Dislocated Elbow Injury: A Guide To Treatment and Recovery

Man with adjustable articulated elbow orthosis typing on laptop keyboard — Man with elbow injury, special modern adjustable articulated elbow orthosis typing on laptop keyboard. Side view shot man wearing arm splint sitting at desk in front window working distantly at home

“A dislocated elbow is a common injury in adults and children and often happens in tandem with bone fractures and nerve and tissue damage. Can physical therapy help to support recovery and ensure range of motion?”

Table of Contents

Dislocated Elbow Injury

Elbow dislocations are generally caused by trauma when the elbow bones no longer connect. Individuals falling onto an outstretched hand is the most common cause of the injury. (James Layson, Ben J. Best 2023) Healthcare providers will try to relocate the elbow using a closed reduction. Individuals may require surgery if they cannot relocate the elbow using closed reduction.

Resetting The Elbow

The elbow is made up of a hinge and ball-and-socket joint, enabling unique motions: (American Society for Surgery of the Hand. 2021)

Hinge joint

The hinge function allows the bending and straightening of the arm.

Ball-and-socket joint

The ball-and-socket function allows you to rotate the palm of your hand to face up or face down.

A dislocated elbow injury can damage bones, muscles, ligaments, and tissues. (American Academy of Orthopaedic Surgeons. 2021) The longer the elbow remains out of the joint, the more damage can occur. Elbow dislocations rarely reset into their joints on their own and are recommended to be evaluated by a qualified healthcare provider to prevent permanent damage to nerves or function.

It is not recommended to try to reset the elbow on your own.
A healthcare provider will work to restore the joint and ensure proper alignment.
Before the reset, they will perform a physical examination to assess blood circulation and any nerve damage.
Providers will order an imaging scan to examine the dislocation and identify broken bones. (American Academy of Orthopaedic Surgeons. 2021)

Type of Dislocation

The two types of elbow dislocations are: (James Layson, Ben J. Best 2023)

Posterior Dislocation

Occurs when there is a significant force on the palm that spreads toward the elbow.
Falling with the hands stretched out to catch yourself, and the elbow joint pushes backward/posterior.

Anterior Dislocation

This is less common and results from applied force on a flexed elbow.
Falling to the ground when the hand is up near the shoulder.
In this case, the elbow joint pushes forward/anterior.
X-rays are used to determine the type of dislocation and to identify any broken bones. (American Society for Surgery of the Hand. 2021)
Depending on the injury, the provider may order a CT scan or MRI to ensure no damage has occurred to nerves or ligaments. (Radiopaedia. 2023)

Signs and Symptoms

A dislocated elbow injury is often caused by trauma. (American Academy of Orthopaedic Surgeons. 2021) General signs and symptoms include: (American Society for Surgery of the Hand. 2021)

Inability to move the elbow.
Bruising and swelling around the area.
Intense pain in the elbow and surrounding area.
Deformity around the elbow joint.
Numbness, tingling, or weakness in the arm or hand can indicate nerve damage.

Treatment Without Surgery

Healthcare providers initially try to treat a dislocated elbow using a closed reduction technique. (American Society for Surgery of the Hand. 2021)
A closed reduction means that the elbow can be relocated without surgery.
Before the closed reduction, a healthcare provider will administer medications to help relax the individual and address the pain. (Medline Plus. 2022)
Once relocated into the correct position, a healthcare provider applies a splint (usually at a 90-degree angle of flexion) to keep the elbow in place. (James Layson, Ben J. Best 2023)
The objective is to prevent elbow extension, which can cause re-dislocation.
The splint remains in place for one to three weeks. (American Academy of Orthopaedic Surgeons. 2021)
A physical therapist will assess motion and prescribe exercises to prevent elbow range of motion loss.

Treatment With Surgery

Depending on the severity of the dislocation and the success of the closed reduction, surgery may still be necessary. (James Layson, Ben J. Best 2023)
If any of the following are being experienced by the individual, a healthcare provider may recommend surgery: (American Academy of Orthopaedic Surgeons. 2021)

The elbow remains unstable with a slight extension.
The bones are not correctly aligning.
The ligaments need further repair after a closed reduction.

Complex elbow dislocations can make it difficult to maintain joint alignment.
An assistive device, like an external hinge, may be recommended to help prevent re-dislocating the elbow.
The surgeon will recommend physical therapy after surgery to assist with range-of-motion exercises to optimize and expedite recovery.

Recovery

Recovery times can vary as every injury is different. (American Society for Surgery of the Hand. 2021)
The recovery time depends on the elbow’s stability after closed reduction or surgery.
Healthcare providers will initiate active motion exercises. (American Society for Surgery of the Hand. 2021)
Limiting how long the joint is immobilized will prevent stiffness, scarring, and inhibited movement.
Healthcare providers don’t recommend immobilization for more than a few weeks.

Resuming Normal Activities

Resuming regular activity often depends on the type of treatment for the elbow dislocation: (Ortho Bullets. 2023)

Closed Reduction

The elbow is splinted for five to ten days.
Individuals may engage in physical therapy early motion activity to help prevent loss of range of motion.
Individuals are recommended to do light exercises within two weeks after the injury.

Surgical Reduction

The elbow may be placed in a brace that allows for a gradual increase in motion.
It is essential to maintain controlled movement to prevent motion loss.
The elbow can extend fully within six to eight weeks, although it could take up to five months for complete restoration.
The healthcare provider will determine when it’s safe to resume normal activity.

The Path to Healing Personal Injury

References

Layson J, Best BJ. Elbow Dislocation. [Updated 2023 Jul 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK549817/

American Society for Surgery of the Hand. (2021). Elbow dislocation.

American Academy of Orthopaedic Surgeons. (2023). Elbow dislocation.

Jones J, Carroll D, El-Feky M, et al. (2023). Elbow dislocation. Reference article, Radiopaedia.org doi.org/10.53347/rID-10501

Medline Plus. (2022). Closed reduction of a fractured bone.

Ortho Bullets. (2023). Elbow dislocation.

Ankle Replacement Surgery: What to Expect from Physical Therapy

Dr. Alex Jimenez

A physiotherapist has a patient perform exercises for ankle proprioception in studio

“Progress can be challenging for individuals in post-total ankle replacement surgery. How can physical therapy help in recovery and restoring leg function?”

Table of Contents

Total Ankle Replacement Post Surgery Physical Therapy

Total ankle replacement surgery is a major procedure that takes time to recover. A total ankle replacement surgery or arthroplasty can benefit individuals with chronic ankle pain or disability. This procedure can significantly improve an individual’s overall pain and function with time. Physical therapy is essential to regaining movement in the ankle and restoring full mobility. A physical therapist will work with the individual to control pain and swelling, restore the ankle’s range of motion, train on walking gait and balance, and rebuild strength in the leg. This will help maximize the chances of a successful outcome after surgery.

Total Ankle Replacement

The ankle joint is the section of the lower leg where the shinbone/tibia meets the talus bone on the top of the foot. What can happen is the slippery surface/articular cartilage that coats the ends of these bones begins to thin or deteriorate. As the deterioration progresses, it can lead to significant pain, disability, and difficulty walking. (Cleveland Clinic. 2021) This is where a specialist may recommend total ankle replacement for the best results. Various conditions can be helped by this procedure, including:

Joint damage caused by gout
Post-traumatic arthritis
Rheumatoid arthritis
Advanced osteoarthritis
Osteonecrosis
Septic arthritis (Cort D. Lawton et al., 2017)

During an ankle replacement procedure, an orthopedic surgeon removes the damaged ends of the tibia and talus bones and replaces them with an artificial covering. A polyethylene component is also secured between the two structures to support the smooth movement of the new joint endings. (Massachusetts General Hospital. N.D.) Following the procedure, individuals are typically placed in a protective boot or splint. The healthcare provider will recommend staying off the leg for 4 to 8 weeks to allow healing.

Physical Therapy

Outpatient physical therapy is usually initiated several weeks after the ankle operation. (UW Health Orthopedics and Rehabilitation. 2018) Physical therapy can last for five months or more, depending on the severity of the condition and injury. The physical therapist will focus on different areas to get the best results. (Cort D. Lawton et al., 2017)

Pain and Swelling Control

Post-operative pain and swelling are normal after a total ankle replacement. It is not unusual for an ankle to be swollen for even six to 12 months after the operation. (UW Health Orthopedics and Rehabilitation. 2018) The surgeon will normally prescribe medication to help manage discomfort early on, and physical therapy also plays an important role in addressing the symptoms. Treatments used can include:

Electrical stimulation – mild electrical pulses applied to the muscles.
Ice
Vasopneumatic compression, where an inflatable sleeve is used to create pressure around the area, is commonly utilized at the beginning of physical therapy to reduce pain or swelling.
Other modalities, such as stretching and targeted exercises, are combined with other treatments.

Range of Motion

Early after the procedure, the ankle will be very stiff and tight. This is due to several factors, including the inflammation and swelling after surgery and the time spent immobilized in a boot.
The physical therapist will employ various techniques to improve the ankle joint’s range of motion to rotate and flex.
The physical therapist may employ passive stretching induced by an outside force such as the therapist or a resistance band) to help improve mobility.
Manual techniques like soft tissue massage and joint mobilizations are also utilized. (Massachusetts General Hospital. N.D.)
The therapist will develop a home rehabilitation program comprising self-stretching techniques and gentle movements.

Gait and Balance Training

After weeks of staying off the affected ankle, the surgeon will clear the patient to begin walking training.
The physical therapist will work to improve the overall gait pattern and reduce limping.
They will also help transition from using crutches or a walker to walking independently. (UW Health Orthopedics and Rehabilitation. 2018)
After multiple weeks of reduced movement and lack of bearing any weight on the ankle, the muscles that surround the ankle have often atrophied/weakened, which can impact balance.
When the individual can begin placing weight on the leg, the therapist will apply proprioceptive/sense of body position training to improve overall stability. (UW Health Orthopedics and Rehabilitation. 2018)
Balance exercises will be added to the home program and will progress from week to week.

Strength

The muscles in the leg, ankle, and foot become weak from the surgery and the time spent in a splint or boot. These structures have a significant role in balance, the ability to stand, walk, and go up or down the stairs.

Regaining the strength and power of these muscles is a critical goal of rehabilitation.
In the first weeks, the physical therapist will focus on gentle strengthening exercises.
Isometrics lightly activate the muscles but avoid irritating the surgical site.
As time passes and weight-bearing is allowed, these gentle moves are replaced with more challenging ones, like resistance bands and standing exercises, to accelerate strength gains.

Treating Ankle Sprains with Chiropractic Care

References

Cleveland Clinic. (2021). Total ankle replacement.

Lawton, C. D., Butler, B. A., Dekker, R. G., 2nd, Prescott, A., & Kadakia, A. R. (2017). Total ankle arthroplasty versus ankle arthrodesis-a comparison of outcomes over the last decade. Journal of orthopaedic surgery and research, 12(1), 76. doi.org/10.1186/s13018-017-0576-1

Massachusetts General Hospital. (N.D.). Physical therapy guidelines for total ankle arthroplasty.

