Ice Water Bath For Sore Muscle Recovery

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

Woman having hydromassage therapy — Beautiful woman relaxing in the bathtub having a hydromassage therapy in the SPA

Athletes regularly take an ice-water bath after training or playing. It is known as cold water immersion/cryotherapy. It is used to relieve and reduce muscle soreness and pain after intense training or competition. From runners to professional tennis and football players, taking an ice bath is a common recovery practice. Many athletes utilize ice baths to help with faster recovery, prevent injury, and cool down the body. Here we provide some research on cold-water immersion therapy.

Table of Contents

Ice Water Bath

Cold Immersion After Exercise or Physical Activity

Exercise causes microtrauma/tiny tears in the muscle fibers. The microscopic damage stimulates muscle cell activity to repair the damage and strengthen the muscles/hypertrophy. However, hypertrophy is linked with delayed onset muscle soreness and pain/DOMS, between 24 and 72 hours after physical activity. An ice water bath works by:

Constricting the blood vessels.
Flushes out waste products (lactic acid), out of the muscle tissues.
Decreases metabolic activity.
Slows down physiological processes.
Reduces inflammation, swelling, and tissue breakdown.
Then, applying heat or warming up the water increases and speeds up blood circulation, improving the healing process.
There is no current ideal time and temperature for cold immersion, but most athletes and trainers who use the therapy recommend a water temperature between 54 to 59 degrees Fahrenheit and immersion of five to 10 minutes, and depending on the soreness, sometimes up to 20 minutes.

Pros and Cons

The effects of ice baths and cold water immersion on exercise recovery and muscle soreness.

Relieves Inflammation but Can Slow Down Muscle Growth

A study determined that cold water immersion can disrupt training adaptations.
Research suggests that icing muscles right after maximum exercise decreases inflammation, but can slow down muscle fiber growth, and delay muscle regeneration.
Athletes trying to increase muscle size and strength may need to adjust the therapy sessions.

Reduce Muscle Soreness

A review concluded there was some evidence that ice water immersion reduced delayed onset muscle soreness when compared to resting and rehabilitation or no medical treatment.
The most effects were seen in running athletes.
There was no substantial evidence to conclude whether it improved fatigue or recovery.
The studies did not have a standard for adverse effects or follow-up with the participants regularly.
There was no difference in muscle soreness between cold water immersion, active recovery, compression, or stretching.

Pain Relief

Cold water immersion after a physical activity offers temporary pain relief but can help with a faster recovery.
A study of jiu-jitsu athletes found that following a workout with cold water immersion could lead to decreased muscle aches and help reduce lactate levels.
Alternating cold water and warm water baths (contrast water therapy), may help athletes feel better and offer temporary pain relief.

Active Recovery Alternative

More research is needed before a firm conclusion can be reached on ice-water bath therapy. However, active recovery is a recommended alternative for athletes looking to recover faster.

A study suggested that ice baths were equally effective, but not more effective, as active recovery for reducing inflammation.
Cold water immersion is no greater than active recovery upon local and systemic inflammatory cellular stress.
Research determined that active recovery is still the most widely used, and currently the best way to recover after intense exercise or physical activity.
Low-impact workouts and stretches are still considered the most beneficial cool-down methods.

Cold Water Therapy

Ice Bath

Individuals can use their tub at home to perform cold water therapy.
Individuals may want to purchase a large bag of ice, but the cold water from the faucet will work.
Fill the tub with cold water, and if desired, pour in some ice.
Let the water and ice sit to get the cold temperature.
Measure the temperature if necessary before getting in.
Submerge the lower half of the body and adjust the temperature based on feel by adding more water, ice, or warm water if freezing.
It’s like icing with an ice pack, but the whole body swelling reduces and relaxes the muscles.
Don’t overdo it – one review found the best routine was 11 to 15 minutes of immersion at a temperature between 52 and 60 degrees Fahrenheit.

Cold Shower

A few minutes in a cold shower is another way to perform the therapy.
Individuals can get in a cold shower or start with warm water and slowly transition to cold.
This is the easiest and most time-efficient method of cold water therapy.

Safety

Consult with your doctor or a health care practitioner before practicing cold water therapy.
Exposure to cold water can affect blood pressure, circulation, and heart rate.
Cold water immersion can cause cardiac stress and can result in a heart attack.
Be mindful that exposure to cold temperatures can result in hypothermia.
Get out of the cold water if you experience numbness, tingling, discomfort, and/or pain.

Optimizing Wellness

References

Allan, R, and C Mawhinney. “Is the ice bath finally melting? Cold water immersion is no greater than active recovery upon local and systemic inflammatory cellular stress in humans.” The Journal of Physiology vol. 595,6 (2017): 1857-1858. doi:10.1113/JP273796

Altarriba-Bartes, Albert, et al. “The use of recovery strategies by Spanish first division soccer teams: a cross-sectional survey.” The Physician and sports medicine vol. 49,3 (2021): 297-307. doi:10.1080/00913847.2020.1819150

Bieuzen, François, et al. “Contrast water therapy and exercise-induced muscle damage: a systematic review and meta-analysis.” PloS one vol. 8,4 e62356. 23 Apr. 2013, doi:10.1371/journal.pone.0062356

Fonseca, Líllian Beatriz et al. “Use of Cold-Water Immersion to Reduce Muscle Damage and Delayed-Onset Muscle Soreness and Preserve Muscle Power in Jiu-Jitsu Athletes.” Journal of athletic training vol. 51,7 (2016): 540-9. doi:10.4085/1062-6050-51.9.01

Forcina, Laura, et al. “Mechanisms Regulating Muscle Regeneration: Insights into the Interrelated and Time-Dependent Phases of Tissue Healing.” Cells vol. 9,5 1297. 22 May. 2020, doi:10.3390/cells9051297

Shadgan, Babak, et al. “Contrast Baths, Intramuscular Hemodynamics, and Oxygenation as Monitored by Near-Infrared Spectroscopy.” Journal of athletic training vol. 53,8 (2018): 782-787. doi:10.4085/1062-6050-127-17

Sutkowy, Paweł, et al. “Postexercise impact of ice-cold water bath on the oxidant-antioxidant balance in healthy men.” BioMed research international vol. 2015 (2015): 706141. doi:10.1155/2015/706141

Hamstring Injuries Could Be Implementing Other Issues

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

Table of Contents

Introduction

How do non-surgical treatments compare with traditional surgical treatments to improve mobility for individuals with hamstring injuries? The hamstrings are muscles in the lower extremities that provide mobility to the legs and stabilize the pelvis. Many athletes rely on their hamstrings to perform strenuous actions such as sprinting, jumping, squatting, and kicking during sporting events. However, the hamstrings are also very susceptible to injury. Athletes who repeatedly overstretch their hamstrings can experience muscle strain until microscopic tears form, which is common. Similarly, individuals who sit for long periods can also experience hamstring issues. When individuals are not physically active, their hamstrings can become weak and shortened, leading to symptoms such as muscle pain, trigger points, and strain on the accessory muscles. Hamstring injuries can also cause other issues that affect the lower body extremities. This article will explore how hamstring injuries affect mobility and how non-surgical treatments help people regain mobility. We work with certified medical providers who use our patients’ valuable information to treat individuals suffering from hamstring injuries and inform them about non-surgical treatments to regain mobility. We encourage patients to ask essential questions and seek education from our associated medical providers about their condition. Dr. Jimenez, D.C., provides this information as an educational service. Disclaimer

Hamstring Injuries Implementing Other Issues

Do you experience stiffness in the back of your thighs when warming up before exercising? Are you feeling radiating pain from the side of your hips and glutes due to prolonged sitting? Or do you tend to limp, affecting your gait and walking? Many people are unaware they are overexerting their hamstrings, which can cause pain. Those who engage in sports or work sedentary jobs may over or underuse their hamstrings, affecting their flexibility and mobility to the lower extremities. According to research studies, hamstring injuries are the most common non-contact muscle injuries caused by two mechanisms of injuries: stretch-type and sprint-type. Sprint-type injuries associated with hamstrings occur when the muscles are overexerted due to maximal or near-maximal action, causing muscle fatigue. To that point, hamstring injuries can also affect a person’s walking mobility.

Running without properly warming up the hamstring muscle can cause muscle fatigue. Stretch-type injuries associated with the hamstring muscles involve combination movements that include extreme hip flexion and knee extension. These injuries can also mimic sciatica, leading people to believe their sciatic nerve is acting up. However, treatments available can help reduce the pain associated with hamstring injuries and lengthen the shortened muscle to reduce pain.

Best Lower Body Stretches To Increase Flexibility-Video

BEST Hip, Piriformis & Hamstring Stretches, Increase Flexibility To Stop Pain

If you want to reduce the pain associated with hamstring injuries, incorporating RICE can help prevent it from becoming chronic. This involves gently stretching the affected muscle to avoid cramps and pain while increasing flexibility. Hamstring injuries can also be linked to other chronic issues, which can cause inflammation in the surrounding muscles. Studies show that conditions like piriformis syndrome can cause nerve entrapment in the hamstrings, resulting in radiating pain down the leg that mimics low back pain and sciatica. As previously mentioned, hamstring injuries can limit mobility and be linked to chronic conditions. Thankfully, non-surgical treatments can help reduce pain and provide relief. Check out the video above to learn different stretches that can help reduce pain in the lower body and increase flexibility.

Treatments To Restore Mobility

If rest, ice, compression, and gentle stretching do not provide relief, incorporating treatments for hamstring injuries to restore mobility can benefit many individuals. Seeking the help of a pain specialist, such as a massage therapist or chiropractor, to create a customized plan/program is recommended. There are various approaches that pain specialists can use to regain mobility and treat hamstring injuries.

MET Therapy

Many chiropractors and massage therapists incorporate MET (muscle energy techniques) therapy to gently stretch out the shortened hamstring muscle and help restore joint mobility in the lower extremities. In “Clinical Applications of Neuromuscular Techniques,” written by Leon Chaitow, N.D., D.O., and Judith Walker DeLany, L.M.T., stated that MET is crucial in stretching and strengthening the hamstring muscles through isometric contraction. At the same time, additional research studies reveal that the MET technique allows the hamstrings to have a greater increase in hip flexion ranges. MET therapy also helps strengthen the accessory muscles surrounding the hamstrings to restore mobility.

Spinal Decompression

If hamstring injuries are caused by nerve entrapment, then trying out spinal decompression can help restore mobility to the hips and lower extremities. According to “The Ultimate Spinal Decompression,” written by Dr. Eric Kaplan, D.C., FIAMA, and Dr. Perry Bard, D.C., stated that spinal decompression is safe and gentle on the spine as it provides gentle traction on the spinal disc to reduce pain and increase disc height. When hamstring injuries are associated with nerve entrapment, it could result from a herniated disc that aggravates the nerve root and causes referred pain to the hamstrings. Using gentle traction on the spine can help alleviate the pain caused by the aggravating nerve and reduce pain in the hamstrings. Many individuals can incorporate these treatments to reduce hamstring injuries and regain their mobility back to their legs.

