Gymnastics Injuries: Functional Health and Wellness Clinic

By

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

-

Gymnastics is a demanding and challenging sport. Gymnasts train to be powerful and graceful. Today’s moves have become increasingly technical acrobatic moves with a much higher degree of risk and difficulty. All the stretching, bending, twisting, jumping, flipping, etc., increases the risk of neuromusculoskeletal injuries. Gymnastics injuries are inevitable. Bruises, cuts, and scrapes are common, as are overuse strains and sprains, but severe and traumatic injuries can occur. Injury Medical Chiropractic and Functional Medicine Team can treat and rehabilitate injuries and help to strengthen and prevent injuries. The therapy team will thoroughly evaluate the individual to determine the injury/s severity, identify any weaknesses or limitations, and develop a personalized plan for optimal recovery, stability, and strength.

Table of Contents

Gymnastic Injuries

One of the main reasons injuries are more prevalent is because today’s athletes start earlier, spend more time practicing, perform more complex skill sets, and have higher levels of competition. Gymnasts learn to perfect a skill and then train to make their bodies look elegant while executing the routine. These moves require precision, timing, and hours of practice.

Injury Types

Sports injuries are classified as:

Chronic Overuse injuries: These cumulative aches and pains occur over time.
They can be treated with chiropractic and physical therapy and prevented with targeted training and recovery.
Acute Traumatic injuries: These are typically accidents that happen suddenly without warning.
These require immediate first aid.

Most Common Injuries

Gymnasts are taught how to fall and land to lessen the impact on the spine, head, neck, knees, ankles, and wrists.

Back

Common back injuries include muscle strains and spondylolysis.

Bruises and Contusions

Tumbling, twisting, and flipping can result in various bruises and contusions.

Muscle Soreness

This is the sort of muscle soreness experienced 12 to 48 hours after a workout or competition.
Proper rest is necessary for the body to recover fully.

Overtraining Syndrome

Overtraining syndrome happens when individuals train beyond the body’s ability to recover.

Sprains and Strains

Sprains and strains.
The R.I.C.E. method is recommended.

Ankle Sprains

Ankle sprains are the most common.
When there is a stretching and tearing of ligaments surrounding the ankle joint.

Wrist Sprains

A sprained wrist happens when stretching or tearing the ligaments of the wrist.
Falling or landing hard on the hands during handsprings is a common cause.

Stress Fractures

Leg stress fractures result from overuse and repeated impact from tumbling and landings.

The most common include:

Shoulder instability.
Ankle sprains.
Achilles tendon strains or tears.
Gymnasts wrist.
Colles’ fracture.
Hand and Finger injuries.
Cartilage damage.
Knee discomfort and pain symptoms.
A.C.L. tears – anterior cruciate ligament.
Burners and stingers.
Low back discomfort and pain symptoms.
Herniated discs.
Spinal fractures.

Causes

Insufficient flexibility.
Decreased strength in the arms, legs, and core.
Balance issues.
Strength and/or flexibility imbalances – one side is stronger.

Chiropractic Care

Our therapists will start with an evaluation and a biomechanical assessment to identify all the factors contributing to the injury. This will consist of a thorough medical history to understand overall health status, training schedule, and the physical demands on the body. The chiropractor will develop a comprehensive program that includes manual and tool-assisted pain relief techniques, mobilization work, MET, core strengthening, targeted exercises, and injury prevention strategies.

Facet Syndrome Chiropractic Treatment

References

Armstrong, Ross, and Nicola Relph. “Screening Tools as a Predictor of Injury in Gymnastics: Systematic Literature Review.” Sports medicine – open vol. 7,1 73. 11 Oct. 2021, doi:10.1186/s40798-021-00361-3

Farì, Giacomo, et al. “Musculoskeletal Pain in Gymnasts: A Retrospective Analysis on a Cohort of Professional Athletes.” International journal of environmental research and public health vol. 18,10 5460. 20 May. 2021, doi:10.3390/ijerph18105460

Kreher, Jeffrey B, and Jennifer B Schwartz. “Overtraining syndrome: a practical guide.” Sports Health vol. 4,2 (2012): 128-38. doi:10.1177/1941738111434406

Meeusen, R, and J Borms. “Gymnastic injuries.” Sports medicine (Auckland, N.Z.) vol. 13,5 (1992): 337-56. doi:10.2165/00007256-199213050-00004

Sweeney, Emily A et al. “Returning to Sport After Gymnastics Injuries.” Current sports medicine reports vol. 17,11 (2018): 376-390. doi:10.1249/JSR.0000000000000533

Westermann, Robert W et al. “Evaluation of Men’s and Women’s Gymnastics Injuries: A 10-Year Observational Study.” Sports Health vol. 7,2 (2015): 161-5. doi:10.1177/1941738114559705

The Root Causes of Pain | El Paso, Tx (2023)

By

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

-

The Root Causes of Pain | El Paso, Tx (2023)

Thanks for Watching!

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: [email protected] 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: http://bit.ly/drjyt

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

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

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

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

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

DISCLAIMER: https://dralexjimenez.com/legal-disclaimer/.

Thyroid Hormone Imbalances & MET Therapy

By

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

-

Table of Contents

Introduction

When it comes to our bodies, many functioning systems help the body regulate its temperature, provide mobility and stability when in motion, and protect the host from pathogens that enter inside to cause havoc. One of the systems that helps the body is the endocrine system, which produces many hormones to keep the body functioning properly. The thyroid, a small, butterfly-shaped organ at the base of the neck, produces the hormones in the body. The thyroid helps regulate hormone production; however, when pathogen factors affect the body’s hormonal production, it can lead to musculoskeletal pain and dysfunction. Today’s article examines how the thyroid produces hormones, how hormone imbalances are connected with musculoskeletal pain, and how MET therapy can help restore hormone imbalances from affecting the body in the future. We utilize information about our patients to certified medical providers using soft tissue therapies like MET to reduce musculoskeletal pain associated with hormonal imbalances. We encourage patients by referring them to associated medical providers based on their diagnosis while supporting the fact that education is a marvelous way to ask our providers the most interesting questions at the patient’s acknowledgment. Dr. Alex Jimenez, D.C., incorporates this information as an educational service. Disclaimer

How Does The Thyroid Produce Hormones?

