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Sciatica Causes: Genetics, Low Back Problems, Piriformis, Arthritis

Rear view of male patient complaining of back pain and female doctor examining him during medical exam at hospital

Sciatica Causes: The sciatic nerve forms by the union of Lumbar4 to Sacral31 nerve roots and exits the pelvis through the greater sciatic foramen, below the piriformis muscle located deep in the buttocks. The nerve runs down the back of the thigh, into the leg, and ends in the foot. The sciatic nerve becomes inflamed, irritated, and/or mechanically compressed. Any type of pain and/or neurological symptom/s from the sciatic nerve is referred to as sciatica. Sciatica is a type of lumbar radiculopathy, which means that the pain originates from the low back and/or sacral nerve roots.

Sciatica Causes: Genetics, Low Back Problems, Piriformis, Arthritis

Sciatica Causes

Physical forces on the nerve can cause mechanical compression due to the following conditions:

Herniated Discs

  • A disc in the lower back can bulge or herniate, causing irritation and/or compression of a sciatic nerve root.

Foraminal Stenosis

  • Stenosis, the intervertebral opening through which the nerve roots travel, begins to narrow/close in, can compress or irritate the sciatic nerve.

Degeneration

  • Degenerative changes in the spine like the thickening of facet joint capsules and/or ligaments can compress the sciatic nerve.

Segmental Instability

  • Instability of a spinal vertebral segment that happens if one vertebra slips over the one beneath it – spondylolisthesis
  • Vertebral defects – spondylolysis
  • Complete dislocation of one or more vertebrae can compress the nerve root/s of the nerve.

Other Sciatica Causes

  • Tumors, cysts, infections, or abscesses in the lower spine or pelvic region can also cause sciatic nerve compression.

Chemical Inflammation

  • Chemical irritants can include hyaluronic acid and/or fibronectin/protein fragments that leak out of degenerated or herniated discs. These irritants can cause inflammation and/or irritation of the sciatic nerve.
  • Degenerated discs can cause nerve tissues to grow into the disc, penetrating the outer and inner layers of the disc, causing sciatica. Immune system responses can contribute to pain when exposed to disc fluid.
  • Substances such as glycosphingolipids/fats and neurofilaments /protein polymers secreted by the immune system are increased in individuals with sciatica. These substances are released from the reaction between nerve roots and exposed disc material, causing inflammation.

Job Occupation

Individuals with specific jobs have an increased risk of developing sciatica. Examples include:

  • Truck drivers
  • Desk workers
  • Teachers
  • Warehouse workers
  • Machine workers
  • Plumbers
  • Electricians
  • Carpenters
  • Fitness trainers

Sitting and standing for long periods, using improper posture, constantly bending, twisting, reaching, and regularly lifting are risk factors for sciatica.

Piriformis Syndrome

Piriformis syndrome is a condition where the piriformis muscle swells and spasms from overuse or inflammation irritating the sciatic nerve that is right underneath. The nerve can get trapped in the muscle causing sciatica-like symptoms that include:

  • Pain follows the same pattern in the leg as a compressed sciatic nerve root.
  • Tingling
  • Numbness

Discomfort from piriformis syndrome feels similar to sciatica, but it is not caused by compressed sciatic nerve root. Piriformis pain comes from compression of the sciatic nerve near the piriformis muscle.

Genetic Sciatica Causes

Sciatica caused by degenerated and/or herniated discs can be genetic. Research has shown that certain genetic factors are more prevalent in individuals with back and spinal problems. These congenital disabilities can cause the discs to become weak and susceptible to external stress. With time the proteins in the disc break down, compromising the integrity and function.

Arthritis and Joint Issues

Arthritis or other inflammatory conditions around the hip joint can cause pain down the leg, similar to sciatica. This is referred pain that spreads out from the source and is not radicular nerve pain that originates in the nerve roots.

  • Conditions like sacroiliac joint dysfunction or sacroiliitis can cause sciatica-like pain that runs down the back of the thigh but usually ends before or at the knee.
  • The pain can be acute and debilitating, like sciatica but is caused by an abnormal motion or malalignment of the sacroiliac joint.

Body Composition


Normal Cholesterol Ranges

High cholesterol can lead to severe consequences when left untreated, but it can be difficult to spot with no noticeable warning signs. This is why it’s essential to monitor cholesterol levels with blood tests, especially if there is an increased risk. Example of normal cholesterol levels for adults 20 years of age or older:

  • Total cholesterol 125-200 mg/dL
  • LDL <100 mg/dL
  • HDL >40 mg/dL men, >50 mg/dL women

Lifestyle

  • Lack of physical activity contributes to high cholesterol levels.
  • Diets that mainly consist of processed foods and saturated fats increase the risk of high LDL levels.
  • Smoking can lower HDL levels.

Aging

  • Individual risk for developing high cholesterol tends to increase as the body advances in age. This is why it is recommended to have regular physicals and blood tests.

Genetics

  • Some individuals are more genetically predisposed to developing high cholesterol and heart disease.
  • Knowing family medical history can help predict whether it may become a problem.
References

Davis D, Maini K, Vasudevan A. Sciatica. [Updated 2021 Sep 2]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK507908/

Giuffre BA, Jeanmonod R. Anatomy, Sciatic Nerve. [Updated 2021 Jul 29]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK482431/

Hicks BL, Lam JC, Varacallo M. Piriformis Syndrome. [Updated 2021 Jul 18]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK448172/

Raj MA, Ampat G, Varacallo M. Sacroiliac Joint Pain. [Updated 2021 Aug 30]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK470299/

Pregnancy Chiropractor

Shot of beautiful young physiotherapist woman massaging tummy on pretty pregnant woman on a stretcher at home.

With a growing belly and changes in connective tissue, many pregnant women are unable to stay comfortable. A pregnancy chiropractor is safe and effective in helping manage pain in the back, hips, legs, joints and establish pelvic balance. This can provide the baby with space to grow and move throughout the pregnancy and lead to faster, easier labor and delivery. Relief and better symptom management are possible with a pregnancy chiropractor.

Pregnancy Chiropractor

Chiropractic Is Safe During Pregnancy

Before engaging in any treatment during pregnancy, consult a doctor. For the most part, non-invasive chiropractic is considered safe for healthy, low-risk pregnancies and even higher-risk pregnancies once cleared by a doctor. Because pregnant women cannot take medications or undergo other invasive treatment options for pain, chiropractic treatment is recommended for sore, tight muscles, irritability, and pain management.

How A Pregnancy Chiropractor Can Help

What a chiropractor can offer includes:

  • Restore pelvic balance.
  • Improve mechanics for standing, sitting, and walking that could otherwise cause pain.
  • Pain management through therapeutic massage and adjustments.
  • Spinal alignment is restored.
  • Improved blood perfusion.
  • Energy levels improve.
  • Reduce symptoms of nausea.
  • Better positioning and movement for the baby.
  • Optimize the pelvic position to allow for an easier birth; evidence indicates a shorter labor time thanks to an optimal pelvic position.

Clinic Appointment

The pregnancy chiropractor begins with an initial consultation. Here the patient asks questions, discusses any concerns, along with a full assessment of medical history. They will suggest various treatment options to restore the body to its optimal balance. The chiropractor will continually monitor the patient to tailor the treatments to their specific needs and achieve the most relief.


Body Composition


Impact of Breastfeeding and Body Composition

It turns out that breastfeeding and weight loss are showing that there could be a relationship. A study suggested that breastfeeding could eliminate weight gain during six months. These findings are corroborated by another study comparing body fat loss between exclusively breastfeeding and mixed feeding mothers. The researchers found that exclusively breastfeeding promotes more significant body fat loss than mixed feeding among mothers during the first 12 weeks after childbirth. A weight loss of approximately about a pound per week between 4 and 14 weeks after delivery in overweight, lactating women who were exclusively breastfeeding showed no adverse effect on the growth and development of their newborns.

References

Bernard, Maria, and Peter Tuchin. “Chiropractic Management of Pregnancy-Related Lumbopelvic Pain: A Case Study.” Journal of chiropractic medicine vol. 15,2 (2016): 129-33. doi:10.1016/j.jcm.2016.04.003

Borggren, Cara L. “Pregnancy and chiropractic: a narrative review of the literature.” Journal of chiropractic medicine vol. 6,2 (2007): 70-4. doi:10.1016/j.jcme.2007.04.004

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

Holiday Chiropractic Stress Relief

Professional senior physiotherapist doing manual treatment to a young woman with spine problems in the cabinet of rehabilitation clinic

Getting ready for holiday celebrations takes a great deal of work. Visiting family and friends, traveling, spending hours shopping, wrapping gifts, setting up lights, trees, planning meals can make the body feel achy, tight, tired, and sore. Stress is multiplied by ten, adding to the muscle tension, which can cause illness and other health problems. Chiropractic treatment alleviates symptoms bringing stress relief to enjoy the holidays. This includes body adjustments, therapeutic massage, health coaching, nutrition guidance, strengthening exercises, stretch training, and everything to maintain full-body health, prevent illness and injury so individuals can feel and function at their best.

Holiday Chiropractic Stress Relief

Aches and Pains

Shopping at stores, malls can cause the body to experience adverse physical effects. Spending hours walking and standing can trigger neck, shoulder, back, leg, and foot pain. Spending hours hunched over a computer, laptop, tablet, or phone while online shopping can also cause neck, back, and shoulder pain. Soreness and pain can result from the spine and the rest of the body becoming misaligned.

Muscle tightening is a common sign of stress. When the mind and body become overwhelmed or anxious, the neck, shoulders, or upper back muscles can tense up. Muscle tension can limit the body’s range of motion and trigger headaches. Therapeutic massage, mobilization, soft tissue therapy, ultrasound, and other chiropractic treatments can generate stress relief. Massaging the body also triggers the release of endorphins that help the body calm down and relax. The adjustments and massage also increase/improve blood flow that supports healing and reduces anxiety when stress begins to build.

Stomach Issues

Following the usual diet during the holiday season is a challenge. Work parties, restaurant parties, and family meals offer an array of holiday foods and treats. The body is not used to eating a lot of rich, fatty, sugary, or fried foods, and can experience bloating, constipation, gas, and other uncomfortable symptoms. These issues can be traced to the nerves that control the organs. Chiropractic can balance the nerves to help avoid uncomfortable digestive problems and help the body handle the rich diet better.

Maintaining Health and Stress Relief

Aches and pains are not the only effects of stress, body misalignment, and tight joints and/or muscles. If these structures press against the nerves and/or organs, it can affect immune system function. Chiropractic ensures that the organs communicate correctly through the nerves, balance the body,  reduce inflammation, and improve lymph fluid drainage. The fluid removes toxins and wastes from the body, making fighting colds and other illnesses easier.


Body Composition


White Coat Syndrome

White Coat Syndrome is the term used for any changes in blood pressure that individuals experience in response to being in a medical office or clinic. Three distinct diagnoses are based on how an individual’s blood pressure responds to being in the presence of a healthcare professional:

White Coat hypertension

  • This is when an individual is not taking medication for blood pressure but presents with high blood pressure in a medical office and returns to normal once they leave the medical facility.

White Coat effect

  • This is when an individual is taking medication for high blood pressure and shows a high blood pressure reading in a medical office that indicates their medication is not working.

Masked Hypertension

  • This is when an individual has normal blood pressure in a medical office but high blood pressure elsewhere.
References

Ahmad, Asma Hayati, and Rahimah Zakaria. “Pain in Times of Stress.” The Malaysian journal of medical sciences: MJMS vol. 22,Spec Issue (2015): 52-61.