UW Health Orthopedics and Rehabilitation. (2018). Rehabilitation guidelines following total ankle arthroplasty.

Living With Postural Orthostatic Tachycardia Syndrome

Dr. Alex Jimenez

Session of manual therapy for pregnant woman in modern wellness center — Session of manual therapy for a pregnant woman in a modern wellness center, the room has a lot of sunlight

“Postural orthostatic tachycardia syndrome is a medical condition that causes lightheadedness and palpitations after standing. Can lifestyle adjustments and multidisciplinary strategies help reduce and manage symptoms?”

Table of Contents

Postural Orthostatic Tachycardia Syndrome – POTS

Postural orthostatic tachycardia syndrome, or POTS, is a condition that varies in severity from relatively mild to incapacitating. With POTS:

The heart rate increases dramatically with body position.
This condition often affects young individuals.
Most individuals with postural orthostatic tachycardia syndrome are women between the ages of 13 and 50.
Some individuals have a family history of POTS; some individuals report POTS began after an illness or stressor, and others report it began gradually.
It usually resolves over time.
Treatment can be beneficial.
Diagnosis is based on assessing blood pressure and pulse/heart rate.

Symptoms

Postural orthostatic tachycardia syndrome can affect young individuals who are otherwise healthy and can begin suddenly. It usually happens between the ages of 15 and 50, and women are more likely to develop it than men. Individuals can experience various symptoms within a few minutes of standing up from a lying or seated position. The symptoms can occur regularly and daily. The most common symptoms include: (National Institutes of Health. National Center for Advancing Translational Sciences. Genetic and Rare Diseases Information Center. 2023)

Anxiety
Lightheadedness
A feeling like you’re about to pass out.
Palpitations – sensing rapid or irregular heart rate.
Dizziness
Headaches
Blurred vision
Legs turn to reddish-purple.
Weakness
Tremors
Fatigue
Sleep problems
Trouble concentrating/brain fog.
Individuals may also experience recurrent episodes of fainting, usually without any trigger/s other than standing up.
Individuals can experience any combination of these symptoms.
Sometimes, individuals cannot handle sports or exercise and may feel light-headed and dizzy in response to mild or moderate physical activity, which can be described as exercise intolerance.

Associated Effects

Postural orthostatic tachycardia syndrome can be associated with other dysautonomia or nervous system syndromes, like neurocardiogenic syncope.
Individuals are often co-diagnosed with other conditions like:
Chronic fatigue syndrome
Ehlers-Danlos syndrome
Fibromyalgia
Migraines
Other autoimmune conditions.
Bowel conditions.

Causes

Usually, standing up causes blood to rush from the torso to the legs. The sudden change means less blood is available for the heart to pump. To compensate, the autonomic nervous system sends signals to the blood vessels to constrict to push more blood to the heart and maintain blood pressure and a normal heart rate. Most individuals do not experience significant changes in blood pressure or pulse when standing up. Sometimes, the body is unable to perform this function correctly.

If blood pressure drops from standing and causes symptoms like lightheadness, it is known as orthostatic hypotension.
If the blood pressure remains normal, but the heart rate gets faster, it is POTS.
The exact factors that cause postural orthostatic tachycardia syndrome are different in individuals but are related to changes in:
The autonomic nervous system, adrenal hormone levels, total blood volume, and poor exercise tolerance. (Robert S. Sheldon et al., 2015)

Autonomic Nervous System

The autonomic nervous system controls blood pressure and heart rate, which are the areas of the nervous system that manage internal bodily functions like digestion, respiration, and heart rate. It is normal for blood pressure to drop slightly and the heart rate to speed up a little when standing. With POTS, these changes are more pronounced.

POTS is considered a type of dysautonomia, which is diminished regulation of the autonomic nervous system.
Several other syndromes are also thought to be related to dysautonomia, like fibromyalgia, irritable bowel syndrome, and chronic fatigue syndrome.
It isn’t clear why the syndrome or any of the other types of dysautonomia develop, but there seems to be a familial predisposition.

Sometimes the first episode of POTS manifests after a health event like:

Pregnancy
Acute infectious illness, for example, a severe case of influenza.
An episode of trauma or concussion.
Major surgery

Diagnosis

A diagnostic evaluation will include a medical history, a physical examination, and diagnostic tests.
The healthcare provider will take blood pressure and pulse at least twice. Once while lying down and once while standing.
Blood pressure measurements and pulse rate lying down, sitting, and standing are orthostatic vitals.
Typically, standing up increases the heart rate by 10 beats per minute or less.
With POTS, heart rate increases by 30 beats per minute while blood pressure remains unchanged. (Dysautonomia International. 2019)
The heart rate stays elevated for over a few seconds upon standing/usually 10 minutes or more.
Symptoms happen frequently.
Lasts more than a few days.

Positional pulse changes are not the only diagnostic consideration for postural orthostatic tachycardia syndrome, as individuals can experience this change with other conditions.

Tests

Some experts use a tilt-table test for the initial diagnosis and monitor therapy. (National Institutes of Health. National Center for Advancing Translational Sciences. Genetic and Rare Diseases Information Center. 2023)
During this test, blood pressure and pulse are measured several times when lying on a table and when the table is moved to an upright position.

Differential Diagnosis

There are various causes of dysautonomia, syncope, and orthostatic hypotension.
Throughout the evaluation, the healthcare provider may look at other conditions, like dehydration, deconditioning from prolonged bed rest, and diabetic neuropathy.
Medications like diuretics or blood pressure medication can cause similar effects.

Treatment

Several approaches are used in managing POTS, and individuals may require a multidisciplinary approach. The healthcare provider will advise regularly checking blood pressure and pulse at home to discuss the results when going in for medical checkups.

Fluids and Diet

Drinking non-caffeinated fluids can keep the body hydrated.
A healthcare provider can calculate the right amount of fluids that are needed each day.
Overnight dehydration is common, so it is especially important to drink fluids first thing in the morning, preferably before getting out of bed and standing.
It is also important to maintain adequate sodium levels. (National Institutes of Health. National Center for Advancing Translational Sciences. Genetic and Rare Diseases Information Center. 2023)

Exercise Therapy

Exercise and physical therapy can help the body learn to adjust to an upright position.
Because it can be challenging to exercise when dealing with POTS, a targeted exercise program under supervision may be required.
An exercise program may begin with swimming or using rowing machines, which do not require upright posture. (Dysautonomia International. 2019)
After a month or two, walking, running, or cycling may be added.
Studies have shown that individuals with POTS, on average, have smaller cardiac chambers than individuals who don’t have the condition.
Regular aerobic exercise has been shown to increase cardiac chamber size, slow heart rate, and improve symptoms. (Qi Fu, Benjamin D. Levine. 2018)
Individuals must continue an exercise program for the long term to keep symptoms from returning.

Medication

Prescription medications to manage POTS include midodrine, beta-blockers, pyridostigmine – Mestinon, and fludrocortisone. (Dysautonomia International. 2019)
Ivabradine, used for the heart condition of sinus tachycardia, has also been used effectively in some individuals.

Conservative Interventions

Other ways to help prevent symptoms include:

Sleeping in the head-up position by elevating the head of the bed off the ground 4 to 6 inches utilizing an adjustable bed, blocks of wood, or risers.
This increases the blood volume in circulation.
Performing countermeasure maneuvers like squatting, squeezing a ball, or crossing the legs. (Qi Fu, Benjamin D. Levine. 2018)
Wearing compression stockings to prevent too much blood from flowing into the legs when standing can help avoid orthostatic hypotension. (Dysautonomia International. 2019)

Conquering Congestive Heart Failure

References

National Institutes of Health. National Center for Advancing Translational Sciences. Genetic and Rare Diseases Information Center (GARD). (2023). Postural orthostatic tachycardia syndrome.

Sheldon, R. S., Grubb, B. P., 2nd, Olshansky, B., Shen, W. K., Calkins, H., Brignole, M., Raj, S. R., Krahn, A. D., Morillo, C. A., Stewart, J. M., Sutton, R., Sandroni, P., Friday, K. J., Hachul, D. T., Cohen, M. I., Lau, D. H., Mayuga, K. A., Moak, J. P., Sandhu, R. K., & Kanjwal, K. (2015). 2015 heart rhythm society expert consensus statement on the diagnosis and treatment of postural tachycardia syndrome, inappropriate sinus tachycardia, and vasovagal syncope. Heart rhythm, 12(6), e41–e63. doi.org/10.1016/j.hrthm.2015.03.029

Dysautonomia International. (2019). Postural Orthostatic Tachycardia Syndrome

Fu, Q., & Levine, B. D. (2018). Exercise and non-pharmacological treatment of POTS. Autonomic neuroscience : basic & clinical, 215, 20–27. doi.org/10.1016/j.autneu.2018.07.001

Maintaining a Healthy Fitness Level: Taking A Workout Break

Dr. Alex Jimenez

Young fitness woman taking a break after jogging and listening to music on smartphone

“For athletes, fitness enthusiasts, and individuals getting into regular exercise, can a workout break be beneficial if structured properly?”

Table of Contents

Workout Break

Giving oneself permission to take a break from exercising is necessary, especially to maintain a current fitness level. To stay fit at every level and injury-free, the body needs rest and recovery, especially to progress in performance levels. Regular exercise is important for:

Building endurance
Improving strength
Losing and maintaining weight
Relieving stress

What Is It?

A voluntary pause/workout break is a dedicated amount of time when the individual chooses not to work out. It is typically a response to individual body cues when the person knows their mind and body need to take a break from exercising. A workout break is different than a rest day as it may last one or two weeks from the regular training routine. Individuals may need to take a break because the workouts are becoming boring and/or the possibility of burning out or overtraining.

Fitness Impact

Studies on recreational soccer players showed that three to six weeks of inactivity did not change aerobic capacity and muscle strength. (Chang Hwa Joo. 2018)
Extremely fit individuals will experience a rapid drop in fitness during the first three weeks of inactivity before leveling off. (Chang Hwa Joo. 2018)
It takes about two months of inactivity to lose the gains made completely. (Jonny St-Amand et al., 2012)

Medical experts provide terms for individuals who may be doing too much:

Overreaching is when the training becomes excessive, and performance begins to fall. It can be short- or long-term.
Overtraining occurs when overreaching is not addressed.
Overtraining syndrome/OTS lasts longer and results in more serious performance setbacks along with symptoms like hormone changes, depression, fatigue, and systemic inflammation. (Jeffrey B. Kreher. 2016)
Overreaching or overtraining feels like fitness progress is moving backward instead of forward. The more training, the slower and more fatigued the body becomes.
Endurance athletes have an increased risk of overreaching and overtraining. (Jeffrey B. Kreher. 2016)
The endurance mindset encourages pushing more hours of training to get stronger and faster. However, at a certain point, performance suffers.
Some research suggests using the term paradoxical deconditioning syndrome that can lead to overtraining. (Flavio A. Cadegiani, Claudio Elias Kater. 2019)

Break Benefits

Taking a break allows the restoration of balance to focus on work or school, manage various life events, and enjoy friends and family time. Studies have suggested that achieving a better work/life balance can improve:

Job performance and satisfaction.
Organization
Life and family satisfaction.
Fitness, life balance, and health vary for everybody. (Andrea Gragnano et al., 2020)
Overtraining usually results from training too much and insufficient recovery.
Fitness and training experts recommend rest and light training as therapy for overtraining. (Jeffrey B. Kreher. 2016)

Signs The Body Needs A Break

A few signs and common symptoms may indicate a workout break may be needed.

