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Cervical spine injuries correlated with auto injuries can lead to severe pain. Understand the risks, symptoms, and recovery strategies today. Introduction: A Pain in the Neck, Literally! Imagine this scenario: you are driving along the road, perhaps enjoying a melody, when suddenly—bam!—another vehicle collides with yours from behind. Your neck experiences a rapid motion, moving back and forth in a manner reminiscent of Gomez Addams twirling Morticia in an impassioned tango. This phenomenon, known as whiplash, is a serious condition despite its dramatic presentation. Your neck does a wild dance, snapping back and forth like Gomez Addams twirling Morticia in a passionate tango. That, my friends, is whiplash, and it’s no laughing matter despite the theatrics. Motor vehicle accidents (MVAs) are a leading cause of cervical spinal pain, turning your neck into a grumpy, stiff companion that refuses to cooperate. In this guide, we’ll break down the mystery surrounding cervical spinal pain caused by MVAs, exploring why it occurs, how it’s treated, and why El Paso’s own Dr. Alexander Jimenez is a leader in helping individuals recover. With over 30 years of experience, Dr. Jimenez is like the maestro of a chiropractic orchestra, harmonizing treatments to soothe your aching neck. We’ll also explore the importance of personal injury cases in El Paso and how Dr. Jimenez bridges the gap between medical care and legal needs. So, grab a comfy seat—careful with that neck!—and let’s dive in. References Understanding Cervical Spinal Pain from MVAs What’s Going On in Your Neck? Your cervical spine, the fancy term for the seven vertebrae (C1-C7) in your neck, is a marvel of engineering. It supports your head, lets you nod at a good joke, and keeps your spinal cord safe. However, an MVA can severely damage this delicate system. Cervical spinal pain can feel like a dull ache, a sharp stab, or even a burning sensation that radiates down your arms. Headaches, dizziness, and tingling in your hands may accompany the pain, giving you the impression that your neck is experiencing a severe episode. The Whiplash Waltz Whiplash, the epitome of motor vehicle accident injuries, is characterized by its dramatic nature. During a rear-end collision, your body gets thrust forward, but your head lags like a reluctant dance partner. Then, it snaps forward and back, putting your neck through a chaotic routine. This rapid motion causes compression, shear, and tension in the cervical spine, straining muscles, tearing ligaments, and sometimes damaging discs or nerves. It’s like your neck tried to join a gymnastics team without any training! Studies suggest that whiplash affects nearly 3 million Americans annually, with most cases stemming from auto accidents (Whiplash Injuries). The cervical spine’s natural curve, known as lordosis, can become flattened or reversed, leading to stiffness, pain, and even dizziness if blood flow to the brain is compromised. General Disclaimer * The information herein is not intended to replace a one-on-one relationship with a qualified health care professional, licensed physician, and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request. We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN* email: coach@elpasofunctionalmedicine.com Licensed in: Texas & New Mexico*
Understand how a car accident may result in thoracic outlet syndrome and get insights on managing the condition effectively. Introduction Car accidents can turn your life upside down faster than you can say “fender bender.” Beyond the crumpled bumpers and insurance headaches, they can leave you with injuries that linger like an unwelcome guest. One such injury involves the cervical spine—your neck, the unsung hero that holds up your head while you binge-watch your favorite show. When a crash jolts your neck, it can damage ligaments, leading to a cascade of problems, including a condition called Thoracic Outlet Syndrome (TOS), which can make your arms feel like they’re auditioning for a zombie movie with all that numbness and tingling. In this post, we’ll delve into the clinical perspective of these injuries, highlighting how Dr. Alexander Jimenez in El Paso helps victims recover and why documenting these injuries is crucial for both your health and any potential legal claims. What Happens to the Cervical Spine After a Car Accident? Picture your neck as a tower of Jenga blocks carefully stacked to keep everything in place. Now, imagine a car rear-ending you, sending those blocks wobbling like a bad game night. Whiplash is a rapid back-and-forth motion of the neck that occurs in approximately 1 million car accidents annually in the U.S., costing society up to $29 billion and affecting individuals’ socio-economic lifestyles. Whiplash doesn’t just give you a sore neck; it can seriously mess with the ligaments that hold your cervical spine together. The Anatomy of Your Neck The seven vertebrae in the cervical spine are cushioned by discs and held together by ligaments, which are the anterior longitudinal ligament, posterior longitudinal ligament, capsular ligaments, interspinous ligaments, supraspinous ligaments, and ligamentum flavum. These ligaments are like the seatbelts of your spine, keeping everything secure. However, in a crash, the sudden force, ranging from 3.5 to 8 g’s in a rear-end collision, can stretch or tear these ligaments, thereby reducing their strength. A study found that whiplash decreases the force required for ligament failure by approximately 20% (149.4 N vs. 186.0 N) and energy absorption by roughly 22% (308.6 J vs. 397.0 J). (Tominaga et al., 2006). This damage can lead to cervical instability, where your neck becomes as wobbly as a bobblehead on a dashboard. The Whiplash Effect Whiplash is like your neck trying to do an impromptu dance move it wasn’t prepared for. The rapid motion overstretches ligaments beyond their normal range, sometimes causing micro tears or complete ruptures. This instability can lead to chronic pain, stiffness, and even more complex issues down the road, like Thoracic Outlet Syndrome. It’s as if your neck says, “I’m done holding it together!” and passes the problem to other parts of your body. It’s like a disaster with the neck and ligaments, which is no laughing matter, as it can significantly impact your daily life, from simply turning your head to lifting your arms. Can Ligament Damage Cause Thoracic Outlet Syndrome? Now, let’s discuss Thoracic Outlet Syndrome, or TOS, which may sound like something you’d find in a haunted mansion, but it is, in fact, a medical condition. TOS happens when the nerves or blood vessels in the thoracic outlet—the narrow space between your collarbone and first rib get compressed, causing pain, numbness, or tingling in your arms and hands, making you feel like your limbs are staging a protest. But how does a neck injury from a car crash lead to this? General Disclaimer * The information herein is not intended to replace a one-on-one relationship with a qualified health care professional, licensed physician, and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request. We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN* email: coach@elpasofunctionalmedicine.com Licensed in: Texas & New Mexico*
Learn about the possible delayed symptoms auto accident victims may experience and how to address them effectively. Introduction Auto accidents, even minor ones, can have a profound impact on both the body and mind. While some injuries are immediately apparent, others may not surface until days, weeks, or months later. Recognizing these delayed symptoms, understanding their impact, and knowing how to respond can significantly improve recovery and quality of life. This article examines seven common delayed symptoms, outlines steps to take during the symptom-free period, discusses the effects on the body and daily life, and explores effective treatments, including chiropractic care. Seven Common Delayed Symptoms Delayed symptoms often arise due to the body’s initial adrenaline surge, which can mask pain, or because soft tissue injuries take time to manifest. Here are seven symptoms to watch for: - Neck Pain or Stiffness: Whiplash, a common injury resulting from rear-end collisions, can cause neck pain, stiffness, or a reduced range of motion. Symptoms can emerge days or weeks after the accident. This common injury causes sudden biphasic movements, thus leading to injuries to the bony, muscular, and ligamentous structures of the body. (Alektoroff & Papanagiotou, 2021)
- Headaches: Post-traumatic headaches, often linked to whiplash or mild traumatic brain injury, may start days later and range from tension-type to migraines. These cause the individual to have increased pain sensitivity and cervical musculoskeletal impairments. (Di Antonio et al., 2023)
- Back Pain: Strains, sprains, or herniated discs in the lower or upper back may not cause immediate discomfort but can develop as inflammation builds. Additionally, back pain is associated with impaired movement coordination, which can affect the body’s sensory function. (Delitto et al., 2012)
- Numbness or Tingling: Nerve damage or compression, such as from a pinched nerve or herniated disc; these musculoskeletal issues can lead to tingling or numbness in the arms, legs, or hands.
- Fatigue or Sleep Issues: Physical trauma or stress from the accident can disrupt sleep patterns, leading to chronic fatigue or insomnia over time.
- Cognitive or Emotional Changes: Symptoms like difficulty concentrating, memory problems, anxiety, or irritability may indicate a concussion or post-traumatic stress.
- Joint Pain or Swelling: Joint injuries, such as those to the shoulders or knees, may cause delayed swelling, stiffness, or pain due to inflammation or damage to the cartilage.
General Disclaimer * The information herein is not intended to replace a one-on-one relationship with a qualified health care professional, licensed physician, and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request. We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN* email: coach@elpasofunctionalmedicine.com Licensed in: Texas & New Mexico*
Dealing with spine and back pain from a car accident? Explore treatment options and recovery tips in our guide. Introduction When a person has experienced a car accident, especially if it is minor, they can experience physical trauma to the spine and back as well as the upper and lower extremities. The sudden forces involved in a collision can cause injuries that result in acute or chronic pain. Do you experience stiffness in your neck, shoulders, and back? Do you feel radiating pain down from your back? Or have you constantly experienced headaches that prevent you from doing your daily tasks? Today, we will look at and understand the causes of spine and back pain, recognize the symptoms, and explore how effective treatments like chiropractic care can help individuals recover and regain their quality of life. Spine & Back Pain Causes After a Car Accident The spine and back are vulnerable during a car accident due to the rapid acceleration, deceleration, and twisting motions that occur. Common causes of pain include: - Whiplash and Soft Tissue Injuries: A person in a rear-end collision will experience a common injury known as whiplash. This musculoskeletal injury occurs when the head and neck are forcefully jerked forward and backward. (Stroke, 2023) This can strain or tear muscle tissue structures in the neck and upper back, leading to the development of pain and stiffness throughout the body.
- Herniated Discs: The impact of a car collision can cause the spinal segments to compress or displace the intervertebral discs, causing them to bulge or rupture. This may irritate nearby nerves, compressing them, resulting in back pain-associated numbness or weakness within the upper and lower extremities. (Ge et al., 2019)
- Spinal Misalignment: The sudden jolts and movements the body experiences after a car collision can misalign the spinal vertebrae, disrupting the spine’s natural curvature. This can lead to numerous pain-like symptoms, such as muscle spasms, restricted movement, and pain.
- Fractures or Dislocations: In severe accidents, the spinal vertebrae may fracture or dislocate, causing intense pain and potential nerve damage. These injuries can negatively influence an individual’s social and financial situation when being treated. (Fakharian et al., 2017)
- Facet Joint Injuries: The facet joints, which connect the vertebrae, can become sprained or damaged during a collision, leading to pain.
Symptoms of Spine & Back Pain Depending on the collision’s severity, the spine and back can develop symptoms depending on the type of injury the person is experiencing. Common signs include: - Localized or Radiating Pain
- Stiffness
- Muscle Spasms
- Numbness or Tingling
- Headaches
- Fatigue or Weakness
Delayed onset of symptoms is common, with pain or discomfort appearing hours or days after the accident. Seeking prompt medical evaluation is critical to prevent complications. General Disclaimer * The information herein is not intended to replace a one-on-one relationship with a qualified health care professional, licensed physician, and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request. We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN* email: coach@elpasofunctionalmedicine.com Licensed in: Texas & New Mexico*
Can bone growth stimulators help promote bone healing in cases where fractures or fusions fail to heal properly? Bone Growth Stimulator Individuals who sustain broken bones typically heal the fracture with appropriate treatment, which may include casts, realignment, and surgery. This type of surgery is performed on the spine and joints throughout the body; typically, the bone heals without a problem. Bone healing is a natural process, as bones are constantly replaced with new ones, and after an injury, the body can heal the damage to the bone. However, bone healing sometimes does not happen correctly and/or completely. Bone healing can take a long time, which is known as a delayed union, or it may not occur at all, or a nonunion. This is when a healthcare provider could recommend bone growth stimulation. How They Work Bone growth stimulators apply external or implanted electrical or ultrasonic energy to the fracture or fusion site, stimulating bone growth. These devices are often used when a fracture doesn't heal within the expected timeframe (a nonunion fracture) or when a spinal fusion has not successfully fused. (FDA, 2022) - They come in various shapes, sizes, and technologies depending on the location of the fracture.
- The most commonly used bone stimulators in orthopedics are electrical and ultrasound stimulators.
- The stimulator emits a pulsed electromagnetic or ultrasonic impulse to the area where bone healing should occur.
- Most modern bone stimulators are attached near the fracture site or fused with a small battery pack and worn for a period each day that may last minutes or hours.
Electrical Stimulation - Devices deliver low-level electrical pulses to the fracture site, which can stimulate bone cells to create new bone tissue.
Ultrasound Stimulation - They emit low-intensity pulsed ultrasound waves, which are absorbed by the bone and can promote bone healing.
Implantable vs. External - Some stimulators are surgically implanted, providing constant stimulation directly at the fracture site, while others are external and worn over the skin or cast.
The goal is to activate a series of receptors in the body to encourage a healing response. (Childs, S. G. 2003) The stimulator activates a pathway that releases chemicals within the body to promote fracture healing. This type of process in the body is called a cascade, and it happens when one signal stimulates another method, and so on until healing is complete. The bone stimulator ensures this cascade continues until the healing process is complete. Effectiveness Studies of bone stimulator effectiveness suggest two benefits: - Less pain is associated with the bone healing process.
- Faster fracture healing.
However, these studies haven't shown that these differences lead to improved patient functional outcomes. It would seem that if there is less pain and faster healing, then the patient should recover without complications. However, some researchers have suggested this is probably because the differences in pain and healing times are small and not necessarily noticeable. (Aleem, I. S. et al., 2016) - While bone growth stimulators can be effective, the results can vary, and their effectiveness is still under investigation.
- Some studies have shown that stimulators can reduce pain and speed up healing time, while others have shown mixed results.
- It's important to discuss the benefits and risks of bone growth stimulation with a doctor to determine if it's the right treatment option.
When Stimulation is Necessary Bone stimulators are currently not used for routine fracture healing. It is certainly possible that bone healing stimulators will be used routinely in the future. They seem to show some benefit in non-healing fractures or fractures that are likely troublesome to heal. Some reasons individuals may have problems healing fractures are injuries to the blood supply to and around the fracture, injuries to specific bones, and overuse-related fractures. (Victoria, G. et al., 2009) These injuries may include (FDA, 2022) Nonunion Fractures - When a fracture doesn't heal within the expected timeframe.
- Open fractures
- Stress fractures
- Scaphoid bone fractures
- Talus fractures
Failed Fusions - When a spinal fusion hasn't been successful.