PBS NewsHour. (December 2018) “Poll: How stressed are Americans this holiday season?” www.pbs.org/newshour/nation/poll-how-stressed-are-americans-this-holiday-season

Pioli, Mariana R et al. “White coat syndrome and its variations: differences and clinical impact.” Integrated blood pressure control vol. 11 73-79. 8 Nov. 2018, doi:10.2147/IBPC.S152761

The United States Consumer Product Safety Commission (CPSC). (2019) “Holiday Safety Information Center” www.cpsc.gov/Safety-Education/Safety-Education-Centers/holiday-safety

Syringomyelia Spinal Cord Disorder

Syringomyelia is a disorder in which a fluid-filled cyst/syrinx forms within the spinal cord. It is progressive, meaning that the cyst grows with time causing compression and damage to the spinal cord. The cyst usually begins in the neck/cervical spine but can develop in any area along the spinal cord. There are several possible causes; however, most are associated with a condition known as Chiari malformation. This is where the skull and neck come together, and either the skull is too small or shaped in a way that causes brain tissue to come out and settle in the spinal canal.

Syringomyelia Spinal Cord Disorder

Syringomyelia Causes

Syringomyelia can be caused by or from complications of:

  • Congenital disabilities like Chiari malformation
  • Chiari type I malformation develops during the fetal developmental stage and causes the lower part of the brain or cerebellum to stick out from its standard location.
  • Hemorrhage/bleeding
  • Inflammation of the spinal cord from virus or bacterial infection like meningitis
  • Spinal cord injury
  • Spinal cord tumor

Symptoms

A damaged spinal cord disrupts communication between the brain and the body. Symptoms differ for every individual, but common syringomyelia symptoms include:

Symptoms usually develop slowly, but exercise, coughing, or some form of strain can cause sudden onset.

Diagnosis

Physical and neurological exams are performed to determine loss of feeling or inability to move around normally, like walking. Diagnostic tests of the spine will include a CT scan with contrast dye and/or an MRI. Early detection can help before it progresses, causing further damage, and delaying treatment can cause irreversible spinal cord injury. It is recommended at the first sign of symptoms to contact a doctor.

Treatment

Some individuals who have syringomyelia may have no symptoms. These individuals can go about their everyday lives but are recommended to be cautious with neck and back strain. For individuals experiencing symptoms, the primary treatment objectives are to:

  • Stop or control damage to the spinal cord
  • Preserve function
  • Prevent disability
  • Treatment options include:
  • Draining the cyst
  • Surgical removal of the cyst
  • Chiropractic and physical therapy could be included in the treatment plan to help the individual rebuild lost muscle strength and regain flexibility.

All too often, individuals with this disorder experience treatment delay/s because symptoms can be nonspecific or vague. Education is the key, and individuals can be diagnosed sooner by paying attention to the body’s warning signs.


Body Composition


Does too much protein hurt the kidneys?

While protein restriction can be appropriate for treating existing kidney disease, research shows that high protein intake in healthy individuals does not disrupt or cause damage to the kidneys or kidney function. The amino acids in protein are more likely to be excreted through urine when not being used. However, there are certain risks associated with consuming too much protein, and it is recommended to keep track of protein intake. Eating more protein:

  • Makes the body feel full longer
  • Can help curb overeating
  • Is essential for recovery and growth

When achieving daily caloric goals, maintaining a balance of nutrients like carbohydrates and healthy fats is essential for overall health.

References

Batzdorf, Ulrich. “Primary spinal syringomyelia. Invited submission from the joint section meeting on disorders of the spine and peripheral nerves, March 2005.” Journal of neurosurgery. Spine vol. 3,6 (2005): 429-35. doi:10.3171/spi.2005.3.6.0429

Di Lorenzo, N, and F Cacciola. “Adult syringomyelia. Classification, pathogenesis and therapeutic approaches.” Journal of neurosurgical sciences vol. 49,3 (2005): 65-72.

Fernández, Alfredo Avellaneda et al. “Malformations of the craniocervical junction (Chiari type I and syringomyelia: classification, diagnosis, and treatment).” BMC musculoskeletal disorders vol. 10 Suppl 1, Suppl 1 S1. 17 Dec. 2009, doi:10.1186/1471-2474-10-S1-S1

Naftel, Robert P et al. “Worsening or development of syringomyelia following Chiari I decompression: case report.” Journal of neurosurgery. Pediatrics vol. 12,4 (2013): 351-6. doi:10.3171/2013.7.PEDS12522

Roy, Anil K et al. “Idiopathic syringomyelia: retrospective case series, comprehensive review, and update on management.” Neurosurgical focus vol. 31,6 (2011): E15. doi:10.3171/2011.9.FOCUS11198

Inadequate Sleep

Male business executive sleeping in office

Individuals talk about how they don’t sleep much because they have so much to do and can operate/function on only 5 or 6 hours of sleep and are surprised when they develop serious health problems and mental health issues. However, inadequate sleep is a big deal. Depriving the body and mind of proper sleep leads to all kinds of health problems that include:

  • Daytime fatigue
  • Irritability
  • Difficulty concentrating and thinking clearly
  • Memory issues
  • Delayed reaction time and response
  • Weakened immune system
  • Decreased libido

Inadequate Sleep

Over time the adverse effects become worse, increasing the risk for severe medical conditions that include:

Chiropractic

Chiropractors focus on whole-body health, are specialists in the musculoskeletal system, and take a multifaceted approach to treat fatigue and inadequate sleep. They can help with sleep problems and other health factors by bringing the body back into alignment/balance, improving circulation, nerve energy flow, and nervous system function. This includes chiropractic adjustments and therapeutic massage.

Spinal Adjustments

  • Misalignment of the cervical spine could be contributing to issues breathing and getting into a deep sleep.
  • Spinal realignment can help with better sleep.

Posture Analysis and Sleep Positions

  • Posture is a significant part of optimal health, especially when breathing correctly.
  • A chiropractor can analyze and correct any posture misalignments.
  • They can also advise how best to sleep, so the airway does not become obstructed during the night.

Health Factors

  • A recommendation for fatigue and inadequate sleep is to lose weight if overweight or obese.
  • A trained nutritionist or health coach can help develop healthy eating and lifestyle habits.

Less Stress and Plenty of Sleep

The combination of spinal adjustments and therapeutic massage can generate significant benefits to help keep the body healthy. Chiropractic adjustments have been found to release stress-reducing hormones like oxytocin and neurotensin. And therapeutic massage has been shown to improve inadequate sleep patterns, as well as:

  • Relax the body
  • Reduce Stress
  • Reduce muscle tension that causes restlessness
  • Relieve pain and discomfort
  • Release positive hormones
  • Increase mobility

Body Composition


Lack of Sleep Makes It Harder To Lose fat

  • Irregular sleep throws off the ghrelin and leptin cycles, making the body hungrier.
  • Sleeping less has been linked to eating more, increasing energy intake.
  • Sleeping less can cause reductions in Basal Metabolic Rate by as much as 20%, reducing total energy output.
  • Being tired also reduces spontaneous movements, reducing total energy output.
References

Jamison, Jennifer R. “Insomnia: does chiropractic help?.” Journal of manipulative and physiological therapeutics vol. 28,3 (2005): 179-86. doi:10.1016/j.jmpt.2005.02.013

Jehan, Shazia et al. “Obstructive Sleep Apnea and Obesity: Implications for Public Health.” Sleep medicine and disorders: international journal vol. 1,4 (2017): 00019.

Kashani, Fahimeh, and Parisa Kashani. “The effect of massage therapy on the quality of sleep in breast cancer patients.” Iranian journal of nursing and midwifery research vol. 19,2 (2014): 113-8.

Kingston, Jana et al. “A review of the literature on chiropractic and insomnia.” Journal of chiropractic medicine vol. 9,3 (2010): 121-6. doi:10.1016/j.jcm.2010.03.003

Fever and Back Pain

Feeling bad. Blond woman suffering from a lower back pain

It is one thing to wake up with back pain, but another when the pain is combined with a fever, body aches, and chills. It could be the flu or another infection. However, after checking the body’s temperature and fever is present with no other symptoms than back pain unless it is the flu; the fever could be another issue that may or may not be related as there are a variety of causes for back pain like:

  • Inflamed muscles
  • Muscle or ligament strain – If in poor physical condition, repeated and constant tension on the back can cause muscle spasms. Repeated heavy lifting or a sudden awkward movement can strain the back muscles and spinal ligaments.
  • Bulging or ruptured discs – Discs act as cushions between the bones/vertebrae in the spine. The soft material inside a disc can bulge or rupture and press on a nerve. However, a bulging or ruptured disc can present without back pain. Disc disease is often found by accident when spine X-rays are performed for another reason.
  • Arthritis – Osteoarthritis can affect the lower back. In some cases, arthritis in the spine can narrow the space around the spinal cord, a condition called spinal stenosis.
  • Osteoporosis – The spine’s vertebrae can develop painful fractures if the bones become porous and brittle.

Back pain without a fever is usually an indication of a misaligned spine.

Fever and Back Pain

Fever A Sign of Something Else

A fever is the body’s way of trying to raise its core temperature in an attempt to kill off a virus or a bacterial infection. Possible causes of back pain with fever include:

Kidney Infection

  • This type of infection often presents with low back pain and fever.

Spinal Epidural Abscess

  • This is an infection of the lower region of the spine, causing fever and lower back pain.

Vertebral Osteomyelitis

  • This is an infection of the lower spine that causes pain in the arms, lower back, and legs, along with a fever.

Meningitis

  • This causes swelling and inflammation of the brain and spine and needs to be addressed immediately.

Spinal Cord Abscess

  • This is an infection of the internal part of the spine. It is rare but can happen, causing low back pain and fever.

Symptoms

This is when seeing a chiropractor can help. A few signs that should not be ignored include:

  • Recently involved in an automobile accident.
  • Suffered a serious fall.
  • Feeling a tingling in the legs.
  • Having balance issues.
  • Having abdominal pain.
  • Pain is not going away, or it goes away for a while, then comes back.
  • Have weakness in the arms or legs.
  • Having bowel or urinary problems that were not present previously.
  • The pain is worse when sitting or standing up after sitting.
  • Have upper back pain after alcohol consumption.

A chiropractor will take a complete medical history, X-rays, an MRI if necessary, and a thorough physical examination will be performed to determine the cause. After a diagnosis is reached, the chiropractor will perform adjustments to relieve the pain and open the nerve pathways to increase circulation to the area. A chiropractic massage will help reduce stress, relieve back pain, and reduce depression, which can also help reduce the fever unless it is from another issue.


Body Composition


Influenza

Influenza or the flu is a contagious respiratory illness caused by viruses that infect the nose, throat, and lungs. It can cause mild to severe illness and, in extreme cases, can lead to death. Like a common cold, the flu is spread primarily through tiny droplets that get expelled from an infected person when they sneeze, cough, or talk. Approximately 8% of the population gets the flu each season. Flu symptoms are sudden, causing the following:

  • Fever
  • Chills
  • Muscle or body aches
  • Headaches
  • Sore throat
  • Runny or stuffy nose
  • Cough
  • Fatigue
  • Vomiting and diarrhea which is more common in children.

Most individuals with healthy immune systems will recover around seven days. However, the elderly, pregnant women, individuals of any age with certain chronic medical conditions like asthma, diabetes, or heart disease, and children under the age of five have an increased risk of developing complications. Flu vaccination is currently recommended for anyone older than six months in the U.S. and effectively prevents infection in 50 – 80% of the population. The primary treatment method for the flu is to support the immune system with plenty of rest, proper nutrition, and hydration.

References

Ameer MA, Knorr TL, Mesfin FB. Spinal Epidural Abscess. [Updated 2021 Feb 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK441890/

Kehrer, Michala et al. “Increased short- and long-term mortality among patients with infectious spondylodiscitis compared with a reference population.” The spine journal: official journal of the North American Spine Society vol. 15,6 (2015): 1233-40. doi:10.1016/j.spinee.2015.02.021

Rubin, Devon I. “Epidemiology and risk factors for spine pain.” Neurologic clinics vol. 25,2 (2007): 353-71. doi:10.1016/j.ncl.2007.01.004

Tsantes, Andreas G et al. “Spinal Infections: An Update.” Microorganisms vol. 8,4 476. 27 Mar. 2020, doi:10.3390/microorganisms8040476

How Chiropractic Affects Inflammation

Girl is sitting. Physiotherapist works with young woman indoors in the spa.

