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Back Pain Mattress: Finding the Perfect Balance for Healthy Sleep

By
Dr. Alex Jimenez
-
A beautiful young couple chooses a new mattress in a store.

What is the recommended way to choose a mattress for individuals with back pain?

 

Back Pain Mattress: Finding the Perfect Balance for Healthy Sleep

Back Pain Mattress

When choosing a back pain mattress, one size does not fit all in selecting one for those with spine pain. Several other factors play a role, as well. However, whether a firm or soft mattress is the best option for individuals whose back pain keeps them up at night, most health experts say the choice is yours and that the mattress that makes you feel most comfortable is likely the best option. The research says that medium firmness seems to provide the most painless sleep. A review gathered information from 24 controlled trials where participants used soft, medium-firm, firm, or custom-inflated mattresses. The results showed that medium-firm and self-adjusted mattresses were best for sleep comfort, quality, and spinal alignment. (Radwan A. et al., 2015)

Medical Status

Selecting the back pain mattress best suited to your spinal condition is more than just how hard or soft the mattress is. Individuals and their healthcare providers should thoroughly review their medical history to tailor the mattress to their needs. Before purchasing a mattress, check the following:

  • Age
  • Medical history
  • Injuries current and past
  • Current diagnosis or diagnoses
  • Disease and/or Conditions
  • Sleeping preferences

For example, symptoms of spinal stenosis tend to present themselves when one is standing and walking but not when lying down. For this reason, mattress firmness is not a big issue only for people with spinal stenosis. However, it must be taken into consideration for those who have degeneration along with spinal stenosis.

Individuals with spinal arthritis without stenosis, disc problems, or non-specific back pain need to consider the relative firmness or softness of the back pain mattress. People with these conditions do better with more support, i.e., a firmer mattress. While everyone needs some back support when they sleep, those who have undergone multiple back surgeries often need less. The tissues have been altered and may be stiffer after several surgeries. In this case, a softer mattress may be more suitable and comfortable.

Mattress Age

Mattress springs break down over time, which makes the bed softer. This can aggravate the spine and back muscles. Based on this, investing in a new mattress makes sense, or pain and stiffness can worsen with the current one. While this will vary among individuals, medical research may help shed some light: A study measured the comfort and quality of sleep for 27 participants with low back pain and stiffness. The participants recorded their sleep comfort and quality in their beds for 21 days and then with a new prescribed mattress and bedding system, which they used for 12 weeks. The study found that the participants showed significant and progressive improvement in back pain and stiffness on the new mattresses and improved sleep quality significantly. (Jacobson B. H. et al., 2010)

Sleeping Position

The position usually slept in makes a difference in the support needed for the back pain mattress. Some recommendations for back sleepers, side and fetal position sleepers, and stomach sleepers:

Side Sleepers

  • Most people are side sleepers.
  • They sleep in the fetal position with their knees drawn up toward their chest.
  • This position tends to place pressure on the hips and shoulders.
  • For side and fetal sleepers, a slightly softer mattress is recommended.
  • The foam the mattress is made of conforms to the body, especially in the thoracic and lumbar regions of the spine.

Stomach Sleepers 

  • For the stomach sleeper, soft mattresses can irritate the back.
  • A soft mattress encourages the abdomen to sink into the bed.
  • The resulting position is known to increase the arch in the lower back and cause pain.
  • A medium-firm surface is good for stomach sleepers.
  • The idea is to derive support from the chosen mattress without the abdominal sinking.
  • The sinking effect is amplified if you have a large abdomen.
  • For thin individuals, sinking may not be as much of an issue.

Back Sleepers

  • For support, place a thin, rolled towel or pillow under the knees and lower back of those who sleep on their backs.
  • A pillow/s under these areas will help support them and provide more comfort.

Researchers divided the participants according to their usual sleep position. They were assigned to a medium-firm mattress with foam and latex layering based on their preferred sleep position. The participants rated their sleep comfort and quality daily for three months. The researchers found that the new mattresses improved back pain and stiffness. For this reason, they concluded that sleep surfaces relate to sleep discomfort and that replacing a mattress with one uniquely suitable to your spinal condition can reduce and relieve pain. (Jacobson B. H. et al., 2010)

Injury Medical Chiropractic and Functional Medicine Clinic

Choosing the right back pain mattress ultimately comes down to personal preference. Individuals should try various mattresses and see which one they like best. Individuals who struggle with sleep or other sleep disorders that impact their ability to get restful sleep should consult with their healthcare provider about getting an assessment and treatment. Injury Medical Chiropractic and Functional Medicine Clinic can help individuals recover and regain the benefits of quality rest through healthy sleep practices and lifestyle accommodations. We build optimal health and wellness solutions with primary healthcare providers and specialists. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

Chiropractic Care Can Transform Pain Into Relief

References

Radwan, A., Fess, P., James, D., Murphy, J., Myers, J., Rooney, M., Taylor, J., & Torii, A. (2015). Effect of different mattress designs on promoting sleep quality, pain reduction, and spinal alignment in adults with or without back pain; systematic review of controlled trials. Sleep health, 1(4), 257–267. doi.org/10.1016/j.sleh.2015.08.001

Jacobson, B. H., Boolani, A., Dunklee, G., Shepardson, A., & Acharya, H. (2010). Effect of prescribed sleep surfaces on back pain and sleep quality in patients diagnosed with low back and shoulder pain. Applied ergonomics, 42(1), 91–97. doi.org/10.1016/j.apergo.2010.05.004

Exploring Nonsurgical Treatments for Piriformis Syndrome

By
Dr. Alex Jimenez
-

Can non-surgical treatments help individuals with piriformis syndrome reduce referred sciatica pain and help restore hip mobility?

Piriformis Muscle & Piriformis Syndrome

Within the lower extremities, various muscles, ligaments, tendons, and nerve roots allow the legs, hips, and thighs, enabling individuals to be mobile and help with good posture. One of the muscles, known as the piriformis muscle, is located in the gluteal region of the lower body, which helps the major muscles with every movement and allows the individual to walk, run, and rotate at the hips. (Chang et al., 2024) At the same time, the piriformis muscle is over the sciatic nerve, the longest and largest nerve that travels through the lower limbs down to the heel and provides motor-sensory function to the lower limbs. (Giuffre et al., 2024) Environmental factors like physical inactivity, excessive sitting or standing, lifting heavy objects, or improper posture can affect the piriformis muscle and develop musculoskeletal issues in the lower extremities. We associate with certified medical providers who inform our patients of the effects of piriformis syndrome, which affects their lower body extremities and causes pain and discomfort. While asking important questions to our associated medical providers, we advise patients to incorporate various non-surgical therapies to reduce the pain-like symptoms associated with piriformis syndrome. Dr. Alex Jimenez, D.C., envisions this information as an academic service. Disclaimer.

 

 

Have you experienced a pins and needles sensation in your hips and thighs that make it unbearable to walk? Do you feel radiating pain that travels down to your feet? Or have you noticed tightness in your hips and glutes region when stretching? When environmental factors impact the body, especially in the upper and lower extremities, they can cause overlapping risk profiles that can develop into chronic conditions. So, environmental factors affecting the piriformis muscle can lead to a musculoskeletal condition called piriformis syndrome. Piriformis syndrome is a somatic and neuropathic musculoskeletal condition caused by excessive or prolonged contraction of the piriformis muscle. (Jankovic et al., 2013) Many individuals who have dealt with piriformis syndrome will begin to report pain in the gluteal region that is causing sensations down the leg that can compress the sciatic nerve. (Hicks et al., 2024)

 

What Triggers Piriformis Syndrome?

Three causing factors can trigger piriformis syndrome in the lower extremities. Environmental factors like excessive movement, physical inactivity, or musculoskeletal conditions can compress the sciatic nerve over time, entrapping it and causing gradual pain. Additionally, trigger points in the muscles caused by repetitive strain can lead to muscle spasms or inflammation to irritate the sciatic nerve, which may present with a different musculoskeletal condition. (Pfeifer & Fitz, 1989) Finally, many people will begin to think that the pain they are experiencing is sciatica pain instead of piriformis syndrome.

 

Sciatica-Like Symptoms

Now, sciatica and piriformis syndrome are completely different but have similar symptoms that cause them to correlate. Sciatica is caused by spinal issues affecting the lower back that causes radiating pain down the leg. Piriformis syndrome only involves the piriformis muscle pressing one sciatic nerve area, causing overlapping risk profiles. Some of the common symptoms both sciatica and piriformis are associated with include:

  • Numbness
  • Tingling & burning sensations
  • Inflammation
  • Muscle spasms & tenderness
  • Pain & discomfort when sitting or standing

 

Sciatica: Causes, Symptoms, & Tips- Video

Sciatica, Causes, Symptoms and tips| El Paso, Tx (2023)

Non-Surgical Treatments For Piriformis

Luckily, numerous treatments are non-surgical and can help many individuals with piriformis syndrome find relief. Non-surgical treatments are affordable and non-invasive, customized to the person’s pain. With piriformis syndrome, non-surgical treatments can help improve pain and functionality back to the lower extremities and provide symptomatic relief from the piriformis muscle. (Vij et al., 2021) Some of the non-surgical treatments that are excellent for reducing pain-like symptoms associated with piriformis include:

  • Physical Therapy: Physical therapies allow the muscles to be mobilized and stretched and decompress the musculoskeletal structures. (Gandolfi et al., 2023)
  • Acupuncture: A trained acupuncturist incorporates small needles into the acupoints around the piriformis and provides anti-inflammatory effects. (He et al., 2023)
  • Chiropractic Adjustments: Chiropractors utilize mechanical and manual spinal manipulation to realign the body, stretch and strengthen the affected muscles, and alleviate pain.
  • Rest: Avoiding strenuous activities and sleeping on the right mattress can help reduce spinal pain associated with piriformis syndrome and improve sleep quality.

Incorporating these non-surgical treatments to reduce piriformis syndrome can help many individuals be more mindful of their bodies daily. They can be part of a daily routine in a person’s health and wellness journey in managing piriformis syndrome and reducing its pain-like symptoms. Doing so allows the lower extremities to be mobile again and the individual to be pain-free.

References

Chang, C., Jeno, S. H., & Varacallo, M. (2024). Anatomy, Bony Pelvis and Lower Limb: Piriformis Muscle. In StatPearls. www.ncbi.nlm.nih.gov/pubmed/30137781

Gandolfi, M. G., Zamparini, F., Spinelli, A., & Prati, C. (2023). Asana for Back, Hips and Legs to Prevent Musculoskeletal Disorders among Dental Professionals: In-Office Yoga Protocol. J Funct Morphol Kinesiol, 9(1). doi.org/10.3390/jfmk9010006

Giuffre, B. A., Black, A. C., & Jeanmonod, R. (2024). Anatomy, Sciatic Nerve. In StatPearls. www.ncbi.nlm.nih.gov/pubmed/29494038

He, Y., Miao, F., Fan, Y., He, J., Zhang, F., Wang, Z., Wu, Y., Zhao, Y., & Yang, P. (2023). Analysis of Acupoint Selection and Combinations in Acupuncture Treatment of Piriformis Syndrome: A Protocol for Data Mining. J Pain Res, 16, 3265-3272. doi.org/10.2147/JPR.S422857

Hicks, B. L., Lam, J. C., & Varacallo, M. (2024). Piriformis Syndrome. In StatPearls. www.ncbi.nlm.nih.gov/pubmed/28846222

Jankovic, D., Peng, P., & van Zundert, A. (2013). Brief review: piriformis syndrome: etiology, diagnosis, and management. Can J Anaesth, 60(10), 1003-1012. doi.org/10.1007/s12630-013-0009-5

Pfeifer, T., & Fitz, W. F. (1989). [The piriformis syndrome]. Z Orthop Ihre Grenzgeb, 127(6), 691-694. doi.org/10.1055/s-2008-1040313 (Das Piriformis-Syndrom.)