High-Risk Patients - For individuals with factors that can hinder bone healing, such as smoking, diabetes, or certain medications
Bone healing typically proceeds without much problem. However, there are situations where people have issues healing after fractures or surgery. Bone stimulators are not used for routine bone healing but in situations where steps may be needed to help stimulate the body. While the improvement may be small, it may be critical if it is the difference between healing and nonhealing. Injury Medical Chiropractic and Functional Medicine Clinic As a Family Practice Nurse Practitioner, Dr. Jimenez combines advanced medical expertise with chiropractic care to address various conditions. Our clinic integrates Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine to create customized care plans that promote natural healing, mobility, and long-term wellness. By focusing on flexibility, agility, and strength, we empower patients to thrive, regardless of age or health challenges. At El Paso’s Chiropractic Rehabilitation Clinic & Integrated Medicine Center, we passionately focus on treating patients after injuries and chronic pain syndromes. We focus on improving your ability through flexibility, mobility, and agility programs tailored for all age groups and disabilities. We use in-person and virtual health coaching and comprehensive care plans to ensure every patient’s personalized care and wellness outcomes. General Disclaimer * The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, and physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice. Our office has reasonably attempted to provide supportive citations and identified the relevant research studies or studies supporting our posts. We provide copies of supporting research studies that are available to regulatory boards and the public upon request. We understand that we cover matters that require an additional explanation of how they may assist in a particular care plan or treatment protocol. To discuss the subject matter above further, please contact Dr. Alex Jimenez or us at 915-50-0900. Dr. Alex Jimenez, DC, MSACP, CCST, IFMCP*, CIFM*, ATN* Email: coach@elpasofunctionalmedicine.com Licensed in: Texas & New Mexico* References U.S. Food & Drug Administration. (2022). AccelStim Bone Growth Stimulator – P210035. Retrieved from https://www.fda.gov/medical-devices/recently-approved-devices/accelstim-bone-growth-stimulator-p210035#:~:text=What%20is%20it?,the%20transducer%20to%20the%20fracture Childs, S. G. (2003). Stimulators of bone healing. Biologic and biomechanical. Orthopedic nursing, 22(6), 421–428. https://doi.org/10.1097/00006416-200311000-00010 Aleem, I. S., Aleem, I., Evaniew, N., Busse, J. W., Yaszemski, M., Agarwal, A., Einhorn, T., & Bhandari, M. (2016). Efficacy of Electrical Stimulators for Bone Healing: A Meta-Analysis of Randomized Sham-Controlled Trials. Scientific Reports, 6, 31724. https://doi.org/10.1038/srep31724 Victoria, G., Petrisor, B., Drew, B., & Dick, D. (2009). Bone stimulation for fracture healing: What's all the fuss?. Indian Journal of Orthopaedics, 43(2), 117–120. https://doi.org/10.4103/0019-5413.50844
What are the recommendations for a pulled muscle injury to fully recover? Pulled Muscle Recovery Time A pulled muscle, medically known as a strain, occurs when muscle fibers are stretched too far and sometimes tear. A pulled muscle injury typically starts to heal within days. Mild injuries can heal completely in one to three weeks, but more serious strains or tears, depending on the severity, can take six to 12 weeks or longer. (Fernandes T. L., Pedrinelli A., & Hernandez A. J. 2015) Rest, hydration, healthy foods, and slowly returning to activity can help expedite healing time. Timeline The timeline for recovering from a pulled muscle depends on the injury's severity. Pulled muscles are typically categorized into three grades based on the degree and size of pulled muscle fibers, as follows (Hospital for Special Surgery, 2024) Grade 1 (mild) - Heals in a few days.
- A microscopic tear or stretch in the muscle fiber.
- It might feel sore, but you can still use the muscle.
Grade 2 (moderate) - Heals in four to six weeks.
- A partial tear in the muscle causes noticeable pain and swelling, making it harder to move or use the injured muscle.
Grade 3 (severe) - Heals in several months
- This type of muscle strain causes a complete tear, also known as a rupture.
- It results in intense pain, significant swelling, and inability to use the muscle.
- Surgery may be required in some cases.
- Larger muscles, such as the hamstrings and quadriceps, may take longer to heal than smaller muscles due to their increased size and greater weight-bearing loads.
Body Parts More Susceptible To Injury The following are more susceptible to muscle strains, pulls, or tears (Nölle L. V. et al., 2022) - Neck - levator scapulae and trapezius
- Shoulders - rotator cuff muscles
- Lower back - erector spinae
- Groin - adductors
- Front of the thigh - quadriceps
- Behind the thigh - hamstrings
- Calves - gastrocnemius and soleus
Healing Stages and Factors Pulled muscles heal in three predictable stages, though the timing and progression may vary by individual and injury severity (Baoge L. et al., 2012). Inflammatory Stage (zero to three days) - When pulling a muscle, the body reacts instantly with an inflammatory response that may include swelling, redness, bruising, and pain.
- Rest is important during this stage to prevent the injury from getting worse.
Repair Stage (three to 21 days) - Damaged muscle fibers are repaired and regrow during this stage.
- Collagen fills in any tears to rebuild damaged muscle tissue.
- Gentle movement and easy activity can help the fibers line up properly and reduce stiffness.
- Start slowly moving a pulled muscle as soon as possible, but avoid too much activity too soon, as it can delay and prolong healing.
Remodeling Stage (three weeks to one year) - Repaired tissue gets stronger and adapts to regular movement.
- Scar tissue may form.
- Gradually adding more activity, stretching, and strengthening exercises helps treat a pulled muscle and return to full strength and function but should be done carefully to avoid re-injury.
Faster Healing To help speed up recovery from a pulled muscle, try these simple strategies: (Baoge L. et al., 2012) (Laumonier T. & Menetrey J. 2016) Rest - Avoid activities that cause pain, but move the muscle gently to prevent stiffness.
- Prolonged rest can slow healing, so maintain a balance between rest and exercise.
Ice - Add ice for 10–20 minutes for the first 48 hours to reduce swelling and pain.
- Ice helps control inflammation by limiting blood flow to the injured area.
Compression - Use compression stockings or wrap the injured part in bandages to help reduce swelling.
- Ensure the binding is not too tight so circulation is not cut off.
Elevation - Raise the injured area above heart level throughout the day.
- This helps reduce swelling by allowing fluids to drain away from the injury site.
Heat - After the first two to three days, heat therapy increases blood circulation and improves flexibility, helping the muscle heal.
Eat Healthy - Get enough protein for muscle repair.
Maintain Hydration - Drink plenty of water to help with circulation and muscle lubrication.
Massage and Physical Therapy - These hands-on interventions can improve circulation, help reduce scar tissue, and restore range of motion.
Over-the-counter Medications - If needed, over-the-counter nonsteroidal anti-inflammatory medications like Advil or Motrin (ibuprofen) and Aleve (naproxen sodium) can help with pain and swelling.
- Only use as directed.
These steps can help promote faster healing and expedite returning to normal daily activities. When to Resume Normal Activity Individuals may need one to two weeks to recover before resuming normal activity for mild strains. However, for more severe injuries, it could take four to six weeks or longer to return to all daily activities. (Harvard Health Publishing, 2023) It's essential to gradually return to daily activities to avoid reinjury, which can delay and prolong healing. Follow these recommendations to recover from a pulled muscle safely and quickly (Kraemer W., Denegar C., & Flanagan S. 2009) - Once the pain has subsided, the swelling has decreased, and the muscle feels better, start with low-impact exercises.
- Slowly resume normal activities, avoiding overexerting the injured area.
- Gradually increase activity levels and stop if there is any pain.
- Avoid strenuous activities that place excessive stress on the injured muscle until the muscle is completely healed.
Contact a Healthcare Provider While most pulled muscles heal with home care, seek medical attention if: (Penn Medicine, 2023) - Pain persists or worsens after seven to 10 days.
- This can indicate a more serious injury, such as a severe torn muscle.
- Significant pain, loss of motion and strength, and swelling disrupt daily activities or show signs of worsening despite rest and self-care.
- It is difficult to move the affected area, or the muscle cannot bear weight, suggesting a more severe injury.
- There are signs of infection, including redness, warmth, increased swelling, or fever, especially if the skin is cut or broken near the injured area.
- There is unusual bruising or a visible deformity, which could indicate a bone fracture requiring professional evaluation.
A healthcare provider may recommend imaging studies, such as MRI, ultrasound, or X-rays, to assess the extent of the injury, rule out fractures, or check for muscle tears. Injury Medical Chiropractic & Functional Medicine Clinic Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues. General Disclaimer * The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice. Our office has reasonably attempted to provide supportive citations and identified the relevant research studies or studies supporting our posts. We provide copies of supporting research studies that are available to regulatory boards and the public upon request. We understand that we cover matters that require an additional explanation of how they may assist in a particular care plan or treatment protocol. To discuss the subject matter above further, please contact Dr. Alex Jimenez or us at 915-50-0900. Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN* email: coach@elpasofunctionalmedicine.com Licensed in: Texas & New Mexico* References Fernandes, T. L., Pedrinelli, A., & Hernandez, A. J. (2015). MUSCLE INJURY - PHYSIOPATHOLOGY, DIAGNOSIS, TREATMENT, AND CLINICAL PRESENTATION. Revista brasileira de ortopedia, 46(3), 247–255. https://doi.org/10.1016/S2255-4971(15)30190-7 Hospital for Special Surgery. J. N. R., MD. (2024). Muscle Strain: Causes, Symptoms, Treatment. https://www.hss.edu/conditions_muscle-strain.asp Nölle, L. V., Mishra, A., Martynenko, O. V., & Schmitt, S. (2022). Evaluation of muscle strain injury severity in active human body models. Journal of the mechanical behavior of biomedical materials, 135, 105463. https://doi.org/10.1016/j.jmbbm.2022.105463 Baoge, L., Van Den Steen, E., Rimbaut, S., Philips, N., Witvrouw, E., Almqvist, K. F., Vanderstraeten, G., & Vanden Bossche, L. C. (2012). Treatment of skeletal muscle injury: a review. ISRN orthopedics, 2012, 689012. https://doi.org/10.5402/2012/689012 Laumonier, T., & Menetrey, J. (2016). Muscle injuries and strategies for improving their repair. Journal of Experimental Orthopaedics, 3(1), 15. https://doi.org/10.1186/s40634-016-0051-7 Harvard Health Publishing. (2023). Muscle strain. https://www.health.harvard.edu/staying-healthy/muscle-strain-a-to-z Kraemer, W., Denegar, C., & Flanagan, S. (2009). Recovery from injury in sport: considerations in the transition from medical care to performance care. Sports Health, 1(5), 392–395. https://doi.org/10.1177/1941738109343156 Penn Medicine. (2023). Strains. https://www.pennmedicine.org/for-patients-and-visitors/patient-information/conditions-treated-a-to-z/strains
Individuals who have fractured their scaphoid bone may experience pain and swelling in the wrist just below the thumb. Can immobilization with a cast and physical therapy help? Scaphoid Fracture A scaphoid fracture is a break in one of the wrist's small or carpal bones. This type of fracture occurs most often after a fall onto an outstretched hand. Symptoms typically include swelling and pain in the wrist just below the base of the thumb. These fractures can be difficult to diagnose since they don't always appear on an X-ray. If the X-ray is negative and the healthcare provider suspects a scaphoid fracture, an MRI may be necessary. Surgery may be required in more severe cases or when the injury is not healing correctly. (American Academy of Orthopaedic Surgeons, 2023) A Break In The - Navicular Bone The scaphoid is one of eight carpal bones in the wrist. It is located just below the thumb's base and is shaped like a kidney bean. This bone can be identified by holding a thumbs-up position and feeling for the hollow between the two tendons below your thumb. The scaphoid is located at the base of the hollow. A break in the scaphoid bone most commonly occurs in the middle of the bone but can also happen at either end. A scaphoid fracture can be displaced or non-displaced (American Academy of Orthopaedic Surgeons, 2023) Displaced Fracture - It is when the bone fragments have moved out of alignment.
Non-displaced Fracture - It is when the fragments are still in their normal location in the hand.
The scaphoid’s blood supply comes from a small vessel that enters the most distant part of the bone and flows back through the bone. Because of this one small blood supply, a fracture in the center can stop the circulation to the proximal portion of the bone. Because of this, scaphoid fractures need immediate diagnosis and treatment. Symptoms Pain or deep aching on the thumb-side of the wrist, typically after a fall on an outstretched arm, could be a scaphoid fracture. Other symptoms experienced include: (American Academy of Orthopaedic Surgeons, 2023) - Tenderness at the base of the hollow area.
- Pain at the base of the hollow area.
- Swelling in the wrist
- Difficulty gripping objects
Pain can become worse from: (American Academy of Orthopaedic Surgeons, 2023) - Grasping
- Pulling
- Pushing
- Pinching
Diagnosis A healthcare provider will evaluate the hand for tenderness and pain in the hollow and/or the bone. If a break is suspected, they will order an X-ray. (Clementson M., Björkman A., & Thomsen N. O. B. 2020) Many patients are diagnosed with a wrist sprain when they have a fracture. Diagnosis can be difficult because the fracture often doesn’t appear on X-rays until weeks after the healing process starts. Physicians commonly treat a wrist injury as a scaphoid fracture initially and then repeat X-rays within two weeks. (American Academy of Orthopaedic Surgeons, 2023) If the injury doesn't show on an X-ray, the provider may order an MRI, as these fractures can be easier to see on an MRI. An MRI can help ensure appropriate treatment immediately. (Wong S. B. S., & Peh W. C. G. 2019) Treatment If a wrist fracture is diagnosed, the wrist will be immobilized in a cast. However, a healthcare provider may also put the wrist in a cast if the X-ray is negative but they suspect a fracture. This will stabilize the injury until an MRI can be performed. With immobilization and follow-up treatment, scaphoid fractures often heal without surgery. Repeat X-rays are taken over several weeks or months so the provider can make sure the injury is healing correctly. If it is not healing correctly, surgery may be recommended. (Clementson M., Björkman A., & Thomsen N. O. B. 2020) If the fracture is displaced, healing correctly may be a challenge. In this case, a physician may recommend initial surgery to reposition the bones. (Clementson M., Björkman A., & Thomsen N. O. B. 2020) This type of surgery involves pinning the bone in place with screws. Healing Time Recovery With the wrist in a cast, individuals will be instructed on activities to avoid placing even a small amount of strain (American Academy of Orthopaedic Surgeons, 2023) - Lifting
- Pushing
- Pulling objects that weigh more than one pound.
- Sports activities
- Throwing
- Climbing
- Using tools or machinery that vibrate.
Rehabilitation is an important part of healing because immobilization takes a long time. Wrist range-of-motion exercises can be started, followed by strengthening exercises for the wrist flexors and extensors. Supination, pronation, and grip exercises are also part of physical therapy. Complications Scaphoid fractures can lead to serious complications, especially when not properly treated. These include: (American Academy of Orthopaedic Surgeons, 2023) (Almigdad A. et al., 2024) Nonunion - This describes a fracture that fails to heal.