References

Chaitow, L., & Delany, J. (2002). Clinical application of neuromuscular techniques. Vol. 2, The lower body. Churchill Livingstone.

Gunn, L. J., Stewart, J. C., Morgan, B., Metts, S. T., Magnuson, J. M., Iglowski, N. J., Fritz, S. L., & Arnot, C. (2018). Instrument-assisted soft tissue mobilization and proprioceptive neuromuscular facilitation techniques improve hamstring flexibility better than static stretching alone: a randomized clinical trial. Journal of Manual & Manipulative Therapy, 27(1), 15–23. https://doi.org/10.1080/10669817.2018.1475693

Huygaerts, S., Cos, F., Cohen, D. D., Calleja-González, J., Guitart, M., Blazevich, A. J., & Alcaraz, P. E. (2020). Mechanisms of Hamstring Strain Injury: Interactions between Fatigue, Muscle Activation and Function. Sports (Basel, Switzerland), 8(5), 65. https://doi.org/10.3390/sports8050065

Kaplan, E., & Bard, P. (2023). The Ulitimate Spinal Decompression. JETLAUNCH.

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. Anesthesiology and Pain Medicine, 11(1). https://doi.org/10.5812/aapm.112825

Disclaimer

Learning To Sleep On Your Back

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

Closeup shot of a curly woman sleeping — A closeup shot of a curly woman sleeping

Individuals spend around one-third of their life sleeping or resting. Every person has their own preferred sleeping position. However, not all sleep positions are comfortable and supportive to the body, especially the spine. Individuals that sleep on their side or stomach that experience back pain might want to consider switching to sleeping on their back. Changing preferred sleeping positions can seem impossible, however, learning to sleep on your back is possible with a little training and adjustment period.

Table of Contents

Learning To Sleep On Your Back

After side sleeping, back sleeping is the second most common position. Individuals that are stomach or side sleepers that suffer from:

Body and back soreness.
Pain symptoms.
Tension headaches.
Heartburn or acid reflux.
Aches in the joints and ligaments.

Learning to sleep on your back is recommended because its health benefits can potentially solve all these problems and more.

Adapting this sleeping position can help maintain proper spinal alignment.
Relieves waking up with tension headaches.
Relieve sinus problems.

Individuals that are not natural back sleepers understand how difficult it is to force oneself to adapt to a new sleeping position. There are ways to condition the mind and body to fall and stay asleep on your back, resulting in healthy rest. These include:

A Pillow Under The Knees

It may help to place a supportive pillow under the knees.
The knees should be slightly bent and feel comfortable.
Check to make sure that the neck and spine feel comfortable and are in alignment.
Make adjustments as needed.

A Pillow Under The Low Back

In the beginning, switching to back sleeping can increase discomfort in the low back.
Placing a pillow under the lower back can help.
Using too large or thick a pillow could create added discomfort.
Try a few different pillows to find what works best and feels right.

Pillow Surround

Individuals that are active sleepers and tend to roll onto their side or stomach soon after falling asleep, can place pillows around the midsection and hips.
A small barrier of pillows around the body can assist in learning to sleep on your back.
The pillows help prevent the body from rolling.
It’s recommended to place pillows closely against either side of the body.
Using the pillows as an enclosure will force the body to remain in a neutral position throughout the night.

Sleeping On The Right Pillow

Individuals will want to make sure they are using the right sleeping pillow.
In addition to supporting the spine’s alignment, a quality pillow will also support the neck.
The recommended pillow for back sleeping should cradle the head and ensure it stays elevated.
A pillow that is too flat or too thick can cause the head to become unlevel with the body leading to:
Neck and upper body pain
Restricted airflow, which may cause you to snore or suffer from sleep apnea.
Digestive issues like acid reflux and heartburn.
Consider a pillow that’s made out of some type of memory foam to assist with learning to sleep on your back.
The thickness and hugging sensation can help to stay on the back and prevent inadvertently flipping over.

Sleeping On The Right Mattress

A positive back sleeping experience begins with the right mattress. There are so many mattress types to choose from. It is recommended to consider the materials, the firmness level, and the size. For comfortably sleeping on your back, the firmness level is essential.

Consider the positioning of your spine.
The objective is to keep the spine as straight as possible, which is achieved with the proper firmness.
A mattress that is too firm will create unwanted pressure and tension on the shoulders and the pelvic region.
A mattress that is too soft will cause the hips to sink, throwing spinal alignment off and causing back pain symptoms.
A medium-firm mattress is recommended.
Memory foam is a great option for learning to sleep on your back.
Memory foam cradles the natural curve of the body, and hugs the body during sleep, which helps avoid accidentally rolling onto your side or stomach.
Memory foam mattresses with integrated gel can provide cooling and ventilation to keep the body refreshed throughout the night.
A medium-firm memory foam mattress will make sure the body stays straight, with the proper cushioning around the pelvis and hips.

Training To Sleep On Your Back

References

Anderson, Ngaire H et al. “Association of Supine Going-to-Sleep Position in Late Pregnancy With Reduced Birth Weight: A Secondary Analysis of an Individual Participant Data Meta-analysis.” JAMA network open vol. 2,10 e1912614. 2 Oct. 2019, doi:10.1001/jamanetworkopen.2019.12614

Desouzart, Gustavo, et al. “Effects of sleeping position on back pain in physically active seniors: A controlled pilot study.” Work (Reading, Mass.) vol. 53,2 (2015): 235-40. doi:10.3233/WOR-152243

Khan, Bashir Ahmad, et al. “Effect of bed head elevation during sleep in symptomatic patients of nocturnal gastroesophageal reflux.” Journal of Gastroenterology and Hepatology vol. 27,6 (2012): 1078-82. doi:10.1111/j.1440-1746.2011.06968.x

Portale, G et al. “When are reflux episodes symptomatic?.” Diseases of the esophagus: official journal of the International Society for Diseases of the Esophagus vol. 20,1 (2007): 47-52. doi:10.1111/j.1442-2050.2007.00650.x

Skarpsno, Eivind Schjelderup, et al. “Sleep positions and nocturnal body movements based on free-living accelerometer recordings: association with demographics, lifestyle, and insomnia symptoms.” Nature and Science of Sleep vol. 9 267-275. 1 Nov. 2017, doi:10.2147/NSS.S145777

Surdea-Blaga, Teodora, et al. “Food and Gastroesophageal Reflux Disease.” Current medicinal chemistry vol. 26,19 (2019): 3497-3511. doi:10.2174/0929867324666170515123807

MET Therapy’s Approach To Chronic Pain Problems

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

Table of Contents

Introduction

The musculoskeletal system comprises muscles, ligaments, and tissues surrounding the skeletal structure and vital organs. These components have various functions, including transporting blood and nutrients throughout the body and facilitating movement. However, chronic conditions or aging can cause pain-like symptoms, disrupting daily life and leading to disability. There are many available treatments, both surgical and non-surgical, that can help alleviate chronic pain. This article will explore how chronic pain affects individuals and how treatments like Muscle Energy Technique (MET) therapy can help address it. We work with certified medical providers who use our patients’ valuable information to treat individuals suffering from muscle pain while informing them about non-surgical treatments like MET therapy that can help reduce the effects of chronic pain associated with the musculoskeletal system. We encourage patients to ask essential questions and seek education from our associated medical providers about their condition. Dr. Jimenez, D.C., provides this information as an educational service. Disclaimer

How Does Chronic Pain Affect The Individual?

Have you been dealing with shooting pain in your joints or muscles? When you wake up in the morning, do you feel constant stiffness in your joints? Or do you experience muscle pain slowly throughout the entire day? When it comes to chronic pain in the musculoskeletal system, it can be hard to pinpoint where the pain is located in the body. Research studies reveal that chronic musculoskeletal pain is a challenge for the individual and their doctors and a main contributor to disability worldwide. Chronic musculoskeletal pain can be non-specific and specific depending on the severity and factors contributing to its development. For many individuals experiencing chronic pain associated with the musculoskeletal system, the homeostatic and adaptive function in their muscle fibers has been stretched past their limits.

Additional research studies stated that factors like mechanical forces, ischemia, and even inflammation are all primary stimuli for chronic muscle pain. Factors like lifting/carrying heavy objects, persistent sitting, physical inactivities, and dietary habits all correlate to chronic muscle and joint pain, as repetitive motions or prolonged inactivity can either shorten or overstretch the muscle fibers. At the same time, chronic musculoskeletal diseases like fibromyalgia and myofascial pain syndrome can cause the affected muscles to stiffen, contract, and tender to the touch, which then causes the other surrounding muscles to take over and compensate for the pain. To that point, chronic musculoskeletal pain can cause many individuals to decrease their productivity, call off work constantly, and lead a life of disability.

From Consultation To Transformation- Video

From Consultation to Transformation: Assessing Patients in a Chiropractic Setting| El Paso, Tx(2023)

Have you been dealing with constant muscle and joint pain throughout your life? Has the pain been unbearable that it is affecting your routine? Or do you feel aches or stiffness in your sides or different body areas? Throughout the entire world, many individuals suffer from chronic musculoskeletal pain at one point in their lives, and it has become a social/economic burden. Research studies reveal that chronic pain associated with musculoskeletal disorders can affect many other aspects of a person’s life. When chronic pain starts to affect a person’s ability to function, it can have a negative effect on the person’s mental health. When chronic pain is associated with musculoskeletal disorders, it also correlates with work, as many individuals with chronic pain have reduced work productivity, lost wages, and lost hours that can take a toll on their income. However, there is hope, as many affordable treatments can reduce the effects of chronic musculoskeletal pain and its associated symptoms. Non-surgical treatments like chiropractic care and MET therapy can help many individuals with chronic musculoskeletal pain find the relief they deserve. The video above explains how non-surgical treatments approach chronic musculoskeletal pain, from assessing patients through consultation to transforming their health and wellness. By taking back their health, many individuals can find relief from their pain and get back to their routines.

MET Therapy’s Approach To Chronic Pain

Non-surgical treatments like MET (muscle energy technique) therapy has a unique approach to reducing chronic pain in the musculoskeletal system. In the book, “Clinical Applications of Neuromuscular Techniques,” Dr. Leon Chaitow, N.D., D.O., and Dr. Judith Walker DeLany, L.M.T., mentioned that the fascia and the characteristics of the connective tissues are relevant for MET by commencing stretching the affected muscles that are in chronic pain and use biomechanical forces to initiate a low intense force to lengthen the tissues and increase their flexibility. MET therapy helps many individuals with chronic pain associated with musculoskeletal disorders, as research studies reveal that MET therapy can help increase the strength of weakened muscles and help increase the spinal ROM. MET therapy is non-surgical, cost-effective, and safe to reduce chronic pain associated with musculoskeletal disorders.