Vij, N., Kiernan, H., Bisht, R., Singleton, I., Cornett, E. M., Kaye, A. D., Imani, F., Varrassi, G., Pourbahri, M., Viswanath, O., & Urits, I. (2021). Surgical and Non-surgical Treatment Options for Piriformis Syndrome: A Literature Review. Anesth Pain Med, 11(1), e112825. doi.org/10.5812/aapm.112825

Disclaimer

Discover the Power of Sleep Sounds for a Good Night’s Rest

By
Dr. Alex Jimenez
-
Nothing soothes the soul like a deep sleep. Shot of a young man sleeping peacefully in bed at home

Can listening to sleep sounds help achieve and maintain healthy sleep patterns for individuals having trouble sleeping?

Discover the Power of Sleep Sounds for a Good Night's Rest

Sleep Sounds

Sleep sounds include white, pink, green, or brown noise, binaural beats, ASMR, nature, and ambient sounds. Each has different benefits and can potentially improve sleep. (Ebben M. R., Yan P., & Krieger A. C. 2021) Sound has no color, but it follows a spectrum. The color of a sound refers to the power spectrum of a particular noise signal. Each color has different qualities.

  • White noise, such as an untuned radio or television, is the most well-known background noise and is often used as a sleep aid.
  • Green noise features more powerful mid-range frequencies.
  • Brown noise is a more low-frequency rumble deeper than green and white noise.
  • Pink noise combines white noise softened by brown and could be the most effective option for improving sleep.

White noise is a sound that includes all the audible frequencies at equal volume, like a continuous hiss. One study found that adults fell asleep faster while listening to white noise. (Messineo L. et al., 2017)

Green noise, which features more powerful mid-range frequencies, is similar to natural sounds like ocean waves, rainfall, and rustling leaves. It’s more soothing than white noise and can help individuals with anxiety sleep better.

Brown noise, also known as red noise, has a deeper tone than white noise and is similar to the hum of an airplane. It can help mask lower-pitched sounds and may be especially helpful for individuals with ADHD, as it aids in productivity and concentration. Brown noise mimics sounds found in nature but with a low-frequency rumble. Examples include heavy rainfall, thunder, or loud waves.

Pink Noise

While further scientific research on sleep noise is needed, evidence has begun to suggest that pink noise may be the most effective option for improving sleep. (Ong J. L. et al., 2016) Pink noise is softer and more soothing than the other colored sleep sounds. It combines white noise softened by brown noise and is considered more relaxing because of its lower pitch. It has a pleasant-sounding, balanced volume across frequencies, making it calming to the human ear. Pink noise includes digital recreations of natural sounds such as a gently flowing stream, soft rain falling, wind rustling through trees, or calm waves lapping at the shore.

In a study, adults over 60 were given intermittent bursts of pink noise while sleeping, similar to rushing water. (Papalambros N. A. et al., 2017) The following morning, participants were given memory tests, which indicated that retention levels were approximately three times greater than those of the control group not exposed to the pink noise. Another study found that steady pink noise significantly reduced brain wave complexity during sleep while improving stable sleep time with less fragmentation and fewer wake periods. (Zhou, J. et al., 2012)

Injury Medical Chiropractic and Functional Medicine Clinic

Choosing the right sound for you ultimately comes down to personal preference. Individuals can try each color and see which one they like best. Individuals who struggle with sleep or other sleep disorders that impact their ability to get restful sleep should consult with their healthcare provider about getting an assessment and treatment to restore health. Individuals can recover and regain the benefits of quality rest through healthy sleep practices and lifestyle accommodations. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

Beyond Medicine: The Power of Chiropractic Care

References

Ebben, M. R., Yan, P., & Krieger, A. C. (2021). The effects of white noise on sleep and duration in individuals living in a high noise environment in New York City. Sleep medicine, 83, 256–259. doi.org/10.1016/j.sleep.2021.03.031

Messineo, L., Taranto-Montemurro, L., Sands, S. A., Oliveira Marques, M. D., Azabarzin, A., & Wellman, D. A. (2017). Broadband Sound Administration Improves Sleep Onset Latency in Healthy Subjects in a Model of Transient Insomnia. Frontiers in neurology, 8, 718. doi.org/10.3389/fneur.2017.00718

Ong, J. L., Lo, J. C., Chee, N. I., Santostasi, G., Paller, K. A., Zee, P. C., & Chee, M. W. (2016). Effects of phase-locked acoustic stimulation during a nap on EEG spectra and declarative memory consolidation. Sleep medicine, 20, 88–97. doi.org/10.1016/j.sleep.2015.10.016

Papalambros, N. A., Santostasi, G., Malkani, R. G., Braun, R., Weintraub, S., Paller, K. A., & Zee, P. C. (2017). Acoustic Enhancement of Sleep Slow Oscillations and Concomitant Memory Improvement in Older Adults. Frontiers in human neuroscience, 11, 109. doi.org/10.3389/fnhum.2017.00109

Zhou, J., Liu, D., Li, X., Ma, J., Zhang, J., & Fang, J. (2012). Pink noise: effect on complexity synchronization of brain activity and sleep consolidation. Journal of theoretical biology, 306, 68–72. doi.org/10.1016/j.jtbi.2012.04.006

Eating Habits and Insomnia: Exploring the Connection

By
Dr. Alex Jimenez
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A woman makes a salad of fresh vegetables, squeezes the juice of a lemon, the concept of diet and healthy eating.

Insomnia is a condition with causes that vary from person to person and can be a result of stress, caffeine, and excessive screen time. Can modifying eating habits help reduce episodes and improve sleep patterns?

Eating Habits and Insomnia: Exploring the Connection

 

Eating Habits and Insomnia

Insomnia is a common sleep disorder characterized by persistent difficulty falling asleep, staying asleep, and/or both. Individuals often experience daytime sleepiness, mood disturbances, or cognitive impairments. There are two types:

  • Primary insomnia, which is not linked to other health conditions.
  • Secondary insomnia is associated with other health issues like asthma, depression, or heartburn. (National Library of Medicine, 2024)

While there are various causes of insomnia, researchers have recently learned more about its impact on eating habits. New data has found that an individual’s dietary pattern may impact sleep habits. (Gan Z. H. et al., 2024)

Risk Factors

Chronic insomnia is linked to negative health outcomes, including an increased risk of high blood pressure, diabetes, obesity, depression, heart attack, and stroke. (Chalet F. X. et al., 2023) (Marie-Pierre St-Onge et al., 2016) Researchers recruited over five thousand participants who did not have insomnia and evaluated their eating habits and insomnia incidence. (Gan Z. H. et al., 2024) Results showed that 464 of the participants developed insomnia, and of those, the risk was lower in vegetarians than those who ate more meat. Males who followed a more plant-based diet had a reduced incidence of insomnia; however, this relationship was not seen among females. The research suggests that a diet with more vegetables may positively affect sleep. Many plant-based foods are rich sources of sleep-supporting compounds, such as melatonin. Treating and preventing insomnia is important for restoring health and daily functioning.

Past nutritional data highlights the relationship between healthy sleep and a diet rich in fruits, vegetables, legumes, and other sources of tryptophan and melatonin. (Zuraikat F. M. et al., 2021) Prior research also shows how vegetarian diets can help reduce chronic inflammation, positively impacting sleep. (Dzierzewski J. M. et al., 2020) Specifically, the Mediterranean diet, known for its anti-inflammatory effects, is linked to improved sleep and reduced insomnia. (Zaidalkilani A. T. et al., 2021) Also, data links a vegetarian diet to improved mood, which might enhance the quality of sleep by moderating mental health, including depression condition. (Wang X. et al., 2023)

Support Quality Sleep

According to dieticians, looking at an individual’s eating habits during the day is crucial in determining why they can’t sleep at night. Often, making a few small dietary adjustments is enough to help with better sleep. Some steps to try include:

  • Increase magnesium by adding more leafy greens, nuts, and seeds.
  • Incorporating melatonin-rich foods like walnuts rather than relying on melatonin supplements.
  • Easing off caffeine, alcohol, and refined carbohydrates can help improve sleep quality.

Dietary changes should not be the only way to combat insomnia. Cognitive behavioral therapy (CBT-I) is a recommended first-line treatment rather than sleeping medications, along with learning healthy sleep habits and using the right mattress. This therapy can help improve sleep habits and behaviors by rethinking sleep and current practices that could affect an individual’s ability to sleep well. Combining CBT-I with a healthy diet and regular physical activity can significantly impact overall health and sleep patterns.

Injury Medical Chiropractic and Functional Medicine Clinic

Individuals who struggle with insomnia or other sleep disorders that impact their ability to get restful sleep should consult with their healthcare provider about getting an assessment and treatment to avoid deprivation side effects and restore health. A chiropractic therapy team can assess your condition and develop a customized treatment plan. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body heal.

Revolutionizing Healthcare

References

National Library of Medicine: MedlinePlus. (2024). Insomnia. Retrieved from medlineplus.gov/insomnia.html

Gan, Z. H., Chiu, T. H. T., Lin, C. L., Lin, M. N., & Kuo, P. H. (2024). Plant-based dietary patterns and risk of insomnia: a prospective study. European journal of clinical nutrition, 78(3), 228–235. doi.org/10.1038/s41430-023-01380-x

Chalet, F. X., Saskin, P., Ahuja, A., Thompson, J., Olopoenia, A., Modi, K., Morin, C. M., & Wickwire, E. M. (2023). The Associations between Insomnia Severity and Health Outcomes in the United States. Journal of clinical medicine, 12(6), 2438. doi.org/10.3390/jcm12062438

St-Onge, M. P., Grandner, M. A., Brown, D., Conroy, M. B., Jean-Louis, G., Coons, M., Bhatt, D. L., & American Heart Association Obesity, Behavior Change, Diabetes, and Nutrition Committees of the Council on Lifestyle and Cardiometabolic Health; Council on Cardiovascular Disease in the Young; Council on Clinical Cardiology; and Stroke Council (2016). Sleep Duration and Quality: Impact on Lifestyle Behaviors and Cardiometabolic Health: A Scientific Statement From the American Heart Association. Circulation, 134(18), e367–e386. doi.org/10.1161/CIR.0000000000000444

Zuraikat, F. M., Wood, R. A., Barragán, R., & St-Onge, M. P. (2021). Sleep and Diet: Mounting Evidence of a Cyclical Relationship. Annual review of nutrition, 41, 309–332. doi.org/10.1146/annurev-nutr-120420-021719

Dzierzewski, J. M., Donovan, E. K., Kay, D. B., Sannes, T. S., & Bradbrook, K. E. (2020). Sleep Inconsistency and Markers of Inflammation. Frontiers in neurology, 11, 1042. doi.org/10.3389/fneur.2020.01042

Zaidalkilani, A. T., Alhaj, O. A., Serag El-Dine, M. F., Fekih-Romdhane, F., AlRasheed, M. M., Jahrami, H. A., & Bragazzi, N. L. (2021). Arab Women Adherence to the Mediterranean Diet and Insomnia. Medicina (Kaunas, Lithuania), 58(1), 17. doi.org/10.3390/medicina58010017

Wang, X., Song, F., Wang, B., Qu, L., Yu, Z., & Shen, X. (2023). Vegetarians have an indirect positive effect on sleep quality through depression condition. Scientific reports, 13(1), 7210. doi.org/10.1038/s41598-023-33912-7

Long Thoracic Nerve: An Essential Nerve for Shoulder Mobility

By
Dr. Alex Jimenez
-
chiropractor stretching arm of handsome patient in hospital

Can understanding the anatomy and function of the long thoracic nerve help individuals make informed healthcare decisions after an injury to the nerve?

