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Abdominal Self Massage to Ease Constipation

By
Dr. Alex Jimenez
-
Top view of smiling young woman doing yoga and lying on floor with hands on stomach, copy space

For individuals struggling with constipation, a common digestive issue, could performing abdominal self-massage help bring relief?

Abdominal Self Massage to Ease Constipation

Abdominal Self Massage

Constipation refers to having a bowel movement fewer than three times per week. In addition to stress, certain lifestyle issues can lead to constipation, including not getting enough fiber, exercise, and proper hydration. Many also experience constipation while traveling. Abdominal self-massage involves gently massaging the stomach with your hands, either in a circular motion or with strokes, to improve digestion, relieve constipation, and reduce bloating. Performing self-massage on and around the abdomen can help ease constipation in several ways, such as stimulating the muscles, producing bowel movements, and soothing chronic stress. (Sinclair M. 2011)

Massage and Constipation

Abdominal massage can provide several benefits, including:

Stimulates and Improves Digestion

  • Massage stimulates the muscles and nerves that control digestion, promoting bowel movements and reducing constipation.

Reduces Bloating

  • Massaging the abdomen may help to reduce bloating and gas by gently moving fluids and gases through the digestive system.
  • In addition, it can help soften stool, speed up the movement of stool through the gut, and reduce the need to use laxatives. (University of Michigan Medicine, 2021)

Relieves Constipation

  • Abdominal massage can help with constipation by encouraging bowel movements.

Reduces Pain and Discomfort

  • Some find that abdominal massage helps to reduce pain and discomfort related to digestive issues.
  • Massage can help relax tense abdominal muscles and reduce pain associated with conditions like irritable bowel syndrome (IBS).

Improved lymphatic drainage

  • Massage helps move lymphatic fluid, which carries waste products and toxins away from the abdominal area.

Research

Although massage isn’t a standard treatment for constipation, some research shows it may help restore regularity. A report reviewed several clinical trials focusing on abdominal massage and its use as a treatment for chronic constipation. The results showed that abdominal massage may provide relief by promoting peristalsis, a series of muscle contractions that help move food through the digestive tract.  The report also found that massage may help lessen colonic transit time, which is when digested food passes through the colon or last segment of the digestive tract. The report determined that abdominal massage can help alleviate constipation-related pain and discomfort. (Sinclair M. 2011)

In clinical trials, individuals with constipation reported improved quality of life after abdominal self-massage. However, some research suggests that using abdominal massage for constipation relief will not decrease the use of laxatives, the most commonly used treatment. (Lämås K. et al., 2009)

How to Massage

Various massage techniques may help relieve constipation and promote bowel movements. These are typically performed while lying down.

  • One technique involves placing the palm on the abdomen and making small, circular, clockwise motions around your belly button.
  • Individuals can also widen these circles so that the massage covers their entire abdomen.
  • Another technique begins by placing your hand below your breastbone, then gliding that hand down the length of your abdomen in one smooth stroke.
  • Repeat the movement with the other hand and continue this cycle for a few minutes.
  • When practicing self-massage, use light and gentle pressure, then gradually increase the pressure.
  • If you experience pain or tenderness, lighten up and return to a comfortable pressure level.

Try performing massage twice daily, aiming for a 20-minute session. Incorporating deep breathing into each session may also help. Before trying a massage or any home remedy, it is recommended to discuss it with a healthcare provider to see if it’s appropriate and safe. Pregnant women, for example, should avoid any massage on their abdomen. Constipation can sometimes signal an underlying condition that requires medical treatment, such as an underactive thyroid. Other symptoms like abdominal pain may be present, but sometimes constipation may be the only symptom.

Other Remedies

Self-massage alone is unlikely to treat chronic constipation; the goal should be to improve overall digestion to keep the organs functioning properly. To maintain regularity, it’s essential to drink plenty of water daily, eat enough fiber-rich foods, and engage in physical activity. Other alternative treatments include therapies like:

  • Acupressure
  • Biofeedback
  • Probiotics

Before trying self-massage, consult a medical caregiver to ensure it is safe and correct for the individual. Abdominal massage may not help with painful bloating caused by disease, infection, or other reasons.

Injury Medical Chiropractic & Functional Medicine Clinic

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

Massage Therapy Rehabilitation

References

Sinclair M. (2011). The use of abdominal massage to treat chronic constipation. Journal of bodywork and movement therapies, 15(4), 436–445. doi.org/10.1016/j.jbmt.2010.07.007

University of Michigan Medicine. (2021). Self-abdominal massage. www.med.umich.edu/1libr/MBCP/AbdominalSelfmassage.pdf

Lämås, K., Lindholm, L., Stenlund, H., Engström, B., & Jacobsson, C. (2009). Effects of abdominal massage in management of constipation–a randomized controlled trial. International journal of nursing studies, 46(6), 759–767. doi.org/10.1016/j.ijnurstu.2009.01.007

Complex Regional Pain Syndrome: Diagnosis and Treatment

By
Dr. Alex Jimenez
-
Physiotherapy, arm and senior woman consulting physiotherapist for injury, healthcare and osteoporo.

Individuals dealing with chronic pain following a minor injury, surgery, or trauma could be experiencing complex regional pain syndrome. What are the symptoms, diagnosis, and treatments available?

Complex Regional Pain Syndrome: Diagnosis and Treatment

Complex Regional Pain Syndrome

Reflex sympathetic dystrophy syndrome (RSDS), more commonly known as complex regional pain syndrome (CRPS), is a chronic pain condition where a person experiences severe, persistent pain in a limb, usually following an injury, that is significantly more profound than from the initial trauma. It is considered a neuroinflammatory disorder in which the body’s response to injury is dysregulated. The condition is characterized by severe burning pain, often in an arm or leg, that can occur following a minor injury, surgery, or trauma. It is associated with abnormal changes in skin temperature, swelling, and sensitivity to touch, usually affecting the affected area’s nerves, skin, muscles, blood vessels, and bones. Other names it is known by include:

  • Causalgia
  • Shoulder-Hand Syndrome
  • Sudeck’s Atrophy

Causes

CRPS is a chronic pain condition believed to result from dysfunction in the central or peripheral nervous systems (National Institute of Neurological Disorders and Stroke, 2017). It involves irritation and abnormal excitation of nervous tissue, leading to abnormal impulses along nerves that affect blood vessels and skin. Animal studies indicate that norepinephrine, a catecholamine released from sympathetic nerves, acquires the ability to activate pain pathways after tissue or nerve injury, resulting in CRPS. Another theory is that CRPS, which follows an injury, is caused by triggering an immune response and continuous inflammation symptoms (swelling, redness, warmth). (Goh E. L., Chidambaram S., & Ma, D. 2017) It is believed to have multiple causes producing similar symptoms.

Triggers

There can be numerous triggers, including:

Symptoms

CRPS usually affects one of the extremities (arm, leg, hand, or foot). The primary symptom is intense, continuous pain. (National Institute of Neurological Disorders and Stroke, 2017) Other symptoms can include

  • Burning pain
  • Swelling
  • Increased skin sensitivity
  • Extreme sensitivity to touch, often causing significant disability in the affected limb.
  • Stiffness and swelling in affected joints
  • Skin color changes – blotchy, purple, pale, red.
  • Skin temperature changes – warmer or cooler than the opposing extremity.
  • Skin texture changes – shiny, thin, sweaty.
  • Changes in nail and hair growth patterns.
  • Pain can spread, for example, from the finger to the entire arm and the opposite extremity or from the left to the right arm.
  • Emotional stress can cause symptoms to worsen.

Some experts suggest three stages during which progressive changes occur in the affected area’s skin, muscles, joints, ligaments, and bones (Harvard Health Publishing, 2023). However, further research is needed.

Stages

Stage One

  • Lasts 1 to 3 months
  • Severe, burning pain
  • Muscle spasm
  • Joint stiffness
  • Rapid hair growth
  • Skin color and temperature changes (Stanford Medicine, 2025)

Stage Two

  • Lasts from 3 to 6 months
  • Pain becomes more intense
  • Swelling
  • Decreased hair growth
  • Nails are cracked, brittle, grooved, spotty
  • Softened bones
  • Stiff joints
  • Weak muscle tone

Stage Three

  • Pain is continuous
  • Muscle atrophy
  • Severely limited mobility
  • Irreversible changes to skin and bone
  • Contractions of muscles and tendons – limbs may be twisted

Diagnosis

  • A patient’s clinical history – signs and symptoms are the major factor in diagnosis.
  • The diagnosis is difficult because many symptoms overlap with other conditions. (Goh E. L., Chidambaram S., & Ma, D. 2017)
  • There is no specific blood test or other diagnostic tests.
  • X-rays may show osteoporosis, and nuclear bone scans may show characteristic uptake patterns that help diagnose.

Treatments

Treatment focuses on relieving painful symptoms and can include: (Goh E. L., Chidambaram S., & Ma, D. 2017)

  • Physical therapy and exercise
  • Psychotherapy to alleviate stress, anxiety, and depression
  • Sympathetic nerve blocks
  • Surgery
  • Spinal cord stimulation
  • Intrathecal drug pumps

Medications

These can include:

  • Topical analgesics
  • Anti-seizure drugs
  • Antidepressants
  • Corticosteroids
  • Opioids

It is estimated that there are 50,000 new cases every year in the United States. (Tajerian M., & Clark J. D. 2016)

Injury Medical Chiropractic & Functional Medicine Clinic

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

The Root Causes of Pain

References

National Institute of Neurological Disorders and Stroke. (2017). Complex regional pain syndrome fact sheet. Retrieved from www.ninds.nih.gov/sites/default/files/migrate-documents/CRPS_FactSheet-E_508C.pdf

Goh, E. L., Chidambaram, S., & Ma, D. (2017). Complex regional pain syndrome: a recent update. Burns & Trauma, 5, 2. doi.org/10.1186/s41038-016-0066-4

Bruehl S. (2015). Complex regional pain syndrome. BMJ (Clinical research ed.), 351, h2730. doi.org/10.1136/bmj.h2730

Harvard Health Publishing. (2023). Complex Regional Pain Syndrome (CRPS). www.health.harvard.edu/a_to_z/complex-regional-pain-syndrome-crps-a-to-z

Stanford Medicine. (2025). Complex Regional Pain Syndrome (CRPS). med.stanford.edu/pain/about/chronic-pain/crps.html

Tajerian, M., & Clark, J. D. (2016). New Concepts in Complex Regional Pain Syndrome. Hand Clinics, 32(1), 41–49. doi.org/10.1016/j.hcl.2015.08.003

Nutritional Yeast for Healthy Cooking and Nutrition

By
Dr. Alex Jimenez
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Nutritional yeast background. Nutritional inactive yeast falling from spoon in glass jar on white background. Copy space. Nutritional yeast is vegetarian superfood with cheese flavor, for healthy diet

Can incorporating nutritional yeast be an option for individuals seeking a healthy vegan and vegetarian cheese substitute?

Nutritional Yeast for Healthy Cooking and Nutrition

Nutritional Yeast

Nutritional yeast is a deactivated form of Saccharomyces cerevisiae yeast, commonly known as baker’s or brewer’s yeast. It’s popular in vegan and vegetarian cooking for its savory, cheesy flavor and nutritional benefits. Nutritional yeast is harvested, rinsed, and heat-dried to deactivate it, removing its leavening properties. This means it doesn’t cause food to rise but adds flavor and vital nutrients.

Nutrition

Nutritional yeast nutrition information is for 16 grams or around 1.5 tablespoons. (U.S. Department of Agriculture, 2019)

  • Calories – 60
  • Fat – 0.5 grams
  • Sodium – 30 milligrams
  • Carbohydrates – 5 grams
  • Fiber – 3 grams
  • Sugars – 0 grams
  • Protein – 8 grams
  • Thiamin – vitamin B1 – 10 milligrams
  • Riboflavin – vitamin B2 – 10 milligrams
  • Vitamin B6 – 12 milligrams
  • Vitamin B12 – 24 micrograms

Carbohydrates

  • Around 1.5 tablespoons contains 5 grams of carbohydrates, including 3 grams of fiber.
  • Yeast provides an especially beneficial form of soluble fiber known as beta-glucan, with unique health benefits. (Bashir K. M. I., & Choi J. S. 2017)

Fats

  • Most brands are naturally fat-free.