Do you feel muscle weakness or pain in certain parts of your body? Do you feel out of breath after walking for a short distance? Or do you feel sluggish throughout the entire day? When many individuals are dealing with these numerous issues, it could be due to their hormones being imbalanced from their thyroids. When it comes to the body, the endocrine system is the mastermind of producing different hormones for the body to help regulate all the biological processes. One of the vital organs of the endocrine system is the thyroid. Studies reveal that the thyroid is an endocrine gland located in the inferior anterior neck of the body and produces T4 and T3 hormones for the body to function properly. The thyroid hormones affect many of the vital organs and body tissues as they help with the following:

Cardio output and increased resting heart rate
Increases BMR (basal metabolic rate), heat production, and oxygen consumption
Stimulates resting respiratory rate and the nervous system
Plays a role in reproductive health and other endocrine organ function

Additional studies have revealed that thyroid hormones help control the body’s metabolism, growth, and other bodily functions while having a casual relationship with the HPT (hypothalamic-pituitary-thyroid) axis. What this relationship does is that it makes sure that the body is working properly in any environment. However, when unwanted pathogens start to affect thyroid hormone production, it can cause a hormone imbalance and lead to unwanted pain-like symptoms in the vital organs and musculoskeletal tissues.

Hormone Imbalances & Musculoskeletal Pain

When unwanted pathogens are associated with environmental factors affecting the body, it can lead to pain-like symptoms that can lead to musculoskeletal pain. In the book, “Clinical Applications of Neuromuscular Techniques,” written by Dr. Judith Walker DeLany, L.M.T., and Leon Chaitow, N.D., D.O., stated that there is a connection between hormonal imbalances and musculoskeletal pain as there are many environmental factors that can influence how much or how little hormone production is being produced from the thyroid. The book also mentions that some of the clinical signs of thyroid hormone deficiency include:

Dry skin and thinning hair
Unnatural fatigue
Unexplained weight increase
Aching muscles
Mental confusion

When the body is dealing with hormone imbalances associated with musculoskeletal pain, studies reveal that symptoms of fatigue, anxiety, irritability, and increased oxidative stress can cause the muscular tissues and ligaments to be weak and cause overlapping risk profiles when the body is in motion. To that point, hormone imbalances could lead to muscle and joint pain associated with myofascial trigger points and muscle shortness.

Finding Hormonal Harmony- Video

"Finding Hormonal Harmony: Restoring Balance to the HPA Axis" | El Paso, Tx (2023)

Have you been experiencing muscle or joint pain? Do you often feel anxious or irritable constantly? Or have you noticed that you are extremely sensitive to the cold? Many of these pain-like issues are signs and symptoms associated with hormone imbalances in the body and can lead to musculoskeletal pain. The body needs hormones to help regulate body temperature, control the body’s metabolism, and help stimulate the endocrine and body systems. Hormones are secreted from the thyroid and travel to the important muscles, organs, and tissues through the bloodstream to assist and help each body section function properly. When pathogens start to disrupt hormone production, the thyroid can overproduce or underproduce hormone secretion and cause many overlapping risk profiles to the body and musculoskeletal system. Fortunately, there are many ways to regulate hormones and reduce the effects of musculoskeletal pain. The video above explains that increasing certain vitamin intake, eating healthy, whole-nutritional foods, and getting adequate exercise and sleep can regulate hormone production and reduce the effects of musculoskeletal pain. These various treatments can be combined with therapy to help realign the body and restore it naturally.

MET Therapy Restoring Hormone Imbalances

Many available therapies can reduce the effects of hormonal imbalances associated with musculoskeletal pain. Treatments like MET (muscle energy techniques) allow many pain specialists to use soft tissue techniques to reduce pain-like symptoms and will enable the body to restore itself naturally. Research studies have revealed that soft tissue therapies like MET can reduce pain, improve body function, and reduce disability. MET therapy can be combined with nutritional foods, hormone therapies, and bodywork strategies that can help regulate hormone production in the thyroid. When a person starts to go to treatment for any ailments affecting their body, it allows these individuals to be more mindful of what is happening to their bodies and make small meaningful changes to their health and wellness.

Conclusion

When it comes to maintaining the body’s health and wellness, it’s important to ensure that unwanted pathogens don’t start affecting thyroid hormone production. The thyroid is a small gland located at the base of the neck that secretes out hormones to the rest of the body. When the thyroid over or under-produces hormones in the organs, muscles, and tissues, it can lead to pain-like symptoms that affect the body’s system and potentially lead to musculoskeletal disorders. Treatments like MET therapy combined with nutritional whole foods and exercises can reduce the effects of hormone imbalances associated with musculoskeletal disorders. This amazing combination allows the body to heal naturally and allows the individual to be pain-free.

References

Armstrong, Maggie, et al. “Physiology, Thyroid Function – Statpearls – NCBI Bookshelf.” In: StatPearls [Internet]. Treasure Island (FL), 13 Mar. 2023, www.ncbi.nlm.nih.gov/books/NBK537039/.

Chaitow, Leon, and Judith Walker DeLany. Clinical Applications of Neuromuscular Techniques. Churchill Livingstone, 2003.

Day, Joseph M, and Arthur J Nitz. “The Effect of Muscle Energy Techniques on Disability and Pain Scores in Individuals with Low Back Pain.” Journal of Sport Rehabilitation, May 2012, pubmed.ncbi.nlm.nih.gov/22622384/.

Shahid, Muhammad A, et al. “Physiology, Thyroid Hormone – StatPearls – NCBI Bookshelf.” In: StatPearls [Internet]. Treasure Island (FL), 8 May 2022, www.ncbi.nlm.nih.gov/books/NBK500006/.

VandeVord, Pamela J, et al. “Chronic Hormonal Imbalance and Adipose Redistribution Is Associated with Hypothalamic Neuropathology Following Blast Exposure.” Journal of Neurotrauma, 1 Jan. 2016, www.ncbi.nlm.nih.gov/pmc/articles/PMC4700394/.

Disclaimer

Finding Relief with Chiropractic Care | El Paso, Tx (2023)

By

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

-

Finding Relief with Chiropractic Care | El Paso, Tx (2023)

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: [email protected] 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: http://bit.ly/drjyt

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

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

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

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

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

DISCLAIMER: https://dralexjimenez.com/legal-disclaimer/.

Life changing Results with Chiropractic Care | El Paso, Tx (2023)

By

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

-

Life changing Results with Chiropractic Care | El Paso, Tx (2023)

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: [email protected] 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: http://bit.ly/drjyt

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

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

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

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

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

DISCLAIMER: https://dralexjimenez.com/legal-disclaimer/.

Engaging The Core: EP Functional Health and Wellness Clinic

By

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

-

Military is engaged in physiotherapy exercises with a specialist — Military man is diligently engaged in physiotherapy exercises with a specialist in the rehabilitation room, the doctor corrects his exercises

The body’s core muscles are used for stability, balance, lifting, pushing, pulling, and movement. Engaging the core muscles means bracing and tightening the abdominal muscles, which include the latissimus dorsi/lats, paraspinal muscles, gluteus maximus/glutes, and trapezius/traps. When engaged, the trunk muscles help maintain spinal stability, support the spine and pelvis in sitting and resting positions and during dynamic movements, and help prevent injury.