Long Thoracic Nerve: An Essential Nerve for Shoulder Mobility

Long Thoracic Nerve

Also referred to as the posterior thoracic nerve, the long thoracic nerve/LTN is a thin superficial nerve that runs from the cervical spine to the chest wall side of the trunk. It supplies motor function to the thorax’s serratus anterior muscle, helping stabilize the shoulder blade. Injury to this nerve can cause limited or abnormal shoulder and shoulder blade motion, including difficulty raising the arm during overhead reaching.

Anatomy

The long thoracic nerve originates from the ventral rami of cervical nerves C5, C6, and C7. (Waxenbaum JA, Reddy V, Bordoni B. 2023) In some individuals, the root from C7 is absent; in others, a small nerve root branches from C8. The nerve roots from C5 and C6 go through the medial scalene muscle to join the C7 nerve. It travels behind the brachial plexus axillary artery and vein and courses down the lateral side of the thorax. The long thoracic nerve terminates at the lower portion of the serratus anterior muscle, sending small nerve tendrils to each muscle’s projections, which attach to the ribs. Because the long thoracic nerve is located on the lateral side of the chest, it is vulnerable to injury during sports or surgical procedures. The nerve also has a smaller diameter than other cervical and brachial plexus nerves, which increases its potential for injury.

Function

The long thoracic nerve attaches to the underside of the shoulder blade and inserts as muscular slips into the ribs. It supplies motor function to the serratus anterior muscle, essential for normal shoulder motion. When it contracts, it pulls the shoulder blade against the ribs and thorax, helping to move and stabilize the arm as it moves forward and up during shoulder motions. Injury to the long thoracic nerve causes a condition called scapular winging. This occurs when the serratus anterior muscle becomes weakened or paralyzed after injury. (Lung K, St Lucia K, Lui F. 2024)

Susceptibility to Injury

The LTN is relatively unprotected and can be damaged by several things, including:

  • Heavy backpacks
  • Sports
  • Activities the body is not used to, like digging
  • Using crutches

Conditions

Injury to the long thoracic nerve may occur as a result of trauma, lifting heavy weights above the shoulder, or a surgical procedure. Surgical procedures that may place the nerve at risk for injury may include: (Lung K, St Lucia K, Lui F. 2024)

  • Axillary lymph node dissection
  • Improperly placed intercostal drains
  • Chest tube placements
  • Mastectomy
  • Thoracotomy

The long thoracic nerve is protected during these procedures by the surgeon and proper surgical technique, but occasionally, difficulties arise during surgery, and the nerve may become injured. Individuals may also have an anatomical variance that places their nerves in varying positions. The surgeon may not see it and accidentally injure their nerves during surgery.

The superficial long thoracic nerve may also be injured during sports or trauma to the trunk. A blow to the side or a sudden overhead stretch to the shoulder may be enough to damage the nerve, paralyzing the serratus anterior muscle.

Weakness or paralysis of the serratus anterior muscle will result in a winged scapula. To test for this:

  • Stand about two feet from a wall, facing it.
  • Place both hands on the wall and gently push against it.
  • If one of the shoulder blades sticks out abnormally, it could be a winged scapula.
  • Have a family member or friend stand behind you and check the shoulder blade position.
  • If you suspect a winged scapula, visit a physician who can assess the condition and determine if there is a long thoracic nerve injury.

Winging the scapula may result in difficulty lifting the arm overhead. The serratus anterior muscle works with other scapular stabilizers, such as the upper trapezius and levator scapula, to properly position the shoulder blade when lifting the arm. Failure of the serratus to stabilize the shoulder blade may make lifting the arm impossible.

Clinical examination is usually used to diagnose a long thoracic nerve injury. X-rays and MRIs cannot show the nerve injury directly, although an MRI can show some secondary signs to help confirm the diagnosis. An electromyographic or EMG test may also be performed to examine the function of the long thoracic nerve.

Treatment and Rehabilitation

Treatment for LTN pain and reduced movement may include:

  • Rest
  • Heat or ice
  • Anti-inflammatory pain medication
  • Neck support or a pillow
  • Avoiding strenuous activity and driving

If the long thoracic nerve is severely injured and the serratus anterior is completely paralyzed, the best course of action is to be active and monitor the condition. Full recovery of arm function can take one to two years. If permanent nerve injury has occurred, surgery may be an option to restore shoulder motion and function. Several different kinds of surgery can be used to address winged scapula. (Vetter M. et al., 2017)

  • One involves transferring the pectoralis major tendon to the scapula (Vetter M. et al., 2017) so it functions as the serratus.
  • Often, the tendon has to be lengthened, which may be done using part of the hamstring tendon.
  • After surgery, individuals will likely wear a sling on their arm for a few weeks, and then gentle range-of-motion exercises will be initiated.
  • After eight to ten weeks, gentle progressive strengthening of the new tendon can begin.
  • Full shoulder motion and strength recovery are expected six to 12 months after surgery.

Physical therapy may be used to help improve serratus anterior functions. (Berthold J. B., Burg T. M., & Nussbaum R. P. 2017) Exercises to strengthen serratus function may include:

Supine Punches

  • Lie on your back and raise both arms toward the ceiling.
  • Make a fist and punch up toward the ceiling.
  • Ensure the motion is steady and deliberate, and keep the elbow straight.
  • Hold the position for three seconds, then slowly lower the arm to the starting position.
  • Perform 10 to 15 repetitions.
  • Holding a small dumbbell in your hands can make the exercise more challenging.

Pushup

  • Lie on your stomach and place your hands flat on the ground by your shoulders as if you were going to perform a pushup.
  • Perform a pushup and press further, allowing the shoulder blades to wrap around the thorax.
  • Hold this position for three seconds, and slowly release.
  • Perform 10 to 15 reps.
  • If this is too difficult, perform the pushup against a wall to reduce the effect of gravity on the exercise.

Scapular Winging in Depth

References

Waxenbaum, J. A., Reddy, V., & Bordoni, B. (2024). Anatomy, Head and Neck: Cervical Nerves. In StatPearls. www.ncbi.nlm.nih.gov/pubmed/30844163

Lung, K., St Lucia, K., & Lui, F. (2024). Anatomy, Thorax, Serratus Anterior Muscles. In StatPearls. www.ncbi.nlm.nih.gov/pubmed/30285352

Vetter, M., Charran, O., Yilmaz, E., Edwards, B., Muhleman, M. A., Oskouian, R. J., Tubbs, R. S., & Loukas, M. (2017). Winged Scapula: A Comprehensive Review of Surgical Treatment. Cureus, 9(12), e1923. doi.org/10.7759/cureus.1923

Berthold, J. B., Burg, T. M., & Nussbaum, R. P. (2017). Long Thoracic Nerve Injury Caused by Overhead Weight Lifting Leading to Scapular Dyskinesis and Medial Scapular Winging. The Journal of the American Osteopathic Association, 117(2), 133–137. doi.org/10.7556/jaoa.2017.025

Learn How to Get a Full Night’s Rest and Reduce Insomnia

By
Dr. Alex Jimenez
-

Can individuals with insomnia find various ways to reduce its effects, such as a full night’s rest and promoting healthy sleep habits?

Insomnia

Many people have often struggled to get a full night’s sleep occasionally, as environmental factors can keep them from falling asleep, making them tired throughout the day. In most cases, many individuals sometimes suffer from a chronic condition known as insomnia. Insomnia is a common sleep disorder, whether short-term or chronic, and it can negatively impact a person’s ability to sleep and stay asleep. (Dopheide, 2020) Insomnia can be in two forms: primary and secondary. Primary insomnia is a fairly common condition that can be resolved without treatment, while secondary insomnia is due to medication side effects or neurological issues that are causing sleep issues. Additionally, insomnia can be developed through various environmental factors like genetic variants, early life stress, major life events, and brain functions and structures that can cause individuals to be vulnerable and have insomnia. (Van Someren, 2021) We associate with certified medical providers who inform our patients of the effects of insomnia that can affect the body when they are not getting enough sleep. While asking important questions to our associated medical providers, we advise patients to incorporate healthy sleeping habits into their treatment plan to reduce insomnia and get proper sleep. Dr. Alex Jimenez, D.C., envisions this information as an academic service. Disclaimer.

 

How It Affects The Body

 

So, how does insomnia affect the body and a person’s daily routine? Well, when environmental factors start to impact a person, it can cause overlapping risk profiles in the body that can develop into mental disorders like depression. There is a bi-directional relationship between insomnia and depression, as it can cause sleep alterations that can affect the nervous system and develop into chronic conditions. (Riemann et al., 2020) Some of the symptoms that insomnia can affect the body include: (Naha et al., 2024)

  • Fatigue
  • Memory impairment
  • Cardiovascular disorders
  • Gastrointestinal disorders
  • PTSD
  • Daytime napping

However, there are ways to manage insomnia and reduce the co-morbidities.

 

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Ways To Manage Insomnia

When managing and treating insomnia, many people must recognize the many environmental factors that can lead to its development. Since insomnia is linked with environmental factors, many people start making small routine changes to mitigate its effects. Many people can start by identifying the disorder and other co-morbidities contributing to its development. (Waterman & Selsick, 2023) This, in turn, helps doctors develop a customized treatment plan to manage their insomnia.

 

Sleep Habits

One of the ways many people deal with insomnia can begin with changing their sleep habits to help reduce the environmental factors affecting their sleep quality. Some of the changes include:

  • Sleeping on a comfortable mattress
  • Reduce screen time by an hour before bed
  • Maintain a regular sleep and waking schedule
  • Make sure the bedroom is dark, cool, and has minimal noise

Incorporating these small changes in sleeping habits can help reduce the stressors contributing to insomnia.

 

Non-Surgical Treatments

Another way for individuals to manage their insomnia is by incorporating non-surgical treatments. Non-surgical treatments like mindfulness meditation, chiropractic care, and acupuncture can help many individuals calm the mind and body by combining deep breathing exercises. (Chan et al., 2021) At the same time, the body and muscles can begin to relax and even help stretch out tense muscles that are affected by insomnia. Many people can utilize non-surgical treatments as part of their routine to live healthy lives and have the best quality of sleep they deserve.

References

Chan, N. Y., Chan, J. W. Y., Li, S. X., & Wing, Y. K. (2021). Non-pharmacological Approaches for Management of Insomnia. Neurotherapeutics, 18(1), 32-43. doi.org/10.1007/s13311-021-01029-2

Dopheide, J. A. (2020). Insomnia overview: epidemiology, pathophysiology, diagnosis and monitoring, and nonpharmacologic therapy. Am J Manag Care, 26(4 Suppl), S76-S84. doi.org/10.37765/ajmc.2020.42769

Naha, S., Sivaraman, M., & Sahota, P. (2024). Insomnia: A Current Review. Mo Med, 121(1), 44-51. www.ncbi.nlm.nih.gov/pubmed/38404423

pmc.ncbi.nlm.nih.gov/articles/PMC10887463/pdf/ms121_p0044.pdf

Riemann, D., Krone, L. B., Wulff, K., & Nissen, C. (2020). Sleep, insomnia, and depression. Neuropsychopharmacology, 45(1), 74-89. doi.org/10.1038/s41386-019-0411-y

Van Someren, E. J. W. (2021). Brain mechanisms of insomnia: new perspectives on causes and consequences. Physiol Rev, 101(3), 995-1046. doi.org/10.1152/physrev.00046.2019

Waterman, L., & Selsick, H. (2023). Insomnia and its treatment should be given more importance. Br J Gen Pract, 73(733), 344-345. doi.org/10.3399/bjgp23X734421

Disclaimer

How to Repay Your Sleep Debt and Improve Your Well-being

By
Dr. Alex Jimenez
-
Snoozing on the late shift.

