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Headache Self-Care Techniques to Alleviate Pain

By
Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP
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woman with headache depression stress health problem migraine. High quality photo

For individuals dealing with headaches, can utilizing self-care techniques help ease symptoms?

Headache Self-Care Techniques to Alleviate Pain

Headaches Self Care

There are different self-pain-relieving approaches to ease headache-related pain that use non-medication options. While headache self-care pain-relieving techniques can help temporarily, they are recommended to help ease headache symptoms until professional treatment is available. Individuals are encouraged to try multiple strategies to find the right treatment regimen that works for them, which is usually a process of trial and error. Self-care headache relief maneuvers can include temple massages, breathing exercises, exercise, or applying a cold pack to the head.

Self-Care Relief

Commonly used for tension headaches or migraine, a few examples of self-care techniques include (Espí-López G. V. et al., 2016)

  • Massaging the temples, neck, or scalp with the hand, fingers, or a massage tool.
  • Applying a cold pack to the affected area.
  • Heat can be used on the affected area, like a headband or a hot shower.
  • Compression such as a handkerchief or belt wrapped tightly around the head or pressing firmly on the painful area.

Compression is more commonly utilized in migraineurs versus scalp massage in people with tension headaches. This is often due to the throbbing sensation caused by a migraine versus a tension headache, which feels like a tight grip or band around the head.

Individuals with cluster headaches are more likely to utilize unique approaches, such as covering one ear, rotating the head, shallow breathing, moving around, or closing the nostril on the same side as the head pain.

Other Complementary Options

Other complementary therapies for headache and migraine care include: (Millstine D. et al., 2017)

  • Trigger point release massage
  • Progressive muscle relaxation
  • Aerobic exercise
  • Yoga
  • Deep breathing exercises
  • Meditation
  • Cognitive-Behavioral Therapy

Various scientific studies support the potential benefit of these complementary therapies. However, individuals should talk with a healthcare provider to choose the best strategy for their headache type and their unique needs/goals. Working with a chiropractic team can help expedite healing. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop a customized treatment plan through an integrated approach to treating injuries and chronic pain syndromes, improving flexibility, mobility, and agility, relieving pain, and helping individuals return to normal activities. If other treatments are needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments.

Tension Headaches and Chiropractic Care

References

Espí-López, G. V., Zurriaga-Llorens, R., Monzani, L., & Falla, D. (2016). The effect of manipulation plus massage therapy versus massage therapy alone in people with tension-type headache. A randomized controlled clinical trial. European journal of physical and rehabilitation medicine, 52(5), 606–617.

Millstine, D., Chen, C. Y., & Bauer, B. (2017). Complementary and integrative medicine in the management of headache. BMJ (Clinical research ed.), 357, j1805. https://doi.org/10.1136/bmj.j1805

Intuitive Eating: Listening to Your Body for Better Health

By
Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP
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Young woman consults with her doctor

Can understanding the philosophy of intuitive eating help individuals achieve and maintain health goals by breaking free from diets and getting healthy by improving their relationship with food and exercise?

Intuitive Eating: Listening to Your Body for Better Health

Intuitive Eating

Intuitive eating is a non-diet approach to eating that focuses on listening to the body with internal body cues. Strict food rules are the main reason diets don’t work and negatively impact overall health and well-being. (Linardon, J., & Mitchell, S. 2017) Intuitive eating is characterized by eating in response to physiological hunger and satiety cues rather than emotional cues. The body was born to eat when hungry and stop when full. However, this natural way of eating can get lost in emotions, food rules, and restrictions. Fortunately, getting back to intuitive eating is possible for everyone.

How Does It Work?

Intuitive eating is a non-diet approach that steps away from a diet mentality and applies healthy behaviors around food. It focuses on unlearning external rules, like diet rules and expectations of what and how much to eat, and emphasizes internal cues like hunger, fullness, and how foods make you feel. It is based on principles that help build a healthier relationship with food. Individuals become aware of what to eat, how much to eat, and when to eat naturally, without worry or guilt.

Mindful Eating

Mindful eating is not the same thing as intuitive eating. Individuals can think of mindful eating as a skill or practice, while intuitive eating is a philosophy.

Principles

Understanding the ten core principles and how they work together is important.

Remove The Diet Mentality

Let go of the quick fixes and gimmick diets. These offer false hope that weight loss is easy, quick, and permanent and can make individuals feel like failures for losing and regaining weight.

Honor Hunger

Hunger is a normal, biological process. The body requires adequate amounts of energy and carbohydrates to function properly. Ignoring these cues and hunger can lead to cravings, overeating, and binges. Learning to honor hunger cues sets the stage for rebuilding trust with food. A food scale can help determine proper portions.

Make Friends With Food

Allow yourself unconditional permission to eat what you want. This means including all foods without labeling them as good or bad. Once an individual tells themself they can’t have a certain food, they can feel deprived, and intense cravings can build that often lead to overeating, binges, and extreme food guilt.

Get the Food Police Out Of Your Head

Learn to say no to self-induced thoughts of good or bad based on what is being eaten or how many calories are involved. Diets often say eating too many calories or enjoying a cookie is bad. These rules and restrictions can lower self-esteem and cause feelings of guilt. Removing negative food thoughts, guilt, and other rules is critical to intuitive eating.

Respect The Body’s Fullness

Listen for body cues that say you are full. This means your body is no longer hungry and should stop eating. Enjoy the flavors, stay aware of satiety signals throughout meals, and always be aware of your fullness level.

Satisfaction Factor

Learn to find joy and satisfaction in the eating experience. Eating what they want in an inviting environment promotes happiness and satisfaction, and a positive eating experience has been shown to promote satisfaction with even less food.

Honor Feelings Without Using Food

Don’t fix problems with food. Learn healthy ways to cope with emotions like stress, anxiety, anger, or boredom without turning to food. Feeding emotional hunger only makes feelings worse and adds guilt to the mix.

Respect Your Body

Body size and shape are unique for each person. Acceptance is an important part of self-respect and love. Instead of being critical, embrace individual genetic blueprints.
Being unrealistic and critical about one’s body makes it difficult to reject the diet mentality.

Exercise

Exercise doesn’t have to be intense or extreme to be effective. Individuals should focus on how good it feels to be active and moving their bodies rather than how many calories are burned during the workout sessions. Feeling great and motivated about exercise is easy when there is increased energy, better sleep, and improved quality of life.

Honor Health

Individuals don’t have to be perfect eaters. Infrequently eating a certain snack or meal won’t make you gain weight or cause health problems.
It’s what is eaten consistently over time that matters. Making food choices that taste good and nourish the body is what counts.

Weight Loss Benefits

Intuitive eating is not designed for weight loss. It aims to improve an individual’s relationship with food, including building healthier food behaviors and not focusing on the weight scale. However, learning to be an intuitive eater can help individuals lose weight by allowing the body to break the diet cycle and settle into its natural set point weight range.

Overall Health Benefits

Intuitive eating has been shown to have both physical and emotional health benefits that include:

  • Higher levels of contentment and satisfaction
  • Reduced stress
  • Increased self-esteem
  • Better body image outlook
  • Improved cholesterol levels
  • Improved metabolism
  • Lower rates of emotional and disordered eating

In a 24-study review that examined the psychosocial effect intuitive eating had on adult women was associated with the following positive results (Bruce, L. J., and Ricciardelli, L. A. 2016)

  • Decreased eating disorders
  • Improved positive outlook on body image
  • Higher emotional functioning

Another study compared restrictive diets and intuitive eating among men and women. The study found that intuitive eating uniquely and consistently presented lower levels of disordered eating and body image concerns. (Linardon, J., & Mitchell, S. 2017) Participants using intuitive eating expressed high levels of body appreciation, and researchers suggested promoting the practice within public health approaches to eating disorder prevention. The study also supported intuitive eating by promoting body acceptance and removing unhealthy thinking about food and eating.

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop a personalized treatment plan through an integrated approach to create personalized care plans for each patient and restore health and function to the body through nutrition and wellness, functional medicine, acupuncture, Electroacupuncture, and sports medicine protocols. If the individual needs other treatment, they will be referred to a clinic or physician best suited for them. Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, nutritionists, and health coaches to provide the most effective clinical treatments.

Eating Smart To Feel Better

References

Linardon, J., & Mitchell, S. (2017). Rigid dietary control, flexible dietary control, and intuitive eating: Evidence for their differential relationship to disordered eating and body image concerns. Eating behaviors, 26, 16–22. https://doi.org/10.1016/j.eatbeh.2017.01.008

Bruce, L. J., & Ricciardelli, L. A. (2016). A systematic review of the psychosocial correlates of intuitive eating among adult women. Appetite, 96, 454–472. https://doi.org/10.1016/j.appet.2015.10.012

Swimmer’s Shoulder: How to Recover and Prevent Future Injuries

By
Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP
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Female warming up for swimming. Stamding on pool edge and warming up hands and shoulders

Competitive swimmers, recreational, and swimming enthusiasts who experience pinching and sharp shoulder pain while swimming may suffer from shoulder impingement. Can understanding symptoms can help healthcare providers develop an effective treatment program?

Swimmer's Shoulder: How to Recover and Prevent Future Injuries

Swimmer’s Shoulder

Swimmer’s shoulder, medically known as rotator cuff impingement syndrome, is a common injury among swimmers. It can limit swimming ability and normal arm use for functional tasks. It is caused by persistent and abnormal rubbing and pinching of the structures in the shoulder, causing pain and irritation of the shoulder’s rotator cuff tendons and the bursa. The injury affects 40% to 90% of swimmers at some point. (Wanivenhaus F. et al., 2012) Self-care treatment involves rest, anti-inflammatory medication, and exercise to restore normal shoulder mobility. Most cases resolve within a few months, but physical therapy may be needed along with continued exercises and stretches to maintain pain relief.

Anatomy

The shoulder is a complex joint with extreme mobility. It is comprised of three bones:

  • The scapula or shoulder blade.
  • The clavicle or collar bone.
  • The humerus or upper arm bone.

These three bones combine at various places to make up the joint. Several muscles attach to and move the joint. (Kadi R. et al., 2017) The rotator cuff is one group of four muscles deep in the shoulder surrounding the joint. When lifting the arm, these muscles contract to hold the ball in the joint’s socket, allowing the arm to be raised in a fluid and smooth motion. Several ligaments hold the shoulder joint together and connect the various bones of the shoulder, giving the joint stability when moving. (Kadi R. et al., 2017)

Symptoms

Common symptoms include: (Wanivenhaus F. et al., 2012)

  • Swelling in the front or top of the shoulder
  • Difficulty reaching up overhead
  • Shoulder pain
  • Shoulder pain when bearing weight through the arm.
  • Symptoms tend to be worse during or immediately after swimming.

This is due to the position of the arms and upper extremities while swimming. (Wanivenhaus F. et al., 2012) Reaching overhead and turning the hand inward can cause the rotator cuff tendons or shoulder bursa to become pinched underneath the acromion process of the shoulder blade, similar to the motion that occurs during the crawl or freestyle stroke. When pinching/impingement occurs, the tendons or bursa can become inflamed, leading to pain and difficulty with normal arm use. (Struyf F. et al., 2017) The condition may also occur due to the laxity of the shoulder ligaments. (Wanivenhaus F. et al., 2012) It is theorized that the ligaments in swimmers become stretched and lax, leading to shoulder joint instability. This can cause the shoulder joint to become loose and compress the shoulder structures.

Diagnosis

A clinical examination can diagnose cases of swimmer’s shoulder. (Wanivenhaus F. et al., 2012) The exam can include:

  • Palpation
  • Strength test
  • Specialized tests

One shoulder test that is often used is called Neer’s test. A physician elevates the arm overhead to the maximum degree during this examination. If this results in pain, the rotator cuff tendons may be compressed, and the test is positive. Individuals may begin treatment after the examination, but a doctor may also refer them for diagnostic testing. An X-ray may be taken to examine the bone structures, and an MRI may be used to examine the soft tissue structures, such as the rotator cuff tendons and the bursa.

