Peroneal Muscles, Weak Ankles, & Trigger Points

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Table of Contents

Introduction

The ankles and the lower legs have a casual relationship by allowing movement to the foot that causes an up-and-down motion. The lower leg has various muscles and tendons that surround the shin bone and allows the feet to take the body from one location to another. The peroneal muscles in the legs allow ankle stability to ensure that the weight from the host’s body doesn’t cause overload to the legs and ankles. However, factors like obesity, trauma, or overexerting can cause the peroneal muscles to be inflamed and develop issues like weak ankles or trigger points that can cause referred pain to the ankles and affect how a person walks. Today’s article examines the peroneal muscles, how weak ankles correlate with trigger points, and ways to strengthen the ankles while managing trigger points. We refer patients to certified providers that incorporate various techniques in the lower body extremities, like lower leg and ankle pain therapies correlating to trigger points, to aid many people dealing with pain symptoms along the peroneal muscles, causing weak ankles. We encourage and appreciate each patient by referring them to associated medical providers based on their diagnosis when it is appropriate. We understand that education is an excellent way when asking our providers intricated questions at the patient’s request and understanding. Dr. Alex Jimenez, D.C., only utilizes this information as an educational service. Disclaimer

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The Peroneal Muscles On The Ankles

Have you been experiencing pain when walking around constantly? What about feeling a sharp or dull ache in the back or side of your legs? Or do you feel like falling when you are just standing around? Many people experiencing these issues on their legs and ankles could be dealing with trigger points along the peroneal muscles in the ankles. The peroneal muscles consist of two muscles in the lateral compartment of the lower legs: the peroneus longus and peroneus brevis. The peroneus longus is an important long muscle in the lower legs as it is at the top of the fibula and then runs down the outer leg while connecting to the foot. One of the primary functions of the peroneus longus is allowing plantarflex and evert the foot at the ankle. This means that the peroneus longus helps provide motor strength and range of motion to the ankles.

The peroneus brevis is one of the shorter peroneal muscles in the legs that go down to the ankles and provides assistance to allow eversion to the foot and plantarflexion to the ankles. This shorter muscle is important since the ankle joint is relatively mobile and needs stability from the surrounding ligaments and muscles. These two muscles work together for ankle stability when walking and positioning when the body is moving. Studies reveal that depending on a person’s environment, the peroneal muscles allow support and stability to the ankle in various positions. A good example is if the foot is placed in a sloped position, the peroneal muscles and the surrounding ligaments help stabilize the ankle so it won’t induce pain, causing the individual not to fall over.

Weak Ankles & Trigger Points

When factors like obesity, trauma, or injuries begin to affect the lower half of the body, it can cause instability in the legs and cause the surrounding muscles, tendons, and ligaments to be overstretched, take on more of an overload to the legs, or suffer from a muscle or tendon tear. These factors are associated with various issues that can invoke pain along with developing trigger points along the lower legs. When there are issues in the peroneal muscles, it can lead to muscle weakness in the ankles or “weak ankles,” which causes instability in the body and causes the individual to sprain their ankles. Studies reveal that when the peroneal tendons have a tear in the lower extremities, it can lead to lateral ankle pain that is often missed when examined. However, to that point, if the incision has been left untreated, it can lead to persistent ankle pain, instability, and ankle dysfunction. In “Myofascial Pain and Dysfunction,” written by Dr. Janet G. Travell, M.D., stated that when individuals suffer from weak ankles or have an ankle sprain, active trigger points can cause pain and tenderness to the ankles and cause the person to become unstable. If left untreated, it can cause them to lose balance and have foot drop and ankle fractures to their foot. The book also mentioned that any ruptures in the tendons and muscles might cause lateral compartment syndrome. When there is instability in the ankles, many people resort to using mobility aids like a cane or a walker to be mobile to compensate for the function lost in their feet.

Trigger Point Therapy On The Peroneal Muscles- Video

Taping for Trigger Point - Peroneal Muscles

Do you feel the pain from the bottom of your feet to your ankles? Does it hurt to walk around for a short period? Or have you sprained your ankle, and there is a dull ache when you try to rotate? Some ankle issues are associated with trigger points affecting the peroneal muscles. The peroneal muscles help the lower legs by allowing eversion to the foot and plantarflexion to the ankles. The two muscles that make up the peroneal muscles are the peroneus longus and the peroneus brevis, and they, along with the other tendons and ligaments, help with ankle stability. Since the ankle is a mobile joint, it can succumb to sprains, tears, and instability in the body, allowing trigger points to develop and causing even more issues. The great news is that there are ways to manage trigger points along the peroneal muscles and reduce ankle instability. The video above shows where the peroneal muscles are located on the leg, where the trigger points are, and how to use K-tape to help support the ankle and prevent more injuries on this moveable joint.

Strengthening The Ankles & Managing Trigger Points

Instability in the ankles can be a bummer to many individuals that are on the move, but when it comes to treatment, it can prevent future injuries from re-occurring. Studies reveal that when pain specialists incorporate joint mobilization techniques and dry needling therapy into their patients, it can allow them to reduce the pain and disability to the ankles, thus managing the trigger points along the peroneal muscles. Another way many people can reduce pain in their peroneal muscles is by incorporating stretches and exercises to strengthen their ankles. This allows the peroneal muscles to be loose and gently stretched while slowly strengthening the ankles in a semi-lock position. When people utilize these techniques on their legs and ankles, it can bring mobility and stability back to the body without fear of falling or causing more issues in the ankles.

Conclusion

As one of the most mobile skeletal joints in the lower body, the ankles work together with the legs to provide mobility and stability to the body. The lower legs have various muscles, tendons, and ligaments that travel down and help support the legs and ankles. One of the muscles that provide that support is the peroneal muscle. The peroneal muscles consist of two muscles known as the peroneus longus and peroneus brevis help with eversion to the foot and allow plantarflexion to the ankle. When a person has sprained their ankle, it causes the peroneal muscle to become overstretched and develop trigger points. The great news is that trigger points are treatable, and various treatments can reduce pain in the affected muscle. This allows stability and mobility back to the ankles and improves the body’s functionality.

References

Abd-Rasid, A F, and M Y Bajuri. “Isolated Peroneus Longus Tear – Commonly Missed Diagnosis of Lateral Ankle Pain: A Case Report.” Malaysian Orthopaedic Journal, U.S. National Library of Medicine, July 2020, www.ncbi.nlm.nih.gov/pmc/articles/PMC7513650/.

Basit, Hajira, et al. “Anatomy, Bony Pelvis and Lower Limb, Foot Peroneus Brevis Muscle.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 8 Feb. 2022, www.ncbi.nlm.nih.gov/books/NBK535427/.

Lezak, Bradley, and Matthew Varacallo. “Anatomy, Bony Pelvis and Lower Limb, Calf Peroneus Longus Muscle.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 25 Aug. 2022, www.ncbi.nlm.nih.gov/books/NBK546650/.

Salom-Moreno, Jaime, et al. “Trigger Point Dry Needling and Proprioceptive Exercises for the Management of Chronic Ankle Instability: A Randomized Clinical Trial.” Evidence-Based Complementary and Alternative Medicine : ECAM, U.S. National Library of Medicine, 2015, www.ncbi.nlm.nih.gov/pmc/articles/PMC4430654/.

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

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WAD Whiplash Associated Disorders: Sciatica Clinic

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Dr. Alex Jimenez

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Paramedics Putting Neck Brace On Patient In Car

Whiplash-associated disorders, or WAD, describe injuries sustained from sudden acceleration/deceleration movements. It is a common outcome after a motor vehicle collision but can also be caused by sports injuries, falls, or assaults. Whiplash refers to the mechanism of the injury, while WAD refers to the presence of symptoms like pain, stiffness, muscle spasm, and headaches. A WAD prognosis is unpredictable, with some cases remaining acute with a full recovery, while others progress to chronic conditions with long-term symptoms and disability. Early intervention recommendations include rest, chiropractic care and physical rehabilitation, massaging and stretching exercises, and an anti-inflammatory diet.

Whiplash Associated Disorders

Cervical hyperextension injuries happen to drivers and passengers of moving, slow-moving (less than 14 miles per hour), and stationary vehicles when struck from behind.

The individual’s body is thrown forward, but the head does not follow the body and instead whips forward, resulting in hyperflexion or extreme forward movement of the neck.
The chin limits forward flexion, but the momentum can be sufficient to cause cervical distraction and neurological injuries.
When the head and neck have reached maximum flexion, the neck snaps back, resulting in hyperextension or extreme backward movement of the neck.

Pathology

Most WADs are considered soft tissue-based injuries with no fractures.

Stages

The injury goes through stages:

Stage 1

The upper and lower spine experiences flexion in stage one.

Stage 2

The spine takes on an S-shape while extending and eventually straightens, causing lordosis.

Stage 3

The entire spine is hyperextending with an intense force that causes the facet joint capsules to compress.

Symptoms

Whiplash-associated disorders can be classified through grades by the severity of symptoms, including neck pain, stiffness, occipital headache, cervical, thoracic, and lumbar back pain, upper-limb pain, and paraesthesia.

Grade 0

No complaints or physical symptoms.

Grade 1

Neck complaints but no physical symptoms.

Grade 2

Neck complaints and musculoskeletal symptoms.

Grade 3

Neck complaints and neurological symptoms.

Grade 4

Neck complaints and fracture and/or dislocation.
Most cervical fractures occur predominantly at C2 or C6, or C7.
Most fatal cervical spine injuries occur at the craniocervical junction C1 or C2.

Affected Spinal Structures

Some symptoms are thought to be caused by injury to the following structures:

Cervical Spine
Nerve roots
Spinal ligaments
Facet Joint Capsule
Facet joints
Intervertebral discs
Cartilage
Paraspinal muscles causing spasms

Causes of pain can be from any of these tissues, with the strain of the injury causing secondary edema, hemorrhage, and inflammation.

