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Aging Arthritis: Sciatica Clinic

By
Dr. Alex Jimenez
-
Smiling Attractive Multi-ethnic Young Female Doctor or Nurse Wearing Scrubs and Stethoscope Talking with Patient.

Aging Arthritis: How the body changes as the years go by is determined by an individual’s diet, physical activity/exercise, genetics, stress levels, sleep patterns, and self-care. As the body ages, natural degeneration from everyday wear and tear will present. The focus is on understanding how age-related degeneration can affect the body and what to do to prevent and treat it.

Aging Arthritis: Injury Medical Chiropractic Functional Medicine

Aging Arthritis

Arthritis refers to joint inflammation and is the fundamental cause of various disorders that include:

  • Osteoarthritis
  • Fibromyalgia
  • Infectious arthritis
  • Gout – metabolic arthritis
  • Rheumatoid arthritis
  • Lupus
  • Childhood arthritis

Inflammation is just one symptom usually accompanied by swelling, pain, stiffness, immobility, and loss of function.

Osteoarthritis

  • The most common type of arthritis is osteoarthritis, where the cartilage within joints begins to break down, and the bones begin to reshape.
  • It’s known as degenerative joint disease/wear and tear arthritis.
  • The hands, hips, and knees are the most commonly affected joints.
  • These changes often develop slowly but worsen if not treated.
  • Symptoms include intense pain, stiffness, and swelling.

Fibromyalgia

  • Fibromyalgia is a condition that causes pain in various areas of the body, sleep problems, and fatigue.
  • Individuals with fibromyalgia can be more sensitive to pain sensations.
  • Treatments and management plans are available to help ease symptoms and restor function.

Infectious Arthritis

  • Infectious arthritis or septic arthritis is caused by an infection in the joints.
  • Bacteria from another area of the body can invade a joint or the fluid surrounding it.
  • Bacteria can enter the body from open wounds, injections, or surgery.
  • Infectious arthritis is usually only present in one joint.
  • Staphylococcus aureus is a bacteria that lives on healthy skin and is the cause of most infectious arthritis cases.
  • A virus or fungus can also generate arthritic inflammatory symptoms.

Gout

  • Gout is a common type of arthritis that causes inflammation and pain.
  • It usually only affects one joint, most commonly the big toe joint.
  • Symptoms can intensify, known as flares, and other periods with no symptoms, known as remission.
  • Recurrent gout episodes can degenerate into gouty arthritis, a more serious form of arthritis.

Rheumatoid Arthritis

  • Rheumatoid arthritis is an autoimmune and inflammatory disease in which the immune system attacks healthy cells, causing inflammation.
  • Rheumatoid arthritis attacks numerous joints simultaneously, specifically in the hands, wrists, and knees.
  • Rheumatoid arthritis causes the joint lining to become inflamed and starts to damage nearby tissues.
  • Tissue damage that is severe or chronic enough can cause pain, balance problems, and visible deformities.
  • Rheumatoid arthritis can also affect organs, like the lungs, heart, and eyes, by causing inflammation.

Lupus

  • Lupus is an autoimmune disease that affects various body systems.
  • An autoimmune disease is when the immune system mistakes its tissues for bacterial, viral, or fungal intruders and attacks them.
  • Lupus symptoms can be vague, making the disease hard to diagnose.
  • The disease is known as the great imitator because symptoms can mimic other diseases.
  • Symptoms range from mild to life-threatening.
  • Seeing a rheumatologist is recommended, as they are specialists that can diagnose and treat arthritis, lupus, and other joint-related diseases.

Childhood Arthritis

  • Arthritis in children is known as juvenile or childhood arthritis.
  • Juvenile idiopathic arthritis/juvenile rheumatoid arthritis is the most frequent form.
  • The condition can cause long-term joint damage that can lead to disability.

Aging Arthritis and Chiropractic Care

Chiropractic care is recommended for the treatment of any form of arthritis. Chiropractic care can work with other therapies to reduce swelling and inflammation, alleviate pain, and improve mobility and flexibility.

  • A chiropractor will utilize body imagery before beginning treatment.
  • Imaging gives insight into the condition of the joints, and the visual, combined with a self-report from the individual, allows the chiropractor to create a personalized treatment plan.
  • Once a chiropractor has identified which techniques the body can handle, treatment will commence that can include:
  • Therapeutic massage
  • Percussive massage
  • Ultrasound
  • Electrotherapy
  • Low-level cold laser therapy
  • Infrared heat

A chiropractor’s objective is to rebalance, realign and strengthen the body, relieve pressure or stress at the junction of the joints, and expedite healing and rehabilitation.

LLT Laser Therapy

References

Abyad, A, and J T Boyer. “Arthritis and aging.” Current opinion in rheumatology vol. 4,2 (1992): 153-9. doi:10.1097/00002281-199204000-00004

Chalan, Paulina, et al. “Rheumatoid Arthritis, Immunosenescence and the Hallmarks of Aging.” Current aging science vol. 8,2 (2015): 131-46. doi:10.2174/1874609808666150727110744

Goronzy, Jorg J et al. “Immune aging, and rheumatoid arthritis.” Rheumatic diseases clinics of North America vol. 36,2 (2010): 297-310. doi:10.1016/j.rdc.2010.03.001

Greene, M A, and R F Loeser. “Aging-related inflammation in osteoarthritis.” Osteoarthritis and cartilage vol. 23,11 (2015): 1966-71. doi:10.1016/j.joca.2015.01.008

Sacitharan, Pradeep Kumar. “Ageing and Osteoarthritis.” Sub-cellular biochemistry vol. 91 (2019): 123-159. doi:10.1007/978-981-13-3681-2_6

Sciatica Pain & The Gluteus Minimus Muscles

By
Dr. Alex Jimenez
-

Introduction

The buttock and the lower back have a casual relationship to the body, as the lower back has various muscles and nerves surrounding the spinal column. In contrast, the buttock region has multiple muscles and the sciatic nerve to keep the body upright. The sciatic nerve travels from the lumbar region of the spine across the gluteus muscles and down to the legs. The gluteus muscles include the Maximus, medius, and minimus, and they work with the sciatic nerve regarding good posture. When normal or traumatic factors begin to affect the body, like sciatica or poor posture, it can lead to developing trigger points associated with the gluteus minimus affecting the sciatic nerve. Today’s article examines the gluteus minimus, how trigger points mimic sciatic pain on the gluteus minimus, and various treatments to relieve sciatic nerve pain. We refer patients to certified providers who incorporate multiple methods in the lower body extremities, like sciatic pain treatments related to trigger points, to aid individuals dealing with pain symptoms along the gluteus medius muscles associated with sciatica. We encourage and appreciate patients by referring them to associated medical providers based on their diagnosis, especially when it is appropriate. We understand that education is an excellent solution to asking our providers complex questions at the patient’s request. Dr. Jimenez, D.C., utilizes this information as an educational service only. Disclaimer

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What Is The Gluteus Minimus?

 

Have you been experiencing radiating pain traveling down to your leg? Do you have difficulty walking or sitting down? Do you feel tenderness or referred pain near your buttock region? Some of the issues correlate with trigger points affecting the gluteus minimus, causing pain in the sciatic nerve. As the smallest muscle in the gluteal region of the buttock, the gluteus minimus shares similar characteristics to the gluteus medius while being located beneath the medius muscle. One of the primary functions of the gluteus minimus is that it predominantly acts as a hip stabilizer and abductor. The nerves from the gluteal muscles include the sciatic nerve, which is on top of the gluteus muscles and the other nerves help supply the muscles to function in the posterior region of the body. Studies reveal that the structural integrity of the gluteus minimus muscles is the key to the lateral hip muscle, which contributes to pelvic stability and lower extremity function. However, when issues affect the gluteal muscles’ posterior region could trigger point pain mimicking sciatica.

 

How Trigger Points Mimic Sciatic Pain On The Gluteus Minimus?

When the lower body extremities begin to suffer from multiple issues that cause the individual to have mobility dysfunction, various factors could correlate to the dysfunction. When the gluteus minimus muscles have been overused or been through a traumatic experience, they can develop trigger points along the muscle fibers and even cause nerve entrapment along the sciatic nerve. Trigger points along the gluteus minimus can mimic sciatic nerve pain down to the back or even the side of the legs that causes excruciating and deep pain in the posterior region. Studies reveal that pain in the buttock region is a deep gluteal syndrome caused by non-discogenic pain that causes sciatic nerve entrapment.

 

 

The book, “Myofascial Pain and Dysfunction,” written by Dr. Janet G. Travell, M.D., states that many patients with active trigger points located in their gluteus minimus would complain about hip pain that could cause them to limp-walk when they are going to places. The pain caused by the active trigger points can make it difficult to stand up from a seated position due to the painful movements. The associated pain that the trigger points are causing to the gluteus minimus can be constant and excruciating; even small stretches can not alleviate the pain. The book also mentioned that trigger points could cause referred pain to the gluteus minimus that can cause various somato-visceral issues to the hips, legs, and knees if the pain worsens.

Sciatic Type Pain: Gluteus Minimus Trigger Points- Video

Sciatic Type Pain - Gluteus Minimus Trigger Points

Are you dealing with pain in your hips, low back, and legs? Do you find it difficult to walk or stand up constantly? Or are you experiencing sciatic nerve pain that is radiating down your leg? All these pain-like symptoms are associated with trigger points along the gluteus minimus affecting the sciatic nerve. The gluteus minimus is the smallest of the gluteal muscles with the same function as the gluteus medius and predominately acts as the hip’s stabilizer and abductor. When the gluteus minimus muscles have been overused from traumatic events or normal factors, they can develop trigger points in the muscle fibers, entrap the sciatic nerve and irritate the nerve causing sciatica. The video above explain where the gluteus minimus is located and pinpoints where the trigger points are in the muscle fibers. Trigger points along the gluteus minimus can mimic sciatica by causing referred pain to travel down the leg. This can cause the individual to be unable to walk or even stand up due to the excruciating pain that they are in. Luckily, trigger points are treatable even though they are tricky to diagnose.

Various Treatments To Release Sciatic Nerve Pain

 

Even though trigger points along the gluteus minimus are tricky to diagnose, they are treatable through various treatments to alleviate the pain that the person is experiencing and can reduce sciatic nerve pain from causing more issues in the legs. Studies reveal that the effectiveness of active soft tissue release and trigger point block treatments combined can release entrapped nerves from the gluteus minimus and reduce low back and sciatic pain from the lower extremities. Now the treatments alone can only do so much to the individual, as many doctors tell their patients to take corrective actions or techniques to reduce the chances of trigger points from forming again on the gluteus minimus. Techniques like glute stretches, ischemic compressions, or using a foam roller can break the myofascial triggers from the gluteus minimus muscles and reduce the pain in the glutes and legs. This will help bring mobility back to the lower extremities.

 

Conclusion

As the smallest muscle in the body’s gluteal region, the gluteus minimus is the lower body’s predominant hip stabilizer and abductor. The gluteus minimus contributes to pelvic stability and lower extremity functionality that can be overused and can develop trigger points associated with sciatica. Trigger points along the gluteus minimus can cause referred pain to the legs and lower back while mimicking sciatic nerve pain. Thankfully various treatments and techniques can help reduce the chances of trigger points forming along the gluteus minimus and release nerve entrapment from the aggravated muscles pressing on the sciatic nerve, bringing back lower extremity mobility to the body.

 

References

Greco, Anthony J, and Renato C Vilella. “Anatomy, Bony Pelvis and Lower Limb, Gluteus Minimus Muscle.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 29 May 2022, www.ncbi.nlm.nih.gov/books/NBK556144/.