Treatment

Appropriate treatment of swimmer’s shoulder involves managing pain and inflammation in your shoulder and improving the way your shoulder moves so you avoid pinching structures inside the joint. (Wanivenhaus F. et al., 2012) There are various treatments available and can include:

  • Rest
  • Physical therapy
  • Acupuncture
  • Non-surgical decompression
  • Targeted exercises and stretches
  • Medications
  • Injections
  • Surgery for serious cases

Physical Therapy

A physical therapist can treat shoulder impingement. They can assess the condition and prescribe treatments and exercises to improve mobility and strength. (Cleveland Clinic, 2023) They may use various treatment modalities to decrease pain and improve circulation to facilitate and expedite healing. Physical therapy treatments can include:

  • Ice
  • Heat
  • Trigger point release
  • Joint mobilizations
  • Stabilization
  • Stretching
  • Exercise
  • Electrical stimulation
  • Ultrasound
  • Taping

Medication

Medication may include over-the-counter anti-inflammatory medicine to help decrease pain and inflammation. A physician may prescribe stronger medication to manage inflammation if the condition is severe. While taking medication, the shoulder will need rest, so avoiding swimming or other shoulder movements for a week or two may be necessary.

Injections

Cortisone is a powerful anti-inflammatory medicine. Individuals may benefit from cortisone injections into their shoulders. (Wanivenhaus F. et al., 2012) When injected, cortisone decreases pain, reduces swelling in the rotator cuff and bursa, and improves shoulder mobility.

Surgery

If symptoms are persistent and fail to be alleviated with conservative treatments, surgery may be recommended. An arthroscopic procedure called subacromial decompression may be performed. (Cleveland Clinic, 2023) This type of surgery is done with small incisions, inserting a camera, and tiny tools. During this procedure, inflamed tissue and bone spurs are removed from the underside of the acromion process of the shoulder blade, allowing more space to the shoulder joint. Post-surgery, individuals can gradually return to swimming and all other activities in about eight weeks.

Recovery

Most episodes last about eight to ten weeks, and severe cases last up to three months. (Struyf F. et al., 2017) Often, the symptoms slowly resolve with rest and gentle stretching. As symptoms improve, individuals can slowly return to normal activity and swimming. However, performing prescribed exercises two to three times a week may be necessary to maintain shoulder strength and mobility and help prevent future episodes of shoulder impingement. Individuals experiencing any of these symptoms should visit their physician for an accurate diagnosis of their condition to begin proper treatment. Discuss goals with a healthcare professional and physical therapist.

Sports Injuries Rehabilitation

References

Wanivenhaus, F., Fox, A. J., Chaudhury, S., & Rodeo, S. A. (2012). Epidemiology of injuries and prevention strategies in competitive swimmers. Sports health, 4(3), 246–251. https://doi.org/10.1177/1941738112442132

Kadi, R., Milants, A., & Shahabpour, M. (2017). Shoulder Anatomy and Normal Variants. Journal of the Belgian Society of Radiology, 101(Suppl 2), 3. https://doi.org/10.5334/jbr-btr.1467

Struyf, F., Tate, A., Kuppens, K., Feijen, S., & Michener, L. A. (2017). Musculoskeletal dysfunctions associated with swimmers’ shoulder. British journal of sports medicine, 51(10), 775–780. https://doi.org/10.1136/bjsports-2016-096847

Cleveland Clinic. (2023). Swimmer’s shoulder. https://my.clevelandclinic.org/health/diseases/17535-swimmers-shoulder

Knee Strengthening Exercises for Joint Health and Pain Relief

By
Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP
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African American man sitting on massage table in doctor office while female physiotherapist checking male leg injury

Can incorporating stretches and exercises help relieve pain and provide more support for individuals with knee pain?

Knee Strengthening Exercises for Joint Health and Pain Relief

Knee Strengthening

The knee is the largest joint connecting the shin and thigh bones. Its cartilage, muscles, ligaments, and nerves all play a role in maintaining the joint’s health and movement. Individuals of all ages can experience knee pain, but it is more common in those with labor-intensive jobs, arthritis, and athletes. A healthcare provider will prescribe targeted stretches and exercises for individuals with pain, inflammation, or a health disorder that affects the strength of their knees to relieve knee pain while strengthening the muscles around the joint. Knee stretches and exercises are great for those with sore knees and knee pain or stiffness, but they can also be used as preventative medicine.

Exercise Benefits

Doing knee-strengthening exercises can significantly improve joint health. The benefits associated with exercises include (Zeng C. Y. et al., 2021)

  • Reduced pain, stiffness, and joint dysfunction.
  • Reduced inflammation.
  • Improved mobility.
  • Improved strength.
  • Cartilage degeneration prevention.
  • Bone loss prevention.

Leg Lifts

Leg lifts are done by lying on the back with one leg bent and the other fully extended. To perform the exercise: (American Academy of Orthopaedic Surgeons, 2009)

  1. Raise the extended leg, keeping it straight.
  2. Hold for three to five seconds once the leg is elevated roughly one foot off the floor.
  3. Lay it back down to rest.
  4. Repeat the exercise 20 times for each leg.

What To Avoid

When performing the single-leg lift, there are certain things to avoid as they can lead to other issues or injuries. This includes: (American Academy of Orthopaedic Surgeons, 2009)

  • Arching the back
  • Flexing the neck
  • Moving too quickly through the motion.
  • Using momentum instead of the muscles.

To know the exercise is being performed correctly, individuals should feel it in the front of their thighs.

Hamstring Stretch on a Bench

If a weight bench is available, doing hamstring stretches can help strengthen the knee. To perform this stretch:

  1. Sit straight on the bench, with one leg straight out and the other planted on the floor.
  2. With the knee straight, hinge over from the hips, keeping a straight, neutral spine.
  3. Slowly push the chest towards the leg straight out on the bench. Hold for 15 to 30 seconds.

This exercise helps with overall strength, stamina, and balance. (Kothawale S. Rao K. 2018) (Wang H. et al., 2016)

What To Avoid

Avoid curving the spine to get closer to the thigh during the stretch. The key is not how far you can bend down but getting a deep stretch. Individuals not yet flexible enough to go all the way down should bend until comfortable but can still feel the stretch in their hamstrings. With practice and time, flexibility will improve. This stretch should be felt in the hamstrings.

Step Exercises

Step exercises, or step-ups, involve using a platform at least 6 inches high. To perform the exercise:

  1. Put one foot onto the platform and use that leg to lift the other foot off the floor.
  2. Hold the position with the foot hanging loosely for 3 to 5 seconds, then place the foot back on the floor.
  3. Repeat each motion 20 times on each leg. (American Academy of Orthopaedic Surgeons, 2009)

What To Avoid

Avoid locking the knees when stepping up on the platform. Locking the knees switches off the muscles that need strengthening (American Academy of Orthopaedic Surgeons, 2009). Step exercises work out various areas of the leg. Individuals should feel this exercise in the thigh, hip, and buttocks.

Post-Exercise Stretching

Post-exercise stretching is vital in physical rehabilitation and strengthening. Stretching after exercise, individuals can (Afonso J. Clemente. et al., 2021)

  • Relieve and reduce soreness.
  • Expedite recovery times.
  • Increase range of motion.
  • Strengthen the knees more quickly and effectively.

Post-exercise stretches for knee pain and weakness can include:

Quadricep Stretch

This stretch targets the quad muscles located in the thighs. To perform this stretch:

  1. Stand with the feet planted flat on the floor, spaced the same width as the shoulders.
  2. Bending the left knee, grab the foot with the left hand and pull the heel toward the buttocks.
  3. Hold for 5 to 10 seconds.
  4. Repeat on both sides.

What to Avoid

There is no need to pull the heel too far into the buttocks. The goal is to feel a deep stretch. Pushing it too far can lead to injury. (Lee J. H. et al., 2021)

Toe Touches

Toe touches will help stretch calve muscles and hamstrings. To perform this stretch:

  1. Sit on the floor with the legs straight out in front.
  2. Bend the body over the legs at the hips, reaching for the toes in front while maintaining a straight back.
  3. Relax the shoulders and keep them away from the ears.
  4. Once touching the toes, hold the stretch for 15 seconds.

What To Avoid

Individuals who cannot yet touch their toes should perform the same steps and reach only as far as is comfortably possible. Over time, flexibility will improve. (Lee J. H. et al., 2021)

Injury Medical Chiropractic Clinic

These are examples of exercises and stretches that a physical therapy and chiropractic team may prescribe. Each case is different and requires reviewing individual medical history and physical examination to determine the proper treatment program. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop a personalized treatment program through an integrated approach to treating injuries and chronic pain syndromes, improving flexibility, mobility, and agility to relieve pain and help individuals return to normal activities. If other treatments are needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments.

Knee Pain Rehabilitation

References

Zeng, C. Y., Zhang, Z. R., Tang, Z. M., & Hua, F. Z. (2021). Benefits and Mechanisms of Exercise Training for Knee Osteoarthritis. Frontiers in physiology, 12, 794062. https://doi.org/10.3389/fphys.2021.794062

American Academy of Orthopaedic Surgeons. OrthoInfo. (2009). Knee exercises. https://orthoinfo.aaos.org/en/staying-healthy/knee-exercises/

Kothawale S. and Rao K. (2018). Effectiveness of positional release technique versus active release technique on hamstrings tightness. Int J Physiother Res., 6(1), 2619-2622. https://doi.org/https://dx.doi.org/10.16965/ijpr.2017.265

Wang, H., Ji, Z., Jiang, G., Liu, W., & Jiao, X. (2016). Correlation among proprioception, muscle strength, and balance. Journal of physical therapy science, 28(12), 3468–3472. https://doi.org/10.1589/jpts.28.3468

Afonso, J., Clemente, F. M., Nakamura, F. Y., Morouço, P., Sarmento, H., Inman, R. A., & Ramirez-Campillo, R. (2021). The Effectiveness of Post-exercise Stretching in Short-Term and Delayed Recovery of Strength, Range of Motion and Delayed Onset Muscle Soreness: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Frontiers in physiology, 12, 677581. https://doi.org/10.3389/fphys.2021.677581

Lee, J. H., Jang, K. M., Kim, E., Rhim, H. C., & Kim, H. D. (2021). Effects of Static and Dynamic Stretching With Strengthening Exercises in Patients With Patellofemoral Pain Who Have Inflexible Hamstrings: A Randomized Controlled Trial. Sports health, 13(1), 49–56. https://doi.org/10.1177/1941738120932911

Understanding Hip Tendonitis: Causes, Symptoms, and Treatment

By
Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP
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Full length shot of a female physician working with a senior male patient.

Can understanding the causes and symptoms of potential hip tendonitis help healthcare providers diagnose and treat the condition for individuals experiencing pain in the front of the hip with restricted hip flexibility that worsens during movement?

Understanding Hip Tendonitis: Causes, Symptoms, and Treatment

Hip Tendonitis

Hip tendonitis is inflammation of the iliopsoas tendon. It is most commonly caused by overuse of the hip flexors without adequate rest for recovery. The condition can occur when the hip muscles overpower the tendons attached to the hip bone, causing inflammation and irritation. This can lead to pain, tenderness, and mild swelling near the hip joint. Hip tendonitis can be diagnosed with a physical examination, and treatment can include:

  • Rest
  • Ice
  • NSAIDs
  • Stretching
  • Physical therapy
  • Chronic cases may require a cortisone injection into the iliopsoas tendon to decrease inflammation.
  • Surgical release of the iliopsoas tendon may be recommended to decrease tightness and pain.