Carpal Collapse - This is a form of degenerative arthritis.
Osteoarthritis - This condition causes degeneration of the cartilage in the joint.
Avascular Necrosis - This is when the blood supply to the bone is reduced or cut off, causing the bone to die.
Injury Medical Chiropractic and Functional Medicine Clinic Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and mitigate issues through adjustments that help the body realign itself. The clinic can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems. General Disclaimer * The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research studies or studies supporting our posts. We provide copies of supporting research studies that are available to regulatory boards and the public upon request. We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please contact Dr. Alex Jimenez or contact us at 915-850-0900. Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN* email: coach@elpasofunctionalmedicine.com Licensed in: Texas & New Mexico* References American Academy of Orthopaedic Surgeons. (2023). Scaphoid fracture of the wrist. https://orthoinfo.aaos.org/en/diseases--conditions/scaphoid-fracture-of-the-wrist Clementson, M., Björkman, A., & Thomsen, N. O. B. (2020). Acute scaphoid fractures: guidelines for diagnosis and treatment. EFORT open reviews, 5(2), 96–103. https://doi.org/10.1302/2058-5241.5.190025 Wong, S. B. S., & Peh, W. C. G. (2019). The role of magnetic resonance imaging in the evaluation of scaphoid fractures. Journal of Medical Radiation Sciences, 66(1), 3–4. https://doi.org/10.1002/jmrs.316 Almigdad, A., Al-Zoubi, A., Mustafa, A., Al-Qasaimeh, M., Azzam, E., Mestarihi, S., Khair, Y., & Almanasier, G. (2024). A review of scaphoid fracture, treatment outcomes, and consequences. International orthopaedics, 48(2), 529–536. https://doi.org/10.1007/s00264-023-06014-2
Can knowing about wrist sprains—their types, symptoms, causes, and diagnoses—help develop an effective treatment program? Wrist Sprain Wrist sprains are injuries that affect ligaments that attach bone to bone. They occur after a fall from work overuse, house tasks, during sports activities, or with other direct trauma. Symptoms of a wrist sprain include: - Pain
- Swelling
- Bruising
- Decreased range of motion
- Weakness
- Tingling
The injury affects the ligaments and soft tissue structures connecting bone to bone. Mild wrist sprains typically heal within a few weeks; most heal without complications in six to 12 weeks. (National Health Service, 2020) However, severe injuries can require surgery, physical therapy, and months to recover fully. Grades and Types The three grades of sprains are graded by the severity of the injury (American Academy of Orthopaedic Surgeons, 2024) Grade 1 - Ligaments are stretched; this is considered a mild sprain.
- The injury may heal in one to three weeks with standard care. (Mass General Brigham, 2025)
Grade 2 - Ligaments are partially torn; this is considered a moderate sprain.
- It may need a brace; healing can take three to six weeks. (Mass General Brigham, 2025)
Grade 3 - Ligaments are torn completely or have pulled away from the bone.
- Sometimes, a piece of bone comes off with it, a condition called an avulsion fracture.
- This is considered a severe sprain. It can take months to heal completely. (Mass General Brigham, 2025)
The wrist is made up of three joints (American Society for Surgery of the Hand, 2017) Distal radioulnar - This joint is between the two forearm bones.
- The radius on the thumb side.
- The ulna on the pinky side.
Radiocarpal - This joint is between the radius and three small bones in the base of the hand.
- The scaphoid
- The triquetrum
- The lunate
Ulnocarpal - This joint is between the ulna and the articular disc and cushions it from the carpal bones, the lunate, and the triquetrum.
Wrist sprains can affect any of these joints but more commonly affect the ligament between the scaphoid and lunate bone or the triangular fibrocartilage complex/TFCC on the pinky side of the wrist. Symptoms The primary symptom of a wrist sprain is pain, especially when moving or touching the injured area. Other symptoms can include: (National Library of Medicine, 2021) (American Academy of Orthopaedic Surgeons, 2024) - Decreased range of motion
- Swelling
- Bruising
- Feeling instability in the wrist
- Weakness
- Numbness/tingling
- Popping sensation
- Warm skin
Causes The common cause of wrist sprain is falling on an outstretched hand. (American Academy of Orthopaedic Surgeons, 2024) Other common causes include: - Repetitive overuse work injuries.
- Housework and tasks.
- Sports include skateboarding, gymnastics, basketball, snowboarding, hockey, and contact sports.
Diagnosis A healthcare provider will diagnose a wrist sprain based on symptoms and injury causes. X-rays are the first imaging to rule out fractures. Other tests can include: - Magnetic resonance imaging - MRI
- Computed tomography - CT scan
- Arthrogram -X-rays with contrast dye
Treatment Nonsteroidal anti-inflammatory drugs, such as Aleve, Advil, Motrin, and aspirin, can treat pain and inflammation. The severity of the wrist sprain determines whether additional treatment is needed. Sprains should initially be treated with the RICE protocol (American Academy of Orthopaedic Surgeons, 2024) Rest - Minimize using the injured wrist for at least two days.
- Wear a splint for support.
- Avoid sudden movements.
- Avoid placing too much pressure on the wrist.
Ice - Cold packs are recommended several times daily for 20 minutes to decrease pain and swelling.
Compression - Wrap the wrist with an elastic bandage or Kinesio tape to help reduce swelling.
Elevation - To decrease swelling, use pillows to elevate the wrist as much as possible above the level of your heart.
- Grade 1 sprains usually heal with basic care within a week or two.
- Grade 2 sprains often require wearing a brace for an extended period while the ligament heals, which can take up to six weeks. (American Society for Surgery of the Hand, 2018)
- The removable brace or splint should be worn when using the arm.
- It can be taken off at rest at night and when bathing. (National Health Service, 2020)
- Individuals may need the brace for a week or more.
A healthcare provider may also recommend stretching exercises to overcome stiffness and regain mobility. (American Academy of Orthopaedic Surgeons, 2024) Physical therapy, occupational therapy, or treatment by a certified hand therapist can also reduce pain and improve range of motion and strength. Treatment for grade 3 sprains often requires surgery. Grade 3 sprains, including avulsion fractures, often require a six-week cast for bones to heal. In some cases, the bones might also need a screw or temporary wires to hold them in the proper position. (Vannabouathong, C. et al., 2018) Severe wrist sprains may also require surgery to repair the injured ligament. If the original ligament cannot be repaired, a piece of the tendon can be used to reconstruct it. (American Society for Surgery of the Hand, 2020) Healing Time Mild to moderate sprains usually recover within a few weeks without long-term complications. (American Society for Surgery of the Hand, 2018) The prognosis for severe wrist sprains improves with early diagnosis and treatment. After surgery, ligaments usually heal within eight to 12 weeks but can take six to 12 months for function to return to normal. (American Academy of Orthopaedic Surgeons, 2024) Injury Medical Chiropractic and Functional Medicine Clinic Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems. General Disclaimer * The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research studies or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request. We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please contact Dr. Alex Jimenez or contact us at 915-850-0900. Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN* email: coach@elpasofunctionalmedicine.com Licensed in: Texas & New Mexico* References National Health Service. (2020). Advice after spraining your wrist. https://www.ruh.nhs.uk/patients/patient_information/ORT_057_Advice_after_a_wrist_sprain.pdf American Academy of Orthopaedic Surgeons. (2024). Wrist sprains. https://orthoinfo.aaos.org/en/diseases--conditions/wrist-sprains Mass General Brigham. (2025). Wrist sprains. https://www.massgeneralbrigham.org/en/patient-care/services-and-specialties/sports-medicine/conditions/hand-arm/wrist-sprain American Society for Surgery of the Hand. (2017). Anatomy 101: Wrist joints. https://www.assh.org/handcare/blog/anatomy-101-wrist-joints National Library of Medicine. (2021). Wrist injuries and disorders. Retrieved from https://medlineplus.gov/wristinjuriesanddisorders.html American Society for Surgery of the Hand. (2018). Sprained wrist. https://www.assh.org/handcare/condition/sprained-wrist Vannabouathong, C., Ayeni, O. R., & Bhandari, M. (2018). A Narrative Review on Avulsion Fractures of the Upper and Lower Limbs. Clinical medicine insights. Arthritis and musculoskeletal disorders, 11, 1179544118809050. https://doi.org/10.1177/1179544118809050 American Society for Surgery of the Hand. (2020). Scapholunate torn ligament. https://www.assh.org/handcare/condition/scapholunate-torn-ligament
Experiencing a whiplash injury can be disorienting and painful. Can recognizing the signs of more serious complications, seeking timely medical intervention, and following a structured whiplash rehabilitation plan help individuals find relief and restore function and quality of life? Whiplash Rehabilitation For individuals who have recently been in an automobile accident, once the initial neck pain and stiffness have passed, it's crucial to recognize potential delayed symptoms, such as nerve damage. While many recover quickly, some may experience prolonged symptoms requiring more aggressive treatment and management. Neck Injury Whiplash injuries result from sudden, forceful whipping back and forth of the head, commonly occurring in rear-end vehicle collisions, and are one of the most common neck injuries. Other potential causes include: (Johns Hopkins Medicine, 2024) Symptoms can include: (Johns Hopkins Medicine, 2024) - Pain that radiates to the shoulders and/or upper back
- Neck stiffness
- Headaches
Mobility, Flexibility, and Sensations The symptoms of a neck injury can vary in severity but commonly include: (Johns Hopkins Medicine, 2024) (American Academy of Physical Medicine and Rehabilitation, 2024) (Medline Plus, 2024) - Neck pain and stiffness are often the most noticeable symptoms and can take several hours to appear and worsen the following day.
- Decreased range of motion
- Difficulty turning or tilting the head
- Tenderness, pain, or stiffness in the shoulders, upper back, or arms - sometimes accompanied by numbness or tingling.
- Having no energy
- Fatigue
- Headaches
- Tiredness and irritability
- Dizziness
- Blurred vision
- Unusual sensations around the face
- Difficulty concentrating or remembering things
Individuals may not feel any symptoms directly following an accident, as it can sometimes take several hours or weeks to develop. (Medline Plus, 2024) Immediate Medical Attention Seek immediate medical attention from a healthcare provider or the emergency clinic for any of the following symptoms (NHS, 2023) - Injured neck and are experiencing severe pain that isn't relieved by over-the-counter medication.
- Feeling pins and needles or tingling in one or both sides of the body.
- Have difficulty walking or sitting upright.
- Experience a sudden shock sensation in the back or neck, extending into the arms and legs.
- Arms or legs feel weak, as these symptoms may indicate nerve damage in the neck or back.
Temporary Pain Relief Temporary treatment often involves medications to reduce pain, inflammation, and muscle spasms and include. (University of Rochester Medical Center, 2024) - Non-steroidal anti-inflammatory Drugs
- Muscle relaxants
- Topical gels
- Injections
- Anticonvulsants for individuals experiencing nerve-related pain or tingling sensations. (Medline Plus, 2020)
Other treatments may include: (University of Rochester Medical Center, 2024) - Ice usually for the first 24 hours
- Neck brace
- Physical therapy
- Gentle neck exercises
Following a healthcare provider's recommendations regarding medication use, including dosage and duration, is critical to managing symptoms while effectively minimizing potential side effects. Rehabilitation Steps To determine the appropriate treatment whiplash rehabilitation plan, a healthcare provider will assess how much the pain affects daily life, including mental health and the ability to do regular activities (American Academy of Physical Medicine and Rehabilitation, 2024). X-rays or other imaging tests will be done to determine how serious the damage to the neck or spine is. Resting and icing the injured area are recommended to relieve inflammation. A provider may recommend slowly increasing neck movements several times daily and continuing with normal daily activities, as exercise will help maintain flexibility. Not moving the neck may prolong pain, stiffness, and healing. Physical therapy may be recommended if symptoms continue for over one or two weeks. (American Academy of Physical Medicine and Rehabilitation, 2024) How Soon Until Pain and Symptoms Resolve Whiplash rehabilitation healing and restoration of function depend on the severity of the injury. Many recover quickly; however, in extreme cases, pain and other symptoms can last 12 months or longer. (American Academy of Physical Medicine and Rehabilitation, 2024) It is recommended to see a provider if: (Johns Hopkins Medicine, 2024) - Pain worsens
- Symptoms last longer than the healthcare provider estimated
- Other symptoms develop, like weakness, numbness, or a sensation of pins and needles.
Long-Term Injury Side Effects Individuals in whiplash rehabilitation usually recover in a few weeks to months, but some may have longer-lasting pain as the injury can cause nerve damage. (Fundaun J. et al., 2022) Discuss any new or worsening symptoms with a healthcare provider for guidance. (Johns Hopkins Medicine, 2024) Chronic Neck and Back Pain Management Treatments for chronic neck and back pain include: (National Institute of Arthritis and Musculoskeletal and Skin Diseases, 2023) - Physical therapy to help strengthen muscles.
- Acupuncture.
- Non-surgical decompression.
- Over-the-counter pain relievers, such as acetaminophen or NSAIDs.
- Muscle relaxants for tightness and tension.
- Prescription pain medications.