Kameda, Masahiro, and Hideyuki Tanimae. “Effectiveness of Active Soft Tissue Release and Trigger Point Block for the Diagnosis and Treatment of Low Back and Leg Pain of Predominantly Gluteus Medius Origin: A Report of 115 Cases.” Journal of Physical Therapy Science, The Society of Physical Therapy Science, Feb. 2019, www.ncbi.nlm.nih.gov/pmc/articles/PMC6382483/.

Martin, Hal David, et al. “Deep Gluteal Syndrome.” Journal of Hip Preservation Surgery, Oxford University Press, July 2015, www.ncbi.nlm.nih.gov/pmc/articles/PMC4718497/.

Travell, J. G., et al. Myofascial Pain and Dysfunction: The Trigger Point Manual: Vol. 2:the Lower Extremities. Williams & Wilkins, 1999.

Whiler, Lisa, et al. “Gluteus Medius and Minimus Muscle Structure, Strength, and Function in Healthy Adults: Brief Report.” Physiotherapy Canada. Physiotherapie Canada, University of Toronto Press, 2017, www.ncbi.nlm.nih.gov/pmc/articles/PMC5963550/.

Disclaimer

Breathing Back Discomfort Causes: Sciatica Clinic

By
Dr. Alex Jimenez
-
Female physiotherapist examining female patient injured back in modern clinic.

Back discomfort symptoms include stiffness, spasms, tenderness, and headaches often caused by unhealthy posture and overuse muscle strain. Breathing back discomfort can be caused by injuries to the spinal musculoskeletal system, conditions and/or disease in the back, lungs, or heart, and other conditions unrelated to the back. When taking a breath, the intercostal muscles surrounding the rib cage contract, expanding the chest and allowing the lungs to fill with air. These muscles directly affect the spine, which is why back issues can present when breathing. Chiropractic care, decompression, and massage therapy, combined with a functional medicine approach, can realign the spine, release tight muscles, and restore function.Breathing Back Discomfort Causes Chiropractor

Breathing Back Discomfort

A problem in the back could be a root cause for discomfort and back problems while breathing.

Spinal Conditions

Scoliosis

  • Scoliosis causes the spine to curve sideways, either in one direction, creating a C shape, or generating an S shape in two directions.
  • The curvature can be so minimal that it cannot be seen or so severe that it can be life-threatening. Most scoliosis cases fall in between.
  • Taking deep breaths can cause discomfort and pain because the spine curvature puts extra strain on certain muscles meant to support the body’s weight in tandem with other muscles that have limited function or are no longer functioning.
  • The condition normally begins in adolescence but can start later in life.

Scoliosis treatment varies depending on the severity.

Monitor

  • A spinal physician will monitor the individual for mild curvature, as sometimes the process stops before it becomes serious. This is known as the wait-and-see, what-happens approach.

Activity, Chiropractic, and Physical Therapy

  • Yoga can stop and even reverse the progression.
  • Chiropractic care and physical therapy can help alleviate symptoms.

Bracing

  • Bracing can be effective at stopping the progression.

Surgery

  • For severe cases, surgery may be necessary.
  • In this case, spinal fusion is the most common surgical procedure for this condition.
  • Newer procedures like vertebral body tethering and ApiFix have been approved and could be an option.

Kyphosis

Kyphosis is another curve in the back that is supposed to be there.

  • Instead of curving like scoliosis, kyphosis causes a curve forward in the thoracic spine/upper back.
  • Problems arise when the curve is too pronounced.
  • This curve can come from unhealthy posture, Scheuermann’s disease, or being born with it.
  • Kyphosis causes breathing back discomfort by straining the muscles in the upper back, which are used for each breath.
  • Treatment often involves chiropractic and/or physical therapy to restore proper curvature and reduce inflammation.
  • A back brace could be prescribed if discomfort and pain continue.
  • Spinal fusion could be recommended for severe cases.

Lungs

The lungs and the spine are close to each other, which is why back discomfort and problems with breathing are connected.

Pneumonia

  • Pneumonia is an infection in the lungs that causes the tiny sacks known as alveoli to fill with fluid.
  • This is where the body takes oxygen from the inhaled air to the bloodstream.
  • The infection causes inflammation and discomfort symptoms in and around the chest and back while taking deep breaths.

Lung Cancer

  • Lung cancer can cause back issues and pain.
  • Frequently coughing causes the muscles around the ribs and back to become overused and strained from the jerking and heaving.
  • The strained muscles cause discomfort and pain when taking a breath.
  • Tumors can push on sensitive nerves in the back, causing inflammation and pain.

Pleurisy

  • There is a thin layer of protective tissue surrounding the lungs called pleura.
  • Pleurisy describes the layer becoming infected and/or inflamed, which causes discomfort symptoms in the back when breathing.
  • Pleurisy can be caused by injury, infection, or cancer.
  • Individuals with autoimmune disorders are more at risk of developing the condition.

Pneumothorax

  • Pneumothorax describes a full or partial lung collapse, usually on one side.
  • The lung can collapse as a result of severe illness or injury.
  • The lung collapses because air gets between the pleura and the lung and not allowing the lung to expand.
  • Pain with breathing is a common indicator of pneumothorax.
  • Individuals with this condition also experience severe shortness of breath and chest pain on one side.

Pulmonary Embolism

  • A pulmonary embolism occurs when a blood clot gets stuck in an artery, blocking blood flow to part of the lung.
  • The lungs will display signs of distress through back pain when trying to take a deep breath.
  • This is a life-threatening condition that causes chest pain, coughing up blood, a heart rate over 100 beats per minute, dizziness or leg swelling, and painful breathing; get to an emergency room immediately.

Heart

Heart Attack

  • The nerves associated with pain in the muscles and bones differ from those surrounding the organs, including the heart.
  • However, a heart attack can cause back pain as the nerves of the heart travel along the same path as spinal nerves, specifically in the upper back.
  • The brain can misinterpret pain signals from the same roots that supply peripheral nerves in the chest, arm, jaw, and back.
  • Because they share nerve pathways, the upper back can present with pain during a heart attack.

Aortic Dissection

  • The largest artery in the body is called the aorta.
  • It comes off the top of the heart and then drops to supply blood to the rest of the body.
  • Sometimes, the vessel can get a small tear in the chest area, which grows from the blood circulation pressure.
  • Aortic dissection can cause intense back pain while breathing.

Chiropractic care, decompression, and massage therapy combined with functional medicine can help realign the spine, stretch and loosen the overused and strained muscles, and provide postural training and nutritional planning to help alleviate symptoms and restore function.

Deep Breathing Back Pain

References

Costumbrado J, Ghassemzadeh S. Spontaneous Pneumothorax. [Updated 2022 Jul 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK459302/

Floman, Y., Burnei, G., Gavriliu, S. et al. Surgical management of moderate adolescent idiopathic scoliosis with ApiFix®: a short peri- apical fixation followed by post-operative curve reduction with exercises. Scoliosis 10, 4 (2015). doi.org/10.1186/s13013-015-0028-9

Hunter MP, Regunath H. Pleurisy. [Updated 2022 Jul 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK558958/

www.lung.org/lung-health-diseases/lung-disease-lookup/pneumothorax/symptoms-diagnosis-treatment

www.lung.org/lung-health-diseases/lung-disease-lookup/pulmonary-embolism/treating-and-managing

Mansfield JT, Bennett M. Scheuermann Disease. [Updated 2022 Aug 21]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK499966/

Raitio A, Syvänen J, Helenius I. Vertebral Body Tethering: Indications, Surgical Technique, and a Systematic Review of Published Results. Journal of Clinical Medicine. 2022; 11(9):2576. doi.org/10.3390/jcm11092576

Lumbago Pain & Gluteus Medius Trigger Pain

By
Dr. Alex Jimenez
-

Introduction

Many individuals utilize the lower half of their bodies to go to different places and use the various surrounding muscles that provide stability on the hips and low back while supporting the upper body’s weight. Along the lower back is the buttock region, where the gluteal muscles help stabilize the pelvis, extend the hips, and rotate the thighs. The gluteal muscles also help shape and support the spine and have an erect posture in the body. One of the gluteal muscles that support the lower body is the gluteus medius, which can succumb to injuries and strain when overused or strained. This leads to developing trigger points that can cause various issues in the lower extremities and lead to corresponding chronic conditions. Today’s article focuses on the gluteus medius muscles, how the lumbago is associated with gluteus medius trigger pain, and various techniques to manage trigger points along the gluteus medius muscle. We refer patients to certified providers who incorporate multiple methods in the lower body extremities, like butt and low back pain treatments related to trigger points, to aid individuals dealing with pain symptoms along the gluteus medius muscles near and surrounding the body’s lower extremities. We encourage and appreciate patients by referring them to associated medical providers based on their diagnosis, especially when it is appropriate. We understand that education is an excellent solution to asking our providers complex questions at the patient’s request. Dr. Jimenez, D.C., utilizes this information as an educational service only. Disclaimer

Download

What Is The Gluteus Medius?

 

Have you been experiencing pain near your buttock and lower back? Have you been feeling unstable when you are walking? What about feeling pain in your tailbone that makes it unbearable to sit down? Many of these issues are associated with referred pain caused by trigger points affecting the gluteus medius. As part of the gluteal muscle region, the gluteus medius lies between the gluteus maximus and minimus is a flat, triangular muscle and is the primary hip abductor. The gluteus medius and minimus work together for internal rotation for the thighs and lateral rotation for the knees when they are extended. The gluteus medius muscles also help stabilize the pelvis, while the trunk maintains an upright position when the legs are in motion. Studies reveal that the gluteus medius is a key lateral hip muscle that correlates with muscle function with other muscle groups like the quadriceps and abdominal muscles. When injuries or not activating the gluteal muscles often, various muscle issues can cause problems to the gluteus medius muscles. 

 

Lumbago Associated With Gluteus Medius Trigger Pain

Dysfunction in the hips can lead to various issues that can either be acute or chronic, depending on how severely the muscles have been overused or injured. Studies reveal that low back pain has been identified as the leading contributor to disability and when there is dysfunction in the lumbopelvic-hip complex, causing a reduction in gluteus medius strength. When the gluteus medius muscles have become overused or injured through trauma, it can develop trigger points on the muscle causing low back pain issues. When trigger points affect the gluteus medius, additional studies reveal that latent trigger points along the gluteus medius muscles may cause joint movement limitation while causing overload by affecting muscle activation from the hips.

 

 

According to Dr. Janet G. Travell, M.D.’s book, “Myofascial Pain and Dysfunction: The Trigger Point Manual,” patients with active trigger points along their gluteus medius complain of pain when they are doing normal actions like walking or sitting. The pressure from the trigger points along the gluteus medius causes the individual to be in a slumped position, causing them to be uncomfortable. This causes instability in the hips and lower body extremities, making many people miserable. The book also explains that the referred pain patterns caused by gluteus medius trigger points can overlap other chronic conditions like sacroiliac joint dysfunction, low back pain, and inflammation of the subgluteus medius bursa.

 

Trigger Point Of The Week: Gluteus Medius- Video

Trigger Point of the Week - Gluteus Medius

Have you been dealing with hip pain? Do you feel uncomfortable pain when walking or sitting down? Or Do you feel muscle stiffness or tenderness near your tailbone constantly? If you have been experiencing these painful symptoms constantly in your lower back or your hips, it could be due to your gluteus medius muscles being affected by trigger points. The video above overviews the gluteus medius location and how trigger points or myofascial pain syndrome causes referred pain to the lower back and hips. When trigger points affect the gluteus medius, the referred pain can overlap and correlate to low back and hip pain, thus causing various issues to the muscles surrounding the low back and buttock region. Regarding trigger points affecting the gluteus medius, they can be treatable through multiple techniques specific to the low back, buttocks, and hips.