There is a high prognosis for a full recovery.

Tendonitis

Inflammation in a muscle’s tendon leads to pain and tenderness that worsens the more the muscle is used. An overuse injury means the tendon becomes repeatedly stressed through repetitive muscle contractions, causing muscle and tendon fibers to micro-tear. If not enough rest is allowed for the micro-tears to heal, a chronic cycle of pain and inflammation develops within the affected tendon. Other tendons that are prone to developing the condition include:

  • The tendon of the wrist extensors/tennis elbow.
  • The tendon of the wrist flexors/golfer’s elbow.
  • The Achilles’ tendon/Achilles tendonitis.
  • The patellar tendon/jumper’s knee.
  • The tendons of the thumb/De Quervain’s tenosynovitis.

Bursitis

  • Bursae are small fluid-filled sacs that help cushion and decrease friction around joints.
  • Because the iliopsoas tendon overlays bursae, inflammation of the tendon can also cause bursitis or inflammation of the bursae surrounding the tendon.
  • Tendonitis and bursitis can and often occur together due to overlapping symptoms.

Causes

The iliopsoas originates in the pelvis and vertebrae of the lower spine and attaches to the top of the femur or thigh bone. It allows the hip joint movement that brings the leg closer to the front of the body, like lifting the leg to step up or jump. It also helps keep the torso stable when standing with one or both feet on the ground and rising from a lying position. Hip tendonitis most often results from physical activities that require repeated leg lifting when stepping, running, kicking, or jumping. This can include:

  • Running
  • Dancing
  • Gymnastics
  • Martial arts
  • Cycling
  • Playing soccer

Iliopsoas tendonitis can also occur after hip arthroscopy, a minimally invasive surgical procedure to repair structures inside the hip joint because of altered joint movement and muscle activation patterns after surgery. (Adib F. et al., 2018)

Symptoms

The primary symptoms of hip tendonitis include a soreness or deep ache in the front of the hip that worsens after physical activity and limits the range of motion because of the pain. Other symptoms include:

  • Tenderness to touch in the front of the hip.
  • The pain can feel like a dull ache.
  • Stiffness may also be present.
  • Hip flexor tightness.
  • Altered posture, with the pelvis rotated forward and an exaggerated curve in the lower back.
  • Lower back pain.
  • Discomfort after prolonged sitting.
  • Altered walking pattern characterized by shortened steps.

Diagnosis

  • Hip tendonitis is diagnosed through a physical examination and medical history reviews of individual symptoms.
  • Individuals may also have an X-ray of their hip performed to examine the joint alignment and determine if a fracture or arthritis is present.

Treatment

  • Initial treatment involves rest from physical activities, applying ice, and gentle stretching.
  • Nonsteroidal anti-inflammatory drugs/NSAIDs can ease pain and swelling, decrease inflammation, and reduce muscle spasms.
  • If chronic pain persists, individuals may receive a cortisone injection into their iliopsoas tendon. (Zhu Z. et al., 2020)
  • A personalized physical therapy program focusing on hip flexor stretching and strengthening, as well as strengthening the glutes and core, will help expedite an optimal recovery.

Surgery

For cases that do not improve after three months of treatment, surgery to lengthen the iliopsoas tendon, a procedure known as a tenotomy, may be performed. It involves making a small cut into a portion of the tendon, allowing the tendon to increase in length while decreasing tension as it heals back together. A tenotomy temporarily reduces the strength of the iliopsoas; however, this weakness usually resolves within three to six months after surgery. (Anderson C. N. 2016)

Chiropractic Care

Chiropractic care can be an effective treatment because it can help restore proper alignment and motion in the hip, reduce inflammation, and improve muscle and joint function. Treatments may include:

  • Spinal adjustments to realign the spine and other joints, reducing pressure on nerves and inflammation.
  • Non-surgical decompression
  • Manual therapy – massage, trigger point therapy, or spinal manipulation.
  • Acupuncture
  • Graston technique
  • Rehabilitative exercises like stretching, strengthening, and range of motion exercises.

Tendonitis generally has an excellent prognosis for full recovery as long as thorough rest from activities is taken to allow the inflamed tendon to heal. The postsurgical prognosis is positive for chronic and severe cases of iliopsoas tendonitis that require surgery.

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop a customized treatment program through an integrated approach to treating injuries and chronic pain syndromes, improving flexibility, mobility, and agility to relieve pain and help individuals return to normal activities. If other treatments are needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments.

Inflammation and Integrative Medicine

References

Adib, F., Johnson, A. J., Hennrikus, W. L., Nasreddine, A., Kocher, M., & Yen, Y. M. (2018). Iliopsoas tendonitis after hip arthroscopy: prevalence, risk factors and treatment algorithm. Journal of hip preservation surgery, 5(4), 362–369. https://doi.org/10.1093/jhps/hny049

Zhu, Z., Zhang, J., Sheng, J., Zhang, C., & Xie, Z. (2020). Low Back Pain Caused by Iliopsoas Tendinopathy Treated with Ultrasound-Guided Local Injection of Anesthetic and Steroid: A Retrospective Study. Journal of pain research, 13, 3023–3029. https://doi.org/10.2147/JPR.S281880

Anderson C. N. (2016). Iliopsoas: Pathology, Diagnosis, and Treatment. Clinics in sports medicine, 35(3), 419–433. https://doi.org/10.1016/j.csm.2016.02.009

Understanding the Gluteus Maximus: Functions and Importance

By
Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP
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Man professional doctor osteopath fixing and stretching mans back with hands during exersicing at rehabilitation theapy in manual therapy clinic, top view. Chiropractor during work.

Individuals dealing with pain in the buttocks can make life difficult to sit, walk, or perform simple, everyday tasks. Can understanding the anatomy, location, and function of the gluteus maximus muscle help in muscle rehabilitation and avoid potential injuries?

Understanding the Gluteus Maximus: Functions and Importance

Gluteus Maximus

The gluteus maximus is the largest human body muscle responsible for hip extension, external rotation, adduction, and abduction, as well as the ability to stand upright.  The primary muscle extends laterally and keeps the body upright by supporting the bony pelvis and trunk. (Neto W. K. et al., 2020) When the gluteus maximus is strained, injured, or weak, it can lead to pain and inflammation.

Common symptoms can include:

  • Stiffness in the buttock
  • Discomfort while sitting
  • Difficulty standing up from sitting
  • Difficulty bending over
  • Pain when walking, especially upstairs or on a hill
  • Pain in the lower back and/or tailbone

Anatomy and Structure

The muscles that comprise the glutes are the gluteus maximus, gluteus medius, and gluteus minimus. The gluteus medius runs underneath the gluteus maximus, and the gluteus minimus is underneath the gluteus medius.

The gluteus maximus is one of the strongest muscles. Fibers from the muscle connect to different body parts, including the femur/thighbone and the iliotibial band, which comprises connective tissue that runs up the thigh.  The superior gluteal artery transports blood from the heart to the glutes.

Nerve Supply

The inferior gluteal nerve, part of the sacral plexus branch, innervates the maximus muscle. The sacral plexus nerves support motor and sensory function in the thighs, lower legs, feet, and pelvis. The sciatic nerve runs under the gluteus maximus, from the lower back down to the leg, and is often the cause of nerve pain in and around the area. (Carro L. P. et al., 2016) The main nerve of the perineum is the pudendal nerve, which runs under the gluteus maximus muscle.

Location

The gluteus maximus muscle defines the buttocks. It can be called a superficial muscle, sometimes referred to muscles that help provide shape. The origin of the gluteus maximus connects to the sacrum, the ilium, or the large upper part of the hip bone, the thoracolumbar fascia tissue, and the sacrotuberous ligaments attached to the posterior superior iliac spine. The gluteus maximus has a 45-degree angle from the pelvis to the buttocks and then inserts at the gluteal tuberosity of the femur and the iliotibial tract.

Variations

Sometimes, a duplicate muscle may originate from the gluteus maximus muscle in rare cases. However, it is more common that the gluteus maximus muscle fibers may be inserted into different body parts than where they are typically inserted. (Taylor, V. G., Geoffrey & Reeves, Rustin. 2015) This can cause a condition called greater trochanteric pain syndrome or GTPS. Inflammation of the gluteus medius, minimum tendons, and bursa inflammation can also cause GTPS. Individuals with GTPS will have tenderness or a pulsing feeling on the outer side of the hip and thigh when lying on the side, along with other symptoms.

Function

The gluteus maximus extends and externally rotates the hip joint, stabilizing the body. It is highly engaged during running and hiking activities. Regular walking does not typically target gluteus maximus strength training. However, the gluteus maximus promotes balance when walking and other activities by helping keep the pelvis and posture upright.

Conditions

The most common condition associated with the gluteus maximus is muscle strain, and deep gluteus maximus syndrome is another condition that can cause pain and involves the muscles.

Muscle Strain

A muscle strain can result from stretching and working the muscle too much that it becomes overstretched or tears. (Falótico G. G. et al., 2015) This can happen from not warming up or cooling down properly, repetitive use injury, and over-exercising. Alternatively, not exercising and not utilizing your gluteus maximus can weaken it, leading to lower back pain, hip pain, and stability and posture issues. (Jeong U. C. et al., 2015)

Deep Gluteus Maximus Syndrome

This syndrome causes pain in the buttocks when the sciatic nerve becomes entrapped. (Martin, H. D. et al., 2015) The location of the pain can help healthcare providers determine where the nerve is trapped. Those with deep gluteus maximus syndrome may experience various types of discomfort, including (Martin, H. D. et al., 2015)

  • Numbness and tingling in the leg
  • Pain when sitting
  • Pain when walking
  • Pain that radiates down the back and hips and into the thigh

To diagnose the condition, a healthcare provider may perform a physical examination and various tests to rule out other conditions that can cause similar symptoms.

Treatment and Rehabilitation

If there is pain in the buttocks and/or lower extremities, it’s important to consult a primary doctor, chiropractor, or physical therapist. They will evaluate the strength of the gluteus muscles to diagnose any strain or weakness. From there, they will develop a personalized treatment plan to help heal the injury, strengthen the muscles, and restore function. Treatment will include stretches once the strain is rested and improves.

  • Recommendations can include taking a few days off to rest the muscle or, at the very least, stop performing the work or activity that caused the strain.
  • Ice and over-the-counter medication like ibuprofen can help reduce inflammation.
  • For weak gluteus maximus, a physical therapist will strengthen and retrain the muscle with a tailored program of exercises. (Jeong U. C. et al., 2015)
  • Treatment for deep gluteus maximus syndrome may include conservative treatment, such as chiropractic decompression and realignment, physical therapy, medications for pain and inflammation, and injections.
  • If conservative treatments do not relieve the pain, a primary healthcare provider may recommend surgery. (Martin, H. D. et al., 2015)

Working with a chiropractic physical therapy team can help individuals return to normal function and expedite healing. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop a customized treatment program through an integrated approach to treating injuries and chronic pain syndromes, improving flexibility, mobility, and agility to relieve pain and help individuals return to normal activities. If other treatments are needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments.

The Science of Motion and Chiropractic Care

References

Neto, W. K., Soares, E. G., Vieira, T. L., Aguiar, R., Chola, T. A., Sampaio, V. L., & Gama, E. F. (2020). Gluteus Maximus Activation during Common Strength and Hypertrophy Exercises: A Systematic Review. Journal of sports science & medicine, 19(1), 195–203.

Carro, L. P., Hernando, M. F., Cerezal, L., Navarro, I. S., Fernandez, A. A., & Castillo, A. O. (2016). Deep gluteal space problems: piriformis syndrome, ischiofemoral impingement and sciatic nerve release. Muscles, ligaments and tendons journal, 6(3), 384–396. https://doi.org/10.11138/mltj/2016.6.3.384

Taylor, Victor & Guttmann, Geoffrey & Reeves, Rustin. (2015). A variant accessory muscle of the gluteus maximus. International Journal of Anatomical Variations. 8. 10-11.