Joints

Zygapophyseal joints
Atlanto-axial joint
Atlanto-occipital joint
Intervertebral discs
Cartilaginous endplates

Adjacent Joints

Temporomandibular joint
Shoulder complex
Thoracic spine
Ribs

Spinal Muscles

Ligaments

Alar ligament
Anterior atlanto-axial ligament
Anterior atlanto-occipital ligament
Apical ligament
Anterior longitudinal ligament
Transverse ligament of the atlas

Bones

Atlas
Axis
Vertebrae C3-C7

Nervous Systems Structures

Nerve roots
Spinal cord
Brain
Sympathetic nervous system

Vascular System Structures

Internal carotid artery
Vertebral artery

Peripheral Vestibular System

Chiropractic Care

A chiropractor will identify areas of restricted joint motion, muscle tension, muscle spasm, intervertebral disc injury, and ligament injury.

They will analyze posture, and spinal alignment, check for tenderness, tightness, and how well the spinal joints move.
This will allow the chiropractic physical therapy team to understand the injured body mechanics and how the spine is operating to make a thorough diagnosis.
The doctor will order imaging tests like an x-ray or an MRI to evaluate any degenerative changes that may have existed before the whiplash injury.
Once the injury has been accurately diagnosed, the chiropractor will design a personalized treatment plan.

Spinal Adjustments

Spinal manipulation is applied to areas of the spine that are out of alignment to realign the spine and activate the healing process.
Flexion-distraction technique is a gentle technique that uses slower, less intense pushing motions on the discs used to treat disc herniations that often occur after a whiplash injury.
Instrument-assisted manipulation utilizes special instruments to apply various forces or massage settings to the area.
Targeted spinal manipulation targets specific areas to rework, release, and rebuild the structures.
Massage Therapy stimulates the affected muscles to relax them from their tense state.
A treatment plan may utilize:
Instrument-assisted therapy
Trigger point therapy
Resistance-based stretches to rehabilitate soft tissue damage.

Our chiropractic team is ready to help you feel your best so you can return to normal activities and get on with your life.

Automobile Injuries and Chiropractic

References

Pastakia, Khushnum, and Saravana Kumar. “Acute whiplash associated disorders (WAD).” Open access emergency medicine: OAEM vol. 3 29-32. 27 Apr. 2011, doi:10.2147/OAEM.S17853

Ritchie, C., Ehrlich, C. & Sterling, M. Living with ongoing whiplash-associated disorders: a qualitative study of individual perceptions and experiences. BMC Musculoskelet Disord 18, 531 (2017). doi.org/10.1186/s12891-017-1882-9

www.sciencedirect.com/topics/medicine-and-dentistry/whiplash-associated-disorder

Sterling, Michele. “Whiplash-associated disorder: musculoskeletal pain and related clinical findings.” The Journal of manual & manipulative therapy vol. 19,4 (2011): 194-200. doi:10.1179/106698111X13129729551949

Wong, Jessica J et al. “Are manual therapies, passive physical modalities, or acupuncture effective for the management of patients with whiplash-associated disorders or neck pain and associated disorders? An update of the Bone and Joint Decade Task Force on Neck Pain and Its Associated Disorders by the OPTIMa collaboration.” The spine journal: official Journal of the North American Spine Society vol. 16,12 (2016): 1598-1630. doi:10.1016/j.spinee.2015.08.024

Woodward, M N et al. “Chiropractic treatment of chronic ‘whiplash’ injuries.” Injury vol. 27,9 (1996): 643-5. doi:10.1016/s0020-1383(96)00096-4

Shin Splints & Myofascial Trigger Points

By

Dr. Alex Jimenez

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Table of Contents

Introduction

The legs are crucial for many individuals to move, jump, run, walk, and stand in various locations. The legs involve the thighs, hips, and knees as they work together to provide support and a range of movements for the body. For athletes, the legs allow them to run from one obstacle to another and kick the object to finish the game they are participating. Many individuals require strong leg muscles to keep the body balanced and stabilized from the upper body’s weight. One leg muscle that allows the body to be stabilized is the anterior tibialis muscle. When the legs suffer from various sports injuries or injuries in general, it can lead to issues like shin splints correlated with trigger points that can cause pain to the lower portion of the legs and can affect the body’s stability. Today’s article examines the anterior tibialis muscles, how shin splints are associated with myofascial trigger points, and various methods to treat shin splints. We refer patients to certified providers that incorporate various techniques in the lower body extremities, like lower leg pain therapies correlating to myofascial trigger point pain, to aid many people dealing with pain symptoms along the anterior tibialis muscles, causing shin splints. We encourage and appreciate each patient by referring them to associated medical providers based on their diagnosis, especially when appropriate. We understand that education is an excellent source to asking our providers intricated questions at the patient’s request. Dr. Alex Jimenez, D.C., only utilizes this information as an educational service. Disclaimer

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What Is The Tibialis Anterior Muscles?

Have you been dealing with leg pain affecting your ability to move? Do you feel radiating pain going down to your feet? Or does even the smallest amount of pressure sends shooting pain from your knees to your feet? Many of these leg pain issues correlate to myofascial trigger points along the anterior tibialis muscles, mimicking shin splints. Studies reveal that the leg is divided into anterior, lateral, and posterior crural compartments. As one of the largest four muscles in the anterior compartment of the legs, the tibialis anterior is a thick muscle located in the front of the lateral tibia of the legs. The tibialis anterior has the muscle that allows the function to the lower leg and tendons that travel down to the ankle and foot. The anterior tibial muscle plays an important role in the lower leg through dorsiflexion and inversion of the foot. To that point, the anterior tibial muscle plays a key role in energy absorption when walking and maintaining balance.

Shin Splints Associated With Myofascial Trigger Points

Since the anterior tibial muscle plays a key role in energy absorption when it comes to walking and maintaining balance in the body, when the lower leg extremity muscles have been overused, it causes stress on the tibial anterior. It can lead to medial tibial stress syndrome or shin splints. Studies reveal that shin splints affect many athletes, especially runners, by causing pain and discomfort to the tibial anterior. This can cause mobility and balancing issues in the legs and lead to the development of myofascial trigger points in the anterior tibial muscle. Now, how do shin splints and myofascial trigger points correlate with each other?

Dr. Janet G. Travell, M.D., author of “Myofascial Pain and Discomfort: The Trigger Point Manual,” mentioned that one of the chief complaints many people have when experiencing myofascial trigger points would feel muscle weakness of dorsiflexion to the foot when walking. Other complaints include:

Falling
Dragging their feet
Ankle weakness

The book also mentioned that myofascial pain causes referred pain to the anterior tibial muscle, thus mimicking shin splints. The activation from myofascial trigger points causes an overload of the anterior tibial muscle, thus causing various pain issues in the legs and restricting mobility to the muscle itself.

An Overview Of Tibialis Anterior Trigger Points- Video

Tibialis Anterior Trigger Points - Overview

Have you been dealing with radiating pain from your knees to your feet? Do your legs feel heavy from walking a short distance? Or do your leg muscles feel cramps that hinder your ability to move? These pain-like issues are associated with the anterior tibialis muscle being affected by trigger points. Trigger points or myofascial pain syndrome can affect the worldwide population by affecting a muscle or muscle group in the body that can impair mobility, cause pain-like symptoms, and reduces a person’s overall sense of well-being. Trigger points along the tibialis anterior muscle cause mobility issues and mimic shin splint issues in the legs. All is not lost, however, as there are ways to reduce pain-like symptoms and help manage myofascial trigger points in the anterior tibialis muscle. The video above explains where the trigger points are located in the tibialis anterior through palpitation. By finding the trigger points in the affected muscle, doctors can refer patients to pain specialists who target trigger points and provide treatment to reduce the pain.

Various Methods Of Treating Shin Splints

There are various methods to treat the tibialis anterior when treating shin splints associated with trigger points. Studies reveal that one of the multiple ways to reduce shin splints is to strengthen the core hip muscles, improve running mechanics, and prevent lower-extremity overuse injuries. Muscle strength training allows the other muscles from the abdominals, gluteal, and hips to be stronger and reduce strain on the anterior tibialis muscles. Another method that many individuals should consider is to wear the appropriate footwear. Wearing the proper footwear can reduce the shock absorption to the feet and reduce the overloading forces on the anterior tibialis. These are two methods to manage trigger points and prevent shin splints from re-occurring in the legs.

Conclusion

As one of the four leg muscles, the anterior tibialis is a large muscle located in front of the lateral tibia and travels down to the ankles and foot. This muscle plays an important role in the legs as it allows dorsiflexion and inversion of the foot while also playing a key role in energy absorption when walking and maintaining balance. When the anterior tibialis becomes overused, it can develop trigger points, which invoke shin splints in the legs. When the legs suffer from shin splints associated with trigger points, it can cause pain in the lower leg extremities and cause the body to become unstable. However, various methods can take the load off the tibialis anterior and help improve the body’s stability, allowing the individual to walk without feeling pain traveling up from their feet.

References

Deshmukh, Nikita S, and Pratik Phansopkar. “Medial Tibial Stress Syndrome: A Review Article.” Cureus, U.S. National Library of Medicine, 7 July 2022, www.ncbi.nlm.nih.gov/pmc/articles/PMC9356648/.

Galbraith, R Michael, and Mark E Lavallee. “Medial Tibial Stress Syndrome: Conservative Treatment Options.” Current Reviews in Musculoskeletal Medicine, U.S. National Library of Medicine, 7 Oct. 2009, www.ncbi.nlm.nih.gov/pmc/articles/PMC2848339/.

Juneja, Pallavi, and John B Hubbard. “Anatomy, Bony Pelvis and Lower Limb, Tibialis Anterior Muscles.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 29 Aug. 2022, www.ncbi.nlm.nih.gov/books/NBK513304/.

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

Zielinska, Nicol, et al. “Anatomical Variations of the Tibialis Anterior Tendon Insertion: An Updated and Comprehensive Review.” Journal of Clinical Medicine, U.S. National Library of Medicine, 19 Aug. 2021, www.ncbi.nlm.nih.gov/pmc/articles/PMC8396864/.