Constantly unmotivated or bored
Not looking forward to working out
Poor performance
Physical exhaustion
Fatigue
Soreness that does not resolve
Lack of progress in workouts

Alternate Activities

During the workout break, engage in other active things that work the body differently, like playing table tennis, for example, or activities that are fun but keep the body moving without doing hard workouts. Remember, the body doesn’t have to be completely inactive. Individuals can try out:

Leisurely bike riding
Dancing
Climbing
Easy yardwork
Yoga or Pilates
Stretching

Returning To Working Out

It could feel like starting over, but it won’t take long for the body to remember how to exercise. It just needs to get used to working out again. It can be tempting to jump into an all-out workout routine, but that is not recommended because of the risk of injury. Here are a few basic principles to keep the body strong and healthy while easing back into a regular workout routine.

Start Simple

Start with a lighter version of the regular routine using lighter weights and less intensity.

Give The Body Time

Use the first two weeks for the body to get used to the workouts.
It can take up to three weeks to get back, depending on workouts before and how much relaxation time has passed.

Take Extra Rest Days

Returning to exercise means the body is going to be extra sore.
Plan extra recovery days so the body can heal and gain strength.
Each week, gradually increase the intensity until it is back to regular performance.

Revolutionizing Healthcare

References

Joo C. H. (2018). The effects of short term detraining and retraining on physical fitness in elite soccer players. PloS one, 13(5), e0196212. doi.org/10.1371/journal.pone.0196212

St-Amand, J., Yoshioka, M., Nishida, Y., Tobina, T., Shono, N., & Tanaka, H. (2012). Effects of mild-exercise training cessation in human skeletal muscle. European journal of applied physiology, 112(3), 853–869. doi.org/10.1007/s00421-011-2036-7

Kreher J. B. (2016). Diagnosis and prevention of overtraining syndrome: an opinion on education strategies. Open access journal of sports medicine, 7, 115–122. doi.org/10.2147/OAJSM.S91657

Cadegiani, F. A., & Kater, C. E. (2019). Novel insights of overtraining syndrome discovered from the EROS study. BMJ open sport & exercise medicine, 5(1), e000542. doi.org/10.1136/bmjsem-2019-000542

Gragnano, A., Simbula, S., & Miglioretti, M. (2020). Work-Life Balance: Weighing the Importance of Work-Family and Work-Health Balance. International journal of environmental research and public health, 17(3), 907. doi.org/10.3390/ijerph17030907

A Healthy Snack Option – Sunflower Seeds Explained

Dr. Alex Jimenez

Composition with sunflower, oil and seeds on wooden background

“For individuals looking for a quick healthy snack, can adding sunflower seeds to one’s diet provide health benefits?”

Table of Contents

Sunflower Seeds

Sunflower seeds are the fruit of the sunflower plant. They have been found to contain antioxidants, vitamins, and minerals, which can help maintain immune system health, heart health, and more. Regularly grabbing a handful as a snack or adding to salads, oatmeal, baked goods, tuna salad, pasta, and vegetable toppings can help increase energy levels, reduce inflammation, and support general body health.

Benefits

Sunflower seeds are beneficial for various bodily functions and protect against certain chronic health conditions. They can help with the following: (Bartholomew Saanu Adeleke, Olubukola Oluranti Babalola. 2020) (Ancuţa Petraru, Florin Ursachi, Sonia Amariei. 2021)

Inflammation

The seed’s high vitamin E value, combined with flavonoids and various plant compounds, can help reduce inflammation.
Research suggests that eating seeds at least five times a week may reduce inflammation and lower the risk of developing certain diseases. (Rui Jiang et al., 2006)

Heart Health

They are high in healthy fats, like polyunsaturated and monounsaturated fats.
Plant sterols, or the natural compounds in sunflower seeds, are recommended for their cholesterol-lowering properties. (University of Wisconsin Health. 2023)
Data show sunflower and other seeds consumption may lower rates of heart disease, high blood pressure, and high cholesterol.

Energy

The seeds contain vitamin B, selenium, and protein, which can help energize the body throughout the day.
These nutrients support blood circulation, oxygen delivery, and food conversion into energy.

Immune System Support

Sunflower seeds contain minerals and nutrients like zinc and selenium that help the body’s natural ability to defend against viruses and bacteria.
These minerals translate into benefits like immune cell maintenance, inflammation reduction, infection protection, and an overall increase in immunity.

Nutrition

Individuals don’t need to consume a lot of sunflower seeds to gain the nutritional benefits. Inside is a well-rounded mix of healthy fats, antioxidants, and other nutrients. Inside a 1-ounce portion of roasted sunflower seeds/without salt: (U.S. Department of Agriculture. 2018)

Calories – 165
Carbohydrates – 7 grams
Fiber – 3 grams
Sugar – 1 grams
Protein – 5.5 grams
Total fat – 14 grams
Sodium – 1 milligrams
Iron – 1 milligram
Vitamin E – 7.5 milligrams
Zinc – 1.5 milligrams
Folate – 67 micrograms

Female Health

When it comes to female reproductive health, there are aspects that the seeds may be able to help support.
The seed’s rich amounts of vitamin E, folate, phosphorus, and healthy fats are crucial for fetal development and maternal health.
In addition, the seeds’ phytochemicals can support digestion and the immune system, which can be beneficial during pregnancy. (National Institutes of Health Office of Dietary Supplements. 2021)

Male Health

Sunflower seeds can help males acquire protein for muscle-building.
As an alternative to meat, these seeds contain a healthy amount of plant-based protein without the additional saturated fat or cholesterol of meat.
A handful provides this nutrient for those who don’t get the daily potassium requirement. (Ancuţa Petraru, Florin Ursachi, Sonia Amariei. 2021)

Shelled Seeds and Salt Intake

Sunflower seeds naturally do not contain high amounts of sodium, but they are often packaged with added salt that can potentially sabotage their nutritional benefits.
The shells are usually coated in salt for flavor, as much as 70 milligrams for every 1 ounce of seeds.
High in calories, individuals should consider moderating portions to one-quarter cup and eating the unsalted varieties. (U.S. Department of Agriculture. 2018)

Other Ways To Incorporate Seeds Into Meals

Other ways to add sunflower seeds to meals include:

Sprinkling them on chicken or a tuna salad.
Salad topping.
Topping for cereal and oatmeal.
Mixing them into batter for baked goods, like cookies.
Adding them to homemade or grocery store trail mix.
Grinding the seeds for a flour coating for meat or fish.
Sprinkling them into vegetable dishes, casseroles, stir-fries, and pasta.
Sunflower butter can be an alternative to peanut or other nut butters.

Sports Injury Rehabilitation

References

Adeleke, B. S., & Babalola, O. O. (2020). Oilseed crop sunflower (Helianthus annuus) as a source of food: Nutritional and health benefits. Food science & nutrition, 8(9), 4666–4684. doi.org/10.1002/fsn3.1783

Petraru, A., Ursachi, F., & Amariei, S. (2021). Nutritional Characteristics Assessment of Sunflower Seeds, Oil and Cake. Perspective of Using Sunflower Oilcakes as a Functional Ingredient. Plants (Basel, Switzerland), 10(11), 2487. doi.org/10.3390/plants10112487

Jiang, R., Jacobs, D. R., Jr, Mayer-Davis, E., Szklo, M., Herrington, D., Jenny, N. S., Kronmal, R., & Barr, R. G. (2006). Nut and seed consumption and inflammatory markers in the multi-ethnic study of atherosclerosis. American journal of epidemiology, 163(3), 222–231. doi.org/10.1093/aje/kwj033

University of Wisconsin Health. (2023). Health facts for you: Plant stanols and sterols.

U.S. Department of Agriculture. (2018). Seeds, sunflower seed kernels, dry roasted, without salt.

National Institutes of Health Office of Dietary Supplements. (2021). Vitamin E: Fact Sheet for Health Professionals.

U.S. Department of Agriculture. (2018). Seeds, sunflower seed kernels, toasted, with salt added.

How to Reduce Chronic Tension Headaches

Dr. Alex Jimenez

Chiropractor readjusting the cervical of a patient lying on a stretcher in a clinic

“For individuals affected by headaches that occur 15 or more days a month for more than three months, can knowing the signs and symptoms help healthcare providers help treat and prevent chronic tension headaches?”

Table of Contents

Chronic Tension Headaches

Most individuals have experienced a tension-type headache. The pain is usually described as a dull tightening or pressure on both sides of the head, like having a tightening band around the head. Some individuals experience these headaches frequently, a condition known as chronic tension headaches. Chronic tension headaches are uncommon but can be debilitating, as they can interfere with a healthy quality of life and daily living.

Tension headaches are typically caused by stress, anxiety, dehydration, fasting, or lack of sleep and usually resolve with over-the-counter medications. (Cleveland Clinic. 2023)
This is a primary headache disorder that affects around 3% of the population.
Chronic tension headaches can occur daily and negatively impact the quality of life and daily functioning. (Cleveland Clinic. 2023)

Symptoms

Tension headaches can be referred to as stress headaches or muscle contraction headaches.
They can present with dull, aching pain and include tightness or pressure across the forehead, sides, or back of the head. (Cleveland Clinic. 2023)
Additionally, some individuals experience tenderness on the scalp, neck, and shoulders.
Chronic tension headaches materialize 15 or more days a month on average for more than three months.
The headache can last for several hours or be continuous for several days.

Causes

Tension headaches are typically caused by tight muscles in the shoulders, neck, jaw, and scalp.
Teeth grinding/bruxism and jaw clenching can also contribute to the condition.
Headaches can be brought on by stress, depression, or anxiety and are more common in individuals who:
Work long hours in stressful jobs.
Don’t get enough sleep.
Skip meals.
Frequently consume alcohol. (Cleveland Clinic. 2023)

Diagnosis

Individuals experiencing headaches that interfere with daily life or need to take medication more than twice a week are recommended to consult a healthcare provider. Before the appointment, it can be helpful to keep a headache diary:

Record the days
Times
Description of the pain, intensity, and other symptoms.

Some questions the healthcare provider may ask include:

Is the pain pulsating, sharp, or stabbing, or is it constant and dull?
Where is the pain most intense?
Is it all over the head, on one side, on the forehead, or behind the eyes?
Do the headaches interfere with sleep?
Is working or doing tasks difficult or impossible?

A healthcare provider will likely be able to diagnose the condition based on symptoms alone. However, if the headache pattern is unique or different, the provider may order imaging tests, like MRI or CT scans, to rule out other diagnoses. Chronic tension headaches can be confused with other chronic daily headache disorders like chronic migraine, hemicrania continua, temporomandibular joint dysfunction/TMJ, or cluster headaches. (Fayyaz Ahmed. 2012)

Treatment

Pharmacological therapy for chronic tension headaches usually involves preventive medication.