Various Techniques For Managing Trigger Pain Along The Gluteus Medius

 

When issues of low back or hip pain begin to cause a problem in the lower extremities, the gluteus muscles can invoke pain-like symptoms in the affected muscle regions, thus developing trigger points. Even though trigger points are tricky to diagnose, they can be treated with various techniques that many people can incorporate into their daily lives. Exercises like resistance training on the gluteus medius can help improve hip abductor functionality and increase the strength of the gluteus medius. To manage trigger points along the gluteus medius, many people must do these corrective actions to reduce the pain that they may be causing to their glutes. When people are putting on pants, it is best to sit down and then put on their pants to prevent muscle strain on their hips and gluteus medius. Another corrective action is to move around after sitting down for a prolonged period to avoid trigger pain from developing. These corrective actions and techniques can help strengthen the lower body extremities and improve hip mobility. 

 

Conclusion

As part of the gluteal muscle region, the gluteus medius lies between the gluteus maximus and minimus by being a primary hip abductor. The gluteus medius helps with pelvic stabilization and helps the trunk maintain an upright position when the legs are in motion. When normal or traumatic factors affect the gluteus medius, it can develop trigger points on the muscle fibers, causing referred pain to the hips and lower back. Trigger points along the gluteus medius are manageable through various techniques that people can use to prevent hip and low back issues. These techniques can minimize the trigger points and strengthen the gluteus medius muscles in the glutes.

 

References

Bagcier, Fatih, et al. “The Relationship between Gluteus Medius Latent Trigger Point and Muscle Strength in Healthy Subjects.” Journal of Bodywork and Movement Therapies, U.S. National Library of Medicine, Jan. 2022, pubmed.ncbi.nlm.nih.gov/35248262/.

Sadler, Sean, et al. “Gluteus Medius Muscle Function in People with and without Low Back Pain: A Systematic Review.” BMC Musculoskeletal Disorders, BioMed Central, 22 Oct. 2019, www.ncbi.nlm.nih.gov/pmc/articles/PMC6805550/.

Shah, Aashin, and Bruno Bordoni. “Anatomy, Bony Pelvis and Lower Limb, Gluteus Medius Muscle.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 25 Jan. 2022, www.ncbi.nlm.nih.gov/books/NBK557509/.

Stastny, Petr, et al. “Strengthening the Gluteus Medius Using Various Bodyweight and Resistance Exercises.” Strength and Conditioning Journal, Strength and Conditioning Journal, June 2016, www.ncbi.nlm.nih.gov/pmc/articles/PMC4890828/.

Travell, J. G., et al. Myofascial Pain and Dysfunction: The Trigger Point Manual: Vol. 2:the Lower Extremities. Williams & Wilkins, 1999.

Whiler, Lisa, et al. “Gluteus Medius and Minimus Muscle Structure, Strength, and Function in Healthy Adults: Brief Report.” Physiotherapy Canada. Physiotherapie Canada, University of Toronto Press, 2017, www.ncbi.nlm.nih.gov/pmc/articles/PMC5963550/.

Disclaimer

Training Oneself To Enjoy Vegetables: Sciatica Clinic

By
Dr. Alex Jimenez
-
adult man slicing vegetables for salad at kitchen

First, know that it is not crazy, and you’re not alone. It is difficult for individuals to achieve health and fitness goals when they don’t like to eat vegetables. Intermittent fasting, Paleo, vegan, Mediterranean, or New Nordic, almost all healthy nutrition plans require vegetable consumption to achieve optimal health. However, it is never too late to learn to enjoy vegetables. Injury Medical Chiropractic and Functional Medicine Clinic can recommend ways not just to eat vegetables because they are healthy but to truly enjoy them.Training Oneself To Enjoy Vegetables: Functional Chiropractor

Training Oneself To Enjoy Vegetables

Everyone’s taste preferences are different.

  • Many individuals grew up in homes where vegetables were prepared in unappetizing ways.
  • Over boiling and steaming are common preparation methods that many had experience with, including broccoli, cauliflower, asparagus, and Brussels sprouts, which made them flavorless, mushy and is where many decided they were not going to eat these foods.
  • Many don’t like vegetables because many have chemical compounds that make them taste bitter.
  • If food intake is more packaged and less fresh, an individual’s palate will be more conditioned to seek out processed food’s fatty, sweet flavors.
  • Some individuals may be genetically inclined to dislike vegetables.

Vegetable Purpose

Vegetables are full of nutrients that are very beneficial to the body.

  • Vegetables contain antioxidants, vitamins, minerals, fiber, and phytonutrients.
  • These nutrients help keep the mind and body healthy and avoid deficiencies.
  • Vegetables add fiber that provides a feeling of fullness by giving volume to fill the stomach without added calories.
  • This controls energy balance/calories in vs. calories out, which helps shed body fat without feeling hungry and maintain body weight.
  • Vegetables feed the intestinal bacteria that help the digestive tract.
  • Vegetables provide hydration that helps the fiber eliminate waste products.
  • Vegetables add variety to help maintain healthy nutrition.

Branching Out

The key is to branch out incrementally. Most individuals will have a vegetable or two that they can tolerate. This could be a starting point by expanding on new variations on those tolerable vegetables that will lead to broadened taste preferences. This can be done through different cooking methods that include:

Regardless of where you’re starting, there are simple ways to make the vegetable bitterness less intense, more palatable, and more enjoyable that consists of:

  • Vegetable Challenge
  • Vegetable Complement
  • Vegetable Cushion

Vegetable Challenge

  • Pick a vegetable that you would not normally eat that requires effort to try.
  • Motivate yourself to try it – health reasons, children, family, friends, etc.
  • Take a small bite; you may hate it, like it, or it has no effect.
  • You at least tried it.
  • Research suggests that individuals may need to try new foods many times (prepared differently) before tolerating or liking them.

Vegetable Complement

  • Build on flavor perception
  • Well-developed recipes have flavor harmony.
  • It means pairing food with a vegetable to activate various tastes and flavors pleasing to the palate simultaneously.

Vegetable Cushion

  • On the tongue are a variety of receptors that bind to the chemicals in food.
  • When these receptors are activated, they send a chemical signal to the brain about the taste.
  • Variations in the number and type of receptors help develop flavor preferences.
  • Basic tastes – sweet, sour, spicy, salty, bitter, and umami.
  • Pairing bitterness with other distinct flavors, like sweet and spicy, can develop and change the brain’s perception of bland or bitter vegetables to tasty and delicious.
  • Cushions for bitterness include honey, real maple syrup, sour cream, Mexican crema, hot sauce, oils, almonds, and butter used in balance to enhance and bring out flavors.

The objective is to start small and work your way to becoming more comfortable with experimenting and combining more flavors. Consultation with a professional nutritionist can help individuals get on a healthy nutrition plan that they can enjoy.

Tip From A Dietitian

References

Christoph, Mary J et al. “Intuitive Eating is Associated With Higher Fruit and Vegetable Intake Among Adults.” Journal of nutrition education and behavior vol. 53,3 (2021): 240-245. doi:10.1016/j.jneb.2020.11.015

Melis M, Yousaf NY, Mattes MZ, Cabras T, Messana I, Crnjar R, Tomassini Barbarossa I, Tepper BJ. Sensory perception of salivary protein response to astringency as a function of the 6-n-propylthioural (PROP) bitter-taste phenotype. Physiol Behav. 2017 Jan 24;173:163-173.

Mennella JA. Development of food preferences: Lessons learned from longitudinal and experimental studies. Food Qual Prefer. 2006 Oct;17(7-8):635-637.

Tordoff, Michael G, and Mari A Sandell. “Vegetable bitterness is related to calcium content.” Appetite vol. 52,2 (2009): 498-504. doi:10.1016/j.appet.2009.01.002

Wallace, Taylor C et al. “Fruits, vegetables, and health: A comprehensive narrative, umbrella review of the science and recommendations for enhanced public policy to improve intake.” Critical reviews in food science and nutrition vol. 60,13 (2020): 2174-2211. doi:10.1080/10408398.2019.1632258

Wieczorek, Martyna N et al. “Bitter taste of Brassica vegetables: The role of genetic factors, receptors, isothiocyanates, glucosinolates, and flavor context.” Critical reviews in food science and nutrition vol. 58,18 (2018): 3130-3140. doi:10.1080/10408398.2017.1353478

Experiencing Pain In Your Gluteus Max? Could Be Trigger Points

By
Dr. Alex Jimenez
-

Introduction

The body’s lower extremities have various muscles that allow the legs and feet to move around from one location to another. The different muscles that make up the lower extremities of the body help stabilize the hips and allow mobility to the legs. The legs and hip muscles have a mutual relationship with one body muscle that helps the lower body, and it’s the glutes, specifically the gluteus maximus. Many individuals must realize that the glutes must be activated when working out. When the glutes are not activated, it can lead to the rest of the lower extremities, like the lower back, hips, and knees, taking most of the loaded weight on the body. This leads to the development of trigger points associated with butt pain along the gluteus maximus, causing referred pain down the legs. Today’s article looks at the gluteus maximus muscles, how trigger points are associated with butt pain, and relieving pain is associated with trigger points along the gluteus maximus. We refer patients to certified providers who incorporate multiple techniques in the lower body extremities, like butt pain treatments related to trigger points, to aid individuals dealing with pain symptoms along the gluteus maximus muscles near and surrounding the body’s lower extremities. We encourage and appreciate patients by referring them to our associated medical providers based on their diagnosis, especially when it is appropriate. We understand that education is an excellent solution to asking our providers complex questions at the patient’s request. Dr. Jimenez, D.C., utilizes this information as an educational service only. Disclaimer

Download

What Is The Gluteus Maximus?

 

Have you been experiencing pain in your hips, low back, and knees? Are you uncomfortable when you are trying to sit down? Or are you experiencing sciatic pain-like symptoms running from your buttock to your leg? These issues affecting the body’s lower extremities may correlate with trigger points along the gluteus maximus in the buttock. The gluteus maximus is the largest gluteus muscle that makes up the shape and form of the buttock and hip areas of the body. The gluteus maximus can come in different sizes depending on the individual’s body type. This large muscle plays a prominent role in the body as it helps maintain an erect posture for the upper body. Studies reveal that the gluteus maximus is one of the primary hip extensors, and some of its functions include extending and externally rotating the thighs. The gluteus maximus, when trained properly through exercise, can increase in size and strength while supporting the upper body. However, only a few people realize that when their gluteus maximus muscles are not properly trained, it can lead to various issues that can cause trigger points to form along the gluteus maximus.

 

Trigger Points Associated With Butt Pain

 

As mentioned earlier, when individuals don’t properly strengthen their gluteus maximus through exercises, it can lead to unwanted pain symptoms affecting the lower back, hips, and knees in the lower body. When the gluteus maximus muscles are not fully activated to their full potential, they can develop into trigger points associated with butt pain. Studies reveal that trigger points or myofascial pain syndrome associated with the gluteus maximus can affect the entry point of the inferior gluteal nerve, causing pain and a limited range of motion to the joints. Dr. Janet G. Travell, M.D., who wrote “Myofascial Pain and Dysfunction,” mentioned that the symptoms caused by active trigger points could make the individual uncomfortable and cause a cramping sensation to the gluteus maximus. At the same time, trigger points along the gluteus maximus can correlate with referred pain that can entrap the sciatic nerve causing sciatica to affect the legs. When this happens, many other issues can pop up and affect the lower extremities, mimicking low back pain.

 

How To Release Trigger Points On The Gluteus Maximus-Video

Treating Trigger Points - How to Release Triggers in Gluteus Maximus

Are you experiencing a cramping sensation in your buttock? What about feeling an electric sense running down your leg? Or are you dealing with low back pain? Many of these issues are associated with trigger points affecting the gluteus maximus, causing butt pain. The gluteus maximus is a large, superficial muscle that helps support the hips and ensures that the upper body has an erect posture. When issues affect the gluteus maximus, it can lead to unwanted pain in the lower back, hips, and knees, causing the individual to be in constant pain. This leads to the development of trigger points along the gluteus maximus, thus mimicking sciatica. The video above demonstrates where the trigger points are located in the gluteus maximus and how they can potentially overlap to cause sciatica nerve pain. The video also shows how to use various techniques to relieve the pain from the trigger points and help release the trapped muscle from causing additional pain in the lower body.

