What Are The Therapeutic Options For Upper Crossed Syndrome?

Can various therapeutic options provide relief for individuals with upper crossed syndrome to restore muscle strength?

Table of Contents

Introduction

Many individuals often suffer neck and shoulder pain from poor posture, improper heavy lifting, musculoskeletal conditions, auto accidents, whiplash, etc. The surrounding muscles that connect the neck and shoulders help protect the cervical and thoracic region of the spine and can succumb to injuries that can cause pain-like symptoms causing discomfort to the individual. Neck, shoulder, and back pain are the three most common issues many individuals have experienced. These musculoskeletal disorders can also correlate with pre-existing conditions; many people will feel pain and discomfort while trying to find the relief they seek. One of the most common issues people often experience is upper crossed syndrome, which can be associated with neck and shoulder pain. Today’s article explains what upper cross syndrome is and how it affects the neck and shoulders while also diving into how different therapeutic options like spinal decompression and chiropractic care can reduce the effects of upper cross syndrome. We speak with certified medical providers who incorporate our patients’ information to provide numerous treatment plans to mitigate upper-crossed syndrome in the neck and shoulders. We also inform our patients that there are many therapeutic options, like chiropractic care and spinal decompression, to minimize muscle pain in the neck and shoulders. 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 upper-crossed syndrome. Dr. Alex Jimenez, D.C., utilizes this information as an academic service. Disclaimer

What Is Upper Crossed Syndrome?

Have you been dealing with muscle pain in your shoulders or neck after being on the computer for a while? Do you feel stiffness in your shoulders that rotating them causes temporary relief? Or does it hurt when you turn your head from side to side? Many of these pain-like scenarios are often associated with upper-cross syndrome. Many people don’t often realize that upper crossed syndrome is a musculoskeletal condition that affects the neck, shoulder, and chest muscles and causes them to be weak and tight due to poor posture. The upper crossed syndrome can cause referred pain to the upper extremities, leading to cervicogenic headaches, limited range of motion, trigger points in the muscles, and muscle imbalance. (Moore, 2004) When many people are dealing with upper crossed syndrome due to poor posture, it can lead to many issues in the neck and shoulders.

How Does It Affect The Neck & Shoulders?

Now, why does upper crossed syndrome affect the neck and shoulders? Many people unintentionally hunched over when looking at their phones, being on the computer, or relaxing at home. This causes specific muscles in the neck and shoulder region, like the serratus and lower trapezius muscles, to become weak while the pectoral and neck muscles are tight. (Chu & Butler, 2021) This, in turn, causes the shoulders to be more rounded and hunched, causing the neck and head to crane forward. When people are dealing with upper crossed syndrome, many would often complain about pain-like symptoms like:

Headaches
Neck Strain
Muscle tightness
Upper back pain
Restricted range of motion
Numbness/Tingling sensations in the arms

The upper crossed syndrome can also occur gradually over time and cause nerve compression to the upper extremities. When the upper neck and shoulder muscles start to affect the surrounding nerve roots, which then leads to nerve dysfunction in the sensory and motor skills when a person picks up an object. (Lee & Lim, 2019) However, many individuals dealing with upper-crossed syndrome can seek treatment to relieve muscle pain in their neck and shoulders.

An Overview Of Upper Crossed Syndrome- Video

What is Upper Cross Syndrome? | El Paso, Tx (2023)

Since upper cross syndrome is a musculoskeletal condition that affects the neck and shoulders, it can result in muscle imbalance and pain in the individual. Many people, especially in the working field, develop this syndrome by being hunched over for an extended period. (Mujawar & Sagar, 2019) This causes the head to be more forward, the neck posture to be curved and hunched, and the shoulders to be rounded. The video above explains upper-crossing syndrome, its causes, and how it is treated.

Spinal Decompression Reducing Upper Crossed Syndrome

Numerous treatments can help restore muscle strength and reduce muscle pain in the neck and shoulders. Treatments like spinal decompression can help reduce upper crossed syndrome by slowly using gentle traction to the cervical spine region and gently stretching the neck muscles to provide relief. Spinal decompression is one of the non-surgical treatments that many individuals with headaches associated with upper crossed syndrome can find the comfort they seek through pain reduction and improve their quality of life. (Eskilsson et al., 2021) At the same time, spinal decompression can be part of a personalized treatment plan that many individuals can add to their daily routine to prevent the pain from returning. (Saunders, 1983)

Chiropractic Care Restoring Muscle Strength

Just like spinal decompression, chiropractic care is a non-surgical treatment that can be combined with various stretching techniques to restore the neck’s range of motion and reduce pain associated with upper-crossed syndrome. (Mahmood et al., 2021) Chiropractic care incorporates manual and mechanical techniques like MET (muscle energy techniques) and spinal manipulation to realign the spine out of subluxation. When chiropractors integrate MET to manage upper crossed syndrome, many individuals find that their pain has decreased, their cervical range of motion is improved, and their neck disability is reduced. (Gillani et al., 2020) When many individuals start thinking about their health and wellness, they can make small changes to improve their posture and be more mindful of their bodies to reduce the chances of upper-cross syndrome returning.

References

Chu, E. C., & Butler, K. R. (2021). Resolution of Gastroesophageal Reflux Disease Following Correction for Upper Cross Syndrome-A Case Study and Brief Review. Clin Pract, 11(2), 322-326. doi.org/10.3390/clinpract11020045

Eskilsson, A., Ageberg, E., Ericson, H., Marklund, N., & Anderberg, L. (2021). Decompression of the greater occipital nerve improves outcome in patients with chronic headache and neck pain – a retrospective cohort study. Acta Neurochir (Wien), 163(9), 2425-2433. doi.org/10.1007/s00701-021-04913-0

Gillani, S. N., Ain, Q., Rehman, S. U., & Masood, T. (2020). Effects of eccentric muscle energy technique versus static stretching exercises in the management of cervical dysfunction in upper cross syndrome: a randomized control trial. J Pak Med Assoc, 70(3), 394-398. doi.org/10.5455/JPMA.300417

Lee, E. Y., & Lim, A. Y. T. (2019). Nerve Compression in the Upper Limb. Clin Plast Surg, 46(3), 285-293. doi.org/10.1016/j.cps.2019.03.001

Mahmood, T., Afzal, W., Ahmad, U., Arif, M. A., & Ahmad, A. (2021). Comparative effectiveness of routine physical therapy with and without instrument assisted soft tissue mobilization in patients with neck pain due to upper crossed syndrome. J Pak Med Assoc, 71(10), 2304-2308. doi.org/10.47391/JPMA.03-415

Moore, M. K. (2004). Upper crossed syndrome and its relationship to cervicogenic headache. J Manipulative Physiol Ther, 27(6), 414-420. doi.org/10.1016/j.jmpt.2004.05.007

Mujawar, J. C., & Sagar, J. H. (2019). Prevalence of Upper Cross Syndrome in Laundry Workers. Indian J Occup Environ Med, 23(1), 54-56. doi.org/10.4103/ijoem.IJOEM_169_18

Saunders, H. D. (1983). Use of spinal traction in the treatment of neck and back conditions. Clin Orthop Relat Res(179), 31-38. www.ncbi.nlm.nih.gov/pubmed/6617030

Disclaimer

Understanding Forward Head Posture: Guide to Posture Correction

Dr. Alex Jimenez

Shot of a young female doctor writing down a patients information in an office.

“Individuals that sit at a desk/workstation for hours for work or school, or drive for a living, could be fostering a long-term condition known as forward head posture. Can understanding the signs and symptoms help to prevent the condition?”

Table of Contents

Forward Head Posture

Neck pain often causes or is caused by misalignment in the area between the shoulders and head. Forward head posture is a common problem that can strain the neck muscles, leading to pain and worsening neck, shoulder, and back posture. (Jung-Ho Kang, et al., 2012) For individuals who are at risk of developing or are already showing signs/symptoms, it’s important to get medical attention to prevent complications, such as chronic neck pain or compressing a nerve. Individuals can continue to do the work that they need to do but may need some postural adjustments and re-training so as not to continue straining the neck while working.

Postural Deviation

The head is in a healthy alignment with the neck when the ears line up with the gravity line.
The gravity line is an imaginary straight line that represents gravity’s downward pull.
It is used in posture assessments as a reference for noting the positions of the body and determining the presence of any postural misalignment or deviation.
A forward head posture occurs when the head begins to position forward of the gravity line when looking at the body from the side.
Forward head posture is a postural deviation because the head varies from the reference line. (Jung-Ho Kang, et al., 2012)

Muscle Imbalances

Forward head posture often results in a strength imbalance between muscles that support and move your neck, shoulders, and head. (Dae-Hyun Kim, et al., 2018)
The muscles in the back of the neck become shortened and overactive as they flex forward, while the muscles in the front become lengthened, weaker, and strained when they relax.

Kyphosis

Kyphosis also known as hunchback is when the shoulders round forward, and the head is also brought forward. (Jung-Ho Kang, et al., 2012) After many hours sitting at a desk, computer, or driving, kyphosis can also cause and/or worsen forward head posture.

This occurs because the upper back area supports the neck and head.
When the upper back moves or changes position, the head and neck follow.
The majority of the head’s weight is in the front, and this contributes to the forward movement.
An individual with kyphosis has to lift their head to see.

Treatment

A chiropractic injury specialist team can develop a personalized treatment plan to relieve pain symptoms, provide postural retraining, realign the spine, and restore mobility and function.

Standing and sitting using a healthy posture, along with exercises to strengthen the neck muscles, can help get the spine in alignment. (Elżbieta Szczygieł, et al., 2019)
Targeted stretching can help if the neck muscles are tight.
At-home stretches may also relieve pain.

Risk Factors

Pretty much everyone is at risk of developing a forward head posture. Common risk factors include:

Constantly looking down at a phone and staying in this position for a long time aka text neck.
Desk jobs and computer use can significantly round the shoulders and upper back, leading to a forward head posture. (Jung-Ho Kang, et al., 2012)
Driving for a living causes prolonged back, neck, and shoulder positioning.
Sleeping or reading with a large pillow under the head can contribute to forward head posture.
Doing work that requires dexterity and close-up positions, like a seamstress or technician can cause over-positioning of the neck.
Individuals who regularly carry a significant amount of weight in front of their body may begin to develop kyphosis.
An example is carrying a child or another load in front of the body.
Large breasts can also increase the risk of kyphosis and forward head posture.