Table of Contents

Engaging The Core

To know how to engage the core, individuals need to understand what the core is. The most important muscles for engaging the core include: These muscles are involved every time the body inhales and exhales, in posture control, and when using the bathroom, they start and stop the process.

Rectus Abdominis

The rectus abdominis muscle is responsible for the six-pack.
It’s a long, flat muscle that extends from the pubic bone to the sixth and seventh ribs.
The rectus abdominis is primarily responsible for bending the spine.

External Obliques

These are the muscles on either side of the rectus abdominis.
The external obliques allow the torso to twist, bend sideways, flex the spine, and compress the abdomen.

Internal Obliques

The internal obliques lie below the external obliques.
They work with the external obliques in the same functions.

Transverse Abdominis

This is the deepest layer of muscle in the abdomen.
It completely wraps around the torso and extends from the ribs to the pelvis.
The transverse abdominis are not responsible for spine or hip movement but for stabilizing the spine, compressing the organs, and supporting the abdominal wall.

Latissimus Dorsi

Commonly known as the lats, these muscles run along both sides of the spine from just below the shoulder blades to the pelvis.
The lats help stabilize the back, especially when extending the shoulders.
They also contribute to body ability when twisting from side to side.

Erector Spinae

The erector spinae muscles are on each side of the spine and extend down the back.
These muscles are responsible for extending and rotating the back and side-to-side movement.
These are considered postural muscles and are almost always working.

What Not To Do

Individuals learn from mistakes, which might make learning how to engage the core easier by understanding what not to do. Common examples of failing to or not engaging the core correctly.

The back slumps when sitting down – the upper body lacks strength and stability.
When bending, the stomach sticks out more.
Swaying or leaning far to one side when walking – lack of lower body strength causes balance and stability problems.
The lower abdomen and back present with discomfort and pain symptoms.

Training

Engaging the core decreases the chance of sustaining an injury at home, work, or exercising and can help with chronic back pain. It creates a stable musculature around the spine that keeps the vertebrae from over-flexing, over-extending, and bending too far to one side. Engaging the core muscles can mean different things, depending on what is trying to be achieved.

For example, if doing bending work, the muscles needed, and the order in which they contract differs from when trying to maintain balance while standing on one leg.
The muscles engaged will differ in their movement depending on whether an individual is:
Trying to move the spine or stabilize it.
Pushing or pulling weight.
Standing, sitting, or lying down.

For a strong and functional core, the objective is to be able to engage the core in any situation. Engaging the core can be challenging, but with training and practice, the body becomes stronger. Practice engaging the core throughout daily activities that include.

Bracing the core while standing, sitting at a workstation or desk, and walking.
Day-to-day activities, like reaching for something from a high shelf, grocery shopping, and taking the stairs.

Injury Medical Chiropractic and Functional Medicine Clinic can create a personalized program to address musculoskeletal issues, core training, targeted exercise, stretching, nutrition, massage, and adjustments to get the body to optimal health and maintain health.

The Non-Surgical Solution

References

Eickmeyer, Sarah M. “Anatomy and Physiology of the Pelvic Floor.” Physical Medicine and rehabilitation clinics of North America vol. 28,3 (2017): 455-460. doi:10.1016/j.pmr.2017.03.003

Lawson, Samantha, and Ashley Sacks. “Pelvic Floor Physical Therapy and Women’s Health Promotion.” Journal of Midwifery & Women’s Health vol. 63,4 (2018): 410-417. doi:10.1111/jmwh.12736

Seaman, Austin P et al. “Building a Center for Abdominal Core Health: The Importance of a Holistic Multidisciplinary Approach.” Journal of gastrointestinal surgery: official journal of the Society for Surgery of the Alimentary Tract vol. 26,3 (2022): 693-701. doi:10.1007/s11605-021-05241-5

Vining, Robert, et al. “Effects of Chiropractic Care on Strength, Balance, and Endurance in Active-Duty U.S. Military Personnel with Low Back Pain: A Randomized Controlled Trial.” Journal of Alternative and complementary medicine (New York, N.Y.) vol. 26,7 (2020): 592-601. doi:10.1089/acm.2020.0107

Weis, Carol Ann, et al. “Chiropractic Care for Adults With Pregnancy-Related Low Back, Pelvic Girdle Pain, or Combination Pain: A Systematic Review.” Journal of Manipulative and physiological therapeutics vol. 43,7 (2020): 714-731. doi:10.1016/j.jmpt.2020.05.005

Zachovajeviene, B et al. “Effect of the diaphragm and abdominal muscle training on pelvic floor strength and endurance: results of a prospective randomized trial.” Scientific Reports vol. 9,1 19192. 16 Dec. 2019, doi:10.1038/s41598-019-55724-4

Sweating: EP Functional Health and Wellness Clinic

By

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

-

Pensive female athlete cleaning sweat with a towel after sports training. — Tired athletic woman thinking of something while wiping sweat with a towel after exercising at home.

When the body shifts out of homeostasis or when something in the body is out of balance, the body sweats. Sweating is a process known as perspiration that releases salt-based fluids from the body’s sweat glands to help the body stay cool and regulate body temperature. Sweat is commonly found under the arms, on the feet, and on the palms of the hands. Body temperature, outdoor temperature, or emotional state changes can cause sweating.

Table of Contents

Sweating

An individual has around 2-4 million sweat glands, which begin to become fully active during puberty. There are two types of sweat glands: eccrine and apocrine. The most common areas of sweating include:

Face.
Armpits.
Palms of the hands.
Soles of the feet.
Sweating in normal amounts is an essential bodily process.
Not sweating enough or sweating too much can cause problems.
Sweat is mostly water but contains small amounts of salt.
Sweat also contains electrolytes and minerals – including potassium, chloride, magnesium, zinc, copper, proteins, urea, and ammonia.
Electrolyte levels need to be replenished after heavy sweating.

Causes

Sweating is normal. However, a variety of causes can stimulate increased sweating.

High Temperature

Elevated body temperature.
Elevated outdoor temperature.
Are the primary cause of increased sweating.

Emotions and stress

Emotions and conditions can also make the body break out in a heavy sweat.

Emotional stress
Anxiety
Anger
Fear
Embarrassment

Foods

Sweating may be a response to certain foods. This type of sweat is known as gustatory sweating, which can be caused by:

Spicy foods
Caffeinated drinks – like soda, coffee, and tea.
Alcoholic beverages.
Medications

Illness and Medications

Sweating may be caused by medication use and certain illnesses:

Hypoglycemia – low blood sugar levels.
Fever.
Fever-reducing medications.
Pain relieving medications.
Infection.
Cancer.
Synthetic thyroid hormones.
Complex regional pain syndrome – CRPS, is a rare form of chronic pain that usually affects an arm or leg.

Menopause

The hormonal fluctuations associated with menopause can trigger sweating.
Women going through menopause often experience night sweats and sweat during hot flashes.