Identifying The Patterns

Many pain specialists who incorporate MET will begin by assessing the individual with chronic pain associated with musculoskeletal disorders. They will get examined by testing their range of motion, spinal and joint mobility, and any additional factors to develop a personalized plan that caters to the individual. Once the pain issue is found, the individual will work with other medical professionals to help strengthen their muscles and help reduce the pain-like symptoms that are causing them. To that point, MET therapy combined with other treatments is beneficial for those with chronic illnesses and needs relief from pain.

Conclusion

Many individuals suffering from chronic musculoskeletal pain often experience limited mobility, shortened muscles, and referred pain in different areas of their bodies. Chronic musculoskeletal pain is a social/economic problem that has affected many individuals and left them missing out on important life events. Treatments like MET (muscle energy technique) therapy can help reduce pain by stretching the muscle fibers to alleviate pain and restore joint mobility to the body. When many individuals start to utilize MET therapy, it can reduce chronic pain and allow them to get back their health and wellness.

References

Bains, D., Chahal, A., Shaphe, M. A., Kashoo, F. Z., Ali, T., Alghadir, A. H., & Khan, M. (2022). Effects of Muscle Energy Technique and Joint Manipulation on Pulmonary Functions, Mobility, Disease Exacerbations, and Health-Related Quality of Life in Chronic Obstructive Pulmonary Disease Patients: A Quasiexperimental Study. BioMed Research International, 2022, 1–9. https://doi.org/10.1155/2022/5528724

Bonanni, R., Cariati, I., Tancredi, V., Iundusi, R., Gasbarra, E., & Tarantino, U. (2022). Chronic Pain in Musculoskeletal Diseases: Do You Know Your Enemy? Journal of Clinical Medicine, 11(9), 2609. https://doi.org/10.3390/jcm11092609

Chaitow, L., & Delany, J. (2002). Clinical application of neuromuscular techniques. Vol. 2, The lower body. Churchill Livingstone.

El-Tallawy, S. N., Nalamasu, R., Salem, G. I., LeQuang, J. A. K., Pergolizzi, J. V., & Christo, P. J. (2021). Management of Musculoskeletal Pain: An Update with Emphasis on Chronic Musculoskeletal Pain. Pain and Therapy, 10(1). https://doi.org/10.1007/s40122-021-00235-2

Gregory, N. S., & Sluka, K. A. (2014). Anatomical and Physiological Factors Contributing to Chronic Muscle Pain. Current Topics in Behavioral Neurosciences, 20, 327–348. https://doi.org/10.1007/7854_2014_294

Disclaimer

Pesto – Nutritional and Health Benefits

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

Ingredients for pesto sauce. — Ingredients for italian pesto sauce (pesto alla genovese).

Pesto is a sauce that is made with garlic, pine nuts, basil, cheese, and olive oil, which creates a strong, rich flavor. It is used as a marinade, dip, salad dressing, sandwich spread, and a topping for dishes like pasta and pizza. It can be homemade or bought premade, including vegan varieties. It is made with nutritious ingredients and can be consumed as part of a balanced diet. The sauces can vary in nutrition, but in general, it is a rich source of healthy fats and is also part of the Mediterranean Diet.

Table of Contents

Pesto

Carbohydrates

The sauce is not a significant source of complex carbohydrates, dietary fiber, or sugar.
A spoonful contains under 1 gram of carbohydrates.
It is often paired with foods rich in carbohydrates, like sandwiches, pizza, and pasta.

Fats

Nearly 60% of the calories in pesto come from fats, provided by the olive oil, cheese, and pine nuts.
There are 9.47 grams of fats per spoonful, which includes:
5.63 grams of monounsaturated fatty acids.
1.53 grams of saturated fatty acids.
1.68 grams of polyunsaturated fatty acids.
It also contains 2.56mg of cholesterol.
According to U.S. Dietary Guidelines for Americans, 20% to 35% of daily calories should come from fat.

Protein

The sauce is not a protein-rich food with only 1.38 grams of protein per tablespoon.
It is often used as a condiment, it can add flavor to other foods higher in protein.

Vitamins and Minerals

Pesto contains:
33.1mg of calcium.
36.8mg of phosphorus.
31.8mg of potassium.
9.76mg of magnesium.

Health Benefits

Some of the potential health benefits of pesto.

Antioxidant Properties

Garlic, pine nuts, olive oil, and basil are rich sources of antioxidants.
Antioxidants have an essential role in defending the body against free radical damage, which can lead to disease.
Diets high in antioxidants reduce the risk of various diseases, like heart disease and cancer.
Consuming antioxidant-rich foods like pesto on a regular basis can increase antioxidant levels.

Cardiovascular Benefits

Olive oil health benefits include the reduced risk of heart disease.
Substituting other high-fat foods like margarine, butter, and mayonnaise with olive oil can help lower the risk of heart disease and stroke.

Help Lower Cholesterol

Four different types of fats – saturated, trans, monounsaturated, and polyunsaturated fats.
Saturated fats can raise LDL/unhealthy cholesterol levels.
Foods rich in monounsaturated and polyunsaturated fats like pesto can help lower LDL cholesterol levels in the blood and support HDL/healthy cholesterol levels.

Weight Management

Pesto is commonly consumed on the Mediterranean diet and can be part of a nutritious lifestyle that supports a healthy weight.
Research has shown that following a Mediterranean diet can lead to and maintain long-term changes in weight management.
Store-bought pesto can contain a large amount of sodium.
Individuals following a low-sodium diet or taking heart medications should check with their doctor before consuming these products.
To control the amount of sodium, consider making a homemade recipe that uses less salt and aligns with individual dietary preferences.

Types

Grocery stores generally carry several varieties of pesto.
Basil is the main ingredient but some varieties are made with other herbs.
Pesto traditionally contains parmesan cheese/milk products and pine nuts/tree nuts which are common food allergens.
The sauce is a vegetarian-friendly sauce, but vegans can look for cheese and dairy-free versions.
It is possible that an allergic reaction can occur in individuals allergic to dairy products and nuts.
Individuals allergic to nuts can choose nut-free varieties.

From Consultation to Transformation

References

Agnoli C, Sieri S, Ricceri F, et al. Adherence to a Mediterranean diet and long-term changes in weight and waist circumference in the EPIC-Italy cohort. Nutr Diabetes. 2018;8(1):22. doi:10.1038/s41387-018-0023-3

Bolling, Bradley W et al. “Tree nut phytochemicals: composition, antioxidant capacity, bioactivity, impact factors. A systematic review of almonds, Brazils, cashews, hazelnuts, macadamias, pecans, pine nuts, pistachios, and walnuts.” Nutrition research reviews vol. 24,2 (2011): 244-75. doi:10.1017/S095442241100014X

Bower, Allyson, et al. “The Health Benefits of Selected Culinary Herbs and Spices Found in the Traditional Mediterranean Diet.” Critical Reviews in food science and nutrition vol. 56,16 (2016): 2728-46. doi:10.1080/10408398.2013.805713

Guasch-Ferré M, Liu G, Li Y, et al. Olive oil consumption and cardiovascular risk in U.S. adults. J Am Coll Cardiol. 2020;75(15):1729-1739. doi:10.1016/j.jacc.2020.02.036

Liu, Qing, et al. “Antibacterial and Antifungal Activities of Spices.” International journal of molecular sciences vol. 18,6 1283. 16 Jun. 2017, doi:10.3390/ijms18061283

Marcelino, Gabriela et al. “Effects of Olive Oil and Its Minor Components on Cardiovascular Diseases, Inflammation, and Gut Microbiota.” Nutrients vol. 11,8 1826. 7 Aug. 2019, doi:10.3390/nu11081826

Nicastro, Holly L, et al. “Garlic and onions: their cancer prevention properties.” Cancer prevention research (Philadelphia, Pa.) vol. 8,3 (2015): 181-9. doi:10.1158/1940-6207.CAPR-14-0172

Sestili, Piero, et al. “The potential effects of Ocimum basilicum on health: a review of pharmacological and toxicological studies.” Expert opinion on drug metabolism & toxicology vol. 14,7 (2018): 679-692. doi:10.1080/17425255.2018.1484450

Sun, Liangzi, et al. “Tryptophan targeted pulsed electric field treatment for enhanced immune activity in pine nut peptides.” Journal of food biochemistry vol. 44,6 (2020): e13224. doi:10.1111/jfbc.13224

USDA FoodData Central. Pesto sauce.

MET Therapy Protocol: The Comprehensive Guide for Muscle Pain

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

Table of Contents

Introduction

Regarding the musculoskeletal system, the various muscles, tissues, and ligaments help protect the spine and vital organs that make the body functional. These muscles are sectioned into different groups that help provide movement and motion to the host without feeling pain. However, when normal factors or traumatic forces begin to affect the musculoskeletal system, it can cause unnecessary stress on the muscle fibers. These environmental factors can lead to muscle pain and correlating symptoms affecting the upper and lower body portions. When muscle pain affects the body, it can mask other pre-existing conditions that can make the individual feel miserable. Fortunately, many individuals will go to therapy treatment to reduce the effects of muscle pain and have a personalized plan that they can follow to prevent muscle pain from returning in the future. Today’s article focuses on one of the non-surgical treatments known as MET (muscle energy technique) therapy that can help reduce the effects of muscle pain and what is the protocol treatment plan to relieve muscle pain in the body. We work with certified medical providers who use our patients’ valuable information to treat individuals suffering from muscle pain while informing them about non-surgical treatments like MET therapy that can help reduce the effects of musculoskeletal pain. We encourage patients to ask essential questions and seek education from our associated medical providers about their condition. Dr. Jimenez, D.C., provides this information as an educational service. Disclaimer

How Does Muscle Pain Affect The Body?

Do you experience muscle aches, stiffness, or pain in one or more parts of your body? These pain-like symptoms are often caused by muscle pain. Research studies revealed that free nerve endings in muscle fibers can send pain signals to the brain, leading to decreased productivity and economic burden. Overstretching muscles during daily routines can cause trigger points, small nodules in muscle fibers that cause stiffness and contraction. This can lead to misalignment and additional problems over time.

Muscle pain can be a symptom of different conditions, with severity ranging from acute to chronic. Research studies stated that when musculoskeletal pain affects more than 30% of the world, it can significantly impact an individual’s life. This type of pain can be related to sensory innervation of the bones, joints, and muscles and can negatively affect a person’s daily routine. However, there are various ways to reduce muscle pain, which individuals can incorporate to relieve muscle pain and reduce its chances of returning.