Individuals who don’t get enough sleep at night can feel it in many ways. Can sleep deprivation or other sleep disorders contribute to an accumulated sleep debt?

How to Repay Your Sleep Debt and Improve Your Well-being

Sleep Debt

Sleep debt is the difference between the amount of sleep an individual needs and the amount they get. It can accumulate over time and can negatively impact physical and mental health.

What Is It?

Regardless of the cause, sleep debt, also called a sleep deficit, is the accumulated amount of sleep loss from insufficient sleep. (Harvard Health Publishing, 2019) For example, if the body needs eight hours of sleep a night but only gets six, it has accumulated two hours of sleep debt for that particular night. This can occur due to sleep restriction, in which too few hours are spent sleeping, which can have significant consequences, especially if the debt builds.

The Effects

Sleep deprivation is linked to various mental and physical health problems, including:

  • Poor concentration or short-term memory
  • Depression and anxiety
  • High blood pressure
  • Heart disease
  • Diabetes
  • Kidney disease

Sleep deprivation can also contribute to other long-term health consequences. Individuals can have hallucinations and even a potentially increased risk of death. (Colten H. R., Altevogt B. M., & Institute of Medicine (US) Committee on Sleep Medicine and Research, 2006) Symptoms of discomfort and pain are also worsened by poor sleep.

Other Causes

Other possible causes of poor sleep quality can include individuals who have a sleep disorder such as insomnia, sleep apnea, or circadian rhythm disorders, which could lead to symptoms that are similar to those that occur with a sleep debt. (Columbia University Department of Neurology, 2022) Even though enough sleep hours were obtained, it could be fragmented, resulting in daytime sleepiness and other health issues. Some signs of sleep debt include:

  • Feeling tired throughout the day.
  • Having trouble focusing and reacting.
  • Feeling frustrated, cranky, or worried in social situations.
  • Having difficulty judging others’ emotions.

Even after sufficient sleep hours, individuals who wake up feeling unrefreshed may need to see a sleep physician or specialist for sleep testing.

Getting Out of Sleep Debt

Fortunately, the short-term effects of sleep deprivation can be reversed with sufficient rest. To recover from sleep debt, individuals can try: (Harvard Health Publishing, 2019)

  • Getting into a normal bedtime routine.
  • Using afternoon naps in moderation.
  • Avoiding stimulants, especially in the afternoon or evening.
  • Going to bed earlier.
  • Catching up by sleeping in on the weekends.
  • Keeping a sleep diary.
  • Changing their mattress.
  • Talking with a doctor.

Although sleep deprivation affects everyone, older adults seem to rebound quicker than young adults. Individuals may initially require sleeping longer than average to compensate for the recent losses. That’s why meeting daily sleep needs and following better sleep guidelines to preserve health and well-being are important. (Colten H. R., Altevogt B. M., & Institute of Medicine (US) Committee on Sleep Medicine and Research, 2006)

Injury Medical Chiropractic and Functional Medicine Clinic

Individuals who struggle with insomnia or other sleep disorders that impact their ability to get restful sleep should consult with their healthcare provider about getting an assessment and treatment to sleep well, avoid deprivation side effects, and restore health. Through healthy sleep practices and lifestyle accommodations, individuals can recover from sleep debt and regain the benefits of quality rest. A chiropractic therapy team can assess your condition and develop a customized treatment plan. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

Move Better, Live Better, Chiropractic Care

References

Harvard Health Publishing. (2019). Weekend catch-up sleep won’t fix the effects of sleep deprivation on your waistline. Harvard Health Blog. www.health.harvard.edu/blog/weekend-catch-up-sleep-wont-fix-the-effects-of-sleep-deprivation-on-your-waistline-2019092417861

Colten, H. R., Altevogt, B. M., & Institute of Medicine (US) Committee on Sleep Medicine and Research (Eds.). (2006). Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem. National Academies Press (US).

Columbia University Department of Neurology. (2024). Sleep Disorders. www.neurology.columbia.edu/patient-care/specialties/sleep-disorders?id=42069

Control Sugar Cravings with These 5 Natural Sweeteners

By
Dr. Alex Jimenez
-

Sweet foods were a delicacy for our ancestors. Can individuals incorporate these 5 natural sweeteners to curb any sugar cravings in food?

Introduction

Everyone worldwide craves sweet foods to get through their day and have the energy to move around. At everyone’s disposal, many foods and beverages contain an unlimited supply of sugar. At that point, when many people start to consume excessive amounts of sugary foods and beverages, it can lead to the development of chronic conditions. Hence, many people start to consume less sugary foods and beverages by switching to natural sweeteners to satisfy their sugar cravings. In today’s article, we will look at how natural sweeteners affect blood glucose levels, divide them into the top 5 natural sweeteners, and see their natural benefits when consumed. We associate with certified medical providers who inform our patients of the effects of excessive sugar and how it can affect their blood glucose levels. While asking important questions to our associated medical providers, we advise patients to incorporate healthy natural sweeteners in their foods as part of their customized treatment plan. Dr. Alex Jimenez, D.C., envisions this information as an academic service. Disclaimer.

 

Natural Sweeteners Effect On Blood Glucose

Do you have an intense craving for sweet treats or chips and pasta constantly throughout the day? Have you experienced low energy throughout the day, and does eating something help you continue your errands? Or have you been healing with constant headaches that make concentrating difficult? Many of these environmental factors are associated with excessive sugar cravings. The human body can produce glucose energy levels from food a person is consuming, and when environmental factors start to affect the body, it can cause issues like insulin resistance. Insulin resistance is a complex condition that causes the body to not respond to the insulin hormone. It can impair biological response to the liver, muscles, and tissues. (Martins & Conde, 2022) Since blood glucose plays a vital role in the body as it gives the host energy, environmental factors, and food play a huge part in blood glucose.

 

 

Environmental factors, such as blood glucose and natural sweeteners or sugary foods and drinks, are also in play for many people. Multiple environmental factors influence people’s food environment. (St-Onge et al., 2023) Since many individuals have a sweet tooth, consuming that much glucose can lead to the development of chronic conditions like diabetes, insulin resistance, and cellular inflammation. Some symptoms of consuming excessive amounts of glucose include elevated blood sugar, fat accumulation, and referred pain in the musculoskeletal system. Luckily, many individuals who want healthier eating habits can change their food consumption and sugar intake by swapping processed sweeteners with natural sweeteners when the sugar craving starts taking control. Switching to a natural sweetener can be effective when consumed in moderation to curb the sugar cravings that people mostly crave. Below are some of the top 5 natural sweeteners with low glycemic indicators and nutritional benefits.

 

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Stevia

Located in South America, the Stevia plant contains rebaudiosides and steviosides used in many food products as a substitute for sugar and a low-calorie natural sweetener. (Schiatti-Siso et al., 2023) At the same time, Stevia has beneficial properties that can help reduce plasma glucose concentration and inflammation while providing anti-glycemic and anti-viral effects to the body. (Kasti et al., 2022) Many people who switch out regular sugar for Stevia can incorporate Stevia in their cooking, and to prevent an aftertaste, they can add a bit of sea salt to mitigate the aftertaste.

 

Stevia Nutritional Benefits

One of the nutritional benefits Stevia offers is that it contains antioxidant properties that can help neutralize inflammation, which is a co-factor when a person consumes excess amounts of sugar combined with environmental factors. (Peteliuk et al., 2021) Some of the other benefits that Stevia has includes:

  • Anti-cancer properties
  • Improve kidney function
  • Lowers blood pressure
  • Diabetes reduces

 

Monk Fruit

Located in southern China and northern Thailand, monk fruit has a very low glycemic and sugar content. Most of its sweetness comes from a chemical structure in the fruit called mogrosides (Additives et al., 2019). Additionally, monk fruit is an intrinsic natural sweetener, as it is highly sweeter than other sweeteners and is found in nature. (Mahato et al., 2020) Plus, it has nutritional beneficial properties that make it amazing.

 

Monk Fruit Nutritional Benefits

Some of the nutritional benefits that monk fruit provides include:

  • Has antioxidants
  • Promotes weight loss
  • Has anti-cancer properties
  • Decreases blood sugar, total cholesterol & triglycerides
  • Improves the digestive and respiratory system

 

 

Yacon

Like the Stevia plant, yacon is an indigenous root in South America that can be extracted and turned into syrup. It is a popular sugar substitute for its sweet taste and has been used for medicinal purposes. (Braschi et al., 2024) Additionally, many people who utilize yacon will begin to notice that their gut will feel better. This is because yacon contains prebiotic fibers that can modify the composition and activity of intestinal microbiota. (Ribeiro et al., 2023)

 

Yacon Nutritional Benefits

Some of the nutritional benefits that Yacon provides include:

  • Increase body metabolism
  • Reduce hunger cravings
  • Has anti-inflammatory properties
  • Reduce constipation

 

 

Coconut Sugar

Coconut sugar is a popular sweetener that is used in southeastern Asian cuisines. It is made from phloem sap from coconut palm tree blossoms. (Saraiva et al., 2023) As one of the lowest natural sweeteners, it can substitute for many dairy products like ice cream to provide sweetness. (Beegum et al., 2022) Additionally, coconut sugar contains over 16 amino acids and four different B vitamins.

 

Coconut Sugar Nutritional Benefits

Some of the nutritional benefits of coconut sugar include:

  • Being a source of iron, potassium, magnesium, & zinc
  • Relieve diabetic neuropathy symptoms
  • Reduce anxiety, depression, and bipolar mood disorder
  • Treats high blood pressure

 

 

Honey

Honey is a superfood that positively affects blood sugar and has numerous properties worldwide. It contains numerous minerals and nutrients that can help with cellular insulin sensitivity and must be consumed in moderation for blood sugar balance. Many people have used honey for medicinal purposes, including wound healing and gut ailments. (Iftikhar et al., 2022) At the same time, honey, especially raw honey, can help reduce allergy symptoms.