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Signs of Hormonal Imbalances In Men THIS IS WHY | El Paso, Tx 2022

By

Dr. Alex Jimenez

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Signs of Hormonal Imbalances In Men *THIS IS WHY* | El Paso, Tx 2022

In this episode an expert will take us the assessment and treatment of Hormonal Dysfunctions in men. Helping us understand its root causes, how aging affects it. Also the physiological impact of low testosterone levels and its links to chronic disorders. Stay tuned for more!

We are excited you are taking positive steps to learn about health challenges affecting you and your family. There is the power in making educated decisions about your health by gaining high-level science-based truth and knowledge. We work to uncover the root causes of health issues. Our unique health approach uses functional wellness principles to identify and treat health issues’ potential underlying causes.

Our care plans are base on Functional Medicine as a systems approach based on biology that focuses on identifying and addressing the root cause of disease. We focus on the paradigm that symptom or differential diagnosis may be one of many contributing factors to an individual’s illness.

This approach shifts from the traditional disease-centered focus of most medical practices to a more holistic person-centered approach.

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Lateral Recess Stenosis: Sciatica Clinic

By

Dr. Alex Jimenez

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The spine is the body’s central highway, with the spinal canal as the main lane that handles all the traffic. There are entrances and exits, or spinal cavities, that allow the nerves to branch off the spinal cord and run throughout the body. A traffic jam develops during lane closures, accidents, or construction at an entrance or exit. Lateral recess stenosis causes the narrowing of the spine’s lateral recess/Lee’s entrance, which can compress nerves, impede nerve circulation, and cause painful symptoms.

Table of Contents

Lateral Recess Stenosis

The spinal column provides a strong and flexible structure for the spinal cord. The nerves travel from the spinal cord through various openings and passageways to the rest of the body. One of the openings is known as the lateral recess. Stenosis means narrowing. When a lateral recess in a vertebra develops stenosis, the nerve in that area can get jammed/pinched with no room to move, causing varying symptoms and sensations.

Symptoms

Depending on where the stenosis is taking place (neck, middle or low back), common symptoms of lateral recess stenosis can include:

Back pain that can spread out to other areas.
Cramping that can spread out to other sites.
Radiating pain that worsens with movement and eases with rest.
Numbness or weakness of the legs or arms.
Electrical tingling sensations down the leg or arm.

Causes

The National Institute of Health lists the major causes:

Natural Wear and Tear

Natural aging with gradual degeneration remains the most common cause of stenosis.

Congenital – Born With Stenosis

Scoliosis
Achondroplasia – problems with bone formation.

Disease

Rheumatoid arthritis
Tumors
Paget’s Disease

Natural Aging Process

Herniated disc
Spondylolisthesis – vertebra slips forward
Spondylosis – spinal osteoarthritis

Traumatic Injury

Automobile crashes and accidents
Work Injuries
Sports injuries

Treatment

Lateral recess stenosis has no current cure, but there are options to treat stenosis symptoms.

Chiropractic and Physical Therapy

A chiropractic physical therapy team can relieve symptoms, restore function, and strengthen the muscles.
Muscle groups around the stenosis area are built up to take the pressure off of the area, alleviating symptoms.

Medications

A doctor or spine specialist may recommend or prescribe medication to ease symptoms. These include:
Tylenol – acetaminophen.
NSAIDS – Advil/ibuprofen or Aleve/naproxen.
Muscle relaxers

Steroid Injections

According to a study, neurogenic claudication is the main reason for disability and loss of independence in the elderly.
Neurogenic claudication describes pain and weakness in the buttocks and legs during physical activity that originates from the nerves, not the vessels.
This can happen from inflammation and swelling around a compressed nerve.
A steroid injection can decrease inflammation for several months.

Surgery

If activity modification, NSAIDs, bracing, and physical therapy don’t work or provide adequate relief, a doctor or specialist could recommend surgery.

Lateral inter-body fusion provides indirect decompression.
Endoscopic decompression is a new technique.
Fusion is reserved when there is instability combined with the condition.

Back Problems Chiropractor

References

American College of Rheumatology (n.d.) “Spinal Stenosis” www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Spinal-Stenosis

Arthritis Foundation (n.d.) “Corticosteroids” www.arthritis.org/drug-guide/corticosteroids/corticosteroids

Drug Design, Development and Therapy (2014) “Steroid for epidural injection in spinal stenosis: a systematic review and meta-analysis” doi.org/10.2147/DDDT.S78070

Lee, Seung Yeop, et al. “Lumbar Stenosis: A Recent Update by Review of Literature.” Asian spine journal vol. 9,5 (2015): 818-28. doi:10.4184/asj.2015.9.5.818

Liu, Kuan, et al. “Steroid for epidural injection in spinal stenosis: a systematic review and meta-analysis.” Drug design, development, and therapy vol. 9 707-16. Jan 30, 2015, doi:10.2147/DDDT.S78070

Medline Plus (n.d.) “Achondroplasia” medlineplus.gov/genetics/condition/achondroplasia/

Microspine (n.d.) “Endoscopic Decompression” www.microspinemd.com/microspine-surgery/endoscopic-decompression/

National Institutes of Health (n.d.) “Spinal Stenosis” www.niams.nih.gov/health-topics/spinal-stenosis

Northwest Medical Center (2022) “Lateral Recess/Foraminal Stenosis” nw-mc.com/lateral-recessforaminal-stenosis/

NSPC Brain and Spine Surgery (n.d.) Lateral Recess Stenosis nspc.com/lateral-recess-stenosis/

Raja A, Hoang S, Patel P, et al. Spinal Stenosis. [Updated 2022 Jul 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK441989/

Having Unquestionable Knee Pain? Could Be Trigger Points

By

Dr. Alex Jimenez

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Table of Contents

Introduction

As one of the stabilizers for the body, the knees are located between the thighs and legs, allowing flexion and extension. The knees help the hips by supporting the upper body’s weight and allowing the legs to move from one place to another without feeling pain. The knee has various muscles and ligaments surrounding the knee joint, allowing the leg to be bent when active. One of the muscles is located behind the knee, known as the popliteus, and supports the legs. However, minor injuries or actions can affect the knees causing the joint to be in a “lock” position and develop myofascial trigger points that can induce muscle spasms in the knees. Today’s article focuses on the popliteus muscle, how knee pain is associated with trigger points, and how to manage knee pain through various treatments. We refer patients to certified providers that incorporate multiple methods in the lower body extremities, like knee pain treatments correlating to myofascial trigger points, to aid many people dealing with pain symptoms along the popliteus muscles. We encourage and appreciate each patient by referring them to associated medical providers based on their diagnosis, especially when appropriate. We understand that education is an excellent source to asking our providers intricated questions at the patient’s request. Dr. Alex Jimenez, D.C., only utilizes this information as an educational service. Disclaimer

Download

What Is The Popliteus Muscle?

Have you been dealing with pain behind your knees? Do you have issues bending your knees when climbing up or down the stairs? Or do your back knee muscles start to twitch uncontrollably, causing muscle spasms? Many knee issues correlate with various factors that can affect the popliteus muscle and develop trigger points. The popliteus is a small muscle with a very important job as it is a major stabilizing muscle to the knees. The popliteus muscle originates from the lateral side of the femur and inserts itself into the posterior surface of the tibia. Some attachments are between the popliteus and lateral meniscus, allowing the knees to be in motion and providing flexion without pain and entrapment. Additional studies reveal that when a person exercises, the popliteus’s basic function helps bring about and maintain internal rotation of the tibia on the femur. The popliteus also helps prevent the foot from external rotation and allows the individual to stand correctly. However, injuries to the knee could overstretch the popliteus muscle and cause mobility issues to the knee flexion.

Knee Pain Associated With Trigger Points

When dealing with knee pain, it could often be a joint disorder like osteoarthritis or a musculoskeletal condition like sciatica pain associated with the knee. These issues could be due to normal factors like constantly sitting down or bending down to lift heavy objects that cause the knees to buckle. However, when the popliteus muscle has been continuously overused from being bent, it can form tiny nodules known as trigger points to cause knee pain. Studies reveal that trigger points on the muscles surrounding the knee are often ignored during a clinical diagnosis. Trigger points cause referred pain to the surrounding muscles, accompanied by various sensory sensations like heaviness, tingling, and hypersensitivity to the popliteus muscle. In “Myofascial Pain and Dysfunction,” written by Dr. Travell, M.D. stated that one of the chief complaints that many patients often talk to their doctors about is the pain they feel in the back of their knees when they are in a crouch position. The book also states when normal actions like running or twisting have overloaded the popliteus muscle, it can cause trauma or strain to the popliteus muscle and tear the posterior cruciate ligament to the knees.

How To Find Trigger Points In The Popliteus- Video

Have you been having knee issues that make walking difficult for a long period? Do you feel like your knees are locking up constantly? What about feeling unstable when standing or carrying objects around? These issues that affect the knees are associated with trigger points along the popliteus muscles. The popliteus muscle is small, located at the back of the knees, and assists with knee flexion. When the popliteus muscle becomes overused, it can cause trigger points to form and cause knee issues. Studies reveal that various issues, like tendon injuries, are associated with repetitive mechanical stresses that can cause degenerative knee lesions. Any trauma or muscle strain can affect the knee’s function of flexing and bending without pain for trigger points to form along the popliteus muscles. The video above focuses on the popliteus muscle, where the trigger points are located, and where the referred pain patterns are situated in the knees. On the bright side, all is not lost, as various treatments offer ways to manage knee pain associated with trigger points.