Protein

  • It provides all essential amino acids with 8 grams per 1.5 tablespoons.

Vitamins and Minerals

Most nutritional yeast products are fortified with added B vitamins. Most provide 600% or more B vitamins per 16 grams and 1,000% of the daily value for vitamin B12, depending on the brand. It also has:

  • Calcium
  • Thiamin
  • Iron
  • Potassium

Nutritional Yeast Health Benefits

Health benefits include:

Reduces Risk of Anemia

Iron is typically the first nutrient to come to mind. However, inadequate folate or vitamin B12 also causes anemia. A common treatment for a vitamin B12 deficiency is injections, but large doses consumed can also be effective. (National Institutes of Health, Office of Dietary Supplements, 2024) Individuals who follow a plant-based or vegan diet often have limited sources of vitamin B12. Most brands of nutritional yeast are fortified with B12, providing more than 500% of the daily value per serving. Because B12 is water-soluble, it won’t cause toxicity when consumed in high doses and can serve as a key source of this essential nutrient.

Supports Heart Health

Nutritional yeast contains beta-glucan, a carbohydrate found in the cell walls of plants, bacteria, and fungi. Higher intakes lead to favorable cardiovascular outcomes, including lowering bad cholesterol and increasing good cholesterol. (Bashir K. M. I., & Choi J. S. 2017) In addition, most brands contain potassium, which reduces blood pressure.

Promote Healthy Immune System Function

More research is needed, but several studies have shown how yeast-derived beta-glucan can strengthen the immune system. (Stier H., Ebbeskotte V., & Gruenwald J. 2014) These benefits are attributed to beta glucan’s bacterial fermentation in the intestines. Beta-glucan may also stimulate the activity of crucial immune system cells, like macrophages.

Prevents Constipation

Fiber is essential. The recommended fiber intake is at least 25 to 35 grams daily. Unfortunately, many do not get enough. Nutritional yeast contributes 3 grams of fiber per 16 grams. Fiber regulates bowel movements by pulling water into the colon and adding bulk and softness to stool. (University of Michigan, 2008)
Using nutritional yeast can help reach an adequate fiber intake.

Diabetes Management

Getting enough fiber helps prevent blood sugar fluctuations. Low-fiber diets have been shown to increase the risk of diabetes in various populations. (Harvard T.H. Chan, School of Public Health, 2022) Fiber slows digestion and increases satiety, controlling hunger and the glycemic response. Fiber is beneficial for preventing diabetes and helping those with diabetes maintain good numbers.

Allergies

  • Individuals who suspect a yeast or mold allergy see an allergist for a full evaluation.
  • Yeast overgrowth is another possible condition that is unrelated to yeast allergies.
  • Yeast overgrowth can occur in compromised immune systems or following antibiotic treatment.
  • Because yeast is present in many foods, anyone with a true yeast allergy may have to avoid several food items, including baked goods, fermented alcoholic beverages, marmite/vegemite, sourdough bread, and certain multivitamins. (Cunningham E. 2013)

Adverse Effects

Nutritional yeast is inactive and unlikely to cause negative effects. However, for individuals who suffer from irritable bowel syndrome (IBS) or migraines, yeast may be a trigger. (UMass Medical School Center for Applied Nutrition, 2020)

Varieties

  • Nutritional yeast may be sold as granules, powder, or flakes. (UMass Medical School Center for Applied Nutrition, 2020)
  • Check the label to see if the product is fortified with added vitamins and minerals or has added sodium.
  • Nutritional yeast is a dry food product available year-round in supermarkets or sold in a bulk food bin.

Storage, Safety, and Use

Although nutritional yeast is a dry product, it will stay in the refrigerator longer after it has been opened. Store it in an airtight container, and be mindful of the expiration date on the label.

It can be added to savory dishes such as pasta, roasted meats, vegetables, and salads. Ways to use include:

  • On scrambled eggs.
  • On top of garlic bread.
  • Popcorn seasoning.
  • Add to soups.
  • In pasta dishes, as a substitute for parmesan cheese.
  • An alternative to cheese sauce.

Injury Medical Chiropractic and Functional Medicine Clinic

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

Learning About Food Substitutions

References

U.S. Department of Agriculture. FoodData Central. (2019). Nutritional yeast. Retrieved from fdc.nal.usda.gov/food-details/1744022/nutrients

Bashir, K. M. I., & Choi, J. S. (2017). Clinical and Physiological Perspectives of β-Glucans: The Past, Present, and Future. International journal of molecular sciences, 18(9), 1906. doi.org/10.3390/ijms18091906

National Institutes of Health, Office of Dietary Supplements. (2024). Vitamin B12: Fact sheet for health professionals. Retrieved from ods.od.nih.gov/factsheets/VitaminB12-HealthProfessional/

Stier, H., Ebbeskotte, V., & Gruenwald, J. (2014). Immune-modulatory effects of dietary Yeast Beta-1,3/1,6-D-glucan. Nutrition journal, 13, 38. doi.org/10.1186/1475-2891-13-38

University of Michigan. (2008). Bowel function anatomy. medicine.umich.edu/sites/default/files/content/downloads/bowel-function.pdf

Harvard T.H. Chan, School of Public Health. (2022). Fiber. nutritionsource.hsph.harvard.edu/carbohydrates/fiber/

Cunningham E. (2013). Is there a diet for “yeast allergy”? Journal of the Academy of Nutrition and Dietetics, 113(3), 484. doi.org/10.1016/j.jand.2013.01.013

UMass Medical School Center for Applied Nutrition. Chan, U., School, M., & Nutrition, C. F. A. (2020). Nutritional yeast: Nourishing or no-go? UM. www.umassmed.edu/nutrition/blog/blog-posts/2020/2/nutritional-yeast–nourishing-or-no-go/

Insights About Developmental Disorders & Learning Disabilities

By
Dr. Alex Jimenez
-

Understand the complexities of developmental disorders and learning disabilities and how they affect individuals uniquely.

Introduction To Developmental Disorders

When talking about disabilities, whether from health conditions or diseases, many healthcare professionals have to think about two languages crucial to the individual they are assessing. One is person-first language, and the other is identity language. In person-first language, it pertains to how a person places more importance on the individual and their uniqueness. This involves individuals young and old with ADHD or Down syndrome. This is compared to the identity-first language, which often highlights the disorder or disease more than the individual (e.g., autistic child). The goal that many healthcare professionals aim for when treating individuals with disabilities or developmental disorders is to use respectful terminology to reduce social stigma, prejudice, and discrimination.

Many young individuals have their cognitive and social skills evaluated when entering and progressing through school. These evaluations sometimes indicate that a young individual or children might need special assistance with either language or learning to interact with others. Evaluation and diagnosis are the first steps in providing many people with the tools and resources needed to function. However, there are also significant social implications regarding diagnosis and labeling. Many healthcare providers must consider that anyone, young or old, can be misdiagnosed. Once the person receives the diagnosis label, the individual and whoever is in the person’s life have to interpret the person’s actions through that label. For instance, if a child has been misdiagnosed as having a learning disability, it can influence the child’s self-concept. It may be due to difficulties in school that cause children to have trouble at their academic level. This self-fulfilling prophecy causes them to act this way, causing people to predict what will happen come true. Healthcare professionals must pay attention to the power of labels and apply them accurately when assessing patients.

It is also important to consider that people’s difficulties can change over time. An example would be a child who has problems in school that may improve later or grow up to be an adult where these problems are no longer relevant. That person, however, will still have a label for having a learning disability. Even though it is fairly common for children and young individuals to have abnormal behaviors, healthcare providers should recognize that the distinction between abnormal/atypical and normal/typical behavior is not always clear. When evaluating learning disabilities, misdiagnosis may be more of a concern.
When it comes to the diagnosis of developmental disabilities, it is required that a pediatrician, psychologist, psychiatrist, or other accredited professional should assess a child for a developmental disability, as there are many factors to consider. Many common behaviors in children, like temper tantrums, being overly active, being shy, etc., might be misinterpreted as a behavioral disorder like ADHD (attention-deficit/hyperactivity disorder). Therefore, trained professionals use multiple assessments or questionnaires completed by the parent(s) and teacher(s) in conjunction with in-person observations and case history before diagnosing.

 

Autism Spectrum Disorders

As a common developmental disorder, autism spectrum disorder (ASD) can affect various areas of development, such as communication and behavior, in many individuals. The spectrum is wide and varies from person to person. In the United States, it is estimated that about 1 out of every 36 children or individuals has been diagnosed with autism, covering a wide variety of abilities and symptom expression between high and low functioning. ASD is characterized by age-inappropriate, impaired social communication and may have a complex interaction between genetics, epigenetic, and environmental factors associated with cerebral dysfunction. (Mukherjee, 2017) When it comes to social skills and communication, ASD can impact a person’s language skills as it can become difficult. A person within the autism spectrum may respond to a question by repeating the question, may not respond appropriately, or may not communicate in response at all. Some symptoms for an individual within the autism spectrum may be sensitivity to touch, sound, or visual stimulation. Individuals with autism often view the world differently and learn in unique ways while preferring routines and can become upset when routines are altered. For example, moving furniture or changing the daily schedule can be very upsetting.

 

There is no single known cause of autism, though research has indicated a possible genetic link. This could be due to the intricate neurobiological mechanisms that correlate with the immune system and neuroinflammation, causing atypical functional connectivity and neurotransmitter alterations. (Rajabi et al., 2024) Luckily, there are holistic approaches to reducing autism symptoms to help improve a person’s quality of life within the spectrum.

 

Holistic Treatments For Individuals Within The Autism Spectrum

When it comes to holistic treatment approaches for individuals with autism, they can vary for the individual while not affecting their sensory issues. Physical activities and motor skill training can help their mobility and improve movement performance. (Shahane et al., 2024) Additionally, individuals within the autism spectrum could be dealing with abnormal sensitivity and gastrointestinal difficulties that can cause numerous pain-like symptoms in the body. Incorporating and allowing autistic individuals to try out anti-inflammatory foods and prebiotics can help improve the symptoms associated with ASD while reducing the inflammatory effects on their bodies. (Sivamaruthi et al., 2020)

 

What Are Learning Disabilities?

When a person, both young and old, has an intellectual disability or an intellectual development disability, they could have significant impairment in intellectual and adaptive functioning. This, in turn, generally results in an IQ (intelligence quotient) under 70, which is two standards below the median. This causes deficits within two or more adaptive behaviors that affect everyday general living, causing them to learn slowly in all areas of learning. This is known as learning disabilities.

A learning disability (LD) is a specific impairment of academic learning that interferes with a particular aspect of schoolwork and significantly reduces a person’s educational performance. It can be shown as a major discrepancy between a person’s ability and some achievement features, causing them to be delayed in various academic areas. Many people often confuse the difference between a learning problem and a learning disability, as a learning problem stems from physical, sensory, or motor handicaps or generalized intellectual impairment.

 

Dyslexia

One of the most prevalent learning disorders, dyslexia is characterized by difficulties reading; fundamentally, many dyslexics struggle to learn how to spell and interpret words and become proficient in phonological representation. (Snowling & colleagues, 2020) The reason for this is because a number of anatomical alterations in the brain impair the brain’s capacity to integrate data from various RSNs (resting state networks), which lessens the neuroplasticity of the brain. In 2020, Munzer et al. There are reading experts in several therapies to aid with the troublesome regions of the patient.

 

Dysgraphia

Writing disabilities like dysgraphia are often linked to dyslexia. It is sometimes used as a general term for all impairments of written language. Different forms of dysgraphia include orthographic dysgraphia and phonological dysgraphia. When a person has phonological dysgraphia, they are unable to write words using their phonemes. On the other hand, people with orthographic dysgraphia are able to spell words that are spelled consistently but not erratically. When using a pen or pencil, some people with dysgraphia may have issues making letters and with motor control.