Falótico, G. G., Torquato, D. F., Roim, T. C., Takata, E. T., de Castro Pochini, A., & Ejnisman, B. (2015). Gluteal pain in athletes: how should it be investigated and treated?. Revista brasileira de ortopedia, 50(4), 462–468. https://doi.org/10.1016/j.rboe.2015.07.002

Jeong, U. C., Sim, J. H., Kim, C. Y., Hwang-Bo, G., & Nam, C. W. (2015). The effects of gluteus muscle strengthening exercise and lumbar stabilization exercise on lumbar muscle strength and balance in chronic low back pain patients. Journal of physical therapy science, 27(12), 3813–3816. https://doi.org/10.1589/jpts.27.3813

Martin, H. D., Reddy, M., & Gómez-Hoyos, J. (2015). Deep gluteal syndrome. Journal of hip preservation surgery, 2(2), 99–107. https://doi.org/10.1093/jhps/hnv029

Discover How to Reduce Stiff Person Syndrome

By
Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP
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Can individuals with stiff person syndrome incorporate non-surgical treatments to reduce muscle stiffness and restore muscle mobility?

Introduction

The musculoskeletal system allows the body’s extremities to be mobile, provides stability to the host, and has an outstanding relationship with the other body systems. The musculoskeletal system’s muscles, tissues, and ligaments help protect the body’s vital organs from environmental factors. However, many individuals often deal with repetitive motions in the upper and lower body extremities that can cause pain and discomfort. Additionally, environmental factors, illnesses, and injuries can affect the musculoskeletal system and play a part in co-morbidities in overlapping risk profiles. These issues can cause the musculoskeletal system to develop a condition known as stiff person syndrome. Today’s articles focus on what stiff person syndrome is, the symptoms it is associated with, and how non-surgical treatments can help alleviate the symptoms of stiff person syndrome. We discuss with certified associated medical providers who consolidate our patients’ information to assess stiff person syndrome and its associated symptoms affecting the musculoskeletal system. We also inform and guide patients while asking their associated medical provider intricate questions to integrate non-surgical treatments to reduce the overlapping symptoms correlating with stiff person syndrome. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer.

 

What Is Stiff Person Syndrome

 

Have you been dealing with muscle stiffness in your lower extremities affecting your mobility? Have you noticed that your posture is rigid due to ongoing muscle spasms in your lower back? Or have you felt tightness in your back muscles? Many pain-like symptoms are associated with back pain, a common musculoskeletal condition; however, they can also correlate with a rare condition known as stiff person syndrome. Stiff person syndrome is a rare autoimmune disorder that is progressive and is characterized by rigidity and stimulus-triggered painful muscle spasms that affect the lower body and extremities. (Muranova & Shanina, 2024) There are three classifications that a person is experiencing with stiff person syndrome, and they are:

  • Classic Stiff Person Syndrome
  • Partial Stiff Person Syndrome
  • Stiff Person Syndrome Plus

Since stiff person syndrome is a rare condition, many individuals may not exhibit any objective findings early on, which then causes a delayed diagnosis that can impact a person’s quality of life (Newsome & Johnson, 2022). At the same time, since stiff person syndrome is a rare autoimmune disease, it can affect the musculoskeletal system with associated pain-like symptoms.

 

The Symptoms

Some symptoms associated with stiff person syndrome that can develop over time are muscle stiffness and painful muscle spasms. This is because the neuron receptors from the central nervous system can become haywire and cause non-specific somatic symptoms that make the individuals deal with comorbid chronic pain and myofascial tenderness in the muscles. (Chia et al., 2023) This is because stiff person syndrome can spread into different areas of the musculoskeletal system and can gradually develop over time. For muscle stiffness associated with stiff person syndrome, the muscles can become stiff over time, causing pain and discomfort, thus leading to many individuals developing abnormal posture, making it difficult to be mobile. Muscle spasms can affect the entire body itself or in a specific location and cause intense pain that lasts for hours. However, many individuals can incorporate non-surgical treatments to reduce the pain-like symptoms in the musculoskeletal system.

 

Movement Medicine: Chiropractic Care- Video

Movement Medicine: Chiropractic Care | El Paso, Tx (2024)

Non-Surgical Treatments For Stiff Person Syndrome

When it comes to reducing the musculoskeletal pain symptoms of stiff person syndrome, many individuals can begin to go to their primary doctor for early diagnosis and develop a customized treatment plan to manage the pain-like symptoms and provide a positive impact in creating awareness of this rare condition. (Elsalti et al., 2023) By assessing the pain-like symptoms of stiff person syndrome, many people can incorporate non-surgical treatments to manage the musculoskeletal pain symptoms and improve a person’s quality of life. Non-surgical treatments are cost-effective and can be combined with other therapies to restore mobility. One of the primary goals for managing stiff person syndrome is through pain management, symptom relief, and improved quality of life. (Cirnigliaro et al., 2021)

 

Chiropractic Care For Stiff Person Syndrome

One of the non-surgical treatments that can help reduce symptoms of muscle spasms and muscle stiffness is chiropractic care. Chiropractic care incorporates mechanical and manual manipulation to stretch and mobilize the joint-muscle function while reducing pain and discomfort. (Coulter et al., 2018) For individuals suffering from stiff person syndrome, chiropractic care can help reduce muscle stiffness and muscle spasms in the upper and lower extremities and relieve the pain. Additionally, incorporating non-surgical treatments like chiropractic care and combined therapies can help manage the musculoskeletal pain associated with stiff person syndrome and improve a person’s quality of life.

 

References

Chia, N. H., McKeon, A., Dalakas, M. C., Flanagan, E. P., Bower, J. H., Klassen, B. T., Dubey, D., Zalewski, N. L., Duffy, D., Pittock, S. J., & Zekeridou, A. (2023). Stiff person spectrum disorder diagnosis, misdiagnosis, and suggested diagnostic criteria. Ann Clin Transl Neurol, 10(7), 1083-1094. https://doi.org/10.1002/acn3.51791

Cirnigliaro, F. A., Gauthier, N., & Rush, M. (2021). Management of refractory pain in Stiff-Person syndrome. BMJ Case Rep, 14(1). https://doi.org/10.1136/bcr-2020-237814

Coulter, I. D., Crawford, C., Hurwitz, E. L., Vernon, H., Khorsan, R., Suttorp Booth, M., & Herman, P. M. (2018). Manipulation and mobilization for treating chronic low back pain: a systematic review and meta-analysis. Spine J, 18(5), 866-879. https://doi.org/10.1016/j.spinee.2018.01.013

Elsalti, A., Darkhabani, M., Alrifaai, M. A., & Mahroum, N. (2023). Celebrities and Medical Awareness-The Case of Celine Dion and Stiff-Person Syndrome. Int J Environ Res Public Health, 20(3). https://doi.org/10.3390/ijerph20031936

Muranova, A., & Shanina, E. (2024). Stiff Person Syndrome. In StatPearls. https://www.ncbi.nlm.nih.gov/pubmed/34424651

Newsome, S. D., & Johnson, T. (2022). Stiff person syndrome spectrum disorders; more than meets the eye. J Neuroimmunol, 369, 577915. https://doi.org/10.1016/j.jneuroim.2022.577915

Disclaimer

Fish Nutrition Facts: Caloric Content, Fat Composition, and More

By
Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP
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Happy doctor nutritionist sitting at workplace at desk in office among fresh vegetables, diet plan concept

For individuals trying to lose weight or improve their diet, can incorporating more fish help improve overall health?

Fish Nutrition Facts: Caloric Content, Fat Composition, and More

Fish Nutrition

The American Heart Association recommends eating at least two servings of fish each week (American Heart Association, 2021). The type of fish chosen makes a difference, as fish nutrition and calories vary. Some can have a higher calorie count but contain healthy fat.

Nutrition

Comparing fish calories and nutrition data can be tricky. How it is prepared can significantly change its nutritional makeup, and the exact nutrition also varies depending on the variety. As an example, a half portion of a Wild Alaskan Salmon Fillet contains: (U.S. Department of Agriculture. FoodData Central. 2019)

  • Serving Size 1/2 fillet – 154 grams
  • Calories – 280
  • Calories from Fat – 113
  • Total Fat – 12.5 grams
  • Saturated Fat – 1.9 grams
  • Polyunsaturated Fat – 5 grams
  • Monounsaturated Fat – 4.2 grams
  • Cholesterol – 109 milligrams
  • Sodium – 86 milligrams
  • Potassium – 967.12 milligrams
  • Carbohydrates – 0 grams
  • Dietary Fiber – 0 grams
  • Sugars – 0 grams
  • Protein – 39.2 grams

The following guide includes other types of fish based on USDA nutrition data (U.S. Department of Agriculture. FoodData Central). Fish calories and nutrition are listed for a 100-gram or 3.5-ounce serving.

Halibut

  • Raw with skin
  • 116 calories
  • 3 grams fat
  • 0 grams carbohydrate
  • 20 grams protein

Tuna

  • Yellowfin, fresh, raw
  • 109 calories
  • Less than one gram of fat
  • 0 grams carbohydrate
  • 24 grams protein

Cod

  • Atlantic, raw
  • 82 calories,
  • 0.7 grams fat
  • 0 grams carbohydrate
  • 18 grams protein

Mahimahi

  • Raw
  • 85 calories
  • 0.7 grams fat
  • 0 grams carbohydrate
  • 18.5 grams protein

Ocean Perch

  • Atlantic, raw
  • 79 calories
  • 1.4 grams fat
  • 0 grams carbohydrate
  • 15 grams protein

Research suggests that fatty fish is the best for weight loss and improved health. Certain types of fish contain an essential fatty acid called omega-3. This polyunsaturated fat provides the body with various health benefits, like reducing the risk of heart disease. Studies show that individuals who eat seafood at least once per week are less likely to die from heart disease. (National Institutes of Health. National Center for Complementary and Integrative Health, 2024) Researchers also believe that omega-3 fatty acids may help reduce symptoms of rheumatoid arthritis and could even improve brain and eye health. Essential omega-3 fatty acids can be taken as a supplement. However, research has not shown that supplements can provide the same benefits as eating omega-3 foods. (Rizos E. C. et al., 2012)

Benefits

The American Heart Association suggests eating a variety of low-calorie fish that include: (American Heart Association, 2021)

Salmon

  • 3 ounces
  • 175 calories
  • 10 grams fat
  • 1.7 grams of omega-3 fatty acids

Anchovies

  • 3 ounces
  • 111 calories
  • 4 grams fat
  • 1.7 grams of omega-3 fatty acids

Pacific and Jack Mackerel

  • 3 ounces
  • 134 calories
  • 7 grams fat
  • 1.6 grams of omega-3 fatty acids

Pacific Black Cod

  • 3 ounces
  • 70 calories
  • 1 gram fat
  • 1.5 grams of omega-3 fatty acids

Whitefish

  • 3 ounces
  • 115 calories
  • 5 grams fat
  • 1.5 grams of omega-3 fatty acids

Albacore Tuna

  • 3 ounces, canned, packed in water
  • 109 calories
  • 3 grams fat
  • 0.7 grams of omega-3 fatty acids

Atlantic Herring

  • 3 ounces
  • 134 calories
  • 8 grams of fat
  • 1.4 grams of omega-3 fatty acids

Tilapia

  • 4 ounces
  • 145 calories
  • 3 grams of fat
  • 0.1 grams of omega-3 fatty acids

The way that the fish is prepared can change the calorie count. Baked, grilled, and broiled fish are usually the lowest in calories.

Storage and Safety

Fish experts suggest that individuals buy the freshest available. What questions should you ask when visiting the local market?