Inflammation is the body’s response to infection, injury, or irritation. It causes swelling, redness, pain and sometimes causes the affected area to be unable to function. Acute inflammation happens after spraining the ankle or getting a mosquito bite and is the body’s method of preserving itself. This type of inflammation helps remove harmful irritants and pathogens, so healing ensues, along with healthy beneficial swelling that disappears with time. Chronic inflammation is when the body generates a stronger-than-necessary inflammatory response from an imbalanced immune system or a condition that causes the immune system to attack healthy tissue. Certain foods, lack of sleep, and constant stress increase the risk of developing chronic inflammation. Chiropractors are known for their expertise in stretching the muscles, ligaments, tendons, and adjusting/realigning joints and bones. Chiropractic treatment can also affect inflammation positively.

How Chiropractic Affects Inflammation

Inflammation Affects Health

When inflammation presents, there is significant potential that disease is also present in the body. Inflammation is a natural response to restore the body to homeostasis or balance. White blood cells and other immune cells are sent to the area to ward off invading bacteria, viruses, debris, etc., and reduce or defeat the infection. For some individuals, inflammation occurs within their body regularly and reappears repeatedly. This can be caused by injuries that never completely healed, frequent strains, and injuries from a weakened musculoskeletal system. Inflammation can also come from infection, irritation, the production of diseased cells, or allergies. Organs and tissues can be inflamed for a long time and can cause damage to the cells that comprise those regions of the body. This can lead to:

  • Thinning and weakening of organ walls and tissues.
  • Decreased organ function.
  • The overall deterioration of the body’s systems and wellness.

Causes

Some common diseases and conditions that create chronic inflammation are:

  • Asthma
  • Chronic peptic ulcers
  • Tuberculosis
  • Rheumatoid arthritis
  • Periodontitis
  • Ulcerative colitis
  • Crohn’s disease
  • Sinusitis
  • Active hepatitis

Risk Factors

Certain risk factors that can increase the likelihood of inflammation are:

  • Advanced age
  • Obesity
  • Regular consumption of processed fats and sugar
  • Smoking
  • Stress
  • Poor sleep
  • Chronic inflammation can increase the risk of:
  • Various diseases and cancer
  • Rheumatoid arthritis
  • Periodontitis
  • Hay fever

Stress

Stress is one of the leading causes of illness and disease in the body and contributes significantly to inflammation. Organs and tissues can also become inflamed under pressure. When stress kicks in, chemical reactions occur, causing the release of the hormone cortisol. Cortisol is initially an anti-inflammatory hormone, but a prolonged release can eventually create a dysfunctional cycle of widespread inflammation. Chronic stress can cause inflammation throughout the body. Usually, the body’s weakest or most strained region will suffer the most effects of overall inflammation. Even after the stress reduces or is resolved, the inflammation effects can continue to linger. Inflammation can:

  • Decrease organ function
  • Strain tissues
  • Strain ligaments
  • Force bones and joints out of alignment and subluxation.
  • Cause decreased efficiency and performance of the body’s systems and organs.

Chiropractic Affects On Inflammation

When the body is out of alignment, it can compress tissues, muscles, and ligaments. Chiropractic works primarily on the skeletal structure and the nervous system. The nervous system plays an essential role in regulating immune response, which creates or decreases inflammation in the body. When the bones and joints are out of alignment, they cause strain on the nervous system and the immune system, often triggering an immune response. Chiropractic adjustments of the bones and joints reset and rejuvenate nervous system function. Realignment of the spine, including neck, shoulders, arms, pelvis, hips, knees, and feet, enhances nerve circulation and alleviates abnormal immune system function. To begin relieving inflammation from injury, misalignment, stress, and strain on the body, consult and see how chiropractic affects inflammation.


Body Composition


Dietary Fats

There are four main types of dietary fats listed on food labels:

These are not to be confused with adipose tissue/stored fat in the body. These four fats have different physiological effects once they are digested. Some are beneficial, and some can negatively impact health and are recommended to be taken in moderation.

Saturated vs. Unsaturated fats

Fats are made up of chains of carbon atoms with a carboxyl group COOH at one end and methyl groups CH3 at the other end. Carbons are attached to each other and to hydrogen atoms. The way the carbons are chained differentiates saturated and unsaturated fats and impacts how the body processes them. Unsaturated fats have one or more double bonds between the carbon atoms, and foods rich in unsaturated fats are usually liquid at room temperature, like olive oil. Saturated fats contain no double bonds and are generally solid at room temperatures, like butter and cheese.

References

Arulselvan, Palanisamy et al. “Role of Antioxidants and Natural Products in Inflammation.” Oxidative medicine and cellular longevity vol. 2016 (2016): 5276130. doi:10.1155/2016/5276130

Hannibal, Kara E, and Mark D Bishop. “Chronic stress, cortisol dysfunction, and pain: a psychoneuroendocrine rationale for stress management in pain rehabilitation.” Physical therapy vol. 94,12 (2014): 1816-25. doi:10.2522/ptj.20130597

Pahwa R, Goyal A, Bansal P, et al. Chronic Inflammation. [Updated 2021 Sep 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK493173/

Getting Fit and Staying Active

Happy diverse people exercise together in gym to stay healthy. People sport training concept

Many individuals are trying to get fit and stay active through physical activity and exercise. Getting back to a previous fitness routine is an achievable and realistic goal. Fitness means having the energy and strength to perform physical activity and the body feeling as good as possible. Getting fit improves total health. But it does not require training like an athlete. Just walking for a half-hour every day can help individuals reach an adequate fitness level that helps them feel better and increase energy levels.

Getting Fit and Staying Active

Benefits of Getting Fit

Getting the body fit and in shape:

  • Increases endurance
  • Increases muscle strength
  • Delivers oxygen and nutrients to tissues
  • Improves cardiovascular health
  • Helps release toxins
  • Improves overall energy levels
  • Improves sleep
  • Handle stress better

Being fit allows the body to work harder without as much work, the mind is better focused, the body burns more calories, even when at rest, and proper weight is maintained. Fitness reduces the risk of falls, heart attack, diabetes, high blood pressure, and certain cancers.

How Much Physical Activity Is Needed?

Experts say the goal should be one, or a combination, of these:

  • Moderate aerobic activity, like brisk walking, for at least 2½ hours a week.
  • It is up to the individual how many days to exercise, but it is best to be active at least three days a week.
  • Activity is recommended at least 10 minutes at a time. For example, an individual could:
  • Take a 10-minute walk three times a day, five days a week.
  • Take a half-hour walk three days a week.
  • On the other four days, take a 15-minute walk.
  • Take a 45-minute walk every other day.

Vigorous exercise is recommended at least three days a week for at least 10 minutes at a time. This activity makes the body breathe harder and increases heart rate. More vigorous activities, like running, could be included for at least one hour a week. This can be spread out 75 minutes, whichever way is more convenient for the individual. For example, an individual could:

  • Run for 25 minutes 3 times a week.
  • Run for 15 minutes 5 times a week.

Children as young as preschool age need activity as well. Encourage children ages 6 to 17 to engage in moderate to vigorous exercise for at least 1 hour every day.

Types of Physical Activity

Aerobic fitness

  • This makes the body breathe faster and makes the heart work harder.
  • Activities include walking, running, cycling, and swimming.
  • It is also known as cardio or cardiovascular training.

Muscle fitness

  • Muscle strength means building stronger muscles and increasing the length of time they can be used.
  • Activities like weight lifting, push-ups, squats, and resistance bands can improve muscular fitness.

Flexibility

  • Flexibility is the ability to move the joints and muscles through their full range of motion.
  • Stretching exercises can help generate flexibility.

Being More Physically Active

Moderate physical activity is safe for most individuals, but it’s recommended to talk to a doctor before engaging in physical activity/exercise. To help get started:

Make physical activity part of everyday

  • Make a regular habit of using stairs, not elevators, and walking, bicycling to do errands near home.

Start walking

  • Walking is a great fitness activity that most individuals can do.
  • Make it a habit to take a daily walk with family, friends, coworkers, or pets.

Find a workout partner

  • Working out with a partner can make exercising more enjoyable.

Find fun activities that you can stick with

  • Vary activities, so they don’t become boring and monotonous.
  • Use a calorie-burning application to determine how many calories are burned during exercise and daily activities.

Body Composition


Damaged Collagen

There are several reasons the body’s collagen production can slow down or become less efficient. The quality of the collagen made can decrease as well. Environmental factors can be avoided to protect collagen production; however, damage from disease and natural processes is inevitable. Aging is the most common cause of decreased natural collagen. As the body ages, collagen production and quality decrease. This leads to thinner, more fragile skin and achy joints. Certain chronic diseases like lupus and rheumatoid arthritis cause collagen deficiency, leading to issues that include:

  • Joints
  • Blood vessels
  • Organs
  • Skin

To avoid collagen damage, avoid environmental factors like:

  • Smoking
  • UV exposure can accelerate the average rate of collagen damage that comes with aging.
  • UV exposure damage can also play a role in certain skin cancers.
  • Excessive sugar and fat intake increases inflammation and decreases protein synthesis.
References

American College of Sports Medicine, et al. (2009). Position stand: Exercise and physical activity for older adults. Medicine and Science in Sports and Exercise, 41(7): 1510–1530.

Anspaugh DJ, et al. (2011). Building muscular strength and endurance. Wellness: Concepts and Applications, 8th ed., pp. 111–137. New York: McGraw-Hill.

Centers for Disease Control and Prevention (2004). Strength training among adults aged 65 or older. MMWR, 53(2): 25–28.

U.S. Department of Health and Human Services (2008). 2008 Physical Activity Guidelines for Americans (ODPHP Publication No. U0036). Washington, DC: U.S. Government Printing Office. Available online: www.health.gov/paguidelines/guidelines/default.aspx.

Williams MA, et al. (2007). Resistance exercise in individuals with and without cardiovascular disease: 2007 update: A scientific statement from the American Heart Association Council on Clinical Cardiology and Council on Nutrition, Physical Activity, and Metabolism. Circulation, 116(5): 572–584.

Getting Started Eating Healthy

Loving hispanic parents serving their little children while having lunch together at home. Childhood, parenthood, latin cuisine concept

A typical diet consists of consuming three meals: breakfast, lunch, dinner, and snacks in between. However, this is not always the case, depending on individual eating patterns and habits. Getting started eating healthy and losing body fat does not require severe dietary restrictions, starvation, and constantly exercising. Although achieving rapid weight loss might sound appealing, individuals often end up feeling depressed, tired, and unmotivated after some time. This is the most common cause of not maintaining a healthy balance and achieving optimal health. Individuals can still eat the foods they love by making long-term improvements that include:

  • Understanding the body’s caloric needs
  • Making smart nutritional choices
  • Adopting healthy eating habits
  • Incorporating enough exercise

Having all of the necessary information to make educated and informative choices for the body is the most effective and valuable way to getting started eating healthy.

Getting Started Eating Healthy

Getting Started

Healthy eating starts with learning and adopting new ways to eat. This means adding fresh fruits, vegetables, whole grains and cutting back on processed foods with added fat, salt, and sugar. Converting to healthier eating also includes learning about balance, variety, and moderation.

Balance

On most days, aim to eat more:

  • Grains
  • Protein foods
  • Vegetables
  • Fruits
  • Dairy
  • Listen to the body
  • Eat when hungry
  • Stop when full and satisfied

Variety

  • Choose different foods in each food group.
  • Don’t reach for an apple every time when eating fruit.
  • Eating various foods every day will help you get all the nutrients you need.

Moderation

  • Don’t have too much or too little of one food.
  • Eating in moderation means all foods can be part of a healthy diet.
  • Even sweets are okay.

Paying Attention To Foods

Eating healthy will help the body get the right balance of vitamins, minerals, and other nutrients. It will help the body:

  • Feel its best.
  • Increase energy levels.
  • Handle stress better.
  • Prevent various health problems like:
  • Heart disease.
  • High blood pressure.
  • Type 2 diabetes.
  • Types of cancer.