 

Dyscalculia

The inability to absorb arithmetic concepts (such number, place value, and time), retain math information, and comprehend how problems are structured on paper are all symptoms of dyscalculia, a kind of math-related impairment. As a result, many students end up having bad school experiences and consistently failing at arithmetic assignments, which breeds failure anxiety and lowers self-esteem. Harris and Schulte-Korne (2019) People who deal with numbers suffer from working memory problems as a result. Atypical patterns of mathematical cognitive performance may be reflected in this, since the parietal lobes may be smaller and less active. Downer (2024)

 

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Optimizing Your Wellness | El Paso, Tx (2023)

Attention-Deficit/Hyperactivity Disorder (ADHD)

A neurodevelopmental disease known as attention-deficit/hyperactivity disorder (ADHD) causes problems with cognitive and motor function. This is because certain brain regions are smaller than others, which may lead to patterns of impulsive, hyperactive, and inattentive behavior. These patterns can also alter the neurotransmitters in the brain, which can disrupt regular functioning. In 2017, ADHD & The Brain

Among the symptoms of inattention are:
Task difficulty and avoiding them
Disregarding directions
Lack of organization
Ignoring details and becoming easily sidetracked
Forgetting.

Excessive movements, which are indicative of hyperactivity in ADHD, include:
Being restless
Finding it difficult to remain still
Inappropriate running and climbing on objects
Responses that are blurred out
Waiting is hard.
obstructing and disturbing other people.

Whether they are adults or toddlers, energetic people often come off as noisy. This leads to social and intellectual difficulties throughout their lives. People with ADHD often get worse grades, perform poorly on standardized tests, have greater expulsion rates, and are more likely to drop out of school during the academic year than their peers without ADHD.

 

Causes of ADHD

Genetics is a major factor in the development of ADHD, according to several twin and family studies. Gender, exposure to environmental variables, and the diagnosis of an ADHD subtype have all been suggested as possible modifiers of ADHD development in several studies. The Gizer group (2009) It is believed that a particular gene that regulates the neurotransmitter dopamine is implicated in ADHD. According to certain brain imaging studies, people with ADHD have anomalies in the frontal lobes, which are a region of the brain with a lot of dopamine. Individuals with ADHD will have reduced frontal brain activity during mental activities since the frontal lobe regulates behavior. Therefore, anomalies in this area might be a major factor in explaining part of the hyperactive, uncontrollable behavior associated with ADHD.

It has been believed that some environmental elements, such as sugar and artificial colors, increase an individual’s hyperactivity. In order to alleviate the symptoms of ADHD, many individuals choose to cut them down. However, there have been a lot of research comparing the effects of cigarette smoke exposure on the development of severe ADHD symptoms in the fetus. (Linnet & colleagues, 2003)

 

 

ADHD Treatment

The most widely used treatments for ADHD include stimulant medication, non-surgical therapies, and lifestyle modifications that may help lessen the symptoms of the disorder. Many people believe that using stimulant medicine is paradoxical, however it may help individuals with ADHD concentrate by activating the undeveloped areas of the brain, notably the frontal and prefrontal lobes. This in turn aids in managing ADHD’s detrimental consequences.

Both non-pharmaceutical therapies and physical exercise may enhance cognitive and motor abilities. In 2015, Ziereis and Jansen However, cognitive behavioral therapy is a popular non-surgical treatment that may help patients become more conscious of their thoughts and change them from negative to positive. A lot of medical practitioners may use both CBT and medicine in their patients’ treatment regimen. It is especially advantageous since the drug facilitates behavior change more rapidly, which speeds up the learning process for long-term behavioral changes via cognitive behavioral therapy. on order to enhance their quality of life on their path toward health and wellness, people with developmental disorders and learning impairments may have a personalized treatment plan by implementing minor adjustments and using a variety of therapy choices.

 

Injury Medical & Functional Medicine Clinic

We associate with certified medical providers who understand the importance of the various effects of developmental disorders and learning disabilities affecting the body. While asking important questions to our associated medical providers, we advise patients to implement small changes to their daily routine to reduce the symptoms affecting their bodies. Dr. Alex Jimenez, D.C., envisions this information as an academic service. Disclaimer.

References

ADHD & The Brain. (2017).  American Academy of Child & Adolescent Psychiatry. www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/ADHD_and_the_Brain-121.aspx

Dowker, A. (2024). Developmental Dyscalculia in Relation to Individual Differences in Mathematical Abilities. Children (Basel), 11(6). doi.org/10.3390/children11060623

Gizer, I. R., Ficks, C., & Waldman, I. D. (2009). Candidate gene studies of ADHD: a meta-analytic review. Hum Genet, 126(1), 51-90. doi.org/10.1007/s00439-009-0694-x

Haberstroh, S., & Schulte-Korne, G. (2019). The Diagnosis and Treatment of Dyscalculia. Dtsch Arztebl Int, 116(7), 107-114. doi.org/10.3238/arztebl.2019.0107

Linnet, K. M., Dalsgaard, S., Obel, C., Wisborg, K., Henriksen, T. B., Rodriguez, A., Kotimaa, A., Moilanen, I., Thomsen, P. H., Olsen, J., & Jarvelin, M. R. (2003). Maternal lifestyle factors in pregnancy risk of attention deficit hyperactivity disorder and associated behaviors: review of the current evidence. Am J Psychiatry, 160(6), 1028-1040. doi.org/10.1176/appi.ajp.160.6.1028

Mukherjee, S. B. (2017). Autism Spectrum Disorders – Diagnosis and Management. Indian J Pediatr, 84(4), 307-314. doi.org/10.1007/s12098-016-2272-2

Munzer, T., Hussain, K., & Soares, N. (2020). Dyslexia: neurobiology, clinical features, evaluation and management. Transl Pediatr, 9(Suppl 1), S36-S45. doi.org/10.21037/tp.2019.09.07

Rajabi, P., Noori, A. S., & Sargolzaei, J. (2024). Autism spectrum disorder and various mechanisms behind it. Pharmacol Biochem Behav, 245, 173887. doi.org/10.1016/j.pbb.2024.173887

Shahane, V., Kilyk, A., & Srinivasan, S. M. (2024). Effects of physical activity and exercise-based interventions in young adults with autism spectrum disorder: A systematic review. Autism, 28(2), 276-300. doi.org/10.1177/13623613231169058

Sivamaruthi, B. S., Suganthy, N., Kesika, P., & Chaiyasut, C. (2020). The Role of Microbiome, Dietary Supplements, and Probiotics in Autism Spectrum Disorder. Int J Environ Res Public Health, 17(8). doi.org/10.3390/ijerph17082647

Snowling, M. J., Hulme, C., & Nation, K. (2020). Defining and understanding dyslexia: past, present and future. Oxf Rev Educ, 46(4), 501-513. doi.org/10.1080/03054985.2020.1765756

Ziereis, S., & Jansen, P. (2015). Effects of physical activity on executive function and motor performance in children with ADHD. Res Dev Disabil, 38, 181-191. doi.org/10.1016/j.ridd.2014.12.005

Disclaimer

Greenstick Fracture: Insights for Parents of Young Children

By
Dr. Alex Jimenez
-
Friendly doctor showing an x-ray image of a broken bone to a young patient, the girl is wearing an arm brace

Broken bones are common injuries. Because children’s bones grow rapidly, they have increased flexibility. When injuries, specifically fractures, occur, they do not always break cleanly across the bone or into pieces. What type of fracture is this, and how are they treated?

Greenstick Fracture: Insights for Parents of Young Children

Greenstick Fracture

A greenstick fracture is a partial break in a bone that occurs when a bone bends and cracks instead of breaking into separate pieces. (Wolfe J. A. et al., 2019) The term is based on a young green branch that bends and splinters but does not break into pieces when bent. Only one side of the bone is broken, while the other side gets bent. Many children experience at least one fracture during their growing years. This is one of multiple fracture types seen in children. They can happen in adults but are uncommon.

Causes

Greenstick fractures mostly occur in infants or toddlers, sometimes in children during their early adolescent and pre-adolescent years. They are partial-thickness fractures (a break in a bone that doesn’t completely break it) characterized by a break on one side and a bend on the other. Buckle fractures and bow fractures are different types of partial-thickness fractures. Greenstick fractures commonly occur:

  • In children under 10 years old
  • Occurs when a child reaches out to break a fall
  • During motor vehicle collisions
  • Sports
  • Direct impacts
  • Non-accidental trauma

It is more common in long bones, including:

  • Radius
  • Ulna
  • Humerus
  • Fibula
  • Tibia
  • Clavicle

The fracture pattern often indicates a limb’s bending or contortion.

Symptoms

Greenstick fracture symptoms can include:(Atanelov Z, & Bentley T.P. 2025)

  • Localized swelling
  • Localized bruising
  • Pain
  • Deformity, such as the affected body part looking crooked or out of alignment.

Treatment

If the bone is not significantly bent out of alignment, a splint or cast may be all that is necessary to treat the break. If the bone is visibly out of alignment, it must be manually straightened before the limb is put into a cast. If the break is severe, surgery may be required. Fortunately, a growing skeleton can remodel bone, so fractured bones can often realign themselves over time with minimal intervention. Healing depends on various factors, including:

  • Age of the child
  • The severity of the break
  • Location of the break

The younger the child is, the faster the recovery will be. (Pountos I., Clegg J., & Siddiqui A. 2010)

Sometimes, the fracture must be bent back and repositioned in a fracture reduction procedure. An anesthetic may be used as the doctor manually realigns the bone into the correct position. After the reduction, a cast or splint will stabilize the bone and maintain proper alignment. Depending on how quickly the bone heals, a cast may be necessary for a few weeks, months, or longer, depending on the patient and/or underlying conditions.

Healing

  • Healing involves specialized cells that gradually rebuild and fine-tune the new bone.
  • The average time for a greenstick fracture to heal completely may take four weeks.

Injury Medical Chiropractic & Functional Medicine Clinic

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

Building a Stronger Body

References

Wolfe, J. A., Wolfe, H., Banaag, A., Tintle, S., & Perez Koehlmoos, T. (2019). Early Pediatric Fractures in a Universally Insured Population within the United States. BMC pediatrics, 19(1), 343. doi.org/10.1186/s12887-019-1725-y

Atanelov, Z., & Bentley, T. P. (2025). Greenstick Fracture. In StatPearls. www.ncbi.nlm.nih.gov/pubmed/30020651

Pountos, I., Clegg, J., & Siddiqui, A. (2010). Diagnosis and treatment of greenstick and torus fractures of the distal radius in children: a prospective randomised single-blind study. Journal of children’s orthopaedics, 4(4), 321–326. doi.org/10.1007/s11832-010-0269-3

Pectoralis Minor: Role in Posture and Mobility

By
Dr. Alex Jimenez
-
Adult concentrated muscular handsome man in sportswear stretching body muscles in sunny park.

For individuals dealing with posture problems causing neck, back, and shoulder pain, can pectoralis minor stretches designed to work these areas be a part of physical therapy or as regular exercises at home?

Pectoralis Minor: Role in Posture and Mobility

Pectoralis Minor Muscle Stretches

The pectoralis minor is a small, triangular muscle situated deep to the pectoralis major in the anterior chest wall. It originates from the margins of the third to fifth ribs adjacent to the costochondral junction and connects to the coracoid process of the scapula. The pectoralis minor helps with posture, mobility, and shoulder stability and aids breathing. Muscle tightness can cause pain in the chest, shoulder, and neck and a restricted range of motion. Strain and injuries can occur during activities involving overhead movements or forceful pushing. Pectoralis minor stretches are designed to work these muscles that span the ribs and connect to the shoulder to help improve posture and relieve pain and chest weakness. They can help reduce muscle tightness and other conditions like thoracic outlet syndrome. (Kaur U. et al., 2023) (Wagner E. R. et al., 2023) Talk with a healthcare provider Before starting any exercise or stretching program.

Corner Pectoralis Stretch

A corner pec stretch is similar to a wall push-up, except the emphasis is on staying in a position that lengthens the chest muscles. It’s important to move the whole body as a unit and not bend.