Neck Injuries

References

Kang, J. H., Park, R. Y., Lee, S. J., Kim, J. Y., Yoon, S. R., & Jung, K. I. (2012). The effect of the forward head posture on postural balance in long time computer based worker. Annals of rehabilitation medicine, 36(1), 98–104. doi.org/10.5535/arm.2012.36.1.98

Kim, D. H., Kim, C. J., & Son, S. M. (2018). Neck Pain in Adults with Forward Head Posture: Effects of Craniovertebral Angle and Cervical Range of Motion. Osong public health and research perspectives, 9(6), 309–313. doi.org/10.24171/j.phrp.2018.9.6.04

Szczygieł, E., Sieradzki, B., Masłoń, A., Golec, J., Czechowska, D., Węglarz, K., Szczygieł, R., & Golec, E. (2019). Assessing the impact of certain exercises on the spatial head posture. International journal of occupational medicine and environmental health, 32(1), 43–51. doi.org/10.13075/ijomeh.1896.01293

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

Tingling and Pins and Needles: Paresthesia and its Symptoms

Dr. Alex Jimenez

Chiropractor applying pressure to the back of a patient — Close-up photo of a chiropractor applying pressure to the back of a patient

“Individuals feeling tingling or pins and needles sensations that overtake the arms or legs could be experiencing paresthesia, which occurs when a nerve has been compressed or damaged. Can knowing the symptoms and causes help in diagnosis and treatment?”

Table of Contents

Paresthesia Body Sensations

The numbness or tingling feeling when an arm, leg, or foot has fallen asleep is not so much about blood circulation but nerve function.

Paresthesia is an abnormal sensation felt in the body due to the compression or irritation of nerves.
It can be a mechanical cause like a compressed/pinched nerve.
Or it may be due to a medical condition, injury, or illness.

Symptoms

Paresthesia can cause various symptoms. These symptoms can range from mild to severe and can be brief or long-lasting. Signs can include: (National Institute of Neurological Disorders and Stroke. 2023)

Tingling
Pins and needles sensations
Feeling like the arm or leg has fallen asleep.
Numbness
Itching.
Burning sensations.
Difficulty contracting the muscles.
Difficulty using the affected arm or leg.

The symptoms typically last for 30 minutes or less.
Shaking the affected limb often relieves the sensations.
Paresthesia usually affects only one arm or leg at a time.
However, both arms and legs can be affected, depending on the cause.

Consult a healthcare provider if the symptoms last for more than 30 minutes. Treatment may be required if paresthesia body sensations are brought on by a serious underlying cause.

Causes

Sitting with incorrect and unhealthy postures can compress a nerve and generate symptoms. However, some causes are more concerning and can include:

Central nervous system conditions – stroke or multiple sclerosis/MS. (National Institute of Neurological Disorders and Stroke. 2023)
Altered nerve function brought on by a condition, like diabetes.
Compression or irritation of spinal nerve/s. (American Association of Neurological Surgeons. 2023)
Tension and traction or pulling on a nerve.

Seeking Medical Assistance

If the symptoms don’t go away after 30 minutes or keep returning for unknown reasons, call a healthcare provider to find out what is causing the abnormal sensations. A worsening case should be monitored by a healthcare provider.

Peripheral neuropathy caused by diabetes usually begins with a feeling of paresthesia in the foot/feet and can worsen and lead to other complications.
This is a symptom that diabetes is poorly controlled and needs to be managed appropriately. (National Institute of Diabetes and Digestive and Kidney Diseases. 2018)

Diagnosis

A healthcare provider will work with the individual to understand the symptoms and perform the appropriate diagnostic tests to determine the cause. A healthcare provider will choose the tests based on a physical examination. Common diagnostic procedures include: (Merck Manual Professional Version. 2022)

Magnetic resonance imaging – MRI of the spine, brain, or extremities.
X-ray to rule out bone abnormalities, like a fracture.
Blood tests.
Electromyography – EMG studies.
Nerve conduction velocity – NCV test.

If paresthesia is accompanied by back or neck pain, a healthcare provider may suspect a compressed/pinched spinal nerve.
If the individual has a history of diabetes that is poorly controlled, they may suspect peripheral neuropathy.

Treatment

Treatment for paresthesia depends on the diagnosis. A healthcare provider can help determine the best course of action for the specific condition.

Nervous System

If symptoms are triggered by a central nervous condition like MS, individuals will work closely with their healthcare provider to get the appropriate treatment.
Physical therapy could be recommended to help improve overall functional mobility. (Nazanin Razazian, et al., 2016)

Spinal Nerve

If paresthesia is caused by compression of a spinal nerve, like sciatica, individuals may be referred to a chiropractor and physical therapy team to release the nerve and pressure. (Julie M. Fritz, et al., 2021)
A physical therapist may prescribe spinal exercises to relieve compression of the nerve and restore normal sensations and motion.
Strengthening exercises to restore flexibility and mobility may be prescribed if weakness presents along with paresthesia body sensations.

Herniated Disc

If a herniated disc is causing the abnormal sensations, and there has been no improvement with conservative measures, a healthcare provider may suggest surgery to relieve pressure on the nerve/s. (American Association of Neurological Surgeons. 2023)
In surgical procedures like a laminectomy or discectomy, the objective is to restore nerve function.
Post-surgery, individuals may be recommended to a physical therapist to help regain mobility.

Peripheral Neuropathy

If peripheral neuropathy from diabetes is the cause, the symptoms can become permanent and may change slightly with medication. (National Institute of Diabetes and Digestive and Kidney Diseases. 2018)

What Is Plantar Fasciitis?

References

National Institute of Neurological Disorders and Stroke. (2023) Paresthesia.

American Association of Neurological Surgeons. (2023) Herniated disc.

National Institute of Diabetes and Digestive and Kidney Diseases. (2018) Peripheral neuropathy.

Merck Manual Professional Version. (2022) Numbness.

Razazian, N., Yavari, Z., Farnia, V., Azizi, A., Kordavani, L., Bahmani, D. S., Holsboer-Trachsler, E., & Brand, S. (2016). Exercising Impacts on Fatigue, Depression, and Paresthesia in Female Patients with Multiple Sclerosis. Medicine and science in sports and exercise, 48(5), 796–803. doi.org/10.1249/MSS.0000000000000834

Fritz, J. M., Lane, E., McFadden, M., Brennan, G., Magel, J. S., Thackeray, A., Minick, K., Meier, W., & Greene, T. (2021). Physical Therapy Referral From Primary Care for Acute Back Pain With Sciatica : A Randomized Controlled Trial. Annals of internal medicine, 174(1), 8–17. doi.org/10.7326/M20-4187

Bulging Disc Symptoms, Treatment, & Pain Relief Options

Dr. Alex Jimenez

back-pain-physical-therapy-and-chiropractor-with-2023-10-07-03-28-16-utc_02 — Back pain, physical therapy and chiropractor with patient, spine injury and healthcare with help an.

“Individuals dealing with back pain problems could be suffering from a bulging disc. Could knowing the difference between slipped and herniated disc symptoms help with treatments and finding relief?”

Table of Contents

Bulging Disc Pain

Back pain can become debilitating if not treated properly. A bulging disc is a common cause of cervical, thoracic, and lower back pain symptoms. It happens when one of the fluid-filled cushions between the vertebrae begins to shift out of place. Instead of being aligned with the edges, the disc bulges over. This begins to generate pressure on the nerves causing pain and inflammation.

Bulging discs are often caused by age, but repetitive movements and/or lifting heavy objects can contribute to the condition.
Symptoms can resolve on their own, but individuals are recommended to consult with a physical therapist and/or chiropractor to make sure the disc healed properly, otherwise, it can lead to worsening and/or further injuries.

Bulging Disc vs. Herniated Disc

Bulging and herniated discs cause pain symptoms.

They both can be linked to injuries and degenerative disc disease but are not the same condition. (Penn Medicine. 2018)
Sometimes the terms bulging and herniated disc are used interchangeably, which can be confusing. (American Academy of Orthopaedic Surgeons. 2022)

Bulging – the intervertebral disc moves out of place but stays intact.
Herniated – the thick outer layer of the disc ruptures, causing the cushioning gel inside to leak onto the spinal nerves.

Location of Symptoms

A bulging disc can happen anywhere along the spine.
However, most occur between the last five vertebrae in the lower back.
This is the lumbar spine. (American Academy of Orthopaedic Surgeons. 2022)
This is because the lower back is subject to all kinds of pressure and movement with daily activities, increasing the chances of pain and injuries.
The next most common place is the neck/cervical spine where there are constant movements making it prone to injury and pain symptoms.

Causes

Bulging discs are most often caused by body aging and normal wear and tear. As time goes on the intervertebral discs naturally degenerate, known as degenerative disc disease. This can cause the discs to pull downward, causing them to bulge from their placement. (Penn Medicine. 2018) Factors that can cause or worsen the condition include:

Practicing unhealthy postures.
Repetitive motions.
Lifting heavy objects
Spinal injuries.
Medical history of spinal or disc disease in the family.

Treatment

Treating a bulging disc takes time and patience. (American Academy of Neurological Surgeons. 2023)

Examination

Individuals with back pain that interferes with daily functions or has lasted longer than six weeks, should see a healthcare provider for a diagnosis. They will order a magnetic resonance imaging scan/MRI, which can show where a disc is protruding. (American Academy of Neurological Surgeons. 2023)

Rest

For bulging disc pain, resting the back is necessary. However,
Many patients benefit from a day or two of bed rest. (American Academy of Orthopaedic Surgeons. 2022)
After that, start light activities like walking. Avoid any movements that make your pain worse.

NSAIDs

NSAID pain medications like Advil, Motrin, or Aleve can keep pain symptoms and inflammation reduced.
However, this is for short-term use, as the underlying cause still needs to be addressed.
A healthcare provider will recommend safe dosage and how long these medications should be taken. (American Academy of Orthopaedic Surgeons. 2022)

Physical Therapy

Individuals may be recommended by their healthcare provider for a referral to a physical therapist.
A physical therapist will address the injury for rehabilitation and introduce strengthening exercises. (American Academy of Orthopaedic Surgeons. 2022)
Chiropractic Adjustments (NIH. 2022)
Non-surgical spinal decompression
Traction therapy
Therapeutic massage
Muscle Energy Technique

Steroid Injection

An epidural steroid injection can provide relief for individuals still experiencing symptoms after six weeks.
A healthcare provider will inject cortisone into the spine to reduce inflammation and pain. (American Academy of Orthopaedic Surgeons. 2022)

Surgery

If conservative treatments don’t work, a healthcare provider may recommend surgery, like a microdiscectomy.
This procedure uses small incisions to remove all or part of a bulging disc.
Most individuals with a bulging disc will not require surgery. (American Academy of Neurological Surgeons. 2023)

Inflammation: Integrative Medicine Approach

References

Penn Medicine. (2018) Bulging disc vs. herniated disc: What’s the difference?