When was it caught?

The fresher, the better. Fish may remain edible for five days after being caught but may not taste as fresh.

How was it stored?

How the fish is stored and delivered to the market will impact its taste. Fish should be chilled immediately after catching and kept cold throughout delivery and transport.

How does it look and smell?

If the fish has a bad odor, it is likely not fresh. Fresh fish should smell like seawater. If buying fillets, look for a moist texture with clean-cut edges. If the fish is whole, look for clear eyes and a firm texture.

Where is it from?

Buying local fish from sustainable fisheries is recommended but not always possible, depending on where individuals live. There is a Smart Seafood Buying Guide that advises on buying American fish and provides a list of fish with lower mercury levels for health and safety. (Natural Resources Defense Council, 2024)

What is the best way to prepare this fish?

Sometimes, the fishmonger is the best source for simple and healthy recipes and preparation methods. Use fresh fish within two days, or store in the freezer. When ready to use frozen fish, thaw in the refrigerator and never at room temperature. For individuals who don’t like fish taste, there are a few things to help improve the taste. First, try less fishy types. For example, many report that around 100 calories per serving of red snapper tastes less fishy than heavier fish like salmon. Second, try adding fresh herbs and citrus to manage the taste.

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop a personalized treatment plan through an integrated approach to treating injuries and chronic pain syndromes, improving flexibility, mobility, and agility programs to relieve pain and help individuals return to optimal function. Our providers use an integrated approach to create personalized care plans for each patient and restore health and function to the body through nutrition and wellness, functional medicine, acupuncture, Electroacupuncture, and sports medicine protocols. If the individual needs other treatment, they will be referred to a clinic or physician best suited for them. Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, nutritionists, and health coaches to provide the most effective clinical treatments.

Nutrition Fundamentals

References

American Heart Association. (2021). Fish and Omega-3 Fatty Acids. https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/fats/fish-and-omega-3-fatty-acids

U.S. Department of Agriculture. FoodData Central. (2019). Fish, salmon, king (chinook), raw (Alaska Native). Retrieved from https://fdc.nal.usda.gov/fdc-app.html#/food-details/168047/nutrients

National Institutes of Health. National Center for Complementary and Integrative Health. (2024). 7 things to know about omega-3 fatty acids. Retrieved from https://www.nccih.nih.gov/health/tips/things-to-know-about-omega-fatty-acids

Rizos, E. C., Ntzani, E. E., Bika, E., Kostapanos, M. S., & Elisaf, M. S. (2012). Association between omega-3 fatty acid supplementation and risk of major cardiovascular disease events: a systematic review and meta-analysis. JAMA, 308(10), 1024–1033. https://doi.org/10.1001/2012.jama.11374

Natural Resources Defense Council. (2024). The smart seafood buying guide: five ways to ensure the fish you eat is healthy for you and for the environment. https://www.nrdc.org/stories/smart-seafood-buying-guide

Managing Meralgia Paresthetica: Treatment Options and Tips

By
Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP
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Individuals experiencing pain, numbness, tingling, or a burning sensation in the front and outer thigh could have meralgia paresthetica, a nerve entrapment. Can understanding the condition help healthcare providers develop an effective treatment plan?

Managing Meralgia Paresthetica: Treatment Options and Tips

Meralgia Paresthetica

Meralgia paresthetica, or MP, is also known as Bernhardt-Roth syndrome, lateral femoral cutaneous nerve syndrome, or lateral femoral cutaneous neuralgia. It occurs when the lateral femoral cutaneous nerve, a sensory nerve that passes over the brim of the pelvis and down the front of the thigh, becomes compressed. The nerve supplies information about sensations over the front and outside of the thigh. This can happen for several reasons, including:

  • Recent hip injuries, such as from a motor vehicle collision/accident.
  • Repetitive hip activities, like cycling.
  • Pregnancy
  • Weight gain
  • Wearing tight clothing.

The nerve entrapment condition causes tingling, numbness, and burning pain in the front and/or outer thigh.

Causes

There can be several different causes of this condition, but it is frequently seen in pregnancy, sudden weight gain, wearing tight clothing or belts, and other conditions. (Ivins G. K. 2000) Sometimes, meralgia paresthetica can be caused by medical procedures. For example, the condition can present after an individual has surgery and is in an unusual position for a long period of time, where there is direct external pressure on the nerve. Also, the nerve can become damaged during a surgical procedure. (Cheatham S. W. et al., 2013) This can occur when a bone graft is obtained from the pelvis or anterior hip replacement surgery.

Symptoms

Individuals may experience some or all of the following symptoms (Chung K. H. et al., 2010)

  • Numbness over the outside of the thigh.
  • Pain or burning on the outside of the thigh.
  • Sensitivity to lightly touching the outside of the thigh.
  • Worsening of symptoms with certain positions.
  • Increased symptoms when wearing belts, work belts, or tight-waist clothes.

The symptoms may come and go or be persistent. Some individuals are hardly noticeable and do not impact their lives or activities, while others can be very bothersome and cause significant pain. (Scholz C. et al., 2023)

Treatment

Treatment depends on how long the injury has been present and the frequency and severity of the condition.

Clothing Modifications

If the cause is due to tight clothing, belts, or work belts, then garment modification should alleviate symptoms.

Pregnancy

Pregnant women usually find complete relief of their symptoms after delivery. (Hosley, C. M., and McCullough, L. D. 2011)

Weight Loss Program

If recent weight gain is thought to contribute to the condition, then a weight loss program may be recommended.

Cortisone Injections

If simple steps do not relieve symptoms, a cortisone injection around the nerve area may be recommended. The goal is to reduce inflammation that contributes to nerve pressure (Houle S. 2012). Cortisone injections may be a definitive treatment or a temporary treatment.

Chiropractic

Chiropractic care can be an effective, natural, and safe treatment. Adjustments can help relieve pressure on the lateral femoral cutaneous nerve (LFCN) by realigning the spine and restoring nerve function. Chiropractors may also use soft tissue therapies, such as massage, to relieve muscle tension and support the body’s healing process. Other chiropractic techniques that may be used include:

  • Pelvic mobilizations
  • Myofascial therapy
  • Transverse friction massage
  • Stretching exercises
  • Stabilization exercises for the core and pelvis
  • Therapeutic kinesiology tape

A chiropractic treatment program may include 10–15 treatments over 6–8 weeks, but the number of treatments needed will vary from person to person. If there’s no noticeable progress after 3–4 weeks, it may be time to consult a specialist or surgeon.

Surgery

Surgery is rarely necessary. However, a surgical procedure may be considered when all conservative treatments fail to provide relief. (Schwaiger K. et al., 2018) A surgeon dissects and identifies the nerve, looks for compression locations, and tries to free the nerve from any areas where it may be pinched. Alternatively, some surgeons transect/cut the nerve so it no longer causes problems. If the transection procedure is performed, there will be a permanent area of numbness over the front of the thigh.

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop a customized treatment plan to relieve pain, treat injuries, improve flexibility, mobility, and agility, and help individuals return to optimal function. If other treatments are needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments.

Chiropractic Care for Leg Instability

References

Ivins G. K. (2000). Meralgia paresthetica, the elusive diagnosis: clinical experience with 14 adult patients. Annals of surgery, 232(2), 281–286. https://doi.org/10.1097/00000658-200008000-00019

Cheatham, S. W., Kolber, M. J., & Salamh, P. A. (2013). Meralgia paresthetica: a review of the literature. International journal of sports physical therapy, 8(6), 883–893.

Chung, K. H., Lee, J. Y., Ko, T. K., Park, C. H., Chun, D. H., Yang, H. J., Gill, H. J., & Kim, M. K. (2010). Meralgia paresthetica affecting parturient women who underwent cesarean section -A case report-. Korean journal of anesthesiology, 59 Suppl(Suppl), S86–S89. https://doi.org/10.4097/kjae.2010.59.S.S86

Scholz, C., Hohenhaus, M., Pedro, M. T., Uerschels, A. K., & Dengler, N. F. (2023). Meralgia Paresthetica: Relevance, Diagnosis, and Treatment. Deutsches Arzteblatt international, 120(39), 655–661. https://doi.org/10.3238/arztebl.m2023.0170

Hosley, C. M., & McCullough, L. D. (2011). Acute neurological issues in pregnancy and the peripartum. The Neurohospitalist, 1(2), 104–116. https://doi.org/10.1177/1941875211399126

Houle S. (2012). Chiropractic management of chronic idiopathic meralgia paresthetica: a case study. Journal of chiropractic medicine, 11(1), 36–41. https://doi.org/10.1016/j.jcm.2011.06.008

Schwaiger, K., Panzenbeck, P., Purschke, M., Russe, E., Kaplan, R., Heinrich, K., Mandal, P., & Wechselberger, G. (2018). Surgical decompression of the lateral femoral cutaneous nerve (LFCN) for Meralgia paresthetica treatment: Experimental or state of the art? A single-center outcome analysis. Medicine, 97(33), e11914. https://doi.org/10.1097/MD.0000000000011914

Unlocking the Potential of Magnesium Spray for Pain Relief

By
Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP
-
Close-up photo of curly-haired woman at home near the window with severe neck pain, mulatto business woman massaging her neck with closed eyes

When muscle pains and aches present from health conditions, work, exercise, housework, etc., many individuals turn to topical sprays, creams, ointments, and gels to bring relief. Can magnesium spray be beneficial in the fight against neuromusculoskeletal pain?

Unlocking the Potential of Magnesium Spray for Pain Relief

Magnesium Spray

Magnesium spray is a liquid form of magnesium applied externally to the skin that has been marketed to promote muscle relaxation, improve sleep, and manage migraines. However, studies of its effectiveness have had mixed results. Some studies have shown that topical use can:

  • Improve chronic muscle and joint pain. Example: fibromyalgia.
  • Decrease the frequency and severity of nerve pain symptoms. Example: peripheral neuropathy.
  • Reduce the incidence and severity of an intubation-related sore throat after surgery.
  • Further studies of various groups are necessary to clarify the optimal dose for each condition and to determine how topical magnesium affects magnesium blood levels.

What is It?

Magnesium is a mineral that has an important role in many of the body’s processes and is essential for the following (Gröber U. et al., 2017)

  • Nerve transmission
  • Muscle contraction
  • Blood pressure regulation
  • Blood sugar regulation
  • Protein production
  • DNA and RNA production

Currently, there is no recommended dosage for topical magnesium use. However, some major health institutions have established a recommended daily amount taken by mouth. Listed are the recommended daily magnesium intake based on age and other factors. (National Institutes of Health Office of Dietary Supplements, 2022)

  • 14 to 18 years old: 410 mg for males, 360 mg for females and when lactating, and 400 mg when pregnant.
  • 19 to 30 years old: 400 mg for males, 310 mg for females and when lactating, and 350 mg when pregnant.
  • 31 to 50 years old: 420 mg for males, 320 mg for females and when lactating, and 360 mg when pregnant.
  • 51 years old and above: 420 mg for males and 320 mg for females.

Although self-care is appropriate for minor injuries or exercise, individuals are encouraged to see their healthcare provider for severe musculoskeletal pain symptoms.

Benefits

Though taking oral magnesium supplements is common, there is limited research on using magnesium on the skin to improve magnesium levels. Studies comparing the absorption of magnesium taken by mouth with the spray applied to the skin require further research. However, some studies look at the localized effect of magnesium spray on improving a sore throat after surgery and nerve, muscle, and joint pain.

Intubation-Related Sore Throat

Topical magnesium reduced the severity of sore throat after surgery in individuals undergoing tracheal intubation compared to a placebo. (Kuriyama, A. et al., 2019) However, further studies are necessary to clarify the optimal dose.