Movement As Medicine- Video

Movement as Medicine | El Paso, Tx (2023)

When it comes to musculoskeletal pain, it can have a significant impact on a person’s body. It can affect their daily routine, causing them to have limited mobility and feel miserable. Musculoskeletal pain causes the involved muscle fibers to stiffen up and contract. This causes the surrounding muscles to compensate for the pain the affected muscle feels and causes body misalignment. However, all is not lost, as available treatments can help reduce the effects of muscle pain and can bring back a person’s mobility. One of these treatments is MET (muscle energy technique) therapy. Research studies reveal that MET is an osteopathic technique that many pain specialists like chiropractors and massage therapists use to improve musculoskeletal function by mobilizing joints, stretching tight muscles and facia to reduce pain, and improving circulation and lymphatic flow. Since many individuals don’t stretch their bodies as often as needed, their muscles can become tight and stiff, which causes the development of muscle pain. So by utilizing MET therapy, a person dealing with muscle pain can regain mobility. MET therapy can also be combined with other treatments like chiropractic care to help realign the body out of subluxation and strengthen/lengthen tight muscles. The video above explains how movement is used as medicine to reduce the effects of muscle pain.

MET Treatment Protocol

According to “Clinical Application of Neuromuscular Techniques,” written by Leon Chaitow, N.D., D.O., and Judith Walker DeLany, L.M.T., when the body is experiencing restricted joints, incorporating MET therapy can indicate where the problem is located in the soft musculoskeletal tissues. When it comes to many individuals going to MET therapy for muscle pain, many doctors have their protocol approach when assessing patients for muscle pain treatment.

Looking At Body Language

When assessing patients with muscle pain, looking at their body language and how they carry themselves is important. Many doctors and pain specialists should note how the individual is breathing, their posture, and if there is any perspiration on the skin. By taking note of how the individual looks physically, many doctors will begin to formulate a treatment plan while communicating with the patient to gather more information and create a trusting relationship. Afterward, the doctor can start the physical examination to locate where the pain is in the body.

Physical Examination

The MET treatment protocol’s physical examination portion allows the doctor to go through a sequential assessment involving observation, joint and muscle testing, palpations, evaluation of accessory movement, etc., to create a basic formula to create a personalized treatment plan. The physical examination of MET allows the muscles to influence muscle contractions on the surrounding fascia and alter the muscle’s physiology by reflex mechanisms. These stretches help the restricted joints be re-mobilized, and help stretch the tightened muscles to feel relief from metabolic waste.

Therapeutic Plan

The therapeutic plan for MET treatment is personalized and customizable for the individual to follow through to reduce muscle pain from re-occurring in the body. Many doctors specializing in MET therapy work with other associated medical providers to ensure that the person in pain has the help they need. Physical therapy, dietary nutrition, non-surgical treatments, and health coaches all work together to create a personalized health and wellness plan to make sure that muscle pain and its associated factors are being treated. This allows individuals to be more mindful of their bodies and regain their health and wellness.

Conclusion

Muscle pain can affect a person’s ability to move around and can affect multiple areas in the upper and lower body portions. Muscle pain correlates to tight muscle fibers that become stiff and can develop trigger points in the fascia and cause restricted movement. When this happens, it can cause the individual to miss out on daily activities and prevent them from working. Luckily available treatments can help reduce muscle pain by re-mobilizing the joints and stretching out the tight muscle. MET, or muscle energy technique therapy, helps stretch muscle fascia and mobilize joints to regain the body’s range of motion and help reduce muscle pain. Many people who incorporate MET into their daily routine can restore mobility and continue their health and wellness journey.

References

Chaitow, L., & Delany, J. (2002). Clinical application of neuromuscular techniques. Vol. 2, The lower body. Churchill Livingstone.

Puntillo, F., Giglio, M., Paladini, A., Perchiazzi, G., Viswanath, O., Urits, I., Sabbà, C., Varrassi, G., & Brienza, N. (2021). Pathophysiology of musculoskeletal pain: a narrative review. Therapeutic Advances in Musculoskeletal Disease, 13, 1759720X2199506. https://doi.org/10.1177/1759720×21995067

Waxenbaum, J. A., & Lu, M. (2020). Physiology, Muscle Energy. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK559029/

Disclaimer

Sets, Reps, and Rest: A Strength Training Guide

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

Young man is engaged on a modern simulator in the gym. Male athlete is doing exercises for legs with training machine. — Young man is engaged on a modern simulator in the gym. Male athlete is doing exercises for legs with training machine

Fitness, exercising, weight, and strength training programs use terms like sets, reps, and rest intervals. Knowing what they mean and how to use them for optimal results is important to achieve health goals. An individual’s training program will differ in the weights, reps, sets, rest intervals, and execution speed depending on whether the training is for fitness, muscle growth, strength, power, or endurance. Here we offer a strength training guide on understanding these terms and how they apply to a workout program.

Table of Contents

Strength Training Guide

Reps

Rep means repetition.
A rep is one completion of an exercise, such as one bench press, or one bicep curl.
So, one bicep curl equals one rep, and 10 bicep curls equals 10 reps.
Reps make up a set, which is typically the total number of reps done before taking a break.
A repetition maximum – 1RM is an individual’s personal best or the most they can lift once in a single repetition.
A 10RM would be the most an individual could lift and successfully perform 10 reps with proper form.

Sets

A set is a series of repetitions performed sequentially.
For example, one set of bench presses could be eight reps
Sets are designed according to the individual’s workout program.

Rest

The rest interval is the time of resting between sets that allow the muscles to recover.
The rest period between sets can range from 30 seconds to two minutes.
Exercises can have short or long rests between reps.
The ideal rest period depends on the objective of the workout and health goals.
Muscle hypertrophy/building: 30 to 60 seconds
Muscle endurance: 30 to 60 seconds
Strength: 2 to 5 minutes
Power: 1 to 2 minutes

It’s important to time rest between sets.
Not resting long enough and starting with another set too soon can fatigue the muscles too soon, increasing the risk of injury.
Resting too long between reps can cool the muscles down and release tension before starting again.

Execution Speed

The speed at which one rep of an exercise is performed is contraction velocity.
Concentric – shortening of the muscle is often the lifting part of a rep.
Eccentric – lengthening of the muscle, often the lowering part of a rep helps to build muscle mass.

Strength: 1 to 2 seconds concentric and eccentric
Hypertrophy: 2 to 5 seconds concentric and eccentric
Endurance: 1 to 2 seconds concentric and eccentric
Power: Less than 1 second concentric and 1 to 2 seconds eccentric

Choosing Weights

The distribution of repetitions against a percentage of 1RM maximum lift is as follows. This example uses a bench press where 1RM is 160 pounds.

100% of 1RM: 160 pounds, 1 repetition
60% of 1RM: 96 pounds, warm-up reps
85% of 1RM: 136 pounds, 6 repetitions
67% of 1RM: 107 pounds, 12 repetitions
65% of 1RM: 104 pounds, 15 repetitions

An individual should be able to do one lift at 1RM, six reps at 85%, 15 reps at 65%, and so on.

Goals to Build a Program

A training program is a schedule of exercise types, frequency, intensity, and volume, for weight training or any other type of fitness training. Individuals can devise various combinations of sets, reps, rest, and exercise types to find what works best for them. A qualified strength and conditioning trainer can help develop a program. The variables can be adjusted and include:

Exercise selection
Weights or resistance used
Number of reps
Number of sets
Execution speed
Rest time between sets
Rest time between training sessions and days of the week

General Fitness

A basic strength training fitness program targets strength and muscle-building.
Between eight and 15 repetitions for two to four sets will help achieve both.
Choose eight to 12 exercises, making sure to hit the lower and upper body and core.

Strength

Building strength uses the most weight, the least number of reps, and the longest rest periods.
The neuromuscular system responds to heavy weights by increasing the body’s ability to lift heavy loads.
For example, individuals with a strength goal could use a 5×5 system.
This means five sets of five repetitions.

Muscle Growth

Muscle growth and bodybuilding training use lighter weights, more reps, and less rest periods.
Muscle requires metabolic stress to increase in size.
This means working the muscles to the point where lactate builds and the muscle suffers internal damage, sometimes called “training to failure.”
Then resting and proper nutrition help muscle repair and the muscle grows larger in the process.
A program could be three sets of 8 to 12 reps, with loads that reach or near the failure point on the last few reps.

Power

Power training uses slightly lighter weights, takes longer rest periods, and focuses on execution speed.
Power is the ability to move an object at high speed.
Each push, pull, squat, or lunge is done at a quick tempo.
This type of training requires practicing the acceleration of a lift, resting properly, and repeating.

Muscular Endurance

Endurance weight training requires more reps in each set, up to 20 or 30, with lighter weights.
Individuals should ask themselves what is the day-to-day physical activity that requires the most muscular endurance?
For example, runners will want to concentrate on increasing endurance in their legs.
Swimmers may shift and focus on their arms one day then legs another.

Movement as Medicine

References

Liu, Chiung-Ju, and Nancy K Latham. “Progressive resistance strength training for improving physical function in older adults.” The Cochrane Database of systematic reviews vol. 2009,3 CD002759. 8 Jul. 2009, doi:10.1002/14651858.CD002759.pub2

Loturco, Irineu, et al. “Muscle Contraction Velocity: A Suitable Approach to Analyze the Functional Adaptations in Elite Soccer Players.” Journal of sports science & medicine vol. 15,3 483-491. 5 Aug. 2016

Rønnestad, B R, and I Mujika. “Optimizing strength training for running and cycling endurance performance: A review.” Scandinavian Journal of Medicine & Science in Sports vol. 24,4 (2014): 603-12. doi:10.1111/sms.12104

Suchomel, Timothy J et al. “The Importance of Muscular Strength: Training Considerations.” Sports medicine (Auckland, N.Z.) vol. 48,4 (2018): 765-785. doi:10.1007/s40279-018-0862-z

Tøien, Tiril, et al. “Maximal strength training: the impact of eccentric overload.” Journal of Neurophysiology vol. 120,6 (2018): 2868-2876. doi:10.1152/jn.00609.2018

Westcott, Wayne L. “Resistance training is medicine: effects of strength training on health.” Current sports medicine reports vol. 11,4 (2012): 209-16. doi:10.1249/JSR.0b013e31825dabb8

IDD Therapy Treatment Protocols For Spinal Decompression

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

Table of Contents

Introduction

Many individuals are unaware of their pain until they perform specific movements that cause discomfort. This is due to the heavy weight that causes the body to carry an axial overload, compressing the spinal disc, which can lead to herniation or degeneration over time if not treated promptly. Compressed spinal discs can cause chronic conditions such as low back pain, spinal stenosis, or intervertebral disc disease (IDD). Several factors contribute to the development of IDD, including chronic conditions that can lead to compressed spinal discs. This condition can be relieved over time through therapy treatments that can reduce the pain effects of IDD and help individuals be more mindful of their spine. This article will discuss IDD therapy’s role in relieving spine pain, treatment protocols, and how it is combined with spinal decompression, a non-surgical therapy. We work with certified medical providers who use our patients’ valuable information to treat individuals suffering from back and spinal disc degeneration while informing them about non-surgical treatments like IDD(intervertebral disc degeneration) therapy and spinal decompression that can help relieve their pain and help rehydrate their spinal disc. We encourage patients to ask essential questions and seek education from our associated medical providers about their condition. Dr. Jimenez, D.C., provides this information as an educational service. Disclaimer

What Is IDD Therapy?