Managing Knee Pain Through Various Treatments

When it comes to knee pain, many individuals will apply an ice or heat compress to allow the surrounding muscles to relax while reducing the pain and swelling. Other individuals use over-the-counter medicines to eliminate the pain for a few hours. While these work at managing knee pain, various treatments target trigger points and can help improve flexion mobility back to the knees. Studies reveal that muscle stretching on the popliteus muscle contributes to joint position sense to knee joint stability and function. Stretching the popliteus muscles can reduce the pain in the back of the knee while elongating the muscle fibers to manage trigger points from forming again. Other treatments that people can do to avoid trigger points from returning is to avoid walking or running in a lateral sloped area to prevent the knees from locking up. Incorporating these treatments to prevent knee issues and allow the knee to function properly.

Conclusion

The knees are one of the stabilizers in the body that are located between the thighs and legs, allowing flexion and extension. As a small muscle located in the back of the knees, the popliteus stabilizes the knees and enables them to be in motion without pain. However, when the popliteus muscle becomes overstretched and overused, it can develop trigger points in the popliteus that invoke referred pain to the surrounding muscles and cause the knees to lock up. To that point, it causes the body to be unstable and mimics knee pain issues. Fortunately, trigger points are treatable through various treatments that help relieve the pain and reduce the trigger points from returning. When these treatments are utilized on the knees, the surrounding muscles regain flexion mobility in the lower body.

References

English, S, and D Perret. “Posterior Knee Pain.” Current Reviews in Musculoskeletal Medicine, U.S. National Library of Medicine, 12 June 2010, www.ncbi.nlm.nih.gov/pmc/articles/PMC2941578/.

Ghaffarinejad, Farahnaz, et al. “Effect of Static Stretching of Muscles Surrounding the Knee on Knee Joint Position Sense.” British Journal of Sports Medicine, U.S. National Library of Medicine, Oct. 2007, www.ncbi.nlm.nih.gov/pmc/articles/PMC2465159/.

Hyland, Scott, and Matthew Varacallo. “Anatomy, Bony Pelvis and Lower Limb, Popliteus Muscle.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 6 June 2022, www.ncbi.nlm.nih.gov/books/NBK526084/.

Mann, R A, and J L Hagy. “The Popliteus Muscle.” The Journal of Bone and Joint Surgery. American Volume, U.S. National Library of Medicine, Oct. 1977, pubmed.ncbi.nlm.nih.gov/908724/.

Sánchez Romero, Eleuterio A, et al. “Prevalence of Myofascial Trigger Points in Patients with Mild to Moderate Painful Knee Osteoarthritis: A Secondary Analysis.” Journal of Clinical Medicine, U.S. National Library of Medicine, 7 Aug. 2020, www.ncbi.nlm.nih.gov/pmc/articles/PMC7464556/.

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

Disclaimer

Treatments of Adrenal Insufficiency | Must Watch El Paso, Tx (2022)

By

Dr. Alex Jimenez

-

Treatments of Adrenal Insufficiency | *Must Watch* El Paso, Tx (2022)

In this episode an expert will take us through the assessment and treatment methods of Adrenal Dysfunction. Explaining the clinical significance of common dysfunctional cortisol diurnal patterns and more!

We are excited you are taking positive steps to learn about health challenges affecting you and your family. There is the power in making educated decisions about your health by gaining high-level science-based truth and knowledge. We work to uncover the root causes of health issues. Our unique health approach uses functional wellness principles to identify and treat health issues’ potential underlying causes.

Our care plans are base on Functional Medicine as a systems approach based on biology that focuses on identifying and addressing the root cause of disease. We focus on the paradigm that symptom or differential diagnosis may be one of many contributing factors to an individual’s illness.

This approach shifts from the traditional disease-centered focus of most medical practices to a more holistic person-centered approach.

Our discussions team includes Integrative Doctors, Functional Medicine Experts, Nutritionists, Health Coaches, Chiropractors, Physical Medicine Doctors, Therapists, and Exercise Performance Specialists.
We provide clinical insights, treatment options, and methods to achieve clinically sound, specific measured goals.*

Functional & Integrative Health Live Events *

✅ Stress Hormones & Health
✅ Gut Health, Inflammation & Auto-Immunity*
✅ Musculoskeletal Rehabilitation
✅ Fibromyalgia & Inflammation
✅ Diabetes & Autoimmunity*
✅ Weight Loss
✅ Body Composition Analysis
✅ Thyroid Dysfunction*
✅ Autoimmune Disorder*
✅ Heart Disease & Inflammation*
✅ Agility & Mobility
✅ Injury Recovery Programs
✅ Complex Lower Back Pain Recovery Plans
✅ Severe Sciatica Syndromes
✅ Other Complex Health Challenges
✅ Neutraceutical Recommendations
✅ Advanced Translational Nutrigenomics*
✅ Nutrigenomics, Proteomics, Metabalomics
✅ Care Plans (Advanced Clinical Practice)

We present, bridge, and connect these various health programs, functional medicine protocols, fitness methods, injury recovery programs, and offer complete wellness packages.

To that end, we shed light and offer treatment options and bring a deep understanding of the real underlying causes of those suffering from acute and interconnected chronic degenerative disorders.

Ultimately, we empower you to achieve and maintain your personalized, healthy way of living by understanding the root causes of disorders.

It is all about.

LIVING, LOVING & MATTERING

Join us in improving your health.

Blessings,

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, CTG*
email: coach@elpasofunctionalmedicine.com phone:
phone: 915-850-0900

Licensed in Texas & New Mexico*

Notice: Our information scope is limited to musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present talks and clinical collaboration with specialists from a wide array of disciplines. Each specialist in our events is governed by their professional scope of practice and their jurisdiction of licensure.

The information in these events is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice.

Our presentations are designed to share knowledge and information from Dr. Jimenez’s research, experience, and collaborative functional medicine community. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional.
We use and discuss functional health & wellness protocols to treat and support the musculoskeletal system’s care for injuries or disorders. Our events, webinars, posts, topics, subjects, and insights cover clinical matters, issues, and issues that relate and support, directly or indirectly, our clinical scope of practice.*

Subscribe: bit.ly/drjyt

Facebook Clinical Page: www.facebook.com/dralexjimenez/
Facebook Injuries Page: www.facebook.com/elpasochiropractor/
Facebook Neuropathy Page: www.facebook.com/ElPasoNeuropathyCenter/

Yelp: El Paso Rehabilitation Center: goo.gl/pwY2n2
Yelp: El Paso Clinical Center: Treatment: goo.gl/r2QPuZ

Clinical Testimonies: www.dralexjimenez.com/category/testimonies/

Information:
Clinical Site: www.dralexjimenez.com
Injury Site: personalinjurydoctorgroup.com
Sports Injury Site: chiropracticscientist.com
Back Injury Site: www.elpasobackclinic.com
Functional Medicine: wellnessdoctorrx.com

Twitter: twitter.com/dralexjimenez
Twitter: twitter.com/crossfitdoctor

DISCLAIMER: dralexjimenez.com/legal-disclaimer/

Running With A Prosthetic Leg: Sciatica Clinic

By

Dr. Alex Jimenez

-

Young male runner with a prosthetic leg running outdoors. Sport, disability and healthy lifestyle concept.

Before you begin running, talk with your physician, prosthetist, and other clinicians involved in your rehabilitation/health care treatment. Learning to use a prosthetic takes time and practice. Individuals that meet the minimum recommendations for running and have mastered walking on a prosthesis can begin running. The world of sports prosthetics has realized technological advancements to become highly refined and targeted for all levels of competition.

Table of Contents

Before Running Recommendations

Every individual has specific healthcare needs, and guidelines should be considered to prevent injuries.

To become a runner and progress to a good runner, individuals need to focus on strengthening their legs to build endurance levels to meet the energy demands.
Working with a sports chiropractic and physical therapy team is recommended to build, strengthen, and condition the muscles and develop healthy posture and walking habits.

Skin Health

Talk with your healthcare team to ensure the skin can withstand the forces while running. If limb skin quality is insufficient, running can result in sores and blisters that prevent wearing a prosthesis until they heal. Other considerations include the following:

The incision should be healed.
All stitches and staples have been removed.
There should be no drainage.
Ensure there are no open wounds or blisters.

Bone Health

Research suggests in some cases that a decrease in bone density/osteopenia or osteoporosis of the residual limb can occur after amputation.
This can result in pain when applying weight through the residual limb.
Some amputations can result in heterotopic ossification – bone growth in the soft tissues outside the normal skeleton.
If heterotopic ossification is causing symptoms, it is not recommended to run and talk to your physician and prosthetist about options.

Proper Fitting of Prosthetic

Suboptimal socket fit can result in an altered gait.
If there is any compensation when walking, the gait deviations will be exacerbated when running.
Gait deviations can result in abnormal loading, resulting in injuries.
Talk to your prosthetist about the fit if it is less than optimal.
It is recommended to participate in gait training with a chiropractic physical therapy team to learn to walk with proper form.

Balance and Agility

Agility drills are recommended to transition from walking to running.

They help coordinate the limbs and can be done with a regular prosthesis.
Agility and balance exercises promote stability in the socket to become more stabilized during quick movements.
They can help to prevent balance-related falls.
When working on balance, do it in a safe environment with a friend, family, or something to hold on to.

Strength Training

The unaffected leg will now be the main powerhouse, so the focus needs to be on strengthening all the muscles in that leg.
If you have bilateral amputations or both legs, the hips will be the powerhouse for running. It needs to generate all the force to propel the body forward.
Individuals with a below-knee amputation will also have the hamstrings to help out.
Hip musculature needs to be strong to meet running demands.
Without proper strength, the body will compensate in various ways, which can lead to injuries.

Endurance

Endurance training is essential.
A high level of endurance is required before training to run to meet the energy demands.
One study showed that running with a SACH/Solid Ankle Cushion Heel Foot requires 28-36% more energy than individuals without amputations.

Running With Prosthetic

Energy

Running on a prosthesis requires more energy. It could be recommended to use a running prosthesis instead of the everyday prosthesis. The energy needed to run is:

Greater for individuals with amputations above the knee than those below the knee.
Even greater for those with amputations on both sides.