Conditions

The following conditions result from either excessive sweating or not sweating enough.

Hyperhidrosis

Hyperhidrosis is a condition of excessive sweating from the armpits, hands, and feet.
This condition can be embarrassing and could prevent individuals from going about their daily routines.

Hypohidrosis

Hypohidrosis is the absence of sweat.
Sweat is how the body releases excess heat.
Individuals can become dehydrated and have an increased risk of heatstroke.

Chiropractic Adjustments

The nervous system coordinates and oversees all functions of the body. Some can be consciously controlled, and others are automatic. The autonomic nervous system – ANS regulates involuntary processes, including blood pressure, heart rate, digestion, respiration, gland function, sweating, etc. The ANS is divided into the sympathetic and parasympathetic systems.

The sympathetic nervous system – when activated, creates a state of elevated activity and attention or the fight or flight response.
This process increases blood pressure and heart rate, preparing the body to respond to various stressors.
The parasympathetic nervous system promotes resting and digesting processes that lower heart rate and blood pressure.
The parasympathetic calms the body.

Chiropractic adjustments have been known to affect the autonomic nervous system. This is achieved by increasing parasympathetic activity/relaxation and down-shifting the sympathetic/fight or flight response and inflammation. A chiropractic adjustment can remove subluxations, which cause interferences in the nervous system. Chiropractic restores and improves the brain and body system communication.

Thoracic Spine Pain

References

Baker, Lindsay B. “Physiology of sweat gland function: The roles of sweating and sweat composition in human health.” Temperature (Austin, Tex.) vol. 6,3 211-259. 17 Jul. 2019, doi:10.1080/23328940.2019.1632145

Cabanac, M. “Temperature regulation.” Annual Review of Physiology vol. 37 (1975): 415-39. doi:10.1146/annurev.ph.37.030175.002215

Cui, Chang-Yi, and David Schlessinger. “Eccrine sweat gland development and sweat secretion.” Experimental dermatology vol. 24,9 (2015): 644-50. doi:10.1111/exd.12773

Kiani, Aysha Karim, et al. “Neurobiological basis of chiropractic manipulative treatment of the spine in the care of major depression.” Acta bio-medica : Atenei Parmensis vol. 91,13-S e2020006. 9 Nov. 2020, doi:10.23750/abm.v91i13-S.10536

McCutcheon, L J, and R J Geor. “Sweating. Fluid and ion losses and replacement.” The Veterinary clinics of North America. Equine practice vol. 14,1 (1998): 75-95. doi:10.1016/s0749-0739(17)30213-4

VACATKO, S. “O hydrataci epidermis” [Sweating]. Ceskoslovenska dermatologie vol. 26,3 (1951): 131-7.

Running Foot Numbness: EP Sciatica Clinic

By

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

-

It’s not unusual for runners to experience tingling, pins and needles, and numbness in their feet while running. Running foot numbness is a relatively common problem for runners and can be easily remedied. Numbness will present in one part of the foot or just the toes. Sometimes it can spread throughout the whole foot. Different causes, most of which are not serious, can be easily dealt with. Serious causes can be treated with chiropractic, massage, decompression therapy, and functional medicine.

Table of Contents

Running Foot Numbness

Reasons, why the feet experience numbing sensations when running, include:

Improper footwear.
Laces that are tied too tightly.
Foot strike pattern.
Foot structure.
Training schedule.
Muscle tightness.
Compressed nerve.
Medical conditions like neuromas or peripheral neuropathy.

Footwear

A common cause of running foot numbness is having overly tight shoes that place added pressure on nerves.
If this could be the reason, the remedy is to get new shoes.
Try to find a store that specializes in running shoes and ask for help.
Footwear professionals look at the size of the foot, the shape, and running gait.
For example, individuals with a wide foot may need a style with a wider/larger toebox or the front of the shoe that houses the forefoot.
Get a pair that’s one-half to a full size larger than a regular everyday shoe size.
This is because when running, the feet swell, especially in hot and humid weather.
Going up a half or whole size will also accommodate thicker socks for individuals that run in cold weather.
Sometimes numbness can result from biomechanical issues that can be corrected with the proper shoe.

Tight Laces

Sometimes it’s not the shoes but the laces that are too tight.
Pulling a little tighter to get a firm fit around the ankle is common, but this can entrap nerves on top of the foot at the ankle/anterior tarsal tunnel, similar to the carpal tunnel in the wrist.
This can be problematic for individuals with high arches.
Loosening the laces are recommended.
However, runners may feel insecure with looser laces.
Experimenting with different lacing techniques is recommended to find one that keeps the shoes comfortable without creating undue pressure over the top of the foot.
Using padding under the tongue of the shoe can help.

Foot Fall Pattern

Sometimes running form can put pressure on nerves that, lead to numbness.
Overstriding – Landing heel first with the foot ahead of the body’s center of gravity places the feet on the ground for too long.
Correcting this issue can be achieved by shortening the stride and focusing on landing on the midsole.
This way, the feet will land directly under the body.
Running like stepping on hot coals is recommended, keeping the movements light and quick.
Correcting overstriding saves energy and lowers the risk of shin splints.
A sports chiropractor, physical therapist, or running coach can help fine-tune form for specific guidance.

Foot Structure

The anatomy of the feet, specifically the arches, can contribute to running foot numbness.
Flat feet mean the entire bottom of each foot is in contact with the floor when barefoot.
Overly flexible feet are more likely to experience nerve compression.
This can be corrected with shoe orthotic inserts.
Over-the-counter orthotics may work, but custom orthotics are another option if they don’t.

Muscle Tightness

Stiff, inflexible muscles can lead to anatomical conditions that generate nerve pressure.
Warm-up exercises before running will get the muscles loose and ready.
Stretching is very important before and after running.
Individuals prone to muscle tightness should include flexibility exercises.
Yoga can improve flexibility and body alignment.
Foam rollers and other massage tools will work out kinks in areas where tightness forms and affects nerves, like the quadriceps, calves, hamstrings, and I.T. band.
Regular sports massage and chiropractic can help keep the body pliable.

Sciatic Nerve Issues

A compressed nerve causes a decrease in the sensation to the areas the nerve supplies.
Foot numbness, especially around the heel or the sole, can be caused by sciatic nerve compression.
The pain from sciatica might originate in the back but can end up causing numbness in the feet and/or toes.
Poor posture, tight piriformis muscles, or other back injuries can also cause sciatica.
A chiropractor or physical therapist can prescribe decompression therapy, MET stretches, and rehabilitative exercises.

Prevention

Most of the time, running foot numbness can be treated by adjusting footwear or technique. Here are a few tips for injury prevention:

Evaluate Shoes

First, make sure the shoelaces are not overly tight.
If the shoes are uncomfortable when running, look for another set and get a custom fitting.