The spine comprises muscles, tendons, ligaments, discs, and bones extending from the skull’s base to the bottom of the sacrum. Its primary function is to keep the body upright and protect the spinal cord from injuries. According to research studies, the spinal discs act as shock absorbers during movement and can become damaged over time, causing pain-like symptoms and chronic conditions. IDD therapy is a common treatment for reducing pain caused by degenerative discs.

Research suggests that intervertebral disc degeneration can cause symptoms related to musculoskeletal disorders such as low back pain, disc herniation, and spinal stenosis. Conservative and non-invasive treatments can reduce the pain-like symptoms and effects caused by IDD. IDD therapy allows the spine to be re-toned, restructured and re-educated. Like spinal decompression, IDD therapy uses gentle traction pulling to rehydrate the discs and reduce the pressure on the nerve roots, as stated by research studies. IDD therapy helps restore muscle strength, increase the spine’s range of motion, and promote the body’s natural healing process to reduce spinal pain associated with environmental factors.

Home Exercise For Pain Relief- Video

Home Exercises for Pain Relief | El Paso, Tx (2023)

Do you experience difficulty doing activities due to back pain? Do you feel stiffness or instability in your lower back? These may be symptoms of intervertebral degenerative disease caused by repetitive motions. IDD can cause chronic musculoskeletal disorders and disability. However, available non-surgical treatments like IDD therapy, which uses negative pressure to rehydrate the spinal disc, can reduce pain. Other non-surgical therapies like chiropractic care and physical therapy can help restore mobility and strengthen back muscles. Check out the video above for home exercise routines that relieve pain.

IDD Treatment Protocols

Dr. Eric Kaplan, D.C., FIAMA, and Dr. Perry Bard, D.C., wrote “The Ultimate Spinal Decompression,” explaining how chiropractors and massage therapists use personalized IDD therapy plans to treat musculoskeletal pain associated with intervertebral degenerative disease. IDD therapy involves strapping the individual to a traction machine and utilizing specific protocols for treatment.

The Treatment Schedule

The first step in IDD therapy is examining the individual’s range of motion, muscle strength, nerve conduction, and SSEP tests. This allows the doctor to document the pain’s location and develop a personalized treatment plan, including the indicated problem, treatment frequency, duration, etc. Afterward, the individual will receive other treatments before the IDD traction therapy machine.

Therapeutic Ultrasound
Electro-stimulation
Interferential Stimulation
Hydrocolator

This machine gently pulls the spine to create negative space between the spinal column, allowing nutrients to rehydrate the disc and begin healing. The process lasts 20-30 minutes and may cause mild soreness, but progress is seen after a few sessions.

Pre-& Post-Session Physical Therapy

The benefit of combining IDD therapy with physical therapy is that stretching techniques can loosen the surrounding muscles before spinal mobilization, allowing the soft tissues to accept the treatment. After treatment, cryo-therapeutic therapy or an ice pack can alleviate soreness and inflammation. Drinking plenty of water is important to replenish intra-cellular cells, and physical activities can be slowly incorporated to strengthen muscles.

Conclusion

Taking care of the spine is important by not constantly allowing axial overload to compress the spinal disc through repetitive motion. This causes the disc to degenerate and lead to back pain. However, non-surgical treatments like IDD therapy can help reduce the pain and help strengthen the surrounding muscles protecting the spine. IDD therapy is similar to spinal decompression, which allows the individual to be harnessed to a machine and uses gentle traction on the spine to create negative space in the spinal column and promote the body’s healing factors. Many individuals can see the beneficial results over time and continue their daily routine pain-free.

References

Choi, J., Lee, S., & Hwangbo, G. (2015). Influences of spinal decompression therapy and general traction therapy on the pain, disability, and straight leg raising of patients with intervertebral disc herniation. Journal of Physical Therapy Science, 27(2), 481–483. https://doi.org/10.1589/jpts.27.481

Kaplan, E., & Bard, P. (2023). The Ultimate Spinal Decompression. JETLAUNCH.

Kos, N., Gradisnik, L., & Velnar, T. (2019). A Brief Review of the Degenerative Intervertebral Disc Disease. Medical Archives, 73(6), 421. https://doi.org/10.5455/medarh.2019.73.421-424

Xin, J., Wang, Y., Zheng, Z., Wang, S., Na, S., & Zhang, S. (2022). Treatment of Intervertebral Disc Degeneration. Orthopaedic Surgery, 14(7), 1271–1280. https://doi.org/10.1111/os.13254

Disclaimer

Compressed Nerve In The Knee

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

Caucasian woman with orthosis working with physical therapist

A nerve becomes pinched/compressed when added pressure is placed on it by surrounding structures that can include muscles, bones, ligaments, tendons, or a combination. This injures and damages the nerve causing function problems and symptoms and sensations in that area or other parts of the body that are supplied by that nerve. Medical practitioners refer to this as nerve compression or entrapment. Although compressed nerves are more commonly associated with the neck, arms, hands, elbows, and lower back, any nerve in the body can experience irritation, spasms, inflammation, and compression. The causes and treatment of a compressed nerve in the knee.

Compressed Nerve In The Knee

There’s only one nerve that goes through the knee that has an increased risk of getting compressed. It’s a branch of the sciatic nerve called the peroneal nerve. The nerve goes around the outside of the knee before traveling down the outside of the lower leg. At the bottom of the knee, it lies between the bone and skin, making it vulnerable to irritation or compression by anything that can put pressure on the outside of the knee.

Causes

Traumatic injuries over time can lead to pressure on the nerve from inside the knee. Common causes of a compressed nerve in the knee include:

Frequently Crossing Legs

Compression by the opposite knee, while the legs are crossed is the most common cause.

Knee Brace

A too-tight or strong brace can compress the leg and nerve.

Thigh-High Compression Stockings

Designed to maintain pressure on the legs, if too tight these stockings can compress the nerve.

Squatting Posture For Long Periods

This position places pressure on the side of the knee.

Fractures

A fracture of the large lower leg bone/tibia or sometimes the small bone/fibula near the knee can entrap the nerve.

Lower Leg Cast

The portion of the cast around the knee can be tight and compress the nerve.
Tell the doctor if a cast or brace feels tight or is causing numbness or pain in the leg.

Knee-High Boots

The top of a boot can land right below the knee and be too tight pinching the nerve.

Knee Ligament Injury

The nerve can become compressed due to bleeding or inflammation from an injured ligament.

Knee Surgery Complications

This is rare, but the nerve can inadvertently get pinched during knee replacement surgery or an arthroscopic procedure.

Prolonged Bed Rest

When lying down the legs tend to rotate outward and the knees flex.
In this position, the mattress can place pressure on the nerve.

Tumors or Cysts

Tumors or cysts can develop right on top or next to a nerve irritating and compressing the area.

Abdominal or Gynecologic Surgery

The equipment used to keep the legs rotated outward and the knees flexed for gynecologic and abdominal surgeries can compress the nerve.

Symptoms

The peroneal nerve supplies sensation and movement to the outside of the lower leg and the top of the foot. When compressed, it becomes inflamed, which causes the symptoms of a compressed nerve. Usually, only the lining/myelin sheath around the nerve is what gets injured. However, when the nerve gets damaged, the symptoms are similar but more severe. Common symptoms include:

Weakness that limits the ability to lift the foot toward the leg aka dorsiflexion.
This causes dragging the foot when walking.
The ability to turn the foot outward and extend the big toe is also affected.
Symptoms can be felt on the outside of the lower leg and on the top of the foot and include:
Tingling or pins and needles sensations.
Numbness.
Loss of sensation.
Pain.
Burning.
For individuals that have had a pinched nerve for two or more weeks, the muscles supplied by the nerve can begin to waste away or atrophy.
Symptoms can be intermittent or continuous depending on the cause.
The other common cause is a pinched nerve in the lumbar/lower spine.
When this is the cause, sensations, and pain will present in the lower back or the back and outside of the thigh.

Diagnosis

A doctor will look at medical history and perform an examination to make a diagnosis, determine the cause, and lay out a personalized treatment plan. The nerve in the knee can be felt as it travels around the top of the tibia, so a doctor may tap on it. If there is shooting pain down the leg, a pinched nerve may be present. Tests a doctor may order can include:

Knee X-ray

Shows any bone fractures or abnormal masses.

Knee MRI

Can confirm the diagnosis
Shows masses within the nerve.
Shows details of fractures or other problems in the bones.

Electromyogram – EMG

Tests electrical activity in the muscles.

Nerve Conduction Test

Tests the signal speed of the nerve.

Treatment

Treatment is aimed at reducing pain and improving mobility.

Over-the-Counter Pain Medication

OTC medication can reduce inflammation and improve symptoms short term.

Ice and Heat

Applying either heat or ice for 15 to 20 minutes at a time can provide relief from the symptoms.
An ice pack can make symptoms worse if it adds more pressure on the nerve.

Chiropractic and Physical Therapy

Chiropractic and physical therapy can release the compressed nerve, realign the structures, strengthen the muscles, and provide gait training.

Orthotic Boot

If walking gait is affected because the foot cannot bend, an orthotic boot can help.
This is a support that maintains the foot in a neutral position to walk normally.

Corticosteroid Injection

A corticosteroid injection can reduce inflammation and relieve pressure on the nerve.

Surgery

The nerve can suffer permanent damage if it has been pinched for a long time.
If that happens, surgery cannot repair the damage.
A doctor can perform surgery to correct a fracture, tumor, or other invasive problem causing a compressed nerve.
If conservative treatment doesn’t work, a peroneal nerve decompression procedure can be done to remove the pressure.
If surgery is needed, symptoms can disappear immediately, but it takes around four months to recover and rehabilitate.