 

Honey Nutritional Benefits

Some of the nutritional benefits that honey provides include:

  • Immunity & energy booster
  • Has anti-fungal properties
  • A natural cough suppressant
  • Reduce allergies
  • Skin moisturizer

 

References

Additives, E. P. o. F., Flavourings, Younes, M., Aquilina, G., Engel, K. H., Fowler, P., Frutos Fernandez, M. J., Furst, P., Gurtler, R., Gundert-Remy, U., Husoy, T., Mennes, W., Moldeus, P., Oskarsson, A., Shah, R., Waalkens-Berendsen, I., Wolfle, D., Degen, G., Herman, L.,…Castle, L. (2019). Safety of use of Monk fruit extract as a food additive in different food categories. EFSA J, 17(12), e05921. doi.org/10.2903/j.efsa.2019.5921

Beegum, P. P. S., Nair, J. P., Manikantan, M. R., Pandiselvam, R., Shill, S., Neenu, S., & Hebbar, K. B. (2022). Effect of coconut milk, tender coconut and coconut sugar on the physico-chemical and sensory attributes in ice cream. J Food Sci Technol, 59(7), 2605-2616. doi.org/10.1007/s13197-021-05279-y

Braschi, G., Njieukam, J. A., Gottardi, D., Genovese, J., Tylewicz, U., Patrignani, F., & Rocculi, P. (2024). Investigating the potential of yacon (Smallanthus sonchifolius) juice in the development of organic apple-based snacks. Heliyon, 10(11), e32342. doi.org/10.1016/j.heliyon.2024.e32342

Iftikhar, A., Nausheen, R., Muzaffar, H., Naeem, M. A., Farooq, M., Khurshid, M., Almatroudi, A., Alrumaihi, F., Allemailem, K. S., & Anwar, H. (2022). Potential Therapeutic Benefits of Honey in Neurological Disorders: The Role of Polyphenols. Molecules, 27(10). doi.org/10.3390/molecules27103297

Kasti, A. N., Nikolaki, M. D., Synodinou, K. D., Katsas, K. N., Petsis, K., Lambrinou, S., Pyrousis, I. A., & Triantafyllou, K. (2022). The Effects of Stevia Consumption on Gut Bacteria: Friend or Foe? Microorganisms, 10(4). doi.org/10.3390/microorganisms10040744

Mahato, D. K., Keast, R., Liem, D. G., Russell, C. G., Cicerale, S., & Gamlath, S. (2020). Sugar Reduction in Dairy Food: An Overview with Flavoured Milk as an Example. Foods, 9(10). doi.org/10.3390/foods9101400

Martins, F. O., & Conde, S. V. (2022). Impact of Diet Composition on Insulin Resistance. Nutrients, 14(18). doi.org/10.3390/nu14183716

Peteliuk, V., Rybchuk, L., Bayliak, M., Storey, K. B., & Lushchak, O. (2021). Natural sweetener Stevia rebaudiana: Functionalities, health benefits and potential risks. EXCLI J, 20, 1412-1430. doi.org/10.17179/excli2021-4211

Ribeiro, P. V. M., Veloso, T. G., de Oliveira, L. L., Mendes, N. P., & Alfenas, R. C. G. (2023). Consumption of yacon flour and energy-restricted diet increased the relative abundance of intestinal bacteria in obese adults. Braz J Microbiol, 54(4), 3085-3099. doi.org/10.1007/s42770-023-01140-w

Saraiva, A., Carrascosa, C., Ramos, F., Raheem, D., Lopes, M., & Raposo, A. (2023). Coconut Sugar: Chemical Analysis and Nutritional Profile; Health Impacts; Safety and Quality Control; Food Industry Applications. Int J Environ Res Public Health, 20(4). doi.org/10.3390/ijerph20043671

Schiatti-Siso, I. P., Quintana, S. E., & Garcia-Zapateiro, L. A. (2023). Stevia (Stevia rebaudiana) as a common sugar substitute and its application in food matrices: an updated review. J Food Sci Technol, 60(5), 1483-1492. doi.org/10.1007/s13197-022-05396-2

St-Onge, M. P., Cherta-Murillo, A., Darimont, C., Mantantzis, K., Martin, F. P., & Owen, L. (2023). The interrelationship between sleep, diet, and glucose metabolism. Sleep Med Rev, 69, 101788. doi.org/10.1016/j.smrv.2023.101788

 

Disclaimer

Enhancing Physical Performance through Short Naps

By
Dr. Alex Jimenez
-
Tired overworked woman worker sleeping on sofa in corporate office. Working overtime for deadline, mental health, sleepless from job stress concept

Could regular daytime naps help individuals slow the aging process from natural brain shrinkage?

Enhancing Physical Performance through Short Naps

Taking Naps

Research and experts suggest that a short nap between 10 to 40 minutes provides the most benefits, including:

  • Improved mood
  • Cognitive performance
  • Alertness

A study suggests that daytime napping might prevent the brain from shrinking with age. (Paz V., Dashti H. S., & Garfield V. 2023)

Optimal Nap Time

A small study of young adults found that naps lasting 10 to 60 minutes immediately improved mood and alertness. However, most research shows that naps under 30 minutes offer the most benefit because individuals are less likely to enter the deep sleep stage or experience sleep inertia – a period of impaired alertness right after waking.  A meta-analysis also suggested that short naps reduce fatigue, increase productivity, and enhance physical performance. (Dutheil F. et al., 2021) A 10-minute nap is the most effective at improving:

  • Sleep latency or sleep onset latency (SOL)
  • Fatigue
  • Vigor
  • Cognitive performance

Some sleep specialists recommend that patients not take naps longer than 40 minutes, as too much napping could be unhealthy. Studies have shown that excessive daytime sleepiness and napping for over 60 minutes might increase the risk of type 2 diabetes and heart problems. (Yamada T, Nobuhiro S, Takashi K. 2016)

Health

In the study published in Sleep Health, researchers used data from over 30,000 participants aged 40 to 69 from the U.K. Biobank. Researchers examined genetic variants associated with taking naps regularly. (Paz V., Dashti H. S., & Garfield V. 2023) The researchers found a link between regular daytime napping and larger brain volume. The difference in brain volume between individuals who nap regularly and those who don’t was equivalent to 2.6 to 6.5 years of aging. However, no association was found between napping and cognitive performance reaction time or visual memory. The brain naturally shrinks with age, but this process is accelerated in individuals with neurodegenerative diseases and cognitive decline.

How To Avoid Napping for Too Long

Taking naps is good for you. But there’s a difference between healthy daytime sleep and counterproductive excessive sleeping.

  • Sleep specialists recommend setting an alarm for a nap or asking a family member, friend, or coworker to wake you up.
  • Individuals can try placing their phones or alarm clocks far away so they have to move to turn them off.
  • Individuals are recommended to stand up immediately to wake the body through movement and light exposure to avoid feeling groggy after a nap.
  • One study suggests consuming caffeine before a nap may be an effective countermeasure for sleep inertia. (Hilditch C. J., Dorrian J., & Banks S. 2016)
  • Engaging in physical activities before and after naps can also help promote wakefulness.

Sometimes, people feel exhausted for various reasons, such as stress and nutrition, rather than a lack of sleep. In these cases, sleeping more than the body needs will only worsen sleep quality at night. When individuals are experiencing daytime fatigue, rather than lying back down or sitting in bed, sleep specialists suggest walking around. This allows the fatigue to pass, and the patient can sleep better at night.

Injury Medical Chiropractic and Functional Medicine Clinic

Chiropractic’s goals are to help individuals enhance movement with less pain due to a condition after injury or surgery. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body heal itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

Secrets of Optimal Wellness

References

Paz, V., Dashti, H. S., & Garfield, V. (2023). Is there an association between daytime napping, cognitive function, and brain volume? A Mendelian randomization study in the UK Biobank. Sleep health, 9(5), 786–793. doi.org/10.1016/j.sleh.2023.05.002

Dutheil, F., Danini, B., Bagheri, R., Fantini, M. L., Pereira, B., Moustafa, F., Trousselard, M., & Navel, V. (2021). Effects of a Short Daytime Nap on the Cognitive Performance: A Systematic Review and Meta-Analysis. International journal of environmental research and public health, 18(19), 10212. doi.org/10.3390/ijerph181910212

Yamada T, N. S., Takashi K. (2016). Daytime napping, daytime sleepiness and the risk of metabolic diseases: dose-response meta-analysis using restricted cubic spline model. J Am Coll Cardiol., 67(13), 1951. doi.org/https://doi.org/10.1016/S0735-1097(16)31952-0

Hilditch, C. J., Dorrian, J., & Banks, S. (2016). Time to wake up: reactive countermeasures to sleep inertia. Industrial health, 54(6), 528–541. doi.org/10.2486/indhealth.2015-0236

Discover Exciting Ways to Use Protein Powder in Your Daily Diet

By
Dr. Alex Jimenez
-
Homemade oat cookies and ingredients for baking on rustic wooden board

Can protein powder be used in different ways to effectively support nutrition goals for individuals who aim to build muscle, maintain weight, or acquire more protein in their diet?

Discover Exciting Ways to Use Protein Powder in Your Daily Diet

Different Ways To Use Protein Powder

Protein powder is a quick and easy way to get protein before or after a workout. Add a scoop to a shaker bottle, mix with water, and you’re ready. However, having the same shake daily can become boring. Finding different ways to use protein powder can be a welcome change in workout nutrition habits. It is versatile, making it a great addition to smoothies, baked goods, oatmeal, yogurt, and more.

Health Benefits

How to Use

Learning different ways to use protein powder can help create an exciting and diversified menu, from meals to snacks. Individuals can use conventional or organic powder. Here are a few ideas:

Oatmeal

  • Adding protein powder to overnight oats or stovetop oatmeal is a great way to increase protein content.
  • Protein powder mixes well with oats and milk.

Baked Goods

  • Protein powder goes well with many baked goods.
  • Another way to use protein powder is to add it to brownie, muffin, cupcake, or cookie recipes.

Yogurt

  • Combine with yogurt and fruit for a nutrient and calorie-dense breakfast or snack to fuel the body.
  • It’s also a great post-workout snack.

Coffee

  • Adding protein powder to coffee makes it easy to increase daily protein intake.
  • Stir with a spoon, like adding powdered cream, or blend or froth hot coffee with protein powder to make it like a cappuccino.

Pancakes

  • Adding to a batch of pancakes is a great way to use protein powder.

How much protein powder per day?

Consuming one to two scoops (between 25 to 50 grams) daily is generally safe, which is what most recipes call for. Following the recommended dosage on the product label is highly recommended. The Recommended Dietary Allowance of protein for a healthy adult, regardless of age, is 0.8 grams per kilogram of body weight per day. (Wu G. 2016)

How long after a workout should protein powder be taken?

Whether running or lifting weights, consuming protein within the anabolic window approximately 30 minutes to two hours after a workout enhances muscle recovery, repair, and growth. (Aragon A. A., & Schoenfeld, B. J. 2013) Daily protein intake is recommended for improved performance, muscle growth, and optimal recovery. (Cintineo H. P. et al., 2018) Muscle building is 25 percent higher when protein intake is evenly spaced throughout the day. (Mamerow M. M. et al., 2014) 

Protein Shake Side Effects

Consuming the recommended amount of one to two scoops daily is generally safe and doesn’t have side effects. However, exceeding recommended daily intake can cause unwanted side effects that include:

  • Bloating
  • Flatulence
  • Increased bowel movements
  • Acne
  • Nausea
  • Thirst
  • Fatigue
  • Headache
  • Lack or loss of appetite

Studies have found that excess whey protein supplementation is associated with increased aggression, acne, and disturbance of the gut microbiota. (Vasconcelos Q. D. J. S. et al., 2021)

For individuals who want to get more out of their pre- or post-workout supplements, choose high-quality organic protein powders that contain all essential amino acids and wholesome ingredients with no fillers or additives. Consult a healthcare provider if considering supplementing with protein powder or looking to increase protein intake along with a registered dietitian to help determine how much protein is needed based on personal needs, activity, and fitness levels and goals.