Amitriptyline is one medication that has been found to be beneficial in chronic tension headache prevention.
A tricyclic antidepressant is a sedating medication and is usually taken before sleeping. (Jeffrey L. Jackson et al., 2017)
According to a meta-analysis of 22 published studies in the Journal of General Internal Medicine, these medications are superior to placebo in reducing headache frequency, with an average of 4.8 fewer headache days per month.

Additional preventive medications may include other antidepressants like:

Remeron – mirtazapine.
Anti-seizure medications – like Neurontin – gabapentin, or Topamax – topiramate.

A healthcare provider may also prescribe medication to treat headache episodes, which include:

Prescription non-steroidal anti-inflammatory drugs or NSAIDs, including acetaminophen, naproxen, indomethacin, or ketorolac.
Opiates
Muscle relaxants
Benzodiazepines – Valium

Non-Medication Treatment

Behavioral therapies are sometimes used on their own or in combination with medication to prevent and manage chronic tension headaches. Examples include:

Acupuncture

An alternative therapy that involves using needles to stimulate specific points on the body believed to connect with certain pathways/meridians that carry vital energy/chi throughout the body.

Biofeedback

In Electromyography – EMG biofeedback, electrodes are placed on the scalp, neck, and upper body to detect muscle contraction.
The patient is trained to control muscle tension to prevent headaches. (William J. Mullally et al., 2009)
The process can be costly and time-consuming, and there is little evidence to support its effectiveness.

Physical Therapy

A physical therapist can work out stiff and tight muscles.
Train individuals on stretches and targeted exercises for loosening tight head and neck muscles.

Cognitive Behavioral Therapy/CBT

Involves learning how to identify headache triggers and cope in a less stressful and more adaptive way.
Headache specialists often recommend CBT in addition to medication when developing a treatment plan. (Katrin Probyn et al., 2017)
Teeth-grinding and jaw-clenching training/treatment can help when they are contributors.
Regular exercise, as well as practicing healthy sleep hygiene, can be beneficial in prevention.

Supplements

Some individuals with chronic tension headaches may find relief using supplements. The American Academy of Neurology and the American Headache Society report the following supplements can be effective: (National Center for Complementary and Integrative Health. 2021)

Butterbur
Feverfew
Magnesium
Riboflavin

If the headaches come on suddenly, cause waking up from sleep, or last for days, it’s important to consult a healthcare provider to rule out any underlying causes and develop a personalized treatment plan.

Tension Headaches

References

Cleveland Clinic. (2023). Tension Headaches.

Ahmed F. (2012). Headache disorders: differentiating and managing the common subtypes. British journal of pain, 6(3), 124–132. doi.org/10.1177/2049463712459691

Jackson, J. L., Mancuso, J. M., Nickoloff, S., Bernstein, R., & Kay, C. (2017). Tricyclic and Tetracyclic Antidepressants for the Prevention of Frequent Episodic or Chronic Tension-Type Headache in Adults: A Systematic Review and Meta-Analysis. Journal of general internal medicine, 32(12), 1351–1358. doi.org/10.1007/s11606-017-4121-z

Mullally, W. J., Hall, K., & Goldstein, R. (2009). Efficacy of biofeedback in the treatment of migraine and tension type headaches. Pain physician, 12(6), 1005–1011.

Probyn, K., Bowers, H., Mistry, D., Caldwell, F., Underwood, M., Patel, S., Sandhu, H. K., Matharu, M., Pincus, T., & CHESS team. (2017). Non-pharmacological self-management for people living with migraine or tension-type headache: a systematic review including analysis of intervention components. BMJ open, 7(8), e016670. doi.org/10.1136/bmjopen-2017-016670

National Center for Complementary and Integrative Health. (2021). Headaches: What You Need To Know.

Diagnosis & Treatment of Spinal Synovial Cysts

Dr. Alex Jimenez

Physiatrist examining patient for sciatica using straight leg raise test — Smiling adult man lying supine on examination bed while physiotherapist lifting his extended lower limb with resistance

“Individuals that have gone through a back injury may develop a synovial spinal cyst as a way to protect the spine that could cause pain symptoms and sensations. Can knowing the signs help healthcare providers develop a thorough treatment plan to relieve pain and prevent worsening of the condition and other spinal conditions?”

Table of Contents

Spinal Synovial Cysts

Spinal synovial cysts are benign fluid-filled sacs that develop in the spine’s joints. They form because of spinal degeneration or injury. The cysts can form anywhere in the spine, but most occur in the lumbar region/lower back. They typically develop in the facet joints or junctions that keep the vertebrae/spinal bones interlocked.

Symptoms

In most cases, synovial cysts don’t cause symptoms. However, the doctor or specialist will want to monitor for signs of degenerative disc disease, spinal stenosis, or cauda equina syndrome. When symptoms do present, they typically cause radiculopathy or nerve compression, which can cause back pain, weakness, numbness, and radiating pain caused by the irritation. The severity of symptoms depends on the size and location of the cyst. Synovial cysts can affect one side of the spine or both and can form at one spinal segment or at multiple levels.

Effects Can Include

Radiculopathy symptoms can develop if the cyst or inflammation caused by the cyst comes into contact with a spinal nerve root. This can cause sciatica, weakness, numbness, or difficulty controlling certain muscles.
Neurogenic claudication/impingement and inflammation of spinal nerves can cause cramping, pain, and/or tingling in the lower back, legs, hips, and buttocks. (Martin J. Wilby et al., 2009)
If the spinal cord is involved, it may cause myelopathy/severe spinal cord compression that can cause numbness, weakness, and balance problems. (Dong Shin Kim et al., 2014)
Symptoms related to cauda equina, including bowel and/or bladder problems, leg weakness, and saddle anesthesia/loss of sensation in the thighs, buttocks, and perineum, can present but are rare, as are synovial cysts in the middle back and neck. If thoracic and cervical synovial cysts develop, they can cause symptoms like numbness, tingling, pain, or weakness in the affected area.

Causes

Spinal synovial cysts are generally caused by degenerative changes like osteoarthritis that develop in a joint over time. With regular wear and tear, facet joint cartilage/the material in a joint that provides protection, a smooth surface, friction reduction, and shock absorption begins to waste away. As the process continues, the synovium can form a cyst.

Traumas, large and small, have inflammatory and degenerative effects on joints that can result in the formation of a cyst.
Around a third of individuals who have a spinal synovial cyst also have spondylolisthesis.
This condition is when a vertebrae slips out of place or out of alignment onto the vertebra underneath.
It is a sign of spinal instability.
Instability can occur in any spine area, but L4-5 are the most common levels.
This segment of the spine takes most of the upper body weight.
If instability occurs, a cyst can develop.
However, cysts can form without instability.

Diagnosis

Cysts are generally diagnosed through MRI. (Nancy E, Epstein, Jamie Baisden. 2012)
They can sometimes be seen with ultrasound, X-ray, or CT scans.

Treatment

Some cysts remain small and cause few to no symptoms. Cysts only need treatment if they are causing symptoms. (Nancy E, Epstein, Jamie Baisden. 2012)

Lifestyle Adjustments

A healthcare professional will recommend avoiding certain activities that worsen symptoms.
Individuals might be advised to begin stretching and targeted exercises.
Physical therapy or occupational therapy may also be recommended.
Intermittent use of over-the-counter nonsteroidal anti-inflammatories/NSAIDs like ibuprofen and naproxen can help relieve occasional pain.

Outpatient Procedures

For cysts that cause intense pain, numbness, weakness, and other issues, a procedure to drain fluid/aspiration from the cyst may be recommended.
One study found that the success rate ranges from 0 percent to 50 percent.
Individuals who go through aspiration usually need repeat procedures if fluid build-up returns. (Nancy E, Epstein, Jamie Baisden. 2012)
Epidural corticosteroid injections can reduce inflammation and could be an option to relieve pain.
Patients are recommended to receive no more than three injections per year.

Surgical Options

For severe or persistent cases, a doctor may recommend decompression surgery to remove the cyst and surrounding bone to relieve pressure on the nerve root. Surgical options range from minimally invasive endoscopic procedures to larger, open surgeries. The best surgical option varies based on the severity of the situation and whether associated disorders are present. Surgical options include:

Laminectomy – Removal of the bony structure that protects and covers the spinal canal/lamina.
Hemilaminectomy – A modified laminectomy where a smaller portion of the lamina is removed.
Facetectomy – The removal of part of the affected facet joint where the synovial cyst is located, usually following a laminectomy or hemilaminectomy.
Fusion of the facet joints and vertebra – Decreases vertebral mobility in the injured area.

Most individuals experience immediate pain relief following a laminectomy or hemilaminectomy.
Fusion can take six to nine months to heal completely.
If surgery is performed without fusion where the cyst originated, the pain could return, and another cyst could form within two years.
Surgery Complications include infection, bleeding, and injury to the spinal cord or nerve root.

How I Gained My Mobility Back With Chiropractic

References

Wilby, M. J., Fraser, R. D., Vernon-Roberts, B., & Moore, R. J. (2009). The prevalence and pathogenesis of synovial cysts within the ligamentum flavum in patients with lumbar spinal stenosis and radiculopathy. Spine, 34(23), 2518–2524. doi.org/10.1097/BRS.0b013e3181b22bd0

Kim, D. S., Yang, J. S., Cho, Y. J., & Kang, S. H. (2014). Acute myelopathy caused by a cervical synovial cyst. Journal of Korean Neurosurgical Society, 56(1), 55–57. doi.org/10.3340/jkns.2014.56.1.55

Epstein, N. E., & Baisden, J. (2012). The diagnosis and management of synovial cysts: Efficacy of surgery versus cyst aspiration. Surgical neurology international, 3(Suppl 3), S157–S166. doi.org/10.4103/2152-7806.98576

A Guide to Jalapeños: Nutritional Value and Benefits

Dr. Alex Jimenez

Homemade Preserved Pickled Jalapeno Peppers in a Bowl

“For individuals looking to spice up their diet, can jalapeño peppers provide nutrition and be a good source of vitamins?”

Table of Contents

Jalapeño Pepper Nutrition

Jalapeños are one of many types of chili peppers that are used to accent or garnish and add heat to a dish. This pepper variety is generally harvested and sold when it is a glossy dark green but turns red as it matures. The following nutrition information for one 14-gram jalapeño pepper. (FoodData Central. U.S. Department of Agriculture. 2018)

Calories – 4
Fat – 0.05-grams
Sodium – 0.4 – milligrams
Carbohydrates – 0.5-grams
Fiber – 0.4 – grams
Sugars – 0.6 – grams
Protein – 0.1 – grams

Carbohydrates

Jalapeño peppers contain very little carbohydrates and cannot be tested with the standard GI methodology. (Fiona S. Atkinson et al., 2008)
6 grams of carbohydrates in 1-cup serving has an extremely low glycemic load, meaning the peppers do not raise blood sugar levels rapidly or provoke an insulin response. (Mary-Jon Ludy et al., 2012)

Fat

Jalapeños have a trace amount of fat that is mostly unsaturated.

Protein

The peppers are not a recommended source of protein, as they contain less than a gram of protein in a full cup of sliced jalapeños.