Healthy Eating vs. Going On A Diet

Healthy eating is not the same as going on a diet. It means making adjustments/changes that an individual can live with and enjoy. Diets are temporary, as they are intended to cut out certain types of foods to make the body readjust and lose fat. However, during a diet, individuals can become hungrier and think about food all the time. A common side effect is to overeat after the diet to make up for the foods that are missed. Eating a healthy, balanced variety of foods is more satisfying to the body. Combined with more physical activity can help the individual get to a healthy weight—and maintain the healthy weight.

Make Healthy Eating A Habit

Think about the reasons for healthier eating.

  • Improving overall health.
  • Increase energy.
  • Feel better.
  • Set an example for kids and family.
  • Think about small changes that can be made.
  • Choose the ones that can be maintained.
  • Don’t try to change everything at once.
  • Set manageable and achievable goals, like having a salad and a piece of fruit each day.
  • Make long-term goals as well, like having one vegetarian dinner a week.

Get Support

Having a support team can help make the adjustments easier. Family and friends can help make meals, share healthy recipes and cooking tips. For more help, consult a doctor, registered dietitian, or health coach. Get started today.


Body Composition


After Lunch Energy Dip

Most individuals have experienced the moment when after having a nice filling lunch then afterward feeling the need to take a nap. Having a sleepy feeling about one hour after lunch, known as the post-lunch dip, decreases:

  • Alertness
  • Memory
  • Vigilance
  • Mood

A study in the British Journal of Nutrition followed 80 participants over 12 weeks to find whether eating almonds impacted this post-lunch dip. The results found that an almond-enriched high-fat lunch helped reduce memory decline by 58% compared to a high-carbohydrate lunch.

References

American Dietetic Association (2009). Position of the American Dietetic Association: Functional foods. Journal of the American Dietetic Association, 109(4): 735–746. Also available online: www.eatright.org/About/Content.aspx?id=8354.

Dhillon, Jaapna, et al. “Effects of Almond Consumption on the Post-Lunch Dip and Long-Term Cognitive Function in Energy-Restricted Overweight and Obese Adults.” British Journal of Nutrition, vol. 117, no. 3, 2017, pp. 395–402., doi:10.1017/S0007114516004463.

Gallagher ML (2012). Intake: The nutrients and their metabolism. In LK Mahan et al., eds., Krause’s Food and the Nutrition Care Process, 13th ed., pp. 32–128. St. Louis: Saunders.

Katz DL (2008). Dietary recommendations for health promotion and disease prevention. In Nutrition in Clinical Practice, 2nd ed., pp. 434–447. Philadelphia: Lippincott Williams and Wilkins.

U.S. Department of Health and Human Services, U.S. Department of Agriculture (2015). 2015-2020 Dietary Guidelines for Americans 8th ed. health.gov/dietaryguidelines/2015/guidelines/. Accessed January 12, 2016.

Non-Traumatic Spinal Cord Injury

Orthopedist explaining spinal cord on human skeleton to elder patient in physiotherapy office. Chiropractor talking to senior man about anatomy and spine bones for osteopathy diagnosis

Spinal cord injuries or SCI’s don’t just happen from intense force/high-energy trauma like hard falls or auto accidents. Non-traumatic spinal cord injuries are more common. However, traumatic spinal cord injuries tend to get the most attention. This can cause problems as it can delay treatment for individuals with a non-traumatic injury. Awareness is vital because spinal cord disorders tend to not get recognized for their impact on overall health.

Non-Traumatic Spinal Cord Injury

Non-traumatic Spinal Cord Injury

Non-traumatic spinal cord injuries is an umbrella term that includes several disorders, like:

  • Degenerative cervical myelopathy
  • Degenerative spondylosis
  • Rheumatoid arthritis
  • Paget’s disease
  • Multiple sclerosis
  • Metastatic cancer
  • Developmental disorders like Spina Bifida and cerebral palsy
  • Transverse myelitis
  • Amyotrophic lateral sclerosis or Lou Gehrig’s disease
  • Friedreich’s ataxia

Understanding these disorders helps determine a correct diagnosis. Degenerative cervical myelopathy or DCM is the most common form of a non-traumatic spinal cord injury. It is a slow progressive injury that causes continued compression usually brought on by spondylosis or osteoarthritis of the spine’s joints. DCM can have a devastating effect on the quality of life if not diagnosed and treated as it can have a ripple effect by raising the risk of falls, leading to a traumatic spinal cord injury. Being aware can help in preventing the damage.

Other Causes and Complications

Other causes for non-traumatic spinal cord injury include:

  • Nerve damage
  • Blood supply loss to the spinal cord
  • Compression from a tumor or blood clot
  • Infection
  • Spinal abscess
  • Atherosclerosis

One of the most significant risk factors is age. This is due to an increased risk of conditions like osteoarthritis and hypertension as individuals get older, which is why individuals with a non-traumatic spinal cord injury are, on average, older than individuals that suffer a traumatic spinal cord injury. Weakness, instability, and loss of muscle control are common complications that can develop as the non-traumatic spinal cord injury progresses. Other complications that can present include:

  • Chronic pain
  • Sleep disturbance
  • Constipation
  • Urinary incontinence
  • Urinary tract infections
  • Impotence
  • Pressure ulcers/bed sores if immobilized
  • Possible blood clots that can lead to deep vein thrombosis
  • Depression and anxiety

Treatment

With a traumatic spinal cord injury, treatment depends on the severity of the injury. With non-traumatic spinal cord injuries, treatment depends on what type of condition is involved. The primary treatment for non-traumatic spinal cord injuries typically involves various forms of rehabilitation to minimize further damage to the spinal cord. Surgery may be necessary if the spine needs to be decompressed.


Body Composition


Extracellular Water and Intracellular Water

Extracellular Water – ECW

  • Extracellular is the water located outside the body’s cells.
  • The water in the blood falls into this category.
  • Around 1/3 of the body’s fluid is attributed to ECW, and this water is found in the interstitial fluid, transcellular fluid, and blood plasma.
  • This water is important because:
  • It helps control the movement of electrolytes.
  • Allows oxygen delivery to the cells.
  • Clears waste from metabolic processes.

Intracellular Water – ICW

  • Intracellular is the water located inside the body’s cells.
  • It comprises 70% of the cytosol, which is a mix of water and other dissolved elements.
  • It makes up the other 2/3 of the water inside the body.
  • Intracellular water is important because:
  • It helps in cellular processes.
  • Allows molecules to be transported to the different organelles inside the cell.
  • Picks up where the extracellular water leaves off by continuing the pathway for fuel/energy to be transported to the cells.
References

Badhiwala, Jetan H et al. “Degenerative cervical myelopathy – update and future directions.” Nature reviews. Neurology vol. 16,2 (2020): 108-124. doi:10.1038/s41582-019-0303-0

Handbook of Clinical Neurology (2012) “Spinal Cord Injury.” www.sciencedirect.com/topics/medicine-and-dentistry/non-traumatic-spinal-cord-injury

Milligan, James et al. “Degenerative cervical myelopathy: Diagnosis and management in primary care.” Canadian family physician Medecin de famille canadien vol. 65,9 (2019): 619-624.

Physical Management in Neurological Rehabilitation (2004) “Spinal cord injury.” www.sciencedirect.com/topics/medicine-and-dentistry/non-traumatic-spinal-cord-injury

Ankle Instability

Physiotherapist giving leg massage to a woman in clinic

The ankles provide an essential role in total body function. They work as a complex system within the feet to carry the body’s weight and support movement. Any imbalance can cause ankle instability that can cause other areas of the body to go out of balance. This is most often caused by an injury, like an ankle sprain. If not properly addressed, it can lead to chronic instability and long-term health issues throughout the musculoskeletal system. Chiropractic treatment can rehabilitate ankle injuries, strengthen the muscles to prevent instability.

Ankle Instability

Ankle Instability

The entire body is an extensive, complicated, and interconnected system. Every part influences the next as individuals go about their everyday routines. Imbalances can occur in the spine, hips, legs, and knees, leading to limping, ankle pain, or injury. The most common causes of ankle instability include:

  • Poor foot or ankle mechanics
  • Knee or hip imbalances
  • Ankle sprains
  • Muscle strain
  • Tendonitis
  • Arthritis
  • Fractures
  • Chronic inflammation from illness or injury.

Finding The Imbalances

Understanding where the imbalances are and systematically addressing them is the recommended course of action. If an ankle injury is present, local symptoms and dysfunction need to be addressed. However, it is important to assess other body areas to ensure any other dysfunctions are also addressed. This prevents unnecessary re-injury, aggravation, and other problems.

Chiropractic

One or more treatment options will be utilized for proper recovery when dealing with ankle instability.

  • Joint adjustments of the lower body and spine to support nerve and blood circulation.
  • Foot and ankle compression wraps.
  • Ultrasound.
  • Electrical stimulation.
  • Therapeutic massage of the injured and sore tissues.
  • Recommendations for activity modification to prevent unnecessary aggravation and increase stability.
  • Exercise and stretch training.
  • Health coaching on an anti-inflammatory diet and foods to promote recovery.

Chiropractic is recommended for determining any body imbalances that need to be addressed with high-quality research-based care and can expedite the recovery process.


Body Composition


Compression Garments and Socks

These were only used to treat individuals with circulatory problems but are now available to the public. Recovery is about giving the body a chance to relax, recuperate, and recover from swelling, with the objective to resume physical activity. Compression garments come in shirts, pants, sleeves, and socks. The garments and socks are used for quicker recovery time, improved circulation and oxygen delivery to the muscles, and to reduce lactic acid build-up.

References

Anguish, Ben, and Michelle A Sandrey. “Two 4-Week Balance-Training Programs for Chronic Ankle Instability.” Journal of athletic training vol. 53,7 (2018): 662-671. doi:10.4085/1062-6050-555-16

Czajka, Cory M et al. “Ankle sprains and instability.” The Medical clinics of North America vol. 98,2 (2014): 313-29. doi:10.1016/j.mcna.2013.11.003

Gribble, Phillip A. “Evaluating and Differentiating Ankle Instability.” Journal of athletic training vol. 54,6 (2019): 617-627. doi:10.4085/1062-6050-484-17

Lubbe, Danella et al. “Manipulative therapy and rehabilitation for recurrent ankle sprain with functional instability: a short-term, assessor-blind, parallel-group randomized trial.” Journal of manipulative and physiological therapeutics vol. 38,1 (2015): 22-34. doi:10.1016/j.jmpt.2014.10.001

Functional Treatments For Auto Accidents | El Paso, TX (2021)

Auto Accident Doctors & Chiropractor Treatments | El Paso, Tx (2020)

Introduction

In today’s podcast, Dr. Alex Jimenez and Dr. Mario Ruja discuss how chiropractic care can help individuals who have been involved in automobile accidents and the various functional treatments that can help the body’s overall wellbeing.

 

How To Treat Auto Accidents?

 

[00:00:01] Dr. Alex Jimenez DC*:  Hey, Mario, you and I decided to call the podcast what Mario? Chiropractors exposed. The chiropractic exposé.

  

[00:00:14] Dr. Mario Ruja DC*: We’re exposing the pain.

 

[00:00:16] Dr. Alex Jimenez DC*: The differences between chiropractic and the design. And we’re going to be getting funky and deep with the technology and the knowledge. 

 

[00:00:24] Dr. Mario Ruja DC*: It’s kind of scary. I’m just going to tell you right now if you don’t have your seatbelts on. Strap in.

 

[00:00:29] Dr. Alex Jimenez DC*: Mario, today we decided to develop a significant component of our practice: personal injury. Personal injury is a type of practice where we deal with people who are injured from various issues, such as falls, slips, accidents, any nature, workers compensation, and auto accidents. A lot of things happen when you’re in personal injury dynamics. But being a doctor that deals with soft tissue issues, Mario and I have been doing this now for nearly, you know, for myself, almost thirty-two years. And Mario, you’ve been doing about 25, 26 years almost now. Yeah. So we’ve been doing it for a long time, and we have a lot to offer, and we do have a lot to say about the personal injury arena. In the beginning, when we first started understanding what happened, we didn’t ever really understand the complexities of an injury to the same level as what we do today because there is a tremendous amount of knowledge that has come about in the last two to three decades about injuries as well as injuries resulting in prolonged or chronic states that that affect people for their lives. But I also want to talk to Mario specifically more like an open forum today regarding the things that we have, we have seen when it comes to personal injury. How has that affected your practice per se in the last two decades?