If pain becomes chronic, antidepressants such as serotonin and norepinephrine reuptake inhibitors may be prescribed. These medications can help manage pain and improve sleep quality. (Ferreira G. E. et al., 2023) For severe inflammation and pain, corticosteroid injections directly into the affected area can provide relief. Healthcare providers administer these injections, offering long-lasting effects. (Harvard Health Publishing, 2015) Injury Medical Chiropractic and Functional Medicine Clinic Navigating a whiplash injury can be challenging, but understanding the whiplash rehabilitation process can significantly aid in recovery. A healthcare provider can determine the most effective treatment strategies. It is important to talk with a healthcare provider to determine the cause and extent of the injury to provide individualized patient education regarding treatment. This can include physical therapy, rest, health coaching, medication, and surgery, which may be recommended in certain cases. Overcoming these limitations is possible. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues. General Disclaimer * The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research studies or studies supporting our posts. We provide copies of supporting research studies that are available to regulatory boards and the public upon request. We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, don't hesitate to contact Dr. Alex Jimenez or contact us at 915-850-0900. Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN* email: coach@elpasofunctionalmedicine.com Licensed in: Texas & New Mexico* References Johns Hopkins Medicine. (2024). Whiplash Injury. https://www.hopkinsmedicine.org/health/conditions-and-diseases/whiplash-injury American Academy of Physical Medicine and Rehabilitation. (2024). Cervical whiplash. https://www.aapmr.org/about-physiatry/conditions-treatments/musculoskeletal-medicine/cervical-whiplash Rush University Medical Center. (2014). 5 facts about whiplash. https://www.rush.edu/news/5-facts-about-whiplash National Library of Medicine. MedlinePlus. (2024). Whiplash. Retrieved from https://medlineplus.gov/ency/imagepages/9853.htm National Health Service NHS. (2023). Whiplash. https://www.nhs.uk/conditions/whiplash/ University of Rochester Medical Center. (2024). Whiplash injury. https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=85&contentid=p01388 National Library of Medicine. MedlinePlus. (2020). Pregabalin. Retrieved from https://medlineplus.gov/druginfo/meds/a605045.html Fundaun, J., Kolski, M., Baskozos, G., Dilley, A., Sterling, M., & Schmid, A. B. (2022). Nerve pathology and neuropathic pain after whiplash injury: a systematic review and meta-analysis. Pain, 163(7), e789–e811. https://doi.org/10.1097/j.pain.0000000000002509 National Institute of Arthritis and Musculoskeletal and Skin Diseases. (2023). Back pain: diagnosis, treatment, and steps to take. Retrieved from https://www.niams.nih.gov/health-topics/back-pain/diagnosis-treatment-and-steps-to-take Ferreira, G. E., Abdel-Shaheed, C., Underwood, M., Finnerup, N. B., Day, R. O., McLachlan, A., Eldabe, S., Zadro, J. R., & Maher, C. G. (2023). Efficacy, safety, and tolerability of antidepressants for pain in adults: overview of systematic reviews. BMJ (Clinical research ed.), 380, e072415. https://doi.org/10.1136/bmj-2022-072415 Harvard Health Publishing. (2015). New recommendations aim to improve safety of pain-relieving spinal steroid injections. Harvard Health Publishing Harvard Medical School. https://www.health.harvard.edu/blog/new-recommendations-aim-to-improve-safety-of-pain-relieving-spinal-steroid-injections-201505077991
Incorrect manual handling and lifting is a leading cause of workplace injuries. Can health and safety training help reduce injuries and lost workdays? Correct Manual Lifting Technique Manually lifting objects using incorrect techniques can lead to acute back injuries, herniated discs, sciatica, and long-term issues like increased risk of reinjury, body misalignment, and chronic back pain. Individuals can prevent spinal disc compression and/or lower back muscle strain by learning to use correct manual lifting techniques. (CDC. The National Institute for Occupational Safety and Health (NIOSH). 2007) Lifting Guide Individuals can protect their backs and prevent injury by following simple steps when lifting objects. Support Base - Ensure there is a healthy support base from which to lift.
- Keep feet shoulder-width apart with one foot slightly in front of the other.
Ask For Help - If coworkers or colleagues are available, ask for assistance.
- If the load is too heavy, ask for help lifting and moving the object/s.
Use Mechanical Assistant Devices - Use hand trucks, dollies, or pushcarts whenever possible for uneven and heavy loads.
Squat To Lift Object - Bend at the hips and knees only, not the back.
- Put one knee on the ground to ensure stability before lifting.
Check Posture - Looking straight ahead, maintain posture upright with the chest out, shoulders back, and lower back slightly arched.
Lift Slowly - Lift with the knees and hips only, gradually straightening the lower back.
Load Positioning - Once upright, hold the load close to the body around the stomach.
Move and Maintain Alertness - Always take small steps.
- Maintain alertness as to where you are going.
- Keep the shoulders square with the hips when changing directions to avoid twisting and losing or shifting balance.
Rest - If you are fatigued, set the load/object down and rest for a few minutes until you can fully engage in the task.
Squat To Set Object Down - Squat with the knees and hips and set the load down slowly.
- Avoid quickly rising and jerking movements, and allow the legs, hips, and back muscles to reset.
Planning and Tips Lifting anything heavy takes planning to prevent muscle spasms, back strain, and other musculoskeletal injuries. Considerations to keep in mind: Make a Plan Before Lifting - Knowing what object/s are being lifted and where they are going will prevent individuals from making awkward movements while holding and carrying something heavy.
- Set and clear a path.
- If lifting something with another person, ensure both agree and understand the plan.
Lift Close to The Body - Individuals are stronger and more stable lifters if the object is held close to their body rather than at the end of their reach.
- Make sure there is a firm hold on the object.
- It is easier to maintain balance close to the body.
Maintain Feet Shoulder-Width Apart - Keep the feet about shoulder-width apart.
- Having a solid base of support is important while lifting.
- Placing the feet too close together will cause instability while placing them too far apart will hinder movement.
- Take short steps.
Visualize The Motions Involved and Practice The Motions Before Lifting - Think about the motion before lifting.
- Practice the lifting motion before lifting the object.
- Focus on keeping the spine straight.
- Raise and lower to the ground by bending the knees.
- Avoid bending at the waist or hips.
Tighten the Stomach Muscles - Tightening the abdominal muscles will hold the back in a healthy lifting position and help prevent excessive force on the spine.
Lift With the Legs - The legs are stronger than the back muscles, so let the leg strength do the work.
- Lower yourself to the ground by bending the knees, not the back.
Keep Eyes Up - Looking slightly upwards will help maintain a better spine position and help keep the back straight.
Avoid Twisting or Bending - Face in the direction you are walking.
- Stop, take small steps, and continue walking if turning is required.
Back Belts It has become common for many who work in jobs requiring manual lifting to wear back belts or support. However, research does not show that they decrease the risk of a lifting injury. (CDC and The National Institute for Occupational Safety and Health, 2023) Instead, it is recommended that the belt be thought of as a reminder of where the back muscles are positioned to keep the individual aligned, combined with the correct lifting techniques. Injury Medical Chiropractic and Functional Medicine Clinic Training the body and maintaining its optimal health for correct manual lifting techniques requires daily efforts through practice, conscious position corrections, and ergonomics. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues. General Disclaimer * The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research studies or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request. We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, don't hesitate to contact Dr. Alex Jimenez or contact us at 915-850-0900. Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN* email: coach@elpasofunctionalmedicine.com Licensed in: Texas & New Mexico* References CDC. The National Institute for Occupational Safety and Health (NIOSH). (2007). Ergonomic Guidelines for Manual Material Handling. (No. 2007-131). Retrieved from https://www.cdc.gov/niosh/docs/2007-131/pdfs/2007-131.pdf CDC. The National Institute for Occupational Safety and Health (NIOSH) (2023). Back Belts - Do They Prevent Injury? (No. 94-127). Retrieved from https://www.cdc.gov/niosh/docs/94-127/
Are there blood tests for individuals with chronic and severe back pain symptoms that can help healthcare providers diagnose? Blood Tests To Help Diagnose Back Pain If a healthcare provider suspects an infection or inflammatory arthritis is the cause of back pain, blood tests may be used to diagnose. When trying to find the cause of back pain, a healthcare provider will examine the patient's medical history, perform a physical examination, and, if necessary, order diagnostic tests. (Dansie E. J. and Turk D. C. 2013) For example, the National Institute of Arthritis and Musculoskeletal and Skin Diseases says that MRIs can reveal abnormalities in the spine. Still, a person may not feel pain or experience any other symptoms. The NIAMS also says healthy, pain-free individuals can have elevated SED levels. A high sedimentation rate or sed rate, also known as an erythrocyte sedimentation rate (ESR) test, can indicate inflammation in the body. (National Institute of Arthritis and Musculoskeletal and Skin Diseases, 2023) Commonly Used Tests Blood tests that can help diagnose back pain include: Complete Blood Count - CBC - This test can indicate inflammation or infections.
Sed Rate or Erythrocyte Sedimentation Rate - This test measures inflammation by analyzing how red blood cells settle through plasma.
- Inflammation could point to an infection. (Harrison M. 2015)
- If the SED rate indicates that inflammation is present, the possibility of an underlying cause may be some form of arthritis or a tumor, which is rare.
CRP or C-reactive Protein HLA-B27 - A genetic marker in the blood that is more common in individuals with ankylosing spondylitis and reactive arthritis. (McMichael A. and Bowness P. 2002)
- This marker may be tested if the healthcare provider suspects either disease.
- Ankylosing spondylitis is an inflammatory arthritis affecting the sacroiliac joints, hips, and spine. (Sieper J. et al., 2002)
- Reactive arthritis is a type that occurs after an infection in a different body system or area. (Hamdulay S. S., Glynne S. J., and Keat A. 2006)
Injury Medical Chiropractic and Functional Medicine Clinic At Injury Medical Chiropractic and Functional Medicine Clinic, we focus on what works for you to relieve pain and restore function. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. Our areas of practice include Chronic Pain, Personal Injury, Auto Accident Care, Work Injuries, Back Injury, Low Back Pain, Neck Pain, Migraine Headaches, Sports Injuries, severe sciatica, Scoliosis, Complex Herniated Discs, Fibromyalgia, Chronic Pain, Complex Injuries, Stress Management, Wellness and nutrition, Functional Medicine Treatments, and in-scope care protocols. They can also work with other associated medical professionals to develop a personalized treatment plan to help relieve muscle pain, improve the body’s flexibility and mobility, resolve musculoskeletal issues, and prevent future pain symptoms from reoccurring. General Disclaimer * The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research studies or studies supporting our posts. We provide copies of supporting research studies that are available to regulatory boards and the public upon request. We understand that we cover matters that require an additional explanation of how they may assist in a particular care plan or treatment protocol; therefore, to discuss the subject matter above further, don't hesitate to contact Dr. Alex Jimenez or us at 915-850-0900. Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN* email: coach@elpasofunctionalmedicine.com Licensed in: Texas & New Mexico* References Dansie, E. J., & Turk, D. C. (2013). Assessment of patients with chronic pain. British journal of anaesthesia, 111(1), 19–25. https://doi.org/10.1093/bja/aet124 National Institute of Arthritis and Musculoskeletal and Skin Diseases. (2023). Back Pain. Retrieved from https://www.niams.nih.gov/health-topics/back-pain Harrison M. (2015). Erythrocyte sedimentation rate and C-reactive protein. Australian prescriber, 38(3), 93–94. https://doi.org/10.18773/austprescr.2015.034 Sproston, N. R., & Ashworth, J. J. (2018). Role of C-Reactive Protein at Sites of Inflammation and Infection. Frontiers in immunology, 9, 754. https://doi.org/10.3389/fimmu.2018.00754 McMichael, A., & Bowness, P. (2002). HLA-B27: natural function and pathogenic role in spondyloarthritis. Arthritis research, 4 Suppl 3(Suppl 3), S153–S158. https://doi.org/10.1186/ar571 Sieper, J., Braun, J., Rudwaleit, M., Boonen, A., & Zink, A. (2002). Ankylosing spondylitis: an overview. Annals of the rheumatic diseases, 61 Suppl 3(Suppl 3), iii8–iii18. https://doi.org/10.1136/ard.61.suppl_3.iii8 Hamdulay, S. S., Glynne, S. J., & Keat, A. (2006). When is arthritis reactive?. Postgraduate medical journal, 82(969), 446–453. https://doi.org/10.1136/pgmj.2005.044057
Individuals who have sustained trauma to the knee area from work, physical activity, or a motor vehicle collision can experience significant pain and mobility impairment. Can physical therapy help heal and strengthen the PLC? Posterolateral Corner Knee Injury The posterolateral corner, or PLC, comprises muscles, tendons, and ligaments in the back of the knee that help support and stabilize the outside region. The primary role of the PLC is to prevent the knee from excessive amounts of rotation or bowing/turning outward. (Chahla J. et al., 2016) Posterolateral corner injuries can cause significant pain and can dramatically impact an individual's ability to walk, work, or maintain independence. Treatment options will depend on the severity of the injury. The Posterolateral Corner The posterolateral corner comprises multiple structures that support and stabilize the outside of the knee. The structures are subdivided into primary and secondary stabilizers. The primary group includes: - Lateral collateral ligament- LCL
- Popliteofibular ligament - PFL
- Popliteus tendon
The secondary stabilizers include: - The lateral capsule of the knee.
- Coronary ligament.
- Fabellofibular ligament.
- Lateral gastrocneumius tendon.
- The long head of the biceps femoris.
- Iliotibial/IT band (Chahla J. et al., 2016)
The primary role is to prevent the knee from excessively turning outward, so the grouping provides secondary assistance in preventing the lower leg bone/tibia from shifting forward or backward on the thighbone/femur. Occasionally, one or several posterolateral corner structures can be sprained, strained, or torn. How Injury Occurs An injury occurs when a direct blow to the inner portion of the front of the knee causes the leg to bow outward. A posterolateral corner injury may also be sustained without contact, for example, if the knee hyperextends or buckles away from the other leg into a varus/bow leg position. Because the knee usually moves during a PLC, concurrent sprains or tears to the anterior cruciate ligament/ACL or posterior cruciate ligament/PCL are also common. (Chahla J. et al., 2016) Other situations that can also cause PLC injuries include automobile crashes and falls from elevated surfaces. (Shon O. J. et al., 2017) When this type of trauma causes a posterolateral corner injury, bone fractures are also common. Symptoms Depending on the severity of the injury, multiple symptoms may be present, including: - Difficulty walking or climbing stairs due to instability. (Shon O. J. et al., 2017)
- Numbness or tingling in the lower leg.
- Pain, swelling, bruising, and hardening in the knee and surrounding area.
- Outward bowing position of the affected knee when standing.
- Foot drop presents on the injured side. (Chahla J. et al., 2016)
For individuals who suspect that they have sustained a PLC injury or have any of the symptoms listed, it is critical to be seen by an orthopedic specialist or emergency room physician. A healthcare provider will properly evaluate the leg and develop the appropriate treatment. Diagnosis Diagnosis begins with a comprehensive examination. In addition to looking for the symptoms noted, a healthcare provider will move the legs in different directions to assess for any instability. The dial test may be performed, which involves having the patient lie on their stomach while the healthcare professional assesses the side-to-side rotation in the leg to check for excessive motion. (Shon O. J. et al., 2017) Imaging is frequently ordered to determine which anatomical structures are affected more accurately. X-rays can help rule out concurrent fractures and check for excessive laxity in the knee area. MRIs are also useful for visualizing the various tendons and ligaments, helping the healthcare provider look closely at any sprains or tears that may have occurred. However, MRIs may be less accurate in diagnosing PLC injuries after 12 weeks, so they should be obtained as soon as possible. Based on this evaluation, the injury may be classified using the following system (Shon O. J. et al., 2017) Grade 1 - 0 to 5 degrees of rotational or varus/bowing instability.
- Incompletely torn posterolateral corner.
Grade 2 - 6 to 10 degrees of rotational or varus/bowing instability.
- Incompletely torn posterolateral corner.
Grade 3 - Eleven or more degrees of rotational or varus/bowing instability.
- Completely torn posterolateral corner.