American Academy of Orthopaedic Surgeons. (2022) Herniated disk in the lower back.

American Academy of Neurological Surgeons. (2023) Herniated disc.

National Institutes of Health. (2022) Spinal Manipulation: What You Need To Know.

Discover the Health Benefits of Onions

Dr. Alex Jimenez

“For individuals looking to maintain wellness or begin their wellness journey like increasing antioxidants, protection against cancer, immune system support, and other health benefits, can adding onions be a nutritious way to improve overall health?”

Table of Contents

Onions

Onions are nutritious vegetables like garlic, chives, leeks, and shallots. The most common types are red, white, yellow, and Spanish onions. They have antifungal, antibacterial, anti-inflammatory, and other healthful properties.

Whichever way they are prepared they do lose some of their nutritional value when cooked.
They contain flavonoids, glutathione, selenium compounds, vitamin E, and vitamin C.
When selecting onions, look for those without blemishes or discoloration, that are firm, and have dry, papery skins.

Benefits

They contain phytochemicals – compounds plants produce to fight off harmful bacteria, viruses, and fungi. These phytochemicals provide health benefits when consumed and provide the following properties: (Xin-Xin Zhao, et al., 2021)

Anti-obesity
Antioxidants
Antidiabetic
Anti-inflammatory
Antimicrobial
Anticancer
Protect the cardiovascular, digestive, respiratory, reproductive, and neurological systems.
Protect against liver disease.
Support a healthy immune system.

Types and Varieties

They belong to the Allium plant genus which includes plants like garlic, leeks, and chives. (Oregon State University. 2022)

They vary in flavor and can be sweet, tangy, and sour.
Different varieties combined with farming practices contribute to the flavor profile of onions.
There are many varieties of onions.
The most common and widely available are red, white, yellow, and Spanish.
Other types include cipollini, pearl, and Vidalia.

Raw or Cooked

They are beneficial whether eaten raw or cooked, cooking them reduces the number of thiosulfinates – compounds that provide antimicrobial, antifungal, and antibiotic properties.

Research shows that onions that are crushed before cooking retain their health benefits. (Holly L. Nicastro, et al., 2015)
Boiling and frying onions has been shown to cause the most significant loss in nutritious value.
Other preparation methods that decrease health benefits include sautéing, steaming, and microwaving.
Baking onions is shown to increase flavonoid levels.
Consuming dried, powdered onions can also provide nutritious value to foods, especially if the powder is freeze-dried. (Damini Kothari, et al., 2020)

Nutrition Facts

Onions can contribute to a healthy diet. The flavonoids, glutathione, selenium compounds, vitamin E, and vitamin C, contribute to the antioxidant properties of the vegetable. (Holly L. Nicastro, et al., 2015) The nutrition information for one medium onion: (U.S. Department of Agriculture. N.D.)

Total calories: 44
Total fat: 0 grams
Cholesterol: 0 milligrams
Carbohydrates: 10 grams
Dietary fiber: 2 grams
Total sugars: 5 grams
Protein: 1 grams
Calcium: 2 milligrams
Sodium: 4 milligrams
Iron: 1 milligrams
Vitamin D: 0 micrograms

When Selecting

Onions can contain pesticide residue, heavy metals, microbial contamination, and nitrate accumulation. Knowing where the onions come from can help ensure there was no incorrect use of pesticides or that the soil they were grown in was not enriched with heavy metals. When possible, purchase from reputable sources with transparent farming practices, like the farmers markets. (Xin-Xin Zhao, et al., 2021)

Onions found in environments that have not been effectively sterilized have an increased risk of growing harmful bacteria.
To avoid contamination of Escherichia. coli or E. coli, salmonella, and mold, it’s safest to purchase whole onions and cut them at home rather than purchasing pre-chopped onions. (Xin-Xin Zhao, et al., 2021)
Select those that feel firm, have little to no bruises or discolored spots, and have dry papery skin.
Avoid those that show evidence of mold, like white or black spots on the surface or inside the layers, and those with green shoots, which means the onion is still edible but won’t last that long.

Hypertension Diet

References

Zhao, X. X., Lin, F. J., Li, H., Li, H. B., Wu, D. T., Geng, F., Ma, W., Wang, Y., Miao, B. H., & Gan, R. Y. (2021). Recent Advances in Bioactive Compounds, Health Functions, and Safety Concerns of Onion (Allium cepa L.). Frontiers in nutrition, 8, 669805. doi.org/10.3389/fnut.2021.669805

Oregon State University. Types of onions and varieties.

Nicastro, H. L., Ross, S. A., & Milner, J. A. (2015). Garlic and onions: their cancer prevention properties. Cancer prevention research (Philadelphia, Pa.), 8(3), 181–189. doi.org/10.1158/1940-6207.CAPR-14-0172

Kothari, D., Lee, W. D., & Kim, S. K. (2020). Allium Flavonols: Health Benefits, Molecular Targets, and Bioavailability. Antioxidants (Basel, Switzerland), 9(9), 888. doi.org/10.3390/antiox9090888

U.S. Department of Agriculture. Onions.

Combatting Exercise Burnout – Tips and Strategies

Dr. Alex Jimenez

Young attractive sporty tired african american woman in sportswear having morning workout at modern light apartment. Healthy athletic female doing cardio on stationary bike.

“Individuals that engage in a regular fitness regimen can begin to lose interest and motivation. Can knowing the signs of exercise burnout help individuals rediscover their motivation?”

Table of Contents

Exercise Burnout

When maintaining fitness and health becomes a chore and doing anything else is better than working out, individuals could be experiencing exercise burnout. Here are a few signs an individual is getting burned out.

Procrastination

One sign is constantly putting things off.

An individual may put on workout clothes, set up the equipment, etc.
However, the workout never happens as the individual continues to find other things to do.
At some point, they decide it’s too late and they’ll work out tomorrow.

Solution

Simplify the workout. Make some small goals or adjustments and keep the workout light. (Nemanja Lakicevic, et al., 2020) An example could be:

Focus only on stretching.
Take a walk around the block.
Go up and down some stairs equivalent to a few laps.
Do 10 pushups, 10 squats, and 10 lunges, or other exercises and that’s it.

No Longer Interesting

When burned out, exercise is not interesting and disenchanting. (Franklin Velasco, Rafael Jorda. 2020) Trainers will suggest finding something positive about the workouts.

Solution

Switch to a new or different activity. (Nemanja Lakicevic, et al., 2020)

When the interest and passion are nowhere to be found don’t engage in the usual workouts, as this can further decrease motivation.
This is the time to change up the routine and go for a leisurely bicycle or rollerblade, skateboard, etc., session.
Go to a park, just walk around, and forget about exercise just taking in everything.
Play a game with a friend or toss a ball around.

Exhaustion

Not just physical, but mental fatigue could be a sign of exercise burnout.

Solution

Rest.
Individuals may think they have to work out every day and stick to the regimen or else they’ve failed.
This type of mindset can lead to burnout and added stress.
The body and mind require adequate recovery time.
Forget about structured exercise for a day, and see how the mind and body feel the next day.
Two or three days off in a row can make a significant difference in motivation and offer a new perspective on the workout routine.

Low Energy Levels After Exercise

Workouts, although tiring in a good way, should energize the individual. Most workouts should leave the body feeling better than before. When the body feels worse or energy levels are low, this could be a sign of overtraining that could lead to exercise burnout.

Solution

This could be the time to ease off of the fitness regimen.
Forget intense workouts and/or heavy-weight training.
This is the time to soothe the body.
Light yoga workouts or Pilates could help.
This is a form of active recovery, allowing the mind and body to rest from the overwork.

Mood Changes and/or Irritability

When the mind and body are overworked and over-trained, it can cause moodiness, irritability, and frustration that leads to burnout.

Solution

Do something that feels good. This could include:

A therapeutic massage.
A spa session.
Taking a long nap.
Soaking the feet.
Taking a therapeutic bath.
Meditation

Burnout can happen, the objective is to keep the solutions simple like taking a few days off or trying something new to come back feeling refreshed and energized.

Multidisciplinary Evaluation and Treatment

References

Lakicevic, N., Gentile, A., Mehrabi, S., Cassar, S., Parker, K., Roklicer, R., Bianco, A., & Drid, P. (2020). Make Fitness Fun: Could Novelty Be the Key Determinant for Physical Activity Adherence?. Frontiers in psychology, 11, 577522. doi.org/10.3389/fpsyg.2020.577522

Velasco, F., & Jorda, R. (2020). Portrait of Boredom Among Athletes and Its Implications in Sports Management: A Multi-Method Approach. Frontiers in psychology, 11, 831. doi.org/10.3389/fpsyg.2020.00831

What You Need to Know About Small Fiber Neuropathy

Dr. Alex Jimenez

its-a-long-road-to-recovery-shot-of-an-elderly-ma-2023-01-04-21-17-14-utc_02 — Its a long road to recovery. Shot of an elderly man having a physiotherapy session

“Individuals diagnosed with peripheral neuropathy, or with small fiber neuropathy, can understanding symptoms and causes help with potential treatments?”

Table of Contents

Small Fiber Neuropathy

Small fiber neuropathy is a specific classification of neuropathy, as there are different types, which are nerve injury, damage, disease, and/or dysfunction. Symptoms can result in pain, loss of sensation, and digestive and urinary symptoms. Most cases of neuropathy like peripheral neuropathy involve small and large fibers. Common causes include long-term diabetes, nutritional deficiencies, alcohol consumption, and chemotherapy.

Small fiber neuropathy is diagnosed after diagnostic testing showing it is clear that the small nerve fibers are involved.
The small nerve fibers detect sensation, temperature, and pain and help regulate involuntary functions.
Isolated small-fiber neuropathy is rare, but research is ongoing on the type of nerve damage and potential treatments. (Stephen A. Johnson, et al., 2021)
Small fiber neuropathy is not specifically dangerous but is a sign/symptom of an underlying cause/condition that is damaging the body’s nerves.