 

The Dynamics Of Personal Injury

 

[00:01:58] Dr. Mario Ruja DC*: The dynamics of personal injury are complex. But what I can say, Alex, with the outcomes and assessments and the goals of personal injury, it’s straightforward. Number one. There is a trauma, so there’s a date of damage, you know, whether it’s a mountain biking accident or a car accident? A football injury. Soccer. You know, a slip and fall, you try to put the Christmas lights on and wipe out. All of those things, what it comes down to is this event. You have to start with the event, and that is the intro to the story of recovery. And what I’ve noticed is that a majority of the people minimize that event because we’ve been trained to reduce injuries, period. You know, even if we do this consistently as little kids, people say you’re fine. Wipe it off. Run a lap. Be a big boy. It’s not a big deal. I mean, I see this with kids on playgrounds. I mean, they wipe out. I’m talking about they come off the slide, and the first thing that hits the ground is they’re their coccyx, their backs. That is like trauma, like severe trauma. And again, it’s overlooked. And those types of patterns, my quarter of a century-plus of taking care of personal injuries. And again, on another side, the word personal injuries have a negative connotation.

 

[00:04:07] Dr. Alex Jimenez DC*: So that’s what it means.

 

[00:04:09] Dr. Mario Ruja DC*: Yeah, it’s like most people look at it, and it’s fake. You know, it’s not real. People are trying to make something out of nothing. You see, they’re trying to get paid and all that, that is not appropriate at all. And those types of conversations are conversations that show what in my mind, in my view, is no care. Like, you know, it doesn’t matter. You don’t count. Your health doesn’t matter. Wipe it off and quit whining about it. And you’re fine. Well, it begins at an early age like kids, and it goes to adolescents in sports. You know, I see so many personal injuries and in sports like between the ages of seven, 10, 12, 13, and they’re misdiagnosed. They’re undertreated, and they become very chronic. There’s chronicity, Alex, in that. And as they grow up, you have these issues that stem back. And even my patients tell me, “Oh, when I was 12 years old, I had this injury, and I twisted my ankle where I fell off of this. And since then, I’ve never been the same again.”

 

What Kind Of Symptoms Do You Get From An Auto Accident?

 

[00:05:26] Dr. Alex Jimenez DC*: It’s so crucial to early diagnosis issue. When we assess a person, the worst thing is someone not paying attention to a personal injury. A hip injury can lately hang around and lead to a degenerative hip. Twenty years later, it was a neck injury. A football injury could lead to arthritis as time goes on. It took a long time for the surgeon general to come up with a sentence that smoking is hazardous for your health. We had known for literally 40 years, but we had known about arthritis as a disorder. Recently, in the last two decades, the surgeon general has said that arthritis is a disorder of biomechanical imbalance. But where did this biomechanical imbalance begin? Typically an injury in the past, and that people ignored an injury, a football injury, or fall, which causes trauma that is not dealt with, we have to assess the situation and bring some protocol to the individual to allow them to heal and will enable the body to heal like it usually should. Personal injuries are critical. They have striking issues that affect the whole body dynamics, such as an ankle injury. An ankle issue will affect the knee, the hip, the low back, the mid-pack, and the neck, and people just don’t get it. When I’m saying people, insurance carriers, how a person who fell off a ladder and landed on a bum and hurt their lower back now has shoulder issues. You know, six months a year later or headaches?

 

[00:07:12] Dr. Mario Ruja DC*: Exactly. Headaches, I mean, they’re dealing with, you know, issues with chronic headaches, with dizziness. And, you know, the conversation you and I always have on a secondary level is like, Oh, this is not contributed to the injury. OK, so they fell, and somehow their whole body fell. But there’s only one injury, and that’s like the low back. And that’s it, you know, like none of the body, this is what’s so intriguing, and I laugh about it. I go, you know what, what colors the red bus? I don’t know; it’s pink today because we have more pink. No, you cannot have a whole body engaged in a traumatic acceleration, deceleration injury, or an impact. And someone can tell a patient or us that, by the way, the only part that you have injured is your low back or your neck. And that’s it.

 

[00:08:10] Dr. Alex Jimenez DC*: And you know, you were mentioning right there when acceleration-deceleration that those are terms that are used primarily for describing someone coming from a high velocity to a sudden stop. And it’s a general physics term in a prevalent one in the legal realm. And I’m glad that you used it because we’re talking today about motor vehicle accidents, specifically auto accidents that cause injuries and leave people with problems many, many, many months later. You know, I know you know this, and from the time that I began my practice, the most common thing after a motor vehicle accident was someone that said, I don’t have anything that hurts. Right? Absolutely. And then how long does it take before the symptoms show up in your car? 

 

[00:08:57] Dr. Mario Ruja DC*: Realistically, Alex, I would say anywhere between three to four weeks, sometimes even longer. I have patients that refuse treatment, and they tell me this, you know like I was hit by a car from the back. That’s like real common. You know, nowadays, people pay more attention to their cell phones than what’s in front of them or anywhere distractions, right? So for whatever reason, you know, you get hit from the back. I mean that that incident, I hear so many times patients come in, they’re dealing with headaches, migraines, severe migraines where they’re on heavy medications, have neck issues, chronic, and tell me I’ve never been the same. And it started two years ago when this happened. Well, what happened? That event was I got hit from the back. Yeah, yeah, yeah. And then they even tell me I’ve never been the same again. I’ve been damaged. You know what? And they refuse. And I tell them, Well, did you get any care? No, I didn’t get any care because I was OK. I felt fine. And, you know, I didn’t need it.

 

Getting Evaluated After An Auto Accident

 

[00:10:11] Dr. Alex Jimenez DC*: Patients need to get evaluated after an auto accident. They do because you never know what’s going on. And sometimes, the body has impressive capacities of hiding symptoms, literally. You can have a person who comes in your office that hurts my low back and says, I only have pain in my back and lower back. Then after a little quick assessment, we just kind of move the neck, and he goes, Oh, that my neck hurts. And I go, Well, did it hurt before? And they go, No. And it’s not that I’m stimulating. It’s that the pain in the low back camouflages other areas. It’s almost like you hit get hit by a hammer, and all of a sudden on your toe, you suddenly don’t have back pain.

 

[00:10:53] Dr. Mario Ruja DC*: That’s exactly it.

 

[00:10:55]  Dr. Alex Jimenez DC*: The brain can come out and late the symptoms. And then later, two days later, two weeks later, after the carrier called you and said, Are you OK? Then you start, have a presentation of symptoms, and say, Well, I didn’t have anything on that day. You didn’t want to get checked out, and suddenly you have symptoms that you didn’t know about, which happens more often and more commonly when you get older. As people get older, they have these symptoms present. We’ve done studies we can show and NCBI studies where people have issues years later, from a soft tissue cervical injury that leads to chronic headaches, migraines, and mental disorders resulting from poor sleep, just chronic pain is horrible when it affects individuals. Therefore, it’s essential, and our goal today was to have an open forum of whether you should get the care and should get evaluated and what kind of treatment options we have? I mean, we’ll have tons of podcasts where we can talk about the types of treatment protocols and their best efforts. But the bottom line is we have to start with people understanding that they need to be assessed. And it’s crucial that they do because if they don’t, guess what happens.

 

[00:12:12] Dr. Mario Ruja DC*: Well Alex, let me interrupt you for a second and let me say this question number one, and I know, you know the answer, and I hear it all the time, but I want you to kind of like tackle that one as they say, OK, number one, how many patients have you had that walk-in in the past 20, 30 years of your practice that say, “Oh? Dr. Jimenez, you know what, I’ve already been checked out. I went to E.R. I got checked out. They did some X-rays, told me I was OK. Gave me a, you know what, 800 milligrams of ibuprofen. You know, and give me a muscle relaxant, some flex real or whatever. I’m fine. A lot, Mario. How many times? A lot. Or they go to their family practitioner, and it’s the same conversation. You’re fine. Come back in 30 days, and I ask them, and you ask them, and what else did you do? Nothing. What is your opinion? You know, we deal with sports injuries. We deal with football players getting hit for up from the back, tackled, and all of that. Those kids weigh no more than 200 pounds. OK? I mean, we’re talking about high school. Not not the pros. A car weighs a ton.

 

[00:13:38] Dr. Alex Jimenez DC*:  Ten thousand pounds traveling at 60 miles an hour as hundreds of thousands of pounds of machinery.

 

[00:13:44] Dr. Mario Ruja DC*: So now, how many times in your practice career have you heard? No, I already got checked out, and they said I was OK.

 

[00:13:57]  Dr. Alex Jimenez DC*: A lot. Mario, I remember when I first met you, we had a clinical case. Remember the German? Yeah, I’m fine. I went to Vista Hills Hospital, right? And they told me I was OK. He had a compelling accent. The guy came in the briefcase.

 

[00:14:20] Dr. Mario Ruja DC*:  The guy came in to be a briefcase. How much do you weigh?

 

[00:14:21] Dr. Alex Jimenez DC*: I think it was about 40 pounds? Yeah. All right. And what happened is he started to lean forward. And the first protocol we do if you’re in, and first of all, the clinical history was that he flipped the car and hit his head on the top of the vehicle. So as he flipped it, they took him to the hospital, and then they took an X-ray, and sure enough, they let him go. Right? Well, he said he couldn’t move around. And if you remember, he was saying, “I cannot move on this; I have these two briefcases holding me down,” and you could see that it was pulling him forward. And I remember we took the X-rays and looked at how it was broken; the neck was broken.

 

[00:15:01] Dr. Mario Ruja DC*: What part of it was broken?

 

[00:15:03] Dr. Alex Jimenez DC*: The cervical spine, the lower circle around the T-one, was hidden behind the shoulder on the X-ray right. And what we did was we did a swim shot, and we saw the neck. And I’ll never forget what happened. I go, “Mario, look at this,” and he goes, “Oh wow,” and I told Mr. So-and-so. I forgot his name, and we told him, “We got to talk to you about your X-rays, and you got a broken neck,” and then he goes, “What? They did not tell me.” All right. Well, what I did was I went, “This was too complex for even my practice.” My point being is, is that it was something that needed to be assessed. I sent him over to Dr. Thomas Al-Awsat, a great local surgeon, and I got to tell you, I think, the helicopter that landed by his office. He calls me back, saying, “Hey, man, why did you send that to me?” And I go, “Well, you’re the orthopedic surgeon.” Then he goes, “Dude, that is beyond my abilities.” He sent it over to Dr. Meissenhammer, the spinal practitioner, and he’s smarter than I am.

 

[00:16:03] Dr. Mario Ruja DC*: And Dr. Al-Awsat is extremity. 

 

[00:16:07] Dr. Alex Jimenez DC*: I’m going like that was crazy. We sat him down and called the helicopters to airship them. To that point, my point is that there’s a lot of things that are missed many times. We have a lot of great doctors in the city that can come together, and we integrate our practices with neurologists. I know you work with neurologists, pain specialists, chronic pain specialist doctors, physical medicine doctors, which we are. We need to understand that after an injury, there is trauma. You know, sometimes the carriers defy you and say, that’s a garden of the mill injury. It’s not that way. We have to evaluate those things through our history. We’ve seen atrocities, wrongdoings that could have been avoided by a simple assessment, a simple orthopedic assessment, and a neurological evaluation with all the tools that we have in modern science today to be able to come up with a protocol to determine if there is a problem or there isn’t. It seems kind of crazy that we could leave a person, a young girl who’s at the age of 18 has a neck injury and then look at her later on a 50, and she’s got massive arthritis in her neck when we could have done something.