Vitamins and Minerals

One pepper contains about 16 milligrams of vitamin C, about 18% of the recommended daily allowance/RDA.
This vitamin is important for many essential functions, including wound healing and immune function, and must be acquired through diet. (National Institutes of Health Office of Dietary Supplements. 2021)
Jalapeños are a good source of vitamin A, which supports skin and eye health.
In 1/4 cup sliced jalapeño peppers, individuals acquire around 8% of the recommended daily amount of vitamin A for men and 12% for women.
Jalapeños are also a source of vitamins B6, K, and E.

Health Benefits

Many health benefits have been attributed to capsaicin which is the substance that generates the heat in the peppers, including alleviating pain and itching by blocking a neuropeptide that transmits those signals to the brain. (Andrew Chang et al., 2023)

Pain Relief

Research shows capsaicin – supplements or topical ointments/creams – can relieve nerve and joint pain. (Andrew Chang et al., 2023)

Lower the Risk of Heart Disease

A study of individuals with low levels of healthy HDL cholesterol, who are at risk of coronary heart disease/CHD, showed that capsaicin supplements improved risk factors for CHD. (Yu Qin et al., 2017)

Reduce Inflammation

The vitamin C in the peppers acts as an antioxidant, which means it can repair cells damaged by oxidative stress and reduce inflammation.
Inflammation and stress can contribute to chronic diseases like obesity, diabetes, and some cancers. (National Institutes of Health Office of Dietary Supplements. 2021)

Allergies

Hot peppers are related to sweet or bell peppers and are members of the nightshade family.
Allergies to these foods are possible but rare. (American Academy of Allergy Asthma and Immunology. 2017)
Sometimes individuals with pollen allergies can cross-react to raw fruits and vegetables, including different types of peppers.
The capsaicin in jalapeño and other hot peppers can irritate the skin and the eyes, even in individuals with no allergies.
It is recommended to wear gloves when handling hot peppers and avoid touching your face.
Wash hands, utensils, and work surfaces thoroughly when finished.

Adverse Effects

When fresh, jalapeño peppers can have varying heat levels.
They range from 2,500 to 10,000 Scoville units.

Varieties

Jalapeños are one variety of hot peppers.
They can be consumed raw, pickled, canned, or smoked/chipotle peppers and are hotter than fresh or canned because they are dried and treated.

Storage and Safety

Fresh jalapeños can be stored at room temperature for a few days or in the refrigerator for about a week.
Once a jar is opened, keep it in the refrigerator.
For an open can of peppers, transfer to a glass or plastic container for refrigerator storage.
Peppers can be frozen after preparing by cutting off the stems and scooping out the seeds.
Frozen jalapeños are best within 6 months for the best quality, but can be kept for much longer.

Preparation

Removing the seeds can help reduce the heat.
Jalapeños can be eaten whole or sliced and added to salads, marinades, salsa, or cheeses.
Some add jalapeños to smoothies for a spicy kick.
They can be used in various recipes for added heat and tanginess.

Chiropractic, Fitness, and Nutrition

References

FoodData Central. U.S. Department of Agriculture. (2018). Peppers, jalapeno, raw.

Atkinson, F. S., Foster-Powell, K., & Brand-Miller, J. C. (2008). International tables of glycemic index and glycemic load values: 2008. Diabetes care, 31(12), 2281–2283. doi.org/10.2337/dc08-1239

Ludy, M. J., Moore, G. E., & Mattes, R. D. (2012). The effects of capsaicin and capsiate on energy balance: critical review and meta-analyses of studies in humans. Chemical senses, 37(2), 103–121. doi.org/10.1093/chemse/bjr100

National Institutes of Health Office of Dietary Supplements. (2021). Vitamin C: Fact Sheet for Health Professionals.

Chang A, Rosani A, Quick J. Capsaicin. [Updated 2023 May 23]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK459168/

Qin, Y., Ran, L., Wang, J., Yu, L., Lang, H. D., Wang, X. L., Mi, M. T., & Zhu, J. D. (2017). Capsaicin Supplementation Improved Risk Factors of Coronary Heart Disease in Individuals with Low HDL-C Levels. Nutrients, 9(9), 1037. doi.org/10.3390/nu9091037

American Academy of Allergy Asthma and Immunology. (2017). Ask the Expert: Pepper Allergy.

The Benefits of Using an Adjustable Stand Desk at Work

Dr. Alex Jimenez

Standing Workplace. Working in Standing Position. Standing desk for work from home or in office. Young woman programmer working while standing in office.

“For individuals working at a desk or workstation where the majority of the work is done in a sitting position and increases the risk for a variety of health problems, can using a standing desk help prevent musculoskeletal problems and improve short and long-term wellness?”

Table of Contents

Stand Desks

More than 80% of jobs are done in a seated position. Stand desks have proven to help. (Allene L. Gremaud et al., 2018) An adjustable stand desk is intended to be the standing height of an individual. Some desks can be lowered to use while sitting. These desks can improve:

Blood circulation
Back pain
Energy
Focus
Individuals who are less sedentary may experience decreased depression, anxiety, and risk of chronic disease.

Improve Posture and Decrease Back Pain

Sitting for prolonged periods can cause fatigue and physical discomfort. Back pain symptoms and sensations are common, especially when practicing unhealthy postures, already dealing with existing back problems, or using a non-ergonomic desk set-up. Instead of only sitting or standing for the whole workday, alternating between sitting and standing is far healthier. Practicing sitting and standing regularly reduces body fatigue and lower back discomfort. (Alicia A. Thorp et al., 2014) (Grant T. Ognibene et al., 2016)

Increases Energy Levels

Prolonged sitting correlates with fatigue, reduced energy, and productivity. A sit-stand desk can provide benefits like increased productivity levels. Researchers discovered that sit-stand desks could improve the general health and productivity of office workers. Individuals in the study reported:

A significant increase in subjective health.
Increased energy in work tasks.
Improved work performance. (Jiameng Ma et al., 2021)

Chronic Disease Reduction

According to the CDC, six in 10 individuals in the U.S. have at least one chronic disease, like diabetes, heart disease, stroke, or cancer. Chronic disease is the leading cause of death and disability, as well as a leading force of healthcare costs. (Centers for Disease Control and Prevention. 2023) While further research is needed to see if standing desks can reduce the risk of chronic disease, one study looked to quantify the association between sedentary time and the risk of chronic disease or death. Researchers reported that sedentariness for prolonged periods was independently associated with negative health outcomes regardless of physical activity. (Aviroop Biswas et al., 2015)

Improved Mental Focus

Sitting for extended periods slows down blood circulation. This decreased blood flow to the brain lowers cognitive function and increases the risk of neurodegenerative conditions. One study confirmed that healthy individuals who worked in a prolonged sitting position had reduced brain blood flow. The study found that frequent, short walks could help prevent this. (Sophie E. Carter et al., 2018) Standing increases blood and oxygen circulation. This improves cognitive function, which also helps improve focus and concentration.

Depression and Anxiety Reduction

Modern lifestyles typically contain large amounts of sedentary behavior.

However, there is a small amount about the mental health risks of prolonged sedentary behavior. There have been a few studies aimed at improving public understanding. One study focused on a group of older adults, having them self-report sedentary habits that included television, internet, and reading time. This information was compared to their individual scoring on the Centre of Epidemiological Studies Depression scale. (Mark Hamer, Emmanuel Stamatakis. 2014)

The researchers found that certain sedentary behaviors are more harmful to mental health than others.
Television watching, for example, resulted in increased depressive symptoms and decreased cognitive function. (Mark Hamer, Emmanuel Stamatakis. 2014)
Internet use had the opposite effect, decreasing depressive symptoms and increasing cognitive function.
Researchers theorize that the results come from the contrasting environmental and social contexts in which they are happening. (Mark Hamer, Emmanuel Stamatakis. 2014)
Another study looked at the possible correlation between sedentary behavior and anxiety.
Increased amounts of sedentary behavior, especially sitting, seemed to increase the risk of anxiety. (Megan Teychenne, Sarah A Costigan, Kate Parker. 2015)

Incorporating a standing desk into the workspace can help to reduce the negative effects of sedentary behaviors, leading to improved productivity, improved mental and physical health, and a healthy work environment for individuals who work long hours at a desk or workstation.

Understanding Academic Low Back Pain: Impact and Chiropractic Solutions

References

Gremaud, A. L., Carr, L. J., Simmering, J. E., Evans, N. J., Cremer, J. F., Segre, A. M., Polgreen, L. A., & Polgreen, P. M. (2018). Gamifying Accelerometer Use Increases Physical Activity Levels of Sedentary Office Workers. Journal of the American Heart Association, 7(13), e007735. doi.org/10.1161/JAHA.117.007735

Thorp, A. A., Kingwell, B. A., Owen, N., & Dunstan, D. W. (2014). Breaking up workplace sitting time with intermittent standing bouts improves fatigue and musculoskeletal discomfort in overweight/obese office workers. Occupational and environmental medicine, 71(11), 765–771. doi.org/10.1136/oemed-2014-102348

Ognibene, G. T., Torres, W., von Eyben, R., & Horst, K. C. (2016). Impact of a Sit-Stand Workstation on Chronic Low Back Pain: Results of a Randomized Trial. Journal of occupational and environmental medicine, 58(3), 287–293. doi.org/10.1097/JOM.0000000000000615

Ma, J., Ma, D., Li, Z., & Kim, H. (2021). Effects of a Workplace Sit-Stand Desk Intervention on Health and Productivity. International journal of environmental research and public health, 18(21), 11604. doi.org/10.3390/ijerph182111604

Centers for Disease Control and Prevention. Chronic disease.

Biswas, A., Oh, P. I., Faulkner, G. E., Bajaj, R. R., Silver, M. A., Mitchell, M. S., & Alter, D. A. (2015). Sedentary time and its association with risk for disease incidence, mortality, and hospitalization in adults: a systematic review and meta-analysis. Annals of internal medicine, 162(2), 123–132. doi.org/10.7326/M14-1651

Carter, S. E., Draijer, R., Holder, S. M., Brown, L., Thijssen, D. H. J., & Hopkins, N. D. (2018). Regular walking breaks prevent the decline in cerebral blood flow associated with prolonged sitting. Journal of applied physiology (Bethesda, Md. : 1985), 125(3), 790–798. doi.org/10.1152/japplphysiol.00310.2018

Hamer, M., & Stamatakis, E. (2014). Prospective study of sedentary behavior, risk of depression, and cognitive impairment. Medicine and science in sports and exercise, 46(4), 718–723. doi.org/10.1249/MSS.0000000000000156

Teychenne, M., Costigan, S. A., & Parker, K. (2015). The association between sedentary behaviour and risk of anxiety: a systematic review. BMC public health, 15, 513. doi.org/10.1186/s12889-015-1843-x

Kinesiology Tape: Guide to Relieving Neck and Shoulder Pain

Dr. Alex Jimenez

Therapist applying kinesio tape on a man's neck — Senior therapist applying kinesio tape on a man's neck during the medical treatment in the office

“Individuals with neck and shoulder pain may experience tightened lumps or knots in and around the muscles where the neck and shoulder meet. Can using kinesiology tape for neck and shoulder trigger points help to loosen and release them, restore function, and relieve pain?”