Injury Rehabilitation

References

Krych, Aaron J et al. “Is peroneal nerve injury associated with worse function after knee dislocation?.” Clinical orthopedics and related research vol. 472,9 (2014): 2630-6. doi:10.1007/s11999-014-3542-9

Lezak B, Massel DH, Varacallo M. Peroneal Nerve Injury. [Updated 2022 Nov 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK549859/

Soltani Mohammadi, Sussan, et al. “Comparing the squatting position and traditional sitting position for ease of spinal needle placement: a randomized clinical trial.” Anesthesiology and pain medicine vol. 4,2 e13969. 5 Apr. 2014, doi:10.5812/aapm.13969

Stanitski, C L. “Rehabilitation following knee injury.” Clinics in sports medicine vol. 4,3 (1985): 495-511.

Xu, Lin, et al. Zhongguo gu Shang = China Journal of Orthopedics and Traumatology vol. 33,11 (2020): 1071-5. doi:10.12200/j.issn.1003-0034.2020.11.017

Yacub, Jennifer N et al. “Nerve injury in patients after hip and knee arthroplasties and knee arthroscopy.” American Journal of physical medicine & Rehabilitation vol. 88,8 (2009): 635-41; quiz 642-4, 691. doi:10.1097/PHM.0b013e3181ae0c9d

Why People Spend More On Back & Neck Pain?

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

Table of Contents

Introduction

Many people experience neck and back pain due to various factors that affect their daily routine. These pain conditions are common and can be caused by repetitive motions that impact the surrounding muscles, tissues, ligaments, and spinal discs. Chronic pain can develop depending on the severity and duration of the condition. People with demanding jobs, pre-existing conditions, or older adults may seek medical attention to reduce the pain-like symptoms of neck and back pain. However, treatment costs can be high. There are safe, cost-effective, and non-invasive treatments to relieve neck and back pain. This article will explore why neck and back pain is expensive and why non-surgical treatments are cost-effective. It will also discuss how non-surgical therapies like spinal decompression can alleviate back and neck pain. We work with certified medical providers who use our patients’ valuable information to treat individuals suffering from back and neck pain while informing them about non-surgical treatments like spinal decompression that can help relieve their neck and back pain. We encourage patients to ask essential questions and seek education from our associated medical providers about their condition. Dr. Jimenez, D.C., provides this information as an educational service. Disclaimer

Why Does Back & Neck Pain Cost More?

Many people report to their primary doctors that they are experiencing radiating pain from the neck or lower back, which affects their upper or lower extremities. For neck pain, they may experience headaches or shoulder pain that causes pain-like symptoms like numbness or tingling sensations down to their arms and fingers. For back pain, they may experience muscle soreness in their lumbar region, which can result in numbness in the glute muscles or cause sciatic nerve pain, affecting their walking ability. Research studies reveal that cognitive, affective, and lifestyle factors all affect the neck and back. High-demanding jobs, stress, or trauma from an accident can develop neck and back pain. As a result, the body takes more overbearing loads, tightening the surrounding muscles in the neck and back. If not treated right away, it can lead to problematic issues that disrupt their routine.

Based on the book “The Ultimate Spinal Decompression” by Dr. Eric Kaplan D.C., FIAMA, and Dr. Perry Bard, D.C., humans’ evolution to walk upright has strained their stability, leading to axial overload and potential neck and back pain. The book also highlights that the human body was not meant to remain sedentary, which can also contribute to the development of such pain. Research studies revealed that neck and back pain can be nociceptive with neuropathic components, making treatment costly and time-consuming. This economic burden can discourage individuals from seeking treatment despite the pain and expense involved.

Fighting Inflammation Naturally- Video

Are you experiencing persistent neck and back pain? Do your upper or lower extremities feel stiff or tingly? Or is your mobility limited, interfering with your daily activities? These issues are often associated with neck and back pain, disrupting a person’s routine and preventing them from enjoying life. Neck and back pain are common ailments that can be expensive to treat. Research studies revealed that they can also influence individuals’ ability to return to work, increasing treatment costs.

Fighting Inflammation Naturally *Chiropractic Care* | El Paso, Tx (2023)

Additionally, pain-like symptoms often accompany neck and back pain, leading some individuals to spend nearly a billion dollars on treatment. However, cost-effective treatments are available that can help alleviate these symptoms. The video above explains how non-surgical treatments can reduce neck and back pain and relieve pain-like symptoms.

Why Non-Surgical Treatments Are Cost Effective?

Research studies have shown that non-surgical treatments are a cost-effective and effective solution for neck and back pain. Many individuals can utilize these treatments combined with various therapies to improve their quality of life and reduce pain symptoms. Non-surgical treatments offer personalized plans as healthcare providers work together to find solutions. They provide individuals with a positive approach to regaining their health and wellness by informing them about their bodies and how to be more mindful of how pain affects their daily routines. Some non-surgical treatments that can relieve neck and back pain include:

Chiropractic care
Physical therapy
Spinal Decompression
Acupuncture
Massage therapy

How Spinal Decompression Can Alleviate Back & Neck Pain

You might be interested in non-surgical treatments like spinal decompression if you suffer back or neck pain. This technique uses gentle traction on the spinal column to alleviate pain while helping your body heal naturally. Research studies have found that cervical spinal decompression can increase disc height and reduce pain caused by compressed cervical discs. This treatment can also alleviate residual pain symptoms like headaches or muscle stiffness and restore mobility to the neck. For back pain, research suggests that spinal decompression can reduce the effects of compressed spinal discs, which can aggravate nerve roots like the sciatic nerve in the lumbar region. Many people who try spinal decompression feel relief after just a few sessions and become more mindful of what triggers their pain. This can help them make small lifestyle changes to continue their journey toward health and wellness.

Conclusion

Many people struggle with neck and back pain, which can be caused by multiple normal and traumatic factors and can be costly. Individuals often prefer to endure the pain rather than subject themselves to invasive treatments. However, non-surgical therapies that are cost-effective and gentle on the body are available. Spinal decompression therapy is one such treatment that can help alleviate pain and promote the body’s natural healing processes. By reducing pain symptoms, many individuals who undergo spinal decompression therapy can return to their daily routines pain-free.

References

Daniel, D. M. (2007). Non-surgical spinal decompression therapy: does the scientific literature support efficacy claims made in the advertising media? Chiropractic & Osteopathy, 15(1). https://doi.org/10.1186/1746-1340-15-7

Driessen, M. T., Lin, C.-W. C., & van Tulder, M. W. (2012). Cost-effectiveness of conservative treatments for neck pain: a systematic review on economic evaluations. European Spine Journal, 21(8), 1441–1450. https://doi.org/10.1007/s00586-012-2272-5

Kaplan, E., & Bard, P. (2023). The Ultimate Spinal Decompression. JETLAUNCH.

Kazeminasab, S., Nejadghaderi, S. A., Amiri, P., Pourfathi, H., Araj-Khodaei, M., Sullman, M. J. M., Kolahi, A.-A., & Safiri, S. (2022). Neck pain: global epidemiology, trends and risk factors. BMC Musculoskeletal Disorders, 23(1). https://doi.org/10.1186/s12891-021-04957-4

Kleinman, N., Patel, A. A., Benson, C., Macario, A., Kim, M., & Biondi, D. M. (2014). Economic Burden of Back and Neck Pain: Effect of a Neuropathic Component. Population Health Management, 17(4), 224–232. https://doi.org/10.1089/pop.2013.0071

Xu, Q., Tian, X., Bao, X., Liu, D., Zeng, F., & Sun, Q. (2022). Nonsurgical spinal decompression system traction combined with electroacupuncture in the treatment of multi-segmental cervical disc herniation. Medicine, 101(3), e28540. https://doi.org/10.1097/md.0000000000028540

Disclaimer

Massaging The Body Regularly For Overall Health

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

Neck Sports Massage Therapy — Physiotherapist massaging male patient with injured neck muscle. Sports injury treatment

When looking at an anatomical poster/image of the human body, there are all kinds of muscles connected and overlapping, but when we go to feel around those areas, especially when pain symptoms are presenting, it can feel like one solid mass and not individual muscles. This is because of everyday wear and tear, strenuous activities, spasms, heat, dehydration, and stress that causes the muscles to stay in a slightly contracted state, continue to tighten, bunch up and stiffen becoming the new normal for that individual. People learn to go through life like this, never considering that there is something wrong until they experience a significant injury that can take much longer to recover and rehabilitate from. This is why massaging the body on a regular basis is important to maintain healthy relaxed and flexible muscles and prevent strains, pulls, and injuries.

Table of Contents

Massaging the Body

Massage therapy including myotherapy is the practice of kneading or manipulating the body’s muscles and other soft tissues to improve neuromusculoskeletal well-being and health.

It is a form of manual, percussive, and mechanical therapy that includes holding, moving, and applying pressure to the muscles, tendons, ligaments, and fascia.
Massage therapy can be used to describe techniques that vary in touch, pressure, and intensity of the treatment applied.

Benefits

The immediate benefit of regularly massaging the body is feeling deep relaxation and calmness. This happens because massaging prompts the release of endorphins or the brain chemicals/neurotransmitters that produce the feeling of well-being. And the stress hormones like adrenalin, cortisol, and norepinephrine levels are reduced. Studies have shown that high levels of stress hormones can impair and damage the immune system. The physical benefits of massaging the body regularly include:

Alleviated muscle tension.
Improved and increased joint mobility and flexibility.
Increased blood and nerve circulation.
Lymphatic system toxin drainage.
Decreased release of stress hormones.
A relaxed state of mind.
Improved sleep.
Enhanced mental alertness.
Decreased anxiety.
Improved recovery and rehabilitation of soft tissue sprains and injuries.
Improved skin tone.

Massage Types

Depending on the severity of the pain, associated symptoms, and muscle tension a chiropractor and therapeutic massage team will use a variety of techniques and massage types to restore flexibility, mobility, and function. Types of massage include:

Swedish

One of the most popular forms of massage, this technique is designed to promote relaxation and increase and improve blood circulation.

Myofascial

Involves the assessment and treatment of soft tissue pain, injury, and dysfunction affecting movement and mobility.
Myofascial therapy releases tight soft tissue structures like the muscles, tendons, ligaments, and fascia.

Rehabilitative

This type treats and rehabilitates biomechanical dysfunction or injury.
Using specific and targeted mobilization techniques to restore normal health and function.

Lymphatic Drainage

This is a gentle whole-body treatment that relaxes the nervous system, releases toxins, and improves the immune system.

Sports

Sports massage is an application of massage and a blend of techniques to enhance performance and help overworked muscles recover quickly.
The type of technique or treatment applied is dependent on the nature of the stage of training or competition, sports injury or condition, and the assessment of the therapist.

Infant Massage

A gentle massage can help treat constipation, colic, and sleeping problems.
Studies have found that regular massage helps premature babies gain weight faster.

Reflexology

Reflexology is based on the application of pressure to specific points on the body.
Reflex points, which relate to body areas, can be found in the feet, hands, face, and ears.
These points respond to pressure, stimulating the body’s own natural healing process in the same way chiropractic activates natural healing through adjustments and realignment.