Treatment The care received after a posterolateral corner injury can vary depending on the structures involved and the overall severity. Nonsurgical Nonsurgical treatment is typically reserved for isolated grade 1 or 2 PLC injuries. (Shon O. J. et al., 2017) Depending on which structures are affected, a stabilizing brace may be worn, and crutches are often needed to decrease the strain on the knee. Physical therapy is also commonly prescribed and focuses on the following goals: - Gradually reducing crutch use.
- Improving balance and stability.
- Improving walking patterns.
- Regaining the range of motion in the knee.
- Strengthening the leg muscles.
- Gradually reintroducing specific movements like running and jumping.
Surgery Non-surgical treatment tends not to work with grade 3 injuries. If surgery is not performed, individuals may also suffer from chronic knee instability or develop long-term osteoarthritis. (Chahla J. et al., 2019) Surgical treatment is often recommended for grade 3 injuries. The damaged primary stabilizers are surgically reconstructed using a graft from another body region. Surgical repairs may also be performed on any secondary stabilizers to improve stability. (Chahla J. et al., 2019) Any other ligament injuries, such as ACL, PCL, or concurrent fractures, will also be addressed. Following the procedure, individuals immobilize their knee with a brace and do not place weight on the affected leg to protect the surgical area. Depending on the surgeon's recommendations, this can last six weeks or more. Physical therapy is also initiated after a surgical procedure. Though rehabilitation progresses slowly, the goals are often the same as when treating milder PLC injuries. Returning to work, sports, and/or physical activity after surgery may take six months of therapy or more. (Shon O. J. et al., 2017) Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop a personalized treatment program through an integrated approach to treat injuries and chronic pain syndromes, improve flexibility, mobility, and agility, relieve pain, and help individuals return to normal activities. If other treatments are needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments. General Disclaimer * The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research studies or studies supporting our posts. We provide copies of supporting research studies that are available to regulatory boards and the public upon request. We understand that we cover matters that require an additional explanation of how they may assist in a particular care plan or treatment protocol; therefore, to discuss the subject matter above further, don't hesitate to contact Dr. Alex Jimenez or us at 915-850-0900. Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN* email: coach@elpasofunctionalmedicine.com Licensed in: Texas & New Mexico* References Chahla, J., Moatshe, G., Dean, C. S., & LaPrade, R. F. (2016). Posterolateral Corner of the Knee: Current Concepts. The archives of bone and joint surgery, 4(2), 97–103. Shon, O. J., Park, J. W., & Kim, B. J. (2017). Current Concepts of Posterolateral Corner Injuries of the Knee. Knee surgery & related research, 29(4), 256–268. https://doi.org/10.5792/ksrr.16.029 Chahla, J., Murray, I. R., Robinson, J., Lagae, K., Margheritini, F., Fritsch, B., Leyes, M., Barenius, B., Pujol, N., Engebretsen, L., Lind, M., Cohen, M., Maestu, R., Getgood, A., Ferrer, G., Villascusa, S., Uchida, S., Levy, B. A., Von Bormann, R., Brown, C., … Gelber, P. E. (2019). Posterolateral corner of the knee: an expert consensus statement on diagnosis, classification, treatment, and rehabilitation. Knee surgery, sports traumatology, arthroscopy: official journal of the ESSKA, 27(8), 2520–2529. https://doi.org/10.1007/s00167-018-5260-4
Can learning about comminuted fracture symptoms and repair help individuals and healthcare providers develop effective treatment and rehabilitation programs? Comminuted Fractures A comminuted fracture is a severe break in which the bone splits into at least three pieces. Comminuted fractures typically happen in the long bones like those in the arms and legs. But they can also happen in other places, including the ribs. (Corinne Tarantino, 2022) They are usually caused by intense impact, like an automobile collision/accident or a severe fall. Depending on the location of the fracture, recovery from a comminuted fracture can take months and often involves: - Surgery - A surgeon will place screws and rods to hold the pieces of the bone in position. Sometimes, the hardware is left in permanently. (American Academy of Orthopaedic Surgeons, 2021)
- Wearing a cast for several months.
- Physical therapy.
Types In these types of fractures, the bone is completely broken, not just cracked. The break is a highly comminuted fracture if the bone is broken into four or more pieces. (Corinne Tarantino, 2022) Symptoms The symptoms are the same as those of other broken bones, but they can be more intense because the bone is broken in multiple areas, which means there may also be more soft tissue injuries than with a simple fracture. Broken bone symptoms include: (MedlinePlus, 2024) - Persistent pain
- Swelling
- Bruising
- Deformity - the bone looks out of place or is at an odd angle.
- Tingling
- Numbness
- Difficulty moving the limb.
Causes An intense force causes a comminuted fracture, often a car accident or a hard fall, but it can also result from sports injuries. (Corinne Tarantino, 2022) Diagnosis A comminuted fracture is diagnosed by X-ray, which shows where the bone has broken and how many pieces it has split into (MedlinePlus, 2024). Healthcare providers will diagnose any broken bones but also look for other injuries. Treatment Typically, broken bones can be treated with casts, braces, or a boot to keep them immobilized. (MedlinePlus, 2024) Because comminuted fractures are more severe, they often need other treatments, including surgery. Sometimes, the bone can be reset instead of surgery using a closed reduction technique, where the healthcare provider resets the bone manually. Surgery may be recommended if that’s not possible or doesn't work. Types of Surgery Surgery allows the healthcare provider to correctly position all the pieces of the bone to heal in a strong, stable formation. The two types commonly used to treat comminuted fractures are: (American Academy of Orthopaedic Surgeons, 2021) External Fixation - This surgery uses rods and screws outside the body to stabilize the bone.
- This external frame is placed during surgery and later removed.
Open Reduction Internal Fixation - ORIF - During this surgery, the bone is stabilized with metal plates, screws, rods, and/or wires placed inside your body.
- Sometimes, these are permanent, but in other cases, they are removed later.
- An orthopedic surgeon performs these surgeries.
Casting After surgery, a cast is usually needed to prevent the bone from moving and allow healing. Typically, the cast is worn for six to eight weeks, but it may need to be worn longer with comminuted fractures. Some need a cast for several months (American Academy of Orthopaedic Surgeons, 2021). Sometimes, those with an external fixation must continue wearing a cast after removing the pins and rods, giving the bone more time to stabilize. The healthcare provider will inform the patient how long the cast will need to be worn and which sports activities should be avoided even after the cast comes off. Physical Therapy The healthcare provider may recommend physical therapy to help treat the fracture. Usually, when the cast is removed, physical therapy is activated to help rebuild strength and range of motion. (Corinne Tarantino, 2022) Prognosis Although these fractures are severe, they are treatable. The prognosis is good for individuals who follow their healthcare provider’s treatment plan. Most don’t have lingering pain after the initial injury and can eventually return to regular activities. (American Academy of Orthopaedic Surgeons, 2021) Recovery Healing a comminuted fracture can take months. During that time, it's helpful to focus on tasks that can be accomplished, like new hobbies that don’t involve physical injury. Talk to the healthcare provider about any problems with the cast or ongoing pain and what to expect during recovery. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution through an integrated approach to treating injuries and chronic pain syndromes, improving flexibility, mobility, and agility programs to relieve pain and help individuals return to normal. Our providers create personalized care plans for each patient. If other treatments are needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments. General Disclaimer * The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research studies or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request. We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please get in touch with Dr. Alex Jimenez or contact us at 915-850-0900. Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN* email: coach@elpasofunctionalmedicine.com Licensed in: Texas & New Mexico* References Corinne Tarantino, MPH. Osmosis. (2022). Comminuted Fracture: What is it, Examples and More. https://www.osmosis.org/answers/comminuted-fracture Throckmorton T.W. American Academy of Orthopaedic Surgeons. (2021). Fractures (broken bones). https://orthoinfo.aaos.org/en/diseases--conditions/fractures-broken-bones/ MedlinePlus. National Library of Medicine. (2024). Fractures Also called: Broken bone. Retrieved from https://medlineplus.gov/fractures.html
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Explore the connection between whiplash, achilles tendinosis, and auto accidents for better injury management. Introduction Imagine you are driving along, singing to your favorite tune, when—bam!—another car rear-ends you. Your head snaps back and forth like a bobblehead on a bumpy road. This is known as whiplash, and despite its cartoonish appearance, it is a serious injury. Whiplash is a debilitating neck injury that can lead to ligament damage, chronic pain, and a whole lot of discomfort if not treated properly. In El Paso, where motor vehicle accidents (MVAs) are unfortunately common, understanding whiplash and its treatment is crucial. This guide delves into whiplash, focusing on ligamentous injuries, their symptoms, diagnosis, and treatment protocols, particularly those resulting from motor vehicle accidents (MVAs). We will spotlight Dr. Alexander Jimenez, a distinguished chiropractor and nurse practitioner in family practice in El Paso, whose expertise helps personal injury victims recover. With a touch of humor to keep things light, we will delve into the clinical rationale behind these injuries and explore how Dr. Jimenez bridges the gap between medical care and legal support. Let us get started! References: What is Whiplash and How Does It Happen? The Mechanics of Whiplash Whiplash, medically known as a cervical acceleration-deceleration injury, occurs when your head is forcefully whipped backward and then forward. Picture a Slinky toy being stretched and snapped back—that is, your neck during a rear-end collision. This rapid motion strains the neck’s soft tissues, including muscles, ligaments, and nerves. MVAs, particularly rear-end crashes, are the most common cause, but sports injuries, amusement park rides, or even a slip-and-fall can also cause whiplash. The seat pushes your body forward during a rear-end collision, but your head momentarily lags, causing hyperextension (backward motion). Then, as your head rebounds forward, hyperflexion occurs. This double whammy can damage anterior structures, such as the anterior longitudinal ligament (ALL), during hyperextension and posterior structures during hyperflexion. Why It Matters Whiplash is not just a temporary ache. Research suggests it can lead to chronic pain in some cases, especially if untreated. The Cleveland Clinic notes that whiplash can damage bones, muscles, ligaments, and nerves, with recovery varying from weeks to years (Cleveland Clinic). It is important to have early intervention, which is key to preventing long-term complications. References: Understanding Ligamentous Injuries in Whiplash What Are Ligaments? Ligaments are like the duct tape of your body—tough, fibrous bands that hold bones together and stabilize joints. In the neck, ligaments such as the anterior longitudinal ligament (ALL), the transverse ligament, and others maintain the alignment and smooth movement of the cervical spine. General Disclaimer * The information herein is not intended to replace a one-on-one relationship with a qualified health care professional, licensed physician, and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request. We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN* email: coach@elpasofunctionalmedicine.com Licensed in: Texas & New Mexico*
Understanding back problems after a fender bender is essential. Discover effective tips and treatments to manage your pain. Introduction A fender bender may seem minor; however, the sudden jolt can wreak havoc on the upper, middle, and lower portions of the back. Even low-speed collisions can cause injuries that lead to persistent pain and discomfort. Do you experience stiffness in your back that causes pain when you twist and turn? Do you experience tingling or numbing sensations in your extremities that are relieved by shaking them? Or do you get constant headaches that make you lie down in your bed constantly? Many of these pain-like symptoms are associated with these scenarios after being in a fender-bender accident. Today’s article will explore the five common back problems that can arise after a car accident, their symptoms, and effective non-surgical treatments, with a special focus on the role of chiropractic care in the recovery process for many individuals. Whiplash-Associated Disorders One of the most common injuries in rear-end or front-end collisions is whiplash, where the neck and upper back are forcefully jerked back and forth rapidly like a whip. (Stroke, 2023) This causes the muscles, ligaments, and soft tissues to strain, resulting in pain and discomfort for individuals. Symptoms - Neck and upper back pain or stiffness
- Reduced range of motion
- Headaches
- Shoulder pain or tingling in the arms
- Fatigue or dizziness
Non-Surgical Treatments - Chiropractic Care: Chiropractors use gentle spinal adjustments to restore alignment in the cervical and thoracic spine, reducing tension and improving mobility. Chiropractors incorporate various techniques, such as spinal manipulation and soft tissue therapy, that can help alleviate pain-like symptoms and promote healing of the back.
- Physical Therapy: Individuals can incorporate various stretching and strengthening exercises to help restore flexibility and prevent stiffness.
- Ice and Heat Therapy: Applying a cold pack initially reduces inflammation, while heat later relaxes tight muscles.
- Pain Management: Over-the-counter anti-inflammatory medications (e.g., ibuprofen) can help manage discomfort.
Chiropractic care is particularly effective for whiplash because it addresses misalignments that may contribute to pain and restricted movement, offering a drug-free path to recovery. General Disclaimer * The information herein is not intended to replace a one-on-one relationship with a qualified health care professional, licensed physician, and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request. We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN* email: coach@elpasofunctionalmedicine.com Licensed in: Texas & New Mexico*
Find out the best practices for pain management for auto accident survivors and take control of your healing journey today. Introduction Automobile accidents often result in various injuries that can affect the body. Among the most common, soft tissue injuries from auto accidents can lead to significant pain and discomfort in numerous body locations, impacting daily life and requiring a structured approach to pain management. Do you experience various headaches that cause you to be in a quiet, dark room? Do you feel the range of motion in your shoulders feels short? Or do you experience radiating pain in your shoulders and lower back? This article outlines guidelines for managing pain post-accident, focusing on soft tissue injuries, their symptoms, and surgical and non-surgical treatment options. Understanding Soft Tissue Injuries Soft tissue injuries damage muscles, tendons, ligaments, and fascia. Common examples include whiplash, sprains, strains, and contusions. These injuries frequently occur during automobile accidents due to sudden forces exerted on the body, such as rapid deceleration or impact. The mechanisms of soft tissue injuries can become an issue as they can affect a person’s functionality, especially if the area has overlapping risk profiles. (Arosarena & Eid, 2021) Symptoms of Soft Tissue Injuries Various symptoms of soft tissue injuries depend on where the injury is located and how severe it is, but often include: - Pain and Tenderness: Localized or diffuse pain that worsens with movement or pressure.
- Swelling: Inflammation due to fluid buildup in the affected area.
- Stiffness: Reduced range of motion in joints or muscles.
- Bruising: Discoloration from damaged blood vessels beneath the skin.
- Muscle Spasms: Involuntary contractions causing discomfort.
- Weakness: Reduced strength in the injured area, often noticeable in sprains or strains.