Table of Contents

Kinesiology Tape For Neck and Shoulder Trigger Points

The upper trapezius and levator scapula muscles are where the shoulder and neck come together and are often the location of trigger point formations. These trigger points can cause tension, pain, and muscular spasms in the neck and shoulders. Various treatments for releasing trigger points and alleviating the pain symptoms include therapeutic massage, trigger point release, and chiropractic adjustments in a multidisciplinary treatment approach.

Electrical stimulation and ultrasound have often been used to break up the knots, but scientific evidence has shown that these treatments alone are not the most effective. (David O. Draper et al., 2010)
Stretching the neck muscles can bring tension relief and help release the knots.
Practicing healthy postures helps avoid and prevent symptoms. (Cleveland Clinic. 2019)
Kinesiology tape can decrease the pain and spasms and help to release the trigger points.

Therapy

Using kinesiology tape is a form of physical therapy that can be used in various ways.

The tape helps lift the upper tissues from underlying tissues to increase circulation and release muscular spasms.
It can help improve muscular contractions, decrease swelling, and inhibit pain in injured tissues.
Helps stop the trigger points and knots from worsening.
The tape can also be used for managing lymphedema.

Usage

To decrease trigger points, individuals can use a specific kinesiology tape strip called a lift strip. Individuals can consult their healthcare provider or physical therapist to show them the various types of strips to learn how to cut them properly.

Before using kinesiology tape, consult a healthcare provider or physical therapist to assess the injury and situation.
Kinesiology tape is not for everyone, and some people have conditions where the use of kinesiology tape should be avoided altogether.
A therapist can evaluate the neck pain and trigger points to determine if the individual should use kinesiology tape.

To use kinesiology tape for neck and shoulder trigger points:

Get comfortable with the neck and shoulders exposed.
Cut one lift strip for each side of the neck, if necessary.
The lift strip should be around 3 to 4 inches long.
Remove the paper backing in the center with the exposed tape in the center, which should look like a band-aid.
Both ends of the lift strip should still have the paper backing on.
Stretch out the kinesiology tape.
Place the stretched tape directly over the trigger points in the upper shoulder area.
Remove the backing on either side of the lift strip and place the ends on without stretching.
Gently rub the tape to help the adhesive adhere.

Once the tape has been applied, it can be left there for 2 to 5 days.
It’s ok if it gets wet with a bath or shower.
Monitor the skin around the tape to watch for redness or other signs of a negative reaction to the tape.
Kinesiology taping can be a useful tool to decrease pain and spasms but does not replace professional treatment, prescribed exercises and stretches, and posture retraining.
The physical therapy team will teach proper self-care strategies for the individual’s condition.
For individuals with neck and shoulder pain and muscle spasms, a trial of kinesiology taping may help alleviate symptoms and improve the overall injury.

The Non-Surgical Approach to Wellness with Chiropractic Care

References

Draper, D. O., Mahaffey, C., Kaiser, D., Eggett, D., & Jarmin, J. (2010). Thermal ultrasound decreases tissue stiffness of trigger points in upper trapezius muscles. Physiotherapy theory and practice, 26(3), 167–172. doi.org/10.3109/09593980903423079

Cleveland Clinic. (2019). Knots in Your Neck? How to Try a Trigger Point Massage to Release Them.

Strength and Stability With Gluteus Minimus Muscles

Dr. Alex Jimenez

Man athlete pain and injury back arm and leg at home, sports injury bodybuilder, concept health and beauty. High quality photo

“For individuals experiencing gluteus minimus pain and are unsure where to start to deal with it, can a physical therapist, chiropractor, or general practitioner help diagnose lower extremity pain and develop an appropriate treatment plan?”

Table of Contents

Gluteus Minimus Muscles

The gluteus minimus is the smallest muscle of the gluteal muscles. Combined with the gluteus maximus and gluteus medius, these muscles make up the glutes. The glutes help form the buttocks shape, stabilize the hips, rotate the legs, and raise the thighs. The gluteus minimus and medius specifically support the gluteus maximus’s ability to raise the leg to the side and rotate the thigh inwards. (ScienceDirect. 2011)

Anatomy

The gluteus minimus muscles are triangular and lie underneath the gluteus medius near the rotators of the hip joints. The muscles start in the lower ilium region, the upper and largest area of the hip bone that makes up the pelvis and attaches to the femur/thigh bone.
The fibers on the top part of the muscle are thick and compact, while the lower fibers are flat and spread out.
The superior gluteal nerves and blood vessels separate the gluteus minimus and the medius.
The gluteus medius muscles start on the upper ilium region, which covers the gluteus minimus muscle entirely. The location of the gluteus minimus muscles envelopes the sciatic notch or the area in the pelvis that houses the piriformis muscle, superior gluteal vein, and superior gluteal artery, which provide a certain amount of protection.

Function

Movement depends on the location of the femur. The gluteus minimus muscle’s function is to:

Flex
Rotate
Stabilize

When the thigh is extended, it helps abduct or swing the leg out away from the body.
When the hip bones are flexed, the gluteus minimus rotates the thigh inward with the help of the gluteus medius.
The movements are done with the support of the muscle fibers, which contract to move the thigh in both directions. (ScienceDirect. 2011)
The gluteus minimus and the medius also stabilize the hips and pelvis during movement and when resting.

Associated Conditions

One of the most common injuries is muscle wearing and tearing, which can cause pain over and around the greater trochanter. This is known as greater trochanteric pain syndrome or GTPS, a condition usually caused by a gluteus medius or minimus tendinopathy, which can include inflammation of the surrounding bursae. (Diane Reid. 2016) For a gluteus minimus tear, the pain/sensations will be felt outside the hip, especially when rolling or applying weight on the affected side. A tear can happen suddenly with no particular activity causing the tear to occur aside from normal use and stress on the muscle. Physical activities like walking may be painful.

Rehabilitation

Treatment depends on the severity of the condition. Usually, rest, ice, and over-the-counter medication can help reduce swelling and pain symptoms. For pain symptoms that are not subsiding, it’s recommended to see a healthcare provider who can run an MRI or X-ray to see the condition of the muscle and rule out other causes of pain. The healthcare provider will refer the patient to a physical therapy team that can evaluate the strength of the gluteus minimus and provide a list of exercises and stretches to help repair the muscle while conditioning the surrounding muscles. (SportsRec. 2017) Depending on the level of pain, sometimes the healthcare provider will prescribe a cortisone injection to the gluteus minimus muscle in conjunction with physical therapy. This will help alleviate the pain so that the physical therapy exercises can be done comfortably, allowing the gluteus maximus muscle to heal properly and strengthen. (Julie M. Labrosse et al., 2010)

The Science of Motion Chiropractic Care

References

ScienceDirect. (2011). Gluteus minimus muscle.

Reid D. (2016). The management of greater trochanteric pain syndrome: A systematic literature review. Journal of orthopaedics, 13(1), 15–28. doi.org/10.1016/j.jor.2015.12.006

SportsRec. (2017). Physical therapy exercises for the gluteus minimus.

Labrosse, J. M., Cardinal, E., Leduc, B. E., Duranceau, J., Rémillard, J., Bureau, N. J., Belblidia, A., & Brassard, P. (2010). Effectiveness of ultrasound-guided corticosteroid injection for the treatment of gluteus medius tendinopathy. AJR. American journal of roentgenology, 194(1), 202–206. doi.org/10.2214/AJR.08.1215

Turf Toe Injury: How to Recognize the Symptoms and Get Help

Dr. Alex Jimenez

Female martial arts fighter practicing with trainer, punching taekwondo kick pad exercise kicking. Training of kickboxer woman strikes with bare foot mitts punching bag kicking shield.

“For individuals experiencing a turf toe injury, can knowing the symptoms help athletes and non-athletes with treatment, recovery time, and returning to activities?”

Table of Contents

Turf Toe Injury

A turf toe injury affects the soft tissue ligaments and tendons at the base of the big toe under the foot. This condition usually occurs when the toe is hyperextended/forced upward, such as when the ball of the foot is on the ground and the heel is lifted. (American Academy of Orthopaedic Surgeons. 2021) The injury is common among athletes who play sports on artificial turf, which is how the injury got its name. However, it can also affect non-athletes, like individuals working on their feet all day.

Recovery time after turf toe injury depends on the severity and the type of activities the individual plans to return to.
Returning to high-level sports activities after a severe injury can take six months.
These injuries vary in severity but usually improve with conservative treatment. In severe cases, surgery could be required.
Pain is the primary issue that stops physical activities after a grade 1 injury, while grades 2 and 3 can take weeks to months to heal completely.

Meaning

A turf toe injury refers to a metatarsophalangeal joint strain. This joint comprises ligaments that connect the bone on the sole of the foot, below the big toe/proximal phalanx, to the bones that connect the toes to the larger bones in the feet/metatarsals. The injury is usually caused by hyperextension that often results from a pushing-off motion, like running or jumping.

Grading

Turf toe injuries can range from mild to severe and are graded as follows: (American Academy of Orthopaedic Surgeons. 2021)

Grade 1 – The soft tissue is stretched, causing pain and swelling.
Grade 2 – The soft tissue is partially torn. Pain is more pronounced, with significant swelling and bruising, and it is difficult to move the toe.
Grade 3 – Soft tissue is completely torn, and symptoms are severe.

Is This What’s Causing My Foot Pain?

Turf toe can be an:

Overuse injury – caused by repeating the same motion repeatedly for an extended period, that causes symptoms to worsen.
Acute injury – that occurs suddenly, causing immediate pain.

Symptoms can include the following: (Mass General Brigham. 2023)

Limited range-of-motion.
Tenderness in the big toe and surrounding area.
Swelling.
Pain in the big toe and surrounding area.
Bruising.
Loose joints can indicate there is a dislocation.

Diagnosis

If experiencing turf toe symptoms, see a healthcare provider for a proper diagnosis so they can develop a personalized treatment plan. They will perform a physical exam to assess pain, swelling, and range of motion. (American Academy of Orthopaedic Surgeons. 2021) If the healthcare provider suspects tissue damage, they may recommend imaging with X-rays and (MRI) to grade the injury and determine the proper course of action.

Treatment

A healthcare provider will determine the best treatment based on the severity of the injury. All turf toe injuries can benefit from the RICE protocol: (American College of Foot and Ankle Surgeons. Foot Health Facts. 2023)

Rest – Avoid activities that worsen symptoms. This can include using an assistive device like a walking boot or crutches to reduce pressure.
Ice – Apply ice for 20 minutes, then wait 40 minutes before reapplying.
Compression – Wrap the toe and foot with an elastic bandage to support and reduce swelling.
Elevation – Prop the foot above the level of the heart to help decrease swelling.

Grade 1

Grade 1 turf toe is classified by stretched soft tissue, pain, and swelling. Treatments can include: (Ali-Asgar Najefi et al., 2018)

Taping to support the toe.
Wearing shoes with a rigid sole.
Orthotic support, like a turf toe plate.

