coach@elpasofunctionalmedicine.com
phone: 915-850-0900
Licensed in Texas & New Mexico

References

Dines, Joshua S et al. “Tennis injuries: epidemiology, pathophysiology, and treatment.” The Journal of the American Academy of Orthopaedic Surgeons vol. 23,3 (2015): 181-9. doi:10.5435/JAAOS-D-13-00148

Minghelli, Beatriz, and Jéssica Cadete. “Epidemiology of musculoskeletal injuries in tennis players: risk factors.” The Journal of sports medicine and physical fitness vol. 59,12 (2019): 2045-2052. doi:10.23736/S0022-4707.19.09842-6

Stuelcken, Max et al. “Wrist Injuries in Tennis Players: A Narrative Review.” Sports medicine (Auckland, N.Z.) vol. 47,5 (2017): 857-868. doi:10.1007/s40279-016-0630-x

Willis, Leslie H et al. “Effects of aerobic and/or resistance training on body mass and fat mass in overweight or obese adults.” Journal of applied physiology (Bethesda, Md.: 1985) vol. 113,12 (2012): 1831-7. doi:10.1152/japplphysiol.01370.2011

Most Frequent Automobile, Vehicle Accident Injuries

By

Dr. Alex Jimenez

-

Close up smached cars on a road. — Image of a auto accident involving two cars.

With the number of individuals/vehicles on the road today, automobile accidents are frequent and even minor ones can cause damage. The most obvious is the destruction of the vehicle during and after the collision. But these crashes and accidents also cause serious damage to the body that is not immediately visible or felt. Almost every accident and crash results in injuries to one or more of the individuals involved. Vehicle collisions both great and small involve force being applied as two or more vehicles collide. The direction and amount of force can cause damage to the body from twisting, bending, slamming, and jolting in ways the body was not meant to do. There is a 1 in 5 chance of being involved in an automobile accident that causes bodily injury.

The most frequent injuries include:

Table of Contents

Frequent Soft Tissue Injuries

Bruising/Contusions

Even a minor automobile accident can cause bruising. A collision can jerk/jolt the body from the seat belt, while it is doing its job of keeping the individual from flying out the window, it can leave bruises for days afterward. Bruises are rarely serious injuries that require medical attention and usually heal within a week or two.

Whiplash

The physical force from an accident can cause the head to move at speeds that it should not move at. Pain or discomfort in the neck and back after a collision can indicate a sustained whiplash strain to the muscles and ligaments. These strains can be painful and take weeks for a full recovery and if left untreated could result in chronic pain.

Neck and Spinal injuries

The intense force that the body endures from a collision can cause serious damage to the body that is not immediately apparent or present with inflammation/pain letting the individual know that something is not right. Herniations or ruptures of the discs in the spine can occur. This can lead to serious injuries that cause intense pain and limit mobility and flexibility. If pain continues after several days, or there is a history of neck/back injury/s and/or condition/s, consult with an accident chiropractic specialist or spine specialist to see if there is an injury to the spine or surrounding muscles, tendons, and ligaments. Chiropractic treatment and physical therapy are important to return the body to optimal health. Surgery could be an option if there is sustained serious neck or spinal injury.

Frequent Head Injuries

Concussions

During a collision, hitting the head on the steering wheel, window, or roof is frequent and can cause a concussion. Individuals can experience problems with memory, like not remembering what happened before the collision, or feeling like brain function is not as quick. Treatment for any kind of head injury is crucial. Treatment will help alleviate headaches and help restore the brain to a healthy state.

Traumatic Brain Injuries

These injuries can cause life-altering effects. A traumatic brain injury can change:

The way the brain functions
Handles information
Processes emotions

Recovery from a brain injury is possible but can take time, depending on the type and severity of the damage.

Frequent Mental and Emotional Injuries

Post-traumatic Stress Disorder

When the body goes through extreme stress like an automobile accident there is the potential to develop emotional and mental conditions like post-traumatic stress disorder or PTSD. Symptoms can include:

Being scared of driving or riding in a vehicle
Avoiding or responding fearfully to certain sounds or images that are associated with auto accidents
Sleeping problems brought on by anxiety and/or nightmares

Treatment is vital and psychologists and therapists can help individuals express their feelings, and educate individuals on techniques to deal with stresses, anxieties, and fears to get them to a healthy life.

Internal Injuries

Broken Bones

The impact of a collision can cause the body to hit various areas of the vehicle, stressing the musculoskeletal system that it can’t take. This can occur in a variety of ways, with the torso, arms, or legs getting pinned by a part of the vehicle causing fracture/s. Also, depending on the speed of the collision, the seatbelt could stop the body suddenly causing a fracture of the ribs. Broken bones are frequent in auto accidents/crashes, however, some fractures could require surgery and hardware to reset the bones to allow proper healing. Depending on the type of break, individuals could require a month or more of rest. Chiropractic care and physical therapy could help expedite recovery.

Internal Bleeding

The body’s organs are delicate and fragile. The impact forces from an auto accident can cause all kinds of damage, causing them to bleed. These are serious injuries and are quite common in high-speed collisions.

Auto Accident Doctors & Chiropractic Treatment

Body Positivity

Body positivity is about every individual having a psychological representation of their body or body image. This includes:

How an individual thinks about their body shape
Size
Emotions attached to their perception

Fitness and fashion industries used to promote what the perfect body should look like and those with a body image that did not fit these criteria could develop a sense of inferiority. In response to this, body positivity has become a rapidly growing movement on social media. The movement’s objective is to challenge society to focus on an individual’s overall health, and not their body. It encourages acceptance of all body types, no matter the size or shape. The movement has a companion known as the Healthy at Every Size or HAES movement that focuses on health indicators other than weight. It encourages the focus on developing healthy habits that lead to improved health. HAES involves three components:

Intuitive eating
Encourages body acceptance
Promotes physical activity through movement and health instead of a structured exercise regimen

These movements offer realistic and encouraging ways to recognize and achieve optimal health. They accept body and health at every stage of an individual’s fitness and health journey.

Disclaimer

The information herein is not intended to replace a one-on-one relationship with a qualified health care professional, licensed physician, and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the musculoskeletal system’s injuries or disorders. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request. We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, CTG*
email: coach@elpasofunctionalmedicine.com
phone: 915-850-0900
Licensed in Texas & New Mexico

References

Duncan, G J, and R Meals. “One hundred years of automobile-induced orthopedic injuries.” Orthopedics vol. 18,2 (1995): 165-70.

Hamilton JB. Seat-belt injuries. Br Med J. 1968 Nov 23;4(5629):485-6. doi: 10.1136/bmj.4.5629.485. PMID: 5697665; PMCID: PMC1912721.

Sims, J K et al. “Automobile accident occupant injuries.” JACEP vol. 5,10 (1976): 796-808. doi:10.1016/s0361-1124(76)80313-9