Asymmetry

Asymmetrical loading is a common problem when running with a prosthesis. Runners want to use the unaffected limb more than maintain balance for reasons that include:

Not trusting the prosthetic.
Discomfort when loading the residual limb.
Not enough strength in the residual limb.
Unbalanced amounts of force from impact can result in injuries.

Practice Schedule

In the first week, asses how the socket fits and if there is any discomfort.
If something does not feel correct, check with your prosthetist.
Don’t run for more than 10 minutes in the beginning without stopping to check the skin to see if any red spots appear.
The pressure will be increased, so be aware of anything irritating or rubbing the skin.
Individuals who had their amputations some time ago may be able to tolerate the load more easily at the beginning than individuals who recently had an amputation.
Too much too soon can result in injuries.
Slowly ease into running and give the limbs and body time to adapt to the physical and mental stress.

Running With A Prosthetic Limb

References

Beck, Owen N et al. “Reduced prosthetic stiffness lowers the metabolic cost of running for athletes with bilateral transtibial amputations.” Journal of applied physiology (Bethesda, Md.: 1985) vol. 122,4 (2017): 976-984. doi:10.1152/japplphysiol.00587.2016

Bragaru, Mihai, et al. “Sport prostheses and prosthetic adaptations for the upper and lower limb amputees: an overview of peer-reviewed literature.” Prosthetics and orthotics international vol. 36,3 (2012): 290-6. doi:10.1177/0309364612447093

Kanas, Joanne L, and Mark Holowka. “Adaptive upper extremity prostheses for recreation and play.” Journal of pediatric rehabilitation medicine vol. 2,3 (2009): 181-7. doi:10.3233/PRM-2009-0082

Matthews, D et al. “Return to sport following amputation.” The Journal of sports medicine and physical fitness vol. 54,4 (2014): 481-6.

Meyers, Carolyn, et al. “Heterotopic Ossification: A Comprehensive Review.” JBMR plus vol. 3,4 e10172. 27 Feb. 2019, doi:10.1002/jbm4.10172

Morgan, Sara J et al. “Mobility with a lower limb prosthesis: experiences of users with high levels of functional ability.” Disability and rehabilitation vol. 44,13 (2022): 3236-3244. doi:10.1080/09638288.2020.1851400

Dealing With Upper Thigh Pain? Could Be Trigger Points In the Hamstrings

By

Dr. Alex Jimenez

-

Table of Contents

Introduction

Many individuals utilize their lower muscles to move around and stay active as each muscle does its job and allows mobility to the hips and thighs. In sports, the thigh muscles are utilized constantly to extend the legs and bend the knees, allowing a powerful force to win any sports competition. At the same time, various sports injuries can occur to the hips, thighs, and legs and can affect the muscles causing pain and discomfort to the lower extremities. A hamstring injury is one of the most common injuries that can affect the thighs, which can cause many athletes to be taken out of their favorite sport to recover from the injury. Today’s article looks at the hamstring muscle, how trigger points correlate with a hamstring strain, and how various stretches can reduce muscle strain on the hamstrings. We refer patients to certified providers who incorporate multiple methods in the lower body extremities, like upper thigh and hip pain treatments correlating to myofascial trigger point pain, to aid individuals dealing with pain symptoms along the hamstring muscles. We encourage and appreciate patients by referring them to associated medical providers based on their diagnosis, especially when appropriate. We understand that education is an excellent solution to asking our providers complex questions at the patient’s request. Dr. Jimenez, D.C., utilizes this information as an educational service only. Disclaimer

Download

What Are The Hamstring Muscles?

Do you experience pain in the back of your upper thigh? When walking from one place to another, do you hear a popping sound in the back of your thigh? Or are you dealing with muscle tenderness in the back of your upper thigh? Many of these symptoms correlate with issues affecting the hamstrings causing trigger points to affect the upper thighs. As one of the most complex muscles comprising three muscles (semitendinosus, semimembranosus, biceps femoris), the hamstrings play a crucial part in daily activities. From simple actions like standing to explosive movements like sprinting or jumping, the hamstrings are known as posterior thigh muscles that begin from the pelvis and run behind the femur bone and cross the femoroacetabular and tibiofemoral joints. The hamstring muscles in the body play a prominent role in hip extension and is a dynamic stabilizer of the knee joint. To that point, the hamstring muscles are the most susceptible muscle that succumbs to injuries that can lead to disability in the legs and affect daily activities.

Hamstring Strain & Trigger Points

Since the hamstrings are the most susceptible muscles that can succumb to injuries, it takes a while for the muscle to heal, depending on the severity of the damage. Studies reveal that the hamstrings can occur injuries when a person is running or sprinting due to their anatomic arrangement, which causes the muscles to strain. To that point, depending on how much force has impacted the hamstrings, the injuries can lead to 3 of the following:

Grade 1: Mild pain or swelling (no loss of function)
Grade 2: Identifiable partial tissue disruption with moderate pain and swelling (minimal loss of function)
Grade 3: Complete disruption of the tissue with severe pain and swelling (total loss of function)

The pain that patients experience can be painful when walking, causing them to limp. In “Myofascial Pain and Dysfunction,” written by Dr. Janet G. Travell, M.D., stated that when patients are dealing with pain in their hamstrings, it could potentially be associated with trigger points along the three muscles, causing pain and disability in the upper thighs. The book also mentioned that when trigger points affect the hamstrings, it can lead to muscle inhibition, compromising hip stability. Another issue that trigger points associated with hamstring strain causes in the body are that when individuals are sitting down are likely to experience posterior pain in the buttock, upper thighs, and back of the knees. Luckily, there are various ways to reduce the pain along the hamstring muscles.

Trigger Point Of The Week: Hamstrings- Video

Have you dealt with pain along the back of your upper thighs? Does it feel uncomfortable when you are sitting down? Or do your hamstrings ache or feel tight after running for a long period? People dealing with issues in their hamstrings could be dealing with muscle strain associated with trigger points. The hamstring muscles play a vital role in the body as it allows the individual to walk, run, bend the knees and even extend the legs. The hamstring muscles are also the most susceptible to injury, causing disability to the legs. Studies reveal that trigger points associated with the hamstring muscles can lead to soreness or irritability in the muscle fibers that may interfere with the biomechanics and normal functioning of the lower limbs. The video above explains where the hamstrings are located and how the trigger points can cause referred pain to the hamstrings. To that point, trigger points can affect a person’s ability to walk and affect the surrounding muscles in the lower body while mimicking other chronic conditions.

Various Stretches To Reduce Muscle Strain On The Hamstrings

When the hamstrings become injured, the healing rate usually depends on how severe the injury is in the hamstrings. If a hamstring injury is mild, the tears or strains can heal within about three to eight weeks, and if the hamstring injury is severe, the tears or strains could be long as three months. When the hamstrings are tense and on the verge of tearing, many people should stop overusing the muscle. Various stretches can reduce muscle strain on the hamstrings and relieve tension from the hamstrings to allow mobility back to the legs. Studies reveal that manual ischemic compression on the upper thigh muscles can significantly reduce pain in the lower limbs. This allows the individual to manage the trigger points associated with the hamstrings and reduce the chances of them re-occurring in the legs.

Conclusion

As the most important muscle in the lower body extremities, the hamstrings play a crucial part in the body as they allow the individual to walk, run, and stand without feeling pain. However, even though they are important muscles, they are susceptible to injuries. When the hamstrings become injured, the recovery process varies depending on the severity and can develop trigger points along the muscle fibers. To that point, it causes referred pain along the upper thigh muscle and affects a person’s ability to walk. Fortunately, incorporating various stretches to the hamstrings can alleviate the pain and reduce the trigger points from re-occurring in the muscle. This allows mobility back to the legs, and many individuals can resume their daily activities.

References

Esparza, Danilo, et al. “Effects of Local Ischemic Compression on Upper Limb Latent Myofascial Trigger Points: A Study of Subjective Pain and Linear Motor Performance.” Rehabilitation Research and Practice, Hindawi, 4 Mar. 2019, www.ncbi.nlm.nih.gov/pmc/articles/PMC6425406/.

Poudel, Bikash, and Shivlal Pandey. “Hamstring Injury – Statpearls – NCBI Bookshelf.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 28 Aug. 2022, www.ncbi.nlm.nih.gov/books/NBK558936/.

Rodgers, Cooper D, and Avaias Raja. “Anatomy, Bony Pelvis and Lower Limb, Hamstring Muscle.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 29 Jan. 2022, www.ncbi.nlm.nih.gov/books/NBK546688/.

Thummar, Ravindra C, et al. “Association between Trigger Points in Hamstring, Posterior Leg, Foot Muscles and Plantar Fasciopathy: A Cross- Sectional Study.” Journal of Bodywork and Movement Therapies, U.S. National Library of Medicine, 7 Aug. 2020, pubmed.ncbi.nlm.nih.gov/33218537/.

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

Disclaimer

Adrenal Insufficiency Symptoms, Diagnosis and Treatments Part 1 | El Paso, Tx (2022)

By

Dr. Alex Jimenez

-

Adrenal Insufficiency *Symptoms, Diagnosis and Treatments* Part 1 | El Paso, Tx (2022)

In this episode an expert will take us through the assessment and treatment methods of Adrenal Dysfunction. Explaining the clinical significance of common dysfunctional cortisol diurnal patterns and more!

We are excited you are taking positive steps to learn about health challenges affecting you and your family. There is the power in making educated decisions about your health by gaining high-level science-based truth and knowledge. We work to uncover the root causes of health issues. Our unique health approach uses functional wellness principles to identify and treat health issues’ potential underlying causes.

Our care plans are base on Functional Medicine as a systems approach based on biology that focuses on identifying and addressing the root cause of disease. We focus on the paradigm that symptom or differential diagnosis may be one of many contributing factors to an individual’s illness.

This approach shifts from the traditional disease-centered focus of most medical practices to a more holistic person-centered approach.