Running Form

Avoid overstriding by focusing on landing on the midsole instead of the heel.
This will take the pressure off of the feet.

Foot Orthotics

Individuals with flat feet, high arches, or overly flexible feet should consider orthotics.

Avoid Overtraining

Work rest days into the training schedule and gradually build up to avoid overuse injuries.
Stretch to prevent muscle imbalances, keep muscles loose, and improve the range of motion.

Chiropractic and Physical Therapy

If symptoms don’t improve, see a doctor, podiatrist, or chiropractor so they can rule out conditions and develop a personalized treatment plan.

Benefits of Custom Foot Orthotics

References

Aldridge, Tracy. “Diagnosing heel pain in adults.” American family physician vol. 70,2 (2004): 332-8.

Atik, Aziz, and Selahattin Ozyurek. “Flexible flatfoot.” Northern Clinics of Istanbul vol. 1,1 57-64. 3 Aug. 2014, doi:10.14744/nci.2014.29292

Jackson, D L, and B L Haglund. “Tarsal tunnel syndrome in runners.” Sports medicine (Auckland, N.Z.) vol. 13,2 (1992): 146-9. doi:10.2165/00007256-199213020-00010

Souza, Richard B. “An Evidence-Based Videotaped Running Biomechanics Analysis.” Physical Medicine and rehabilitation clinics of North America vol. 27,1 (2016): 217-36. doi:10.1016/j.pmr.2015.08.006

Sridhara, C R, and K L Izzo. “Terminal sensory branches of the superficial peroneal nerve: an entrapment syndrome.” Archives of physical medicine and Rehabilitation vol. 66,11 (1985): 789-91.

Thoracic Spine Pain | El Paso, Tx (2023)

By

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

-

Thoracic Spine Pain | El Paso, Tx (2023)

Are you experiencing pain in your upper back or between your shoulder blades? It could be thoracic spine pain. In this video, we discuss what causes thoracic spine pain and how chiropractic care can provide pain relief. Our experienced chiropractor will explain the techniques used to target and alleviate the pain, helping you to feel better and improve your overall well-being. Don’t let thoracic spine pain hold you back any longer, watch this video to learn how chiropractic care can help.

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: [email protected] 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: http://bit.ly/drjyt

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

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

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

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

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

DISCLAIMER: https://dralexjimenez.com/legal-disclaimer/.

Osteoporosis MUST WATCH | El Paso, Tx (2023)

By

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

-

Osteoporosis *MUST WATCH* | El Paso, Tx (2023)

In this video, we will learn about osteoporosis, a condition that causes bones to become weak and brittle, and how chiropractic care can help manage the symptoms. Whether you or a loved one are struggling with osteoporosis, or simply want to learn more about this condition and how chiropractic care can help, this informative video is a must-watch

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: [email protected] 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: http://bit.ly/drjyt

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

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

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

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

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

DISCLAIMER: https://dralexjimenez.com/legal-disclaimer/.

Supplements To Ease Headaches: EP Functional Health Clinic

By

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

-

Woman Complaining about Headache — Senior woman complaining about headache to doctor visiting her at home

Supplements To Ease Headaches: Individuals dealing with headaches or migraines should consider incorporating supplements to ease headaches’ severity and frequency. Nutrition and food habits affect all systems in the body. Although slower to take effect than medications, if a diet is used correctly to heal the body and maintain health, other treatments may not be necessary or require less. Many health providers understand that food is a medicine that can assist healing therapies like massage and chiropractic care, which makes the treatment more effective when used with dietary adjustments.

Table of Contents

Supplements To Ease Headaches

An unhealthy lifestyle and diet are not the only contributing factor to headaches. Others include:

Stress.
Job occupation.
Sleeping problems.
Muscular tension.
Vision problems.
Certain medication usage.
Dental conditions.
Hormonal influences.
Infections.

Healthy Diet Foundation

The goal of functional medicine is to help individuals reach their health and wellness goals that, include:

Regularly active lifestyle.
Optimal breathing patterns.
Quality sleep patterns.
Thorough hydration.
Healthy nutrition.
Improved digestive health.
Improved mental health.
Improved musculoskeletal health.

Pain Receptors – Headache

Pain and discomfort symptoms present when various head structures become inflamed or irritated. These structures include:

Nerves of the head and neck.
Muscles of the neck and head.
The skin of the head.
Arteries that lead to the brain.
Membranes of the ear, nose, and throat.
Sinuses that form part of the respiratory system.

The pain can also be referred, meaning that pain in one area can spread to nearby areas. An example is headache pain developed from neck stiffness and tightness.

Causes

Foods

Determining whether food sensitivities cause or contribute to headaches or migraines can be challenging. Nutritionists and dieticians recommend keeping a food journal to keep track of foods, snacks, drinks, alcohol intake, how the body reacts, and how the individual feels.

This process can help recognize foods or eating patterns that may contribute to headaches.
An integrative health practitioner can support this process and help identify sensitivities.
By eliminating and avoiding processed foods, headaches may be alleviated. This includes limited exposure to artificial colors, sweeteners, flavors, and other unnatural additives.

Histamine

Histamines can also be triggers for headaches.
Histamine is a vasoactive amine that induces mucus production, blood vessel dilation, and bronchoconstriction.
Histamine is in most body tissues, like the nose, sinuses, skin, blood cells, and lungs. But pollen, dander, dust mites, etc., can release histamine.

Dehydration

Dehydration can affect all of the body and cognitive functions.
Hydrating regularly can prevent headaches and relieve pain.
An easy way to test the cause of headaches is to consider drinking plenty of water/hydrating before any other relief option.
Drinking pure water with no additives is the quickest and easiest way to hydrate your body.
Eat foods with high water content for enhanced hydration, including citrus fruits, cucumbers, melons, zucchini, celery, spinach, and kale.

Toxic Chemicals

Toxic chemicals are found in all kinds of products.
Cleaning products, make-up, shampoo, and other products have been found to contain chemicals that can worsen headaches and even cause migraines.
Consider using natural products and educating on toxic chemicals to know what to look for in everyday products.

Natural Options

Consider a few natural supplements to ease headaches.

Magnesium

Magnesium deficiency has been linked to headaches.
Foods naturally high in magnesium include legumes, almonds, broccoli, spinach, avocados, dried figs, and bananas.

Ginger Root

Ginger root is a natural remedy for nausea, diarrhea, upset stomach, and indigestion.
Ginger root extract can be taken in supplement form or fresh ginger added to meals and teas.

Coriander Seeds

Coriander syrup is effective against migraine pain.
A method to relieve a headache is to pour hot water over fresh seeds and inhale the steam.
To increase the effectiveness, place a towel over your head.