Grades 2 and 3

Grades 2 and 3 come with partial or complete tissue tearing, severe pain, and swelling. Treatments for more severe turf toe can include: (Ali-Asgar Najefi et al., 2018)

Limited weight bearing
Using assistive devices like crutches, a walking boot, or a cast.

Other Treatment

Less than 2% of these injuries require surgery. It is usually recommended if there is instability in the joint or when conservative treatments are unsuccessful. (Ali-Asgar Najefi et al., 2018) (Zachariah W. Pinter et al., 2020)
Physical therapy is beneficial for decreasing pain and improving the range of motion and strength after injury. (American Academy of Orthopaedic Surgeons. 2021)
Physical therapy also includes proprioception and agility training exercises, orthotics, and wearing recommended shoes for specific physical activities. (Lisa Chinn, Jay Hertel. 2010)
A physical therapist can also help ensure that the individual does not return to physical activities before the injury is fully healed and prevent the risk of re-injury.

Recovery Time

Recovery depends on injury severity. (Ali-Asgar Najefi et al., 2018)

Grade 1 – Subjective as it varies depending on the individual’s pain tolerance.
Grade 2 – Four to six weeks of immobilization.
Grade 3 – Eight weeks minimum of immobilization.
It can take up to six months to return to normal function.

Returning To Normal Activities

After a grade 1 turf toe injury, individuals can return to normal activities once the pain is under control. Grades 2 and 3 take longer to heal. Returning to sports activities after a grade 2 injury can take around two or three months, while grade 3 injuries and cases that require surgery can take up to six months. (Ali-Asgar Najefi et al., 2018)

Sports Chiropractic Treatment

References

American Academy of Orthopaedic Surgeons. (2021). Turf toe.

Mass General Brigham. (2023). Turf toe.

American College of Foot and Ankle Surgeons. Foot Health Facts. (2023). RICE protocol.

Najefi, A. A., Jeyaseelan, L., & Welck, M. (2018). Turf toe: A clinical update. EFORT open reviews, 3(9), 501–506. doi.org/10.1302/2058-5241.3.180012

Pinter, Z. W., Farnell, C. G., Huntley, S., Patel, H. A., Peng, J., McMurtrie, J., Ray, J. L., Naranje, S., & Shah, A. B. (2020). Outcomes of Chronic Turf Toe Repair in Non-athlete Population: A Retrospective Study. Indian journal of orthopaedics, 54(1), 43–48. doi.org/10.1007/s43465-019-00010-8

Chinn, L., & Hertel, J. (2010). Rehabilitation of ankle and foot injuries in athletes. Clinics in sports medicine, 29(1), 157–167. doi.org/10.1016/j.csm.2009.09.006

Optimize Muscle Growth: Understand Protein Synthesis

Dr. Alex Jimenez

People at rehabilitation center, woman talking with female rehabilitologist, men training on background. Concept of physical therapy for health and recovery. Consultation before training

“For individuals trying to optimize muscle growth, protein intake is essential. However, the body is limited by how much protein can synthesize to repair and grow muscles. Can knowing protein intake timing, amount, and how to best stimulate muscle growth help achieve better results?”

Table of Contents

Muscle Protein Synthesis

Muscle protein synthesis is a physiological process of producing new muscle protein and is an important component of how the body maintains and builds muscle. Muscle growth is achieved with resistance training and protein intake. (Tanner Stokes, et al., 2018)

How Protein Synthesis Works

Protein is the building block of muscles, while protein synthesis is a natural metabolic process in which protein is produced to repair muscle damage caused by exercise. This happens from amino acids binding to skeletal muscle proteins, increasing muscle size. It counteracts muscle protein breakdown (MPB) due to protein loss during exercise. The breakdown of muscles is a necessary part of building muscle. When damaged, muscles will build back larger, so long as enough calories and protein are consumed to repair and grow the muscles. Muscle protein synthesis can be enhanced by increasing protein intake immediately following exercise. Learning to stimulate muscle protein synthesis through exercise and diet can help accelerate muscle growth, expedite recovery, improve physical performance, and increase overall endurance. (Cameron J. Mitchell et al., 2014)

Effects of Exercise

Protein balance describes the relationship between muscle protein breakdown and muscle protein synthesis. When the body is in protein balance, no muscle growth or wasting occurs, and the individual is considered in a healthy state of biological equilibrium/homeostasis, also known as maintenance. To stimulate muscle growth, individuals need to shake up the protein balance. Although it may seem counter-intuitive, exercise can break down muscle protein, but not more than the amount of protein the body can synthesize. (Felipe Damas, et al., 2015) The more intense the workout, the greater the muscle protein synthesis, as the muscle breakdown stimulates the repair and growth of tissues. Scientists measure intensity by the one-repetition maximum – 1-RM – meaning the maximum weight an individual can lift for one repetition. According to a research study, workout intensities of under 40% of the 1-RM will not affect muscle protein synthesis. And intensities greater than 60% will double or triple muscle protein synthesis. (P. J. Atherton, K Smith. 2012)

Food Impact

The relationship between diet and protein balance is not so straightforward. Even with increased protein intake, muscle protein synthesis occurs for a specific period. This is because the body can only utilize a certain amount of the essential amino acids it receives, with anything more being broken down and excreted by the liver. Nutritionists recommend about 1.4 to 2.0 grams of protein per kilogram of body weight per day for building muscle and strength. (Ralf Jäger, et al., 2017) Enough protein can be obtained by focusing on dairy, eggs, lean meats, nuts, and legumes. It is also recommended to consume enough whole grains, healthy fats, fruits, and vegetables to help the body perform and repair properly. For example, carbohydrates are necessary for muscle building as they stimulate insulin release that supports muscle cell protein absorption. (Vandré Casagrande Figueiredo, David Cameron-Smith. 2013) A study looked into response rates in men prescribed 10, 20, or 40 grams of whey protein immediately following resistance training. Researchers noted the following results: (Oliver C. Witard et al., 2014)

10 grams of whey protein – No effect on muscle protein synthesis.
20 grams – Increased muscle protein synthesis by 49%.
40 grams – Increased the muscle protein synthesis by 56% but also caused the excessive accumulation of urea.
Consuming 20 grams to 40 grams of whey protein after resistance training also increased other essential amino acids associated with lean muscle growth. (Lindsay S. Macnaughton et al., 2016)
Whey protein is a fast-digesting protein.
Increased results can be obtained by consuming slower-digesting protein throughout the day.

Muscle gains vary from person to person as everyone’s body is different. Individuals considering consuming protein beyond the recommended dietary intake should consult their doctor or a registered nutritionist to understand the potential benefits and risks.

Building A Stronger Body

References

Stokes, T., Hector, A. J., Morton, R. W., McGlory, C., & Phillips, S. M. (2018). Recent Perspectives Regarding the Role of Dietary Protein for the Promotion of Muscle Hypertrophy with Resistance Exercise Training. Nutrients, 10(2), 180. doi.org/10.3390/nu10020180

Mitchell, C. J., Churchward-Venne, T. A., Parise, G., Bellamy, L., Baker, S. K., Smith, K., Atherton, P. J., & Phillips, S. M. (2014). Acute post-exercise myofibrillar protein synthesis is not correlated with resistance training-induced muscle hypertrophy in young men. PloS one, 9(2), e89431. doi.org/10.1371/journal.pone.0089431

Damas, F., Phillips, S., Vechin, F. C., & Ugrinowitsch, C. (2015). A review of resistance training-induced changes in skeletal muscle protein synthesis and their contribution to hypertrophy. Sports medicine (Auckland, N.Z.), 45(6), 801–807. doi.org/10.1007/s40279-015-0320-0

Atherton, P. J., & Smith, K. (2012). Muscle protein synthesis in response to nutrition and exercise. The Journal of physiology, 590(5), 1049–1057. doi.org/10.1113/jphysiol.2011.225003

Jäger, R., Kerksick, C. M., Campbell, B. I., Cribb, P. J., Wells, S. D., Skwiat, T. M., Purpura, M., Ziegenfuss, T. N., Ferrando, A. A., Arent, S. M., Smith-Ryan, A. E., Stout, J. R., Arciero, P. J., Ormsbee, M. J., Taylor, L. W., Wilborn, C. D., Kalman, D. S., Kreider, R. B., Willoughby, D. S., Hoffman, J. R., … Antonio, J. (2017). International Society of Sports Nutrition Position Stand: protein and exercise. Journal of the International Society of Sports Nutrition, 14, 20. doi.org/10.1186/s12970-017-0177-8

Figueiredo, V. C., & Cameron-Smith, D. (2013). Is carbohydrate needed to further stimulate muscle protein synthesis/hypertrophy following resistance exercise?. Journal of the International Society of Sports Nutrition, 10(1), 42. doi.org/10.1186/1550-2783-10-42

Witard, O. C., Jackman, S. R., Breen, L., Smith, K., Selby, A., & Tipton, K. D. (2014). Myofibrillar muscle protein synthesis rates subsequent to a meal in response to increasing doses of whey protein at rest and after resistance exercise. The American journal of clinical nutrition, 99(1), 86–95. doi.org/10.3945/ajcn.112.055517

Macnaughton, L. S., Wardle, S. L., Witard, O. C., McGlory, C., Hamilton, D. L., Jeromson, S., Lawrence, C. E., Wallis, G. A., & Tipton, K. D. (2016). The response of muscle protein synthesis following whole-body resistance exercise is greater following 40 g than 20 g of ingested whey protein. Physiological reports, 4(15), e12893. doi.org/10.14814/phy2.12893

Pancakes: Nutrition Facts & Health Benefits

Dr. Alex Jimenez

“For individuals wanting to eat pancakes regularly, are there ways to increase pancake nutrition and lower the calorie and carb counts so they can be included in a balanced diet?”

Table of Contents

Pancake Nutrition

This high-carbohydrate meal can provide enough energy to fuel a day’s physical activity.

Nutrition

The following nutrition information is provided for:

Two regular pancakes made with white flour – 154g. (USDA Food Data Central. 2019)
Butter – 1 teaspoon, unsalted. (USDA Food Data Central. 2019)
Syrup – 1 tablespoon. (USDA Food Data Central. 2019)

Calories – 430.8
Fat – 18.77g
Sodium – 693.9mg
Carbohydrates – 55.9g
Fiber – .75g
Sugars – 8.6g
Protein – 8.64g

Pancakes made with whole-wheat flour offer more fiber and protein. The following is nutrition info for two or three whole-wheat pancakes (150g) made from a mix. (Child Nutrition Recipe Box. 2023)

Calories – 348
Fat – 15g
Sodium – 594mg
Carbohydrates – 45g
Fiber – 6g
Sugars – 6g
Protein – 12g

Carbohydrates

Pancakes will increase carbohydrate intake. The body uses carbohydrates as a primary fuel source, making them an important nutrient. However, most nutritionists suggest that individuals get their daily carbohydrates from nutrient-dense sources. Pancakes typically don’t fall into this category. White flour pancakes do not provide much fiber, and around 60 grams of carbohydrates are consumed in this meal. Substituting whole-wheat flour changes the amount to around 6g of fiber or 20% of the daily recommended value.