  • Stand facing a corner with a relaxed, upright posture.
  • Place your feet so they are parallel, and bend your knees slightly.
  • Stay as relaxed as possible during the movement to protect your joints.
  • Keep your gaze forward.
  • Place your forearms and palms over the walls where two walls connect at a right angle.
  • With your elbows bent to 90 degrees, move forward into the corner of the wall until you feel a comfortable stretch in the pectorals.
  • Keep the hips straight.
  • Hold the position for up to 30 seconds.
  • Return to starting position.
  • If you need a deeper stretch, move the arm position up or down. (University of North Carolina School of Medicine, 2020)

Doorway Stretch

The doorway stretch is similar to the corner stretch. It works the pectoralis major and the minor muscles and helps with mobility. To perform: (Maryland Pain & Wellness Center, 2025)

  • Stand in a doorway with your feet placed together.
  • Place the palms and forearms on either side of the doorway.
  • Your elbows should be even with your shoulders and bend at a 90-degree angle.
  • Keep your back straight.
  • Take a step forward, leaning into the doorway.
  • You should feel the stretch in the muscle.
  • Repeat the stretch with the other foot.

Exercise and ergonomic changes to your chair or desk height can help improve posture and relieve muscle tightness. (Kaur U. et al., 2023)

T Stretch

The T stretch stretches the front of the chest and is done on the floor, typically with a foam roller placed directly under the spine. To perform: (OrthoCarolina, N.D.)

  • Lie down on your back with the foam roller aligned to the spine.
  • Make sure your head and tailbone are supported.
  • Open your arms straight out like a T.
  • Hold the position while stretching.

Y Stretch

The Y stretch is similar to the T stretch; both reduce chest muscle tightness and discomfort. To perform: (OrthoCarolina, N.D.)

  • Use the same foam roll position, lying on your back with the head and tailbone supported and aligned.
  • Stretch the arms out above your head, placing them into the shape of a Y.
  • Allow the chest muscles that connect to the arms to relax.

Studies have examined how quickly a prone scapular retraction can help stretch the back and shoulders. Results suggest the exercises must be performed longer before the pectoralis minor is lengthened to improve symptoms. (Dye J., Allyn M., & Frank C. 2024) However, further research is needed.

Health Conditions

Pectoralis minor stretches may be part of a personalized therapy program to improve mobility, posture, and/or breathing and sleep quality with health conditions that include:

Stretching and strengthening exercises can help improve their flexibility and function. Exercises can improve strength and function by standing or lying down, depending on the stretch.

Injury Medical Chiropractic and Functional Medicine Clinic

The pectoralis minor muscles are often overlooked in clinical examinations but can contribute to musculoskeletal pain and dysfunction. A healthcare provider can teach about stretches, how they can help, and whether they are safe for the individual’s injury and/or condition. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. The clinic can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

Doorway Stretching Routine

References

Kaur, U., Shrestha, D., Hussain, M. A., Dalal, P., Kalita, M., Sharma, V., & Sharma, S. (2023). Prompt Impact of Muscle Energy Technique on Pectoralis Muscle Tightness in Computer Users: A Quasi-Experimental Study. Journal of Lifestyle Medicine, 13(2), 123–128. doi.org/10.15280/jlm.2023.13.2.123

Wagner, E. R., Gottschalk, M. B., Ahmed, A. S., Graf, A. R., & Karzon, A. L. (2023). Novel Diagnostic and Treatment Techniques for Neurogenic Thoracic Outlet Syndrome. Techniques in hand & upper extremity surgery, 27(2), 100–114. doi.org/10.1097/BTH.0000000000000419

University of North Carolina School of Medicine. (2020). Upper Body Stretching. www.med.unc.edu/htcenter/wp-content/uploads/sites/711/2020/04/Upper-Body-Stretching.pdf

Maryland Pain & Wellness Center. (2025). Stretches to Help with Strained Chest Muscles. Maryland Pain & Wellness Center Restoring Hope, Rebuilding Lives. www.marylandpainandwellnesscenter.com/blog/stretches-to-help-with-strained-chest muscles#:~:text=With%20your%20knees%20bent%20and,assist%20in%20deepening%20the%20stretch.

OrthoCarolina. (N.D.). Stretching Guide to Ease Tight Muscles. www.orthocarolina.com/storage/wysiwyg/stretching_guide_1.pdf

Dye, J., Allyn, M., & Frank, C. (2024). Is there an immediate effect on pectoralis minor length after performing a prone scapular retraction exercise using typical sets and repetitions in pain-free participants? Journal of bodywork and movement therapies, 40, 1014–1019. doi.org/10.1016/j.jbmt.2024.07.026

Chankavee, N., Amatachaya, S., Hunsawong, T., Thaweewannakij, T., & Mato, L. (2023). Effects of modified long stick exercise on hyperkyphosis, muscle imbalance, and balance control in elderly community-dwelling women with hyperkyphosis. Journal of back and musculoskeletal rehabilitation, 36(5), 1151–1162. doi.org/10.3233/BMR-220350

Liao, Y. X., Saiken, A., Chang, X., Guo, Y. F., Tan, Z., Deng, F., Meng, Q. L., Zhen, H., Li, Y. M., & Fang, B. M. (2025). Associations of fat, bone, and muscle indices with disease severity in patients with obstructive sleep apnea-hypopnea syndrome. Sleep & breathing = Schlaf & Atmung, 29(1), 82. doi.org/10.1007/s11325-024-03241-8

Thongchote, K., Chinwaro, U., & Lapmanee, S. (2024). Effects of scapulothoracic exercises on chest mobility, respiratory muscle strength, and pulmonary function in male COPD patients with forward shoulder posture: A randomized controlled trial. F1000Research, 11, 1284. doi.org/10.12688/f1000research.126832.2

Dates: A Nutrient Powerhouse for Health

By
Dr. Alex Jimenez
-

Can adding dates to one’s diet be nutritious and provide various health benefits for individuals looking for a naturally sweet snack?

Dates: A Nutrient Powerhouse for Health

Dates

Dates are a type of dried fruit from the date palm tree. Dates are a healthy source of fiber, calcium, magnesium, potassium, niacin, folate, vitamin A, beta-carotene, lutein, and selenium. They can be a healthier alternative to refined sugar because they have a low glycemic index and do not cause a rapid spike in blood sugar levels. They are a rich source of nutrients, including:

  • Fiber: High in fiber, which promotes good digestion and helps keep you feeling full.
  • Potassium: This is essential for heart health and muscle function.
  • Magnesium: supports bone health and energy production.
  • Antioxidants: which protect the body from damage caused by free radicals.
  • Vitamins: a good source of vitamins B6, K, and A.

Consuming them in moderation is recommended, especially for individuals who are trying to lose weight or have diabetes. They are high in sugar, so individuals need to be mindful to avoid or limit additional sources of sugar. Nutritionists and dieticians recommend a modest dose of two large or three small dates, which is around 50 grams and provides half the sugar and calories.

Benefits

Lower Cholesterol

Research has shown that eating dates may also help lower cholesterol and triglyceride levels. However, further research is needed as the current evidence is still inconclusive. (Mirghani H. O. 2024) A recent meta-analysis also showed no significant effect on LDL cholesterol but reduced total cholesterol in individuals with type 2 diabetes.

Help Regulate Blood Sugar

Pitted dates generally don’t contain added sugars but can still contain a significant amount of natural sugars in sucrose, glucose, or fructose. Although their high sugar level may prevent individuals from eating dates as a healthy snack, a key difference between dates and sugary drinks, snacks, or other processed foods is that they contain high levels of fiber. Because of the fiber, which slows glucose absorption in the bloodstream, they also have a low glycemic index, which causes a smaller spike in blood sugar levels. (Mirghani H. O. 2021) Using dates as a sweetener can also be a healthier alternative to refined sugar and can be used in recipes to replace sugar. However, portion control is important.

Support Gut Health

Since dates are high in fiber, they can help the gastrointestinal tract but should be eaten in moderation as part of a balanced, healthy diet. However, they are recommended to be eaten with other fiber-rich foods, specifically those with lower sugar, that includes:

  • Leafy greens
  • Non-starchy vegetables
  • Whole grains
  • Legumes
  • Nuts
  • Seeds

Adding these foods to a diet can also benefit the microbiome. Dates and other fruits can improve the ratio of beneficial gut microbiota. (Eid N. et al., 2015) Eating too many dates could also cause diarrhea, but eating a few daily can help constipation.

Alternatives

  • Other dried fruits, such as prunes, figs, and apricots, are alternatives, but fresh fruits are an even better choice as they are much lower in calories.

Injury Medical Chiropractic and Functional Medicine Clinic

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

Personalized Medicine and Wellness

References

Mirghani H. O. (2024). Effect of dates on blood glucose and lipid profile among patients with type 2 diabetes. World journal of diabetes, 15(6), 1079–1085. doi.org/10.4239/wjd.v15.i6.1079

Mirghani H. O. (2021). Dates fruits effects on blood glucose among patients with diabetes mellitus: A review and meta-analysis. Pakistan journal of medical sciences, 37(4), 1230–1236. doi.org/10.12669/pjms.37.4.4112

Eid, N., Osmanova, H., Natchez, C., Walton, G., Costabile, A., Gibson, G., Rowland, I., & Spencer, J. P. (2015). Impact of palm date consumption on microbiota growth and large intestinal health: a randomised, controlled, cross-over, human intervention study. The British journal of nutrition, 114(8), 1226–1236. doi.org/10.1017/S0007114515002780

Hula Hoop Fitness: Fun and Effective Exercise

By
Dr. Alex Jimenez
-
sporty young woman working out with hula hoop at home

Can hula hooping be an option for individuals and athletes needing an effective, light, fun workout?

Hula Hoop Fitness: Fun and Effective Exercise

Hula Hoop Workout

A hula hoop workout is a low-impact exercise that involves spinning a hula hoop around your body. It can help improve balance, core strength, and aerobic fitness. Hula hooping is a great aerobic exercise that raises the heart rate and engages the whole body. Exercises can be done with a weighted or non-weighted hula hoop. A standard hoop will increase heart rate after about three minutes. A weighted hula hoop can target and build important core and lower body muscles, including the hamstrings, calves, quadriceps, and glutes. Lifting the weighted hula hoop also works the upper body muscles, giving the all-over body workout.

Weighted Hula Hoop

A weighted hula hoop can offer several health benefits.

Burns Calories

According to a research study, hula hooping can burn an average of 200 calories during a 30-minute workout. Researchers found that hooping is comparable in calories burned to boot camp-style fitness classes, kickboxing, and step aerobics. The average heart rate of the study participants was 151 beats per minute, equal to 84% of the age-predicted heart rate maximum. This can result in improved cardiovascular health and muscle conditioning. (American Council on Exercise, 2011)

Helps Build Muscle Mass

A study found that hula hooping increased trunk muscle mass and decreased waist circumference more than walking alone. Participants hula hooped an average of 12.8 minutes daily and walked almost 10,000 steps daily. The results showed more benefits to the core with hula hooping. The body fat percentage in the core region decreased significantly with hula hooping compared to walking. (Lahelma M. et al., 2019)

Lowers LDL Cholesterol

  • In the same study, researchers found that hula hooping can reduce LDL cholesterol more than walking. The results demonstrated an LDL-lowering effect similar to what resistance training does for cholesterol levels. Hula hooping for 13 minutes daily could benefit anyone with elevated cholesterol levels. (Lahelma M. et al., 2019)

Fun Workout

  • Weighted hula hooping can help individuals get out of a workout rut if they’re bored with a routine. It is recommended as either a warmup or a full workout.

Allows for Multitasking

  • If time to work out is limited, you can multitask using a hula hoop, easily add it to an exercise routine, and get moving while speaking on the phone, during breaks, or watching TV.

Benefits

  • Core strength: The exercise requires core strength to keep the hoop spinning.
  • Balance: Helps improve balance.
  • Aerobic fitness: Hooping can be used as a primary cardio routine.
  • Weight loss: Hooping can help burn calories and contribute to weight loss.