Aromatherapy

Essential oils made from selected flowers and plants are added to massage oil for a particular therapeutic property.
For example, the scent of peppermint is used for constipation problems.

Shiatsu

This massage technique aims to improve energy flow by working targeted points on the body.
The underlying principles of shiatsu are similar to those of acupuncture.

Individuals are able to experience an improved quality of life with the combined elements of chiropractic and massage therapy.

Fighting Inflammation Naturally

References

Cheung, Karoline, et al. “Delayed onset muscle soreness: treatment strategies and performance factors.” Sports medicine (Auckland, N.Z.) vol. 33,2 (2003): 145-64. doi:10.2165/00007256-200333020-00005

Koren, Yogev, and Leonid Kalichman. “Deep tissue massage: What are we talking about?.” Journal of Bodywork and movement therapies vol. 22,2 (2018): 247-251. doi:10.1016/j.jbmt.2017.05.006

National Research Council (US) and Institute of Medicine (US) Panel on Musculoskeletal Disorders and the Workplace. Musculoskeletal Disorders and the Workplace: Low Back and Upper Extremities. Washington (DC): National Academies Press (US); 2001. 6, Biomechanics. Available from: https://www.ncbi.nlm.nih.gov/books/NBK222434/

Pachtman Shetty, Sarah L, and Sarah Fogarty. “Massage During Pregnancy and Postpartum.” Clinical obstetrics and gynecology vol. 64,3 (2021): 648-660. doi:10.1097/GRF.0000000000000638

Stecco, Antonio, et al. “Fascial Disorders: Implications for Treatment.” PM & R: the Journal of Injury, Function, and Rehabilitation vol. 8,2 (2016): 161-8. doi:10.1016/j.pmrj.2015.06.006

Weerapong, Pornratshanee, et al. “The mechanisms of massage and effects on performance, muscle recovery, and injury prevention.” Sports medicine (Auckland, N.Z.) vol. 35,3 (2005): 235-56. doi:10.2165/00007256-200535030-00004

Pickleball: Health Benefits For Everybody

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

Pickleball is a growing, increasingly popular sport that can be enjoyed by individuals of every age and fitness level. It combines elements of tennis and badminton at a slightly slower pace that makes it ideal for families and provides excellent health benefits and enjoyable socializing. It is easy to learn and requires little practice. The sport is easy on the body and is a great activity for seniors because it is joint-friendly.

Table of Contents

Pickleball

Individuals do not need to be athletes or belong to a certain age group to play or benefit from the sport. It requires minimal equipment and a few basic skills. Using a flat paddle and a plastic pickleball, opponents singles or doubles play a game like tennis or badminton.

Playing the Game

A three-foot-long net is set up in the center of a court measuring 44 feet long by 20 feet wide.
The court is divided between right and left service zones.
If the receiving side misses the serving side volley, the serving side receives a point.
The game is played to 11 points, but a player or team must win by two points.
The ball’s design keeps the pace manageable and user-friendly.
Pickleball has other intricacies common with other racket-court sports.
The player serves from a specific side.
The no-volley zone, or the kitchen is seven feet from the net on both sides.
There are rules regarding when the player must call the score, how tournaments work, and variations between singles and doubles matches.
Most players only need a few games to pick up the basics.

Reasons To Play

The sport offers a number of health benefits.

Improves Mental Health

One study found individuals who played pickleball tended to have better mental health and outlook.
Researchers followed older adults competing in pickleball competitions and tournaments.
At the end of the study, the researchers found that a commitment to a physical hobby correlated to reduced depression levels.

Improves Cardiovascular Health

The sport is not as physically intense as say tennis, but offers significant benefits for cardiovascular health.
One study found that individuals who played three times a week for an hour had improved cardiorespiratory fitness, lower cholesterol levels, and decreased blood pressure.
Experts found that it is a healthy alternative to traditional exercises like walking or biking.

Improved Hand-Eye Coordination

Pickleball will improve hand-eye coordination and reflexes.
Coordinating the feet, legs, arms, hands, and eye movements quickens responses, challenges the brain to think fast, and increases balance.
Physical activity combined with cognitive challenges has been found to improve cognitive health and prevent mental decline in older adults.

Socialization

Pickleball requires an opponent or two for doubles matches.
A significant benefit is that the sport provides increased socialization.
Socializing with others, especially the elderly can help with loneliness.
Loneliness can negatively impact physical and mental health, increasing the risk of heart disease, stroke, dementia, and depression.

Getting Started

Individuals need minimal gear like paddles, shoes, and balls and knowledge to get started playing. One of the easiest ways to begin is locating a court in the community. This is a great physical activity that can be competitive, but overall it is fun, easy to play, and provides great health benefits.

Home Exercises For Pain Relief

References

Casper, Jonathan M, and Jung-Hwan Jeon. “Psychological Connection to Pickleball: Assessing Motives and Participation in Older Adults.” Journal of Aging and physical activity, 1-6. 24 Oct. 2018, doi:10.1123/japa.2017-0381

Cerezuela, Juan-Leandro, et al. “Pickleball and mental health in adults: A systematic review.” Frontiers in psychology vol. 14 1137047. 21 Feb. 2023, doi:10.3389/fpsyg.2023.1137047

Ryu, Jungsu, et al. “Pickleball, Personality, and Eudaimonic Well-Being in Middle-Aged and Older Adults.” Journal of Aging and physical activity vol. 30,5 885-892. 14 Feb. 2022, doi:10.1123/japa.2021-0298

Vitale, Kenneth, and Steven Liu. “Pickleball: Review and Clinical Recommendations for this Fast-growing Sport.” Current sports medicine reports vol. 19,10 (2020): 406-413. doi:10.1249/JSR.0000000000000759

Webber, Sandra C et al. “Physical Activity Intensity of Singles and Doubles Pickleball in Older Adults.” Journal of Aging and physical activity vol. 31,3 365-370. 10 Sep. 2022, doi:10.1123/japa.2022-0194

Stretches For Sitting and Standing Jobs: EP Sciatica Clinic

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

nurse doctor woman female care exercise physical therapy exercising help assistence physiotherapy strech band clinic therapist patient stretching — Doctor or therapist exercise with young female patient at clinic or hospital

Sitting at a desk or standing at a workstation in the same position for hours at a time every day or night can strain the body’s neuromusculoskeletal system. This causes hunching of the shoulders which leads to body tension, headaches, and neck, shoulder, back, leg, and foot pain. Taking regular breaks to move and stretch out provides various benefits that include pain symptom relief, increased circulation, improved posture, increased energy, muscle relaxation, and improve overall health. Here we look at stretches for sitting and standing jobs.

Table of Contents

Stretches For Sitting and Standing Jobs

Sitting or standing for too long can affect an individual’s health. The body is made to move and not remain in one position for long periods. Standing and sitting for a prolonged period of time increases the risk for chronic conditions, sleep disorders, digestion issues, weight gain, obesity, heart disease, cancer, and diabetes. To help break the cycle of staying in one position, experts recommend taking movement breaks for one to three minutes every 30 to 45 minutes, or at least once an hour.

Individuals are encouraged to find ways to set up a job/work system where they are not limited to just sitting or standing but have a balance where they can move around, do some desk work, move some more, and so on where the body is regularly engaging all the muscles and not only using a few that often leads to overworked muscles and overcompensating postures that lead to injuries. This can be using a standing desk, taking quick short walks, or doing some stretches. Movement loosens up the body and helps maintain mental focus.

Flexibility Breaks

The following stretches for sitting and standing jobs are recommended to be done as often as possible to develop healthy habits.

Set an alarm for every 45 to 55 minutes and perform the stretches.
Hold each stretch for at least 15-30 seconds.
Avoid exercises or stretches that cause discomfort or pain.

Chest Stretch

Many individuals begin to hunch forward. Therefore, it is essential to stretch the pectoral/chest muscles and shoulders. Individuals with shoulder problems or injuries should avoid this stretch.

Stand with the feet shoulder-width apart.
The stretch can be performed seated in a chair.
Move the arms behind the body and, if possible, interlock the fingers together.
Straighten the arms and gently lift the hands up until you feel a stretch in the chest.
Hold for 10 to 30 seconds.
Repeat 5-10 times.
Individuals can also use a resistance band and hold it overhead.
Individuals can put their forearms on either side of a doorway, and gently press forward until the stretch is felt in the chest.

Upper Back Stretch

The upper back stretch will help get circulation moving in all the muscles between the shoulder blades as well as the traps and the shoulders.

Begin in a seated or standing position.
Stretch the arms straight out.
Place one hand on top of the other.
Reach away with your arms.
Relax and gently bend the head down.
Imagine the arms curving up and over an imaginary sphere.
Hold the stretch for 10 to 30 seconds.

Neck Stretch

Tension in the neck can lead to headaches and upper back pain. Forward head posture is common when working at a desk/workstation, which places extra weight and stress on the neck muscles. The head can weigh up to 11 pounds. Staying aware of posture and regular stretching can provide relief.

Start in a sitting position, with the back straight and the shoulders back.
Reach down and grab the side of the chair with your hand.
Gently pull on the chair, while tilting the head in the opposite direction, feeling the stretch down the side of the neck and shoulder.
Hold for 10 to 30 seconds and repeat on the other side.
Repeat five to 10 times on each side.

Inner Thigh Stretch

Stretching the inner thigh is important for the hips and groin. This stretch helps open the hips and gets rid of tightness and tension in the lower body.

In a seated position, widen the legs, toes outward, and lean forward with the elbows on the thighs.
Keep the back straight and the abs contracted.
Gently press forward while using the elbows to push the thighs out until a stretch is felt in the inner thighs.
Hold for 10 to 30 seconds.
Repeat as many times as necessary to get a thorough stretch.

Regular stretching will help to improve the range of motion and help the muscles move more efficiently. Stretching may also help individuals reach or maintain a healthy weight for improved posture.