Nerve Pain

Peripheral neuropathy is nerve damage that causes a tingling and numbing sensation in the arms or legs. In a study of individuals with chronic kidney disease, the daily application of magnesium sprays to limbs affected by peripheral neuropathy for twelve weeks decreased the frequency and severity of nerve pain symptoms. However, one limitation was that it was performed mostly in females. (Athavale, A. et al., 2023)

Chronic Muscle and Joint Pain

A small study assessed whether applying magnesium to the skin could improve the quality of life of female participants with fibromyalgia – a chronic condition that causes muscle and joint pain, fatigue, and other symptoms. The study found that four sprays of magnesium chloride applied twice daily to the upper and lower limbs for four weeks could benefit those with fibromyalgia. However, further research with larger studies is needed to confirm the results. (Engen D. J. et al., 2015)

Does The Spray Increase Overall Magnesium Levels?

Magnesium is transported into cells through magnesium transporters. The outer layer of the skin does not contain these transporters, so absorption occurs in the small areas of the sweat glands and hair follicles. (Gröber U. et al., 2017) One study suggested that applying magnesium to the skin can help with magnesium deficiency within four to six weeks, compared to four to 12 months in the case of oral magnesium supplementation. However, there is minimal research on topical magnesium and its impact on magnesium levels. Another study suggested that 56 mg of magnesium cream applied daily on the skin for 14 days had no statistically significant effect on magnesium blood levels. Although the results were statistically insignificant, a clinically relevant increase in magnesium blood levels was observed. (Kass, L. et al., 2017) Because it remains unclear if magnesium absorption via the skin is more effective than by mouth, further studies are necessary to confirm the amount of magnesium absorbed into the skin.

Using The Spray

In one study, a magnesium chloride solution was poured into a spray bottle and applied as follows (Engen D. J. et al., 2015)

  • The solution was sprayed into the palm and applied evenly on the affected area.
  • There is a four-hour wait time between spray dose applications.
  • Individuals should wait at least one hour after application before showering or washing the product off.
  • Leave the product on the skin throughout the day and wash it off before bed.
  • Rinse the solution off with water if the skin becomes irritated.
  • Avoid applying to open wounds.

Precautions

Avoid magnesium chloride sprays if you are allergic to them or their components. If you have a severe allergic reaction, such as itching, hives, or shortness of breath, seek immediate medical attention. Topically applied magnesium solution has no known side effects other than skin irritation. (Engen D. J. et al., 2015)

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop a personalized treatment plan through an integrated approach to treating injuries and chronic pain syndromes, improving flexibility, mobility, and agility programs to relieve pain and help individuals return to optimal function. If other treatments are needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments.

Why Choose Chiropractic?

References

Gröber, U., Werner, T., Vormann, J., & Kisters, K. (2017). Myth or Reality-Transdermal Magnesium?. Nutrients, 9(8), 813. https://doi.org/10.3390/nu9080813

National Institutes of Health Office of Dietary Supplements. (2022). Magnesium. Retrieved from https://ods.od.nih.gov/factsheets/Magnesium-HealthProfessional/#h2

Kuriyama, A., Maeda, H., & Sun, R. (2019). Topical application of magnesium to prevent intubation-related sore throat in adult surgical patients: a systematic review and meta-analysis. Application topique de magnésium pour prévenir les maux de gorge liés à l’intubation chez les patients chirurgicaux adultes: revue systématique et méta-analyse. Canadian journal of anaesthesia = Journal canadien d’anesthesie, 66(9), 1082–1094. https://doi.org/10.1007/s12630-019-01396-7

Athavale, A., Miles, N., Pais, R., Snelling, P., & Chadban, S. J. (2023). Transdermal Magnesium for the Treatment of Peripheral Neuropathy in Chronic Kidney Disease: A Single-Arm, Open-Label Pilot Study. Journal of palliative medicine, 26(12), 1654–1661. https://doi.org/10.1089/jpm.2023.0229

Engen, D. J., McAllister, S. J., Whipple, M. O., Cha, S. S., Dion, L. J., Vincent, A., Bauer, B. A., & Wahner-Roedler, D. L. (2015). Effects of transdermal magnesium chloride on quality of life for patients with fibromyalgia: a feasibility study. Journal of integrative medicine, 13(5), 306–313. https://doi.org/10.1016/S2095-4964(15)60195-9

Kass, L., Rosanoff, A., Tanner, A., Sullivan, K., McAuley, W., & Plesset, M. (2017). Effect of transdermal magnesium cream on serum and urinary magnesium levels in humans: A pilot study. PloS one, 12(4), e0174817. https://doi.org/10.1371/journal.pone.0174817

Understanding Swayback Posture and Its Effects on the Body

By
Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP
-
Female osteopath performing a examination to a standing patient in the clinic

Can chiropractic treatment alleviate pain and correct swayback posture, a postural deformity that can cause lower back pain and mobility issues, for individuals experiencing it?

Understanding Swayback Posture and Its Effects on the Body

Swayback Posture

Swayback posture is a common dysfunction involving the pelvis and hip joints tilted forward in front. This causes the pelvis to shift forward, which exaggerates the curves in the lower and upper back, known as lordosis and kyphosis. The pelvis may tilt backward relative to the upper half, causing the buttocks to tuck under. The pelvis coordinates the movements of the head, shoulders, and trunk with those of the feet, legs, and thighs. A neutral pelvis, the ideal position, generally supports a mild curve/normal lordosis in the lower back. The small arch helps the body balance the skeletal parts as they work together to support and move the body’s weight. When a postural deformity occurs, one or more bones may shift from their ideal position to compensate for any pain or loss of balance caused by the original deviation. This deviation can lead to muscle strain, ligament sprain, and/or pain. (Czaprowski, D. et al., 2018)

Postural Deviations

Swayback posture causes the thoracic spine to move backward and round over into kyphosis. At the same time, the pelvis is tilted forward, resulting in an exaggeration of the normal lumbar lordosis. (Czaprowski, D. et al., 2018)

  • Healthcare providers, chiropractors, and physical therapists use exact measurements to define and treat postural deformities.
  • A neutral pelvis is a position of balance the entire body uses to help it stay upright, move, and be pain-free.
  • The ideal or neutral pelvic tilt is a 30-degree angle between the vertical and the plane that passes through the top of the sacrum and the axis of the hip joint socket in the front.
  • Swayback posture causes the pelvis to tilt forward another 10 degrees.
  • As a result, the spine compensates, exaggerating the curves in the lower back/lordotic curve and in the mid and upper back/kyphotic curve.
  • When viewed from the side, individuals can see a backward movement of the thoracic spine.
  • In front, the chest tends to sink in.

Muscle Group Imbalances

Healthcare providers look at different contributors or causes of postural deviations. Swayback can sometimes be associated with strength imbalances between muscle groups that move the hips, spine, and pelvis and hold the body upright. This includes:

  • Weakened hip flexors and overly strong or tense hip extensors/the hamstrings.
  • Tight upper abdominals, weak lower abdominals, and weak mid-back muscles may also contribute.
  • A corrective exercise program after seeing a physical therapist will help address some or all underlying muscle imbalances.

Risk Factors

Because weight in the abdominal region pulls the pelvis forward, pregnant women and obese individuals can have an increased risk of developing a swayback posture. (Vismara, L. et al., 2010)

Symptoms

The symptoms of swayback posture often include:

  • Severe lower back pain
  • Difficulty sitting or standing for long periods
  • Difficulty performing certain physical activities.
  • Tightness in the hamstrings and hip flexors
  • Tightness in the upper back muscles
  • Headaches or migraines

Chiropractic Treatment

Chiropractic adjustments are a common treatment used to correct swayback posture and can be corrected through various treatments. These include:

  • Spinal adjustments: The doctor applies pressure to specific spine areas to realign them and help restore proper spinal function.
  • Non-surgical decompression
  • Massage therapies
  • Muscle Energy Technique, or MET, improves muscle strength, flexibility, and function.
  • Acupuncture
  • Exercises to strengthen and stabilize the core muscles
  • Lifestyle adjustments to help reduce stress on the spine
  • Posture exercises
  • Biomechanics training

Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop a personalized care plan for each patient through an integrated approach to treating injuries and chronic pain syndromes, improving flexibility, mobility, and agility programs to relieve pain and help individuals return to optimal function. If other treatments are needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments.

How I Gained My Mobility Back With Chiropractic Care

References

Czaprowski, D., Stoliński, Ł., Tyrakowski, M., Kozinoga, M., & Kotwicki, T. (2018). Non-structural misalignments of body posture in the sagittal plane. Scoliosis and spinal disorders, 13, 6. https://doi.org/10.1186/s13013-018-0151-5

Vismara, L., Menegoni, F., Zaina, F., Galli, M., Negrini, S., & Capodaglio, P. (2010). Effect of obesity and low back pain on spinal mobility: a cross sectional study in women. Journal of neuroengineering and rehabilitation, 7, 3. https://doi.org/10.1186/1743-0003-7-3

The Musculoskeletal System: A Look at the Impact of Heat-Related Illnesses

By
Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP
-

Do individuals with muscle pain know the difference between heat stroke and heat exhaustion and can find ways to stay cool?

Introduction

As the temperature rises worldwide, many individuals are enjoying their time outside and getting more sun in their lives. However, rising temperatures also mean the rise of heat-related illnesses. The two most common heat-related illnesses are heat stroke and heat exhaustion, which can impact an individual’s musculoskeletal system and have different symptoms in terms of severity. Today’s article focuses on the differences between these two heat-related illnesses, how they affect the musculoskeletal system and treatments to stay cool while reducing muscle pain. We discuss with certified associated medical providers who consolidate our patients’ information to assess heat-related illnesses associated with muscle pain. We also inform and guide patients while asking their associated medical provider intricate questions to integrate treatments and ways to stay cool when temperatures rise and reduce muscle pain. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer.

 

Heat Exhaustion VS Heat Stroke

By understanding the differences between heat stroke and heat exhaustion is crucial. Do you often feel overheated after simple activities? Have you experienced muscle pain or cramps? Or do you struggle to cool down? These are all signs of heat-related illnesses. Heat-related illnesses often occur when the body cannot dissipate heat, leading to dysfunctional thermoregulation. (Gauer & Meyers, 2019) The two most common types are heat exhaustion and heat stroke. While they share similar causes, they differ significantly in terms of severity, symptoms, and treatment. (Prevention, 2022)

 

 

Heat exhaustion is a mild condition that often occurs when the human body loses excessive water and salt from profusely sweating. This causes the external temperatures to be more moderate when associated with intense physical activity. (Leiva & Church, 2024) Additionally, when a person is dealing with heat exhaustion, some of the symptoms that they will experience include:

  • Heavy sweating
  • Fatigue
  • Headaches
  • Muscle cramps
  • Pale, cool, moist skin
  • Fast, weak pulse

Even though heat exhaustion is a mild heat-related condition, it can develop into severe heat-related conditions like heat stroke if not treated immediately. Heat stroke is a severe heat-related illness that is not only life-threatening but has two forms that can affect a person’s body temperature: classic and exertional. Classic heat stroke often affects elderly individuals who have chronic medical conditions, while exertional heat stroke affects healthy individuals who are doing strenuous physical activities. (Morris & Patel, 2024) Some of the symptoms associated with heat stroke include:

  • High body temperature (104°F or higher)
  • Hot, red, dry skin
  • Rapid, strong pulse
  • Confusion
  • Seizures
  • Loss of consciousness

 

How Do Both Conditions Affect The Muscles?

Both heat-related illnesses can have a significant effect on the musculoskeletal system and cause muscle pain to not only the extremities but also the entire body system. The issue affects the musculoskeletal system and can lead to painful muscle cramps, involuntary muscle contractions, and muscle pain. Since muscle pain is a multi-factorial condition, heat-related illnesses like heat stroke and exhaustion can influence a person’s lifestyle and comorbid health factors. (Caneiro et al., 2021) When that happens, many individuals can seek treatments to stay cool from heat exhaustion and heat stroke and reduce muscle pain.