Our discussions team includes Integrative Doctors, Functional Medicine Experts, Nutritionists, Health Coaches, Chiropractors, Physical Medicine Doctors, Therapists, and Exercise Performance Specialists.
We provide clinical insights, treatment options, and methods to achieve clinically sound, specific measured goals.*

Functional & Integrative Health Live Events *

✅ Stress Hormones & Health
✅ Gut Health, Inflammation & Auto-Immunity*
✅ Musculoskeletal Rehabilitation
✅ Fibromyalgia & Inflammation
✅ Diabetes & Autoimmunity*
✅ Weight Loss
✅ Body Composition Analysis
✅ Thyroid Dysfunction*
✅ Autoimmune Disorder*
✅ Heart Disease & Inflammation*
✅ Agility & Mobility
✅ Injury Recovery Programs
✅ Complex Lower Back Pain Recovery Plans
✅ Severe Sciatica Syndromes
✅ Other Complex Health Challenges
✅ Neutraceutical Recommendations
✅ Advanced Translational Nutrigenomics*
✅ Nutrigenomics, Proteomics, Metabalomics
✅ Care Plans (Advanced Clinical Practice)

We present, bridge, and connect these various health programs, functional medicine protocols, fitness methods, injury recovery programs, and offer complete wellness packages.

To that end, we shed light and offer treatment options and bring a deep understanding of the real underlying causes of those suffering from acute and interconnected chronic degenerative disorders.

Ultimately, we empower you to achieve and maintain your personalized, healthy way of living by understanding the root causes of disorders.

It is all about.

LIVING, LOVING & MATTERING

Join us in improving your health.

Blessings,

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, CTG*
email: coach@elpasofunctionalmedicine.com phone:
phone: 915-850-0900

Licensed in Texas & New Mexico*

Notice: Our information scope is limited to musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present talks and clinical collaboration with specialists from a wide array of disciplines. Each specialist in our events is governed by their professional scope of practice and their jurisdiction of licensure.

The information in these events is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice.

Our presentations are designed to share knowledge and information from Dr. Jimenez’s research, experience, and collaborative functional medicine community. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional.
We use and discuss functional health & wellness protocols to treat and support the musculoskeletal system’s care for injuries or disorders. Our events, webinars, posts, topics, subjects, and insights cover clinical matters, issues, and issues that relate and support, directly or indirectly, our clinical scope of practice.*

Subscribe: bit.ly/drjyt

Facebook Clinical Page: www.facebook.com/dralexjimenez/
Facebook Injuries Page: www.facebook.com/elpasochiropractor/
Facebook Neuropathy Page: www.facebook.com/ElPasoNeuropathyCenter/

Yelp: El Paso Rehabilitation Center: goo.gl/pwY2n2
Yelp: El Paso Clinical Center: Treatment: goo.gl/r2QPuZ

Clinical Testimonies: www.dralexjimenez.com/category/testimonies/

Information:
Clinical Site: www.dralexjimenez.com
Injury Site: personalinjurydoctorgroup.com
Sports Injury Site: chiropracticscientist.com
Back Injury Site: www.elpasobackclinic.com
Functional Medicine: wellnessdoctorrx.com

Twitter: twitter.com/dralexjimenez
Twitter: twitter.com/crossfitdoctor

DISCLAIMER: dralexjimenez.com/legal-disclaimer/

Gabapentin Medication For Sciatica: The Sciatica Clinic

By

Dr. Alex Jimenez

-

shot-of-a-young-businesswoman-experiencing-back-pa-2022-10-07-20-25-22-utc_02 — Shot of a young businesswoman experiencing back pain while working at her desk in a modern office.

The spine consists of multiple vertebral bones separated by gel-like discs. The discs are the shock absorbers, cushioning the vertebrae. Normal wear and tear, underlying conditions, and injuries can cause the discs to crack, tear, and leak out, also known as a slipped or herniated disc, which is the most common cause of sciatica. In certain cases, physicians are using a medication that is used to control seizures known as gabapentin. Gabapentin is an anticonvulsant used to treat nerve-related back pain, like sciatica.

Table of Contents

First Line Medications

Doctors’ first-line medications for sciatica include anti-inflammatories/NSAIDs such as naproxen or ibuprofen and corticosteroids.
Back spasms can accompany sciatica, increasing the sensations and pain; a muscle relaxer could be added.
If these treatments do not provide adequate symptom relief, a combination of gabapentin, naproxen, ibuprofen (NSAIDs), corticosteroids, and Tylenol could be recommended.
Before going to bed is the recommended time for taking the meds because of the potential for drowsiness.
This allows the patient to be more comfortable and get better sleep.

Gabapentin

Gabapentin is a non-narcotic prescription medication that is part of the anticonvulsant family. FDA approved for the following:

Seizures

It can be used with other medications for controlling epileptic seizures.

Postherpetic Neuralgia

Painful blisters caused by reactivation of herpes zoster virus, aka shingles.

Off-label uses include:

Nerve Pain

Treats sharp burning nerve pain often experienced from:
Shingles outbreak
Diabetes
Spinal cord injury

Restless Legs Syndrome

Manages the various sensations commonly experienced with the condition.

Fibromyalgia

It can be effective in treating pain symptoms.

Brain Signals

Gabapentin alters the way the brain and body transmit signals. It works by blocking the pain-causing neurotransmitters to calm the pain signals to the nerves. This is why it is used for sciatica and neurogenic pain. Individuals dealing with nerve pain, numbness, and tingling in the legs from sciatica or have diabetic neuropathy benefit the most. It is not recommended for chronic, non-specific low back pain. Gabapentin may take up to a month to provide maximum relief; individuals may start to experience some relief within the first week. However, notify a physician if significant pain persists after using Tylenol, NSAIDs, corticosteroids, and gabapentin.

What To Expect

The medication is available in a capsule, tablet with immediate or extended release, and liquid form.
Starting dosage is 300mg once a day.
A physician may increase the dosage up to three times a day.
The medication needs to be taken as prescribed.
Treating neuropathic sciatic pain with gabapentin is standard practice.
This is an off-label usage meaning the FDA has not determined if the medication is safe and effective for sciatica.

Side Effects and Interactions

The most common side effects include:

Dizziness
Fatigue
Tremors

Due to these potential side effects, Individuals should not drive or operate heavy machinery while taking gabapentin.

Rare but more serious side effects can include:

Vision changes
Confusion
Trouble breathing
Behavioral changes or suicidal ideation
Swelling

In 2019, the FDA released a statement cautioning the elderly and those with significant breathing conditions, such as chronic obstructive pulmonary disease/COPD, to use extreme caution when taking gabapentin and similar medications. Elderly individuals are more likely to experience side effects due to age-related changes, decreased kidney function, poor balance, and mobility issues. There is an increased risk of experiencing breathing problems when taking gabapentin with any of the following:

Alcohol
Opioids
CNS/Central Nervous System depressants slow brain activity for sleep, anxiety, and panic disorders.

The consumption of alcohol, opioids, or CNS depressants while taking gabapentin can increase the sedating effects of each substance and lead to respiratory depression. It is imperative that your physician knows all prescription and non-prescription medications, herbal supplements, and vitamins to prevent negative interactions between medications.

Does Gabapentin Work?

References

Center for Drug Evaluation and Research. (n.d.). Serious breathing difficulties with gabapentin and pregabalin. U.S. Food and Drug Administration. Retrieved September 30, 2022, from www.fda.gov/drugs/drug-safety-and-availability/fda-warns-about-serious-breathing-problems-seizure-and-nerve-pain-medicines-gabapentin-neurontin

Grice, Gloria R, and Marsha K Mertens. “Gabapentin as a potential option for treatment of sciatica.” Pharmacotherapy vol. 28,3 (2008): 397-402. doi:10.1592/phco.28.3.397

U.S. Department of Health and Human Services. (2022, March 22). Prescription CNS depressants DrugFacts. National Institutes of Health. Retrieved September 30, 2022, from nida.nih.gov/publications/drugfacts/prescription-cns-depressants

U.S. National Library of Medicine. (n.d.). Gabapentin: Medlineplus drug information. MedlinePlus. Retrieved September 30, 2022, from medlineplus.gov/druginfo/meds/a694007.html

U.S. National Library of Medicine. (n.d.). Pregabalin: Medlineplus drug information. MedlinePlus. Retrieved September 30, 2022, from medlineplus.gov/druginfo/meds/a605045.html

Yasaei R, Katta S, Saadabadi A. Gabapentin. [Updated 2022 May 2]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK493228/

Pain In Your Adductor Muscles? Could Be Myofascial Trigger Points

By

Dr. Alex Jimenez

-

Table of Contents

Introduction

The hips and thighs have a working relationship as their jobs are to maintain stability for the legs and pelvis while supporting the upper body’s weight. These two body groups have various muscles, tendons, and nerves that have specific jobs that allow mobility to the lower body. Many athletes in multiple sports events use their thighs to exert a huge amount of power to be the best. This is due to the adductor muscles in the thighs that allow the athlete to win the event. These adductor muscles are voluminous in size and can become overstretched if the muscles have been worked out too much or injuries have caused dysfunction in the surrounding muscles, causing mobility issues. To that point, the adductor muscles will develop myofascial trigger points and cause hip and thigh pain. Today’s article looks at the two adductor muscles (Longus and Magnus), how myofascial trigger points affect the adductor muscles, and available treatments to manage hip adductor trigger points. We refer patients to certified providers who incorporate multiple methods in the lower body extremities, like thigh and hip pain treatments correlating to myofascial trigger point pain, to aid individuals dealing with pain symptoms along the adductor muscles. We encourage and appreciate patients by referring them to associated medical providers based on their diagnosis, especially when appropriate. We understand that education is an excellent solution to asking our providers complex questions at the patient’s request. Dr. Jimenez, D.C., utilizes this information as an educational service only. Disclaimer

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Adductor Longus & Adductor Magnus

Have you been dealing with groin pain located near your thighs? Do you feel muscle tenderness or stiffness when stretching your inner thighs? Or have you been feeling unstable in your hips or thighs when walking? Many individuals, especially athletes and older adults, could be experiencing myofascial trigger points associated with groin pain along their adductor muscles. The thighs contain several muscles and functions that allow many people to bend and extend their knees and hips. The adductor muscles allow the legs to move inward toward one another. The adductor muscles have five muscles: magnus, brevi, longus, pectineus, and gracilis. These muscles enable functionality to the thighs and hips, and we will look at two adductor muscles in the inner thighs. The long adductor muscle is a large, fan-shaped muscle that starts from the superior aspect of the pubis bone and travels down to connect at the thigh bone. Studies reveal that the adductor longus is a long and thin muscle with many actions for the thighs, including external/lateral rotation and thigh flexion.