Relieving Pain Associated With Trigger Points Along The Gluteus Maximus

 

Since the gluteus maximus is a large important muscle, it is important to strengthen the glutes to prevent low back pain. When it comes to relieving pain associated with trigger points along the gluteus maximus, there are various techniques that many people can utilize to release the tension from the gluteus maximus and the rest of the lower body. Various glute stretches can help elongate the gluteus maximus muscle after a workout and reduce the chances of triggering points and referred pain re-occurring. Another technique that many people should do is to bend at the knees when lifting heavy objects to reduce overload on the lower back and cause more issues on the gluteus maximus.

 

Conclusion

The gluteus maximus is a large superficial muscle with a very important function in the body. This muscle helps with extending and externally rotating the thighs and helps keep the posture erect for the upper back. However, the gluteus maximus muscles are not properly trained and can lead to unwanted issues that cause referred pain to the hips, low back, and knees that correlate with triggering points. Luckily though, through proper training and stretching, the lower body can prevent the gluteus maximus from developing trigger points and help improve a person’s posture.

 

References

Akamatsu, Flavia Emi, et al. “Anatomical Basis of the Myofascial Trigger Points of the Gluteus Maximus Muscle.” BioMed Research International, Hindawi, 2017, www.ncbi.nlm.nih.gov/pmc/articles/PMC5733974/.

Elzanie, Adel, and Judith Borger. “Anatomy, Bony Pelvis and Lower Limb, Gluteus Maximus Muscle.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 28 Mar. 2022, www.ncbi.nlm.nih.gov/books/NBK538193/.

Neto, Walter Krause, et al. “Gluteus Maximus Activation during Common Strength and Hypertrophy Exercises: A Systematic Review.” Journal of Sports Science & Medicine, Uludag University, 24 Feb. 2020, www.ncbi.nlm.nih.gov/pmc/articles/PMC7039033/.

Travell, J. G., et al. Myofascial Pain and Dysfunction: The Trigger Point Manual: Vol. 2:the Lower Extremities. Williams & Wilkins, 1999.

Disclaimer

Stomach Back Pain Causes: Sciatica Clinic

By
Dr. Alex Jimenez
-
Woman healthcare medical worker keeping hands near male back while performing manual examination in wellness center

Back pain is one of the most common reasons individuals go to a doctor, massage therapist, physiotherapist, osteopath, and chiropractor. Various health conditions, some spine-related, others not, list back pain as a symptom. Many of these conditions begin in the stomach or abdominal cavity, which leads to stomach and back pain. Stomach and back pain happening simultaneously, independently, or in combination could be caused by gut problems, back issues, or something completely different. Understanding what causes these two types of pain simultaneously can help figure out a treatment plan.

Stomach Back Pain Causes and Functional ChiropracticStomach Back Pain Causes

Problems in the abdominal cavity and stomach issues can cause back pain and vice versa. Symptoms can also include referred pain when the pain is felt in one part of the body but is caused by pain or injury in another area. Stomach back pain causes depend on the type of condition/s that can include:

Appendicitis

  • Inflammation in the appendix can cause sudden sharp pain in the abdomen.
  • It presents mostly in the lower right area of the abdomen but can appear in or spread to other sites, especially the back.

Dysmenorrhea

  • The medical term for painful menstrual periods.
  • Dysmenorrhea can cause pain in the abdomen and back at the same time.
  • This type of pain can be:
  • Primary – A condition experienced throughout life.
  • Secondary – Starts later in life due to another condition.

Endometriosis

  • Endometriosis causes tissue to grow outside of the uterus.
  • Similar to dysmenorrhea, symptoms include:
  • Abdominal pain
  • Referred low back pain

Fibromyalgia

  • This condition generates pain across the muscles and joints of the body.
  • It shows up with irritable bowel syndrome -IBS.
  • Fibromyalgia can simultaneously present a wide range of stomach problems and back pain.

Gallstones

  • Gallbladder stones or gallstones can cause blockages, inflammation, and painful swelling.
  • A major symptom of gallstones is pain in the upper right of the abdomen, which can spread to the back.

Kidney Dysfunction

  • Kidney stones, infections, and chronic kidney disease can cause pain that’s felt in the abdomen/flank and the mid and/or upper back.

Irritable bowel syndrome – IBS

Inflammatory Bowel Disease – IBD

  • Inflammatory Bowel Disease is a family of immune-mediated, similar to autoimmune conditions with back pain as a symptom that includes:
  • Crohn’s disease
  • Ulcerative colitis

Pancreatitis

  • An inflamed pancreas can cause symptoms like:
  • Stomach issues.
  • Pain across the abdomen and back.

Pancreatic Cancer

  • A common symptom of pancreatic cancer is a dull pain in the upper abdomen/belly and/or middle and/or upper back that is on and off.
  • This can be because of a tumor that has formed on the tail of the pancreas or an area where it presses on the spine.

Stomach Bloating and Low Back Pain

  • Bloating is caused by pressure in the abdomen increasing to the point that it causes discomfort and pain.
  • It can cause simultaneous stomach and back pain as the bloating adds pressure on the muscles, organs, and spine.
  • One of the most common causes of bloating is trapped gas in the GI tract.
  • This happens when the body cannot properly move the gas through the system.
  • Bloating can also be caused by extra sensitivity to regular pressure increases.
  • In these cases, the amount and movement of gas in the system are normal, but the body reacts as though something is wrong.
  • Several GI tract disorders can cause similar bloating issues that include:
  • Dyspepsia
  • Gastritis
  • Celiac diseaseDiverticular disease
  • Food allergies

A chiropractic functional medicine team can work with an individual’s primary physician or specialist to develop a personalized treatment plan to alleviate back pain symptoms, re-balance the body, strengthen the musculoskeletal system and restore function.

Back and Stomach

Stomach and Back Pain at the Same Time
References

Clauw DJ. Chapter 258, Fibromyalgia, Chronic Fatigue Syndrome, and Myofascial Pain. Goldman-Cecil Medicine. Goldman L (ed.). 26th ed. Elsevier; 2020. 1774-1778. www.clinicalkey.com/#!/content/book/3-s2.0-B9780323532662002587

Ford AC, Talley NJ. Chapter 122, Irritable Bowel Syndrome. Feldman M (ed.). Sleisenger and Fordtran’s Gastrointestinal and Liver Disease. 11th ed. Elsevier: 2021. 2008-2020. www.clinicalkey.com/#!/content/book/3-s2.0-B9780323609623001223?scrollTo=%23hl0001104

Inadomi JM, Bhattacharya R, Hwang JH, Ko C. Chapter 7, The Patient with Gas and Bloating. Yamada’s Handbook of Gastroenterology. 4th ed. John Wiley & Sons; 2019. doi.org/10.1002/9781119515777.ch7

Kliegman RM, St Geme JW, Blum NJ, et al. Chapter 378, Pancreatitis. Nelson Textbook of Pediatrics. 21st ed. Elsevier; 2020. 2074-2080. www.clinicalkey.com/#!/content/book/3-s2.0-B9780323529501003783

Krames E, Mousad DG. Spinal Cord Stimulation Reverses Pain and Diarrheal Episodes of Irritable Bowel Syndrome: A Case Report. Neuromodulation. 2004 Mar 22;7(2):82-88. doi.org/10.1111/j.1094-7159.2004.04011.x

Sifri CD, Madoff LC. Chapter 78, Appendicitis. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases. 9th ed. Bennett JA (ed.). Elsevier; 2020. 1059-1063. www.clinicalkey.com/#!/content/book/3-s2.0-B9780323482554000783

Stephen Norman Sullivan, “Functional Abdominal Bloating with Distention,” International Scholarly Research Notices, vol. 2012, Article ID 721820, 5 pages, 2012. doi.org/10.5402/2012/721820

Wang DQH, Afdhal NH. Chapter 65, Gallstone Disease. Feldman M (ed.). Sleisenger and Fordtran’s Gastrointestinal and Liver Disease. 11th ed. Elsevier: 2021. 1016-1046. www.clinicalkey.com/#!/content/book/3-s2.0-B9780323609623000655?scrollTo=%23hl0001772

Weisman, Michael H et al. “Axial Pain and Arthritis in Diagnosed Inflammatory Bowel Disease: US National Health and Nutrition Examination Survey Data.” Mayo Clinic proceedings. Innovations, quality & outcomes vol. 6,5 443-449. 16 Sep. 2022, doi:10.1016/j.mayocpiqo.2022.04.007

Whorwell PJ. Chapter 13, Abdominal Bloating. Irritable Bowel Syndrome: Diagnosis and Clinical Management. Emmanuel A, Quigley EMM (eds.). John Wiley & Sons; 2013. doi.org/10.1002/9781118444689.ch13

Yarze JC, Friedman LS. Chapter 12, Chronic Abdominal Pain. Feldman M (ed.). Sleisenger and Fordtran’s Gastrointestinal and Liver Disease. 11th ed. Elsevier; 2021. 158-167. www.clinicalkey.com/#!/content/book/3-s2.0-B9780323609623000126?scrollTo=%23hl0000408

Pelvic Floor Muscles & Trigger Points

By
Dr. Alex Jimenez
-

Introduction

The body’s pelvic region has many functions crucial for functionality with the host. The various muscles surrounding the pelvis help provide stability to the body’s core, allow circulation to the heart in the cardiovascular system, support the reproductive and abdominal organs, and much more the body requires. The pelvic joints’ various muscles also allow hip mobility and function for the lower body extremities. When traumatic injuries or abnormal activities start to affect the pelvic floor muscles, the various issues can affect the functionality of the pelvic region and cause problems in bladder control for both the male and female bodies. Many of these issues correlate with trigger points surrounding or on the pelvic floor muscles that can affect how the vital organs operate in the body. Today’s article examines the pelvic floor muscles, how trigger points correlate with pelvic pain, and managing pelvic pain is associated with trigger points. We refer patients to certified providers who incorporate multiple techniques in the lower body extremities, like pelvic pain treatments related to trigger points, to aid individuals dealing with pain symptoms along the pelvic floor muscles near and surrounding the pelvis. We encourage and appreciate patients by referring them to our associated medical providers based on their diagnosis, especially when it is appropriate. We understand that education is an excellent solution to asking our providers complex questions at the patient’s request. Dr. Jimenez, D.C., utilizes this information as an educational service only. Disclaimer

Download

What Are The Pelvic Floor Muscles?

 

Have you been experiencing bladder issues that constantly make you go to the bathroom? Have you been dealing with severe cramps that mimic sciatica pain? Or does it hurt when you are sitting down? Many of these issues correlate with muscle pain associated with trigger point pain along the pelvic floor muscles. The pelvic floor muscles are a unique anatomical body location with a balance of different pressures (visceral, muscular, or liquid) that play a fundamental role in the body’s lower extremities. The pelvic floor muscles have four divided compartments but have different parts and functions to allow optimal bodily function. The four pelvic floor compartments include:

  • Anterior or urinary (bladder)
  • Medium or genital (uterus in women, prostate in men)
  • Posterior or anterior (anus, anal cavity, and rectum)
  • Peritoneal (endopelvic fascia and perineal membrane)

Some of the functions that the pelvic floor muscles allow the body to perform properly include proper contraction for sexual function, allowing respiration in the abdominal organs, maintaining bodily fluid actions like going to the restroom, and maintaining good posture by working together with the thoracolumbar and lumbosacral columns of the spine. Studies reveal that the spine’s autonomic nerves, which include the sympathetic and parasympathetic, help supply the posterior and anterior compartments in the pelvic floor. When traumatic factors affect the pelvic floor muscles, it can lead to correlating issues regarding trigger points in the pelvic muscles.