Symptoms

Symptoms include: (Heidrun H. Krämer, et al., 2023)

Pain – symptoms can range from mild or moderate discomfort to severe distress and can happen at any time.
Loss of sensation.
Because the small nerve fibers help with digestion, blood pressure, and bladder control – symptoms of autonomic dysfunction can vary and can include:
Constipation, diarrhea, incontinence, urinary retention – the inability to completely drain the bladder.
If there is progressing nerve damage, the intensity of the pain can decrease, but the loss of normal sensation and autonomic symptoms can worsen. (Josef Finsterer, Fulvio A. Scorza. 2022)
Hypersensitivity to touch and pain sensations can cause pain without a trigger.
The loss of sensation can make individuals unable to accurately detect sensations of touch, temperature, and pain in affected areas, which can lead to various types of injuries.
Although more research is needed, certain disorders that were not considered neuropathies may have small fiber neuropathy components involved.
A study suggested that neurogenic rosacea, a skin condition, could have some elements of small fiber neuropathy. (Min Li, et al., 2023)

Small Nerve Fibers

There are several types of small nerve fibers; two in small fiber neuropathy include A-delta and C (Josef Finsterer, Fulvio A. Scorza. 2022)
These small nerve fibers are distributed throughout the body including the tops of the fingers and toes, trunk, and internal organs.
These fibers are usually located in the superficial areas of the body, such as close to the skin’s surface. (Mohammad A. Khoshnoodi, et al., 2016)
The small nerve fibers that get damaged are involved in transmitting pain and temperature sensations.
Most nerves have a special type of insulation called myelin that protects them and increases the speed of nerve impulses.
Small nerve fibers may have a thin sheath, making them more susceptible to injury and damage at earlier stages of conditions and diseases. (Heidrun H. Krämer, et al., 2023)

Individuals At Risk

Most types of peripheral neuropathy cause damage to the small and large peripheral nerve fibers. Because of this, most neuropathies are a mix of small-fiber and large-fiber neuropathy. Common risk factors for mixed fiber neuropathy include: (Stephen A. Johnson, et al., 2021)

Diabetes
Nutritional deficiencies
Overconsumption of alcohol
Autoimmune disorders
Medication toxicity

Isolated small-fiber neuropathy is rare, but there are conditions that are known to contribute to the cause and include: (Stephen A. Johnson, et al., 2021)

Sjogren Syndrome

This autoimmune disorder causes dry eyes and mouth, dental problems, and joint pain.
It can also cause nerve damage throughout the body.

Fabry Disease

This condition causes a buildup of certain fats/lipids in the body that can lead to neurological effects.

Amyloidosis

This is a rare disorder that causes a buildup of proteins in the body.
The proteins can damage tissues like the heart or nerves.

Lewy Body Disease

This is a neurological disorder that causes dementia and impaired movement and can lead to nerve damage.

Lupus

This is an autoimmune disease that affects joints, skin, and sometimes nerve tissue.

Viral Infection

These infections typically cause a cold or gastrointestinal/GI upsetness.
Less often they can cause other effects like small fiber neuropathy.

These conditions have been seen to cause isolated small-fiber neuropathy or begin as small-fiber neuropathy before progressing to the large nerve fibers. They can also begin as a mixed neuropathy, with small and large fibers.

Progression

Often the damage progresses at a relatively moderate rate, leading to added symptoms within months or years. The fiber nerves that are affected by the underlying condition usually progressively deteriorate, regardless of where they are located. (Mohammad A. Khoshnoodi, et al., 2016) Medications can help alleviate damage to the peripheral nerves. For individuals that are diagnosed in the early stage, it is possible to stop the progression, and potentially prevent involvement of the large fibers.

Treatments

Treatment toward preventing the progression requires controlling the underlying medical condition with treatment options depending on the cause. Treatments that can help prevent the progression include:

Blood sugar control for individuals with diabetes.
Nutritional supplementation for the treatment of vitamin deficiencies.
Quitting alcohol consumption.
Immune suppression for control of autoimmune diseases.
Plasmapheresis – blood is taken and the plasma is treated and returned or exchanged for the treatment of autoimmune diseases.

Symptom Treatment

Individuals can get treatment for the symptoms that will not reverse or cure the condition but can help with temporary relief. Symptomatic treatment can include: (Josef Finsterer, Fulvio A. Scorza. 2022)

Pain management can include medications and/or topical analgesics.
Physical therapy – stretching, massage, decompression, and adjustments to keep the body relaxed and flexible.
Rehabilitation to help improve coordination, which can be impaired by loss of sensation.
Medications to relieve GI symptoms.
Wearing specialized clothes such as neuropathy socks to help with foot pain symptoms.

Treatment and medical management of neuropathies usually involve a neurologist. A neurologist may prescribe medication to help alleviate pain symptoms and provide medical interventions like immunotherapy if there is concern that an autoimmune process could be the cause. Additionally, treatment could include the care of a physical medicine and rehabilitation physician or a physical therapy team to provide stretches and exercises to help strengthen the body and maintain mobility and flexibility.

Peripheral Neuropathy Myths & Facts

References

Johnson, S. A., Shouman, K., Shelly, S., Sandroni, P., Berini, S. E., Dyck, P. J. B., Hoffman, E. M., Mandrekar, J., Niu, Z., Lamb, C. J., Low, P. A., Singer, W., Mauermann, M. L., Mills, J., Dubey, D., Staff, N. P., & Klein, C. J. (2021). Small Fiber Neuropathy Incidence, Prevalence, Longitudinal Impairments, and Disability. Neurology, 97(22), e2236–e2247. doi.org/10.1212/WNL.0000000000012894

Finsterer, J., & Scorza, F. A. (2022). Small fiber neuropathy. Acta neurologica Scandinavica, 145(5), 493–503. doi.org/10.1111/ane.13591

Krämer, H. H., Bücker, P., Jeibmann, A., Richter, H., Rosenbohm, A., Jeske, J., Baka, P., Geber, C., Wassenberg, M., Fangerau, T., Karst, U., Schänzer, A., & van Thriel, C. (2023). Gadolinium contrast agents: dermal deposits and potential effects on epidermal small nerve fibers. Journal of neurology, 270(8), 3981–3991. doi.org/10.1007/s00415-023-11740-z

Li, M., Tao, M., Zhang, Y., Pan, R., Gu, D., & Xu, Y. (2023). Neurogenic rosacea could be a small fiber neuropathy. Frontiers in pain research (Lausanne, Switzerland), 4, 1122134. doi.org/10.3389/fpain.2023.1122134

Khoshnoodi, M. A., Truelove, S., Burakgazi, A., Hoke, A., Mammen, A. L., & Polydefkis, M. (2016). Longitudinal Assessment of Small Fiber Neuropathy: Evidence of a Non-Length-Dependent Distal Axonopathy. JAMA neurology, 73(6), 684–690. doi.org/10.1001/jamaneurol.2016.0057

Low Back Pain: A Chiropractor’s Guide to Spinal Decompression

Dr. Alex Jimenez

Can individuals with low back pain find relief with spinal decompression combined with chiropractic care to reduce muscle pain?

Table of Contents

Introduction

Everyone worldwide has dealt with low back pain, a multifactorial common problem that can mask other musculoskeletal disorders. Low back pain can develop naturally through spinal degeneration, normal environmental factors people put their bodies through, or traumatic factors that can gradually affect the lumbar region over time. The lower back is part of the lumbar spine region as it takes most of the upper body’s weight and stabilizes the lower body when in motion. The lumbar region is thick to support the upper body’s weight and is protected by the surrounding ligaments, muscles, and tissues; however, it is the most susceptible to injury. Many people don’t realize they are experiencing low back pain until an accident or repetitive motions begin to affect the surrounding ligaments or the lumbar intervertebral discs are severely compressed. To that point, many individual are experiencing radiating pain in their lower extremities. However, all is not lost, as there are numerous ways to alleviate low back pain and provide relief to many individuals. Today’s article focuses on the factors that lead to the development of low back pain and how treatments like chiropractic care and spinal decompression can help reduce low back pain and its symptoms. We speak with certified medical providers who incorporate our patients’ information to provide numerous treatment plans to ease low back pain and its associated symptoms. We also inform our patients that there are non-surgical options like chiropractic care and spinal decompression to minimize the radiating pain associated with low back pain. 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 lower back. Dr. Alex Jimenez, D.C., utilizes this information as an academic service. Disclaimer

Factors That Lead To The Development Of Low Back Pain

Do you feel muscle aches and pains in your lower back when stretching? Does the pain cause issues in your mobility when going to run errands? Or do you feel sudden or gradual pain after a long workday of carrying heavy objects or excessively sitting at your desk? When many individuals are experiencing pain in these various scenarios, it can lead to the development of a lower back that correlates with these environmental factors. Low back pain is a common nuisance that many working and non-working individuals experience occasionally. When various risk factors are associated with low back pain, it can cause many individuals to deal with the physical and psychological demands that cause them to do multiple things like heavy lifting, awkward positions, and excessive bending, which can develop pain-like symptoms in the lumbar region. (To et al., 2021) At the same time, compared with other health conditions, low back pain is the highest global burden, causing many individuals to miss out on important events like work and daily activities. (Petrozzi et al., 2020) This causes them to live a life of disability and causes them to feel miserable. Low back pain can affect a person’s socioeconomic demographic and the functionality that they seek the treatment they deserve.

Many individuals who experience low back pain will often lead a life of disability and socioeconomic burden correlated with these factors. (Wong et al., 2022) Many people often think that low back pain only happens to older adults, but low back pain can happen to anybody at any age. Many factors that correlate to the development of low back pain include:

Improper heavy lifting
Walking incorrectly
Being in a slouched or hunched position
An auto accident
Obesity
Gastrointestinal issues
Referred musculoskeletal disorders
Physical inactivity

Many of these environmental factors are associated with low back pain that many people are unaware of when doing their routine. This is due to the surrounding tissues, ligaments, and muscles being overused and affected and the intervertebral disc being constantly compressed from repetitive motions. When this happens, many individuals will often seek treatment to reduce the painful effects of low back pain.

How Chiropractic Care Can Transform Pain Into Relief- Video

How can Chiropractic Care transform pain into relief | El Paso, Tx (2023)

When it comes to reducing low back pain, many individuals will try home remedies to mitigate muscle pain and reduce inflammation associated with low back pain. This provides temporary relief to acute low back pain, but many will seek non-surgical treatment when it comes to chronic low back pain. Non-surgical treatments can help reduce low back pain and its associated symptoms through mechanical and manual techniques. Non-surgical treatments, which include chiropractic care and spinal decompression, could help alleviate low back pain. Since low back pain is associated with altered motor control within the lumbar region, it can hinder lumbar stability, cause impaired detection of passive motion, and affect postural stability. (Fagundes Loss et al., 2020) With non-surgical treatments, many pain specialists can incorporate vertebral mobilizations and manipulation procedures to improve spinal mobility and reduce pain in the lumbar region. The video above explains how chiropractic care and spinal decompression can alleviate lower back pain and help restore functionality in the body.