Injury Medical Chiropractic and Functional Medicine Clinic

Chiropractic care aims to help individuals improve movement with less pain due to condition, after injury, or surgery. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

Benefits of a Healthy Diet and Chiropractic Care

References

Cintineo, H. P., Arent, M. A., Antonio, J., & Arent, S. M. (2018). Effects of Protein Supplementation on Performance and Recovery in Resistance and Endurance Training. Frontiers in nutrition, 5, 83. doi.org/10.3389/fnut.2018.00083

Gorissen, S. H. M., Crombag, J. J. R., Senden, J. M. G., Waterval, W. A. H., Bierau, J., Verdijk, L. B., & van Loon, L. J. C. (2018). Protein content and amino acid composition of commercially available plant-based protein isolates. Amino acids, 50(12), 1685–1695. doi.org/10.1007/s00726-018-2640-5

Batsis, J. A., Petersen, C. L., Cook, S. B., Al-Nimr, R. I., Driesse, T., Pidgeon, D., & Fielding, R. (2021). Impact of whey protein supplementation in a weight-loss intervention in rural dwelling adults: A feasibility study. Clinical nutrition ESPEN, 45, 426–432. doi.org/10.1016/j.clnesp.2021.07.006

West, D. W. D., Abou Sawan, S., Mazzulla, M., Williamson, E., & Moore, D. R. (2017). Whey Protein Supplementation Enhances Whole Body Protein Metabolism and Performance Recovery after Resistance Exercise: A Double-Blind Crossover Study. Nutrients, 9(7), 735. doi.org/10.3390/nu9070735

Fekete, Á. A., Giromini, C., Chatzidiakou, Y., Givens, D. I., & Lovegrove, J. A. (2018). Whey protein lowers systolic blood pressure and Ca-caseinate reduces serum TAG after a high-fat meal in mildly hypertensive adults. Scientific reports, 8(1), 5026. doi.org/10.1038/s41598-018-23333-2

Ha, D. J., Kim, J., Kim, S., Go, G. W., & Whang, K. Y. (2021). Dietary Whey Protein Supplementation Increases Immunoglobulin G Production by Affecting Helper T Cell Populations after Antigen Exposure. Foods (Basel, Switzerland), 10(1), 194. doi.org/10.3390/foods10010194

Wu G. (2016). Dietary protein intake and human health. Food & function, 7(3), 1251–1265. doi.org/10.1039/c5fo01530h

Aragon, A. A., & Schoenfeld, B. J. (2013). Nutrient timing revisited: is there a post-exercise anabolic window?. Journal of the International Society of Sports Nutrition, 10(1), 5. doi.org/10.1186/1550-2783-10-5

Mamerow, M. M., Mettler, J. A., English, K. L., Casperson, S. L., Arentson-Lantz, E., Sheffield-Moore, M., Layman, D. K., & Paddon-Jones, D. (2014). Dietary protein distribution positively influences 24-h muscle protein synthesis in healthy adults. The Journal of nutrition, 144(6), 876–880. doi.org/10.3945/jn.113.185280

Vasconcelos, Q. D. J. S., Bachur, T. P. R., & Aragão, G. F. (2021). Whey protein supplementation and its potentially adverse effects on health: a systematic review. Applied physiology, nutrition, and metabolism = Physiologie appliquee, nutrition et metabolisme, 46(1), 27–33. doi.org/10.1139/apnm-2020-0370

Exploring the Relationship Between Narcolepsy and Sleep

By
Dr. Alex Jimenez
-

Can individuals dealing with narcolepsy find ways to reduce its effects on the musculoskeletal system and improve sleep?

What Is Narcolepsy?

Around the world, many individuals have gotten 8 hours of sleep by doing errands to function throughout the day. Sometimes, it is important to take naps between certain hours of the day to give the body a chance to rest and continue for the rest of the day before going to bed. However, more individuals have experienced sleep disturbances like scrolling through their phones, dealing with chronic conditions like migraines or insomnia, or not having a proper sleep schedule that can negatively impact their sleep. One of the sleep disturbances is narcolepsy, which can cause individuals to have sleep issues throughout the day and even affect their musculoskeletal system. In today’s article, we will be looking at what narcolepsy is, its symptoms, how it affects the muscles, and what treatments can reduce narcolepsy and improve sleep. We associate with certified medical providers who inform our patients of the effects narcolepsy causes on a person and their bodies. While asking important questions to our associated medical providers, we advise patients to include various techniques to reduce the overlapping risk profiles related to narcolepsy and help improve their sleep quality. Dr. Alex Jimenez, D.C., envisions this information as an academic service. Disclaimer.

 

 

Do you often feel extremely tired throughout the day, and is it causing you to take a nap in weird places? Do your arms and legs feel weak from carrying various objects? Or do you feel general aches or pains in your neck, shoulders, and back? Many of these scenarios are associated with sleep disturbances that can affect the musculoskeletal system. One of the sleep disturbances is narcolepsy, characterized by the onset of rapid eye movement (REM) sleep that can correlate with the lack of orexin neurons from the central nervous system, thus causing daytime sleepiness. (Slowik et al., 2024) Narcolepsy has two forms depending on the severity of the condition: type 1 (narcolepsy with cataplexy) and type 2 (narcolepsy without cataplexy). Depending on the severity of narcolepsy, it can disrupt the brain from generating and regulating REM sleep and cause issues for the body when it is awake during the day. (Thorpy et al., 2024) This chronic sleep disorder can disrupt a person’s quality of life and affect their socio-economic lifestyle.

 

Symptoms

Narcolepsy has four main symptoms that can affect a person who is experiencing this condition. The four symptoms are:

  • Excessive daytime sleepiness causes people to fall asleep suddenly during mid-conversation or when doing activities.
  • Cataplexy: Sudden or temporary episodes of muscle weakness in the upper and lower musculoskeletal quadrants. (Sunwoo, 2021)
  • Sleep hallucinations: This can cause individuals to hallucinate visions, causing the symptoms to be mistaken for psychotic symptoms. (Hanin et al., 2021)
  • Sleep paralysis: When the individual is partly awake but cannot move.

Additionally, when narcolepsy starts to affect a person, it could lead to the development of comorbidities like obesity and musculoskeletal issues that may lead to sleep disturbances to take effect. (Maski et al., 2022)

 

How Does It Affect Muscles?

Now, narcolepsy can affect the musculoskeletal system as the central nervous system has neurons known as orexin to stimulate the body’s muscles, tissues, and vital organs. When narcolepsy starts to affect orexin, it can cause overlapping risk profiles to the muscles that become weak, and environmental factors like obesity and metabolic syndrome can complicate diagnosing narcolepsy. (Dhafar & BaHammam, 2022). Now, as environmental factors do play a huge part in the body, causing people to develop narcolepsy, it is important to realize that when muscle weakness can contribute to the issue, it can lead to disastrous consequences. Strong emotions that are associated with muscle weakness for narcoleptic individuals can cause their body to collapse and lead to cataplexy. Cataplexy in narcoleptic individuals often has a sequence starting from the top of the head down to the legs, causing muscle tone loss, and is frequently mistaken for seizures. (Latorre et al., 2022) Luckily, there are ways to manage narcolepsy and improve sleep quality.

 

The Non-Surgical Approach To Wellness- Video

The Non-Surgical Approach to Wellness with Chiropractic Care | El Paso, Tx (2024)

Narcolepsy Treatments To Improve Sleep

When it comes to managing narcolepsy and its associated symptoms, many people can make small changes to their daily routine and incorporate treatment to improve their sleep quality and their lifestyle, too. Many individuals with narcolepsy take medication to not only stimulate their central nervous system neurons but also to reduce daytime sleepiness. Additionally, non-surgical treatments like chiropractic care can help stretch and restore muscle weakness associated with narcolepsy to help individuals manage their symptoms. Other treatments include:

  • Take short naps on a comfortable mattress.
  • Maintaining a proper sleep schedule.
  • Exercise regularly to reduce excessive daytime sleepiness
  • Eating a well-balanced, healthy meal

Incorporating these small changes as part of a daily routine can help mitigate narcolepsy and its associated symptoms. All in all, many individuals with narcolepsy can manage their symptoms and live a healthier life.

 

References

Dhafar, H. O., & BaHammam, A. S. (2022). Body Weight and Metabolic Rate Changes in Narcolepsy: Current Knowledge and Future Directions. Metabolites, 12(11). doi.org/10.3390/metabo12111120

Hanin, C., Arnulf, I., Maranci, J. B., Lecendreux, M., Levinson, D. F., Cohen, D., & Laurent-Levinson, C. (2021). Narcolepsy and psychosis: A systematic review. Acta Psychiatr Scand, 144(1), 28-41. doi.org/10.1111/acps.13300

Latorre, D., Sallusto, F., Bassetti, C. L. A., & Kallweit, U. (2022). Narcolepsy: a model interaction between immune system, nervous system, and sleep-wake regulation. Semin Immunopathol, 44(5), 611-623. doi.org/10.1007/s00281-022-00933-9

Maski, K., Mignot, E., Plazzi, G., & Dauvilliers, Y. (2022). Disrupted nighttime sleep and sleep instability in narcolepsy. J Clin Sleep Med, 18(1), 289-304. doi.org/10.5664/jcsm.9638

Slowik, J. M., Collen, J. F., & Yow, A. G. (2024). Narcolepsy. In StatPearls. www.ncbi.nlm.nih.gov/pubmed/29083681

Sunwoo, J. S. (2021). Narcolepsy, autoimmunity, and influenza A H1N1 vaccination. Encephalitis, 1(2), 31-35. doi.org/10.47936/encephalitis.2021.00010

Thorpy, M. J., Siegel, J. M., & Dauvilliers, Y. (2024). REM sleep in narcolepsy. Sleep Med Rev, 77, 101976. doi.org/10.1016/j.smrv.2024.101976

 

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Exploring the Dynamics of Planes of Motion in the Human Body

By
Dr. Alex Jimenez
-
young girl doing exercise to improve back muscles in a sport club

Can understanding the planes of motion help individuals adjust fitness training to maximize fitness for physical and sports performance and reduce the risk of injury?

Exploring the Dynamics of Planes of Motion in the Human Body

Planes of Motion

The body’s planes of motion are the sagittal, frontal, and transverse planes, which divide it into left and right, front and back, and top and bottom halves. The body moves in different dimensions during daily work, house chores, and physical activity/exercises. The movements in each plane correspond to forward/backward, side-to-side, and rotational motions. Think of each plane as an imaginary line or a pane of glass that divides the body into opposing segments when standing in the anatomical position. (National Academy of Sports Medicine, 2024)

  • Sagittal plane -Divides the body into right and left sides.
  • Frontal plane – Divides the body into front and back.
  • Transverse plane – Divides the body into top and bottom sections.

To determine the plane of motion of a particular movement, consider how the movement would interact with the imaginary lines or plates. When a movement runs parallel to the imaginary line, the movement is occurring in that plane of motion. For example, when going upstairs, the forward and upward movement at the hip, knee, and ankle occurs primarily in the sagittal plane because that movement runs parallel to the imaginary line that divides the body into right and left sides. Frontal plane movements occur while you walk up the stairs and reach for the handrail. The movement is in the frontal plane because the lateral hand reach runs parallel to the line, dissecting the body into front and back sections. If you turn around to look behind, the rotational movement occurs in the transverse plane because your upper torso runs parallel to the line, dissecting the body into an upper and lower section. Individual movements at any joint in the body can occur in a single plane or multiple planes. Complex movements usually happen in several planes of motion concurrently.

Sagittal Plane

Movement in the sagittal plane generally happens in front or behind. This is the most familiar plane of motion because many typical day-to-day activities happen within arm’s reach in front. Walking, texting, or computer work involves movement primarily in the sagittal plane. Several eating mechanics occur in the sagittal plane. Movements include:

  • Flexion – A bending movement that decreases the angle at a joint.
  • Extension – An extending movement that increases the angle at a joint.
  • Hyperextension – Extending the angle at a joint beyond neutral.
  • Dorsiflexion – Bending at the ankle so the top of the foot moves toward the shin.
  • Plantarflexion – Pushing the foot down and away from the body.

Many strength-training exercises in the sagittal plane include biceps curls, forward or reverse lunges, squats, vertical jumping, running, downward dog, and yoga chair poses.