 

How Do Trigger Points Correlate With  Pelvic Pain?

The pelvic floor has four different components to allow the muscles to function properly when traumatic factors start to invoke pain-like symptoms that can affect pelvic functionality in both the male and female body, thus developing trigger point pain associated with pelvic pain. For the female body, trigger points along the bulbospongiosus muscle (part of the pelvic floor muscles) may cause aching pain in the perineal region. In contrast, in the male body, trigger points along the retroscrotal area may cause discomfort while sitting erect. According to the book, “Myofascial Pain and Dysfunction,” written by Dr. Janet G. Travell, M.D., stated that many individuals that are dealing with trigger point pain along their pelvic floor muscles would often complain about feeling localized aching pain in their anal region and may experience painful bowel movements when going to the bathroom.

 

Studies reveal that myofascial trigger points develop “muscle contraction knots” of the pelvic floor muscles, may be identified in many patients suffering from pelvic pain syndrome (urological, colorectal, and gynecological), and are associated with trigger points. Trigger points are tricky when diagnosing where the pain is located since myofascial pain syndrome mimics other chronic conditions of the surrounding muscles, causing referred pain. Additional studies reveal that the location and severity of pelvic floor myofascial pain was significantly correlated with various pelvic pain symptoms that can affect both males and females with different conditions. When doctors recognize that their patients are dealing with trigger points associated with pelvic pain after an examination, they devise a treatment plan and work with other specialists to manage trigger points and reduce pain in the pelvic region.

 

Top 3 Pelvic Floor Exercises- Video

Top 3 Pelvic Floor Exercises - Simple Pelvic Floor Physical Therapy Exercises at Home!

Have you been dealing with urinary issues that make it tricky to go to the bathroom? Do you have trouble finding a comfortable position when you are sitting down? Or do you feel pain radiating down your buttock and leg? Pelvic pain is a common issue that can affect both men and women that can cause various pain symptoms that correlate with trigger points along the pelvic floor muscles. When trigger points affect the pelvic floor muscles, it can lead to referred pain that connects with pelvic pain in the body’s lower extremities. Many factors can affect the pelvis, like issues affecting the digestive, reproductive, or urinary systems, a trauma in the surrounding pelvic muscles that causes them to be weak or corresponding issues on the hips and lower back. Trigger points associated with pelvic pain may be tricky. Still, they can be treatable with different therapies that can reduce the pain and help strengthen those weak muscles in the pelvic region. The video above demonstrates three other pelvic floor exercises that can help support the pelvic muscles and reduce the trigger points from reoccurring in the pelvic area of the lower body.

Managing Pelvic Pain Associated With Trigger Points

 

Various treatments can manage pain associated with trigger points through multiple therapies that can reduce pain-like symptoms along the pelvic floor muscles. Many therapies, like trigger point therapy and muscle training, can help reduce the pain along the pelvic floor muscles and bring back bowel function to the pelvic region. Studies reveal that doctors provide a range of protocols designed to strengthen the pelvic floor muscles and the different muscle groups around the pelvic area while improving function. However, treatment alone can only go so far, as people must take corrective actions to ensure that the trigger points do not return in the future. Movements like corrective posture exercises focusing on the lower back, hips, and pelvis and eating a fiber-rich diet can reduce pelvic pain. This allows the individual to get their lower half mobility back. 

 

Conclusion

The pelvic floor muscle has four divided components that will enable optimal bodily function that has different jobs in the male and female bodies. The pelvic floor muscles have many crucial functions that provide the host stability in the body’s core, allow circulation to the cardiovascular system, and, most importantly, support the reproductive and abdominal organs. When issues affect the pelvic floor muscles, it can lead to pelvic pain associated with trigger points that can disrupt many from going to the bathroom or disrupting sexual functionality. All is not lost, as various therapies can reduce the pain and strengthen the pelvic muscles in the lower body. This allows lower body mobility back to the host and prevents unnecessary issues from reoccurring.

 

References

Bordoni, Bruno, et al. “Anatomy, Abdomen and Pelvis, Pelvic Floor.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 18 July 2022, www.ncbi.nlm.nih.gov/books/NBK482200/.

Marques, Andrea, et al. “The Status of Pelvic Floor Muscle Training for Women.” Canadian Urological Association Journal = Journal De L’Association Des Urologues Du Canada, Canadian Medical Association, Dec. 2010, www.ncbi.nlm.nih.gov/pmc/articles/PMC2997838/.

Meister, Melanie R, et al. “Pelvic Floor Myofascial Pain Severity and Pelvic Floor Disorder Symptom Bother: Is There a Correlation?” American Journal of Obstetrics and Gynecology, U.S. National Library of Medicine, Sept. 2019, www.ncbi.nlm.nih.gov/pmc/articles/PMC6732028/.

Moldwin, Robert M, and Jennifer Yonaitis Fariello. “Myofascial Trigger Points of the Pelvic Floor: Associations with Urological Pain Syndromes and Treatment Strategies Including Injection Therapy.” Current Urology Reports, U.S. National Library of Medicine, Oct. 2013, pubmed.ncbi.nlm.nih.gov/23943509/.

Raizada, Varuna, and Ravinder K Mittal. “Pelvic Floor Anatomy and Applied Physiology.” Gastroenterology Clinics of North America, U.S. National Library of Medicine, Sept. 2008, www.ncbi.nlm.nih.gov/pmc/articles/PMC2617789/.

Travell, J. G., et al. Myofascial Pain and Dysfunction: The Trigger Point Manual: Vol. 2:the Lower Extremities. Williams & Wilkins, 1999.

Disclaimer

Percussive Massage Therapy: Sciatica Clinic

By
Dr. Alex Jimenez
-
Back pain treated with a percussive self-massage gun in a mature woman.

The body’s musculoskeletal system consists of bones, cartilage, ligaments, tendons, and connective tissues. These parts get pushed to the extreme with everyday wear and tear, job, school, house chores, and tasks. All the flexing and contracting cause tightness, strain, and soreness that can contribute to negative muscle behavior that holds the muscles in an unhealthy position and in a semi-flexed or tightened state. An example is an unhealthy posture that becomes the norm for an individual. A percussive massage can release tightness, maintain flexibility, relieve discomfort, alleviate stress, and improve circulation.How Percussive Massage Therapy Works: Injury Chiropractor

Percussive Massage Therapy

A percussive/percussion massage is a form of physical therapy that utilizes vibration through repeated pressure bursts to massage muscles. Percussive therapy offers more control over targeted muscle groups than foam rollers and other static massagers. The treatment involves using an electric massage device to relieve muscle tension. Different massage heads for various therapeutic purposes move rapidly and forcefully, applying pressure directly to the soft tissues while the vibrations help release and loosen the areas.

How The Massage Works

  • Fascia, which wraps around the muscles and joints, can become tight and inflamed, causing soreness and pain.
  • Research shows that tight fascia can limit mobility and proper range of motion.
  • When a muscle group is stiff and limits the range of motion of a specific part of the body, the rest of the muscles and body will overcompensate. This increases the risk of serious injury.
  • Percussive therapy loosens the tissues and increases blood circulation.
  • Once the stiffness and soreness are relieved, continued percussive therapy can prevent tightness from reforming, improve the range of motion, and speed up muscle recovery.
  • Massage guns can penetrate up to an inch into the soft tissue, stimulating the muscles and helping release tension.

Benefits

Improved mobility

  • Percussive massage distributes the thickened fascia fluid to relieve pressure and tightness.
  • Repeated pressure at high speed thins the fluids, making the fascia more workable so the muscles can move easily and efficiently.

Reduced Soreness

  • Lactic acid builds up in the muscles after working, physical activity, and exercise.
  • This build-up causes soreness and pain.
  • The percussion forces muscle fibers to release the lactic acid, reducing the soreness.

Decreased DOMS/Delayed Onset Muscle Soreness

  • It’s common to experience pain and soreness 24 to 72 hours after unfamiliar physical activity, such as a new job, exercise routine, or rehabilitation after injury or surgery.
  • This is known as delayed onset muscle soreness or DOMS, which results from tiny muscle fiber tears.
  • Percussive therapy increases skin temperature, blood flow, and hormonal responses to reduce inflammation and pain.

Increases Relaxation

  • After work, school, physical activities, and working out, a percussive massage session can help the body wind down and relax.
  • A percussive massage will help the muscles release and relax when the body is exhausted or overwhelmed.

How To Use A Percussive Massager

  • Before starting a new medical treatment, including percussion therapy, talk to your doctor, physical therapist, or chiropractor.
  • Ensure you know the difference between normal muscle soreness and pain from an injury.
  • Don’t use a massager on an injured muscle or body part, as the aggressive motion could aggravate the injury.
  • Avoid using the device on bones or joints.
  • Never use a massage gun directly on the neck; perform the massage on the shoulders and upper back.
  • Start with the lowest intensity level.
  • The low and medium settings should provide plenty of power for most users.
  • As you become more comfortable with the device, you’ll understand how your body reacts then you can try out the higher settings.
  • A percussive massager should be used in short bursts on small, targeted areas.
  • It is recommended to perform treatments for only a few minutes.
  • Seeing the muscles turning reddish during the massage signals that blood is flowing and it’s time to move on to another area.
  • If the massage gun makes the skin sore or sensitive, make tiny circles instead of holding the massager in one spot.
  • Some massagers have pressure-sensing technology to help apply the right amount of pressure.

Combined with chiropractic and professional massage, percussive therapy can help individuals maintain a relaxed musculoskeletal system. 

Best Massage Guns

References

Cafarelli, E et al. “Vibratory massage and short-term recovery from muscular fatigue.” International journal of sports medicine vol. 11,6 (1990): 474-8. doi:10.1055/s-2007-1024840

Cerciello, Simone, et al. “Clinical applications of vibration therapy in orthopedic practice.” Muscles, ligaments and tendons journal vol. 6,1 147-56. 19 May. 2016, doi:10.11138/mltj/2016.6.1.147

Cheatham, Scott W et al. “Mechanical Percussion Devices: A Survey of Practice Patterns Among Healthcare Professionals.” International journal of sports physical therapy vol. 16,3 766-777. 2 Jun. 2021, doi:10.26603/001c.23530

García-Sillero, Manuel et al. “Acute Effects of a Percussive Massage Treatment on Movement Velocity during Resistance Training.” International journal of environmental research and public health vol. 18,15 7726. 21 Jul. 2021, doi:10.3390/ijerph18157726

Jack Martin, “A critical evaluation of percussion muscle gun therapy as a rehabilitation tool focusing on lower limb mobility.” A literature review. Department of Health and Wellbeing. The University of Winchester. osf.io/preprints/sportrxiv/j9ya8/

Imtiyaz, Shagufta et al. “To Compare the Effect of Vibration Therapy and Massage in Prevention of Delayed Onset Muscle Soreness (DOMS).” Journal of clinical and diagnostic research: JCDR vol. 8,1 (2014): 133-6. doi:10.7860/JCDR/2014/7294.3971

Konrad, Andreas et al. “The Acute Effects of a Percussive Massage Treatment with a Hypervolt Device on Plantar Flexor Muscles’ Range of Motion and Performance.” Journal of sports science & medicine vol. 19,4 690-694. 19 Nov. 2020

Baseball Training: Chiropractic Sciatica Clinic

By
Dr. Alex Jimenez
-
Female batter ready to hit the ball during a baseball game

All sports differ in the relative importance of various physical skills contributing to the game and individual performance. Baseball is a precision sport with fast, explosive movements and full-body activity. The ability to repeatedly perform near maximum level with little rest is necessary for baseball players. Baseball training involves a multidimensional approach that focuses on speed, agility, and strength in a way that is relative to the motions and requirements of the sport.