Now the adductor Magnus is a large triangular-shaped muscle of the inner thighs that are important for thigh and hip function and stabilizing the pelvis. Studies reveal that even though the adductor Magnus is a large muscle in the inner thighs, its primary function is to allow the thigh to move in a larger range of motion without any pain inflicted on the thigh muscles. However, the adductor muscle can succumb to various issues affecting the thighs and groin regions of the body that can be overstretched and strain the body.

Myofascial Trigger Points Affecting The Adductor Muscles

Groin pain is a multi-factorial pain issue that affects the lower limbs, and its often due to muscle strain in the inner thigh muscles. This pain increases during vigorous activities and when there is a sudden twist in the hips. When the adductor muscles suddenly change in motion when the body is active, they can be overstretched and correlate to myofascial trigger points that can affect the inner thigh and groin regions. According to “Myofascial Pain and Dysfunction,” by Dr. Travell, M.D., patients with active myofascial trigger points in the two adductor muscles (Longus and Magnus) would become frequently aware of the pain in their groin and medial thigh. When the adductor muscles have myofascial trigger points in the inner thigh, diagnosing is difficult since the individual thinks they are suffering from groin pain when the pain is in their inner thighs. To that point, studies reveal that many individuals participating in various sports would suffer from groin pain due to myofascial trigger points affecting the adductor muscles. Luckily, there are multiple treatments to reduce the pain in the adductor muscles.

Hip Adductors: Trigger Point Anatomy- Video

Have you been dealing with groin pain when you are walking? What about experiencing unquestionable thigh pain that affects your daily activities? Or does stretching your inner thigh muscles seem difficult, causing muscle tenderness? Many of these symptoms correlate with groin pain associated with myofascial trigger points affecting the adductor muscles in the inner thighs. The adductor muscles allow mobility function to the thighs and enable the hips to have a wide range of motion. When the adductor muscles are overstretched due to a sudden change of hip rotation or injury has occurred on the thighs can lead to referred pain in the groin and inner thighs and develop myofascial trigger points. The video above shows where the trigger points are located in the hip adductor muscles. The video also explains where the pain is localized in the adductor muscles and the symptoms it produces that can affect the lower body extremities. Fortunately, even though diagnosing myofascial trigger points are a bit challenging, available treatments can manage trigger points along the hip adductors.

Available Treatments To Manage Hip Adductor Trigger Points

When myofascial trigger points affect the hip adductor muscles, many individuals complain about stiffness in their inner thighs and how they feel miserable when they don’t have mobility from their thighs and hips. As stated earlier, trigger points are a bit challenging when diagnosed, but they are treatable when doctors examine patients dealing with myofascial pain in their hips and thigh muscles. Once the diagnosis is complete, doctors work with pain specialists who can locate the trigger points and devise a treatment plan to relieve the pain. Available treatments like trigger point injections can minimize the pain and reduce the chances of trigger points returning. Other available therapies like exercising or stretching, especially for the hips and thighs. Specific exercises for the hips and thigh muscles can help strengthen the adductor muscles from suffering pain and can help reduce the pain symptoms. Another treatment is applying moist heat on the hip adductor muscles to release the tension from the tight muscles and allow mobility back to the hip adductors.

Conclusion

The adductor muscles work with the hips and thighs to allow a wide range of motions and extension to the knees and hips. The hips and the thighs allow stability to the lower body and support the weight to the upper body. When injuries or sudden changes start to affect the adductor muscles, it can lead to symptoms of groin pain associated with myofascial trigger points. Myofascial trigger points produce tiny nodules in the affected muscle that causes referred pain to the muscle group. When this happens, it causes the body to be dysfunctional and can affect a person’s mobility to function in the world. Luckily myofascial trigger points are treatable through various techniques and treatments that can reduce the chances of trigger points from re-occurring in the body.

References

Jeno, Susan H, and Gary S Schindler. “Anatomy, Bony Pelvis and Lower Limb, Thigh Adductor Magnus Muscle.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 1 Aug. 2022, www.ncbi.nlm.nih.gov/books/NBK534842/.

Sedaghati, Parisa, et al. “Review of Sport-Induced Groin Injuries.” Trauma Monthly, Kowsar, Dec. 2013, www.ncbi.nlm.nih.gov/pmc/articles/PMC3864393/.

Shahid, Shahab. “Adductor Longus Muscle.” Kenhub, Kenhub, 30 June 2022, www.kenhub.com/en/library/anatomy/adductor-longus-muscle.

Simons, D. G., and L. S. Simons. Myofascial Pain and Dysfunction: The Trigger Point Manual: Vol. 2:the Lower Extremities. Williams & Wilkins, 1999.

Takizawa, M, et al. “Why Adductor Magnus Muscle Is Large: The Function Based on Muscle Morphology in Cadavers.” Scandinavian Journal of Medicine & Science in Sports, U.S. National Library of Medicine, 27 Apr. 2012, pubmed.ncbi.nlm.nih.gov/22537037/.

van de Kimmenade, R J L L, et al. “A Rare Case of Adductor Longus Muscle Rupture.” Case Reports in Orthopedics, Hindawi Publishing Corporation, 2015, www.ncbi.nlm.nih.gov/pmc/articles/PMC4397006/.

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Sciatica Foot and Ankle Issues: Sciatica Clinic

By

Dr. Alex Jimenez

-

Doctor performing shockwave therapy procedure in clinic — Close up of physiotherapist in sterile gloves using pain relief device while performing physiotherapy procedure on woman foot

It didn’t happen at work, school, or exercise, and there haven’t been any trips and/or falls, but you can’t pinpoint what is causing foot and ankle discomfort and sensations. However, the cause could be originating in the lumbar spinal region. Sciatica is a set of symptoms that refer to pain, numbness, and tingling radiating down the leg from the lower back, affecting the legs, hips, buttocks, and feet. Injury Medical Chiropractic and Functional Medicine Clinic can release the compressed nerve, massage circulation back into the nerve, and restore mobility and function.

Table of Contents

Sciatica Foot and Ankle

Sciatic nerve sensations can run down the back of the leg down into the foot.

Compression or irritation to any nerve roots can present with symptoms in the hip, thigh, calf, and foot.
Sciatica foot and ankle symptoms can accompany numbness and muscle weakness.
Sciatic nerve irritation mostly causes symptoms on the outside of the foot but can spread to other areas.

Nerve Roots

One or more of the lower spine’s sciatic nerve roots are being compressed or pinched. The foot symptoms location depends on which nerve root is affected.

If the S1 root is affected, symptoms will radiate to the sole and side of the foot.
If L5 is affected, symptoms will radiate to the top of the foot and the big toe.
If the L4 root is affected, symptoms can radiate to the medial or inside the ankle area.

Chiropractic Care and Relief

Foot Massage

A foot massage can be helpful.

A massage therapist finds points around the ankles that are tender.
Tenderness indicates a lymphatic blockage or muscle tension that needs to be worked out.
They will apply varying pressures to massage the muscles and get the circulation flowing.
The therapist will loosen the tarsal and metatarsal bones to loosen the muscles and nerves.
Moving the bones resupplies the joints, forces out inflammatory metabolic waste, opens the space for the nerves, and allows improved lymphatic drainage and blood flow to expedite healing.

Nerve Flossing

Nerve flossing exercises can help stretch and maintain the released nerve.

A chiropractor will perform and train the individual on targeted stretches to the Achilles tendon and plantar fascia.
They will stretch, release, and open the ankle and sciatic nerve.

Injections

A cortisone injection where the nerve is affected can help in certain cases.

Injections of a corticosteroid, an anti-inflammatory medicine, can offer relief for up to three months and are given under local anesthesia.
The medicine reduces the inflammation and swelling around the nerve roots.

Foot Orthotics

Custom foot orthotics can help support a postural foot or ankle problem.
Overpronation is when the ankles collapse inward, which creates an imbalance of leg lengths that affects the hips, pelvis, and spine.
Orthotics can help provide symptom relief.

Nutrition

Part of a treatment plan will include an anti-inflammatory and antioxidant nutritional plan.

A professional nutritionist will make recommendations based on the individual’s case.
Magnesium-rich foods are generally recommended for sciatica as this nutrient aids the body in releasing muscle contractions.
99 percent of the body’s magnesium is stored in the bones, muscles, and soft tissues, with only 1 percent concentrated in the blood.

Foods rich in magnesium include:

Avocado
Bananas
Apricots
Dried pumpkin seeds
Dairy
Dark chocolate
Dried figs
Black beans
Brown rice
Fish
Spinach
Swiss chard
Yogurt

Benefits of Custom Foot Orthotics

References

Davis, David, et al. “Sciatica.” StatPearls, StatPearls Publishing, 6 May 2022.