- Neck or Back Pain: Common musculoskeletal pain associated with whiplash, where pain may radiate to the shoulders or arms due to a cracking sound within the cervical spine, causing pain to appear either hours or days. (Bannister et al., 2009)
General Disclaimer * The information herein is not intended to replace a one-on-one relationship with a qualified health care professional, licensed physician, and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request. We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN* email: coach@elpasofunctionalmedicine.com Licensed in: Texas & New Mexico*
Explore the symptoms and treatment options for whiplash to ensure a smooth recovery and improve your quality of life. Introduction When a person is involved in a sudden impact, either from a car accident, sports injury, or fall, what may initially feel like a minor jolt can evolve into debilitating pain and functional limitation. One such injury that often goes underappreciated in its complexity is whiplash. Although frequently associated with rear-end collisions, whiplash is a multifactorial injury that can result in long-lasting effects on the cervical spine and musculoskeletal system if left unaddressed. Have you experienced stiffness in your neck and shoulders? Do you feel chronic headaches that won’t go away? Or do you feel that your range of motion in your neck feels shortened? In today’s article, we will discuss whiplash and its common causes, the associated symptoms, how it affects the cervical spine and the musculoskeletal system, and evidence-based treatment strategies to reduce the pain-like symptoms. What Is Whiplash? Whiplash is a type of neck injury associated with a rapid back-and-forth head-and-neck motion, mimicking the crack of a whip, hence the name. This causes persistent physical complaints and disability, and complaints when left untreated. (Mayou & Radanov, 1996) Medically, it is categorized under cervical acceleration-deceleration (CAD) injuries. This abrupt motion can damage muscles, ligaments, intervertebral discs, and even the neural structures of the cervical spine. Common Causes Of Whiplash While motor vehicle accidents are the most recognized cause, many mechanisms can precipitate a whiplash injury: - Rear-end car collisions
- Contact sports (e.g., football, hockey, wrestling)
- Physical assault or shaken trauma
- Slips, trips, and falls
- Roller coaster rides or sudden jolts
Even minor collisions at speeds as low as 5–10 mph can produce enough force to cause whiplash symptoms in vulnerable individuals. General Disclaimer * The information herein is not intended to replace a one-on-one relationship with a qualified health care professional, licensed physician, and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request. We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN* email: coach@elpasofunctionalmedicine.com Licensed in: Texas & New Mexico*
What is a bone density test, how is it performed, and what do the results mean? Bone Density Test A bone density test examines bone mass, which indicates overall bone strength. Assessing bone density or mass is necessary for diagnosing osteopenia or osteoporosis, conditions that increase the risk of broken bones. The scan is performed through dual-energy X-ray absorptiometry (DEXA), which examines the thickness of the bones. Results from DEXA scans are compared to standardized values to determine whether bone density is lower than normal and whether osteopenia or osteoporosis is present. Examination The procedure examines bone density, or bone mass. The bones' density, or mass, is an overall indicator of bone strength. The greater the bone density, the thicker and stronger the bones are. The test is used to diagnose osteoporosis, a condition characterized by brittle bones at risk of breaking due to significantly low bone density. A bone density test can also diagnose osteopenia, a condition characterized by lower than normal bone mass that can lead to osteoporosis. (National Institute of Arthritis and Musculoskeletal and Skin Diseases, 2025) It is recommended that all women aged 65 and older and all men aged 70 and older have a bone density scan to screen for bone loss to help prevent fractures. (Kling J. M., Clarke B. L., & Sandhu N. P. 2014) - Bone density scans can establish a baseline level of bone density and track changes over time.
- For individuals with osteoporosis or osteopenia, a bone density scan can help track how well their bones respond to treatment.
Procedure The most common bone density test is a dual-energy X-ray absorptiometry, or DEXA, scan. A DEXA scan is similar to getting an X-ray taken, but it uses two beams to produce a more detailed and sensitive reading. (National Institute of Arthritis and Musculoskeletal and Skin Diseases, 2025) - During a DEXA scan, the patient will lie on their back on a table with their legs elevated on a padded platform.
- An X-ray scanner will pass over the spine and hips while another scans beneath.
- While the scan takes place, the patient will be asked to hold very still to obtain an accurate image.
- The scan will obtain bone density readings from the spine and hip, the two most commonly fractured bones, and generally takes less than 30 minutes.
Results A DEXA scan measures bone density in grams per centimeter squared (g/cm²). This number indicates how densely bone cells are packed together in a specific area of bone. This bone density reading is then compared to a standardized value to determine if bone density is within a normal range or lower than average. For postmenopausal women and men aged 50 and older, bone density values are given a T score. The T-scores are then compared to a standardized bone density level of a healthy 30-year-old adult with peak bone density levels. (Kling J. M., Clarke B. L., & Sandhu N. P. 2014) Scores indicate the following: (Kling J. M., Clarke B. L., & Sandhu N. P., 2014) - Equal to minus 1.0 or above: Normal bone density
- Between minus 1.0 and minus 2.5: Low bone density (osteopenia)
- Equal to minus 2.5 or below: Osteoporosis
- Bone density values are reported as a Z score for women who have not undergone menopause and men under 50 years old.
- Z scores are compared to bone density levels of individuals of the same age and sex.
- A Z score of minus 2.0 or lower indicates low bone density, which can be caused by factors other than aging, such as medication side effects, nutritional deficiencies, or thyroid problems.
Arthritis Diagnosis Because a DEXA scan only measures the thickness of bones, it doesn't work to diagnose arthritis. An X-ray of the affected joint is currently the most accurate way to diagnose arthritis. The Kellgren-Lawrence classification system categorizes the extent of arthritis based on the severity of joint damage seen on an X-ray. According to this system, arthritis can be classified as: (Kohn M. D., Sassoon A. A., & Fernando N. D. 2016) Grade 1 (minor) - Minimal or no joint space narrowing, with possible bone spur formation.
Grade 2 (mild) - Possible joint space narrowing, with definite bone spur formation.
Grade 3 (moderate) - Definite joint space narrowing, moderate bone spur formation, mild sclerosis (abnormal thickening of bone), and possible deformation of bone ends.
Grade 4 (severe) - Severe joint space narrowing, large bone spur formation, marked sclerosis, and definite deformation of bone ends.
Injury Medical Chiropractic & Functional Medicine Clinic Exercise can be incredibly beneficial for improving bone density, joint mobility, and the strength of surrounding muscles, which support and protect joints and bones. Talk to a healthcare provider to learn what interventions and available treatment options would be the most effective. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues. General Disclaimer * The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, and physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice. Our office has reasonably attempted to provide supportive citations and identified the relevant research studies or studies supporting our posts. We provide copies of supporting research studies that are available to regulatory boards and the public upon request. We understand that we cover matters that require an additional explanation of how they may assist in a particular care plan or treatment protocol. To discuss the subject matter above further, please contact Dr. Alex Jimenez or us at 915-50-0900. Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN* email: coach@elpasofunctionalmedicine.com Licensed in: Texas & New Mexico* References National Institute of Arthritis and Musculoskeletal and Skin Diseases. (2025). Bone mineral density tests: what the numbers mean. Retrieved from https://www.niams.nih.gov/health-topics/bone-mineral-density-tests-what-numbers-mean Kling, J. M., Clarke, B. L., & Sandhu, N. P. (2014). Osteoporosis prevention, screening, and treatment: a review. Journal of women's health (2002), 23(7), 563–572. https://doi.org/10.1089/jwh.2013.4611 Kohn, M. D., Sassoon, A. A., & Fernando, N. D. (2016). Classifications in Brief: Kellgren-Lawrence Classification of Osteoarthritis. Clinical orthopaedics and related research, 474(8), 1886–1893. https://doi.org/10.1007/s11999-016-4732-4
Broken bones are common injuries. Because children's bones grow rapidly, they have increased flexibility. When injuries, specifically fractures, occur, they do not always break cleanly across the bone or into pieces. What type of fracture is this, and how are they treated? Greenstick Fracture A greenstick fracture is a partial break in a bone that occurs when a bone bends and cracks instead of breaking into separate pieces. (Wolfe J. A. et al., 2019) The term is based on a young green branch that bends and splinters but does not break into pieces when bent. Only one side of the bone is broken, while the other side gets bent. Many children experience at least one fracture during their growing years. This is one of multiple fracture types seen in children. They can happen in adults but are uncommon. Causes Greenstick fractures mostly occur in infants or toddlers, sometimes in children during their early adolescent and pre-adolescent years. They are partial-thickness fractures (a break in a bone that doesn't completely break it) characterized by a break on one side and a bend on the other. Buckle fractures and bow fractures are different types of partial-thickness fractures. Greenstick fractures commonly occur: - In children under 10 years old
- Occurs when a child reaches out to break a fall
- During motor vehicle collisions
- Sports
- Direct impacts
- Non-accidental trauma
It is more common in long bones, including: - Radius
- Ulna
- Humerus
- Fibula
- Tibia
- Clavicle
The fracture pattern often indicates a limb's bending or contortion. Symptoms Greenstick fracture symptoms can include:(Atanelov Z, & Bentley T.P. 2025) - Localized swelling
- Localized bruising
- Pain
- Deformity, such as the affected body part looking crooked or out of alignment.
Treatment If the bone is not significantly bent out of alignment, a splint or cast may be all that is necessary to treat the break. If the bone is visibly out of alignment, it must be manually straightened before the limb is put into a cast. If the break is severe, surgery may be required. Fortunately, a growing skeleton can remodel bone, so fractured bones can often realign themselves over time with minimal intervention. Healing depends on various factors, including: - Age of the child
- The severity of the break
- Location of the break
The younger the child is, the faster the recovery will be. (Pountos I., Clegg J., & Siddiqui A. 2010) Sometimes, the fracture must be bent back and repositioned in a fracture reduction procedure. The doctor may use an anesthetic while manually realigning the bone into the correct position. After the reduction, a cast or splint stabilizes the bone and maintains proper alignment. Depending on how quickly the bone heals, a cast may be necessary for a few weeks, months, or longer, depending on the patient and/or underlying conditions. Healing - Healing involves specialized cells that gradually rebuild and fine-tune the new bone.
- The average time for a greenstick fracture to heal completely may take four weeks.
Injury Medical Chiropractic & Functional Medicine Clinic Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues. General Disclaimer * The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research studies or studies supporting our posts. We provide copies of supporting research studies that are available to regulatory boards and the public upon request. We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please contact Dr. Alex Jimenez or contact us at 915-850-0900. Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN* email: coach@elpasofunctionalmedicine.com Licensed in: Texas & New Mexico* References Wolfe, J. A., Wolfe, H., Banaag, A., Tintle, S., & Perez Koehlmoos, T. (2019). Early Pediatric Fractures in a Universally Insured Population within the United States. BMC pediatrics, 19(1), 343. https://doi.org/10.1186/s12887-019-1725-y Atanelov, Z., & Bentley, T. P. (2025). Greenstick Fracture. In StatPearls. https://www.ncbi.nlm.nih.gov/pubmed/30020651 Pountos, I., Clegg, J., & Siddiqui, A. (2010). Diagnosis and treatment of greenstick and torus fractures of the distal radius in children: a prospective randomised single-blind study. Journal of children's orthopaedics, 4(4), 321–326. https://doi.org/10.1007/s11832-010-0269-3
For individuals with shoulder pain and problems, what are the stages of a frozen shoulder, how long do they last, and what can be done to relieve pain? Frozen Shoulder Stages A frozen shoulder, also called adhesive capsulitis, is a very common cause of shoulder pain. It causes severe pain and limited mobility. The condition progresses through stages and can take up to two years to resolve completely. The stages of frozen shoulder include pre-freezing, freezing, freezing, and thawing. Stage 1 Pre-Freezing - 1 month to 3 months Pre-freezing describes the earliest stage of a frozen shoulder. This is when individuals first start to notice pain in their shoulder. (Soussahn, S. et al., 2024) Many in this stage will first experience the pain at night while changing sleeping positions. As the condition progresses, individuals may notice pain when they move their shoulders, especially when raising their arms or reaching behind them. Individuals may also find reduced mobility in that shoulder and may ache even when not using it. Because motion may be only slightly restricted in this stage, an early frozen shoulder can be mistaken for a rotator cuff problem. (Chan H. B. Y., Pua P. Y., & How C. H. 2017) Root Cause A frozen shoulder happens when there is inflammation in the tissue that surrounds the shoulder joint. Although the specific causes aren't known, immobilization after an injury and other shoulder conditions, like bursitis, may play a role. (Johns Hopkins Medicine, 2025) Stage 2 Freezing - 10 weeks to 8 months The freezing stage is the most painful. The shoulder capsule becomes inflamed and can thicken and stiffen. As this happens, shoulder movements become increasingly difficult and painful. (Soussahn, S. et al., 2024) Stage 3 Frozen - 4 months to 12 months The third stage of a frozen shoulder is known as the frozen phase, where the shoulder is stiff. The examination finding confirming the frozen shoulder diagnosis is that neither the individual nor another person can move the shoulder. (UpToDate, 2024) With a rotator cuff issue, a patient cannot move their arm normally, but the healthcare provider can. This distinguishes between a frozen shoulder and a rotator cuff injury. The frozen stage is typically much less painful than freezing, but pain can result from simple activities. (Soussahn, S. et al., 2024) Rotation of the shoulder joint is limited, making activities like washing hair or reaching painful or difficult. Stage 4 Thawing - 5 months to 2 years In this phase, the shoulder joint capsule becomes thickened and stiff but gradually loosens with time. (Soussahn, S. et al., 2024) Stretching the shoulder capsule, even allowing for some discomfort, is important to ensure the shoulder joint's mobility continues to recover. Not having the extreme pain associated with freezing the joint and seeing gradual gains in mobility make this stage tolerable. Treatment Frozen shoulder treatment starts with physical therapy and joint stretching. Anti-inflammatory medications, ice and heat application, and alternative therapies can all help manage the discomfort. A healthcare provider may also recommend a corticosteroid injection to reduce inflammation, relieve pain, and expedite improved mobility. Redler L. H. & Dennis E. R. 2019) Surgery is seldom needed but is an option for treating a frozen shoulder. It is usually only considered if prolonged efforts at therapy have failed to improve symptoms. One of the problems is that surgery could worsen shoulder problems. (Le H. V., Lee S. J., Nazarian A., & Rodriguez E. K. 2017) Prognosis The timeline for recovery can be long, measured in months and possibly years. (Le H. V., Lee S. J., Nazarian A., & Rodriguez E. K. 2017) Expecting a quick recovery can cause more frustration. However, individuals can take steps to speed their recovery and reduce discomfort. Physical therapy can be beneficial, and a healthcare provider can suggest treatments to help alleviate pain while recovering. Over time, almost all patients will find complete relief and a normal or near-normal range of motion in their shoulder joints. Injury Medical Chiropractic and Functional Medicine Clinic Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems. General Disclaimer * The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research studies or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request. We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please contact Dr. Alex Jimenez or contact us at 915-850-0900. Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN* email: coach@elpasofunctionalmedicine.com Licensed in: Texas & New Mexico* References Soussahn, S., Hu, D., Durieux, J., Kosmas, C., & Faraji, N. (2024). Adhesive capsulitis: Utility of magnetic resonance imaging as a primary diagnostic tool and clinical management support. Current problems in diagnostic radiology, 53(4), 464–469. https://doi.org/10.1067/j.cpradiol.2024.03.005 Chan, H. B. Y., Pua, P. Y., & How, C. H. (2017). Physical therapy in the management of frozen shoulder. Singapore Medical Journal, 58(12), 685–689. https://doi.org/10.11622/smedj.2017107 Johns Hopkins Medicine. (2025). Frozen shoulder. https://www.hopkinsmedicine.org/health/conditions-and-diseases/frozen-shoulder UpToDate. (2024). Patient education: Frozen shoulder (beyond the basics). https://www.uptodate.com/contents/frozen-shoulder-beyond-the-basics Redler, L. H., & Dennis, E. R. (2019). Treatment of Adhesive Capsulitis of the Shoulder. The Journal of the American Academy of Orthopaedic Surgeons, 27(12), e544–e554. https://doi.org/10.5435/JAAOS-D-17-00606 Le, H. V., Lee, S. J., Nazarian, A., & Rodriguez, E. K. (2017). Adhesive capsulitis of the shoulder: review of pathophysiology and current clinical treatments. Shoulder & elbow, 9(2), 75–84. https://doi.org/10.1177/1758573216676786
Individuals who don't get enough sleep at night can feel it in many ways. Can sleep deprivation or other sleep disorders contribute to an accumulated sleep debt? Sleep Debt Sleep debt is the difference between the amount of sleep an individual needs and the amount they get. It can accumulate over time and can negatively impact physical and mental health. What Is It? Regardless of the cause, sleep debt, also called a sleep deficit, is the accumulated amount of sleep loss from insufficient sleep. (Harvard Health Publishing, 2019) For example, if the body needs eight hours of sleep a night but only gets six, it has accumulated two hours of sleep debt for that particular night. This can occur due to sleep restriction, in which too few hours are spent sleeping, which can have significant consequences, especially if the debt builds. The Effects Sleep deprivation is linked to various mental and physical health problems, including: - Poor concentration or short-term memory
- Depression and anxiety
- High blood pressure
- Heart disease
- Diabetes
- Kidney disease
Sleep deprivation can also contribute to other long-term health consequences. Individuals can have hallucinations and even a potentially increased risk of death. (Colten H. R., Altevogt B. M., & Institute of Medicine (US) Committee on Sleep Medicine and Research, 2006) Symptoms of discomfort and pain are also worsened by poor sleep. Other Causes Other possible causes of poor sleep quality can include individuals who have a sleep disorder such as insomnia, sleep apnea, or circadian rhythm disorders, which could lead to symptoms that are similar to those that occur with a sleep debt. (Columbia University Department of Neurology, 2022) Even though enough sleep hours were obtained, it could be fragmented, resulting in daytime sleepiness and other health issues. Some signs of sleep debt include: - Feeling tired throughout the day.