Celery or Celery Seed Oil

Celery can reduce inflammation and lower blood pressure.
However, pregnant women or individuals with kidney conditions, low blood pressure, taking thyroid medication, blood thinners, lithium, or diuretics should not use celery seed.

Peppermint and Lavender Essential Oils

Both have a natural numbing and cooling effect that helps relieve headache pain.
Peppermint oil has also been found to be a natural antibacterial, antiviral, antifungal, antiparasitic, and pain reliever.
Lavender oil can eliminate nervous tension, enhance blood circulation, and relieve pain.
Both are effective pain relief tools for headache and migraine sufferers.

Butterbur

This shrub grows in Europe, some parts of Asia, and North America.
A study found that individuals who consumed 75 mg of the extract twice daily reduced migraine attacks’ frequency.

Feverfew

A herb plant whose dried leaves have been found to relieve symptoms associated with headaches, migraines, menstrual cramps, asthma, dizziness, and arthritis.
Feverfew can be found in supplements.
It can alter the effects of certain prescription and non-prescription medications.

There is plenty of evidence to support the benefits of healthy nutrition. Combined with a healthy diet and lifestyle, these supplements can help relieve headaches. As with any supplement, talk to a doctor before starting a supplement regimen.

Chiropractic Care For Migraines

References

Ariyanfar, Shadi, et al. “Review on Headache Related to Dietary Supplements.” Current Pain and headache report vol. 26,3 (2022): 193-218. doi:10.1007/s11916-022-01019-9

Bryans, Roland, et al. “Evidence-based guidelines for the chiropractic treatment of adults with headache.” Journal of Manipulative and physiological therapeutics vol. 34,5 (2011): 274-89. doi:10.1016/j.jmpt.2011.04.008

Diener, H C et al. “The first placebo-controlled trial of a special butterbur root extract for the prevention of migraine: reanalysis of efficacy criteria.” European Neurology vol. 51,2 (2004): 89-97. doi:10.1159/000076535

Kajjari, Shweta, et al. “The Effects of Lavender Essential Oil and its Clinical Implications in Dentistry: A Review.” International Journal of clinical pediatric dentistry vol. 15,3 (2022): 385-388. doi:10.5005/jp-journals-10005-2378

Maier, Jeanette A et al. “Headaches and Magnesium: Mechanisms, Bioavailability, Therapeutic Efficacy and Potential Advantage of Magnesium Pidolate.” Nutrients vol. 12,9 2660. 31 Aug. 2020, doi:10.3390/nu12092660

Mansouri, Samaneh, et al. “Evaluating the effect of Coriandrum sativum syrup on being migraine-free using mixture models.” Medical Journal of the Islamic Republic of Iran vol. 34 44. 6 May. 2020, doi:10.34171/mjiri.34.44

Pareek, Anil, et al. “Feverfew (Tanacetum parthenium L.): A systematic review.” Pharmacognosy Reviews vol. 5,9 (2011): 103-10. doi:10.4103/0973-7847.79105

Skypala, Isabel J et al. “Sensitivity to food additives, vaso-active amines and salicylates: a review of the evidence.” Clinical and translational allergy vol. 5 34. 13 Oct. 2015, doi:10.1186/s13601-015-0078-3

Prehabilitation Sports Injury Prevention: EP Sciatica Clinic

By

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

-

chiropractor standing near man exercising with dumbbell in clinic

A big part of sports is avoiding and preventing injuries, as injury prevention is far better than rehabilitation and recovery. This is where prehabilitation comes in. Prehabilitation is a personalized, constantly evolving, and developing strengthening exercise program. The program aims to provide sports-specific targeted exercises and activities to maintain athletes’ physical abilities and mental preparedness for their sport. The first step is for an athletic trainer, sports chiropractor, and physical therapist to examine the individual.

Table of Contents

Prehabilitation

Everybody is different when it comes to developing an effective prehabilitation program. Every individual’s program should be progressive and re-evaluated to adapt and adjust to the athlete’s needs. The first step is learning to prevent injuries and following basic injury prevention protocols. Knowing what to do when the body sustains an injury, like home treatment and when it’s time to see a doctor.

Athletes

Athletes of all levels are recommended to incorporate a prehabilitation program into their training. As athletes engage in their sport, their bodies adjust to the physical demands of practicing, playing, and training. Imbalances can happen naturally with normal activity but become more pronounced with each practice, game, and training session and often are the cause of injury. The repetitive movements and regular stresses can cause neuromusculoskeletal symptoms to present. This includes:

Tightness of muscle groups.
Pain and discomfort symptoms.
Stabilization issues.
Strength imbalances.

Program

A chiropractic therapist will measure the individual’s range of motion and strength, biomechanics, evaluate medical history, and present health status. Individuals with an injury or a condition can also benefit from prehabilitation.

Each program is personalized and will address total body balance, sports-specific needs, and weaknesses.
The exercises will balance strength, coordination, range of motion, and stabilization.
The premise is looking at and comparing movements from left to right, front to back, and upper to lower body.
Activities can be subtle, focused exercises or a complex movement sequence to stabilize or improve a specific skill.
Programs focus on strengthening and stabilizing the core, abdominals, hips, and back.
Instability is common and often presents from a lack of core training, as athletes tend to focus on what parts of the body their specific sport utilizes, leaving the core without a regular training routine.
A prehabilitation program has to be constantly updated to adjust to the individual’s progress.
Tools like foam rollers, balance boards, weights, and exercise balls are used.

Training

Prehabilitation should start before any acute or chronic injury occurs, but often it takes a few injuries for individuals to decide to get into a prehabilitation program. Depending on an athlete’s training cycle, prehabilitation can be incorporated into practice or as an independent workout and become part of an athlete’s training routine. A session can include the following:

Warm-up and cool-down exercises.
Exercises to perform while resting or waiting during practice.
A targeted workout on specific weaknesses.
A complete workout for days off or active rest days.
Mini workouts for when traveling and recovery days.

For athletes, feeling challenged and motivated can be the difference between success and failure. Working with a trainer, sports chiropractor, and therapists who know sports, understand athletic needs, and communicate well, will contribute to a successful prehabilitation program.