Ge, Phillip S et al. “Iatrogenic pseudoaneurysm of the superior gluteal artery presenting as pelvic mass with foot drop and sciatica: case report and review of the literature.” Vascular and endovascular surgery vol. 44,1 (2010): 64-8. doi:10.1177/1538574409351990

Hughes, Michael S et al. “Post-traumatic catamenial sciatica.” Orthopedics vol. 31,4 (2008): 400. doi:10.3928/01477447-20080401-15

Mayo Clinic. “Sciatica.” www.mayoclinic.org/diseases-conditions/sciatica/symptoms-causes/syc-20377435?p=1

National Institutes of Health. “Sciatica.” medlineplus.gov/sciatica.html

Pan, Hung-Chuan, et al. “Magnesium supplement promotes sciatic nerve regeneration and down-regulates inflammatory response.” Magnesium research vol. 24,2 (2011): 54-70. doi:10.1684/mrh.2011.0280

Myofascial Pain Syndrome Affecting The Quadriceps Femoris

By

Dr. Alex Jimenez

-

Table of Contents

Introduction

The hips and the thighs have an established relationship where mobility and stability play a part in the body’s lower extremities. The lower extremities’ main job is to support the upper body’s weight while stabilizing the hips and allowing movement from the thighs to the legs and feet. When it comes to the thighs in the lower body, the various muscle surrounds the thighs and skeletal joints to allow the legs to move from one place to another. One of the muscle groups in the thighs is known as the quadriceps femoris. This muscle group is activated when a person is in motion and can succumb to injuries from trauma or normal factors. When this happens, issues like myofascial pain syndrome can affect the thigh muscle and cause referred pain to travel to the knees. Today’s article focuses on the quadriceps femoris, how myofascial pain syndrome is associated with thigh pain, and trigger point therapy on the quadriceps. We refer patients to certified providers who incorporate multiple methods in the lower body extremities, like thigh and hip pain treatments correlating to myofascial pain, to aid individuals dealing with pain symptoms along the quadriceps for muscle. We encourage and appreciate patients by referring them to associated medical providers based on their diagnosis, especially when appropriate. We understand that education is an excellent solution to asking our providers complex questions at the patient’s request. Dr. Jimenez, D.C., utilizes this information as an educational service only. Disclaimer

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What Are The Quadriceps Femoris?

Have you been dealing with knee issues when you are walking? What about muscle tenderness or soreness in your thighs? Or have you been experiencing knee complaints when you are running? These areas of complaint are correlated with trigger points associated with thigh pain along the quadriceps femoris. As one of the most voluminous muscles in the human body, the quadriceps femoris is a group of muscles predominant in the thighs and is extraordinarily important. This muscle group is essential for daily activities like climbing the stairs or getting up from a seated position, allowing repercussions on the knees and hip joints. The quadriceps femoris consist of four thigh muscles to allow extension to the knees:

Vatus medialis
Vatus lateralis
Vatus intermedius
Rectus femoris

Studies reveal that these four different muscles fuse to form the quadricep tendon and stabilize the patella and thigh flexion at the hips and knee extension. This muscle group is highly important for athletes participating in sports events but can succumb to injuries through muscle strain.

Myofascial Pain Syndrome Associated With Tigh Pain

When the thigh muscles, especially the quadriceps femoris, can be overstretched and overused when in motion. Thigh pain is nothing to be alarmed about in its acute form; however, it can develop small nodules along the four muscle fibers that can cause referred pain to the hips and knees. To that point, it can correlate through quadriceps muscle strain to the thighs. Studies reveal that normal factors like kicking, jumping, or a sudden change of direction of running can potentially cause the muscle fibers to be overstretched and develop pain due to localized swelling corresponding to loss of motion from myofascial pain syndrome.

In “Myofascial Pain and Dysfunction,” written by Dr. Janet G. Travell, M.D., the book states that myofascial pain syndrome can invoke referred pain to the affected muscle or muscle group, causing the body to be dysfunctional. Myofascial pain syndrome associated with thigh pain can be managed through various treatments and could allow mobility back to the thighs, legs, knees, and hips. The book even mentions how the four muscles in the quadriceps femoris cause different pain issues in various body parts due to myofascial pain syndrome. For the rectus femoris, many people would complain about knee pain and weakness when climbing stairs. The vatus medialis would initially produce a toothache-like pain deep within the knee joint, often misinterpreted as joint inflammation. The vatus intermedius causes many individuals to have difficulty fully straightening their knees and causes them to develop buckling knee syndrome. And finally, the vatus lateralis could cause many individuals to complain about feeling pain when walking and that the pain is being distributed on the lateral aspect of the thigh, including the knees.

Trigger Point Therapy: Stretching The Quadriceps- Video

Have you been dealing with pain in your thighs and knees? Do you find it difficult to climb up or down the stairs? Or have you been experiencing inflammation in your knee joints? All these symptoms that you are experiencing in your thighs, knees, and hips correlate with trigger points created by myofascial pain syndrome affecting the quadriceps femoris. The quadriceps femoris is a voluminous group of muscles that allows the individual to do daily activities like climbing up or down the stairs, running, jumping, and getting up from a seated position. When various issues can cause the quadricep femoris to become overstretched and overused, it could develop myofascial pain syndrome/trigger points along the muscle fibers to mimic knee pain and cause dysfunction in knee mobility. Even though myofascial pain syndrome is poorly diagnosed, individuals can manage it through various treatments that target myofascial trigger pain. The video above explains where the quadriceps femoris muscles are located on the thigh and where the trigger points are in the muscle fibers. The video also provides various stretching techniques on the quadriceps to reduce pain-like symptoms along the thighs.

Trigger Point Therapy On The Quadriceps

When it comes to releasing myofascial pain syndrome on the quadriceps, treatments like dry needling, acupuncture, or manual stretching can help loosen and lengthen the quadricep muscles from becoming shorten and can reduce myofascial trigger points from causing more issues on the knees and thighs. At the same time, treatment alone can only go so far in rehabilitation unless the person dealing with myofascial pains syndrome associated with thigh pain do some corrective actions to prevent trigger points from reproducing on the quads. Actions like:

Avoid prolonged sitting
Stretching the quads as part of your warm-up
Sleeping with a pillow between the knees

These actions allow the quadriceps to relax and prevent pain-like issues from affecting the knees. To that point, these actions can help many individuals have mobility back to their legs and allow them to bend their knees without feeling pain.

Conclusion

The quadriceps femoris consists of four thigh muscles that fuse to enable mobility functions in the knees without pain. As the most voluminous muscle group in the body, the quadriceps femoris allows the thighs to function when in motion and allow the knees to extend. When various issues cause the quadriceps femoris muscles to be overstretched, it can develop trigger points/myofascial pain syndrome that mimics knee pain and can affect how a person is walking. Thankfully, various treatments specializing in myofascial pain syndrome can reduce the pain symptoms from the quadriceps femoris and bring back knee mobility to the legs.

References

Bordoni, Bruno, and Matthew Varacallo. “Anatomy, Bony Pelvis and Lower Limb, Thigh Quadriceps Muscle.” In: StatPearls [Internet]. Treasure Island (FL), StatPearls Publishing, 10 May 2022, www.ncbi.nlm.nih.gov/books/NBK513334/.

Kary, Joel M. “Diagnosis and Management of Quadriceps Strains and Contusions.” Current Reviews in Musculoskeletal Medicine, Humana Press Inc, 30 July 2010, www.ncbi.nlm.nih.gov/pmc/articles/PMC2941577/.

Rozenfeld, Evgeni, et al. “The Prevalence of Myofascial Trigger Points in Hip and Thigh Areas in Anterior Knee Pain Patients.” Journal of Bodywork and Movement Therapies, U.S. National Library of Medicine, 14 May 2019, pubmed.ncbi.nlm.nih.gov/31987560/.

Simons, D. G., and L. S. Simons. Myofascial Pain and Dysfunction: The Trigger Point Manual: Vol. 2:the Lower Extremities. Williams & Wilkins, 1999.

Waligora, Andrew C, et al. “Clinical Anatomy of the Quadriceps Femoris and Extensor Apparatus of the Knee.” Clinical Orthopaedics and Related Research, Springer-Verlag, Dec. 2009, www.ncbi.nlm.nih.gov/pmc/articles/PMC2772911/.

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HORMONAL DYSFUNCTIONS Assessment and treatments | El Paso, Tx (2022)

By

Dr. Alex Jimenez

-

*HORMONAL DYSFUNCTIONS* Assessment and treatments | El Paso, Tx (2022)

In this episode an expert will take us on the path of understanding Hormone Dysfunction, its assessment and treatments. He will also define the foundational PTSD Strategy steps to address hormone dysfunctions and more! Stay tuned for more episodes of this educational presentations.

We are excited you are taking positive steps to learn about health challenges affecting you and your family. There is the power in making educated decisions about your health by gaining high-level science-based truth and knowledge. We work to uncover the root causes of health issues. Our unique health approach uses functional wellness principles to identify and treat health issues’ potential underlying causes.

Our care plans are base on Functional Medicine as a systems approach based on biology that focuses on identifying and addressing the root cause of disease. We focus on the paradigm that symptom or differential diagnosis may be one of many contributing factors to an individual’s illness.

This approach shifts from the traditional disease-centered focus of most medical practices to a more holistic person-centered approach.

Our discussions team includes Integrative Doctors, Functional Medicine Experts, Nutritionists, Health Coaches, Chiropractors, Physical Medicine Doctors, Therapists, and Exercise Performance Specialists.
We provide clinical insights, treatment options, and methods to achieve clinically sound, specific measured goals.*

Functional & Integrative Health Live Events *

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We present, bridge, and connect these various health programs, functional medicine protocols, fitness methods, injury recovery programs, and offer complete wellness packages.

To that end, we shed light and offer treatment options and bring a deep understanding of the real underlying causes of those suffering from acute and interconnected chronic degenerative disorders.

Ultimately, we empower you to achieve and maintain your personalized, healthy way of living by understanding the root causes of disorders.

It is all about.

LIVING, LOVING & MATTERING

Join us in improving your health.

Blessings,

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email: coach@elpasofunctionalmedicine.com phone:
phone: 915-850-0900

Licensed in Texas & New Mexico*

Notice: Our information scope is limited to musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present talks and clinical collaboration with specialists from a wide array of disciplines. Each specialist in our events is governed by their professional scope of practice and their jurisdiction of licensure.

The information in these events is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice.

Our presentations are designed to share knowledge and information from Dr. Jimenez’s research, experience, and collaborative functional medicine community. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional.
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