Hula Hoop Workout

  • Stand with a straight spine and feet shoulder-width apart.
  • Draw your abdomen in to engage your core.
  • Place the hoop around your waist, just above your hips.
  • Hold the hoop with both hands and toss it to one side.
  • Keep your back straight and move forward and back as fast as you can.
  • Pulse your hips and feet in a rocking motion.
  • Keep your arms out to the side or above your head.
  • Be mindful of posture, which will help you hoop better.

Weighted Workout

A full-weighted hula hoop workout. Start with a warmup for 5 minutes with a light jog or running in place. Then, perform three sets of the following:

Minute 1

  • 50 seconds of a hula hoop halo with the right arm – swinging the hoop around your arm
  • 10 seconds of rest

Minute 2

  • 50 seconds of a hula hoop halo with the left arm
  • 10 seconds of rest

Minute 3

  • 50 seconds around the waist, hula hooping
  • 10 seconds of rest

Minute 4

  • 50 seconds of hula hoop squats, keeping the hoop around the legs and not dropping it
  • 10 seconds of rest

Minute 5

  • 50 seconds of hula hoop sit-ups, keeping the hoop around your legs and not dropping it
  • 10 seconds of rest

Minute 6

  • 0 seconds of hula jumping front to back, keeping the hoop around your legs and not dropping it
  • 10 seconds of rest

How long you hula hoop each day is a matter of personal preference. To gain cardiovascular benefits, it is recommended that adults engage in at least 150 minutes per week of moderate-intensity aerobic activity. Spreading out the exercise throughout the week is preferable. (American Heart Association, 2024)

Injury Medical Chiropractic and Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. The clinic can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

Can Core Exercises Help With Back Pain?

References

American Council on Exercise. (2011). ACE-sponsored research: Hooping—Effective workout or child’s play? www.acefitness.org/certifiednewsarticle/1094/ace-sponsored-research-hooping-effective-workout-or-child-s-play/

Lahelma, M., Sädevirta, S., Lallukka-Brück, S., Sevastianova, K., Mustelin, L., Gylling, H., Rockette-Wagner, B., Kriska, A. M., & Yki-Järvinen, H. (2019). Effects of Weighted Hula-Hooping Compared to Walking on Abdominal Fat, Trunk Muscularity, and Metabolic Parameters in Overweight Subjects: A Randomized Controlled Study. Obesity facts, 12(4), 385–396. doi.org/10.1159/000500572

American Heart Association. (2024). American Heart Association Recommendations for Physical Activity in Adults and Kids. www.heart.org/en/healthy-living/fitness/fitness-basics/aha-recs-for-physical-activity-in-adults

Back Cracking and Its Effects on Back Pain

By
Dr. Alex Jimenez
-
Person lying face down on massage table, receiving therapeutic back massage from a professional therapist in a clinical environment, creating a relaxing atmosphere

Are there benefits to back cracking, risks, and how can it be done safely?

Back Cracking and Its Effects on Back Pain

Back Cracking

Back cracking is intentionally applying pressure or twisting movements, producing a popping or cracking sound in the spine. Back cracking involves stretching or extending the spine. In most cases, it is considered safe when done gently as it can provide temporary relief from back pain and stiffness by:

  • Stretching the ligaments and muscles around the spine
  • Releasing gas bubbles that may be causing pressure
  • Improving joint mobility

Mechanism of Action

  • Cracking your back creates small gas bubbles in the synovial fluid (the lubricating fluid in the joints).
  • These bubbles form when the pressure in the joints is suddenly released, causing a popping or cracking sound.

It is generally safe, but there are certain conditions under which individuals should avoid cracking their backs.

Popping Sound

Research has used a new type of magnetic resonance imaging (MRI), cine MRI, to study the noise source. Cine MRI produces moving images.

  • This study using this MRI found that the formation of bubbles makes a popping sound.
  • The popping sound does not come from the popping of bubbles in the synovial fluid, as previously believed. (Kawchuk G. N. et al., 2015)
  • When someone cracks their back, the force pulls the joint’s bones apart, causing the pressure within the joint to drop and form a bubble, eventually dissipating. (Kawchuk G. N. et al., 2015)

Crepitus

  • Crepitus is the medical term for cracking or popping noise from joints.
  • It is not a condition or disease but can be a symptom of one.
  • Other terms include clicking or crunching.

Is It Safe To Perform Daily?

Back cracking once a day is generally considered safe. But if it causes pain or swelling, then stop and contact a healthcare provider. If someone feels the need to crack their back more throughout the day, it could be a sign that they need to see a professional chiropractic healthcare provider. (AICA Orthopedics, 2022) Individuals may crack their backs to address certain conditions or to relieve various discomfort symptoms that can include: (National Center for Complementary and Integrative Health, 2025)

  • Headache
  • Neck pain
  • Lower back pain
  • Sciatica

Individuals may often experience mild side effects like headache, stiffness, or pain. These side effects tend to resolve within a day. Though back cracking can provide temporary relief for some conditions, some serious side effects like neurological problems or strokes have been reported. (National Center for Complementary and Integrative Health, 2025)

Stretches and Movements

When someone needs to crack their back, they can perform a spine stretch. Here are a couple of stretches and movements. (American Academy of Orthopedic Surgeons, 2022)

Sitting Rotation Stretch

  • Sit on the floor with both legs straight.
  • Cross the right foot over the left leg.
  • Rotate the upper body to the right side and press against the right knee with the left elbow.
  • Hold the stretch for 30 seconds and come back to the center.
  • Repeat on the other side.

Knee to Chest

  • Lie flat on the ground.
  • Lift one leg and bring the knee to the chest, pulling the knee in with your hands.
  • Hold for five seconds.
  • Repeat with the other leg.

Several back-cracking assistive devices, such as poles and wheels, are available. Talk to a healthcare provider to determine the right type and ensure it is safe for you and your condition or injury.

Individuals Who Should Avoid Back Cracking

Back cracking can cause additional stress or damage to the joints in those with back injuries or other conditions. Individuals with these conditions should avoid back cracking (AICA Orthopedics, 2022)

  • Numbness or tingling of the arms or legs.
  • Osteoporosis
  • Spinal cancer
  • Spinal abnormalities
  • Individuals who have a high stroke risk.

A Professional Back Adjustment

A chiropractor is a healthcare provider who specializes in spine and spinal adjustments. They adjust the spine and other areas of the body to correct misalignment problems, reduce and relieve pain, and allow the body to recover independently. (National Library of Medicine. MedlinePlus, 2023) The chiropractor will take a health history to learn about previous injuries and conditions. Then, they will evaluate the patient and determine the best course of action. Although a chiropractor performs spinal adjustments, they may also incorporate other treatments, including: (National Library of Medicine. MedlinePlus, 2023)

  • Stretching
  • Non-surgical decompression and traction
  • Acupuncture
  • Muscle Energy Technique (MET)
  • Exercise routines
  • Heat
  • Ice
  • Electrical stimulation
  • Dietary supplements
  • Nutrition and lifestyle counseling

Injury Medical Chiropractic & Functional Medicine Clinic

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

Chiropractic Secrets

References

Kawchuk, G. N., Fryer, J., Jaremko, J. L., Zeng, H., Rowe, L., & Thompson, R. (2015). Real-time visualization of joint cavitation. PloS one, 10(4), e0119470. doi.org/10.1371/journal.pone.0119470

AICA Orthopedics. (2022). Is cracking your back bad? aica.com/is-cracking-your-back-bad/

National Center for Complementary and Integrative Health. (2025). Spinal manipulation: what you need to know. Retrieved from www.nccih.nih.gov/health/spinal-manipulation-what-you-need-to-know

American Academy of Orthopedic Surgeons. (2022). Spine conditioning program. orthoinfo.aaos.org/en/recovery/spine-conditioning-program/

National Library of Medicine. MedlinePlus.  (2023). Chiropractic. Retrieved from medlineplus.gov/chiropractic.html

Walking Backward: A Therapy for Lower Back Pain

By
Dr. Alex Jimenez
-
Trainer assisting an elderly client on treadmill in a modern gym environment with plenty of natural light streaming through large windows

Can walking backward on a treadmill aid in treating conditions and injuries, improving strength, gait, and mobility in the lower extremities and knee, hip, and ankle range of motion (ROM)?

Walking Backward: A Therapy for Lower Back Pain

 

Walking Backward On A Treadmill

Walking backward is often used in physical therapy to treat multiple conditions and injuries and help improve strength, gait, balance, and mobility in the lower extremities. It is also used to improve knee, hip, and ankle range of motion and lower back pain and burn calories.

The Difference Backward vs. Forward

The difference from forward walking is that certain motions are normal gait characteristics.

  • First, the leg swings through the air, and the heel lands on the ground.
  • Then, the straight knee bends slightly as you roll from heel to toe.
  • As this occurs, the opposite leg rolls from the toes and up into the air.
  • This heel-to-toe motion repeats, and normal walking takes place.

Reverse walking creates the opposite gait process.

  • The leg swings through the air and reaches backward with a bent knee.
  • The toes contact the ground, and the bent knee straightens as you roll from toe to heel.
  • Then, the heel leaves the ground with the knee straight, repeating the process.
  • The toe-to-heel gait can provide various benefits. (Cha H. G., Kim T. H., & Kim M. K. 2016)

Benefits

Walking backward on a treadmill benefits include:

  • Improved range of motion in the knee
  • Hamstring flexibility and mobility
  • Quadriceps strengthening

Walking backward also helps burn calories, improve heart function, and improve balance and stability. (Cha H. G., Kim T. H., & Kim M. K. 2016)

Knee Range of Motion

  • Reverse walking can help increase knee extension range of motion. (Zhang M. et al., 2022)
  • Individuals with knee injuries, surgeries, or arthritis may lose their knee extension or the knee’s ability to straighten.
  • The bent knee straightens fully when walking backward, moving from the toes onto the heel.
  • This helps to improve the range of motion into knee extension.

Quadriceps Function

  • Reverse walking can improve the function of the quadriceps muscles in the upper thighs. (Alghadir A. H. et al., 2019)
  • The quads are active when straightening the knee.
  • Exercises like quad sets, short arc quads, and straight leg raises increase quad strength.

Hamstring Flexibility

  • The hamstrings are located in the back of the upper thighs and work to bend the knees and extend the hips.
  • For individuals with tight hamstrings, a therapist may have you walk backward on the treadmill to improve the flexibility of the muscle group. (BBC, 2023)
  • When walking backward, the hamstring contracts to bend the knee as it swings through the air.
  • Then, the hamstring is stretched from the toe to heel movement, and the knee straightens.

Balance, Gait, and Mobility

  • Reverse walking can improve gait characteristics after an injury, surgery, or illness. (Balasukumaran T., Olivier B., & Ntsiea M. V. 2019)
  • Walking backward can help reset one’s gait and improve one’s ability to walk forward.
  • A study on stroke patients found that backward walking training was superior to standing balance training for improving balance and walking speed. (Rose, D. K. et al., 2018)

Burns Calories

  • Backward walking has been found to burn more calories than forward walking.
  • Walking backward uses up about 40% more calories per minute than forward walking at the same speed. (Cha H. G., Kim T. H., & Kim M. K. 2016)

Heart and Lung Function

  • Walking backward on a treadmill can also benefit heart and lung health.
  • Backward walking is more challenging and forces the individual to work harder.
  • Research shows it requires more oxygen and places more demands on the cardiovascular system. (Thomas K. S., Hammond M., & Magal M. 2018)
  • As a result, it improves heart and lung health better.

Conditions That Benefit

Individuals with a lower extremity impairment that results in loss of normal walking mobility may benefit from reverse walking. Common conditions that may help include: (BBC, 2023) (DelMastro H. M. et al., 2023)

  • Hamstring strain
  • Sciatica with tightness in hamstrings
  • Hip, knee or ankle surgery
  • Lower extremity fracture
  • Cerebral palsy
  • Multiple sclerosis
  • Parkinson’s disease
  • Stroke

A physical therapist will decide if an individual’s condition warrants reverse walking as part of a rehabilitation program.