Frontal Plane

The frontal plane divides the body into front/anterior and back/posterior sections. Frontal plane movements are lateral or side-to-side and include:

  • Abduction – Moving the body or a limb laterally and away from the body’s midline.
  • Adduction – Moving the body or a limb towards the body’s midline.
  • Elevation – Moving the shoulder blades up.
  • Depression – Moving the shoulder blades down.
  • Eversion – Rolling the foot towards the inside/medial side.
  • Inversion – Rolling the foot towards the outside/lateral side.

Frontal plane movements are less common than sagittal movements. For example, individuals walk forward more than side to side or reach for something in front rather than directly to the side. Frontal plane movements in fitness include side lunges, lateral shoulder raises, and side shuffles, and in yoga poses, standing side bends and the triangle.

Transverse Plane

The transverse plane divides the body into upper/superior and lower/inferior sections. Transverse plane movements generally involve rotation. Movement in this plane is less common. Exercise injuries most often occur during transverse/rotational movements. (National Academy of Sports Medicine, 2024) Movements include:

  • Rotation – Moving the torso or a limb around its vertical axis.
  • Pronation – Rotating the forearm or foot to a palm-side or foot-side down position.
  • Supination – Rotating the forearm or foot to a palm-side or foot-side-up position.
  • Horizontal Abduction – Moving the upper arm away from the body’s midline when elevated to 90 degrees.
  • Horizontal Adduction – Moving the upper arm towards the body’s midline when elevated to 90 degrees.

Typical everyday activities in the frontal plane include turning the head to look behind or turning a doorknob. Exercises in the transverse plane include hitting a golf ball, swinging a baseball bat, or performing a seated twist.

Training Within the Planes of Motion Benefits

Training in all three planes can help with movement in several ways, providing greater ease in life and sports.

Prepares Body for Daily Tasks

Many traditional strength-training programs focus on training one muscle at a time, often in a single plane of motion. For example, weight lifters might do bicep curls to primarily work the biceps in the sagittal plane, a chest fly exercise to primarily work the pectoral muscles in the transverse plane, or lateral raises to work the shoulders in the frontal plane. However, compound exercises have recently become much more common. Compound movements allow individuals to train several muscle groups simultaneously and in different planes of motion.

In this way, training activities mimic daily living activities. For example, individuals often lift several heavy bags of groceries and turn to open the car or trunk, involving both sagittal and transverse movement. Preparing the body for complex activities with compound exercises allows individuals to perform them more easily throughout the day.

Prepares Body for Sports and Physical Activities

Complex multi-planar movements help prepare for safe and effective physical activity and sports performance (National Academy of Sports Medicine, 2024). Researchers and experts understand that many physical and athletic activities require the body to move in different directions, often quickly and under high stress. Several studies have found that anterior cruciate ligament/ACL injuries are more likely to occur during multi-planar rather than single-planar movements. (Quatman C. E., Quatman-Yates C. C., & Hewett T. E. 2010) Training the body to perform multi-planar movements safely and effectively through exercise can help reduce the risk of injury during daily activities or stressful athletic competitions.

Encourages Variation For Full Body Strengthening

Individuals tend to fall into certain movement patterns, such as repeatedly performing the same fitness activity or exercises. This can cause them to have a favorite plane of motion. One way to break away from the same routine is to include movement from all planes of motion. For example, many abdominal workout machines help train in multiple planes of motion, challenging your body to move in different ways. Dumbbells, kettlebells, TRX straps, and bands allow individuals to move joints freely in various planes of motion and work several muscles.

Runners train primarily in the sagittal plane, even if they cross-train by swimming, cycling, or using cardio machines. For this reason, trainers and coaches often recommend doing some form of yoga or weight training that allows them to move their joints in different ways, including lateral movements or rotation. Even flexibility training should incorporate all three planes of motion. For example, walkers might choose to do a simple calf or hamstring stretch at the end of their workout but may also benefit from a seated spine rotation or a lying hip stretch.

Injury Medical Chiropractic and Functional Medicine Clinic

Understanding the concept and importance of training in the three planes of motion can help improve sports and physical performance and prevent musculoskeletal injuries. Chiropractic care aims to help individuals enhance movement with less pain due to condition, after injury, or surgery. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

The Difference of Using Custom Foot Orthotics

References

National Academy of Sports Medicine. (2024). Sagittal, Frontal and Transverse Body Planes: Exercises & Movements. NASM. blog.nasm.org/exercise-programming/sagittal-frontal-traverse-planes-explained-with-exercises?utm_source=blog&utm_medium=referral&utm_campaign=organic&utm_content=ReasonsToBecomeCES

Quatman, C. E., Quatman-Yates, C. C., & Hewett, T. E. (2010). A ‘plane’ explanation of anterior cruciate ligament injury mechanisms: a systematic review. Sports medicine (Auckland, N.Z.), 40(9), 729–746. doi.org/10.2165/11534950-000000000-00000

Unlock the Benefits of Bed Pilates for Improved Well-being

By
Dr. Alex Jimenez
-
African-american girl exercising in bed in the morning, stretching legs

Can Pilates exercise movements be performed in bed for individuals recovering from illness or injury?

Unlock the Benefits of Bed Pilates for Improved Well-being

Bed Pilates

Pilates exercises can be practiced in bed. Joseph Pilates’ exercises and equipment, such as his patented V-shape bed, were designed to help rehabilitate injured individuals who had to stay on or near a bed. After a healthy night’s sleep, Pilates exercises dynamically stimulate circulation and the nervous system. They can also be used to calm the mind and body before going to bed.

  • Those with health concerns should check with their healthcare provider before starting any exercise program to ensure safety.
  • Beginners are recommended to learn the Pilates principles and movement fundamentals.

Here are a few Pilates mat exercises adapted for individuals who need or prefer to exercise in bed. A firm mattress is recommended, as a soft mattress will mess up the correct form, making the exercise ineffective.

Spine Twist

This exercise helps improve the flexibility of the spine and core, making it easier to move around, and supports healthy posture. (Geremia J. M. et al., 2015) Pilates exercises like the spine twist have been found to reduce low back pain and disability. (Notarnicola A. et al., 2014) To perform:

  • Sit up in bed, torso straight, abs engaged, and inhale.
  • Exhale as you turn your head and shoulders to the right.
  • Keep your torso straight, and imagine growing taller through the turn.
  • Inhale as you return to the starting position.
  • Exhale and turn to the other side.
  • Repeat five times on each side.

Tendon Stretch

The tendon stretch helps by improving flexibility in the hamstrings and calves. (Chinnavan E., Gopaladhas S., & Kaikondan P. 2015) To perform:

  • Sit up straight, legs straight out.
  • Bring heels together and use a towel to pull your feet towards you while pushing your heels away.
  • Hold for three seconds.
  • Next, without the towel, point your toes away.
  • Hold for another three seconds.
  • Do ten reps.

Double-Leg Stretch

The double-leg stretch is an intermediate exercise that works the abdominals and the core. If this move feels difficult, start with one leg at a time. Another option is to keep the knees slightly bent instead of extending the legs fully. To perform:

  • Bring both knees to your chest and, with your hands, press down on the ankles to stretch the lower back.
  • Pull in the abdomen.
  • Exhale and extend the arms up and the leg or legs as far out in front as possible.
  • Hold the position for ten seconds and then release.
  • Do ten reps.

Pelvic Curl

The pelvic curl builds strength in the lower back and core. To perform:

  • Bend knees and place feet on the bed hip-distance apart.
  • Curl your pelvis, squeeze the glutes, and lift your body.
  • Hold for five seconds.
  • Slowly count five seconds while lowering back down, imprinting the spine into the mattress.
  • Do ten reps.

Hip-Opening Exercise

A hip-opening exercise, or frog, can be done while lying down or sitting in bed. Hip openers help keep the spine and hips flexible and in alignment. To perform:

  • Bring the soles of your feet together and as close to the torso as possible.
  • Let the knees open up as far as possible, and that feels comfortable.
  • While in the stretch, breathe in and out as deep as possible.
  • If sitting, place hands on ankles and use forearms to push down on the knees for added stretch.

Injury Medical Chiropractic and Functional Medicine Clinic

Chiropractic care aims to help individuals improve movement with less pain due to condition, after injury, or surgery. A chiropractic therapy team can assess your condition and develop a customized treatment plan to expedite pain relief and improve mobility. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

Home Exercises for Pain Relief

References

Geremia, J. M., Iskiewicz, M. M., Marschner, R. A., Lehnen, T. E., & Lehnen, A. M. (2015). Effect of a physical training program using the Pilates method on flexibility in elderly subjects. Age (Dordrecht, Netherlands), 37(6), 119. doi.org/10.1007/s11357-015-9856-z

Notarnicola, A., Fischetti, F., Maccagnano, G., Comes, R., Tafuri, S., & Moretti, B. (2014). Daily pilates exercise or inactivity for patients with low back pain: a clinical prospective observational study. European journal of physical and rehabilitation medicine, 50(1), 59–66.

Chinnavan, E., Gopaladhas, S., & Kaikondan, P. (2015). Effectiveness of pilates training in improving hamstring flexibility of football players. Bangladesh Journal of Medical Science, 14(3), 265–269. doi.org/10.3329/bjms.v14i3.16322

Understanding MET Back Pain: A Comprehensive Overview

By
Dr. Alex Jimenez
-

Can individuals experiencing back pain from various factors incorporate MET (muscle energy techniques) to restore mobility?

Factors That Causes Back Pain

More often than not, many individuals have experienced back pain in various parts of their lives. As one of the leading pains that people have dealt with worldwide, many factors can contribute to the development of back pain, and it can affect different musculoskeletal locations in the upper and lower body quadrants. Back pain has often been associated with the workplace or environmental factors. For back pain, the problem can range from all back sections, affecting the muscles, ligaments, tissues, intervertebral joints, or the bone itself. (Wiberg, 1949) People are constantly in motion, and the muscles can be overstretched and tight over time. When that happens, many people seek treatment to reduce back pain’s overlapping risk profiles and restore mobility. Today’s article focuses on the factors associated with back pain and how non-surgical treatments like MET (muscle energy technique) can help reduce back pain and restore mobility. We discuss with certified medical providers who inform our patients how various environmental factors are correlated with back pain and how it can affect the body. While asking informed questions to our associated medical providers, we advise patients to include various non-surgical treatments like MET to be incorporated to reduce overlapping risk profiles associated with back pain. Dr. Alex Jimenez, D.C., encompasses this information as an academic service. Disclaimer.

 

How often do you experience pain in different locations in your back after doing some strenuous activities? Do you feel like you are taking many breaks due to feeling tightness or sharp sensations in your back? Or have you felt that your posture is more hunched than normal? Many of these environmental factors scenarios are correlated with back pain, and it can become an issue over time. Back pain can be in two categories: specific and non-specific, and it can impact a person’s quality of life. Non-specific back pain can be associated with mobility impairment in the different back sections, referred to as radiating pain in the lower extremities or musculoskeletal disorders. (Delitto et al., 2012) This causes issues like repetitive loading to the spine and various pain-like symptoms to the back, causing a disbalance to the individual. (Zemková & Zapletalová, 2021) When it comes to environmental factors correlating with back pain, there are numerous ways for it to be developed and, over time, cause discomfort for the individual, as back pain symptoms vary for everyone.

 

Sleep

When it comes to the connection between sleep and back pain, these two issues can cause a vicious cycle of disturbed sleep and issues like insomnia. (Van Looveren et al., 2021) Now, when it comes to sleep disturbances and back pain, many individuals may be sleeping with the wrong mattress, causing their bodies to can cause pressure on their joints and spinal discs. This causes in-bed sleep behaviors like movements and postures could lead to health complications like pressure sores, apnea, and painful muscle spasms in the back and lower extremities. (Elnaggar et al., 2023) Luckily, there are various ways to reduce back pain, improve sleep quality, and restore body motion.