 

[00:17:20] Dr. Mario Ruja DC*: And what I would say is we need to honor each patient as though they are our children or our parents. You know, if we have those standards of care. We would care more, do more, be a little more patient and not as fast to judge or tell the patient you’re fine. And I understand many traumas, many other issues are more pressing, and often that’s the case. And we all do our best. You know, Alex, I always tell people everyone does their best when they are, you know, and for myself, I look at those cases, the injuries as very, very important cases because they delineate the rest of your life. So the better you take care of that car accident. And the reason we’re talking about cars is that the impact is enormous. And some of these cars, you may not see the effect. And that’s another conversation that I think is important because people think, oh, it’s a scratch, you know, and then the older the car, this is one thing that I’ve noticed, the older the vehicle. I mean, we’re talking about bumpers that are made out of steel. Yeah, I mean, that thing is not going to bend. But I’ll tell you what, that force will vibrate through the whole car to impact you more.

 

[00:19:06] Dr. Alex Jimenez DC*: You know, as you mentioned that we learned in physics plastic deformation. That’s what it is plastic. It absorbs the energy. Today’s cars are designed to absorb energy, and the old cars were more complex. So that energy, it’s almost like when people know I can imagine driving your car on and no tires, no rubber. You feel the impact when you’re on an older car, pre the 60s and 70s. That thing hurt, man. That thing was not an energy-absorbing kind of structure. There are cars out there that absorb energy better. But what we’ve learned is that position the impact, velocity, angles, and vectors all come into place, and it’s essential to understand the individual’s age.

 

[00:19:54] Dr. Mario Ruja DC*: The preexisting. I can tell you someone, someone that’s in their 20s and someone who is in their 60s. Same situation, same impact. Different care, totally other symptoms, totally different outcome. Why preexisting issues, secondary morbidities, you know, all of those things are considered, and those patients have had other problems before. But the point that I always reflect and share with the patient wherever you are. The particular impact escalated and amplified the concerns you had prior, which is vital to clarify again. Often, you know, those issues are not created, and the verbiage that’s used is it’s preexisting because, you know, you have arthritis. Yeah, I understand that. But the question is, did that impact make my arthritis and the situation better or worse? I’m sorry but let’s be straightforward.

 

Does The Impact Affect Me?

 

[00:21:02] Dr. Alex Jimenez DC*: Is it their fault that they are 60? Is it their fault that they have arthritis? Is it their fault that they have a back prior existing issue with rods in their spine from a previous situation? No, it’s not. When the impact happens, it lights those things. Yeah, whatever you have predisposed, it lights it up, and it makes it worse. You’re right.

 

[00:21:20] Dr. Mario Ruja DC*: Preexisting and those are conversations that need to be clarified and answered for the patients, mainly because it’s not their fault, you know, they’re the ones that didn’t wake up in the morning and go, You know what? Let me see if I can hit a tree today. Yeah, so I can, you know, just kind of stimulate my neck so I can move better? No, that’s the point. The point is that we need to meet each patient where they are. The fact is we need to meet them where they are. And if you are at that point in your life where you have high blood pressure diabetes, I mean, we’re talking about a conversation that we had a week ago was metabolic syndrome where you have type two diabetes. Now, Alex, tell me about your experience; I’ll let you answer this. How does a patient with diabetes differ in their recovery? The speed, the time of their recovery? With one who doesn’t have diabetes?

 

[00:22:22] Dr. Alex Jimenez DC*: Using that example, you can first of all, when you have diabetes, by definition, it’s the sugar imbalance issues the body’s more inflammatory. It just basically cuts down to inflammation. It affects the kidneys. And if they’re pre-diabetic, they may be through growing metabolic disorder, where inflammation and blood sugar issues are going haywire. Well, it’s inflamed. It’s a predisposed inflammatory structure dynamic being. Now you get that person, and you hit him with a shovel that weighs one hundred thousand pounds in the back, right? Right. You light up the whole body, and you’ve taken someone who had a kind of a silent form of inflammation. You put that body through an inflammatory state that cascades to the point where the person literally their blood sugar. How many times after that did you have an accident where the people just complained their blood sugars off? Everything. Their diabetes has gone haywire. They weren’t the same. Did it take months even to stabilize the blood sugar?

 

Managed

 

[00:23:24] Dr. Mario Ruja DC*: The recovery again, as you, as you mentioned, because of all these secondary issues is much longer and again due to the cascade effect of an injury, amplifying not only the symptoms but amplifying and putting so much talk on the metabolic process that that that person is already in. They’re already in a high state of inflammation. Now we just lit the whole body into the second phase of that. And actually, and that’s where I would like everyone to understand that there needs to be a higher level of care for those cases. And many times, it’s a more extended level. So this is not just one month, you know, we’re done thank you very much and have a nice day. Now, this is something that needs to be very well managed. The word is managed, very well cared for. So this is not like a little drive-through, you know, program, and therefore, we minimize those types of secondary issues and become even more chronic and impact the functional aspect of their long-term life.

 

[00:24:49] Dr. Alex Jimenez DC*: You know, the word today that didn’t exist 20 years ago was functional medicine. A person who’s in a car accident isn’t just hurt on their knee. Is it just hurt on their neck? Their whole bodies have gone through a slamming potentiation, or an energy field has gone through their body. It affects every organ. It involves the mind, the brain, the skull, brain matter, the intestinal organs. It affects everything and puts everything into chaos. If someone has a susceptibility and gets hit in an auto accident, it brings out a lot of the disorders that were just silent. Now they’re present, and we have to hit a functional approach. When we assess someone, we have to evaluate how it’s affected their mind. When I started practicing Mario, you know, PTSD wasn’t even though it was considered part of the DSM three-book; even the veterans didn’t qualify it as a diagnosis. It was in our tenure over the last 20 years that people understand the impact of the mind, how it gets altered in a motor vehicle accident, the mind, the way the cognition, the what they call cognitive dissidence the brain has in effect as a result of an impact. And how many times do you get a patient that says, You know what? I got hit in a car accident, and I’m afraid, I’m scared. I don’t know what to to do when I cross an intersection; they’re hurting mind-wise. So not only is the mind affected but the physiology of their whole bodies are affected.

 

Addiction

 

[00:26:35] Dr. Mario Ruja DC*: Talking about mind, let me do this. This is the word that is very important for all of us. Concussions. So now, after all these years, even in the game of football. After a very well-documented movie called Concussion. It was almost like a documentary. This is real. So from multiple impacts in football, people are getting depressed. Suicide is connected with it. Anger management, addiction, Alex.

 

[00:27:27] Dr. Alex Jimenez DC*: Wait for a second, Mario? Addiction? Tell me all about that. Let’s talk about that because this is a whole thing.

 

[00:27:33] Dr. Mario Ruja DC*: No, that’s I don’t. Oh, it’s the only accident. No. It’s not connected. It’s only just the low back and neck. And let’s leave it alone. No, you’re exactly right. We’ve got to address this. We need to put it up front and direct to everyone. Because let me tell you, if a football injury can cause concussions, which has a cascade effect towards depression, suicide addiction patterns, then let me ask you this. Is it too crazy to say that maybe car accidents have a similar effect?

 

[00:28:11] Dr. Alex Jimenez DC*: Oh, absolutely. It’s crazy. You know what? First of all, our awareness of concussions was very different. You know, 20, 30 years ago, it was the stinger. 

 

[00:28:24] Dr. Mario Ruja DC*: Yeah, rub it out.

 

[00:28:27] Dr. Alex Jimenez DC*: The legs going the wrong way to sting or walk it off. You got knocked down on their back, you know, a stinger. We now know the complications of the inflammatory cascade resulting from a football impact, that these things affect people’s brains. When they start affecting their brains, it affects their emotions. You’re right, and suicide is a complication of concussion. And when people get involved in motor vehicle accidents, they often do get subconcussive, pre concussive, and real concussive situations.

 

Is Ignorance Bliss?

 

[00:28:58] Dr. Mario Ruja DC*: And are they OK? Let’s talk about this. Are they assessed? Are they addressed?

 

[00:29:07] Dr. Alex Jimenez DC*:  No, not all the time. An excellent qualified doctor will do an orthopedic, neurological assessment, and all of the other tools and canons that they use to figure out what’s wrong with this individual. As you said, when that patient equals one, each person has its dynamics. You cannot state that everyone involved in a 30 mile an hour impact has a two-week injury. This is ridiculous. You know, doctors would laugh at that, but this is the standard. The guideline says a sprain strain of the neck. And let’s classify that. But there are different levels. There are complications. We need to make sure we diagnose, treat, and put together a team of individuals supporting wrap ourselves around this patient to give them the treatment protocols they need. This is very important because if we don’t Mario, that person 20 years from now will be affected. And we all know that if it involves an individual in their 20s and 20 years later, he’s 40, it has affected the whole family.

 

[00:30:14] Dr. Mario Ruja DC*: Absolutely. It affects everybody. It does, Alex. I will say this from personal experience. It affects everyone because we all go through it; the rule is that when one goes through it, we all go through it. Because the dynamics of that family changes immediately, the energy changes in the house, everything change. Yeah, the weekly routine changes. Now we have to take mom or dad, or we have to do this, or we can’t do these other things. We can’t go to football practice imaginable because now we have to go to therapy and some other things. And the other question that I want to throw out is very sensitive, like I don’t want to throw it out at you and make sure you don’t fumble this one, right? So let me tell you why it is so easy to get your car fixed but not your body? Now I want to throw it to you quickly. This isn’t a fastball, all right. Why is it that we take care of these things? We don’t go; that’s not it. You know that scratch was there before. Now we’re not fixing your car. Why is it that it’s so easy to fix material things? Right? And we never look at we never say this. This car was like three years old or four years old, you know, and we’re not going to pay for it. We’re just going to spend like like maybe half because it’s already old. Why is it that car material things are paid for in full, Alex, and people are not? Why is it? You know, I’m really curious.

 

[00:32:09] Dr. Alex Jimenez DC*: I’ll answer it.

 

[00:32:10] Dr. Mario Ruja DC*: Yeah, please.

 

[00:32:11] Dr. Alex Jimenez DC*: It is called ignorance, Mario. It is ignorance of the fact of what will happen to that individual, and I cannot tell you that I have treated a lot of patients in my life, some of them were adjusters, that terrorized my patients in the early 90s that stated, you don’t have a problem. X-Y-Z. Every time they say the person was involved in an accident, they don’t have a problem. They are just blanket statements. They don’t have any issues and would create devastation with the patient and the treatments they need. Guess what? I had one that I remember our first one, and let’s call her Karen Peoples, and she worked for an insurance company with a P on it. And she remembers. And I remember her voice, she had a unique voice, and one day I had that voice in my office. And that same Karen from that insurance company says I was involved in an accident with my daughter and I go with you that Karen from that insurance a long time ago. And she goes, Yes, I was the head adjuster. And I say to her, “You know, you created a lot of devastation for a lot of my patients, not understanding what was going on with them.” She goes, “I never knew. I never knew that an impact with such little force of 20 to 30 miles an hour could leave my daughter in such devastating pain and me because I didn’t know and I didn’t know,” and I go, “But you continuously created havoc for these patients,” and she goes, “I live with that every day. I live with the bitterness of getting divorced. I had the protocols that were in place.” I don’t know what it was, but you know, she led me to believe that it was her job. But the bottom line was that she realized then that an injury that now was a small relative that she would have brushed off and made someone feel worth nothing or had no value for care has now affected her life and her daughter. It affected them that they were always being treated in the office for about a good three to four months, and they appreciated it for the first time. So to answer your question Mario, it’s just ignorance to understanding. Because we live in a culture, I don’t have time to take care of my body. I don’t have time to give myself the care that I do. We treat nurses. You and I treat nurses. These are the top echelon nurse practitioners, the top end. By the time they retired, they’re broken. These are the people that took care of themselves but didn’t take care of themselves. They took care of other people, but not themselves. All right. So the whole idea of why just people tend to believe that it’ll be gone tomorrow? They still think they’re 15. But once you cross 25, 30 years old, the body takes longer to heal. The body dynamics are altered. And as that happens, things take a much more logical approach to consider what we need to do to recover a person. So as we do these things, the answer is we believe that cars, though they are more important in terms of the present to get me here and there, they don’t see the distance and the how long and how it affects them when they’re seventy years old and can’t walk because of an old injury back in the day. So we need to establish norms, and N equals one patient-doctor equals one. We understand we assess; we determine what’s going on with the patient. And when we do that, you and I do a great service to our patients and their families and for the future generation. I cannot tell you that anxiety stays with you. No anxiety. If you’re a very anxious and irritable person, I can ask you who’s there? Was the irritable person anxious in your family? Well, there’s my mom, and who was that behind? That was my grandmother. Right? So if we give chronic pain to an individual? Have you ever seen children of an individual who has chronic pain not affect the children in some capacity? It does. So when we kind of blow-off pain and that it doesn’t need to be, you know, whatever. Here is a couple of hundred dollars here. Take Motrin out the door. You take some flexible risk of yourself becoming addicted to certain medications because it happens. And there’s a place for things. And when there’s a need for medication, you and I are very aware we’re open to that. But when the consequence leads to a lifetime and not only a lifetime, but a legacy of perpetual issues for a future generation? Oh, it was just because we didn’t know Mario. We didn’t know they didn’t know the distant consequences of trauma. I have people that I hate to say this, but it’s ridiculous. But the anxious anxiety that is so deeply embedded in some of my patients leads back to the Civil War. I mean, back to their families when they were trying to survive during the depression and that that that same mental state follows them through. Well, an auto accident can do the same. I mean, if it traumatizes them, it gives them an injury, and they can’t walk around, and now their neck doesn’t move. And they used to be a car mechanic, and now they don’t have a job. And all of a sudden, they can’t bring the bacon home. What happens?