 

Secrets Of Optimal Wellness-Video

Secrets of Optimal Wellness | El Paso, Tx (2023)

Treatments For Staying Cool & Reduce Muscle Pain

While it is important to understand the difference between heat stroke and heat exhaustion due to the crucial timing and effective interventions, finding various treatments to reduce muscle pain and find ways to stay cool is important. Many individuals can wear technology to monitor the person’s physiological status actively and prevent injuries while providing early detection for heat-related illnesses. (Dolson et al., 2022) This can reduce the chances of muscle pain and help regulate body temperature. For individuals dealing with heat exhaustion, they can:

  • Move to a cooler environment
  • Be well-hydrated with water and electrolyte-rich drinks
  • Rest
  • Wear cool clothes to lower body temperature

For individuals dealing with heat stroke, they can:

  • Call emergency services immediately
  • Apply cool clothes or ice packs to the body
  • Monitor vital signs

Both treatments can ensure positive results in preventing life-threatening situations that can affect the musculoskeletal system.

 

Conclusion

Given the significant impact both heat stroke and heat exhaustion can have on the musculoskeletal system, it’s essential to take proactive measures. Proper hydration, cooling, and rest can help manage and alleviate muscle pain associated with these heat-related illnesses. By staying informed, maintaining hydration, and taking proactive steps to protect yourself from excessive heat, you can significantly reduce the chances of these heat-related illnesses affecting your outdoor activities.

 

References

Caneiro, J. P., Bunzli, S., & O’Sullivan, P. (2021). Beliefs about the body and pain: the critical role in musculoskeletal pain management. Braz J Phys Ther, 25(1), 17-29. https://doi.org/10.1016/j.bjpt.2020.06.003

Dolson, C. M., Harlow, E. R., Phelan, D. M., Gabbett, T. J., Gaal, B., McMellen, C., Geletka, B. J., Calcei, J. G., Voos, J. E., & Seshadri, D. R. (2022). Wearable Sensor Technology to Predict Core Body Temperature: A Systematic Review. Sensors (Basel), 22(19). https://doi.org/10.3390/s22197639

Gauer, R., & Meyers, B. K. (2019). Heat-Related Illnesses. American Family Physician, 99(8), 482-489. https://www.ncbi.nlm.nih.gov/pubmed/30990296

https://www.aafp.org/pubs/afp/issues/2019/0415/p482.pdf

Leiva, D. F., & Church, B. (2024). Heat Illness. In StatPearls. https://www.ncbi.nlm.nih.gov/pubmed/31971756

Morris, A., & Patel, G. (2024). Heat Stroke. In StatPearls. https://www.ncbi.nlm.nih.gov/pubmed/30725820

Prevention, C. f. D. C. a. (2022). Heat stress — heat related illness. The National Institute for Occupational Safety and Health (NIOSH) Retrieved from https://www.cdc.gov/niosh/topics/heatstress/heatrelillness.html#cramps

Disclaimer

Discover the Best Fruits Low in Sugar

By
Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP
-
many fruits splashes into water

Can fruit help with a sweet craving for individuals trying to limit sugar?

Discover the Best Fruits Low in Sugar

Fruits Low In Sugar

Fruits and their natural sugars: Whether following a low-carbohydrate diet or having diabetes and watching your A1C, many have heard that fruit is either bad or okay because of its natural sugars. Sugars in fruit are natural. How they affect blood sugar depends on various factors, like which foods they’re paired with and if diabetes is a factor. Counting carbs or noting the glycemic index or glycemic load of foods being eaten, understanding low-sugar fruits can help make choices that best fit your dietary needs. Certain fruits are considered lower in sugar because they contain fewer carbohydrates and sugar, allowing you to consume a larger portion.

  • One serving of fruit has about 15 grams of carbohydrates.
  • A serving is one small apple, half a medium-sized banana, or a cup of berries.
  • Fruits like berries can be eaten in more significant portions for the same amount of carbohydrates but less sugar.

Fruits

Low-sugar fruits include:

  • Lemons and Limes
  • Rhubarb
  • Apricots
  • Cranberries
  • Guava
  • Raspberries
  • Blackberries
  • Kiwi
  • Figs
  • Tangerines
  • Grapefruit

Natural Sugar

How much fruit an individual eats may differ if they follow a specific low-carb meal plan or are counting or modifying their carbohydrate intake because of diabetes. Adults should consume two cups of fruit or juice or a half-cup of dried fruit daily. (U.S. Department of Health and Human Services and U.S. Department of Agriculture, 2015) Most fruits have a low glycemic index/GI because of the amount of fiber they contain and because the sugar is mostly fructose. However, dried fruits like raisins, dates, sweetened cranberries, melons, and pineapples have a medium glycemic index. Sweetened dried fruits have an even higher glycemic index.

Fruits from Lowest to Highest Content

Fruits are a healthy way to satisfy a sweet craving. The fruits listed are ranked from lowest to highest sugar content, providing a quick way to assess sugar content. The fruits lowest in sugar have some of the highest nutritional values, plus antioxidants and other phytonutrients.

Limes and Lemons

Limes contain:

  • 1.1 grams of sugar
  • 7 grams of carbs
  • 1.9 grams of fiber per fruit

Lemons contain:

  • 1.5 grams of sugar
  • 5.4 grams of carbs
  • 1.6 grams of fiber per fruit

Rhubarb

Rhubarb contains:

  • 1.3 grams of sugar
  • 5.5 grams of carbs
  • 2.2 grams of fiber per cup

Apricots

Apricots contain:

  • 3.2 grams of sugar
  • 3.8 grams of carbs
  • 0.7 grams of fiber per small apricot

Apricots are available fresh in spring and early summer. They can be eaten whole, skin and all. However, watch portions of dried apricots as they shrink when dried.

Cranberries

Cranberries contain:

  • 3.8 grams of sugar
  • 12 grams of carbs
  • 3.6 grams of fiber per cup when fresh.

While they’re low in sugar, be aware that they are usually sweetened when dried or used in a recipe.

Guavas

Guava contains:

  • 4.9 grams of sugar
  • 7.9 grams of carbs
  • 3 grams of fiber per fruit

They can be sliced or dipped in salty sauce, including the rind.

Berries

These fruits generally have the lowest sugar content and are among the highest in fiber, antioxidants, and other nutrients. Berries, lemon, and lime can be added to flavor water.

Raspberries

Raspberries contain:

  • 5.4 grams of sugar
  • 14.7 grams of carbs
  • 8 grams of fiber per cup

Eat a handful, or use them as a topping or ingredient. Fresh in summer or frozen year-round.

Blackberries

Blackberries contain:

  • 7 grams of sugar
  • 13.8 grams of carbs
  • 7.6 grams of fiber per cup

Strawberries contain:

  • 7.4 grams of sugar
  • 11.7 grams of carbs
  • 3 grams of fiber per cup

Berries are excellent choices for a snack, a fruit salad, or an ingredient in a smoothie, sauce, or dessert.

Blueberries

Blueberries contain:

  • 15 grams of sugar
  • 21 grams of carbs
  • 3.6 grams of fiber per cup

While blueberries are higher in sugar than other berries, they’re packed with powerful antioxidants.

Kiwis

Kiwis contain:

  • 6.2 grams of sugar
  • 10.1 grams of carbs
  • 2.1 grams of fiber per kiwi

Kiwis have a mild flavor, and the seeds and skin can be eaten.

Figs

Figs contain:

  • 6.5 grams of sugar
  • 7.7 grams of carbs
  • 1.2 grams of fiber per small fig

These figures are for fresh figs, and it may be harder to estimate for dried figs of different varieties, which can have 5 to 12 grams of sugar per fig.

Tangerines

Tangerines contain:

  • 8 grams of sugar
  • 10.1 grams of carbs
  • 1.3 grams of fiber per medium fruit

These low-sugar citrus fruits have less sugar than oranges and are great for salads. They are also portable, making them healthy additions to packed lunches and snacks.

Grapefruit

Grapefruit contains:

  • 8.5 grams of sugar
  • 13 grams of carbs
  • 2 grams of fiber per half fresh grapefruit

Individuals can enjoy fresh grapefruit in a fruit salad or by itself, adjusting the amount of sugar or sweetener.

Low-Carb Diets

Individuals following a low-carb eating plan should remember that while some popular diet plans factor in the glycemic index or glycemic load of foods, others only factor in the number of carbohydrates.

20 Grams of Carbohydrates or Less

  • Individuals will likely not consume fruit or rarely substitute it for other food items with less than 20 grams of carbohydrates daily.
  • Nutrients are obtained from vegetables.
  • Some diets don’t even allow low-sugar fruits in the first phase.

20-50 Grams of Carbohydrates

  • These eating plans allow 20 to 50 grams of carbs daily, allowing room for one daily fruit serving.

50-100 Grams of Carbohydrates

  • If the eating plan allows 50 to 100 grams of carbs per day, individuals may be able to follow the FDA guidelines for two fruit servings a day, as long as other resources of carbohydrates are limited.
  • Other popular plans, like the Paleo diet and Whole30, don’t place a limit on fruit.
  • Although not necessarily a low-carb diet, Weight Watchers also allows fruit.

In general, individuals following a low-carb diet are recommended to try to eat fruits low in sugar.

Diabetes

Fruit choices when managing diabetes will depend on the type of diet being followed. For example, when counting carbohydrates, individuals should know that 1/2 cup of frozen or canned fruit has about 15 grams of carbohydrates.

  • Enjoy 3/4 to 1 cup of fresh berries, melon, or 17 grapes for the same carbs.
  • If using the plate method, add a small piece of whole fruit or 1/2 cup of fruit salad to the plate.
  • When using the glycemic index to guide food choices, remember that most fruits have a low GI and are encouraged.
  • Melons, pineapples, and dried fruits have medium GI index values, so watch portion size.

Individuals with diabetes may want to consult their primary doctor or a registered dietitian to help design an eating plan that incorporates fruit appropriately.

Body In Balance: Chiropractic, Fitness, and Nutrition

References

U.S. Department of Health and Human Services and U.S. Department of Agriculture. 2015–2020 Dietary Guidelines for Americans. 8th Edition. December 2015. Available at http://health.gov/dietaryguidelines/2015/guidelines/

The Impact of Cycling on Osteoarthritis

By
Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP
-

Can individuals with osteoarthritis can incorporate cycling to reduce joint pain and regain their joint mobility?

Introduction

The joints in the musculoskeletal system allow the individual to be mobile while allowing the extremities to do their jobs. Just like the muscles and ligaments of the body, the joints can also wear and tear through repetitive motions, leading to joint pain in the extremities. Over time, the wear and tear from the joints can lead to the potential development of osteoarthritis, which then can affect joint mobility and lead to a life of pain and misery for individuals. However, numerous ways exist to reduce osteoarthritis’s pain-like symptoms and help restore joint mobility through cycling. Today’s article looks at how osteoarthritis affects the joints, how cycling is incorporated for osteoarthritis, and how it can reduce joint pain. We discuss with certified associated medical providers who consolidate our patients’ information to assess osteoarthritis and its associated pain symptoms affecting the joints in the extremities. We also inform and guide patients while asking their associated medical provider intricate questions to integrate cycling into their personalized treatment plan to manage the pain correlated with osteoarthritis affecting their joints. Dr. Jimenez, D.C., includes this information as an academic service. Disclaimer.