- Having trouble focusing and reacting.
- Feeling frustrated, cranky, or worried in social situations.
- Having difficulty judging others' emotions.
Even after sufficient sleep, individuals who wake up feeling unrefreshed may need to see a sleep physician or specialist for sleep testing. Getting Out of Sleep Debt Fortunately, the short-term effects of sleep deprivation can be reversed with sufficient rest. To recover from sleep debt, individuals can try: (Harvard Health Publishing, 2019) - Getting into a normal bedtime routine.
- Using afternoon naps in moderation.
- Avoiding stimulants, especially in the afternoon or evening.
- Going to bed earlier.
- Catching up by sleeping in on the weekends.
- Keeping a sleep diary.
- Changing their mattress.
- Talking with a doctor.
Although sleep deprivation affects everyone, older adults rebound quicker than young adults. Individuals may initially require sleeping longer than average to compensate for the recent losses. That's why meeting daily sleep needs and following better sleep guidelines to preserve health and well-being are important. (Colten H. R., Altevogt B. M., & Institute of Medicine (US) Committee on Sleep Medicine and Research, 2006) Injury Medical Chiropractic and Functional Medicine Clinic Individuals who struggle with insomnia or other sleep disorders that impact their ability to get restful sleep should consult with their healthcare provider about getting an assessment and treatment to sleep well, avoid deprivation side effects, and restore health. Through healthy sleep practices and lifestyle accommodations, individuals can recover from sleep debt and regain the benefits of quality rest. A chiropractic therapy team can assess your condition and develop a customized treatment plan. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to build optimal health and wellness solutions. We focus on what works for you to relieve pain, restore function, prevent injury, and help mitigate issues through adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal problems. General Disclaimer * The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research studies or studies supporting our posts. We provide copies of supporting research studies that are available to regulatory boards and the public upon request. We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please contact Dr. Alex Jimenez or contact us at 915-850-0900. Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN* email: coach@elpasofunctionalmedicine.com Licensed in: Texas & New Mexico* References Harvard Health Publishing. (2019). Weekend catch-up sleep won’t fix the effects of sleep deprivation on your waistline. Harvard Health Blog. https://www.health.harvard.edu/blog/weekend-catch-up-sleep-wont-fix-the-effects-of-sleep-deprivation-on-your-waistline-2019092417861 Colten, H. R., Altevogt, B. M., & Institute of Medicine (US) Committee on Sleep Medicine and Research (Eds.). (2006). Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem. National Academies Press (US). Columbia University Department of Neurology. (2024). Sleep Disorders. https://www.neurology.columbia.edu/patient-care/specialties/sleep-disorders?id=42069
For individuals going through post surgery, injury rehabilitation, illness and/or chronic condition management, can physical therapy isometric exercises help? Isometric Exercise Isometric exercises are used in physical therapy to help build muscle endurance, improve range of motion, relieve pain, and reduce blood pressure more effectively than other types of exercise. Because they don't involve joint movement, they are a solid starting point for rehabilitation and are suitable for individuals with a limited range of motion. They can be performed by pushing against an immovable object, like a wall, or by having a therapist provide resistance. Examples of isometric exercises include: - Planks
- Glute bridges
- Adductor isometrics
A physical therapist/PT may have a patient perform isometric exercises after injury or illness. During an isometric contraction, the muscle does not change in length, and there is no motion around the joint surrounding the muscle/s. (Rhyu H. S. et al., 2015) When To Use Isometric muscular contractions can be used at any time during physical rehabilitation and strengthening or a home exercise program and are regularly used with the following (Rhyu H. S. et al., 2015) - Post-surgery
- When muscles cannot contract forcefully enough to move the joint it surrounds.
- To help increase neuromuscular input to a specific muscle/s.
- When injury or condition frailty makes other forms of exercise dangerous and not beneficial.
A healthcare provider or physical therapist should be consulted first if isometrics are used in a rehabilitation program. Benefits The benefits of using isometric exercise after injury or surgery may include the following: - No special equipment is necessary to perform isometric exercises.
- The ability to safely contract a muscle while protecting a surgical incision or scar tissue.
- The muscles can be strengthened in a specific range of motion around a joint. (NikolaidouO. et al., 2017)
A physical therapist can help determine whether isometric exercise benefits the specific condition. Effectiveness Isometric exercise is very effective after injury or surgery. However, when a muscle is contracted isometrically, it gains strength in a very small area and with a short range of motion. For example, an isometric shoulder external rotation performed with the arm at the side will only strengthen the rotator cuff muscles in the specific position that the arm is in. (NikolaidouO. et al., 2017). - Strength gains are specific to the joint's position during the exercise.
- Individuals who want to strengthen their gluteal muscles in their hip using isometrics would have to contract their glute muscles in one specific position for several reps.
- Once several reps of the exercise in one position have been performed, the individual moves their hip joint into a new position and repeats the gluteal contractions in the new position.
- This makes the exercise time-consuming, but it is perfect for injury rehabilitation, preventing and avoiding worsening or further injuries.
How to Perform To perform isometric exercises, all that is needed is something stable to push against. (Rhyu H. S. et al., 2015) For example, to strengthen the shoulder muscles: - Stand next to a wall and try to lift an arm out to the side.
- Allow the hand to press against the wall so no motion occurs at the shoulder joint.
- Once pressed against the wall, hold the contraction for 5 to 6 seconds and slowly release it.
- Perform 6 to 10 repetitions of the exercise.
- This could be one set of completed isometric exercises for the shoulder muscles.
Elastic resistance bands or tubing can also be used to perform isometric exercises. Hold the tubing in a specific position and then move the body away from the anchor point instead of moving the joint. The muscles will contract against the increased resistance of the elastic tubing, and no motion will occur at the joint. A physical therapist can show and train on how to perform isometric exercises with the bands. Neuromuscular Stimulation Isometric exercise can strengthen muscles and help improve the neuromuscular recruitment of the muscles being trained. This enhances muscle contraction and expedites gains in muscle recruitment while protecting the joint. Isometric exercise can also be used during physical therapy using neuromuscular electrical stimulation (NMES). (Fouré A. et al., 2014) For example, a PT may use NMES to improve muscular function for individuals who have difficulty contracting their quadriceps after knee surgery and may be instructed to perform isometric quad-setting exercises during the session. Injury Medical Chiropractic and Functional Medicine Clinic A physical therapist can use isometric exercises to help individuals injured or have had surgery and are experiencing difficulty with normal functional mobility by improving their strength during recovery. The exercises can safely enhance the function and stability of the muscles and return individuals to the previous level of activity and function. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues. General Disclaimer * The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research studies or studies supporting our posts. We provide copies of supporting research studies that are available to regulatory boards and the public upon request. We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, don't hesitate to contact Dr. Alex Jimenez or contact us at 915-850-0900. Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN* email: coach@elpasofunctionalmedicine.com Licensed in: Texas & New Mexico* References Rhyu, H. S., Park, H. K., Park, J. S., & Park, H. S. (2015). The effects of isometric exercise types on pain and muscle activity in patients with low back pain. Journal of Exercise Rehabilitation, 11(4), 211–214. https://doi.org/10.12965/jer.150224 Nikolaidou, O., Migkou, S., & Karampalis, C. (2017). Rehabilitation after Rotator Cuff Repair. The Open Orthopaedics Journal, 11, 154–162. https://doi.org/10.2174/1874325001711010154 Fouré, A., Nosaka, K., Wegrzyk, J., Duhamel, G., Le Troter, A., Boudinet, H., Mattei, J. P., Vilmen, C., Jubeau, M., Bendahan, D., & Gondin, J. (2014). Time course of central and peripheral alterations after isometric neuromuscular electrical stimulation-induced muscle damage. PloS one, 9(9), e107298. https://doi.org/10.1371/journal.pone.0107298
Can physical therapies help individuals with a Colles' or wrist fracture? Colles' Fracture A broken wrist or Colles fracture can be a painful and stressful experience. Individuals may be unable to perform their jobs or engage in recreational activities. A Colles fracture is a break in the radius bone of the forearm that occurs near the wrist, usually about an inch from the end of the bone. It's a common type of broken wrist often caused by falling on an outstretched hand. (American Academy of Orthopaedic Surgeons, 2022) As the individual lands on their hand, the end of the radius bone breaks off and gets pushed toward the inner wrist. If the wrist is flexed when falling on the hand, the radius may break and move toward the front of the wrist. This is called a Smith's fracture. (Matsuura, Y. et al., 2017) A physical therapy team can help improve functional mobility to quickly and safely return to normal activity. Symptoms Individuals who have suffered trauma to their wrist or have fallen onto their hand or wrist may have a Colles fracture. Common signs and symptoms of a wrist or Colles fracture include: (American Academy of Orthopaedic Surgeons, 2022) - Bruising
- Loss of mobility in the wrist.
- Swelling in the arm, wrist, or hand.
- Pain
- Visible deformity or a lump on the backside of the forearm near the wrist.
Initial Treatment Individuals who have fallen and injured their wrist and hand and suspect a Colles fracture should seek immediate medical attention. Call a healthcare provider or report to a local emergency clinic. Left untreated, a Colles fracture can result in complications and permanent loss of arm and hand function (American Academy of Orthopaedic Surgeons, 2022). An X-ray will show a wrist fracture. Because of the pain and swelling, it is recommended that individuals put an ice pack on their wrists and hands until they can get to a healthcare provider or emergency room. The R.I.C.E. principle can help control swelling and lessen pain until a medical professional can provide treatment. The initial treatment is to reduce the fracture. This is where a healthcare provider situates the broken bone or bones back into the correct position to ensure proper healing. This is done manually if the fractured bone is not too far out. If the fracture is severe, a surgical procedure known as an open reduction internal fixation or ORIF may be required to reduce the fracture. (American Academy of Orthopaedic Surgeons, 2022) Once the fracture has been reduced, it must be immobilized. This is done with a cast or a brace. Individuals may also be required to wear a sling. They may need to visit a physical therapist to learn how to wear the sling properly. It is essential to keep the bones immobilized for proper healing. Consult a healthcare provider for questions about cast, sling, or brace. Physical Therapy After four to six weeks of immobilization, a healthcare provider may remove the cast and refer a physical therapist or team. (American Academy of Orthopaedic Surgeons, 2022) A physical therapist may measure and evaluate pain, swelling, range of motion, and strengthening. The physical therapist may assess the surgical scar tissue and analyze the hand, wrist, and arm function of individuals who underwent an ORIF procedure to reduce the fracture. After the initial evaluation, a physical therapist will work with the patient to develop an appropriate plan of care to help improve the impairments and functional limitations. The therapist may prescribe a specific exercise program as well. Pain and Swelling - Individuals may experience pain and swelling around their wrists and hands.
- A physical therapist can provide individuals with various treatments and modalities to help decrease swelling and pain.
Range of Motion - After a Colles' fracture, individuals may lose hand, wrist, and elbow mobility.
- The shoulder may also be tight, especially after wearing a sling.
- Range of motion exercises for the hand, wrist, and elbow can be prescribed.
Strength - Loss of strength is common after a Colles' fracture.
- Exercises focusing on hand, wrist, and elbow strength may be prescribed.
- At-home exercises and stretches will get the best results from physical therapy.
Scar Tissue - Individuals who have had an ORIF procedure will likely have scar tissue that has developed around the surgical site.
- A physical therapist may perform scar tissue massage and mobilization to help improve mobility and can train patients how to self-massage.