 

Understanding Academic Low Back Pain-Video

Understanding Academic Low Back Pain: Impact and Chiropractic Solutions | El Paso, Tx (2024)

What Is MET?

When people come in for back pain treatment, non-surgical therapies can help stretch the overworked and tired back muscles and restore mobility to the body’s upper and lower extremities. One of the non-surgical treatments that pain specialists like chiropractors and massage therapists use is MET therapy or muscle energy technique therapy. MET comprises soft tissue manipulation that uses controlled isometric and isotonic contractions. (Sarkar et al., 2021) This helps the body not only improve the physiological function of the muscles but also decrease pain. MET can also be combined with other therapies to help lengthen short muscles, improve the range of motion from the joints, and increase fluid drainage from the body’s peripheral regions. (Batool et al., 2024)

 

MET Reducing Back Pain

Regarding MET, reducing back pain is possible as MET can be integrated with physical therapy to improve the disability and functionality of the person with back pain. (Wahyuddin et al., 2020) When people start to incorporate MET and non-surgical treatments as part of their routine for their health and well-being, they will begin to notice that the pain they have been experiencing in their back is diminishing over time. This allows them to be more mindful of their backs and bodies while making small changes to their routine. Sleeping better with a correct mattress, exercising more to stretch and strengthen muscles, eating healthier foods, and relaxing more allow people to be pain-free in their health and wellness journey.

 

References

Batool, K., Mehmood, M., Jafar, M., & Gull, M. (2024). Comparative efficacy of muscle energy technique and Bowen technique on hamstrings muscle tightness in chronic low back pain patients. Pak J Med Sci, 40(9), 2080-2084. doi.org/10.12669/pjms.40.9.8517

Delitto, A., George, S. Z., Van Dillen, L., Whitman, J. M., Sowa, G., Shekelle, P., Denninger, T. R., & Godges, J. J. (2012). Low Back Pain. Journal of Orthopaedic & Sports Physical Therapy, 42(4), A1-A57. doi.org/10.2519/jospt.2012.42.4.a1

Elnaggar, O., Arelhi, R., Coenen, F., Hopkinson, A., Mason, L., & Paoletti, P. (2023). An interpretable framework for sleep posture change detection and postural inactivity segmentation using wrist kinematics. Sci Rep, 13(1), 18027. doi.org/10.1038/s41598-023-44567-9

Sarkar, M., Goyal, M., & Samuel, A. J. (2021). Comparing the Effectiveness of the Muscle Energy Technique and Kinesiotaping in Mechanical Sacroiliac Joint Dysfunction: A Non-blinded, Two-Group, Pretest-Posttest Randomized Clinical Trial Protocol. Asian Spine Journal, 15(1), 54-63. doi.org/10.31616/asj.2019.0300

Van Looveren, E., Bilterys, T., Munneke, W., Cagnie, B., Ickmans, K., Mairesse, O., Malfliet, A., De Baets, L., Nijs, J., Goubert, D., Danneels, L., Moens, M., & Meeus, M. (2021). The Association between Sleep and Chronic Spinal Pain: A Systematic Review from the Last Decade. J Clin Med, 10(17). doi.org/10.3390/jcm10173836

Wahyuddin, W., Vongsirinavarat, M., Mekhora, K., Bovonsunthonchai, S., & Adisaipoapun, R. (2020). Immediate effects of muscle energy technique and stabilization exercise in patients with chronic low back pain with suspected facet joint origin: A pilot study. Hong Kong Physiother J, 40(2), 109-119. doi.org/10.1142/S1013702520500109

Wiberg, G. (1949). Back pain in relation to the nerve supply of the intervertebral disc. Acta Orthop Scand, 19(2), 211-221, illust. doi.org/10.3109/17453674908991094

Zemková, E., & Zapletalová, L. (2021). Back Problems: Pros and Cons of Core Strengthening Exercises as a Part of Athlete Training. International Journal of Environmental Research and Public Health, 18(10), 5400. doi.org/10.3390/ijerph18105400

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Waking Up with Heartburn: Signs of GERD and More

By
Dr. Alex Jimenez
-
A young Hispanic woman with curly hair sits cross-legged on a bed, clutching her stomach with a pained expression on her face suggesting discomfort or illness

Individuals who wake up with a burning feeling in the chest or throat, along with a bitter taste, more than likely are experiencing morning or waking heartburn. Can simple steps, like not having any food three hours before going to bed, help prevent heartburn when waking up?

Waking Up with Heartburn: Signs of GERD and More

Waking Up With Heartburn

Heartburn is characterized by a burning sensation in the chest and neck and an acidic, bitter taste. It occurs when stomach acid flows into the esophagus tube that connects the throat to the stomach and often happens when lying down. Heartburn is a symptom of acid reflux, a digestive disorder that occurs when the stomach contents back up into the esophagus. Waking up with heartburn throughout the night or when waking in the morning is common during pregnancy and after drinking alcohol. (UCSF Health, 2024) But chronic acid reflux can also be a sign of a health condition like gastroesophageal reflux disease (GERD) and hiatal hernia, or another condition may cause it and can be triggered by stress, certain foods, and other factors.

Causes

Having occasional heartburn is normal. However, frequently waking up with heartburn may indicate gastroesophageal reflux disease (GERD). Other possible causes of this condition and factors that may contribute to frequently waking up with heartburn include: (National Library of Medicine, 2023)

  • Increased stress
  • Wearing belts or clothes that are tight around the waist.
  • Medications include sedatives, bronchodilators, beta-blockers, calcium channel blockers, and tricyclic antidepressants.
  • Pregnancy
  • Hiatal hernia – the top area of the stomach pushes through an opening in the diaphragm.

Sleeping and Heartburn

Research shows a relationship between sleep disorders like insomnia and an increased risk of acid reflux (Qin S. et al., 2023). A study of over 6,000 people found that those who woke up less often during the night were 50% less likely to experience heartburn than those with disrupted sleep.

Symptoms

Symptoms can include: (Johns Hopkins Medicine, 2024)

  • A burning sensation in the chest that can last from minutes to hours
  • Pain in the chest when lying down or bending
  • Burning sensation in the throat
  • A hot, acidic, and/or salty sour taste in the back of the throat

Along with these symptoms, individuals who have GERD may also experience: (National Institute of Diabetes and Digestive and Kidney Disease, 2020)

  • Chronic cough or hoarseness
  • Pain and difficulty swallowing
  • Nausea
  • Chest pain

When symptoms are constant, it’s important to see a healthcare provider.

See a Healthcare Provider

If heartburn persists long-term, it can lead to inflammation, breathing problems, and narrowing of the esophagus. Seeing a healthcare provider is recommended if lifestyle adjustments don’t help or symptoms continue despite taking over-the-counter antacids. Other symptoms that need professional diagnosis include: (National Institute of Diabetes and Digestive and Kidney Disease, 2020)

  • Chest pain or difficulty breathing, like wheezing or hoarseness
  • Loss of appetite, nausea, vomiting
  • Unexpected weight loss
  • Difficulty swallowing
  • Signs of blood in the digestive tract or stool

Tell a healthcare provider when and how you are experiencing symptoms. It may be helpful to keep a journal of frequency, specific symptoms, times when waking up with heartburn, what foods and the time of day when eating, and any other information.

Heart Attack Symptoms

Heartburn can feel like the chest pain associated with a heart attack. See a healthcare provider if you’re unsure if your heart or digestive system is causing the discomfort. Seek emergency medical attention if you have any of the following (American Heart Association, 2022)

  • Squeezing pressure, fullness, or pain in the center of the chest that lasts several minutes or stops and returns
  • Shortness of breath with or without chest pain
  • Pain in either or both arms, the back, neck, jaw, or abdomen
  • Other signs include lightheadedness, nausea, and breaking out in a cold sweat

Diagnosis

A healthcare provider can diagnose heartburn and related conditions based on the following (UCSF Health, 2024)

  • Discussing symptoms
  • X-rays, or imaging tests, that look at the esophagus, stomach, and small intestine
  • An esophageal pH monitoring test that checks how often and how long stomach acid stays in the esophagus
  • An upper endoscopy procedure where a small tube with a camera is inserted down the mouth to examine the esophagus and stomach

Prevention

Making a few lifestyle changes can reduce waking up with heartburn (National Institute of Diabetes and Digestive and Kidney Disease, 2020)

  • Elevate body when sleeping
  • Stop eating at least three hours before going to bed
  • Lose weight
  • Avoid spicy, high-fat, and acidic foods
  • Limit coffee and other forms of caffeine
  • Avoid carbonated drinks and alcoholic beverages

Staying hydrated helps with overall digestion. However, drinking too much water at once can make heartburn worse. Drinking small amounts throughout the day and avoiding sparkling water is recommended since carbonated drinks can trigger heartburn. (Harvard Health Publishing, 2023)

Treatment

There are various over-the-counter and prescription medications for heartburn. (National Institute of Diabetes and Digestive and Kidney Disease, 2020) Be sure to discuss the risks and benefits of the medicines with your healthcare provider. Heartburn treatments include:

Antacids

  • These oral over-the-counter medications help relieve symptoms of mild heartburn and GERD.
  • They should not be used daily or for severe symptoms as they can cause side effects like diarrhea or constipation.

H2 Blockers

  • Histamine-2 receptor antagonists – These medications reduce the stomach’s acid to help promote healing in the esophagus.
  • H2 blockers are available over-the-counter and by prescription.

Proton Pump Inhibitors (PPIs)

  • These medications, available over-the-counter and by prescription, reduce acid and help heal the esophageal lining in individuals with GERD.
  • They are often used for long-term treatment.

If medication and lifestyle changes don’t help, a healthcare provider may recommend surgery to strengthen the valve between the esophagus and stomach. (National Institute of Diabetes and Digestive and Kidney Disease, 2020)

Injury Medical Chiropractic and Functional Medicine Clinic

Lifestyle and dietary changes, as well as medications, may be used to treat the condition. See a healthcare provider if your heartburn is persistent or accompanied by other symptoms. A healthcare provider can determine the most effective treatment strategies. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems.

Functional Medicine’s Influence Beyond Joints

References

UCSF Health.(2024). Heartburn. www.ucsfhealth.org/conditions/heartburn

National Library of Medicine. (2023). Heartburn. Retrieved from medlineplus.gov/ency/article/003114.htm

Qin, S., Wang, C., Wang, X., Wu, W., & Liu, C. (2023). Causal association of gastroesophageal reflux disease with obstructive sleep apnea and sleep-related phenotypes: a bidirectional two-sample Mendelian randomization study. Frontiers in neurology, 14, 1283286. doi.org/10.3389/fneur.2023.1283286

Johns Hopkins Medicine. (2024). Gastroesophageal Reflux Disease (GERD). www.hopkinsmedicine.org/health/conditions-and-diseases/gastroesophageal-reflux-disease-gerd

National Institute of Diabetes and Digestive and Kidney Disease. (2020). Symptoms and causes of GER & GERD. Retrieved from www.niddk.nih.gov/health-information/digestive-diseases/acid-reflux-ger-gerd-adults/symptoms-causes

American Heart Association. (2022). American Heart Association. Heartburn or Heart Attack? www.heart.org/en/health-topics/heart-attack/angina-chest-pain/heartburn-or-heart-attack

Harvard Health Publishing. (2023). 9 at-home treatments for acid reflux. www.health.harvard.edu/newsletter_article/9-ways-to-relieve-acid-reflux-without-medication

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