Chiropractic Care & Low Back Pain

When it comes to reducing low back pain associated with environmental factors, many pain specialists can look at the physical distress cognitive, and functional patterns that are correlated with faulty lumbar movement. (Khodadad et al., 2020) This allows the pain specialist to create a personalized treatment plan for low back pain. Non-surgical treatments like chiropractic care are excellent for reducing low back pain. Chiropractic care incorporates spinal manipulation techniques to realign the spine and help stretch the affected surrounding muscles. Many individuals who include chiropractic care in their routine find significant pain reduction and reduced disability after a few consecutive treatments. (Gevers-Montoro et al., 2021) Chiropractic care can be combined with physical and massage therapy to stretch and strengthen the affected muscles. This, in turn, helps the individual regain spinal mobility and reduce pain.

Spinal Decompression & Low Back Pain

Spinal decompression is another non-surgical treatment that can help alleviate low back pain, like chiropractic care. Spinal decompression utilizes gentle traction on the lumbar spine to be gently pulled to relieve the affected muscles causing lower back pain. Spinal decompression can also ease leg pain associated with low back pain and reduce referred pain affecting the lower extremities. (Wang et al., 2022) Spinal decompression can also improve spinal disc height and help improve muscle strength and trunk endurance. (Kang et al., 2016) The combination of spinal decompression and chiropractic care to reduce lower back pain is effective as these two forms of non-surgical treatments can effectively reduce many people’s musculoskeletal pain and make them aware of the environmental factors that are the root causes of their lower back pain and prevent it from returning.

References

Fagundes Loss, J., de Souza da Silva, L., Ferreira Miranda, I., Groisman, S., Santiago Wagner Neto, E., Souza, C., & Tarrago Candotti, C. (2020). Immediate effects of a lumbar spine manipulation on pain sensitivity and postural control in individuals with nonspecific low back pain: a randomized controlled trial. Chiropr Man Therap, 28(1), 25. doi.org/10.1186/s12998-020-00316-7

Gevers-Montoro, C., Provencher, B., Descarreaux, M., Ortega de Mues, A., & Piche, M. (2021). Clinical Effectiveness and Efficacy of Chiropractic Spinal Manipulation for Spine Pain. Front Pain Res (Lausanne), 2, 765921. doi.org/10.3389/fpain.2021.765921

Kang, J.-I., Jeong, D.-K., & Choi, H. (2016). Effect of spinal decompression on the lumbar muscle activity and disk height in patients with herniated intervertebral disk. Journal of Physical Therapy Science, 28(11), 3125-3130. doi.org/10.1589/jpts.28.3125

Khodadad, B., Letafatkar, A., Hadadnezhad, M., & Shojaedin, S. (2020). Comparing the Effectiveness of Cognitive Functional Treatment and Lumbar Stabilization Treatment on Pain and Movement Control in Patients With Low Back Pain. Sports Health, 12(3), 289-295. doi.org/10.1177/1941738119886854

Petrozzi, M. J., Rubinstein, S. M., Ferreira, P. H., Leaver, A., & Mackey, M. G. (2020). Predictors of low back disability in chiropractic and physical therapy settings. Chiropr Man Therap, 28(1), 41. doi.org/10.1186/s12998-020-00328-3

To, D., Rezai, M., Murnaghan, K., & Cancelliere, C. (2021). Risk factors for low back pain in active military personnel: a systematic review. Chiropr Man Therap, 29(1), 52. doi.org/10.1186/s12998-021-00409-x

Wang, W., Long, F., Wu, X., Li, S., & Lin, J. (2022). Clinical Efficacy of Mechanical Traction as Physical Therapy for Lumbar Disc Herniation: A Meta-Analysis. Comput Math Methods Med, 2022, 5670303. doi.org/10.1155/2022/5670303

Wong, C. K., Mak, R. Y., Kwok, T. S., Tsang, J. S., Leung, M. Y., Funabashi, M., Macedo, L. G., Dennett, L., & Wong, A. Y. (2022). Prevalence, Incidence, and Factors Associated With Non-Specific Chronic Low Back Pain in Community-Dwelling Older Adults Aged 60 Years and Older: A Systematic Review and Meta-Analysis. J Pain, 23(4), 509-534. doi.org/10.1016/j.jpain.2021.07.012

Disclaimer

Avocado for a Healthy Gut Microbiome

Dr. Alex Jimenez

Female nutritionist show avocado fresh vegetables and a tape measure on her table .Concept of a healthy lifestyle, body care and weight loss. Selective focus. Blurred background.Home remote

“Individuals need to eat more fiber for optimal gut health. Can adding avocado to their diet help improve the gut microbe diversity?”

Table of Contents

Avocado Gut Support

A diverse gut microbiome is beneficial to overall health. According to a recent study, eating one avocado a day can help maintain the gut microbes healthy, diverse, and balanced. (Sharon V. Thompson, et al., 2021) The researchers observed positive changes in gut bacteria and increased bacterial diversity in individuals who consumed an avocado every day for 12 weeks. (Susanne M Henning, et al., 2019)

Gut Diversity

The gut microbiome refers to the microorganisms living in the intestines. There are around 100 trillion microorganisms, including bacteria, viruses, fungi, and more, exist in the gastrointestinal tract. (Ana M. Valdes, et al., 2018) Having a diverse microbiome means that the body has a range of different organisms that offer various health benefits. Not having enough bacterial diversity has been linked to: (Ana M. Valdes, et al., 2018)

Arthritis
Obesity
Type 1 diabetes
Type 2 diabetes
Inflammatory bowel disease
Celiac disease
Arterial stiffness
Atopic eczema

Why Avocados?

The Institute of Medicine recommends a daily fiber intake ranging from 19 grams to 38 grams per day, depending on various factors like age. (Diane Quagliani, Patricia Felt-Gunderson. 2016)
Approximately 95% of adults and children do not consume the recommended amount of fiber. (Diane Quagliani, Patricia Felt-Gunderson. 2016)
Including foods like avocados in a healthy diet can help meet daily fiber requirements.
Fruit fiber like pectin, has been shown to promote a healthy gut microbiome as well. (Beukema M, et al., 2020)
Researchers suggest this could be because of pectin’s positive effect on beneficial probiotics.(Nadja Larsen, et al., 2018)
Although further research is needed fiber is believed to help protect the lining of the colon by increasing the bulk and weight of stool and expediting elimination.
Fiber also adds bulk to an individual’s diet and slows the speed of digestion, which makes the body feel fuller longer.

Improved Gut

Individuals can support a healthy microbiota by making small adjustments in their diet, including:

Eating a variety of fruits and vegetables with the skin, as this is where a majority of the nutrition is.
Fermented foods like yogurt, kombucha, sauerkraut, kimchi, and kefir.
Limiting consumption of processed foods, sugar, and artificial sweeteners.
More whole-grain foods.

Ways to eat more avocados include adding them to:

Smoothies
Salads
Sandwichs
Guacamole
If there are more avocados that can be eaten before they overripen, they can be frozen.
Peel and slice them first, then place them in freezer bags to have year-round.
They are rich in healthy fat, however, in moderation, they are not likely to contribute to weight gain.

Individuals can work toward having a diverse gut microbiome by paying attention to the foods they eat. Specific foods and dietary patterns can influence the different types of bacterial diversity which can support health.

Smart Choices, Better Health

References

Thompson, S. V., Bailey, M. A., Taylor, A. M., Kaczmarek, J. L., Mysonhimer, A. R., Edwards, C. G., Reeser, G. E., Burd, N. A., Khan, N. A., & Holscher, H. D. (2021). Avocado Consumption Alters Gastrointestinal Bacteria Abundance and Microbial Metabolite Concentrations among Adults with Overweight or Obesity: A Randomized Controlled Trial. The Journal of nutrition, 151(4), 753–762. doi.org/10.1093/jn/nxaa219

Henning, S. M., Yang, J., Woo, S. L., Lee, R. P., Huang, J., Rasmusen, A., Carpenter, C. L., Thames, G., Gilbuena, I., Tseng, C. H., Heber, D., & Li, Z. (2019). Hass Avocado Inclusion in a Weight-Loss Diet Supported Weight Loss and Altered Gut Microbiota: A 12-Week Randomized, Parallel-Controlled Trial. Current developments in nutrition, 3(8), nzz068. doi.org/10.1093/cdn/nzz068

Valdes, A. M., Walter, J., Segal, E., & Spector, T. D. (2018). Role of the gut microbiota in nutrition and health. BMJ (Clinical research ed.), 361, k2179. doi.org/10.1136/bmj.k2179

Quagliani, D., & Felt-Gunderson, P. (2016). Closing America’s Fiber Intake Gap: Communication Strategies From a Food and Fiber Summit. American journal of lifestyle medicine, 11(1), 80–85. doi.org/10.1177/1559827615588079

Beukema, M., Faas, M. M., & de Vos, P. (2020). The effects of different dietary fiber pectin structures on the gastrointestinal immune barrier: impact via gut microbiota and direct effects on immune cells. Experimental & molecular medicine, 52(9), 1364–1376. doi.org/10.1038/s12276-020-0449-2

Larsen, N., Cahú, T. B., Isay Saad, S. M., Blennow, A., & Jespersen, L. (2018). The effect of pectins on survival of probiotic Lactobacillus spp. in gastrointestinal juices is related to their structure and physical properties. Food microbiology, 74, 11–20. doi.org/10.1016/j.fm.2018.02.015

The Benefits Of Jumping Rope: Enhance Balance & Coordination

Dr. Alex Jimenez

“Individuals trying to get and stay in shape can find it difficult to get a regular workout. Can jumping rope help when there is no time?”

Table of Contents

Jumping Rope

Jumping rope can be a highly cost-effective exercise to incorporate high-intensity cardiovascular fitness into a workout routine. It is inexpensive, efficient, and done properly can improve cardiovascular health, improve balance and agility, increase muscular strength and endurance, and burn calories. (Athos Trecroci, et al., 2015)

Jumping rope can be utilized in interval training to keep the heart rate elevated and allow the muscles to rest in between weight lifting and other intense exercises.
A jump rope can be used when traveling as its portability makes it a top piece of workout gear.
It can be combined with bodyweight exercises for a dependable and portable exercise routine.

Benefits

Jumping rope is a medium-impact exercise with benefits that include:

Improves balance, agility, and coordination
Builds stamina and foot speed for coordination, agility, and quick reflexes.
Variations include one-leg jumping and double unders or with each jump, the rope goes around twice to add difficulty.
Builds Fitness Fast
Burns calories

Depending on skill level and jumping rate, individuals can burn 10 to 15 calories a minute by jumping rope.
Faster rope jumping can burn calories similar to running.

Precautions

For individuals who have high blood pressure, jumping rope may not be recommended. The downward arm position can reduce blood circulation back to the heart which can further increase blood pressure. Studies have shown that jumping at a moderate intensity is beneficial for individuals who are pre-hypertensive. (Lisa Baumgartner, et al., 2020) Individuals with hypertension and/or a heart condition, are recommended to discuss the potential risks with their doctor before beginning a new exercise routine.