Baseball Training: Injury Medical Chiropractic ClinicBaseball Training

Trainers have to assess the unique needs of the sport and determine the time needed to improve each quality within the athlete. They should focus on the following:

  • Improving core strength and trunk rotation.
  • Increasing shoulder stability and strength.
  • Improving quick reactive movements.
  • Increasing explosiveness.
  • Improving running, throwing, and bat speed.
  • Injury prevention.

Baseball training workouts are targeted at increasing running speed, bat speed, pitching, and throwing velocity that breaks down the muscle groups for improving performance while decreasing the risk of injury. Training consists of combined conditioning that includes:

  • Sprinting
  • Interval runs
  • Jump rope
  • High-intensity cardio
  • Strength training

Rotational Movements

  • Players often lack abdominal or core strength.
  • One of the main aspects of baseball is the hitting and throwing that is done in a rotational movement and are explosive.
  • Players are recommended to train rotationally with light weights and high speed.
  • Exercises emphasizing rotating the hips and torso with resistance, including cable and pulley machines, dumbbell workouts, and medicine ball workouts, are effective.
  • Abdominal crunches and various rotational twists with a medicine ball can develop a strong muscular base in this area.
  • This will improve strength and power in the core area, which is vital for swinging a bat and throwing.

Shoulder and Rotator Cuff Work

  • High stress is placed on the shoulder joint and the rotator cuff muscles.
  • Pitching happens at the shoulder joint and is one of the fastest human movements.
  • Repetitive stress increases the risk of injury.
  • Exercises that strengthen the anterior and posterior shoulder muscles in a balanced manner are recommended.
  • Shoulder flexibility is necessary to allow external rotation when throwing at high speeds.
  • Deceleration is the area of pitching where injuries happen most.
  • Plyometric shoulder and upper body exercises can help with the explosive pitching motion.

Explosive Speed

Bat Speed

  • Players need increased lower body and core strength to develop power in the swing.
  • The muscles require rotational training at a high velocity.
  • Strong hip and leg muscles initiate the swing.
  • The core area transfers the rotational speed to the torso.
  • The arms complete the swing.
  • The efficient transfer of force from the lower body to the upper body or the kinetic chain principle requires balance for optimal transfer.
  • Strong lats, triceps, and forearms facilitate optimal bat acceleration during ball contact.
  • Forearm and triceps exercises, squats, bench presses, and pull-ups are recommended.

Throwing Velocity

  • Throwing a baseball at high velocity is a full-body movement that requires total body development.
  • Strong leg, hip, and core muscles are necessary to transfer power from the ground, up through the lower body, to the torso, and then the arm and hand to generate a fast, whipping ball release.
  • Weighted or medicine ball exercises can improve velocity.
  • This will improve generating power in the throwing muscles.
  • The objective is to build power utilizing a heavy and then a light load to build arm speed, and using proper form will improve throwing velocity safely.
  • Proper trunk rotation during arm cocking and strength and flexibility training should involve trunk rotational exercises to develop the obliques so that maximum arm speed can be generated.

Biomechanical Analysis

Video analysis of a player includes:

  • Pitching mechanics
  • Hitting mechanics
  • Fault correction
  • Feedback
  • Assessing progress

Mental and Emotional Skills

  • Mental and emotional skills training helps players deal with success, failure, and game pressure.
  • Players have to deal with consistent failure and remain confident.

Hitting Mistakes

References

Ellenbecker, Todd S, and Ryoki Aoki. “Step-by-Step Guide to Understanding the Kinetic Chain Concept in the Overhead Athlete.” Current reviews in musculoskeletal medicine vol. 13,2 (2020): 155-163. doi:10.1007/s12178-020-09615-1

Fleisig, Glenn S et al. “Biomechanical Analysis of Weighted-Ball Exercises for Baseball Pitchers.” Sports health vol. 9,3 (2017): 210-215. doi:10.1177/1941738116679816

Rhea, Matthew R, and Derek Bunker. “Baseball-specific conditioning.” International journal of sports physiology and performance vol. 4,3 (2009): 402-7. doi:10.1123/ijspp.4.3.402

Seroyer, Shane T et al. “The kinetic chain in overhand pitching: its potential role for performance enhancement and injury prevention.” Sports health vol. 2,2 (2010): 135-46. doi:10.1177/1941738110362656

Thigh & Low Back Pain Caused By Trigger Points

By
Dr. Alex Jimenez
-

Introduction

The posterior section of the lower half of the body consists of the hips, low back, pelvis, legs, and feet, which provide stability to the body while supporting the upper body’s weight. The various muscles surround the lower extremities and make different motions for mobility and functionality by contracting and retracting when the legs and hips are in motion. The various muscles that provide stability to the hips and the legs are the iliopsoas muscles. When normal age or incidents affect the lower body extremities, it can correlate to the development of trigger point pain. Today’s article examines the iliopsoas muscles, how referred trigger pain affects the thighs and low back, and treating trigger point pain on the thighs and low back. We refer patients to certified providers who incorporate multiple techniques in the low back and thigh pain therapies related to trigger points to aid individuals dealing with pain symptoms along the iliopsoas muscle in the lower back, thigh, and near the pelvis. We encourage and appreciate patients by referring them to our associated medical providers based on their diagnosis, especially when it is appropriate. We understand that education is an excellent solution to asking our providers complex questions at the patient’s request. Dr. Jimenez, D.C., utilizes this information as an educational service only. Disclaimer

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What Is The Iliopsoas Muscle?

Have you been dealing with muscle cramps in your thighs? What about feeling muscle stiffness in your lower back when you are stretching? Or do you feel your thigh muscles become heavy after a workout? Many of these issues correlate with the iliopsoas muscle becoming overused and developing trigger points, thus affecting the thighs and lower back. In the lower body extremities, the muscles that help provide stability to the hips are the iliopsoas muscles. The iliopsoas muscles consist of three muscles: iliacus, psoas major, and psoas minor, which can work individually or as a unit. When working individually, the iliacus muscle provides stability to the pelvis, the psoas major muscle helps stabilize the lumbar spine when a person is sitting, and the psoas minor helps with flexion of the trunk and stretch the iliac fascia. As a unit, however, these muscles work together to become the primary flexors of the thighs and allow hip flexion. 

 

 

Studies reveal that the iliopsoas is a deep muscle group that anatomically connects the spine to the body’s lower limbs. The iliopsoas muscles have an important function in the body’s lower limbs as primary hip flexors for daily activities, especially for those in sports. However, many impairments and pathologies affect the iliopsoas, which causes significant limitations and challenges since the symptoms mask the pain, causing individuals to think they are dealing with low back and hip pain. 

 

Referred Trigger Pain On The Thighs & Low Back

 

Since the iliopsoas muscles provide hip and thigh flexion to the lower body, many impairments and pathologies can affect this muscle group, causing issues in the hips, thighs, and even the lower back. These impairments can cause the iliopsoas muscles to be overused and overstretched, thus potentially developing trigger points along the iliopsoas muscles, causing referred pain on the thighs and low back. Studies reveal that when the iliopsoas muscle becomes overused or traumatic issues affect it, it can lead to problems in hip flexion and impairment in the lower extremities. In “Myofascial Pain and Disorders: The Trigger Point Manual,” written by Dr. Janet G. Travell, M.D., when trigger points begin to affect the iliopsoas muscles, it is known as the “Hidden Prankster” as normal factors like poor posture can overload the back causing trigger points to form not only on the iliopsoas muscles but the hamstrings, gluteal, thoracolumbar paraspinal, and posterior cervical muscles. Trigger points can mimic other chronic conditions that cause referred pain in different body areas. Trigger point pain in the iliopsoas muscle can lead to back pain, groin pain, snapping hips, and standing up difficult for the individual if it is not treated immediately.

 

Trigger Point Therapy: Iliopsoas Muscle- Video

Trigger Point Therapy - Iliopsoas

Since the iliopsoas muscles provide hip and thigh flexion to the lower body, many impairments and pathologies can affect this muscle group, causing issues in the hips, thighs, and even the lower back. These impairments can cause the iliopsoas muscles to be overused and overstretched, thus potentially developing trigger points along the iliopsoas muscles, causing referred pain in the thighs and low back. Studies reveal that when the iliopsoas muscle becomes overused or traumatic issues affect it, it can lead to problems in hip flexion and impairment in the lower extremities. In “Myofascial Pain and Disorders: The Trigger Point Manual,” written by Dr. Janet G. Travell, M.D., when trigger points begin to affect the iliopsoas muscles, it is known as the “Hidden Prankster” as normal factors like poor posture can overload the back causing trigger points to form not only on the iliopsoas muscles but the hamstrings, gluteal, thoracolumbar paraspinal, and posterior cervical muscles. Trigger points can mimic other chronic conditions that cause referred pain in different body areas. Trigger point pain in the iliopsoas muscle can lead to back pain, groin pain, snapping hips, and standing up difficult for the individual if it is not treated immediately.

Treating Trigger Point Pain On The Thighs & Low Back

 

When trigger point pain begins to cause issues in the thighs and low back, the iliopsoas muscles will suffer from muscle spasms, stiffness, and difficulty standing. This is due to nerve entrapment from aggravated iliopsoas muscles caused by trigger points. However, various treatments can manage trigger point pain in the thighs, and low back through multiple techniques that pain specialists utilize can help relieve the pain symptoms from the iliopsoas muscle and manage trigger point pain. Studies reveal that combination treatments like soft tissue manipulation and trigger point therapy can help release the tiny nodules from the affected muscle and reduce the symptoms from re-occurring in the body. Other treatments, like correcting one’s posture, strength exercising, and even stretching, can help lengthen the iliopsoas muscles, stretch and strengthen the surrounding muscles, and prevent pain-like symptoms from affecting the thigh and low back muscles again. These various treatments can even improve hip mobility in the lower body extremities. 

 

Conclusion

In the lower body extremities, an iliopsoas is a group of deep muscles that provide stability to the lumbar spine and allow hip and thigh flexion. These groups of deep muscles can work individually or together to enable the individual to sit, stand and move around through physical activities; however, when the iliopsoas muscles become overused or suffer from a traumatic event, they can develop trigger points that can cause mobility issues on the thighs, hips, and lower back. Even though trigger points are difficult to diagnose, they are treatable through various treatments. Various treatments, like soft tissue massages, trigger point therapy, strength exercising, or stretching the iliopsoas muscles, can release trigger points from the affected body part and help bring back mobility function to the hips, thighs, and low back.

 

References

Bordoni, Bruno, and Matthew Varacallo. “Anatomy, Bony Pelvis and Lower Limb, Iliopsoas Muscle.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 2 Apr. 2022, www.ncbi.nlm.nih.gov/books/NBK531508/.

Dydyk, Alexander M, and Amit Sapra. “Psoas Syndrome.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 12 June 2022, www.ncbi.nlm.nih.gov/books/NBK551701/.

Kameda, Masahiro, and Hideyuki Tanimae. “Effectiveness of Active Soft Tissue Release and Trigger Point Block for the Diagnosis and Treatment of Low Back and Leg Pain of Predominantly Gluteus Medius Origin: A Report of 115 Cases.” Journal of Physical Therapy Science, The Society of Physical Therapy Science, Feb. 2019, www.ncbi.nlm.nih.gov/pmc/articles/PMC6382483/.

Lifshitz, Liran, et al. “Iliopsoas the Hidden Muscle: Anatomy, Diagnosis, and Treatment.” Current Sports Medicine Reports, U.S. National Library of Medicine, June 2020, pubmed.ncbi.nlm.nih.gov/32516195/.