 

[00:37:49] Dr. Mario Ruja DC*: That’s an excellent point. That’s a very valid point, Alex. And I see this with athletes when an event happens to where it alters their function because their function is their identity. You follow me. So all of a sudden, it’s like, here’s a wrestler with an injury he can’t wrestle more. Here’s a football player. He has to retire early. Here, here is a, let’s say, mechanic. He cannot do his job anymore. So again, in our culture, our function is our identity. Would you say that? So, that’s where it’s so important that we honor functional medicine.

 

It’s Okay To Say “I’m Not Fine.”

 

[00:38:45] Dr. Alex Jimenez DC*: You know, let me kind of mention something because you said, we aren’t we are the thing that we do. In Spanish, there is a word that rides on insult. It is inutile. You’re not worthy of something. If you break apart the word you notice, like when someone calls with someone inutile, it’s like you’re insulting me. Like, I’m not helpful. Well, the word is in without utility. Without utility function, without function, you hurt yourself; you become inutile. So the answer to it is when you’re hurt. What’s the big bravo thing? You don’t want to tell people you’re hurt because you don’t want to be inutile.

 

[00:39:27] Dr. Mario Ruja DC*: That’s psychological. I love that. I love that connection because here is the 360, which is where it all comes around. Identity function, chronicity. And this is where we disconnect. When we disconnect, we say, no, I’m fine. How many times do you hear people say I’m fine.

 

[00:39:49] Dr. Alex Jimenez DC*: I’m fine. Busted leg. I’m fine. 

 

[00:39:53] Dr. Mario Ruja DC*: And you look at him, you go, “Dude, you’re not fine.”

 

[00:39:57] Dr. Alex Jimenez DC*: You’re not fine. No, we got to check you out, and we got to figure out and come up with a plan.

 

[00:40:01] Dr. Mario Ruja DC*: I see so many people that instead of, you know, again, the conversation is in car accidents and all that. Oh, they’re amplifying it there. You know what? That’s very rare. OK. You know what most working, society, a working force like in El Paso, we love to work. That’s our identity. We don’t want to stop working. I have so many people to say, no, I need to go back to work. I want to.

 

[00:40:29] Dr. Alex Jimenez DC*:  I got to tell you, I grew up in a world where people walked around with neck braces, and we knew it. Now, today we don’t use one’s neck braces as much or belts everywhere. You know what? People do not come to my office faking it; they don’t. I mean, it doesn’t happen. It’s not like they are hurting their jobs. I am a very fair guy in terms of, look, this is something real. And as soon as we treat and we’re done with them and be on your way and be happy, but if you’re not given the opportunity, then the healing and repair process or what we call the fibrosis of repair or scar tissue doesn’t allow itself to heal appropriately, let alone that’s the physical component. But as we talked about and people don’t understand the consequence of these things’ emotional effect. You know, a girl gets raped, a man watches his best friend, gets his head blown off in a war, right? A person drops in an elevator, 40 floors. They make it. They survive. Each one of these people looks normal to you. They look normal. But are they different now? They have been altered. They have been changed. These things happen even though they look present and say, You know, there’s nothing wrong with you. You know, do you know she was raped? Do you know that he saw a friend? Do you know that he was in an accident where nobody survived? And I’ve seen accidents. Ridiculously, everyone dies except one person. Yes, right. One person survives, and how did that happen? Well, the forces are such that, you know, it clipped when a certain energy force and it took out a certain group of people and some people are fine. Sometimes you have eight or nine people in the car, and no one gets hurt, and one person gets paralyzed. How does that happen?

 

[00:42:17] Dr. Mario Ruja DC*: And this is where you know the statements and the examples. These are like very high-end statements, you know, right? Yeah. Now the majority of them, let’s say 80 percent of them exactly fit into that conversation. Because why? You look at them, and they look fine. There are no contusions, no broken bones, and nothing like that, so they look fine. And a lot of them, even in my practice, they come in, they’re like, “No, I’m fine, you know, it’s not that bad. I, you know, came in because so-and-so, one of my family members told me to go in” or, “You know what? Oh, I have just a little like, you know, just a little quick in my neck and, you know, when I wake up, and that’s it.” So they like point one thing. But it’s how we evaluate by the time we do a spinal surface EMG electrical monograph. I mean, this is data. This is pre and post. You look at muscle balance. You look at vectors. By the time we do that, we say, by the way, what about these areas? “Oh yeah. You know what? I do have that. And all of a sudden, after 30 minutes to 45 minutes of digging in and looking into it, then they say, “You know what? I’m so glad that you looked into it because I didn’t think it was that bad.”

 

[00:43:39] Dr. Alex Jimenez DC*: Mario, you and I, that’s where we realized that we’re at that we’re so comfortable with ourselves that we bring in other talents. We have top radiologists that work with us. Top MRI specialist CAT scans, ultrasounds…

 

[00:43:56] Dr. Mario Ruja DC*:  Top orthopedics. Again, that’s the problem.

 

[00:44:01] Dr. Alex Jimenez DC*: We will find the problem if there is one, and we will determine, and we will be fair, and we do not want to abuse any system. But what we’re trying to do is to let people know that they should get evaluated, they should be treated, they should be. If they need it, they should get it. If they don’t, well, then we send them in the same way. Many of my patients that come in; they’re not hurt. I’ve many times eight or nine people come in, and they’re all in the same car, and I only treat two people right. That’s fine because you only treat that, which has issues. And we have to assess the problem correctly. And that is what many of those who have the power do not think they should have those benefits for free and available. That’s just it’s ludicrous. And when we present that stuff, you know what, you and I go to court all the time. We go in depositions. We stand up for our patients. We represent. We are their voice to bring a clinical point of view to a physiological change. And when we do that, many times people understand, and I’ve got to tell you, when you’re talking to 12 people in a jury, there is most likely three or four of those people that have been jacked up in a car accident at one time, and the chronic chronicity result after something like that could occur, if not them, they’ve seen it in their family. So today’s day is not to turn our back on people we have to assess, and that’s what we plan on doing, you and me. With our expertise, we have a lot of a book to learn how to ride bicycles. But until you get on a bike, you will never, ever learn how to ride a bike. You and I have been in clinical practice literally for over 50 years combined. We have ridden the bicycle, understand the truth, know the dynamics, and willingly tell everybody about an issue with one of our patients. And we’re proud of that. And I know that you’ve been very accurate, and I have been very faithful to our patients, and we call it like it is. And I look forward to talking to more about this because it is an area, though it’s general talk right now, we can go into any route of these for days and hours and get into the nitty-gritty and get nasty with the science more. You and I, what are we going to do? We’re going to expose what we do. We’re going to uncover the stories. And as we do that kind of stuff and tell people about that, we’re going to bring awareness that has never been in, at least in the forums, to develop without a time or saying you’ve got four minutes to say something. It takes a long time to kind of set an idea.

 

Conclusion

 

[00:47:02] Dr. Mario Ruja DC*: Yeah. And I also want to share the word is results, OK. In all of the environments and the places and ecosystems that I work with and am part of. It’s about results, Alex. It’s about results. Before and after, what are the results? Am I better? Am I stronger? Can I move better? Am I able to get back to the function that I was before? And you know what, Alex? It’s called functional medicine. It’s called results. It’s called chiropractic. It’s called integrative care. What that means is that that we are a team. I am not all to everyone and all my patients, and neither are you. And we realize and honor that it takes a village to raise a child, but also it takes many professionals to take care and give the best care and the best results to a patient in need of the results that they deserve.

 

[00:48:19] Dr. Alex Jimenez DC:* The care and N-equals one, guys. We’re going to bring it, and we’re going to stop it there. We’re going to continue these conversations. And Mario, thank you for being the voice you have always been because we have a lot to say about what is going on. And we’re going to try to bring out the awareness to our community and teach about what we do and let people know what their options are and have the result, as you said. So we’ll leave it there. And God bless.

 

Disclaimer

Chiropractic Reset For Jet Lag

Waist up side view portrait of charming young Caucasian female in black sportswear lying on massage table during the physiotherapy session in wellness center

Chiropractic Reset: Traveling is not an easy adjustment as it disrupts the body’s internal clock. When flying even just 3 hours, the body can start to experience symptoms like:

  • Fatigue
  • Confusion
  • Insomnia
  • Joint and muscle pain
  • Stiffness
  • Stomach problems
  • Nausea
  • Hunger
  • Bad mood

Not only is the flight a physical challenge, but so are the long lines, backed-up traffic, lost luggage, etc. All take a toll on the mind and body; a chiropractic reset can help restore the body’s balance and energy levels.

Chiropractic Reset For Jet Lag

Jet Lag

Jet lag happens when the brain region known as the hypothalamus or center that controls sleep cycles, appetite, and temperature conflicts with travel changes. A survey from international flight attendants found that despite being used to long air travel:

  • 90% had fatigue over the first five days.
  • 94% had a lack of energy/motivation.
  • 93% had broken sleep.
  • 70% had ear, nose, or throat issues.

Scientists have estimated that it takes a full day to recover for every hour of time difference. The direction traveled can affect how intense the symptoms are since it’s easier for the body to delay its internal clock than speed it up. Traveling east is more difficult on the body compared to traveling west.

Ways To Limit The Effects

Workout

  • Get a thorough physical workout the day before you fly.
  • It doesn’t matter; it can be an hour on an elliptical machine, a mile jog, or a vigorous swim.
  • The objective is to get the lymph system moving to help prevent edema in the legs, hands and flush toxins from the body.

Take a Walk Every Hour

  • Try and get up at least once an hour for long trips and every half hour for shorter ones.
  • This will help prevent back pain.
  • Reduce the risk of blood clots from prolonged sitting and change in cabin pressure.

Bring Familiar Food

  • Fresh fruit, vegetables can be placed in a ziplock baggie.
  • Nuts are allowed as long as there are no passengers with severe allergies.
  • If it’s a long flight, include protein-like:
  • Chicken wings.
  • Hard-boiled eggs.
  • Cooked burgers.
  • All fit the criteria for a long plane flight.

Sleep

  • Try and get a proper night’s rest the night before the flight.
  • Eye patches and music also work well if available.
  • Utilize the flying time to increase rest.