Choosing a Rope

Jump ropes are available and made from various materials and come with different handles.
Cordless jump ropes are great for working out in limited spaces.
Some of these materials help jump ropes spin faster with a smooth motion.
Some options have a swivel action between the cords and handles.
The rope you buy should be comfortable to hold and have a smooth spin.
Weighted jump ropes can help develop upper body muscle tone and endurance. (D. Ozer, et al., 2011) These ropes are not for beginners and are not necessary for an agility workout.
For individuals who want a weighted rope, be sure the weight is in the rope and not the handles to prevent straining the wrists, elbows, and/or shoulders.

Size the rope by standing on the center of the rope
Pull the handles up along the sides of the body.
For beginners, the handles should just reach the armpits.
As the individual’s skills and fitness develop, the rope can be shortened.
A shorter rope spins faster, forcing more jumps.

Technique

Following proper technique will ensure a more safe and effective workout.

Start slowly.
The proper jumping form keeps the shoulders relaxed, elbows in, and slightly bent.
There should be very few upper-body movements.
The majority of the turning power and motion come from the wrists, not the arms.
During jumping, keep the knees slightly bent.
Bounce softly.
The feet should leave the floor just enough to allow the rope to pass.
Land softly on the balls of the feet to avoid knee injuries.
It is not recommended to jump high and/or land hard.
Jump on a surface that is smooth and free of obstacles.
Wood, a sports court, or a rubberized mat are recommended.

Warming Up

Before beginning jumping rope, do a light, 5 to 10-minute warm-up.
This can include walking or jogging in place, or slow-paced jumping.

Increase Time and Intensity Gradually

The exercise can be relatively intense and high-level.

Start slowly and increase gradually.
An individual might try three 30-second sets at the end of a routine workout for the first week.
Depending upon fitness level, individuals may feel nothing or some slight soreness in the calf muscles.
This can help determine how much to do for the next jump rope session.
Gradually increase the number of sets, or the duration, over several weeks until the body can go for about ten minutes of continuous jumping.
One way is to jump after each weight-lifting set or other circuit exercise – like adding jumping for 30 to 90 seconds in between exercise sets.

Stretch Out After

Cooling down and stretching after is helpful to gradually reduce heart rate and relax the muscles. (Bas Van Hooren, Jonathan M. Peake. 2018)

Sample Workouts

There are variations of workouts. Here are a few:

Double foot jump

This is the basic jump.
Both feet slightly lift off from the ground and land together.

Alternate foot jump

This uses a skipping step.
This allows landing more prominently on one foot after each spin.

Running step

A slight jog is incorporated while jumping.

High step

A moderate pace with a high knee raise increases intensity.

Rope jumping is a great addition to an interval training or cross-training routine that creates an efficient whole-body workout that incorporates both cardiovascular endurance and muscular strength.

Overcoming ACL Injury

References

Trecroci, A., Cavaggioni, L., Caccia, R., & Alberti, G. (2015). Jump Rope Training: Balance and Motor Coordination in Preadolescent Soccer Players. Journal of sports science & medicine, 14(4), 792–798.

Baumgartner, L., Weberruß, H., Oberhoffer-Fritz, R., & Schulz, T. (2020). Vascular Structure and Function in Children and Adolescents: What Impact Do Physical Activity, Health-Related Physical Fitness, and Exercise Have?. Frontiers in pediatrics, 8, 103. doi.org/10.3389/fped.2020.00103

Ozer, D., Duzgun, I., Baltaci, G., Karacan, S., & Colakoglu, F. (2011). The effects of rope or weighted rope jump training on strength, coordination and proprioception in adolescent female volleyball players. The Journal of sports medicine and physical fitness, 51(2), 211–219.

Van Hooren, B., & Peake, J. M. (2018). Do We Need a Cool-Down After Exercise? A Narrative Review of the Psychophysiological Effects and the Effects on Performance, Injuries and the Long-Term Adaptive Response. Sports medicine (Auckland, N.Z.), 48(7), 1575–1595. doi.org/10.1007/s40279-018-0916-2

Tips for Improving Posture with Ankylosing Spondylitis

Dr. Alex Jimenez

Young man with back pain doing stretching exercises in the living room of his apartment

“Ankylosing spondylitis is an inflammatory arthritis that causes changes in posture that occur over time. Can exercise and maintaining spinal alignment help improve posture problems?”

Table of Contents

Ankylosing Spondylitis Posture Improvement

Ankylosing spondylitis/AS is an autoimmune arthritis that primarily affects the spine. It can also spread to other joints of the body and affect the internal organs. Back pain problems are a common side effect of the condition and depending on the severity of damage to the spine, it can have a serious impact on posture.

Affects Posture

The condition usually first affects the sacroiliac joints at the bottom of the spine where they attach to the pelvis. As the condition progresses it works its way to the upper spine. The spine consists of 26 vertebrae/bones stacked on top of each other.

Ankylosing spondylitis can cause the bones to fuse together. (National Institute of Arthritis and Musculoskeletal and Skin Diseases. 2023)
The condition causes kyphotic deformity – rounding of the upper back, and the lower back flattening.
As the disease progresses, the spine becomes immobilized in a stooped-over position and causes significant difficulty with daily tasks.
A stooped posture can place pressure on the internal organs and lead to breathing difficulties.
The condition leads to balance problems which increase the risk of falls. (Alessandro Marco De Nunzio, et al., 2015)

Posture Improvement Tips

Standing and Walking

When standing or walking try to remember to:

Maintain a straight spine.
Line up the ears, shoulders, hips, knees, and ankles in a straight line.
Squeeze the shoulder blades together and down toward the back pockets.
Relax the arms at the sides.
Look straight ahead.
Tuck the chin back slightly.

Sitting

The natural curves of the spine need support for proper posture when sitting. Try these tips when at a desk or at a table:

Position the height of the chair so the hips and knees are bent at 90-degree angles.
Place the feet flat on the floor or use a footstool based on chair height.
Place a lumbar support pillow or rolled-up towel behind the lower back.
Position the screen monitor at eye level to keep the upper back straight.
Keep the keyboard and mouse close to the body to prevent overreaching which can increase the rounding of the shoulders and upper back.

Lying Down

Ankylosing spondylitis can make lying down uncomfortable. To support the spine while lying down try to:

Sleep on a semi-firm mattress or type like memory foam to conform to the body.
Place a pillow between the knees to maintain a straight spine when lying on the side.
Use a specialized pillow to prevent placing the upper back in a rounded position.

Posture Exercises

For individuals with ankylosing spondylitis stretching and strengthening exercises can help improve body posture. Individuals are recommended to talk to their healthcare provider before beginning an exercise program.

Chin Tucks

Sit up straight.
Squeeze the shoulder blades together.
Rest the arms at your sides.
Look straight ahead, pull the chin back and in until the stretch is felt along the muscles of the neck.
Hold for three to five seconds and relax.
Repeat 10 times.

Corner Stretch

Stand facing a corner.
Raise the arms to shoulder height.
Place one forearm flat against each wall.
Stagger the feet.
Slowly shift weight over the front leg and lean in toward the corner.
Stop once the stretch is felt across the chest.
Hold for 10 to 20 seconds and relax.
Repeat three times.

Scapular Squeezes

Sit up straight with arms resting at the sides.
Squeeze the shoulder blades together like they are holding an object between them.
Hold for three seconds and relax.
Repeat 10 times.

Maintaining spinal alignment will help decrease back pain that occurs with AS.

Targeted exercises can help stretch tight muscles and strengthen the muscles responsible for maintaining spinal alignment.
Maintaining healthy posture when sitting, standing, and sleeping can help prevent deformities in the spine.
Regular physical activity can help combat stiffness and help maintain overall strength.

For an individualized exercise program, see a physical therapist or chiropractor on incorporating posture exercises to help prevent complications from developing.

Arthritis

References

National Institute of Arthritis and Musculoskeletal and Skin Diseases. Ankylosing spondylitis.

De Nunzio, A. M., Iervolino, S., Zincarelli, C., Di Gioia, L., Rengo, G., Multari, V., Peluso, R., Di Minno, M. N., & Pappone, N. (2015). Ankylosing spondylitis and posture control: the role of visual input. BioMed research international, 2015, 948674. doi.org/10.1155/2015/948674

How To Ease Lumbar Back Pain With Distraction Techniques

Dr. Alex Jimenez

In individuals with lumbar back pain, can pain specialists utilize distraction techniques to reduce muscle spasms?

Table of Contents

Introduction

Many individuals dealing with specific or nonspecific back pain can agree that it can dampen their moods as they try to find the relief they seek to get back to their routine. More often than not, back pain is a common multifactorial musculoskeletal disorder that can affect the entire body, and it all starts with how people do simple movements incorrectly, causing compression to the spine. Since the spine is the main backbone of the body, it is responsible for training, stability, and flexibility. The surrounding muscles that encompass the spine act like a barrier to protect the skeletal joints and the spinal cord from injuries that are either traumatic or normal wear and tear. Lumbar back pain is also an economic burden that can cause unnecessary stress to the body, which leads to muscle spasms and causes even more stress to the individual. With lumbar back pain being a common nuisance to everyone worldwide, many will opt for treatment to reduce the pain and continue their daily activities. In today’s article, we will explore the issues of lumbar back pain and how treatments with distraction techniques alleviate the effects of lumbar back pain and reduce muscle spasms. We speak with certified medical providers who incorporate our patients’ information to provide numerous treatment plans to mitigate lumbar back pain associated with environmental factors. We also inform our patients that there are non-surgical options to reduce the pain-like symptoms related to lumbar back pain and reduce the effects of muscle spasms. We encourage our patients to ask astounding educational questions to our associated medical providers about the pain-like symptoms they are experiencing correlating with the lumbar spine. Dr. Alex Jimenez, D.C., utilizes this information as an academic service. Disclaimer

The Issues Of Lumbar Back Pain

Do you often feel pain radiating from your lower back to your legs after work? Did you lift something heavy that caused your back muscles to strain and be in pain? Or do you and your loved ones feel muscle spasms in your lower back after stretching in the morning? When many individuals are dealing with these musculoskeletal issues, it often correlates with lumbar back pain. As stated earlier, the spine is the body’s backbone, and its main job is to support the body’s weight, provide stability to the upper and lower quadrants, and allow the host to move without pain or discomfort. When normal or traumatic factors start to affect many individuals over time, it can lead to the development of lumbar back pain, and it can become an issue for many young and older adults. Since lumbar back pain can be mechanical or nonspecific, it can arise intrinsically from the spine and the spinal components through repetitive muscle trauma that can be overused while being one of the common causes many people experience pain in their lumbar spine. (Will et al., 2018) When many individuals are dealing with lumbar back pain, it can become a reoccurring issue, and many go to medical clinics to get treatment for their lumbar back pain.