Fat

Pancakes can include dairy and eggs and are topped with butter that contributes a significant amount of fat. Pancake mix may contain trans fat. Some brands include partially hydrogenated oils. Health experts recommend that individuals limit or completely avoid foods containing trans fat. If the label ingredient list contains partially hydrogenated ingredients, it is recommended to avoid it. (MedlinePlus. 2022)

Protein

Pancakes may provide some protein, which varies based on the type of flour used. Some brands add protein powder to increase intake.

Vitamins and Minerals

Pancakes and ready mixes are generally made from enriched flour. Enriched foods are those that have had nutrients added during the manufacturing process. In most cases, the nutrients, vitamins, and minerals are stripped away, and then some are added back in during processing. Constantly eating enriched bread products limits diet-friendly fiber and nutrients. The enriched flour in pancakes and added sugar and syrup raise blood sugar levels rapidly and then generate hunger shortly afterward.

Calories

Total nutrition numbers also depend on serving size. The numbers on the label only apply to a single serving which is just two medium pancakes. Many individuals consume 3-4 medium pancakes and double the amount of butter and syrup as well. This can add up to more than 1,000 calories.

Benefits

Whole-wheat pancakes made with whole-grain flour are more nutritious than pancakes made with white flour and can be a delicious way to eat more whole grains. They can be topped with berries or other fruits for added fiber and nutrients.

Digestion

Whole-wheat pancakes made with whole-grain flour provide significant fiber for healthy digestion. Fiber helps with waste evacuation and has prebiotic compounds that fuel beneficial gut bacteria. (Joanne Slavin. 2013)

Improves Hunger Satisfaction

Whole-grain pancakes taste heartier and include fiber that keeps the body fuller longer than pancakes made with faster-digesting refined flour.

Decreases Risk of Heart Disease

A review of studies examining whole grain consumption and heart disease found that eating whole grains was associated with a reduced risk of heart disease. (Dagfinn Aune, et al., 2016)

Reduces Risk of Obesity

Research suggests that whole grain intake reduces the risk of obesity and could help individuals maintain a stable weight. (Katrina R. Kissock et al., 2021) The fiber will also help keep the fuller longer after the meal.

Helps Prevent Birth Defects

Whole-wheat flour is fortified with folic acid, an important B vitamin during pregnancy. Folic acid decreases the risk of neural tube defects, which can affect the development of the brain or spine. (Centers for Disease Control and Prevention. 2022)

Variations

Nutrients for regular pancakes will vary based on the size.

One made-from-scratch small pancake – 3″ across provides:

30 calories
1 gram of protein
5 grams of carbohydrate
0 grams of fiber
1 gram of sugar

One made-from-scratch medium pancake – 5″ across provides:

93 calories
2 grams of protein
15 grams of carbohydrate
0 grams of fiber
2 grams of sugar

One made-from-scratch large pancake – 7″ across provides:

186 calories
4 grams of protein
30 grams of carbohydrate
1 gram of fiber
5 grams of sugar

Making Pancakes

If pancakes are part of a weekly meal plan, try to keep them lower in sugar, fat, and calories.

Make pancakes from scratch without the mix to avoid any trans fats.
Use whole wheat flour to get fiber to increase hunger satisfaction.
Instead of frying the pancakes in oil or butter, use a quality non-stick pan to reduce fat intake.
Use syrup with no sugar.
Top with blueberries, raspberries, or strawberries.

Eating Right to Feel Better

References

USDA Food Data Central. (2019). Pancakes, plain, prepared from recipe.

USDA FoodData Central. (2019). Butter, without salt.

USDA FoodData Central. (2019). Syrups, table blends, pancake.

Child Nutrition Recipe Box. (2023). Pancakes – USDA recipe for schools.

MedlinePlus. (2022). Facts about trans fat.

Slavin J. (2013). Fiber and prebiotics: mechanisms and health benefits. Nutrients, 5(4), 1417–1435. doi.org/10.3390/nu5041417

Aune, D., Keum, N., Giovannucci, E., Fadnes, L. T., Boffetta, P., Greenwood, D. C., Tonstad, S., Vatten, L. J., Riboli, E., & Norat, T. (2016). Whole grain consumption and risk of cardiovascular disease, cancer, and all cause and cause specific mortality: systematic review and dose-response meta-analysis of prospective studies. BMJ (Clinical research ed.), 353, i2716. doi.org/10.1136/bmj.i2716

Kissock, K. R., Neale, E. P., & Beck, E. J. (2021). Whole Grain Food Definition Effects on Determining Associations of Whole Grain Intake and Body Weight Changes: A Systematic Review. Advances in nutrition (Bethesda, Md.), 12(3), 693–707. doi.org/10.1093/advances/nmaa122

Centers for Disease Control and Prevention. (2022). Folic acid.

Try Non-surgical Decompression for Sensor Nerve Dysfunction

Dr. Alex Jimenez

Can individuals with sensory nerve dysfunction incorporate nonsurgical decompression to restore sensory-mobility function to their bodies?

Table of Contents

Introduction

The spinal column in the musculoskeletal system comprises bones, joints, and nerves that work together with various muscles and tissues to ensure that the spinal cord is protected. The spinal cord is part of the central nervous system where the nerve roots are spread out to the upper and lower body parts that supply sensory-motor functions. This allows the body to move and function without pain or discomfort. However, when the body and spine ages or when a person is dealing with injuries, the nerve roots can become irritated and cause weird sensations like numbness or tingling, often correlating with body pain. This can cause a socio-economic burden on many individuals and, if not treated right away, can lead to chronic pain. To that point, it can lead to many individuals dealing with body extremity pain associated with sensory nerve dysfunction. This causes many individuals dealing with musculoskeletal disorders to start looking for treatment. Today’s article examines how nerve dysfunction affects the extremities and how nonsurgical decompression can help reduce nerve dysfunction to allow mobility back to the upper and lower limbs. We speak with certified medical providers who incorporate our patients’ information to provide nonsurgical solutions like decompression to help individuals with nerve dysfunction. We also inform patients how nonsurgical decompression can restore mobility-sensory to the upper and lower extremities. We encourage our patients to ask intricated and educational questions to our associated medical providers about the pain-like symptoms they are experiencing correlating with the sensory nerve dysfunction. Dr. Alex Jimenez, D.C., utilizes this information as an academic service. Disclaimer.

How Nerve Dysfunction Affects The Extremities

Do you experience tingling or numb sensations in your hands or feet that don’t want to go away? Do you feel pain in different back portions that can only be relieved through stretching or resting? Or does it hurt to walk for long distances that you feel like you need to rest constantly? Many pain-like scenarios are associated with sensory nerve dysfunction that can affect the upper and lower extremities. When many individuals experience sensory nerve dysfunction and deal with weird sensations in their extremities, many think it is due to musculoskeletal pain in their neck, shoulders, or back. This is only part of the issue, as many environmental factors can be associated with sensory nerve pain, as the nerve roots are being compressed and agitated, causing sensory nerve dysfunction in the extremities. Since the nerve roots are spread out from the spinal cord, the brain sends the neuron information to the nerve roots to allow sensory-mobility function in the upper and lower extremities. This allows the body to be mobile without discomfort or pain and functional through daily activities. However, when many individuals start to do repetitive motions that cause the spinal disc to be compressed constantly, it can lead to potential disc herniation and musculoskeletal disorders. Since numerous nerve roots are spread to the different extremities, when the main nerve roots are aggravated, it can send pain signals to each extremity. Hence, many people are dealing with nerve entrapment that leads to lower back, buttock, and leg pain that can affect their daily routine. (Karl et al., 2022) At the same time, many people with sciatica are dealing with sensory nerve dysfunction that affects their walking ability. With sciatica, it can be associated with spinal disc pathology and causes many individuals to seek treatment. (Bush et al., 1992)

Sciatica Secrets Revealed-Video

Sciatica Secrets Revealed! | El Paso, Tx (2023)

When it comes to looking for treatment to reduce sensory nerve dysfunction, many individuals will opt for nonsurgical solutions to minimize the pain-like symptoms and reduce the pain signals that are causing the upper and lower extremities to suffer. Nonsurgical treatment solutions like decompression can help restore sensory nerve function through gentle traction by causing the spinal disc to lay off the aggravated nerve root and start the body’s natural healing process. At the same time, it helps reduce musculoskeletal disorders from returning. The video above shows how sciatica associated with sensory nerve dysfunction can be decreased through nonsurgical treatments to allow the body’s extremities to feel better.

Nonsurgical Decompression Reducing Nerve Dysfunction

Nonsurgical treatments can help reduce low back pain associated with sensory nerve dysfunction to restore sensory-motor function to the upper and lower extremities. Many individuals who incorporate nonsurgical treatments like decompression as part of their health and wellness routine can see improvement after consecutive treatment. (Chou et al., 2007) Since many healthcare practitioners incorporate nonsurgical treatments like decompression into their practices, there has been quite an improvement in pain management. (Bronfort et al., 2008)

When many individuals start to use nonsurgical decompression for sensory nerve dysfunction, many will see improvement in their pain, mobility, and activities of their daily living. (Gose et al., 1998). What spinal decompression does for the nerve roots is that it helps the affected disc that is aggravating the nerve root, pulls the disc back to its original position, and rehydrates it. (Ramos & Martin, 1994) When many individuals start thinking about their health and wellness, nonsurgical treatments can be effective for them due to their affordable cost and how they can be combined with other therapies to manage better the pain associated with nerve dysfunction affecting their body extremities.

References

Bronfort, G., Haas, M., Evans, R., Kawchuk, G., & Dagenais, S. (2008). Evidence-informed management of chronic low back pain with spinal manipulation and mobilization. Spine J, 8(1), 213-225. doi.org/10.1016/j.spinee.2007.10.023

Bush, K., Cowan, N., Katz, D. E., & Gishen, P. (1992). The natural history of sciatica associated with disc pathology. A prospective study with clinical and independent radiologic follow-up. Spine (Phila Pa 1976), 17(10), 1205-1212. doi.org/10.1097/00007632-199210000-00013

Chou, R., Huffman, L. H., American Pain, S., & American College of, P. (2007). Nonpharmacologic therapies for acute and chronic low back pain: a review of the evidence for an American Pain Society/American College of Physicians clinical practice guideline. Ann Intern Med, 147(7), 492-504. doi.org/10.7326/0003-4819-147-7-200710020-00007

Gose, E. E., Naguszewski, W. K., & Naguszewski, R. K. (1998). Vertebral axial decompression therapy for pain associated with herniated or degenerated discs or facet syndrome: an outcome study. Neurol Res, 20(3), 186-190. doi.org/10.1080/01616412.1998.11740504

Karl, H. W., Helm, S., & Trescot, A. M. (2022). Superior and Middle Cluneal Nerve Entrapment: A Cause of Low Back and Radicular Pain. Pain Physician, 25(4), E503-E521. www.ncbi.nlm.nih.gov/pubmed/35793175

Ramos, G., & Martin, W. (1994). Effects of vertebral axial decompression on intradiscal pressure. J Neurosurg, 81(3), 350-353. doi.org/10.3171/jns.1994.81.3.0350