Exercise

Flight time can make a difference

  • If possible, try to get a flight that gets to your destination in the evening.
  • Then, stay up until 10 pm local time.
  • If you have to take a nap, set the alarm not to surpass two hours.

Avoid caffeine and alcohol

  • You don’t have to go without alcohol or caffeine, but they should be cut out a few hours before sleeping.
  • Both can affect the ability to fall asleep, stay asleep, and the quality of sleep.

Change sleep patterns beforehand

  • In the week leading up to the trip, start adjusting sleep time and wake time to get closer to the new time zone.
  • This way, upon arrival, the body is basically adjusted.

Skip the big meal

  • To help the digestive system, try not to eat a massive meal upon arrival.
  • Allow body functions like sleep and digestion to adjust to the changes.

Bask in the sun

  • Daylight has a significant effect on the body’s clock.
  • Get outside to wake up the brain to help the body and mind adjust to the daytime hours.

Melatonin

  • This is a hormone in the body that helps control the circadian rhythm.
  • Melatonin is dependent on the amount of light the body is exposed to.
  • When there’s light, melatonin release is stopped.
  • When dark, melatonin release is stimulated.
  • It is recommended not to take melatonin before leaving, or it will make the jet lag worse.
  • Wait until landing in the new time zone to supplement one hour before regular sleep time at the new location.
  • Continue for three nights or until the body has adjusted.

Pycnogenol

  • Pycnogenol has been studied for its effect of reducing jet lag symptoms.
  • It reduces cerebral and joint swelling, which leads to fewer short-term memory problems, fatigue, and cardiac issues.
  • It has been shown to decrease deep vein thrombosis and superficial vein thrombosis, typical side effects of long flights.
  • Recommendations are to take three times a day for up to five days maximum of seven days after landing.

Chiropractic Reset

Chiropractic reset adjustments the day before and especially after the flight can restore balance to the nervous system and the body. This will help reset sleeping and waking patterns after the stress of flying.


Body Composition


Metabolic Syndrome

Metabolic syndrome is a name for a set of symptoms and conditions that revolve around cardiovascular health.

  • Obesity and a high amount of visceral fat are significant risk factors for being diagnosed with metabolic syndrome.
  • Individuals can prevent metabolic syndrome by:
  • Focusing on minimizing visceral fat.
  • Maximizing lean mass leads to weight loss.
  • A diet that boosts HDL is essential.
  • Proper body hydration.

Body composition analysis can be thought of as a tool for understanding the approach to preventing the onset of metabolic syndrome. Knowing how to identify the risks can support individuals in making informed decisions on their healthcare journey.

References

Belcaro, G et al. “Jet-lag: prevention with Pycnogenol. Preliminary report: evaluation in healthy individuals and hypertensive patients.” Minerva cardioangiologica vol. 56,5 Suppl (2008): 3-9.

Herxheimer, Andrew. “Jet lag.” BMJ clinical evidence vol. 2014 2303. 29 Apr. 2014

Janse van Rensburg, Dina C Christa et al. “How to manage travel fatigue and jet lag in athletes? A systematic review of interventions.” British journal of sports medicine vol. 54,16 (2020): 960-968. doi:10.1136/bjsports-2019-101635

Straub, WF et al. “The effect of chiropractic care on jet lag of Finnish junior elite athletes.” Journal of manipulative and physiological therapeutics vol. 24,3 (2001): 191-8.

Zerón-Rugerio, María Fernanda et al. “Eating Jet Lag: A Marker of the Variability in Meal Timing and Its Association with Body Mass Index.” Nutrients vol. 11,12 2980. 6 Dec. 2019, doi:10.3390/nu11122980

Changing Positions and Posture Throughout The Day

Businessman looking at computer while standing at desk in office

Changing positions and posture. Individuals who have to sit at a desk, workstation, or cubicle for most of the day increase their risk of back pain, contributing to other health issues.  GetAmericaStanding.org reports the average adult sits for ten hours or more a day. Prolonged sitting at home and work without movement, physical activity, exercise can lead to issues like:

Long periods of inactivity are associated with increased mortality as sedentariness causes the same damage related to smoking and obesity. It can be challenging to find ways to remain active while sitting at work; this is where changing positions and posture, also known as dynamic sitting throughout the day, can help.

Changing Positions and Posture Throughout The Day

Changing Positions and Posture Throughout the Day

Constantly sitting in a chair means the body remains static, causing blood and energy circulation to slow down, stressing the body’s muscles. Changing the body’s positions regularly along with short periods of activity like standing up, walking around while on the phone, and stretching helps to work out the muscles and keep circulation at optimal levels.

The Importance of Changing Positions and Posture

The body was meant to move and requires movement to stay healthy.

Staying in one position for too long can lead to loss of core strength from the abdominal musculature becoming deconditioned. Muscle deconditioning leads to weakness and tightness. The imbalance affects the spinal support system leading to back, hip, and leg pain. Moving around and doing quick mini-workouts can help strengthen the body, increase core strength, improve posture, burn calories and prevent pain and injury.

The Basics

According to a 2018 study, researchers found improvements in cardiometabolic health among individuals that would stand up, sit less, and move more. Ways to adjust the work or home office to make changing positions and posture easier include.

Medical Consultation

These small changes and adjustments can make a big difference when experiencing body pain from too much sedentariness. However, it is crucial to know if other issues are causing the health problem/s. If back or any pain is associated with any of the following, consult a medical professional.

  • Trauma from an accident or injury.
  • Balance issues.
  • Weakness in the legs.
  • Infection.
  • Fever.
  • Unexplained weight loss.
  • Overflow urinary incontinence is when the bladder fills up and empties without feeling the need to urinate.
  • Severe constipation.

Body Composition


How to Read Blood Pressure Measurements

An individual’s blood pressure includes:

Systolic Blood Pressure

  • This is the first or top number listed on a blood pressure reading and is the measurement of the pressure that the blood exerts against the walls of the arteries.
  • A normal systolic reading should be less than 120 mm Hg.

Diastolic Blood Pressure

  • This is the second number that measures the force of the blood against the artery walls when the heart is resting between beats.
  • A normal diastolic reading is less than 80 mm Hg.

Pulse

  • The pulse is the number of beats per minute the heart is beating.
  • A normal adult pulse is between 60 to 100 beats per minute.

When checking blood pressure, a doctor will read out a vital sign in the normal range of 120/80 mmHg or below. Anything above that could be an indication of an underlying health condition.

References

“Ergonomics for Prolonged Sitting.” The University of California at Los Angeles, Los Angeles, CA. www.uclahealth.org/spinecenter/ergonomics-prolonged-sitting

“Workplace sitting is associated with self-reported general health and back/neck pain: a cross-sectional analysis in 44,978 employees.” BMC Public Health, London, UK. May 2021. pubmed.ncbi.nlm.nih.gov/33957889/

“Active Sitting Guide: 6 Reasons To Really Consider It.” The Ergonomics Health Association. (n.d.) ergonomicshealth.com/active-sitting-guide/

“Cardiometabolic Impact of Changing Sitting, Standing, and Stepping in the Workplace.” Medicine & Science in Sports & Exercise, Indianapolis, IN. March 2018. oce.ovid.com/article/00005768-201803000-00015/HTML

“Reducing occupational sitting time and improving worker health: the Take-a-Stand Project, 2011.” Preventing Chronic Disease, Atlanta, GA. 2012.

“Office exercise: Add more activity to your day.” The Mayo Clinic, Rochester, MN. October 2019. www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/office-exercise/art-20047394

“The Tools: Put an End to Your Sedentary Lifestyle.” Ergotron, St. Paul, MN. (n.d.). www.juststand.org/the-tools/

Mini Workouts Over The Day Just As Effective

Young healthy man doing sports exercises in the living room at home

Trying to fit exercise into a busy day can be a struggle to find a 30–45-minute window. However, research has found that mini workouts and accumulated exercises over the day are as effective as one complete session. Studies show that short workout sessions take the place of one long workout by breaking up the routine into several small ones and are just as effective.

Mini Workouts Over The Day Just As Effective

Time of Exercise

According to the CDC and its Physical Activity Guidelines, adults should focus on a minimum of 150 minutes of moderate-intensity aerobic exercise or 75 minutes of vigorous-intensity aerobic exercise weekly, along with strength training at least two days per week. The workouts should focus on total-body targeting the major muscle groups. However, a long session can be broken up into several mini workouts to achieve the same benefits and achieve the same number of minutes.

Benefits of Mini Workouts

The benefits of short, multiple exercise sessions are that they provide increased flexibility in an individual’s daily schedule, allowing them to focus on their health while navigating family, work, and other obligations. Performing mini-workouts throughout the day makes it easier to stay committed to an exercise program, experience the benefits, and achieve their health goals.

Increase Brain Health and Mood

  • Shorter duration workouts save time, allow multiple forms of exercise into a single day, and improve neurological, physical, and psychological benefits.
  • Performing an exercise as short as 3–5 minutes throughout the day can benefit the brain and mood.

Lower Blood Pressure

  • A study compared the effects of short aerobic exercise sessions and continuous exercise on 24-hour ambulatory blood pressure.
  • The study found that doing three 10-minute walks during the day morning, midday, and late afternoon lowered blood pressure more than doing one 30-minute walk in prehypertensive individuals.

Easier to Exercise

  • Performing high-intensity workouts for a long time is not easy, even for seasoned athletes.
  • This is why mini workout sessions appeal to fitness fans of all levels.
  • Decreasing the time allows the individual to exercise at higher intensities.

Reduce the Stress of Working Out

  • Incorporating shorter workouts can reduce the stress or fear that individuals have towards working out.
  • When looking at fitness from this perspective, shortened workouts naturally become a part of the day that helps relieve stress.

Achieve Fitness Goals

  • Shorter workouts allow individuals with busy schedules to focus on what they can perform in controlled sessions throughout the day without feeling overwhelmed by committing to an entire workout session.
  • Mini workouts are easy to schedule, more sustainable to perform, and easier to commit to long-term.
  • They allow for more focused and intensive exercise, especially when easily distracted.

Plan Ahead and Follow Through

The recommended way to accumulate a balance of strength, cardio, and mobility exercises throughout the day is to set up a plan. Find a routine that is enjoyable and not a chore, then set up the office space, work area, home to accommodate the exercises. For cardiovascular and strengthening benefits, an example of Tabata or HIIT workout.

  • Five exercises.
  • Two minutes on each exercise with a work-rest ratio of 30 seconds on, 30 seconds off.
  • Depending on an individual’s fitness level, the work-rest ratio can be modified.
  • To improve mobility and strength, use weights or resistance bands.
  • Focus on proper form.

Try shorter workouts for a quick burst of exercise:

  • Pick two to three exercises like bicep curls, shoulder presses, bodyweight squats, calf raises, lunges, or planks.
  • Set a watch for 3 minutes.
  • Perform 30 seconds of one exercise.
  • Switch to another exercise for 30 seconds.
  • Alternate until the 3 minutes are up.

Body Composition


Bodyweight Workout 1

  • Ten bodyweight squats.
  • Ten pushups.
  • Twenty jumping jacks.
  • Twenty-second plank.
  • Ten glute bridges.
  • Twenty seconds of rest.
  • Repeat as many times as possible in 10 minutes.

Bodyweight Workout 2

  • Thirty seconds of bodyweight squats.
  • Thirty seconds of jumping jacks or high knees.
  • Thirty-second plank.
  • Thirty seconds of rest.
  • Repeat 4–5 times.

Yoga Stretching

References

How much physical activity do adults need? (2015, June 4) cdc.gov/physicalactivity/basics/adults/

Mayo Clinic Staff. (2014, October 10). Depression and anxiety: Exercise eases symptoms mayoclinic.org/diseases-conditions/depression/in-depth/depression-and-exercise/art-20046495

Mayo Clinic Staff. (2015, April 16). Exercise and stress: Get moving to manage stress mayoclinic.org/healthy-lifestyle/stress-management/in-depth/exercise-and-stress/art-20044469