Travell, J. G., et al. Myofascial Pain and Dysfunction: The Trigger Point Manual: Vol. 2:the Lower Extremities. Williams & Wilkins, 1999.

Disclaimer

Sacroiliac Joint Surgery: Sciatica Clinic

By
Dr. Alex Jimenez
-
Male doctor shows on the spine model the place where the intervertebral hernia appears

The function of the SI joints is to allow torsional or twisting movements when moving the legs that act as levers. Without the sacroiliac joints and the pubic symphysis at the front of the pelvis, which allow these precision movements, the pelvis would be at higher risk of a fracture. The sacroiliac joints transmit body weight and all the physical forces down through the sacrum to the hips and legs. Individuals, especially athletes with pain in the lower back, hip, groin, or leg, could be experiencing SIJ/sacroiliac joint dysfunction. A physician or surgeon could recommend sacroiliac joint surgery for severe SI joint dysfunction and pain that has not resolved with conservative treatment.

Sacroiliac Joint SurgerySacroiliac Joint Surgery

There are two sacroiliac joints. They connect the large iliac bones that make up the sides of the pelvis and the sacrum or triangle-shaped vertebrae between the iliac bones at the base of the spine. Pain in this area can come from sacroiliitis or inflammation of an SI joint, and referred pain may present. A doctor will consider causes such as:

  • Trauma
  • Sports
  • Biomechanical abnormalities
  • Wear and tear from weight-bearing stress
  • Pregnancy
  • Leg length discrepancy
  • Hypermobility
  • Systemic inflammatory conditions
  • Degenerative joint disease
  • Scoliosis
  • Infection, but this is rare.

Sports

There is a pathology of sacroiliac joint dysfunction in athletes. Sports that require repetitive and/or asymmetric loading that includes:

  • Kicking
  • Swinging
  • Throwing
  • Single-leg stance

Any athlete can develop sacroiliac joint dysfunction, but the highest prevalence activities include:

  • Soccer
  • Football
  • Basketball
  • Gymnastics
  • Golfing
  • Powerlifting
  • Cross-country skiing
  • Step aerobics
  • Stair stepper machines
  • Elliptical machines

Fusion Surgery

Surgery is not for patients with less than six months of confirmed localized pain or impairment with other causes ruled out. Surgery is the last option for SI joint pain unless it is an emergency. Doctors and surgeons will recommend non-invasive treatment methods before recommending surgery. Surgery recommendations come when the pain has become intolerable, and the individual can no longer move or operate.

  • Sacroiliac joint fusion is a minimally invasive procedure involving a small incision less than two inches long.
  • Under image guidance, titanium implants are inserted across the sacroiliac joint to provide stability.
  • Holes in the hardware allow for adding bone or for the bone to grow naturally across or onto the area to maintain stability.
  • This surgery can be either outpatient or overnight, depending on surgeon preference and the type of support available.

Surgery Recovery Time

For most individuals, recovery time is around three weeks on crutches.

  • Pain management depends on whether screws or bolts are involved; bolts tend to be more uncomfortable.
  • Post-op pain dissipates in a few days or a couple of weeks.
  • Fusion itself takes six or more months to complete.

Conservative Treatment Options

Conservative treatment modalities to reduce the inflammation can include:

  • Chiropractic
  • Physical therapy
  • Nonsurgical spinal decompression
  • Medications
  • Injections

Rest

  • Staying off your feet for a few days can help decrease pressure on the SI joint.
  • Using an ice or heating pad on the lower back and/or buttocks.
  • Massaging the surrounding muscles may help if the apparent cause is an injury.
  • A doctor could suggest using a cane, walker, or crutches under medical supervision.

Medications

  • Medications include anti-inflammatories such as ibuprofen, naproxen, or prescription alternatives.
  • Acetaminophen helps with pain but not inflammation.

Corticosteroids

  • Steroids are the most powerful anti-inflammatory.
  • A common nonsurgical treatment is cortisol steroids, injected under X-ray guidance.
  • Injections go directly to the source.
  • Oral steroids spread throughout the body but can cause undesirable side effects.

Chiropractic and Physical Therapy

  • Depending on the severity of the condition, chiropractic and physical therapy may be able to strengthen the muscles around the area and realign the joint.
  • A chiropractor will level the pelvis through sacroiliac joint manipulation and mobilization.

Sacroiliac Support Belt

  • Wearing a sacroiliac support belt may help remove the joint’s strain and relieve symptoms.
  • It works by applying compression around the hip and across the joint.

Back, Hip, and Radiating Pain

References

Brolinson, P Gunnar, et al. “Sacroiliac joint dysfunction in athletes.” Current sports medicine reports vol. 2,1 (2003): 47-56. doi:10.1249/00149619-200302000-00009

Heil, Jessica. “Load-Induced Changes of Inter-Limb Asymmetries in Dynamic Postural Control in Healthy Subjects.” Frontiers in human neuroscience vol. 16 824730. 11 Mar. 2022, doi:10.3389/fnhum.2022.824730

International Journal of Spine Surgery. (2020*) “International Society for the Advancement of Spine Surgery Policy 2020 Update—Minimally Invasive Surgical Sacroiliac Joint Fusion (for Chronic Sacroiliac joint Pain): Coverage Indications, Limitations, and Medical Necessity.” doi.org/10.14444/7156

Peebles, Rebecca DO1; Jonas, Christopher E. DO, FAAFP2. Sacroiliac Joint Dysfunction in the Athlete: Diagnosis and Management. Current Sports Medicine Reports: 9/10 2017 – Volume 16 – Issue 5 – p 336-342
doi: 10.1249/JSR.0000000000000410

Myofascial Trigger Pain Affecting The Quadratus Lumborum

By
Dr. Alex Jimenez
-

Introduction

The lower back works with the body’s lower extremities by stabilizing the hips and helping support the upper body’s weight. The lower back also has many functions when it comes to mobility. The lower back allows the person to bend, twist, and rotate the torso without any pain inflicted on the body. When normal factors or traumatic issues start to cause low back pain in the individual, the pain-like symptoms can correlate to the development of trigger points in the lower back muscles. Today’s article examines the quadratus lumborum, how myofascial trigger pain affects the low back, and how to manage myofascial trigger pain through various treatments. We refer patients to certified providers who incorporate multiple techniques in low back pain therapies related to trigger points to aid individuals dealing with pain symptoms along the quadratus lumborum in the lower back. We encourage and appreciate patients by referring them to our associated medical providers based on their diagnosis, especially when it is appropriate. We understand that education is an excellent solution to asking our providers complex questions at the patient’s request. Dr. Jimenez, D.C., utilizes this information as an educational service only. Disclaimer

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What Is The Quadratus Lumborum?

 

Have you been experiencing low back pain? Do you feel relief when you stretch your lower back, only to have the pain return later? Do you feel tenderness or soreness on the sides? Many of these complaints are correlated with low back pain associated with trigger points along the quadratus lumborum. The quadratus lumborum is a flat, quadrangular-shaped muscle in the iliac crest and deep back. This muscle plays an important part in the thoracolumbar fascia that covers the posterior body area while involving the lower and upper parts of the limbs. According to “Myofascial Pain and Dysfunction: The Trigger Point Manual,” written by Dr. Janet G. Travell, M.D., mentioned that the quadratus lumborum functions to control the side bending to the opposite side by lengthening contraction. Other studies reveal that various actions on the lumbar spine have been attributed to the quadratus lumborum. When the quadratus lumborum goes through these different actions, it can cause the muscles to become overused, or when injuries occur in the lower back, it can lead to various issues that can develop into overlapping conditions in the lower back.

 

Myofascial Trigger Pain Affecting The Low Back

 

When it comes to the lower back, many individuals worldwide experience some pain in their backs, and low back pain is common. Various factors cause low back pain from lifting heavy objects, over-exerting the sides with rapid turning, or even normal wear and tear of the body, which can cause lower back pain. When low back pain affects the quadratus lumborum, it can develop trigger points or myofascial trigger pain. Studies reveal that low back pain from the quadratus lumborum can present myofascial pain, causing the individual to have an acute pain episode in their lower back. Myofascial trigger pain is developed when the affected muscle has been overused and causes tiny knots to form along the muscle fibers. When myofascial trigger pain is in the quadratus lumborum, it becomes activated acutely through awkward movements or sudden trauma in the lower back, affecting the mobility of the lower back and the hips. Additional studies reveal that the prevalence of myofascial trigger pain in the quadratus lumborum, when being diagnosed, can display significantly less hip abduction strength. Low back pain associated with myofascial trigger pain can correlate with other chronic issues affecting the body’s lower extremities.

 

Trigger Point Release: Quadratus Lumborum- Video

Trigger Point Release - Quadratus Lumborum

Are you experiencing mobility issues in your hips? Do you feel symptoms of tenderness or stiffness in your lower back? Does it hurt when you are bending down to pick up an item? Most of these symptoms correlate with low back pain, potentially involving trigger points along the quadratus lumborum. Trigger points are formed when the muscle has been overused or been through a traumatic event like an auto accident, and since low back pain is common worldwide, it can mask other chronic conditions that overlap the pain. The video explains where the quadratus lumborum is located in the back, where the trigger points are marked, and how to manage the trigger points through manual manipulation while reducing pain away from the lower body. When myofascial trigger pain begins to wreak havoc on the affected muscles in the lower back. Various treatments applied to the lower back can help alleviate the symptoms caused by trigger points associated with the lower back along the quadratus lumborum.

Managing Myofascial Trigger Pain Through Various Treatments

 

Since low back pain is common worldwide and can potentially lead to the development of trigger points along the various lower back muscles, especially the quadratus lumborum, many individuals would utilize medication specifically for low back pain to reduce the pain symptoms; however, it only masks the pain caused by myofascial trigger pain. Studies reveal manual trigger-point therapy techniques that healthcare providers use to assess patients who are in pain from myofascial trigger pain. Many will go to a pain specialist to manage trigger points when the pain becomes too much for the individual. Another method that many people should utilize as part of their daily practice is doing gentle side stretching on the quadratus lumborum to loosen up the stiff muscles and reduce the chances of trigger points forming in the affected muscle in the future. 

 

Conclusion

The quadratus lumborum is a flat, quadrangular-shaped muscle in the iliac crest and deep back. This muscle helps with posterior mobility of the lower extremities and, when overused, can develop myofascial trigger pain associated with the low back. This can lead to various common back pain issues that affect how a person moves and become unstable when in motion. Fortunately, low back pain associated with myofascial trigger pain is treatable through various treatments that can reduce the pain and manage trigger points located in the low back. When people incorporate treatments to alleviate pain in their lower back, they will begin to experience relief and have their sense of purpose back in their lives.

 

References

Bordoni, Bruno, and Matthew Varacallo. “Anatomy, Abdomen and Pelvis, Quadratus Lumborum.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 18 July 2022, www.ncbi.nlm.nih.gov/books/NBK535407/.

de Franca, G G, and L J Levine. “The Quadratus Lumborum and Low Back Pain.” Journal of Manipulative and Physiological Therapeutics, U.S. National Library of Medicine, Feb. 11AD, pubmed.ncbi.nlm.nih.gov/1826922/.

Grover, Casey, et al. “Atraumatic Back Pain Due to Quadratus Lumborum Spasm Treated by Physical Therapy with Manual Trigger Point Therapy in the Emergency Department.” Clinical Practice and Cases in Emergency Medicine, University of California Irvine, Department of Emergency Medicine Publishing Western Journal of Emergency Medicine, 29 May 2019, www.ncbi.nlm.nih.gov/pmc/articles/PMC6682240/.

Phillips, S, et al. “Anatomy and Biomechanics of Quadratus Lumborum.” Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine, U.S. National Library of Medicine, Feb. 2008, pubmed.ncbi.nlm.nih.gov/18441751/.