 

Osteoarthritis Affecting Joint Mobility

Do you feel pain and stiffness every morning in your joints only for it to feel better throughout the day? Do you experience pain in your knees, hips, and hands? Or have you noticed that your range of motion has decreased drastically? Many individuals, both young and old, can be affected by these pain-like issues and could be at risk of developing osteoarthritis in their joints. Osteoarthritis is the largest and most common musculoskeletal condition that causes a disturbance of the inflammatory cytokine balance, damaging the cartilage and other intra-articular structures surrounding the joints. (Molnar et al., 2021) This is because osteoarthritis develops over time, causing the cartilage to wear away and causing the connecting bones to rub against each other. This, in turn, can affect the extremity’s joint mobility, causing symptoms of stiffness, pain, swelling, and reduced range of motion to the joints.

 

 

Additionally, osteoarthritis is multifactorial as it can cause an imbalance in the joints due to genetics, environmental, metabolic, and traumatic factors that can contribute to its development. (Noriega-Gonzalez et al., 2023) This is because repetitive motions and environmental factors can impact the body and cause overlapping risk profiles to correlate with osteoarthritis. Some overlapping risk profiles associated with osteoarthritis are pathological changes in the joint structure that cause abnormal loading on the joints, which causes joint malalignment and muscle weakness. (Nedunchezhiyan et al., 2022) This causes many people to be in constant pain and trying to find relief from joint pain associated with osteoarthritis.

 

Chiropractic Solutions For Osteoarthritis-Video

Chiropractic Solutions for Osteoarthritis | El Paso, Tx (2024)

Cycling For Osteoarthritis

Engaging in physical activities may seem daunting when managing osteoarthritis symptoms, but it can help restore joint mobility while reducing the pain associated with osteoarthritis. One of the physical activities that has little impact and does not impact the joints is cycling. Cycling for osteoarthritis has many beneficial properties as it can:

  • Strengthen surrounding muscles
  • Retain joint mobility
  • Improve range of motion
  • Weight management
  • Enhancing cardiovascular health

Cycling can help the individual focus on strengthening the lower extremity muscles surrounding the joints, which can help improve pain and functionality. (Katz et al., 2021) This, in turn, helps provide better support and stability to the joints, thus reducing overload on the body while minimizing the risk of injuries. Additionally, cycling can help improve many individuals looking for a healthier change and increase bone mineral density in the joints, thus decreasing the risk of fractures. (Chavarrias et al., 2019)

 

Cycling Reducing Joint Pain

Cycling is a safe and effective exercise for anyone, whether they’re just starting or haven’t been active for a while. The key to optimal recovery and joint functionality is to consult a doctor. This ensures that cycling is a safe option for you, helps you choose the right bike, and provides guidance on how to start slowly, warm up and stretch, maintain proper form, and stay consistent with the cycling sessions. This professional guidance is crucial, as it allows many individuals with joint pain to achieve complete functional recovery to their joints. (Papalia et al., 2020) Cycling is an excellent way to manage osteoarthritis and its associated symptoms. For many individuals with osteoarthritis, this low-impact exercise can be a game-changer, promoting muscle strengthening, improving joint range of motion, and helping alleviate osteoarthritis symptoms.

 

References

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

Katz, J. N., Arant, K. R., & Loeser, R. F. (2021). Diagnosis and Treatment of Hip and Knee Osteoarthritis: A Review. JAMA, 325(6), 568-578. https://doi.org/10.1001/jama.2020.22171

Molnar, V., Matisic, V., Kodvanj, I., Bjelica, R., Jelec, Z., Hudetz, D., Rod, E., Cukelj, F., Vrdoljak, T., Vidovic, D., Staresinic, M., Sabalic, S., Dobricic, B., Petrovic, T., Anticevic, D., Boric, I., Kosir, R., Zmrzljak, U. P., & Primorac, D. (2021). Cytokines and Chemokines Involved in Osteoarthritis Pathogenesis. Int J Mol Sci, 22(17). https://doi.org/10.3390/ijms22179208

Nedunchezhiyan, U., Varughese, I., Sun, A. R., Wu, X., Crawford, R., & Prasadam, I. (2022). Obesity, Inflammation, and Immune System in Osteoarthritis. Front Immunol, 13, 907750. https://doi.org/10.3389/fimmu.2022.907750

Noriega-Gonzalez, D., Caballero-Garcia, A., Roche, E., Alvarez-Mon, M., & Cordova, A. (2023). Inflammatory Process on Knee Osteoarthritis in Cyclists. J Clin Med, 12(11). https://doi.org/10.3390/jcm12113703

Papalia, R., Campi, S., Vorini, F., Zampogna, B., Vasta, S., Papalia, G., Fossati, C., Torre, G., & Denaro, V. (2020). The Role of Physical Activity and Rehabilitation Following Hip and Knee Arthroplasty in the Elderly. J Clin Med, 9(5). https://doi.org/10.3390/jcm9051401

Disclaimer

Take Your Fitness to the Next Level with Sprint Exercise Training

By
Dr Alexander D Jimenez DC, APRN, FNP-BC, CFMP, IFMCP
-
Active young brunette in sport clothes standing on yoga mat and making criss cross crunches exercise. Multiracial healthy woman training abs during domestic workout.

For individuals who don’t have time for a full workout, could incorporating sprint exercise training be an option to improve their cardiovascular and overall health?

Take Your Fitness to the Next Level with Sprint Exercise Training

Sprint Exercise Training

Most think of running when they hear the word sprinting. However, sprinting can be performed in any aerobic activity, whether swimming, cycling, rollerblading, or exercising on an elliptical machine. Sprint exercise training means varying the intensity levels of the activity. It is also known as sprint interval training or speed drills. It targets cardiovascular endurance and is suitable for all fitness levels, from beginners to advanced. This type of training is demanding and requires high motivation, but it can lead to significant improvements and help achieve fitness goals faster.

Sprint workouts are a time saver. Many exercise guidelines recommend up to 60 minutes of moderate exercise 3 times a week; however, many people don’t have the time. Studies have shown that short, high-intensity sprint exercise training improves aerobic capacity and endurance in half the time of traditional endurance exercise. Sprint exercise training burns calories, improves cardiovascular health, builds muscle, and increases speed and power. Sprint workouts are great for individuals who lack time for traditional steady endurance exercise but want to improve cardiovascular health. (Vollaard, N. B. J., and Metcalfe, R. S. 2017) Adding them to a workout routine can take training to a new level.

Training

The key to sprint training is performing an activity at a certain percentage of all-out effort to increase heart rate. Sprint exercise training is recommended three times a week, with at least one to two days of rest or other easy exercises between sprint workouts. How to do.

Warm-up

  • Warm up with easy exercise for five to 10 minutes.
  • Slowly perform the exercise that will be done for the sprints to prepare the body for the intense sprint.

Do the First Sprint

  • Perform the first sprint at around 60% intensity.
  • Slow down and continue warming up if there is muscle tightness or joint pain.

Rest

  • Recover for four minutes by slowing to a comfortable pace, but continue moving.

Do the Second Sprint

  • Perform the next sprint at 80% max intensity.

Rest

  • Rest for four minutes.

Do the Third Sprint

  • Perform the remainder of the sprints at 100% intensity or all-out efforts for 30 seconds.
  • Push to the maximum for each exercise.

Rest

  • Recover for four minutes after each sprint to slow down breathing and heart rate, and can hold a conversation without gasping.

Repeat

  • Repeat the sprint/recovery routine four to eight times, depending on fitness level and ability.
  • For the first workout, stop at four sprints.
  • Gradually build up to eight.

Benefits

Sprint exercise training enhances endurance performance and can be effectively used by athletes, fitness enthusiasts, and individuals who want to improve their fitness and health. (Litleskare, S. et al., 2020) In one study, participants who completed eight weeks of sprint training saw improvements in maximal oxygen uptake or VO2 max. The test is one way to measure cardiovascular fitness. (Litleskare, S. et al., 2020) These short bursts of intense exercise improve muscle health and performance comparable to several weeks of traditional training. (Gunnarsson, T. P. et al., 2013) Other studies have found that short, high-intensity exercise burns more calories than the same amount of moderate-level cardiovascular exercise. (Vollaard, N. B. J., and Metcalfe, R. S. 2017)

Variations

There are different ways to structure a sprinting routine, and different fitness goals will determine the intensity, duration, and number of sprints that should be performed.

Beginners

Those new to sprinting should start slow, as overdoing it can lead to injury. Work on building up a base level of fitness before introducing sprinting into an exercise routine. Start with one set of four sprint/rest cycles when trying sprints. As fitness goals are achieved, add more sprints to each set or different sprints.

Intermediate

Once a sprinting exercise routine is begun, it may only be a few weeks before one is ready to advance to an intermediate level. Try increasing the number of sprints at different intensity levels. However, avoid sprint exercises too often weekly as the body needs adequate rest.

Advanced

Advanced athletes can intensify the routine by increasing intensity and adding reps. One way is by adding resistance. For example, for those running or cycling, try sprinting hills, or if rollerblading, try wearing wrist and ankle weights to increase the load. Swimmers can use strength-building techniques to focus on specific body areas or add resistance. The intensity of any sprinting activity can be intensified by wearing a weighted vest.

Beginner Errors

A few common starting mistakes include going too hard, advancing too quickly, and doing too many for too long. Sprints are not meant to replace moderate-intensity exercise. The goal is to modulate the intensity of aerobic activities. A study showed that not getting enough rest between sprints led to an inability to perform as well during sprinting. (Selmi, M. A. et al., 2016)

Safety

Sprint workouts can be done with running, swimming, cycling, or other aerobic cardiovascular exercises. The following precautions should be considered before adding sprint training to a workout schedule:

Safety

  • Because sprinting is a high-intensity exercise, it is recommended that individuals consult with a healthcare professional and review the physical activity readiness questionnaire (PAR-Q) before beginning a sprint training workout.

Base Fitness

  • A strong fitness base in the sprint activity is also important.
  • To build a fitness base, follow the 10% rule and gradually increase training volume.

Frequency

  • Because of the intensity, sprint workouts should not be done more than three times a week.

Muscle Soreness

  • Launching into a sprint program can cause delayed-onset muscle soreness.
  • Experts recommend having about three to four weeks of base fitness before beginning.
  • Injuries are more likely if the body isn’t properly prepared.

The goal is to do a sprint workout six times in two weeks, then only perform 2 times a week for maintenance for six to eight weeks before changing the workout. On the days following a sprint workout, aim for 20–30 minutes of the same aerobic activity at an easier pace to help recover but maintain results. If pleased with the results, continue with the routine longer, but it is recommended to vary the workouts every few months and throughout the year. Modify the routine to find what works best.

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References

Vollaard, N. B. J., & Metcalfe, R. S. (2017). Research into the Health Benefits of Sprint Interval Training Should Focus on Protocols with Fewer and Shorter Sprints. Sports medicine (Auckland, N.Z.), 47(12), 2443–2451. https://doi.org/10.1007/s40279-017-0727-x

Litleskare, S., Enoksen, E., Sandvei, M., Støen, L., Stensrud, T., Johansen, E., & Jensen, J. (2020). Sprint Interval Running and Continuous Running Produce Training Specific Adaptations, Despite a Similar Improvement of Aerobic Endurance Capacity-A Randomized Trial of Healthy Adults. International journal of environmental research and public health, 17(11), 3865. https://doi.org/10.3390/ijerph17113865

Gunnarsson, T. P., Christensen, P. M., Thomassen, M., Nielsen, L. R., & Bangsbo, J. (2013). Effect of intensified training on muscle ion kinetics, fatigue development, and repeated short-term performance in endurance-trained cyclists. American journal of physiology. Regulatory, integrative and comparative physiology, 305(7), R811–R821. https://doi.org/10.1152/ajpregu.00467.2012

Selmi, M. A., Haj, S. R., Haj, Y. M., Moalla, W., & Elloumi, M. (2016). Effect of between-set recovery durations on repeated sprint ability in young soccer players. Biology of sport, 33(2), 165–172. https://doi.org/10.5604/20831862.1198636

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