Improving Athletic Performance

References

Durrand, James et al. “Prehabilitation.” Clinical medicine (London, England) vol. 19,6 (2019): 458-464. doi:10.7861/clinmed.2019-0257

Giesche, Florian, et al. “Evidence for the effects of prehabilitation before ACL-reconstruction on return to sport-related and self-reported knee function: A systematic review.” PloS one vol. 15,10 e0240192. 28 Oct. 2020, doi:10.1371/journal.pone.0240192

Halloway S, Buchholz SW, Wilbur J, Schoeny ME. Prehabilitation Interventions for Older Adults: An Integrative Review. Western Journal of Nursing Research. 2015;37(1):103-123. doi:10.1177/0193945914551006

Smith-Ryan, Abbie E et al. “Nutritional Considerations and Strategies to Facilitate Injury Recovery and Rehabilitation.” Journal of athletic training vol. 55,9 (2020): 918-930. doi:10.4085/1062-6050-550-19

Vincent, Heather K, and Kevin R Vincent. “Rehabilitation and Prehabilitation for Upper Extremity in Throwing Sports: Emphasis on Lacrosse.” Current sports medicine reports vol. 18,6 (2019): 229-238. doi:10.1249/JSR.0000000000000606

Vincent, Heather K et al. “Injury Prevention, Safe Training Techniques, Rehabilitation, and Return to Sport in Trail Runners.” Arthroscopy, sports medicine, and rehabilitation vol. 4,1 e151-e162. 28 Jan. 2022, doi:10.1016/j.asmr.2021.09.032

Gelatin Health: EP Functional Health and Wellness Clinic

By

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

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Triple chocolate mousse. Cheesecake three chocolates. A beautiful and delicious dessert, decorated with blackberries and blueberries

Gelatin is a stabilizer and thickener used to make desserts like fruit gelatin, pudding, mousse, marshmallows, candy, cakes, ice cream, and certain yogurts. It is also used in some shampoos and skincare products. Because animal products are used to make gelatin, it is not a vegan-friendly food, and even some non-vegans choose not to eat it. However, there are gelatin alternatives that are made from non-animal sources. The use of gelatin may provide certain health benefits, and there are some medical uses for pharmaceutical-grade gelatin.

Table of Contents

Gelatin Health

Gelatin is affirmed as generally recognized as safe/GRAS by the U.S. Food and Drug Administration. Gelatin is made by boiling the skin, tendons, ligaments, or bones of animals – cows or pigs in water. This process releases collagen, a protein that provides structure and is the most abundant in the human body. Once the collagen is extracted, it is:

Concentrated
Filtered
Cooled
Extruded
Dried

Alternatives

Thickening agents can be made from different ingredients. These include:

Agar-agar

Also called agar, this thickener is made from cooked and pressed seaweed.
This gelling agent is available online and in some supermarkets in powdered, flaked, and bar form.
When cooking with it, substitute agar for gelatin using equal amounts if using the powder.
If using flakes, a tablespoon equals about a teaspoon of the powder.
Certain citrus fruits require more agar when substituting.
Agar does not gel well for recipes that include uncooked mangoes, papaya, and pineapple.

Pectin

Pectin is a gelling agent found naturally in apples and citrus fruits.
Food manufacturers use pectin to make some yogurts and candies and enhance fruit-based beverages.
It can also thicken jams, jellies, and other foods.

Carrageen Moss

Carrageen moss is also derived from seaweed.
This thickener is usually for making softer gels and puddings.

Benefits

Improved Bone Health

A benefit of gelatin is the protection of bones; however, evidence supporting its use is limited.
An early study found that hydrolyzed gelatin, such as pharmaceutical grade, may help reduce pain symptoms in individuals with knee or hip osteoarthritis.
Researchers thought that it could have a beneficial effect on cartilage metabolism.
A study found that adding gelatin to an intermittent exercise program improved collagen synthesis and could aid in injury prevention and tissue repair.

Treatment of Diarrhea

Some studies have suggested that gelatin tannate, which contains tannic acid, can reduce chronic diarrhea.
One study found that using gelatin tannate and other products like probiotics could be effective.
However, further research is needed.

Recipe Alternative

Individuals following specific diets or nutritional plans can use gelatin to thicken foods instead of ingredients that they are avoiding or removing from their eating plan.
It can be used by those following low or no – carb or grain-free diets.
Individuals with wheat allergies, celiac disease, non-celiac gluten sensitivity, or who follow a gluten-free diet can use gelatin or other thickeners instead of flour.
Adding flour to foods like soups and stews can increase the carbohydrate count.
Cornstarch is one replacement that thickens when food is heated, like flour; however, gelatin thickens when food is cooled.
For example, some chefs use 1 ½ teaspoons of gelatin per cup of stock to thicken soups.

Nutrition

The USDA provides the following nutrition information for a single envelope or around one tablespoon/7 grams of gelatin.

Carbohydrates

There are about 30 calories per tablespoon, and none of the calories are from carbohydrates.
There are 0 grams of total carbohydrates, 0 grams of sugar, and 0 grams of fiber.
Because there are no carbohydrates, it will not impact blood sugar levels.
However, it is not usually consumed by itself.
It is commonly used to thicken desserts with sugar and carbohydrates that can elevate blood sugar levels.

Fats

There is no fat in a tablespoon serving of gelatin.
A 100-gram serving contains less than a gram of fat.

Protein

Gelatin provides about 6 grams of protein in one tablespoon serving.
It should not be considered a high-protein food.

Vitamins and Minerals

The powder does not contribute any significant micronutrients.
Does not provide vitamins or minerals.

Storage and Safety

It should be kept in a sealed container and stored in a cool, dry place.
It should stay fresh for about three years when unopened and stored correctly.
It should not be frozen.

Chiropractic Success Story

References

Blanco, Francisco J, and Ronald K June 2nd. “Cartilage Metabolism, Mitochondria, and Osteoarthritis.” The Journal of the American Academy of Orthopaedic Surgeons vol. 28,6 (2020): e242-e244. doi:10.5435/JAAOS-D-19-00442

Daneault, Audrey, et al. “Biological effect of hydrolyzed collagen on bone metabolism.” Critical Reviews in food science and Nutrition vol. 57,9 (2017): 1922-1937. doi:10.1080/10408398.2015.1038377

Florez, Ivan D et al. “Gelatin tannate for acute diarrhea and gastroenteritis in children: a systematic review and meta-analysis.” Archives of Disease in Childhood vol. 105,2 (2020): 141-146. doi:10.1136/arch dis child-2018-316385

Hölzl, Katja, et al. “Gelatin methacryloyl as an environment for chondrocytes and cell delivery to superficial cartilage defects.” Journal of tissue engineering and regenerative medicine vol. 16,2 (2022): 207-222. doi:10.1002/term.3273

Lopetuso, L et al. “Gelatin tannate and tyndallized probiotics: a novel approach for the treatment of diarrhea.” European Review for Medical and pharmacological sciences vol. 21,4 (2017): 873-883.