Roach, Sean, et al. “Prevalence of Myofascial Trigger Points in the Hip in Patellofemoral Pain.” Archives of Physical Medicine and Rehabilitation, U.S. National Library of Medicine, Mar. 2013, pubmed.ncbi.nlm.nih.gov/23127304/.

Travell, J. G., et al. Myofascial Pain and Dysfunction: The Trigger Point Manual: Vol. 2:the Lower Extremities. Williams & Wilkins, 1999.

Disclaimer

Muscle Recovery Supplements: Chiropractic Sciatica Clinic

By
Dr. Alex Jimenez
-
Athletic woman takes supplements or vitamins in the form of capsules after training in the gym. Concept of additional nutrition during training

Workout recovery is as important as working out. Pushing muscle past its normal levels creates tiny tears in the muscle tissue. It is the repairing process that generates muscle growth. Muscles that aren’t allowed to recover will not grow or gain muscle mass, and muscle strength could be reduced, making working out a struggle and hindering health goal progress. The body needs time to repair the muscles to reduce the risk of injury. Allowing enough time for recovery reduces overuse-related muscle breakdown and injuries. Muscle recovery supplements can expedite the healing process.Muscle Recovery Supplements Chiropractic Clinic

Muscle Recovery Supplements

Reasons for taking supplements include their ability to heal damaged muscles faster, aid in injury recovery, reduce muscle soreness, reduce muscle fatigue, and provide the muscle cells with energy during recovery.

  • Certain supplements work by supporting or enhancing muscle protein synthesis.
  • Protein synthesis is the muscle cells’ process to make more protein.
  • Protein is the building block for muscle.
  • Increasing protein synthesis gives the body more blocks to use.
  • Other supplements help to reduce muscle soreness.
  • Sore muscles are common.
  • Soreness that occurs soon after working out is usually from lactic acid buildup.
  • There are supplements to help the body get rid of lactic acid faster.
  • There is delayed onset muscle soreness, or DOMS, which lasts longer.
  • Some supplements work on both types of sore muscles.

Supplement Types

The type of recovery supplements depends on the individual and their goals. Here are a few to consider.

Protein Supplement

  • Protein is the most useful supplement for muscle recovery.
  • It helps the muscle repair faster and more effectively after an intense workout.
  • It is important if there is a lack of protein in an individual’s diet.
  • Whey protein is the most popular because it includes essential amino acids.
  • Other options include soy, egg, rice, hemp, and pea.

Branched-Chain Amino Acid – BCAA

  • The body makes certain amino acids; there are a few it cannot make.
  • A BCAA supplement provides these essential amino acids that aid in recovery.
  • This supplement promotes muscle growth, helps ease sore muscles, and reduces muscle fatigue.

Fatty Acid

  • Fatty acids supply energy but also reduce inflammation.
  • A medium-chain triglyceride – MCT fatty acid helps reduce lactic acid buildup.
  • Omega-3 fatty acid reduces muscle fatigue and muscle soreness and provides injury protection.
  • Fatty acid supplements should be stored in a dark, cool place to maintain quality.

Creatine

  • Creatine turns into creatine phosphate, which the body uses for energy.
  • Some studies have found that taking a creatine supplement may aid muscle recovery and greater muscle strength during recovery.

Citrulline Malate

  • Citrulline is a non-essential amino acid found in watermelon that converts into nitric oxide.
  • Nitric oxide helps open blood vessels and improve blood circulation.
  • This allows oxygen and nutrients to reach the muscle faster, speeding the recovery process.
  • Citrulline also improves the bioavailability of L-arginine, another amino acid that aids protein synthesis.

Magnesium

  • Magnesium assists with muscle recovery by helping the muscles relax.
  • When the body doesn’t have enough magnesium, there is a greater chance of muscle cramps.
  • Magnesium helps support healthy muscle contraction.

Tart Cherry Juice Extract

  • This extract works by reducing inflammation in the muscle.
  • Inflammation is normal, but too much can increase muscle soreness and the risk of injury.
  • One study found that cherry juice helps minimize post-exercise muscle pain.

Supplement Plan

After selecting a supplement plan that is the most beneficial for the individual, the next step is to devise a schedule for taking them.

  • When using a muscle recovery supplement can either be a pre-workout supplement or a post-workout supplement.
  • The recommended time to take a specific supplement is based on the type.
  • Individuals should talk with their doctor and a nutritionist before starting any new supplement regimen.
  • This helps ensure the supplements are safe and minimize negative side effects given health and medical conditions.

Nutrition In Recovery

References

Cooke, M.B., Rybalka, E., Williams, A.D. et al. Creatine supplementation enhances muscle force recovery after eccentrically-induced muscle damage in healthy individuals. J Int Soc Sports Nutr 6, 13 (2009). doi.org/10.1186/1550-2783-6-13

DiNicolantonio, James J et al. “Subclinical magnesium deficiency: a principal driver of cardiovascular disease and a public health crisis.” Open heart vol. 5,1 e000668. 13 Jan. 2018, doi:10.1136/openhrt-2017-000668

Gough, Lewis A et al. “A critical review of citrulline malate supplementation and exercise performance.” European journal of applied physiology vol. 121,12 (2021): 3283-3295. doi:10.1007/s00421-021-04774-6

Kuehl, Kerry S et al. “Efficacy of tart cherry juice in reducing muscle pain during running: a randomized controlled trial.” Journal of the International Society of Sports Nutrition vol. 7 17. 7 May. 2010, doi:10.1186/1550-2783-7-17

Vitale, Kenneth C et al. “Tart Cherry Juice in Athletes: A Literature Review and Commentary.” Current sports medicine reports vol. 16,4 (2017): 230-239. doi:10.1249/JSR.0000000000000385

Weinert, Dan J. “Nutrition and muscle protein synthesis: a descriptive review.” The Journal of the Canadian Chiropractic Association vol. 53,3 (2009): 186-93.

Wolfe, Robert R. “Branched-chain amino acids and muscle protein synthesis in humans: myth or reality?.” Journal of the International Society of Sports Nutrition vol. 14 30. 22 Aug. 2017, doi:10.1186/s12970-017-0184-9

Zhang, Shihai, et al. “Novel metabolic and physiological functions of branched-chain amino acids: a review.” Journal of animal science and biotechnology vol. 8 10. 23 Jan. 2017, doi:10.1186/s40104-016-0139-z

Trigger Points Affecting The Lower Torso

By
Dr. Alex Jimenez
-

Introduction

The body’s lower extremities have a very important role as it helps support the upper body’s weight and provide stability to the lower body. The lower half of the body consists of the lower abdominals, hips, pelvic, and buttock regions, which have various muscles surrounding the lumbar and pelvic areas of the spine. These muscles help protect the lower vital organs and work with the central nervous system to utilize the sensory-motor function of the legs and feet. When normal factors like prolonged sitting or standing begin to affect the lower body, it can cause referred pain to travel down to the legs and push the lower extremities to develop symptoms associated with trigger points on the lower torso. Today’s article looks at the lower torso, how trigger points affect the lower torso, and therapeutic ways to manage trigger points in the lower torso. We refer patients to certified providers who incorporate various techniques in more inadequate body pain treatments related to trigger points to aid people suffering from pain-like symptoms along the lower torso muscles along the body’s lower extremities. We encourage and appreciate patients by referring them to our associated medical providers based on their diagnosis, especially when it is appropriate. We understand that education is an excellent solution to asking our providers complex questions at the patient’s request. Dr. Jimenez, D.C., utilizes this information as an educational service only. Disclaimer

Download

What Is The Lower Torso?

 

Have you been feeling stiffness around your hips lately? Have you noticed that you are leaning forward constantly, causing strain on your lower back? Or have you been experiencing pain in one location in your lower half? When dealing with these issues in the lower half of the body, it could correlate with somato-visceral symptoms associated with trigger points in the lower torso. The lower torso of the human body, or the lower abdominals, is defined as the anterior region of the trunk between the thoracic diaphragm and serves as the cavity to house the digestive, urinary, endocrine, and parts of the reproductive system. The lower torso has various muscles and nerves that surround the lower back, the hips, the pelvis, and the buttock region of the body that stabilizes the legs when in motion and supports the upper body. The muscles in the lower torso also surround the lumbar and pelvic areas of the spine to protect the joints and vertebrae from becoming dysfunctional. When issues begin to rise and affect the lower torso, it can lead to overlapping problems affecting the body’s lower extremities.

 

How Do Trigger Points Affect The Lower Torso?

 

Some of the issues affecting the lower torso that most people don’t realize are that prolonged sitting or standing can cause problems to the legs, hips, pelvis, and feet. This causes the blood supply to pool into the legs and feet, thus causing swelling and muscle weakness in the lower torso muscles. Another issue is when the lower torso has been through a traumatic event that can cause the affected muscles to develop tiny nodules known as trigger points to cause problems in the lower back, hips, pelvis, and buttock region of the body. Studies reveal that trigger points are often characterized by pain causing a limited range of motion in the joints while causing muscular contracture and mimicking other chronic conditions affecting the muscles. When trigger points affect the muscles in the lower torso, “Myofascial Pain and Dysfunction,” written by Dr. Janet Travell, M.D., pain associated with movement can cause tingling or electric sensations down to the lower extremities causing somato-visceral referred pain to the lower torso. Since the nerve roots from the spinal cord branch out to the various muscles and become irritated, causing referred pain to different areas of the lower extremities.

 

Trigger Point Therapy For The Abs- Video

Trigger Point Therapy - Treating the Abs

Have you been dealing with hip mobility issues? What about experiencing low back pain after being in a hunch position for an extended period? Or have you been experiencing problems in your pelvic region? Many of these issues are correlated with trigger points associated with the lower torso. Trigger points or myofascial pain syndrome are caused when the affected muscles have been overused or been through a traumatic event that causes referred pain to different body locations. The video explains where trigger points are located in the lower torso, especially in the abdomen and how to release them through palpations and massage. These techniques can help reduce the pain symptoms that affect the lower torso and manage myofascial pain from developing in the future.

Therapeutic Ways To Manage Trigger Points In The Lower Torso

 

Pain specialists like chiropractors and massage therapists will use various techniques to reduce the pain and alleviate the trigger points from the affected muscles. Many often go to a pain specialist who deals with trigger points through recommendations by their primary doctor. They will go through an examination process and explain to the pain specialist where the pain is located. Afterward, they will devise a treatment plan with the patient’s primary doctor, allowing them to follow a routine to prevent the pain from returning. Various techniques like stretching the abdominals, exercising, and resting can manage trigger points from returning to the affected muscles and even help bring muscle strength back to the body.

 

Conclusion

The lower torso consists of the hips, lower back, pelvis, and buttock region while protecting the body’s vital organs. The lower torso helps stabilize, the lower body extremities and supports the upper body’s weight. When normal issues like prolonged sitting or standing start to cause muscle strain to the lower torso region, it can develop trigger points to cause various problems to that region and cause mobility issues in the lower abdominal area. When the pain becomes unbearable, many individuals go to a pain specialist to help manage the trigger points from affecting the lower torso region and bring back mobility function to the lower extremities.

 

References

Akamatsu, Flavia Emi, et al. “Anatomical Basis of the Myofascial Trigger Points of the Gluteus Maximus Muscle.” BioMed Research International, Hindawi, 2017, www.ncbi.nlm.nih.gov/pmc/articles/PMC5733974/.

Travell, J. G., et al. Myofascial Pain and Dysfunction: The Trigger Point Manual: Vol. 2:the Lower Extremities. Williams & Wilkins, 1999.

Wade, Christian I, and Matthew J Streitz. “Anatomy, Abdomen and Pelvis, Abdomen – Statpearls – NCBI Bookshelf.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 25 July 2022, www.ncbi.nlm.nih.gov/books/NBK553104/.

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