Another issue that lumbar back pain causes is affecting the spinal structure and the surrounding muscles, tissues, and ligaments that protect the spine. Since the body is remarkable for sensing when pain affects the spine, the vital structures are affected and start to respond by adopting other measures to maintain the spine’s stability. (Hauser et al., 2022) This means that when the body starts to develop muscle spasms in the spine, the stretched ligaments react rapidly to prevent the spine from destabilizing. This leads to individuals feeling aches and pain in their lower back, which then causes them to miss out on their activities.

The Road To Recovery: Chiropractic Care- Video

The road to Recovery "Chiropractic Care" | El Paso, Tx (2023)

When it comes to lumbar back pain, many everyday factors can contribute to its development and cause issues for many individuals. Many individuals with lumbar back pain often experience referred pain in their lower extremity regions as the lumbar portions of the spine have compressed spinal discs, which can also correlate with nerve entrapment. To this point, many will seek out various treatments to reduce low back pain and its associated symptoms. When patients have prolonged symptoms correlating with lumbar pain, conservative management that is either non-surgical or surgical can help treat the pain-like symptoms related to lumbar back pain. (Mohd Isa et al., 2022) Lumbar back pain treatments can be customizable and cost-effective to the person’s pain severity. Non-surgical treatments can help lumbar back pain issues and reduce referred pain symptoms from different body locations in the upper or lower body quadrants. When people go to get their lumbar back pain treated, pain specialists like chiropractors, massage therapists, and physical therapists utilize various techniques and treatments to reduce pain affecting the surrounding ligaments, tissues, and muscles through stretches and traction. The video above explains how these treatments can help reduce pain caused by environmental factors and also help speed up recovery.

Distraction Techniques To Reduce Lumbar Back Pain

When many individuals get treated for lumbar back pain, many opt for non-surgical treatments due to being more affordable than surgical treatments. Pain specialists like chiropractors or massage therapists use distraction techniques to reduce the pain. These pain specialists also incorporate manual and mechanical therapy to be body-oriented to mobilize, manipulate, and stretch out the soft tissues and strengthen them. (Kuligowski et al., 2021) This, in turn, can help reduce lumbar back pain while allowing the individual to be more mindful about their actions to reduce the chances of back pain from returning. At the same time, the effectiveness of treating lumbar back pain through traction can effectively reduce nerve root compression and unresponsive movement symptoms. (Vanti et al., 2021) Traction therapy is a non-surgical treatment that gently stretches the spine to alleviate pain and help kick-start the natural healing process.

Distraction Techniques Reducing Muscle Spasms

Pain specialists incorporate distraction techniques to reduce lumbar back pain and muscle spasms in the lumbar region. As stated earlier, distraction techniques associated with non-surgical treatments can be an excellent way to minimize lumbar back pain. Distraction manipulation can help elevate the affected intervertebral disc by reducing the pressure off the disc and increasing its height in the spine. (Choi et al., 2015) Many individuals feel better when they incorporate distraction therapy to reduce lumbar pain. At the same time, distraction therapy can also be incorporated into a personalized plan to reduce muscle spasms and strengthen weak muscles that surround the lumbar region. The effects of lumbar traction combined with distraction therapy can improve pain and reduce functional disability within the lumbar spine. (Masood et al., 2022) When many people start to think more about their health and wellness, they can make small changes in their routine to prevent low back pain from progressing into something chronic and strengthen their weak muscles to control the pain-like symptoms from returning.

References

Choi, J., Lee, S., & Jeon, C. (2015). Effects of flexion-distraction manipulation therapy on pain and disability in patients with lumbar spinal stenosis. Journal of Physical Therapy Science, 27(6), 1937-1939. doi.org/10.1589/jpts.27.1937

Hauser, R. A., Matias, D., Woznica, D., Rawlings, B., & Woldin, B. A. (2022). Lumbar instability as an etiology of low back pain and its treatment by prolotherapy: A review. J Back Musculoskelet Rehabil, 35(4), 701-712. doi.org/10.3233/BMR-210097

Kuligowski, T., Skrzek, A., & Cieslik, B. (2021). Manual Therapy in Cervical and Lumbar Radiculopathy: A Systematic Review of the Literature. Int J Environ Res Public Health, 18(11). doi.org/10.3390/ijerph18116176

Masood, Z., Khan, A. A., Ayyub, A., & Shakeel, R. (2022). Effect of lumbar traction on discogenic low back pain using variable forces. J Pak Med Assoc, 72(3), 483-486. doi.org/10.47391/JPMA.453

Mohd Isa, I. L., Teoh, S. L., Mohd Nor, N. H., & Mokhtar, S. A. (2022). Discogenic Low Back Pain: Anatomy, Pathophysiology and Treatments of Intervertebral Disc Degeneration. Int J Mol Sci, 24(1). doi.org/10.3390/ijms24010208

Vanti, C., Turone, L., Panizzolo, A., Guccione, A. A., Bertozzi, L., & Pillastrini, P. (2021). Vertical traction for lumbar radiculopathy: a systematic review. Arch Physiother, 11(1), 7. doi.org/10.1186/s40945-021-00102-5

Will, J. S., Bury, D. C., & Miller, J. A. (2018). Mechanical Low Back Pain. American Family Physician, 98(7), 421-428. www.ncbi.nlm.nih.gov/pubmed/30252425

www.aafp.org/pubs/afp/issues/2018/1001/p421.pdf

Disclaimer

Hope with Regenerative Medicine and Thyroid Regeneration

Dr. Alex Jimenez

Young Hispanic female patient touching her thyroid in front of clinician — Young Hispanic female patient touching her thyroid during self examination while sitting on couch in front of clinician

“As research increases in regenerative medicine with the potential of being able to regrow thyroid tissue, could regeneration therapy eliminate the need for patients to take thyroid replacement hormones?”

Table of Contents

Thyroid Regenerative Therapy

A great hope for regenerative therapy is the ability to grow healthy organs. One of the organs being looked at is the thyroid gland. The goal is to re-grow thyroid tissue in:

Individuals who had to have the gland removed because of thyroid cancer.
Individuals who were born without a fully developed gland.

As science advances and research has expanded from laboratory and animal experiments to test tube human thyroid cell studies, the use of stem cell therapy for this purpose is not there yet, as more extensive research is needed for human consideration.

Human Research

Research on the use of thyroid regenerative therapy for thyroid disease has not published studies in which stem cell therapy has been attempted in human thyroid patients.

The studies that have been done were conducted in mice, and any findings of this research cannot automatically be applied to humans. (H. P. Gaide Chevronnay, et al., 2016)
In human thyroid tissue in test tube studies, the stimulation of cells was achieved in a way that raised the question of making cancerous transformations more likely if it were to be attempted in humans. (Davies T.F., et al., 2011)

Recent Studies

Current research involves advances in embryonic stem cell – ESC and induced pluripotent stem cell – iPSC. (Will Sewell, Reigh-Yi Lin. 2014)
ESCs, also known as pluripotent stem cells, can increase any type of cell in the body.
They are harvested from embryos that were produced, but not implanted, during IVF procedures.
iPSCs are pluripotent cells that have been developed using a reprogramming process of adult cells.

Follicular cells are thyroid cells that make thyroid hormones – T4 and T3 and have been produced from the embryonic stem cells of mice.
In a study published in the journal Cell Stem Cell in 2015, these cells had the ability to grow and were also able to start making thyroid hormone within two weeks. (Anita A. Kurmann, et al., 2015)
After eight weeks, cells that were transplanted into mice that did not have thyroid glands had normal amounts of thyroid hormone.

New Thyroid Gland

Investigators at Mount Sinai Hospital induced human embryonic stem cells into thyroid cells.
They were looking at the possibility of creating a new-like thyroid gland in individuals who have had their thyroid surgically removed.
They reported their results at the 84th annual American Thyroid Association meeting. (R. Michael Tuttle, Fredric E. Wondisford. 2014)

The future looks promising for the ability to regrow thyroid tissue and eliminate thyroid replacement hormone. However, far more research is needed for this to even be considered a possibility.

Cracking the Low Thyroid Code Assessment Guide

References

Gaide Chevronnay, H. P., Janssens, V., Van Der Smissen, P., Rocca, C. J., Liao, X. H., Refetoff, S., Pierreux, C. E., Cherqui, S., & Courtoy, P. J. (2016). Hematopoietic Stem Cells Transplantation Can Normalize Thyroid Function in a Cystinosis Mouse Model. Endocrinology, 157(4), 1363–1371. doi.org/10.1210/en.2015-1762

Davies, T. F., Latif, R., Minsky, N. C., & Ma, R. (2011). Clinical review: The emerging cell biology of thyroid stem cells. The Journal of clinical endocrinology and metabolism, 96(9), 2692–2702. doi.org/10.1210/jc.2011-1047

Sewell, W., & Lin, R. Y. (2014). Generation of thyroid follicular cells from pluripotent stem cells: potential for regenerative medicine. Frontiers in endocrinology, 5, 96. doi.org/10.3389/fendo.2014.00096

Kurmann, A. A., Serra, M., Hawkins, F., Rankin, S. A., Mori, M., Astapova, I., Ullas, S., Lin, S., Bilodeau, M., Rossant, J., Jean, J. C., Ikonomou, L., Deterding, R. R., Shannon, J. M., Zorn, A. M., Hollenberg, A. N., & Kotton, D. N. (2015). Regeneration of Thyroid Function by Transplantation of Differentiated Pluripotent Stem Cells. Cell stem cell, 17(5), 527–542. doi.org/10.1016/j.stem.2015.09.004

Tuttle, R. M., & Wondisford, F. E. (2014). Welcome to the 84th annual meeting of the American Thyroid Association. Thyroid : official journal of the American Thyroid Association, 24(10), 1439–1440. doi.org/10.1089/thy.2014.0429

Healing a Hamstring Muscle Tear: What You Need to Know

Dr. Alex Jimenez

running-pain-injury-and-woman-runner-with-fitness-2023-09-18-22-44-48-utc_02 — Running pain, injury and woman runner with fitness muscle inflammation on a training run in a park

“Hamstring muscle tears are common, especially in athletes and individuals with physically demanding jobs. Is there a better chance of full recovery with surgical repair and post-op rehabilitation?”

Table of Contents

Hamstring Muscle Tear

Most often, a hamstring muscle tear is a partial tear of the muscle. These types of injuries are muscle strains that occur when the muscle fibers are stretched beyond their normal limits. Complete tears of the hamstring muscle are unusual, but they do occur in both athletes and non-athletes. Determining the optimal treatment plan depends on:

The severity of the tendon tear
The expectations of the injured individual.