Injury Medical Chiropractic and Functional Medicine Clinic

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

Control Foot Motion and Posture

References

Cha, H. G., Kim, T. H., & Kim, M. K. (2016). Therapeutic efficacy of walking backward and forward on a slope in normal adults. Journal of Physical Therapy Science, 28(6), 1901–1903. doi.org/10.1589/jpts.28.1901

Zhang, M., Pang, J., Lu, J., Kang, M., Chen, B., Jones, R. K., Zhan, H., & Liu, A. (2022). The Immediate Effect of Backward Walking on External Knee Adduction Moment in Healthy Individuals. Journal of Healthcare Engineering, 2022, 4232990. doi.org/10.1155/2022/4232990

Alghadir, A. H., Anwer, S., Sarkar, B., Paul, A. K., & Anwar, D. (2019). Effect of 6-week retro or forward walking program on pain, functional disability, quadriceps muscle strength, and performance in individuals with knee osteoarthritis: a randomized controlled trial (retro-walking trial). BMC musculoskeletal disorders, 20(1), 159. doi.org/10.1186/s12891-019-2537-9

BBC. (2023). Why walking backwards can be good for your health and brain. www.bbc.com/future/article/20231110-why-walking-backwards-can-be-good-for-your-health-and-brain

Balasukumaran, T., Olivier, B., & Ntsiea, M. V. (2019). The effectiveness of backward walking as a treatment for people with gait impairments: a systematic review and meta-analysis. Clinical Rehabilitation, 33(2), 171–182. doi.org/10.1177/0269215518801430

Rose, D. K., DeMark, L., Fox, E. J., Clark, D. J., & Wludyka, P. (2018). A Backward Walking Training Program to Improve Balance and Mobility in Acute Stroke: A Pilot Randomized Controlled Trial. Journal of Neurologic Physical Therapy: JNPT, 42(1), 12–21. doi.org/10.1097/NPT.0000000000000210

Thomas, K. S., Hammond, M., & Magal, M. (2018). Graded forward and backward walking at a matched intensity on cardiorespiratory responses and postural control. Gait & posture, 65, 20–25. doi.org/10.1016/j.gaitpost.2018.06.168

DelMastro, H. M., Ruiz, J. A., Simaitis, L. B., Gromisch, E. S., Neto, L. O., Cohen, E. T., Wong, E., Krug, R. J., & Lo, A. C. (2023). Effect of Backward and Forward Walking on Lower Limb Strength, Balance, and Gait in Multiple Sclerosis: A Randomized Feasibility Trial. International journal of MS care, 25(2), 45–50. doi.org/10.7224/1537-2073.2022-010

GI Disorders Treatment: Effective Solutions Available

By
Dr. Alex Jimenez
-

Learn about key approaches for GI disorder treatment to manage symptoms and gracefully enhance your quality of life.

What Are GI Disorders?

How frequently does eating a big meal make you feel bloated? Do you suffer from gastrointestinal inflammation or constipation? Or do your muscles and joints feel stiff? Many individuals are unaware that environmental variables may have an effect on their gastrointestinal system and produce several overlapping risk profiles in the body by extending their influence onto the musculoskeletal system. This can result in pain-like sensations that often resemble musculoskeletal illnesses. Depending on the severity, gastrointestinal (GI) diseases are often frequent and may be difficult to treat, with major medical and social repercussions. (Malone and others, 2018). Gastroesophageal reflux disease (GERD), small intestinal bacterial overgrowth (SIBO), and irritable bowel syndrome (IBS) are a few prevalent GI disorders. Chronic pain, inflexible joints, and muscular dysfunction in the musculoskeletal system may all be caused by GI issues. Many people may find practical, non-surgical solutions that help alleviate pain and enhance their quality of life by comprehending the relationship between the stomach and the musculoskeletal system.

 

How GI Disorders Affect The Gut & Musculoskeletal System

Many individuals are curious about how environmental variables might impact their muscles and intestines, and they are a major contributor to the development of GI problems. One environmental element that might impact the muscles and intestines is stress. A person may experience physical and psychological effects from stress, which might alter the way the gut bacteria react and result in gastrointestinal diseases. (Konturek & colleagues, 2011)

 

Inflammation & Systemic Effects

When the body begins to experience GI difficulties, inflammation develops and adheres to the damaged region, resulting in problems with the stomach. In the gastrointestinal system, inflammation may cause low-grade inflammation, compromise the integrity of the gut barrier, and interfere with normal food and nutrient digestion. (Casini & colleagues, 2024) Chronic gastrointestinal disorders like Crohn’s disease or ulcerative colitis, which have inflammatory components, may result from this. The musculoskeletal system may then experience systemic inflammation as a result of the release of inflammatory mediators and cytokines into the bloodstream, which may lead to symptoms including tiredness, joint stiffness, and muscle discomfort.

 

Nutrient Malabsorption & Deficiencies

IBD, chronic diarrhea, and celiac disease may all affect how nutrients are absorbed, resulting in vitamin and mineral deficiencies that can cause joint pain, weakness, and cramping in the muscles that are often confused with fibromyalgia or arthritis.

 

Gut Dysbiosis & The Nervous System

Often referred to as the “second brain,” the gastrointestinal system and the neurological system have a special connection. An imbalance in gut bacteria (dysbiosis) may lead to the development of a leaky gut since the gut contains trillions of bacteria and works to transfer nutrients from meals to other bodies. Toxins may enter the circulation as a result, triggering the immune system. Widespread inflammation and musculoskeletal pain result from this, which impacts the quality of life and pain of the musculoskeletal system from the stomach. In 2024, Casini et al. Both muscle function and pain perception are simultaneously regulated by the gut-brain axis.

 

Visceral-Somatic Reflexes & Referred Pain

Referred pain patterns may result from GI problems, when the musculoskeletal system experiences visceral distress. One sign of visceral pain hypersensitivity is persistent stomach pain or discomfort (Farmer & Aziz, 2009). Because of visceral-somatic reflexes, IBS may produce lower back and pelvic pain, while GERD can cause chest and upper back pain.

Fighting Inflammation Naturally: Video

Fighting Inflammation Naturally | El Paso, Tx (2023)

Functional & Nonsurgical Approaches To Reduce GI Pain

The following non-surgical, evidence-based methods may be used to treat musculoskeletal and intestinal pain:

 

Dietary Modifications

A healthy diet is a good place to start when making little adjustments to enhance gut health. In addition to affecting and regulating many vital bodily processes, including gastrointestinal hormones, a nutritious diet may provide energy, promote body development, and aid in healing. (2019, El-Salhy). Incorporating meals high in omega-3s and polyphenols may help lessen the gut’s inflammatory effects by eliminating trigger foods that result in overlapping pain sensations. The following diets may be helpful for GI disorders:
Dietary Elimination and Anti-Inflammatory
Diet of FODMAPs

 

Pro-& Prebiotics

Probiotics and prebiotics may support the restoration and balance of gut flora in relation to gut health. While prebiotics use foods high in fiber to nourish the good bacteria and promote gut health, probiotics include good bacteria that help balance the gut microbiota and lower inflammation. Incorporating these two helps stop intestinal inflammation by restoring the dynamic equilibrium between the intestinal mucosa’s microbiota and host defense systems. Dhaneshwar and Roy, 2023

 

Stress Management

Reducing environmental stresses that lead to gastrointestinal illnesses and musculoskeletal discomfort helps the body unwind and ease tight muscles. The following are some methods that individuals may use:
Meditation and mindfulness: Progressive muscle relaxation, yoga, and deep breathing may all help lessen pain perception and gut sensitivity.
Enhancing pain tolerance and managing GI symptoms brought on by stress are two benefits of cognitive behavioral therapy, or CBT.

 

Manual Therapies

Pain from musculoskeletal diseases may be lessened by manual therapy. A variety of treatments may be used by massage therapists, physical therapists, and chiropractors to assist strengthen and stretch weak muscle groups and lessen the body’s inflammatory response. Here are a few of these treatments:
The goal of osteopathic manipulative therapy (OMT) is to enhance gastrointestinal motility and alleviate referred pain.
The hands-on technique known as visceral manipulation improves digestion and eases musculoskeletal stress by releasing limitations in the belly.
Massage therapy may ease tension in the back and abdominal muscles and lessen symptoms of stress-related gastrointestinal disorders.

 

Acupuncture

Through autonomic nervous system stimulation, acupuncture has been shown to enhance gastrointestinal motility and lessen discomfort associated with IBS. In order to provide relief, acupuncturists insert tiny, thin needles into the body’s many acupoints. Neuromodulation, intestinal barrier adjustment, and healing are all part of acupuncture. Li et al. (2023)

 

 

Conclusion

Because the risk profiles of GI diseases and the musculoskeletal system overlap and correlate, their interactions are distinct. More efficient therapies to lessen GI illnesses are made possible by an understanding of this link. Comprehensive treatments to GI-related musculoskeletal pain may be obtained by combining functional, non-surgical methods, such as movement-based therapies, manual therapies, stress management, gut microbiota maintenance, and dietary modifications. A person may get long-lasting relief and enhanced well-being by addressing the underlying cause of dysfunction with these little adjustments to their daily routine, such as exercising or following a balanced diet.

 

Injury Medical & Functional Medicine Clinic

We associate with certified medical providers who understand the importance of the effects of GI disorders on not only the gut system but also the musculoskeletal system. While asking important questions to our associated medical providers, we advise patients to implement small changes like physical activities and small dietary changes to their diet to reduce the chances of GI disorders from returning. Dr. Alex Jimenez, D.C., envisions this information as an academic service. Disclaimer.

References

Casini, I., Massai, L., Solomita, E., Ortenzi, K., Pieretti, S., & Aloisi, A. M. (2024). Gastrointestinal Conditions Affect Chronic Pain and Quality of Life in Women. Int J Environ Res Public Health, 21(11). doi.org/10.3390/ijerph21111435

El-Salhy, M. (2019). Nutritional Management of Gastrointestinal Diseases and Disorders. Nutrients, 11(12). doi.org/10.3390/nu11123013

Farmer, A. D., & Aziz, Q. (2009). Visceral pain hypersensitivity in functional gastrointestinal disorders. Br Med Bull, 91, 123-136. doi.org/10.1093/bmb/ldp026

Konturek, P. C., Brzozowski, T., & Konturek, S. J. (2011). Stress and the gut: pathophysiology, clinical consequences, diagnostic approach and treatment options. J Physiol Pharmacol, 62(6), 591-599. www.ncbi.nlm.nih.gov/pubmed/22314561

Li, X., Liu, S., Liu, H., & Zhu, J. J. (2023). Acupuncture for gastrointestinal diseases. Anat Rec (Hoboken), 306(12), 2997-3005. doi.org/10.1002/ar.24871

Malone, M., Waheed, A., & Samiullah, S. (2018). Functional Gastrointestinal Disorders: Functional Lower Gastrointestinal Disorders in Adults. FP Essent, 466, 21-28. www.ncbi.nlm.nih.gov/pubmed/29528206

Roy, S., & Dhaneshwar, S. (2023). Role of prebiotics, probiotics, and synbiotics in management of inflammatory bowel disease: Current perspectives. World J Gastroenterol, 29(14), 2078-2100. doi.org/10.3748/wjg.v29.i14.2078

Disclaimer

Bicycle Stationary Conversion for Indoor Cycling

By
Dr. Alex Jimenez
-
Cropped photo of male athlete biking on cycling stationary bike while exercising indoor. Sport concept

Can converting a bicycle into a stationary bike be a way for individuals to exercise more while still enjoying cycling?

Bicycle Stationary Conversion for Indoor Cycling

Bicycle Stationary Conversion

Is your bike collecting dust in the garage? Do you miss riding, but the weather or temperatures keep you indoors?  Why not quickly and painlessly turn your bike into a stationary bike? An indoor stationary bike is a great way to maintain physical activity while avoiding inclement weather and outdoor elements. Plus, bicycle stationary conversion in your home, office, or garage is quick and straightforward. A bike trainer or roller is needed to convert a bicycle into a stationary bike. The bike is mounted onto the trainer stand, and its rear axle is replaced with a special axle provided with the trainer kit to secure it and hold the wheel in place while allowing you to pedal, creating resistance for indoor cycling.