Shaw, Gregory, et al. “Vitamin C-enriched gelatin supplementation before intermittent activity augments collagen synthesis.” The American Journal of clinical nutrition vol. 105,1 (2017): 136-143. doi:10.3945/ajcn.116.138594

Tehranzadeh, J et al. “Cartilage metabolism in osteoarthritis and the influence of viscosupplementation and steroid: a review.” Acta radiologica (Stockholm, Sweden : 1987) vol. 46,3 (2005): 288-96. doi:10.1080/02841850510016027

The Breathing Connection & The MET Technique

By

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

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Table of Contents

Introduction

Throughout the world, pain and stress are related to musculoskeletal disorders affecting joints and muscles. Many musculoskeletal disorders will have correlating symptoms with overlapping risk profiles that can make a person’s life difficult. Pain and stress have two forms: acute and chronic, which are associated with numerous everyday factors that a person goes through. Even though pain and stress can impact a person’s life, there are multiple ways to reduce these two by calming the mind and doing meditative breathing techniques to relax the body and clear the mind. What is truly amazing is that meditative breathing techniques can be combined with stretching techniques like MET (muscle energy techniques. Today’s article looks at how stress and pain affect the musculoskeletal system, the breathing connection for musculoskeletal pain, and how MET therapy is combined with breathing exercises. We utilize and provide valuable information about our patients to certified medical providers who use soft tissue stretching methods like MET to reduce musculoskeletal stress on the body. We encourage patients by referring them to our associated medical providers based on their findings. We support that education is a marvelous way to ask our providers the most interesting questions at the patient’s acknowledgment. Dr. Alex Jimenez, D.C., incorporates this information as an educational service. Disclaimer

Stress & Pain Affect The Musculoskeletal System

Have you been dealing with shoulder, neck, or back pain? What about feeling an overwhelming pressure that is causing you to stress out? Or do you feel muscle pain and joint stiffness affecting your daily routine? Many of these issues correspond with stress and pain from numerous factors associated with the musculoskeletal system. Research studies revealed that pain and stress are considered two sides of the same coin regarding the musculoskeletal system. Pain and stress are two distinguished symptoms that overlap each other when musculoskeletal disorders affect the body. Pain is a collection of emotional and sensory perceptions that work with musculoskeletal motor behavior. At the same time, stress is characterized by challenging emotional or physiological events that cause adaptive or maladaptive changes to regain homeostasis. With these two factors working together to affect the musculoskeletal system, the body may develop symptoms and cause the individual to be miserable.

The Breathing Connection For Musculoskeletal Pain & Stress

One of the major correspondents that work with pain and stress is anxiety. In “Clinical Applications of Neuromuscular Techniques,” authors Dr. Leon Chaitow, N.D., D.O., and Judith Walker DeLany, L.M.T., mentioned that anxiety aggravates all chronic pain and stress. However, there is a solution to reduce pain and stress in the musculoskeletal system. When pain and stress are combined with anxiety, it can cause breathing disorders and produce inflammatory cytokines and elevated cortisol levels to contribute. But incorporating some deep breathing techniques can help reduce stress and pain affecting the body. Research studies have revealed that slow deep breathing has been known to reduce the effects of musculoskeletal pain and help lower cortisol levels. Breathing techniques are popular in meditation and yoga practices. Deep breathing and mindfulness can help the body relax from everyday factors and calm the individual. Additional studies have mentioned that breathing exercise programs effectively improve lung function, reduce musculoskeletal pain associated with the back, and help improve a person’s quality of life.

The Natural Way To Heal- Video

The Natural Way to Heal: Non-Surgical Chiropractic Care for Pain Relief | El Paso, Tx (2023)

Have you been dealing with musculoskeletal pain throughout your entire body? Do you feel constantly stressed throughout your whole life? Or have you felt anxious that it is making your muscles tense constantly? When many people feel constant stress and are in pain, it can lead to musculoskeletal disorders that can cause many individuals to be miserable. When this happens, overlapping risk profiles affect the musculoskeletal, organs, and nervous systems. At the same time, fortunately, numerous treatments can help reduce pain and stress that is affecting the body. Chiropractic care is non-invasive and can help many individuals be mindful of their bodies. The video above explains how chiropractic care can help realign the body from spinal subluxation and mitigate the effects of muscle pain and stress in the muscle fibers.

MET Therapy Combined With Breathing Exercises

When the body has been dealing with musculoskeletal pain on top of stress, it can cause the individual to be miserable and try to find some relief. Luckily there are available treatments that can help restore the body naturally and reduce the effects of stress and pain. Treatment like MET (muscle energy technique) and breathing exercises allow the muscles to relax and properly stretch to relieve muscle pain. Research studies have revealed that breathing exercises and MET therapy can reduce a person’s symptoms and help regain the muscle and joint range of motion. These two combined treatments can help many individuals dealing with musculoskeletal pain associated with stress to be more aware of what is affecting their bodies. They can help them along their health and wellness journey without medicine.

Conclusion

Overall, pain and stress are part of numerous conditions and disorders that can affect the musculoskeletal system and cause overlapping risk profiles that can cause the individual to be miserable. When pain and stress affect the body, it can cause the muscles, tissues, ligaments, joints, and organs to work harder than before and develop chronic musculoskeletal disorders. Fortunately, treatments like MET (muscle energy technique) and breathing exercises allow the body to relax and help reduce muscle pain symptoms affecting the body. When a person incorporates these treatments as part of their daily routine, they can become more aware of what is affecting their bodies and improve what is going on in their daily lives. This allows them to continue their health and wellness journey pain-free.

References

Abdallah, Chadi G, and Paul Geha. “Chronic Pain and Chronic Stress: Two Sides of the Same Coin?” Chronic Stress (Thousand Oaks, Calif.), U.S. National Library of Medicine, Feb. 2017, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5546756/.

Anderson, Barton E, and Kellie C Huxel Bliven. “The Use of Breathing Exercises in the Treatment of Chronic, Nonspecific Low Back Pain.” Journal of Sport Rehabilitation, U.S. National Library of Medicine, 24 Aug. 2016, https://pubmed.ncbi.nlm.nih.gov/27632818/.

Chaitow, Leon, and Judith Walker DeLany. Clinical Applications of Neuromuscular Techniques. Churchill Livingstone, 2003.

Joseph, Amira E, et al. “Effects of Slow Deep Breathing on Acute Clinical Pain in Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.” Journal of Evidence-Based Integrative Medicine, U.S. National Library of Medicine, 2022, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8891889/.

Zaccaro, Andrea, et al. “How Breath-Control Can Change Your Life: A Systematic Review on Psycho-Physiological Correlates of Slow Breathing.” Frontiers in Human Neuroscience, U.S. National Library of Medicine, 7 Sept. 2018, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6137615/.

Disclaimer

Sciatica during Pregnancy | El Paso, Tx (2023)

By

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

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Sciatica during Pregnancy | El Paso, Tx (2023)

In this video testimonial, a patient shares her experience with sciatica and how chiropractic care helped her find relief from the pain. She talks about the challenges she faced during her pregnancy, how the sciatica affected her daily life, and the positive changes she noticed after seeking chiropractic treatment. Through her story, she encourages others who may be struggling with similar issues to consider chiropractic care as a safe and effective option.

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.
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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.

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