Benefits of Stretching

References

Cooley D, Pedersen S. A pilot study of increasing non-purposeful movement breaks at work as a means of reducing prolonged sitting. J Environ Public Health. 2013;2013:128376. doi:10.1155/2013/128376

Daneshmandi H, Choobineh A, Ghaem H, Karimi M. Adverse effects of prolonged sitting behavior on the general health of office workers. J Lifestyle Med. 2017;7(2):69-75. doi:10.15280/jlm.2017.7.2.69

Fathollahnejad, Kiana, et al. “The effect of manual therapy and stabilizing exercises on the forward head and rounded shoulder postures: a six-week intervention with a one-month follow-up study.” BMC Musculoskeletal Disorders vol. 20,1 86. 18 Feb. 2019, doi:10.1186/s12891-019-2438-y

Feldman, Anatol G. “The Relationship Between Postural and Movement Stability.” Advances in experimental medicine and biology vol. 957 (2016): 105-120. doi:10.1007/978-3-319-47313-0_6

Korakakis, Vasileios, et al. “Physiotherapist perceptions of optimal sitting and standing posture.” Musculoskeletal Science & Practice vol. 39 (2019): 24-31. doi:10.1016/j.msksp.2018.11.004

Lurati AR. Health issues and injury risks associated with prolonged sitting and sedentary lifestyles. Workplace Health Saf. 2018;66(6):285-290. doi:10.1177/2165079917737558

Nakphet N, Chaikumarn M, Janwantanakul P. Effect of different types of rest-break interventions on neck and shoulder muscle activity, perceived discomfort and productivity in symptomatic VDU operators: A randomized controlled trial. Int J Occup Saf Ergon. 2014;20(2):339-53. doi:10.1080/10803548.2014.11077048

Sanders, Martha J, and Claudia Michalak Turcotte. “Posture makes perfect.” Today’s FDA: official monthly journal of the Florida Dental Association vol. 25,2 (2013): 62-5.

Shaghayegh Fard, B et al. “Evaluation of forward head posture in sitting and standing positions.” The European spine journal: official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society vol. 25,11 (2016): 3577-3582. doi:10.1007/s00586-015-4254-x

Walking Energy Snacks: EP Functional Wellness Clinic

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

Smiling black guy sportsman eating protein bar while having break — Smiling black guy sportsman with wireless headset eating protein bar and using phone while break, exercising at park, empty space

Walking is a great physical exercise activity that requires endurance. When walking for two hours or more, refueling energy stores can be done with portable walking energy snacks. These are foods that can be taken along and eaten while on the move. This includes fruits, vegetables, energy bars, trail mix, energy gels, and sports drinks that can replenish the body. However, depending on when an individual goes for a walk, they need to think about breakfast or lunch nutrition before engaging in the walk. This will help to get the most benefits from the snacks, as well as, what to have after the workout for recovery.

Table of Contents

Walking Energy Snacks

Individuals walking for a long time will want a snack – before, during, and after. There are various options to choose from. Individuals may want to experiment with various snack and drink options to find the right balance of carbs, fat, and protein so that the body gets the energy it needs without feeling weighed down or hungry soon after. The ideal walking energy snacks should be healthy, full of energy, and easy to eat on the move.

Fruit Snacks

Fruit snacks are great for the all-natural carbohydrate burst.
Bananas are great for potassium.
Apples, oranges, and raisins are also recommended packable snacks.
For certain individuals, the fiber in some fruits can get digestion moving, requiring a restroom, so plan ahead.
Some individuals can eat fruit regularly but may have an upset stomach during walking, which is why experimentation may be necessary.

Energy Bars

Nutrition bars can provide vitamins and minerals and protein but can be high in calories.
Check the labels to choose the balance of ingredients that’s best for you.
Energy bars offer a healthy combination of carbohydrates, protein, and fat.
They are convenient for a snack when on a walk.
Most products utilize peanuts/other nuts or soy for protein.
Individuals may want to avoid chocolate-covered bars, as they can melt.

Trail Mix

Trail mixes are the original energy bar.
Individuals can mix their own, buy in bulk, or pre-packaged.
Trail mix contains nuts for protein, raisins or other dried fruit for carbohydrates, and chocolate or carob for taste.
The salted varieties can help replace electrolytes.
Be aware of portion control, as trail mix is often high in fat and calories.

Energy Gels

Energy gels provide a carbohydrate boost designed for individuals doing endurance events and activities.
Energy gels need to be taken with water for carbohydrate digestion.
There are some that can be taken without water but may not provide as much energy.
For individuals that walk fast and breathe hard, energy gels can be safer than chewing and possibly choking.
Newer brands are trying to be natural and less sweet.

Energy and Sports Drinks

Water is not enough to keep the body hydrated on long walks.
Sports drinks with sugar and salt replenish H2O and electrolyte levels more thoroughly when walking for more than an hour helping to prevent dehydration and hyponatremia/low salt levels.
It is recommended to avoid:
High-caffeine energy drinks in small cans, as they have too much caffeine and not enough hydrating water.
Sports and energy drinks with additives and herbs, which do not help on walks, and look for those with salt and carbohydrate replacement.

Ankle Sprain Recovery

References

Francois, Monique E et al. “’Exercise snacks’ before meals: a novel strategy to improve glycaemic control in individuals with insulin resistance.” Diabetologia vol. 57,7 (2014): 1437-45. doi:10.1007/s00125-014-3244-6

Islam, Hashim, et al. “Exercise Snacks: A Novel Strategy to Improve Cardiometabolic Health.” Exercise and sport sciences review vol. 50,1 (2022): 31-37. doi:10.1249/JES.0000000000000275

Marangoni, Franca, et al. “Snacking in nutrition and health.” International Journal of food sciences and Nutrition vol. 70,8 (2019): 909-923. doi:10.1080/09637486.2019.1595543

McCubbin, Alan J et al. “Sports Dietitians Australia Position Statement: Nutrition for Exercise in Hot Environments.” International Journal of sports nutrition and exercise metabolism vol. 30,1 (2020): 83-98. doi:10.1123/ijsnem.2019-0300

Moore, Daniel R et al. “Walking or body weight squat “activity snacks” increase dietary amino acid utilization for myofibrillar protein synthesis during prolonged sitting.” Journal of applied physiology (Bethesda, Md.: 1985) vol. 133,3 (2022): 777-785. doi:10.1152/japplphysiol.00106.2022

Njike, Valentine Yanchou, et al. “Snack Food, Satiety, and Weight.” Advances in nutrition (Bethesda, Md.) vol. 7,5 866-78. 15 Sep. 2016, doi:10.3945/an.115.009340

Overexertion, Repetitive Stress Injuries: EP Sciatica Clinic

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

one-young-mixed-race-female-call-centre-telemarket-2023-06-08-19-33-56-utc_02 — One young mixed race female call centre telemarketing agent suffering with aching wrist pain while .

Overexertion and repetitive stress injuries make up a fourth of all work injuries. Repetitive pulling, lifting, punching in numbers, typing, pushing, holding, carrying, and scanning are the most common causes of job-related injuries. These types of injuries are the most common that cause missed days at work. Overexertion can lead to lasting physical chronic conditions, ranging from chronic back pain to chronic joint pain caused by the advanced wearing and tearing of the various musculoskeletal tissues. Chiropractic medicine takes a comprehensive and whole-body approach to treating neuromusculoskeletal injuries. Chiropractic relieves tight or damaged muscles, increases nerve energy flow, and properly aligns the joints through adjustments, spinal traction, decompression, and various forms of manual manipulation.

Table of Contents

Overexertion and Repetitive Stress Injuries

Overexertion and repetitive stress injuries typically occur over time/years of engaging in the same strenuous activity regularly. However, an overexertion injury can occur with one sudden or extreme movement. A worker can injure muscles, tendons, joints, and ligaments. Overexertion can lead to musculoskeletal disorders with symptoms including:

Inflammation
Swelling
Numbness
Stiffness
Chronic pain
Limited or total loss of mobility in the muscles, tendons, ligaments, and joints.

Types

A few of the most common examples of overexertion injuries include:

Soft-Tissue

Injuries to muscles, ligaments, tendons, and joints.

Back

Pulled, strained back muscles.
Herniated discs.
Compressed nerve roots.
Fractured vertebrae.

Dehydration and Heat Stroke

Most common among workers doing outdoor manual labor.

Repetitive and Overuse

Injuries range from carpal tunnel syndrome to stress fractures.
Often the result of weeks, months, or years of repeated movements
In many cases, two or more injuries can happen simultaneously.
For example, a worker is more likely to sustain an injury if they are dehydrated or they are performing dual tasks.

Causes

Certain movements and activities are more likely to cause overexertion injuries. Some of the most common include:

Daily lifting of objects, light and heavy.
Performing awkward movements that cause the body to be in unhealthy positions.
Standing and/or sitting or for long periods.
Using excessive force to perform tasks.
Operating heavy machinery.
Working in hot and/or humid conditions.

High-Rate Injury Industries

Industries in which overexertion injuries are most common include:

Education.
Health services.
Manufacturing.
Construction.
Warehouse work.
Transportation.
Wholesale trade.
Retail stores.

Chiropractic Treatment

These injuries can lead to missed work, debilitating pain, and medical bills. Depending on the severity of the injury, chiropractic care will use massage techniques, spinal manipulation, traction, and decompression therapies, to increase flexibility and mobility to reduce the chances of a recurring injury. The benefits of chiropractic include:

Prevents the risk of worsening or future injuries.
Expedites recovery to help individuals rehabilitate and get back to work sooner.
Improves physical and mental well-being.
Provide recommendations on how to properly stretch and strengthen muscles.
Nutritional anti-inflammatory recommendations.

By learning how to avoid overexertion injuries, workers can be more productive, enjoy work, and improve their quality of life.

From Injury To Recovery

References

Anderson, Vern Putz, et al. “Occupational fatalities, injuries, illnesses, and related economic loss in the wholesale and retail trade sector.” American Journal of industrial medicine vol. 53,7 (2010): 673-85. doi:10.1002/ajim.20813

Choi, Hyun-Woo, et al. “Characteristics of occupational musculoskeletal disorders of five sectors in the service industry between 2004 and 2013.” Annals of Occupational and environmental medicine vol. 29 41. 19 Sep. 2017, doi:10.1186/s40557-017-0198-4

Friedenberg, Rivi, et al. “Work-related musculoskeletal disorders and injuries among emergency medical technicians and paramedics: A comprehensive narrative review.” Archives of Environmental & occupational health vol. 77,1 (2022): 9-17. doi:10.1080/19338244.2020.1832038

Galinsky, T et al. “Overexertion injuries in home health care workers and the need for ergonomics.” Home health care services quarterly vol. 20,3 (2001): 57-73. doi:10.1300/J027v20n03_04

González Fuentes, Aroa, et al. “Work-related overexertion injuries in cleaning occupations: An exploration of the factors to predict the days of absence by means of machine learning methodologies.” Applied ergonomics, vol. 105 103847. 30 Jul. 2022, doi:10.1016/j.apergo.2022.103847

Schoenfisch, Ashley L et al. “Declining rates of work-related overexertion back injuries among union drywall installers in Washington State, 1989-2008: Improved work safety or shifting of care?.” American Journal of industrial medicine vol. 57,2 (2014): 184-94. doi:10.1002/ajim.22240

Williams, J M et al. “Work-related injuries in a rural emergency department population.” Academic emergency medicine: official journal of the Society for Academic Emergency Medicine vol. 4,4 (1997): 277-81. doi:10.1111/j.1553-2712.1997.tb03548.x