Injury Medical Chiropractic and Functional Medicine Clinic After a few weeks of physical therapy, individuals should notice their mobility and strength improve while pain and swelling decrease. Individuals will find it easier to use their arms and hands to perform functional activities. While the fracture should be fully healed six to eight weeks after injury, individuals may still be limited for potentially 12 to 16 weeks. At Injury Medical Chiropractic and Functional Medicine Clinic, we focus on what works for every patient to restore function. If other treatment is needed, individuals will be referred to a clinic or physician best suited to their injury, condition, or ailment. General Disclaimer * The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research studies or studies supporting our posts. We provide copies of supporting research studies that are available to regulatory boards and the public upon request. We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please contact Dr. Alex Jimenez or contact us at 915-850-0900. Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN* email: coach@elpasofunctionalmedicine.com Licensed in: Texas & New Mexico* References American Academy of Orthopaedic Surgeons. (2022). Distal radius fractures (broken wrist). https://orthoinfo.aaos.org/en/diseases--conditions/distal-radius-fractures-broken-wrist/ Matsuura, Y., Rokkaku, T., Kuniyoshi, K., Takahashi, K., Suzuki, T., Kanazuka, A., Akasaka, T., Hirosawa, N., Iwase, M., Yamazaki, A., Orita, S., & Ohtori, S. (2017). Smith's fracture generally occurs after falling on the palm of the hand. Journal of orthopaedic research : official publication of the Orthopaedic Research Society, 35(11), 2435–2441. https://doi.org/10.1002/jor.23556
Can the Oswestry Low Back Pain Disability Questionnaire help assess how low back pain impacts individuals' ability to perform everyday tasks and activities and help physical therapists incorporate the outcome measure into an effective treatment plan? Oswestry Disability Questionnaire The Oswestry Disability Questionnaire, also known as the Oswestry Disability Index, provides objective data about an individual's lower back pain. It determines the severity of the pain and how much it limits their daily activities. The questionnaire is a validated measure backed by research that can be used to justify the need for medical treatment. It includes questions regarding the symptoms and severity of low back pain and how these symptoms interfere with regular activities. Lower back pain can result from various causes (National Institute of Neurological Disorders and Stroke, 2020) - Poor posture
- Pregnancy
- Low back muscle strain
- Muscle imbalances
- Bulging discs
- Herniated discs
- Nerve root compression
- Sacroiliac joint dysfunction
- Arthritis, including inflammatory types of arthritis like psoriatic arthritis and ankylosing spondylitis.
- Lumbar vertebrae compression fractures - usually from trauma or osteoporosis.
- Low back surgery - including spinal fusions, discectomies, and laminectomies.
- Spinal stenosis
- Spondylolisthesis
- Scoliosis
How The Questionnaire Works The Oswestry Disability Questionnaire consists of 10 questions about the impact of lower back pain on daily life. The questions are divided into the following categories: (American Academy of Orthopedic Surgeons, N.D.) Pain Intensity - How intense is the pain?
- If painkillers are used, how much symptom relief do they provide?
Personal Care - Can the patient perform self-care activities like bathing and dressing when experiencing significant pain or limitations?
- Whether physical assistance from another person is needed?
Lifting - Can the patient lift objects like weights with or without pain?
- Can lifting be performed from the floor or a higher surface like a table if the objects are light, moderate, or heavy?
Walking - If and to what extent does the pain limit the patient's walking distance and independence?
- If an assistive device like a cane or crutches are needed?
Sitting - If so, how much pain limits the patient's sitting tolerance?
Standing - If so, how much pain limits the patient's standing tolerance?
Sleeping - If so, how much pain limits a patient's sleeping duration?
- Whether pain medication is needed to help the patient sleep comfortably?
Social Life - If and to what extent a patient’s social activities are limited because of pain symptoms?
Traveling - If so, to what extent does pain limit a patient’s ability to travel?
Employment and/or Homemaking Duties - Does pain limit a patient’s ability to perform job-related and/or household activities, including physically demanding and light duties?
- Patients self-report the information and complete it on their own based on their understanding of the extent of their lower back pain and disability.
- Each question can be scored between 0 and 5, with 0 indicating no limitations and 5 indicating complete disability.
- The scores from all the questions are added together for a cumulative total score of 50 points.
Scores The Oswestry Disability Questionnaire assesses how much a patient’s lower back pain limits daily activities. This information is used in clinical documentation for medical services. A higher score indicates a greater level of disability, according to the following scoring criteria: - 0–4: No disability
- 5–14: Mild disability
- 15–24: Moderate disability
- 25–34: Severe disability
- 35–50: Completely disabled
Physical therapists must create individualized goals for each patient to develop a treatment plan and receive authorization from insurance companies. One of the most important aspects of a physical therapy goal is that it must be measurable. The Oswestry Disability Questionnaire provides a numerical score to track functional limitations and monitor the range of motion and strength testing. A baseline measurement is taken at the beginning of treatment, and progress is tracked in follow-up visits. A new score is used as a treatment goal. According to a study, the minimal clinically important difference (MCID) for the Oswestry Disability Questionnaire is 12.88. The MCID is the minimum score healthcare providers need to confirm a patient's progress in function due to treatment. (Johnsen, L. G. et al., 2013) By tracking changes in the total score before, during, and after treatment, healthcare providers can better assess whether treatment improves symptoms. A decrease in total score by 13 points or more would indicate that treatment is helping to improve a patient’s lower back pain and level of disability. Along with physical examination results, the patient’s score and the severity of symptoms can help healthcare providers determine an appropriate treatment plan. No Disability - Treatment is unnecessary other than providing advice for lifting mechanics and general physical activity to maintain health.
Mild Disability - Conservative measures, such as physical therapy, exercise, hot or cold therapy, pain medication, and rest, are needed to help alleviate symptoms.
Moderate Disability - More aggressive intervention is needed, which can include extensive physical therapy services and pain management.
Severe Disability - Significant medical intervention is needed, including surgery, pain management, equipment like wheelchairs, and help from a caretaker.
Completely Disabled - Patients are either bedbound or have worsening symptoms, and a caretaker is needed to complete daily activities and self-care tasks.
Injury Medical Chiropractic and Functional Medicine Clinic Improvements in range of motion, strength, and quality of movement and a decrease in total score can help show the treatment's positive impact in managing lower back pain. A thorough medical exam and diagnostic tests, such as X-ray, MRI, or EMG, can help determine the underlying causes, discover the cause of the problem, and develop an effective treatment plan. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop personalized treatment programs. Using an integrated approach to treating injuries and chronic pain syndromes to improve flexibility, mobility, and agility and help individuals return to normal activities. Our providers use Functional Medicine, Acupuncture, Electro-Acupuncture, and Sports Medicine principles. If other treatments are needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers. General Disclaimer * The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research studies or studies supporting our posts. We provide copies of supporting research studies that are available to regulatory boards and the public upon request. We understand that we cover matters that require an additional explanation of how they may assist in a particular care plan or treatment protocol; therefore, to discuss the subject matter above further, don't hesitate to contact Dr. Alex Jimenez or us at 915-850-0900. Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN* email: coach@elpasofunctionalmedicine.com Licensed in: Texas & New Mexico* References National Institute of Neurological Disorders and Stroke. (2020). Low Back Pain Fact Sheet. Retrieved from https://www.ninds.nih.gov/sites/default/files/migrate-documents/low_back_pain_20-ns-5161_march_2020_508c.pdf American Academy of Orthopedic Surgeons. (N.D.). Oswestry Low Back Pain Disability Questionnaire. https://www.aaos.org/globalassets/quality-and-practice-resources/patient-reported-outcome-measures/spine/oswestry-2.pdf Johnsen, L. G., Hellum, C., Nygaard, O. P., Storheim, K., Brox, J. I., Rossvoll, I., Leivseth, G., & Grotle, M. (2013). Comparison of the SF6D, the EQ5D, and the Oswestry disability index in patients with chronic low back pain and degenerative disc disease. BMC musculoskeletal disorders, 14, 148. https://doi.org/10.1186/1471-2474-14-148
Can incorporating stretches and exercises help relieve pain and provide more support for individuals with knee pain? Knee Strengthening The knee is the largest joint connecting the shin and thigh bones. Its cartilage, muscles, ligaments, and nerves all play a role in maintaining the joint's health and movement. Individuals of all ages can experience knee pain, but it is more common in those with labor-intensive jobs, arthritis, and athletes. A healthcare provider will prescribe targeted stretches and exercises for individuals with pain, inflammation, or a health disorder that affects the strength of their knees to relieve knee pain while strengthening the muscles around the joint. Knee stretches and exercises are great for those with sore knees and knee pain or stiffness, but they can also be used as preventative medicine. Exercise Benefits Doing knee-strengthening exercises can significantly improve joint health. The benefits associated with exercises include (Zeng C. Y. et al., 2021) - Reduced pain, stiffness, and joint dysfunction.
- Reduced inflammation.
- Improved mobility.
- Improved strength.
- Cartilage degeneration prevention.
- Bone loss prevention.
Leg Lifts Leg lifts are done by lying on the back with one leg bent and the other fully extended. To perform the exercise: (American Academy of Orthopaedic Surgeons, 2009) - Raise the extended leg, keeping it straight.
- Hold for three to five seconds once the leg is elevated roughly one foot off the floor.
- Lay it back down to rest.
- Repeat the exercise 20 times for each leg.
What To Avoid When performing the single-leg lift, there are certain things to avoid as they can lead to other issues or injuries. This includes: (American Academy of Orthopaedic Surgeons, 2009) - Arching the back
- Flexing the neck
- Moving too quickly through the motion.
- Using momentum instead of the muscles.
To know the exercise is being performed correctly, individuals should feel it in the front of their thighs. Hamstring Stretch on a Bench If a weight bench is available, doing hamstring stretches can help strengthen the knee. To perform this stretch: - Sit straight on the bench, with one leg straight out and the other planted on the floor.
- With the knee straight, hinge over from the hips, keeping a straight, neutral spine.
- Slowly push the chest towards the leg straight out on the bench. Hold for 15 to 30 seconds.
This exercise helps with overall strength, stamina, and balance. (Kothawale S. Rao K. 2018) (Wang H. et al., 2016) What To Avoid Avoid curving the spine to get closer to the thigh during the stretch. The key is not how far you can bend down but getting a deep stretch. Individuals not yet flexible enough to go all the way down should bend until comfortable but can still feel the stretch in their hamstrings. With practice and time, flexibility will improve. This stretch should be felt in the hamstrings. Step Exercises Step exercises, or step-ups, involve using a platform at least 6 inches high. To perform the exercise: - Put one foot onto the platform and use that leg to lift the other foot off the floor.
- Hold the position with the foot hanging loosely for 3 to 5 seconds, then place the foot back on the floor.
- Repeat each motion 20 times on each leg. (American Academy of Orthopaedic Surgeons, 2009)
What To Avoid Avoid locking the knees when stepping up on the platform. Locking the knees switches off the muscles that need strengthening (American Academy of Orthopaedic Surgeons, 2009). Step exercises work out various areas of the leg. Individuals should feel this exercise in the thigh, hip, and buttocks. Post-Exercise Stretching Post-exercise stretching is vital in physical rehabilitation and strengthening. Stretching after exercise, individuals can (Afonso J. Clemente. et al., 2021) - Relieve and reduce soreness.
- Expedite recovery times.
- Increase range of motion.
- Strengthen the knees more quickly and effectively.
Post-exercise stretches for knee pain and weakness can include: Quadricep Stretch This stretch targets the quad muscles located in the thighs. To perform this stretch: - Stand with the feet planted flat on the floor, spaced the same width as the shoulders.
- Bending the left knee, grab the foot with the left hand and pull the heel toward the buttocks.
- Hold for 5 to 10 seconds.
- Repeat on both sides.
What to Avoid There is no need to pull the heel too far into the buttocks. The goal is to feel a deep stretch. Pushing it too far can lead to injury. (Lee J. H. et al., 2021) Toe Touches Toe touches will help stretch calve muscles and hamstrings. To perform this stretch: - Sit on the floor with the legs straight out in front.
- Bend the body over the legs at the hips, reaching for the toes in front while maintaining a straight back.
- Relax the shoulders and keep them away from the ears.
- Once touching the toes, hold the stretch for 15 seconds.
What To Avoid Individuals who cannot yet touch their toes should perform the same steps and reach only as far as is comfortably possible. Over time, flexibility will improve. (Lee J. H. et al., 2021) Injury Medical Chiropractic Clinic These are examples of exercises and stretches that a physical therapy and chiropractic team may prescribe. Each case is different and requires reviewing individual medical history and physical examination to determine the proper treatment program. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop a personalized treatment program through an integrated approach to treating injuries and chronic pain syndromes, improving flexibility, mobility, and agility to relieve pain and help individuals return to normal activities. If other treatments are needed, Dr. Jimenez has teamed up with top surgeons, clinical specialists, medical researchers, and rehabilitation providers to provide the most effective treatments. General Disclaimer * The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research studies or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request. We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please get in touch with Dr. Alex Jimenez or contact us at 915-850-0900. Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN* email: coach@elpasofunctionalmedicine.com Licensed in: Texas & New Mexico* References Zeng, C. Y., Zhang, Z. R., Tang, Z. M., & Hua, F. Z. (2021). Benefits and Mechanisms of Exercise Training for Knee Osteoarthritis. Frontiers in physiology, 12, 794062. https://doi.org/10.3389/fphys.2021.794062 American Academy of Orthopaedic Surgeons. OrthoInfo. (2009). Knee exercises. https://orthoinfo.aaos.org/en/staying-healthy/knee-exercises/ Kothawale S. and Rao K. (2018). Effectiveness of positional release technique versus active release technique on hamstring tightness. Int J Physiother Res., 6(1), 2619-2622. https://doi.org/https://dx.doi.org/10.16965/ijpr.2017.265 Wang, H., Ji, Z., Jiang, G., Liu, W., & Jiao, X. (2016). Correlation among proprioception, muscle strength, and balance. Journal of Physical Therapy Science, 28(12), 3468–3472. https://doi.org/10.1589/jpts.28.3468 Afonso, J., Clemente, F. M., Nakamura, F. Y., Morouço, P., Sarmento, H., Inman, R. A., & Ramirez-Campillo, R. (2021). The Effectiveness of Post-exercise Stretching in Short-Term and Delayed Recovery of Strength, Range of Motion and Delayed Onset Muscle Soreness: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Frontiers in physiology, 12, 677581. https://doi.org/10.3389/fphys.2021.677581 Lee, J. H., Jang, K. M., Kim, E., Rhim, H. C., & Kim, H. D. (2021). Effects of Static and Dynamic Stretching With Strengthening Exercises in Patients With Patellofemoral Pain Who Have Inflexible Hamstrings: A Randomized Controlled Trial. Sports Health, 13(1), 49–56. https://doi.org/10.1177/1941738120932911
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Cervical spine injuries correlated with auto injuries can lead to severe pain. Understand the risks, symptoms, and recovery strategies today. If you have any questions or concerns, please call Dr. Jimenez at 915-850-0900.