Cycling

Bicycle stationary conversion isn’t only for die-hard cyclists. Research shows indoor cycling is a great way to stay healthy and consistent with your workouts. One study showed that indoor cycling improves aerobic capacity, blood pressure, lipid profile, and body composition. (Chavarrias, M. et al., 2019)

Stationary Bikes Types

For those who don’t have the space or know that they won’t regularly use a stationary bike, indoor bike trainers and rollers can provide convenient, economical, and compact options. Whether individuals want to exercise more, maintain a riding schedule, or train for an event, trainers and rollers can be highly effective tools for any cyclist. However, choosing between a bike trainer and rollers varies depending on the pros and cons. Selecting the right equipment depends on several factors, including:

  • Personal needs
  • Space – indoor or garage.
  • Cycling experience

Most cyclists, even hobbyists, prefer indoor cycling bikes over traditional stationary bikes because they are riding a real bicycle, including the positioning and pedaling, compared to upright, air, or recumbent bikes.

Trainer

A bike trainer is a stand that lets an individual ride a regular bicycle while stationary. Cyclists often use it to warm up before races, and it comes in handy when weather conditions or time constraints prevent riding outdoors. Most trainer stands can accommodate bicycles. Trainers are suitable for beginners and professional riders. There are two types of indoor bike trainers.

Direct-drive

  • Direct-drive trainers attach to the bike’s rear dropouts, replacing the wheel and providing a direct connection to the resistance unit.
  • These can cost more, but they’re worth the investment because they’re more accurate and deliver the highest resistance levels.

Friction

  • A small roller is installed against the rear wheel with friction trainers, which use magnetic or fluid resistance.
  • These are typically lighter and easier to transport than direct-drive trainers but are less accurate and provide less resistance.

Rollers

Rollers are the most basic type of indoor stationary bike but may not be the best option for individuals new to indoor cycling. This is because it requires advanced cycling techniques, such as balancing and keeping the front tire straight while riding. The cycle is on rollers instead of being fixed, allowing the resistance to range from zero to the equivalent of a direct-drive trainer. Rollers help refine pedaling technique and improve cycling form because you balance and stabilize while riding.

Conversion – What Is Needed

The most important equipment needed to convert the cycle is a bike stand, which will be the foundation of the stationary bike setup. (Bike To Work Day, 2025) There are two-piece stands and one-piece stands. (Bike To Work Day, 2025) Tools like an Allen wrench may be needed. Various bike trainer kits contain all the parts needed for this conversion, but extra standard tools may be required to remove the back wheel and replace the axle.

  • Choose the right trainer: Consider your bike type, desired resistance levels, and budget.
  • Install the trainer: Follow the manufacturer’s instructions to position and secure the trainer properly.
  • Mount the bike: Remove the rear wheel quick release, insert the trainer’s axle, and tighten it securely.
  • Adjust resistance: Most trainers have a knob or lever to control the difficulty level.
  • If you are uncertain whether your bike stand is set up correctly or having issues with the installation, contact a professional bike mechanic. They can help get the stationary bike up and running properly.

Considerations

  • Tire wear: Using a dedicated trainer tire for the rear wheel can minimize wear and tear.
  • Noise level: Some trainers can be noisy, especially wheel-on types.
  • Stability: Ensure the bike is properly secured on the trainer and your training area is stable.

Injury Medical Chiropractic and Functional Medicine Clinic

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. The clinic can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

Body In Balance: Chiropractic, Fitness, and Nutrition

References

Chavarrias, M., Carlos-Vivas, J., Collado-Mateo, D., & Pérez-Gómez, J. (2019). Health Benefits of Indoor Cycling: A Systematic Review. Medicina (Kaunas, Lithuania), 55(8), 452. doi.org/10.3390/medicina55080452

Bike To Work Day. (2025). How to turn a bike into a stationary bike: Things to know. biketoworkday.us/turn-a-bike-into-a-stationary-bike/#Setting_up_Your_Stationary_Bike

Bone Broth Health: Boosting Your Overall Wellness

By
Dr. Alex Jimenez
-
Homemade Beef Bone Broth in Glass Storage Jar on the black background with vegetables. Bones contain collagen, which provides the body with amino acids

Can bone broth help individuals with gut issues or chronic conditions like inflammatory bowel disorder?

Bone Broth Health: Boosting Your Overall Wellness

Bone Broth Health

Bone broth is a nutrient-rich beverage made by simmering animal bones, typically from beef, chicken, or fish, in water for an extended period (24-72 hours). It can be used as a beverage or as a base for soups, stews, and sauces.

Process

  • Bones are roasted or boiled to release flavor.
  • Bones are placed in a pot with water, vegetables (such as onions, carrots, and celery), herbs (such as parsley and thyme), and spices.
  • The mixture is simmered over low heat for a long time, allowing the bones to release their nutrients and collagen.
  • The broth is strained to remove the bones and solids.

Nutrients

Bone broth is a healthy source of:

Collagen

  • A protein that supports skin, hair, and joint health.

Minerals

  • Including calcium, magnesium, phosphorus, and silicon.

Amino acids

  • Essential for building and repairing tissues.

Bone Broth Health Benefits

While there is limited research on the health benefits, the nutrients in bone broth can be beneficial for:

  • Joint health
  • Bone density
  • Digestion
  • Gut health
  • Muscle growth and recovery
  • Hydration
  • Reduce inflammation
  • Improve skin elasticity and appearance
  • Boost immune system

While research on bone broth’s benefits is still limited, it’s a nutritious and hydrating beverage that supports gut health and recovery after a tough workout. It can be drunk on its own or used in cooking. Bone broth is a delicious way to replenish electrolytes and stay hydrated, whether recovering from a flare-up or an intense workout. It is especially helpful for those dealing with gut issues or chronic conditions like inflammatory bowel disorder.

Nutrient-Rich

  • Bone broth is rich in minerals, including calcium, magnesium, potassium, phosphorus, and iodine.

Joint Health

  • Collagen is the main source of protein found in bones, tendons, and ligaments.
  • Research suggests that collagen may support joint health, protect the tissues in joints, and improve symptoms of osteoarthritis. (Martínez-Puig D. et al., 2023)

Anti-Inflammatory

Protein-Rich

  • Incorporating bone broth into one’s diet can help meet protein goals.
  • One cup of bone broth contains four to 20 grams of protein.

Digestion and Gut Health

  • Colostrum is the first milk produced after giving birth, and some research suggests this may offer immune-boosting benefits and gut repair, but more research is needed. (Playford R. J., & Weiser M. J. 2021)
  • Bone broth contains glutamine, an amino acid that can reduce inflammation in the gut, strengthen the gut lining, and maintain a healthy microbiome.
  • It also contains glycine, which may help quell digestive issues such as acid reflux or GERD, though research is limited. (Wang B. et al., 2015) (Nagahama K. et al., 2012)

Many bone broths are high in sodium and may not be suitable for individuals on low-sodium diets. It is recommended that individuals consume less than 2,300 milligrams of sodium per day to support a healthy heart and reduce the risk of high blood pressure, look for other sources of sodium, and incorporate bone broth accordingly. (American Heart Association, 2024) Also, because of the polysaccharides that may leach from the cartilage and the garlic and onions usually present in the bone broth, it’s not suitable for those with a digestive disorder like small intestinal bacterial overgrowth (SIBO) or individuals following a low-FODMAP diet.

What To Look For

Quality

  • When possible, choose a bone broth that’s grass-fed and organic.
  • Quality matters because the process of simmering the bones with water pulls all the nutrients, collagen, and protein into the broth.
  • Starting with the highest quality ingredients ensures it will be as nutritious as possible.

Type

  • Various types include chicken, beef, turkey, and bison varieties.

Packaging

  • Bone broth comes in various packaging, including shelf-stable, frozen, or fresh.
  • When selecting, consider how often it is used, how much is needed, and storage space.
  • For individuals who drink bone broth daily, buying it in bulk and storing it in the pantry or freezer may be more budget-friendly.

Consistency

  • Generally, bone broth is a thick, slightly viscous beverage.
  • Individuals who prefer a thinner liquid should try a shelf-stable broth, which is usually less gelatinous than frozen bone broths.
  • Powdered bone broth is also a great option for those who prefer a lighter beverage.
  • Individuals can choose a low-sodium bone broth to limit sodium intake.

Injury Medical Chiropractic and Functional Medicine Clinic

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

Reducing Inflammation In The Body

References

Martínez-Puig, D., Costa-Larrión, E., Rubio-Rodríguez, N., & Gálvez-Martín, P. (2023). Collagen Supplementation for Joint Health: The Link between Composition and Scientific Knowledge. Nutrients, 15(6), 1332. doi.org/10.3390/nu15061332

Chen, S., Kim, W., Henning, S. M., Carpenter, C. L., & Li, Z. (2010). Arginine and antioxidant supplement on performance in elderly male cyclists: a randomized controlled trial. Journal of the International Society of Sports Nutrition, 7, 13. doi.org/10.1186/1550-2783-7-13

Razak, M. A., Begum, P. S., Viswanath, B., & Rajagopal, S. (2017). Multifarious Beneficial Effect of Nonessential Amino Acid, Glycine: A Review. Oxidative medicine and cellular longevity, 2017, 1716701. doi.org/10.1155/2017/1716701

Playford, R. J., & Weiser, M. J. (2021). Bovine Colostrum: Its Constituents and Uses. Nutrients, 13(1), 265. doi.org/10.3390/nu13010265

Wang, B., Wu, G., Zhou, Z., Dai, Z., Sun, Y., Ji, Y., Li, W., Wang, W., Liu, C., Han, F., & Wu, Z. (2015). Glutamine and intestinal barrier function. Amino acids, 47(10), 2143–2154. doi.org/10.1007/s00726-014-1773-4

Nagahama, K., Nishio, H., Yamato, M., & Takeuchi, K. (2012). Orally administered L-arginine and glycine are highly effective against acid reflux esophagitis in rats. Medical science monitor: international medical journal of experimental and clinical research, 18(1), BR9–BR15. doi.org/10.12659/msm.882190

American Heart Association. Association, A. H. (2024). Lifestyle & Risk Reduction, High Blood Pressure. www.heart.org/-/media/files/health-topics/answers-by-heart/why-should-i-limit-sodium.pdf

An Analysis of Treatments Approaches For Kyphosis

By
Dr. Alex Jimenez
-

Kyphosis affects many people at any age. Discover kyphosis treatment approaches to take action for better health.

What Is Kyphosis?

How many times have you seen that after spending too much time sitting down, your posture has become more hunched? Do you have shoulder and neck muscular tightness that is momentarily relieved by stretching them? Or does bad posture cause you to experience shoulder and back discomfort and tightness? The neck, shoulders, and back are the three primary musculoskeletal regions that people often suffer with. Long-term hunching may cause kyphosis, a disease of the spine. Increases in the forward curvature of the spine that impact the thoracic region are known as kyphosis, and they may be brought on by degenerative alterations in the intervertebral discs. (Mukhdomi and Lam, 2025) A hunchback or rounded upper back is a symptom of kyphosis that may impair posture and general musculoskeletal health. The symptoms may vary from severe stiffness and soreness to breathing problems, depending on the degree of kyphosis. On the other hand, many people may discover different treatment choices to manage this spinal ailment by knowing the environmental variables that contribute to its development as well as the symptoms that are linked with it.