Incomplete tears are when the hamstring muscle is stretched too far, but not completely detached.
If the tear completes, the injury is more significant, as the ends are no longer connected. (American Academy of Orthopaedic Surgeons. 2021)
Complete tears usually occur at the top of the muscle where the tendon tears away from the pelvis.
A complete tear usually occurs when there is a sudden flexion of the hip and extension of the knee joint – when the muscle contracts in this position, it gets stretched beyond its limits.
Complete tears are recognized as different injuries and may require more invasive treatments. (American Academy of Orthopaedic Surgeons. 2021)
Individuals who sustain this type of injury describe a sharp stabbing in the back of the thigh.
The injury may occur in athletes or middle-aged individuals. (American Academy of Orthopaedic Surgeons. 2021)

Basic hamstring strains can be treated with simple steps – rest, ice, anti-inflammatory medications, and conservative therapies.

Symptoms

Symptoms of a hamstring muscle strain can include pain, bruising, swelling, and movement difficulty. (American Academy of Orthopaedic Surgeons. 2021) Individuals who sustain this injury typically experience sudden sharp pain. Signs of a tear can include:

Sharp pain where the buttock and thigh meet.
Difficulty walking.
Sitting can be difficult as the edge of a chair can place pressure directly on the injury.
Spasms and cramping sensations in the back of the thigh.
Weakness in the leg, specifically when bending the knee or lifting the leg behind the body.
Numbness or burning sensations as a result of sciatic nerve irritation.
Swelling and bruising in the back of the thigh – over time it can travel down to the back of the knee and calf and possibly into the foot.
With a complete hamstring tear, there is usually significant swelling and bruising that develops in the back of the thigh.

Diagnosis

The symptoms can be difficult to spot in the early stages which is why X-rays of the hip or thigh are usually obtained.

In some situations, a fragment of bone can get pulled off the pelvis along with the hamstring muscle attachment. MRI testing can be performed to evaluate the attachment and can define critical features of a complete hamstring muscle tear, including: (American Academy of Orthopaedic Surgeons. 2021)

The number of tendons involved.
Complete versus incomplete tearing.
The amount of retraction – the amount the tendons have pulled back.
This will guide the development of treatment.

Treatment

The treatment of a complete tear will depend on different factors. The other variable is the patient and their expectations.

Treatment is more aggressive in younger individuals like high-level athletes.
Treatment is less aggressive in middle-aged individuals.
Often a single tendon tear can be treated non-surgically.
When one tendon is involved, it is typically not pulled very far from its normal attachment and will develop scar tissue in a positive position.
Conversely, when three tendons have been torn, they usually pull more than a few centimeters away from the bone. These cases have better results with surgical repair. (UW Health. 2017)
Surgeons will use patient characteristics – high-level athletes or less physically active individuals – to guide treatment recommendations.

Rehabilitation

Rehabilitation following surgery can take 3-6 months or longer.
The first six weeks limit weight-bearing with the use of crutches.
Patients may be recommended to wear a brace to reduce tension on the repaired hamstring tendons.
Strengthening does not begin until three months post-op, and even light activities are usually delayed. (UW Health. 2017)
Because this injury can have a long recovery time, some individuals may choose nonsurgical treatment.
Sometimes these individuals experience symptoms of discomfort from sitting and may exhibit long-term weakness of the hamstring muscle.

Full recovery from a complete hamstring muscle injury takes time. Studies have shown high-level athletes are able to resume competitive sports after the repair and rehabilitation of an acute hamstring muscle injury. (Samuel K. Chu, Monica E. Rho. 2016)

Delaying surgical treatment may not always lead to optimal results.
When the tendon is torn away from its normal attachment, it begins to scar around the surrounding soft tissues.
When there is a delay of more than a few weeks following the initial injury, regaining the full length of the tendon and muscle can be challenging.
This could delay the rehabilitation process and may limit the potential for full recovery. (Ho Yoon Kwak, et al., 2011)

With severe injuries, there is a better chance of full recovery with surgical repair but could involve a long recovery and commitment to a post-op rehabilitation plan.

Understanding Long-Lasting Injuries

References

American Academy of Orthopaedic Surgeons. (2021) Hamstring muscle injuries.

UW Health. (2017) Rehabilitation guidelines following proximal hamstring primary repair.

Chu, S. K., & Rho, M. E. (2016). Hamstring Injuries in the Athlete: Diagnosis, Treatment, and Return to Play. Current sports medicine reports, 15(3), 184–190. doi.org/10.1249/JSR.0000000000000264

Kwak, H. Y., Bae, S. W., Choi, Y. S., & Jang, M. S. (2011). Early surgical repair of acute complete rupture of the proximal hamstring tendons. Clinics in orthopedic surgery, 3(3), 249–253. doi.org/10.4055/cios.2011.3.3.249

Tackling Lumbar Degenerative Disorders with the Right Treatment

Dr. Alex Jimenez

How can spinal decompression reduce pain while restoring spinal flexibility in many individuals with lumbar degenerative disorders?

Table of Contents

Introduction

As we naturally age, so do our spines and spinal discs, as the natural fluids and nutrients stop hydrating the discs and cause them to degenerate. When disc degeneration starts to affect the spine, it can cause pain-like symptoms in the lumbar regions, which then develop into lower back pain or other musculoskeletal disorders that affect the lower extremities. When disc degeneration starts to affect the lumbar region, many individuals will notice that they are not as flexible as when they were younger. The physical signs of straining their muscles from improper lifting, falling, or carrying heavy objects can cause muscle strain and pain. When this happens, many individuals will treat the pain with home remedies, which can provide temporary relief but can aggravate it more when people make repetitive motions to their lumbar spine, which can result in injuries. Fortunately, non-surgical treatments that can help slow down the process of disc degeneration while rehydrating the spinal disc. Today’s article looks at why disc degeneration affects lumbar flexibility and how treatments like spinal decompression reduce disc degeneration while restoring lumbar flexibility. Coincidentally, we communicate with certified medical providers who incorporate our patients’ information to provide various treatment plans to reduce the disc degeneration process and provide pain relief. We also inform them that there are non-surgical options to reduce the pain-like symptoms associated with disc degeneration and help restore lumbar flexibility. We encourage our patients to ask amazing educational questions to our associated medical providers about their symptoms correlating with body pain in a safe and positive environment. Dr. Alex Jimenez, D.C., incorporates this information as an academic service. Disclaimer

How Does DDD Affect Lumbar Flexibility?

Have you been experiencing stiffness in your back when you wake up in the morning? Do you feel muscle aches and pains when bending down and picking up heavy objects? Or do you feel radiating pain in your legs and back? When many individuals are in excruciating pain, many don’t often realize that their lower back pain could also be associated with their spinal disc degenerating. Since the spinal disc and the body can degenerate naturally, it can lead to the development of musculoskeletal disorders. DDD, or degenerative disc disease, is a common disabling condition that can greatly impact the musculoskeletal system and is the main cause of individuals missing out on their daily activities. (Cao et al., 2022) When normal or traumatic factors begin to cause repetitive motions to the spine, it can cause the spinal disc to be compressed and, over time, degenerate. This, in turn, causes the spine to be less flexible and becomes a socio-economic challenge.

When disc degeneration starts to cause spinal inflexibility, it can lead to the development of low back pain. Since low back pain is a common health concern, it can affect many individuals worldwide, as disc degeneration is a common factor. (Samanta et al., 2023) Since disc degeneration is a multi-factorial disorder, the musculoskeletal and organ systems are also affected as it can cause referred pain to different body locations. Luckily, many individuals can find the treatment they are looking for, as many seek relief from the many pain issues that disc degeneration has caused.

Lumbar Spine Injuries In Athletes- Video

Lumbar Spine Injuries in Athletes | El Paso, Tx (2023)

Since disc degeneration is a multi-factorial cause of disability, it can become a primary source of back pain. When normal factors contribute to back pain, it likely correlates with disc degeneration and can cause cellular, structural, compositional, and mechanical changes throughout the spine. (Ashinsky et al., 2021) However, many individuals seeking treatment can look into non-surgical therapies as they are cost-effective and safe on the spine. Non-surgical treatments are safe and gentle on the spine as they can be customizable to the person’s pain and combined with other treatment forms. One of the non-surgical treatments is spinal decompression, which uses gentle traction on the spine to rehydrate the spinal disc from degeneration and help kick-start the body’s natural healing process. The video above shows how disc degeneration is correlated with disc herniation and how these treatments can reduce its pain-like effects on the spine.

Spinal Decompression Reducing DDD

When many individuals are going in for treatment for disc degeneration, many will often try spinal decompression as it is affordable. Many healthcare professionals will assess the individual by creating a personalized plan before entering the traction machine. Many individuals will get a CT scan to assess the changes caused by DDD. (Dullerud & Nakstad, 1994) This determines how severe the disc space is. The traction machine for spinal decompression determines the optimal treatment duration, frequency, and mode of administrating traction to the spine to reduce DDD. (Pellecchia, 1994) Additionally, the efficiency of traction from spinal decompression can help many people with low back and provide relief. (Beurskens et al., 1995)

References

Ashinsky, B., Smith, H. E., Mauck, R. L., & Gullbrand, S. E. (2021). Intervertebral disc degeneration and regeneration: a motion segment perspective. Eur Cell Mater, 41, 370-380. doi.org/10.22203/eCM.v041a24

Beurskens, A. J., de Vet, H. C., Koke, A. J., Lindeman, E., Regtop, W., van der Heijden, G. J., & Knipschild, P. G. (1995). Efficacy of traction for non-specific low back pain: a randomised clinical trial. Lancet, 346(8990), 1596-1600. doi.org/10.1016/s0140-6736(95)91930-9

Cao, G., Yang, S., Cao, J., Tan, Z., Wu, L., Dong, F., Ding, W., & Zhang, F. (2022). The Role of Oxidative Stress in Intervertebral Disc Degeneration. Oxid Med Cell Longev, 2022, 2166817. doi.org/10.1155/2022/2166817

Dullerud, R., & Nakstad, P. H. (1994). CT changes after conservative treatment for lumbar disk herniation. Acta Radiol, 35(5), 415-419. www.ncbi.nlm.nih.gov/pubmed/8086244

Pellecchia, G. L. (1994). Lumbar traction: a review of the literature. J Orthop Sports Phys Ther, 20(5), 262-267. doi.org/10.2519/jospt.1994.20.5.262

Samanta, A., Lufkin, T., & Kraus, P. (2023). Intervertebral disc degeneration-Current therapeutic options and challenges. Front Public Health, 11, 1156749. doi.org/10.3389/fpubh.2023.1156749