 

Environmental Factors Contributing to Kyphosis

There are a number of environmental factors that might cause kyphosis. This is because a lot of individuals engage in activity that puts a lot of strain on the spine. Kyphosis, on the other hand, may occur as a result of the spine’s gradual aging process. The following are some examples of environmental causes that cause kyphosis:

  • Inadequate Posture
  • Lifestyle of Sedentary Behavior
  • Osteoporosis from Heavy Items and Improper Lifting
  • Spinal Disorders & Injuries

 

Kyphosis Symptoms & Its Effects on the Musculoskeletal System

The cervical and thoracic regions of the spine may be affected by kyphosis, which may result in a number of musculoskeletal issues.The onset of cervical kyphosis may result in referred neck discomfort, which puts more pressure on the posterior soft tissues and forces the head to cope with mechanical imbalance, which leads to exhaustion and strained muscles. (Ogura & colleagues, 2021) Certain risk factors, such as poor bone density and lower extremity dysfunction in older persons, might impede mobility when kyphosis begins to damage the thoracic spine. (Lorbergs et al., 2017) The following are some other musculoskeletal problems linked to kyphosis:

  • Pain and stiffness in the upper back
  • Limited Flexibility & Mobility
  • Pain Referred to Muscle Weakness & Fatigue
  • Issues with Breathing and Digestion

 

Understanding Long-Lasting Injuries- Video

Understanding Long-Lasting Injuries - El Paso, Tx (2023)

Treatment Approaches For Kyphosis

If the curvature of the spine has become so bad, many people have chosen to undergo surgery to manage the symptoms of kyphosis. But since they are less expensive and non-invasive, a lot of individuals have chosen nonsurgical treatments. The goal of nonsurgical therapies for kyphosis is to enhance a person’s posture and lessen its problems. (Jenkins et al., 2021)Their mobility and postural control will significantly improve if they begin using nonsurgical therapies to lessen cervical kyphosis. (Oakley & colleagues, 2024)

 

Chiropractic Care & More

One non-invasive treatment option for kyphosis sufferers is chiropractic adjustments, which may help reduce pain and realign the spine. In order to stretch and strengthen tense, weak muscles and restore the spine to its natural position, chiropractic therapy involves spinal manipulation. Because chiropractic adjustments increase the range of motion in the neck, they may alleviate overlapping risk profiles, such as headaches and kyphotic neck discomfort. In 2022, Norton et al. Furthermore, chiropractors may create a personalized treatment plan for those with kyphosis while offering substantial back and neck relief to avoid a slouched posture. (Fortner and others, 2017) People with kyphosis may benefit from chiropractic therapy in a number of ways.

  • Spinal adjustments may help straighten the vertebrae, improve posture, and lessen excessive curvature.
  • Chiropractors may provide postural training, which involves strengthening the back and core muscles to improve support.
  • Pain management: Physical therapy and spinal decompression methods help ease tense muscles and lessen pain that has been referred.
  • Enhanced Flexibility & Mobility: Mobility exercises and stretching help avoid stiffness and increase range of motion.

 

Additional Treatments For Kyphosis

Other kyphosis management techniques than chiropractic adjustments may assist to increase spinal stability and stop the deterioration of spinal curvature. Among these extra treatments are:

  • Physical Counseling
  • Using Postural Ergonomics Brace

 

Final Thoughts

The quality of life may be greatly enhanced by early diagnosis and appropriate care, even if kyphosis can cause pain and suffering. By aggressively treating kyphosis, whether via physical therapy, chiropractic adjustments, or lifestyle changes, improved posture, less discomfort, and more mobility may result.

 

Injury Medical Chiropractic & Functional Medicine Clinic

We associate with certified medical providers who implement the importance of the causes and symptoms of kyphosis. While asking important questions to our associated medical providers, we advise patients to integrate small changes into their daily routine to reduce the effects of kyphosis from affecting the cervical and thoracic areas. Dr. Alex Jimenez, D.C., envisions this information as an academic service. Disclaimer.

References

Fortner, M. O., Oakley, P. A., & Harrison, D. E. (2017). Treating ‘slouchy’ (hyperkyphosis) posture with chiropractic biophysics((R)): a case report utilizing a multimodal mirror image((R)) rehabilitation program. Journal of Physical Therapy Science, 29(8), 1475-1480. doi.org/10.1589/jpts.29.1475

Jenkins, H. J., Downie, A. S., Fernandez, M., & Hancock, M. J. (2021). Decreasing thoracic hyperkyphosis – Which treatments are most effective? A systematic literature review and meta-analysis. Musculoskelet Sci Pract, 56, 102438. doi.org/10.1016/j.msksp.2021.102438

Lam, J. C., & Mukhdomi, T. (2025). Kyphosis. In StatPearls. www.ncbi.nlm.nih.gov/pubmed/32644371

Lorbergs, A. L., Murabito, J. M., Jarraya, M., Guermazi, A., Allaire, B. T., Yang, L., Kiel, D. P., Cupples, L. A., Bouxsein, M. L., Travison, T. G., & Samelson, E. J. (2017). Thoracic Kyphosis and Physical Function: The Framingham Study. J Am Geriatr Soc, 65(10), 2257-2264. doi.org/10.1111/jgs.15038

Norton, T. C., Oakley, P. A., & Harrison, D. E. (2022). Improving the cervical lordosis relieves neck pain and chronic headaches in a pediatric: a Chiropractic Biophysics((R)) (CBP((R))) case report with a 17-month follow-up. Journal of Physical Therapy Science, 34(1), 71-75. doi.org/10.1589/jpts.34.71

Oakley, P. A., Gage, W. H., Harrison, D. E., & Mochizuki, G. (2024). Non-surgical reduction in thoracolumbar kyphosis and sagittal vertical axis corresponding with improved sensorimotor control in an older adult with spinal deformity: a Chiropractic Biophysics((R)) case report. Journal of Physical Therapy Science, 36(11), 756-764. doi.org/10.1589/jpts.36.756

Ogura, Y., Dimar, J. R., Djurasovic, M., & Carreon, L. Y. (2021). Etiology and treatment of cervical kyphosis: state of the art review-a narrative review. J Spine Surg, 7(3), 422-433. doi.org/10.21037/jss-21-54

Disclaimer

Female Hernia: Misdiagnosis and Treatment Options

By
Dr. Alex Jimenez
-
A young woman is running and doing sports in the park, standing with her hands on her stomach, feeling nauseous and near after exercise.

In females, hernia symptoms are often smaller and deeper without a noticeable lump and can mimic gynecological issues, with misdiagnoses being common. Can knowing the risk factors and how female hernias are treated help women get relief?

Female Hernia: Misdiagnosis and Treatment Options

Female Hernia

A hernia occurs when an internal structure pushes through a weak spot in the abdominal wall, the muscles, and the tissue covering the front of the torso. The more common include:

  • Groin hernia, known as an inguinal hernia.
  • Upper thigh or femoral hernia.

However, a hernia can develop anywhere from the ribcage to the upper thigh. Hernias are less common in women, have different symptoms than in men, and are often misdiagnosed. Lower abdominal and pelvic hernias present differently in women than men, who typically have a visible bulge. Instead, female hernias tend to be smaller, deeper, and less noticeable. They can also cause chronic pelvic pressure or pain that can be mistaken for gynecological problems.

Hernia Symptoms For a Woman

Hernias in women tend to be smaller and deeper than male hernias, with no lump showing. Instead, female hernias can cause chronic, deep pelvic pain and occasional sharp, stabbing pain that comes on fast and lingers. (Köckerling F., Koch A., & Lorenz R. 2019) Hernia pain worsens with exercise, laughing, coughing, or straining to evacuate the bowels. The pain is often described as:

  • Dull
  • Aching
  • Pinching
  • Sharp
  • Shooting
  • Burning

Inguinal hernia pain is usually felt at or above the groin and may radiate to the hip, lower back, vulva, or thigh. Many women find the pain increases during their menstrual cycle. The pain can also be exacerbated by any activity that generates extra pressure on the pelvic floor, including:

  • Prolonged sitting or standing.
  • Bending
  • Getting in or out of bed.
  • Getting in or out of a car.
  • Sexual intercourse

Emergency

Hernias in the pelvic area are at risk of becoming incarcerated hernias. An incarcerated hernia occurs when a portion of the intestine or other abdominal tissue becomes trapped in the hernial sac, making it impossible to push it back into place. If this gets trapped or strangulated, it can cause tissue death. Strangulated hernias are a medical emergency. Symptoms include:

  • Deep red or purple tissues.
  • The hernia bulge does not shrink when you lie down.

Other  symptoms that warrant immediate medical attention include: (Johns Hopkins Medicine, 2025)

  • Worsening pain
  • Bloating
  • Difficulty with bowel movements
  • Nausea
  • Fever
  • A fast, racing heartbeat.

Contact a healthcare provider or the emergency room if experiencing any of the above symptoms.

Types

Hernias can occur anywhere on the abdominal wall. They may be caused by:

  • Internal pressure, such as during pregnancy.
  • A sports injury
  • Tissue weakness

Hernias in the lower abdomen or groin are typically indirect inguinal hernias. The inguinal canal comprises multiple layers of muscles and fascia that the thin round ligament threads through. Other groin and pelvic hernias include:

  • A direct inguinal hernia
  • A femoral hernia at the top of the inner thigh.
  • An obturator hernia in the front upper thigh, although this type is rare.

Other common hernias in women are:

  • Incisional hernia – at the site of a surgical incision
  • Umbilical hernia – around the belly button
  • Ventral hernia – abdominal midline

Less common hernias include:

  • Hiatal hernia – diaphragm
  • Perineal hernia – pelvic floor

Risk Factors

Risk factors for developing a hernia include: (Johns Hopkins Medicine, 2025)

  • Obesity
  • Frequent constipation
  • Abdominal or pelvic surgery.
  • Allergies with chronic sneezing.
  • A chronic cough.
  • Collagen defects or connective tissue disorders.

Pregnancy and repeated pregnancies are linked to an increased risk of hernia. Types that are more common in pregnancy include:

  • Umbilical hernia
  • Ventral hernia
  • Inguinal hernia

Umbilical hernias are the most common. However, only a small percentage of pregnant individuals get them. (Kulacoglu H. 2018)

Diagnosis

A hernia diagnosis is made with a physical examination and, if needed, imaging studies. Patients are asked to describe their symptoms precisely, where the pain is located, and any activities that exacerbate it. To check for a hernia, the healthcare provider will palpate for a hernia while the patient sits, stands, or coughs. Imaging tests can include:

  • Ultrasound
  • CT scan
  • Endoscopy – a camera is used to see inside the esophagus and stomach.

Misdiagnoses

Female hernia symptoms can be vague, which often points healthcare providers in the wrong direction. Female hernias are commonly misdiagnosed as: (Köckerling F., Koch A., & Lorenz R. 2019)

  • Cysts in the reproductive organs
  • Endometriosis
  • Fibroid tumors

Treatment

A small hernia that does not cause problems or pain may be treated with a wait-and-evaluate protocol. A hernia often worsens over time and could eventually require surgery. (University of Michigan Health, 2024) Self-care treatments include:

Medical treatments usually start with conservative measures, including physical therapy, stretching, exercise, and rest. Physical therapists often use myofascial release techniques to relieve muscle spasms. Surgery may be needed to repair the weak area of the abdominal wall to relieve symptoms. (University of Michigan Health, 2024) Hernia repair surgery is typically performed as a laparoscopic surgery. (Köckerling F., Koch A., & Lorenz R. 2019) Most patients heal quickly from the surgery and can return to regular activities in a week or two.

Injury Medical Chiropractic and Functional Medicine Clinic

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

Lumbar Spine Injuries in Sports: Chiropractic Healing

References

Köckerling, F., Koch, A., & Lorenz, R. (2019). Groin Hernias in Women-A Review of the Literature. Frontiers in surgery, 6, 4. doi.org/10.3389/fsurg.2019.00004

Johns Hopkins Medicine. (2025). How to tell if you have a hernia. www.hopkinsmedicine.org/health/conditions-and-diseases/how-to-tell-if-you-have-a-hernia

Kulacoglu H. (2018). Umbilical Hernia Repair and Pregnancy: Before, during, after…. Frontiers in surgery, 5, 1. doi.org/10.3389/fsurg.2018.00001

University of Michigan Health. (2024). Inguinal hernia: Should I have surgery now, or should I wait? www.uofmhealth.org/health-library/za1162

American Academy of Orthopaedic Surgeons. (2022). Sports hernia. orthoinfo.aaos.org/en/diseases–conditions/sports-hernia-athletic-pubalgia/

Northeast Georgia Health System. (2022). Living with a hernia. Northeast Georgia Health System Improving the health of our community in all we do. www.nghs.com/2022/02/15/living-with-a-hernia

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